Purpose : To see the relationship between the response to chemotherapy and the final outcome of neoadiuvant chemotherapy and radiotherapy in patients with mocanry advanced hypopharyngeal cancer. Methods and Materials :A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadiuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75$\%$) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. Results :The overall 2-year and 5-year survival rates are 65.6$\%$ and 43.0$\%$, respectively. 5-year local control rate is 34$\%$. Organ preservation for more than five years is achieved in 12 patients (38$\%$). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR): the response rate was 75$\%$ (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60$\%$ for CR to chemotherapy group, 35.1$\%$ for PR to chemotherapy group, and 50$\%$ for NR to chemotherapy group, respectively (p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3$\%$ vs. 14.7$\%$, p<0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). Conclusion :In this study, there were only five patients who achieved CR after neoadiuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.
The Journal of Korean Society for Radiation Therapy
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v.16
no.1
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pp.73-77
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2004
Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.
GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond
Background: The cyclin D1 gene is one of the most frequently amplified chromosomal regions(11q13) in human carcinomas. In laryngeal and head and neck carcinomas, its overexpression has been shown to be associated with advanced local invasion and presence of lymph node metastases. Cyclin D1 may therefore playa key role in cell growth regulation and tumorigenesis. Lung cancer is a worldwide problem and in many contries it is the most lethal malignancy. As relapse is frequent after resection of early stage non-small cell lung cancer, there is an urgent need to define prognostic factors. Purpose: This study was undertaken to evaluate the prognostic value of the cyclin D1, that is one the G1 cyclins which control cell cycle progression by allowing G1 to S phase transition, on the patients in radically resected non-small cell lung cancer. Method: Total 81 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from January 1, 1983 to July 31, 1995 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for cyclin D1. Results : The histologic classification of the tumor was based on WHO criteria, and the specimens included 45 squamous cell carcinomas, 25 adenocarcinomas and 11 large cell carcinomas. Cyclin D1 overexpression was noted in 26 cases of 81 cases tested (30.9%). Cyclin D1 expression was not significantly associated with cell types of the tumor, pathological staging and the size of the tumor. But cyclin D1 overexpression was significantly correlated with positive lymph node metastasis(p=0.035). The mean survival duration was $22.76{\pm}3.50$ months in cyclin D1 positive group and $45.38{\pm}5.64$ months in eyclin D1 negative group. There was a nearly significant difference in overall survival between cyclin D1 positive and negative groups(p=0.0515) in radically resected non-small cell lung cancer. Conclusion: Based on this study, cyelin D1 overexpression appears an important poor prognostic indicator in non-small cell lung cancer and may have diagnostic and prognostic importance in the treatment of resectable non-small cell lung cancer.
The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.
Lee, JaeSeok;Moon, KyungHwan;Kim, YeongHo;Park, Ye eun;Jeon, Ji Hyang;Kim, Chae Won;Park, Sean;Woo, Ji Hyeon;Jeong, Yeo Jin;Eom, Jong Won;Lee, Wook-Gyo;Kim, Young Ho
Korean journal of applied entomology
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v.59
no.3
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pp.233-241
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2020
Several hard tick species in Ixodidae are medically important pests that transmit infectious disease including severe fever with thrombocytopenia syndrome (SFTS). In Korea, the number of SFTS patients continues to steadily increase since its first report in 2013, and Gyeongsangbuk-do (province) is the second most frequent area of SFTS patient occurrence. In order to investigate the distribution of ticks in Sangju city, we collected ticks using the flagging method from 26 sites comprising urban green area, vulnerable area of management, and rural area, and examined SFTS virus from the collected ticks in 2019. Based on Collection Index (CI = tick number / 1 h / 2 people), CI 143 ticks, including Haemaphysalis longicornis, Haemaphysalis flava, and Ixodes nipponensis, were collected; the most abundant species among the three tick species was H. longicornis (CI 138, 96.5%). Ninety two percent (CI 131) of ticks were collected in vulnerable area of management, where people cannot easily enter and are not managed by city hall, whereas only 8.4% (CI 12) were collected in the urban green area and rural area. Regarding SFTS virus detection, virus was not investigated from 26 pools containing CI 143 ticks. The results of this study are expected to be used as a recommendation for ensuring the safety of local residents from tick-borne diseases.
