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Results of Radiotherapy in Nasopharyngeal Cancer (비인두암의 방사선치료 결과)

  • Shin Byung Chul;Ma Sun Young;Moon Chang Woo;Yum Ha Yong;Jeung Tae Sig;Yoo Myung Jin
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.215-223
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    • 1995
  • Purpose : The aim of this study was to assess the effectiveness, survival rate and complication of radiation in nasopharyngeal cancer. Materials and Methods : From January 1980 to May 1989. Fifty patients who had nasopharyngeal carcinoma treated with curative radiation therapy at Kosin Medical Center were retrospectively studied. Thirty seven patients($74{\%}$) were treated with radiation therapy alone(Group I) and 13 patients ($26{\%}$) treated with combination of chemotherapy and radiation (Group II). Age distribution was 16-75 years(median : 45.8 years). In histologic type, squamous cell carcinoma was in 30 patients($60{\%}$), undifferentiated carcinoma in 17 patients($34{\%}$), and lymphoepithelioma in 3 patients($6{\%}$). According t AJCC staging system. 4 patients($8{\%}$) were in $T_1$, 13 patients($26{\%}$) in $T_2$. 20 patients($40{\%}$) in $T_3$, 13 patients($26{\%}$) in $T_4$ and 7 patients($14{\%}$) in $N_0$, 6 patients($12{\%}$) $N_1$, 23 patients($46{\%}$) in $N_2$, 14 patients($28{\%}$) in $N_3$. Total radiation dose ranges were 5250-9200cGy(median : 7355 cGy) in Group I and 5360-8400cGy(median : 6758cGy) in Group II Radiotherapy on 4-6MV linear accelerator and/or 6-12MeV electron in boost radiation was given with conventional technique to 26 patients($52{\%}$), with hyperfractionation(115-120cGy/fr., 2times/day) to 16 patients($32{\%}$), with accelerated fractionation(160cGy/fr., 2 times/day) to 8 patients($16{\%}$). In chemotherapy, 5 FU 1000mg daily for 5 consecutive days, pepleomycin 10mg on days 1 and 3, and cisplatin 100mg on day 1 were administered with 3weeks interval, total 1 to 3 cycles(average 1.8cycles) prior to radiation therapy. Follow up duration was 6-140 months(mean : 58 months). Statistics was calculated with Chi-square and Fisher's exact test. Results : Complete local control rates in Group I and II were $75.7{\%},\;69.2{\%} Overall 5 year survival rates in Group I and II were $56.8{\%},\;30.8{\%}$. Five year survival rates by histologic type in Group I and II were $52.2{\%},\;14.3{\%}$ is squamous cell carcinoma and $54.5{\%},\;50{\%}$ in undifferentiated carcinoma. Survival rates in Group I were superior to those of Group II though there were not statistically significant. In both group, survival rates seem to be increased according to increasing total dose of radiation up to 7500cGy, but not increased beyond it. There were not statistically significant differences in survival rates by age, stage, and radiation techniques in both group. Twenty four patients($48{\%}$) experienced treatment failures. Complications were found in 12 patients($24{\%}$). The most common one was osteomyelitis(4 patients, $33.3{\%}$) involving mandible (3 patients) and maxilla(1 patient). Conclusion : Chemotherapy in combination with radiotherapy was found to be not effective to nasopharyngeal cancer and the survival rate was also inferior to that of radiation alone group though it was statistically not significant due to small population in chemotherapy combined group.

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The Effect of Doxapram on Cardiopulmonary Function in Dogs under Total Intravenous Anesthesia with Remifentanil and Propofol (개에서 Remifentanil과 Propofol에 의한 완전 정맥 내 마취 시 Doxapram 투여가 심폐기능에 미치는 효과)

  • Yun, Sungho;Kwon, Youngsam
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.491-498
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    • 2015
  • We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.

Arterial and Venous Blood Gas, Electrolytes, Biochemical and Hematological Values in Healthy Korean Native Calves (건강한 한우 송아지의 동맥과 정맥 혈액의 혈액가스, 전해질, 생화학 및 혈액학적 측정치)

  • Lee, Sung-hwan;Ok, Seung-hoon;Kwon, Hyeok-ho;Kim, Doo
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.499-503
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    • 2015
  • The objective of this study was to investigate arterial and venous blood gas, electrolytes, biochemical, and hematological values in healthy Korean native calves (KNC). The healthy 62 KNC within 3 weeks-old were examined. The arterial blood was collected from caudal auricular artery and the venous blood from jugular vein. The blood samples were analyzed immediately using a portable blood gas analyzer. The pH, $pO_2$, $pCO_2$, $cHCO_3{^-}$, BE, $cSO_2$, $Na^+$, $Ca^{2+}$, $Cl^-$, anion gap potassium (AgapK), Hct, cHgb, glucose, lactate and creatinine were determined. The normal values for blood gas, electrolytes, biochemical, and hematological variables determined in this study agree with other published values for normal calves. The mean concentration of glucose and lactate within 3 weeks old of KNC is higher than those of adult cattle. The blood values according to weeks of age within 3 weeks-old of arterial and venous blood variables were not significantly different (P > 0.05). Glucose (r = 0.927) had the strongest correlations between arterial and venous values. The correlation between the values of the arterial and the venous blood was strong in creatinine (r = 0.925), lactate (r = 0.815), $Ca^{2+}$ (r = 0.806), Hct (r = 0.799), $Na^+$ (r = 0.790), cHgb (r = 0.786), base excess (r = 0.749), pH (r = 0.710), $HCO_3{^-}$ (r = 0.710), and $cTCO_2$ (0.663). Analysis of blood samples in a field condition, using hand-held analyzer is rapid and useful in bovine practice.

Clinical Usefulness of Contrast Echocardiography: The Dose Effect for Left Ventricle Visualization in Dogs (심초음파의 조영제의 임상적 유용성: 개에서 좌심영상화에 대한 조영제 용량의 영향)

  • Shin, Chang-ho;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.486-490
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    • 2015
  • Two-demensional echocardiography is routinely used for evaluation of cardiac function. Visualization of the endocardial border is essential for the assessment of global and regional left ventricular with cardiac disease. SonoVue$^{TM}$ is a microbubble contrast agent that consists of sulfur hexafluoride-filled microbubbles in a phospholipid shell. There were many studies about contrast echocardiographic examination using SonoVue$^{TM}$ contrast agent, and various doses of SonoVue$^{TM}$ were used. To our knowledge, in published veterinary medicine, there was not reported for diagnostic efficient dose of SonoVue$^{TM}$ to evaluate contrast enhanced left ventricular endocardial border delineation (LVEBD). The purpose of this study is to compare the visualization time of LVEBD and find efficient dose of SonoVue$^{TM}$ for using various doses in dogs. Ten healthy Beagles were recruited to the study. Three different doses (0.03 ml/kg, 0.05 ml/kg and 0.1 ml/kg) of SonoVue$^{TM}$ were injected. Endocardial segments were assigned based on previously established methodology, where by the four-chamber views of the LV were divided into 6 segments. In this study, Contrast enhancement of the LVEBD after each injection was evaluated visually at the time point of overall contrast enhancement (Segmental scoring 5+) in the LV by three investigators in a blind manner. Statistical analysis was performed with SPSS version 14.0. All data were analyzed using one-way ANOVA, the multiple comparison Scheffe test. When data for the three offsite readers were combined, mean durations of useful contrast were $3.54({\pm}2.14)$, $6.15({\pm}2.61)$, and $24.39({\pm}11.10)$ seconds for the 0.03 ml/kg, 0.05 ml/kg, and 0.1 ml/kg SonoVue$^{TM}$ doses, respectively. After injection of contrast agent, there were no significant change in side effects such as urticaria, angioedema, hypersensitivity reactions, and digestive system disorders. This study suggests that efficient dose of SonoVue$^{TM}$ contrast agent for improvement of the left ventricle visualization is 0.1 ml/kg. The duration of useful enhancement of LVEBD and the reproducibility were also the highest at the 0.1 ml/kg dosage.

Distribution of Epiphytic Bacteria and Acid-Tolerant Bacteria on the Phyllosphere in the Industrial and Clean Areas (공단지역 및 청정지역 식물 잎권의 잎표면세균 및 내산성세균의 분포)