Journal of agricultural medicine and community health
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v.31
no.2
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pp.177-185
/
2006
Objectives: This study was carried out with 31, 519(16,653 boys, 14,857 girls) of elementary school students to investigate the prevalence of obesity at a district in Gwangju City. It can be applied to develope an educational program of the obesity control as basic data in this local area Methods: The data collected from May, 2004 to July, 2004 were analyzed by SAS PC+ 8.0 program. Children were selected depending on criteria from obesity index (%) by using physical index (height, body weight), and then subjects were classified into one of three groups according to the degree of obesity: mild(20~29.9%), moderate(30~49.9%), and severe($?50%{\cdot}$) obesity. Results: It showed that male elementary school students were higher and heavier than female elementary school students(p< .001) in every grade except the 4th grade(height) and the 6th grade ( body weight). The obesity rates of male students(11.6%) showed higher(p< .001) than those of female students(8.8%). Specially the 4th grade elementary school boys were higher than any other groups in obesity(13.7%). As a whole, the prevalence of obestiy showed mild(5.9%), moderate(3.8%), and severe(0.6%). Male students showed higher rate of obesity than those of female students. The obesity of male students showed higher rate than that of female students except 2-3rd grade elementary school students(p< .001). The obesity of 4~6th grade elementary school students showed higher rate than those of 1~3rd grade students(p< .001). Conclusions: The obesity rates of male students are higher than that of female students, and the obesity rates of 4~6th grade students are higher than those of 1-3rd grade students in the elementary school. Additionally, these results suggest that the program may be needed to prevent obesity of children.
Kim, Hui-Jung;Lee, Dong-Soo;Song, So-Hyang;Jung, Su-Mi;Kim, Young-Kyoon;Yoon, Se-Chul;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
Tuberculosis and Respiratory Diseases
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v.44
no.3
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pp.493-504
/
1997
Background : Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stageIII non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it has at most only a modest effect on survival. Recently, cisplatin(cis-diamminedichloroplatinum) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and Method : Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given to times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 times, in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. Results : There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p < 0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p < 0.05) In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. Conclusion : There was no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.3
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pp.416-426
/
2005
Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.
Since more than 50${\%}$ of annual precipitation in Korea falls during Changma, the rainy season of early summer, and Late Changma, the rainy season of late summer, forcasting the onset days Changmas, and the amount related rainfalls would be necessary not only for agriculture but also for flood-control. In this study the authors attempted to build a prediction model for the forecast of the onset date of Changmas. The onset data of each Changma was derived out of daily rainfall data of 47 stations for 30 years(1961~1990) and weather maps over East Asia. Each station represent any of the 47 districts of local forecast under the Korea Meteorological Administration. The average onset dates of Changma during the period was from 21 through 26 June. The dates show a tendency to be delayed in El Ni${\~{n}}o years while they come earlier than the average in La Nina years. In 1982, the year of El Ni${\~{n}}o, the date was 9 Julu, two weeks late compared with the average. The relation of sea surface temperature(SST) over Pacific and Northern hemispheric 500mb height to the Changma onset dates was analyzed for the prediction model by polynomial regression. The onset date of Changma over Korea was correlated with SST in May(SST${_(5)}{^\circ}$C) of the district (8${^\circ}$~12${^\circ}S, 136${^\circ}~148${^\circ}W)of equatirial middle Pacific and the 500mb height in March (MB${_(3)}$"\;"m)over the district of the notrhern Hudson Bay. The relation between this two elements can be expressed by the regression: Onset=5.888SST${_5}"\;"+"\;"0.047MB${_(3)}$"\;"-251.241. This equation explains 77${\%}$ of variances at the 0.01${\%}$ singificance level. The onset dates of Late Changma come in accordance with the degeneration of the Subtro-pical High over northern Pacific. They were 18 August in average for the period showing positive correlation(r=0.71) with SST in May(SST)${_(i5)}{^\circ}$C) over district of IndiaN Ocean near west coast of Australia (24${^\circ}$~32${^\circ}$S, 104${^\circ}$~112${^\circ}$E), but negativ e with SST in May(SST${_(p5)}{^\circ}$ over district (12${^\circ}$~20${^\circ}$S,"\;"136${^\circ}$~148${^\circ}$W)of equatorial mid Pacific (r=-0.70) and with the 500mb height over district of northwestern Siberia (r=-0.62). The prediction model for Late Changma can be expressed by the regression: Onset=706.314-0.080 MB-3.972SST${_(p5)}+3.896 SST${_(i5)}, which explains 64${\%}$ of variances at the 0.01${\%}$ singificance level.
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