  • Ahn, Jong-Hoon;Bang, Sook-Jin;Han, Nam-Jung;Song, Wang-Young;Hwang, Soyoung;Lee, In-Soo;Park, Seong Joo
    • Korean Journal of Microbiology
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    • v.33 no.4
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    • pp.262-266
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    • 1997
  • Total, direct viable count, and acid-tolerant epiphytic bacterial population sizes were quantified on leaves of chestnut tree (Castanea crenata S. et Z.) near Taejon Industrial Estate affected by acid precipitation and deposition as well as in the clean natural forest area, Mt. Kyejok, in Taejon city from August 1996 to August 1997. Geometric mean numbers of total, direct viable count, and acid-tolerant epiphytic bacteria were $9.9{\times}10^5cell/cm^2$, $1.6{\times}10^6cell/cm^2$, and $7.1{\times}10^3cfu/cm^2$ respectively, being 1.5, 2, and 2.6 times those in the clean area. Acid-tolerant epiphytic bacterial numbers at pH 5.6 by MPN method were $3.3{\times}10^4$ in the industrial area, about the same as the number, $3.4{\times}10^4MPN/cm^2$, of the clean area. Acid-tolerant bacterial number at pH 4.0 was $1.9{\times}10^{-1}MPN/cm^2$ in the industrial area, whereas none was detected in the clean area. Acid-tolerant bacteria at pH 3.0 were not detected at all in the industrial area as well as in the clean area. Epiphytic bacterial population sizes were generally the greatest in May when leaves are emerged and grew hut the lowest in November when defoliation occurs. These results showed that air pollutant deposition on leaves did not cause a decrease of epiphytic bacteria at least and acid deposition on leaves did cause an increase of acid-tolerant bacteria.

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Diagnostic limitation and usefulness of 99mTc-DISIDA hepatobiliary scanning on neonatal cholestasis (신생아 담즙정체성 간 질환에서 담도 폐쇄증 감별을 위한 DISIDA 스캔의 진단적 한계성과 유용성)

  • Kim, Jung Mi;Choe, Byung-Ho;Jang, You Cheol;Oh, Ki Won;Cho, Min Hyun;Lee, Kyung Hee;Park, Jin-Young;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.737-744
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    • 2006
  • Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.

Studies on the Characteristics of Phosphorus in the Upland Soil -III. Yield Responses of Added Phosphorus for Soybean in Soils with Different Capacities of Phosphorus Sorbed (경작지(耕作地) 전토양(田土壤)의 인산특성(燐酸特性)에 관(關)한 연구(硏究) -III. 인산(燐酸) 흡수력(吸收力)이 상이(相異)한 밭토양(土壤)에서 대두(大豆)에 대(對)한 시용인산(施用燐酸)의 비효(肥效))

  • Shin, Cheol-Woo;Kim, Jeong-Je;Yoon, Jung-Hui
    • Korean Journal of Soil Science and Fertilizer
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    • v.21 no.3
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    • pp.272-279
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    • 1988
  • A pot experiment was conducted to define the effect of various soil phosphorus fractions for soybean yield and the relations of between various soil phosphorus fraction and each other in 11 upland soils with different capacities of phosphorus fixation and physico-chemical properties of soils. The effect of phosphorus fertilization was high in soils with high capacities of phosphorus fixation and low available phosphorus, and soybean yield was showed significant relationship with available phosphorus and inorganic soil phosphorus fractions. Fractional recovery of added phosphorus in soils were showed various range of 2.5-91.7%, and mean value of soils was 48.5%. In the relationships among the soybean yield, plant phosphorus content, phosphorus uptake and available phosphorus, inoganic phosphorus at flowering stage, soybean yield were showed significant relationship with available phosphorus content, phosphorus uptake were all showed significant correlation without Fe-P, but Fe-P was showed except Jeju soil. Al-P/Fe-P ratio was increased by phosphorus fertilization in soils at flowering stage, and in the relationships between Al-P/Fe-P ratio and soybean yield, phosphorus uptake, soil and plant phosphorus were showed high significant correlation, but Fe-P was not showed at flowering stage. P sorbed by soils from P 20ppm solution was decreased by phosphorus fertilization, and then decreasing rate was higher in soils with low capacity of phosphorus fixation then high phosphorus fixing soils. Also P sorbed was showed negatively high significant correlation with available phosphorus, plant phosphorus, phosphorus uptake and soil inorganic phosphours except Fe-P, and soybean yield was not showed.

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Hyeongok's Bogan-tang was Combined according to the Theory for Properties and Tastes of Herbal Medicines (현곡(玄谷) 보간탕(補肝湯)의 구성한약과 그 기미배오(氣味配伍) 분석)

  • Shin, Soon-Shik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.3
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    • pp.591-595
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    • 2007
  • There are eight kinds of formulas for invigorating the liver to cure its asthenic syndrome based on the types of preparation formulas Began-tang, Boganhwan, Bogansan, Bogandan, Boganeum, Boganjoo, Boganjeon and Bogango. Another formula called Bocheonghwan is to invigorate the green colour of liver. There are 22 kinds of Bogan-tang, 12 kinds of Boganhwan, 25 kinds of Bogansan, one kind of Bogandan, one kind of Boganeum, one kind of Boganjoo, one kind of Boganjeon, one kind of Bogango, and two kinds of Bocheonghwan. Combination of herbal medicines, carried out in formulas for invigorating the liver, consists of various kinds depending on medical scientists' personal experience in medical treatment without any general principles, which makes it difficult to apply it to clinical use. The objectives of this study lie in theoretical establishment of Bogan-tang for curing the asthenic syndrome of liver through analyzing the component medicines and combination principles of Hyeongok's Bogan-tang, and furthermore, maximizing the clinical use of Began-tang. This study analyzed the component medicines and combination principles of Hyeongok's Bogan-tang based on the theory for properties and tastes of herbal medicines from the ${\ulcorner}$yellow Emperor's Canon of Internal Medicine${\lrcorner}$ , the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Began-tang is an odd prescription, composed of 7 kinds of ingredients No.1 Radix Angelicas Sinensis (2don;7.5g), No.2 Rhizoma Chuanxiong (1don;3.75g), No.3 Radii Polygoni Multiflori (1don), No.4 Fructus Lycii (1don), No.5 Cortex Cinnamomi (1don), No.6 Rhizoma Gastrodiae (1don), and No.7 Radix Glycyrrhizae (1don). There are three methods for curing the asthenic syndrome of liver according to the five elements doctrine invigorating the liver, invigorating the kidney and purging the lung. First, if you suffer from the asthenic syndrome of the liver, you need to invigorate your liver. There are two available methods, including taste and property invigoration according to the theory for properties and tastes of herbal medicines. They each imply the pungent taste and the warm property invigorate the liver. In the case of taste invigoration, two herbal medicines with pungent taste, Radix Angelicas Sinensis and Rhizoma Chuanxiong, are combined into the principal and assistant herbal medicine, respectively. For property invigoration, two herDal medicines with the warm property, Cortex Cinnamomi and Rhizoma Gastrodiae, are combined into adjuvant herbal medicines. Secondly, if you suffer from the asthenic syndrome of the liver, you need to invigorate your kidney which is mother in the mother-child relationship in inter-promotion among the five elements. There are two methods to invigorate the kidney, including taste and property invigoration according to the theory for properties and tastes of herbal medicines. They each mean the bitter taste and the cold property invigorate the kidney. Therefore, it is important to use bitter herbal medicines for taste invigoration and cold ones for property invigoration. Both Differ and cold herbal medicines, Radix Polygoni Multiflori and Fructus Lycii, are combined into adjuvant herbal medicines. Lastly, if you suffer from the asthenic syndrome of the liver, you need to purge your lung which is an element being surpassed in the relationship between the elements surpassed and ones not surpassed in inter-restraint among the five elements. There are two methods to purge the lung, which include taste and property invigoration according to the theory for properties and tastes of herbal medicines. Taste invigoration means to purge the lung with pungent taste and property invigoration to purge the lung with warm property. Therefore, it is important to use pungent herbal medicines for taste invigoration and warm ones for property invigoration. Both pungent and warm herbal medicines, Radix Angelicas Sinensis and Rhizoma Chuanxiong, were combined to invigorate and purge the lung. In addition, Radix Glycyrrhizae are combined as dispatcher herbal medicine, harmonizing all the herbal medicines composing the formula. First, to cure the asthenic syndrome of the liver, the methods of invigorating the liver and the kidney, and purging the lung should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herDal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine. As a good example, Hyeongok's Bogan-tangon is combined according to the above theories. In conclusion, this formula was created by applying to the theory for properties and tastes of herbal medicines.

A Suggested New Clinical Classification for Pediatric Intussusception (소아 장중첩증의 새로운 임상적 분류의 제안)

  • Park, Moon Ho;Shon, Su Min;Choe, Byung Kyu;Kim, Yeo Hyang;Lee, Hee Jung;Choi, Won Joung;Kim, Ae Suk;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.39-47
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    • 2006
  • Purpose: We proposed a new classification of pediatric intussusception based on clinical and radiologic findings. Methods: Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records. Results: 1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age ($38.0{\pm}22.9$ months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size ($20.8{\pm}2.7mm$) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9mm were treated surgically. Conclusion: Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.

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Clinical Feature and Dietary Pattern of Infantile Constipation Under Two Years of Age (2세 이하 영유아 변비의 임상 양상과 식이 방식)

  • Kim, Hye-Jin;Moon, Jin Soo;Hwang, Jong Hee;Jang, Hyun Oh;Nam, Seung Yeun;Kim, Dong Wook;Lee, Chong Guk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.31-38
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    • 2006
  • Purpose: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. Methods: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. Results: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). Conclusion: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.

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