• Title/Summary/Keyword: overall treatment time

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Surgical Treatment of Lumbar Spinal Stenosis in Geriatric Population : Is It Risky?

  • Kim, Dong-Won;Kim, Sung-Bum;Kim, Young-Soo;Ko, Yong;Oh, Seong-Hoon;Oh, Suck-Jun
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.107-110
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    • 2005
  • Objective : Lumbar spinal stenosis is increasingly recognized as a common cause of low back pain in elderly patients. Conservative treatment has been initially applied to elderly patients, however, surgical treatment is sometimes indispensable to relieve severe pain. We retrospectively examine the age-related effects on the surgical risk, and results following general anesthesia and operative procedure in geriatric patients for two different age groups of at least 65years old. Methods : Consecutive 51 patients [${\ge}$ 65years], who underwent open surgical procedure for degenerative lumbar spinal stenosis, were selected in the study. Patients were divided into two groups. Group A included all patients who were between 65 and 69years of age at the time of surgery. Group B included all patients who were at least 70years of age at the time of surgery. We reviewed medical history including preoperative American Society of Anesthesiologists[ASA] classification of physical status, anesthetic risk factor, operative time, estimated blood loss, transfusion requirements, hospital stay, operated level, and clinical outcome to look for comparisons between two age groups [$65{\sim}69$ and over 70years]. Results : In preoperative evaluation, mean anesthetic risk factor of patients was numerically similar between the groups. The American Society of Anesthesiologists classification of physical status was similar between two groups. There was no difference in operated level, operative time, estimated blood loss, hospital stay, and anesthetic risk factor between the two groups. The clinical successful outcome showed 82.7% for Group A and 81.8% for group B. The overall postoperative complication rates were similar for both group A and B. Conclusion : We conclude that advanced age per se, did not increase the associated morbidity and mortality in surgical decompression for spinal stenosis.

Effect of Patenting Temperature and Isothermal Time on the Phase Transformation and Microstructure Change in SAE 1078 Steel (SAE 1078 강의 파텐팅 온도 및 등온유지 시간에 따른 상변태 및 미세조직 변화)

  • Gi-hoon Kwon;Hyunjun Park;Kuk-hyun Yeo;Young-Kook Lee;Sang-gweon Kim
    • Journal of the Korean Society for Heat Treatment
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    • v.37 no.5
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    • pp.255-261
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    • 2024
  • To study the effects of patenting temperature and isothermal holding time on the phase transformation and mechanical property changes of SAE 1078 steel, the patenting process was performed at 460℃, 560℃, and 660℃ for isothermal times (30 s, 60 s, 90 s, 120 s, and 150 s) after nitrogen cooling under austenitizing conditions (1000℃, 2 min). In this study, a scanning electron microscope was used to measure the microstructure and interlamellar spacing of pearlite according to process variables, and an X-ray diffraction analyzer was used to calculate the phase fraction. Cooling rate is approximately 18.6℃/s from the austenitizing temperature to the patenting temperature and pearlite transformation begins at 597~602℃. As the patenting temperature increases, the rate of carbon diffusion during isothermal step increases, so a relatively coarse pearlite structure is formed, and the hardness tends to decrease overall. As the isothermal holding time increased, the hardness of the treated specimens converged to 420Hv, 376Hv, and 268Hv, respectively, because the phase transformation was sufficiently completed at 460℃, 560℃, and 660℃. On the other hand, as the isothermal holding time became shorter, sufficient phase transformation did not occur after the isothermal process, so retained austenite existed, resulting in a decrease in hardness.

Predictive Factors for Switched EGFR-TKI Retreatment in Patients with EGFR-Mutant Non-Small Cell Lung Cancer

  • Kwon, Byoung Soo;Park, Ji Hyun;Kim, Woo Sung;Song, Joon Seon;Choi, Chang-Min;Rho, Jin Kyung;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.187-193
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    • 2017
  • Background: Third-generation tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKIs) have proved efficacious in treating non-small cell lung cancer (NSCLC) patients with acquired resistance resulting from the T790M mutation. However, since almost 50% patients with the acquired resistance do not harbor the T790M mutation, retreatment with first- or second-generation EGFR-TKIs may be a more viable therapeutic option. Here, we identified positive response predictors to retreatment, in patients who switched to a different EGFR-TKI, following initial treatment failure. Methods: This study retrospectively reviewed the medical records of 42 NSCLC patients with EGFR mutations, whose cancers had progressed following initial treatment with gefitinib or erlotinib, and who had switched to a different first-generation EGFR-TKI during subsequent retreatment. To identify high response rate predictors in the changed EGFR-TKI retreatment, we analyzed the relationship between clinical and demographic parameters, and positive clinical outcomes, following retreatment with EGFR-TKI. Results: Overall, 30 (71.4%) patients received gefitinib and 12 (28.6%) patients received erlotinib as their first EGFR-TKI treatment. Following retreatment with a different EGFR-TKI, the overall response and disease control rates were 21.4% and 64.3%, respectively. There was no significant association between their overall responses. The median progression-free survival (PFS) after retreatment was 2.0 months. However, PFS was significantly longer in patients whose time to progression was ${\geq}10months$ following initial EGFR-TKI treatment, who had a mutation of exon 19, or whose treatment interval was <90 days. Conclusion: In patients with acquired resistance to initial EGFR-TKI therapy, switched EGFR-TKI retreatment may be a salvage therapy for individuals possessing positive retreatment response predictors.

Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

  • Chan Park;Jin Hyoung Kim;Pyeong Hwa Kim;So Yeon Kim;Dong Il Gwon;Hee Ho Chu;Minho Park;Joonho Hur;Jin Young Kim;Dong Joon Kim
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.213-224
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    • 2021
  • Objective: Clinical outcomes of patients who undergo transarterial chemoembolization (TACE) for single small hepatocellular carcinoma (HCC) are not consistent, and may differ based on certain imaging findings. This retrospective study was aimed at determining the efficacy of pre-TACE CT or MR imaging findings in predicting survival outcomes in patients with small HCC upon being treated with TACE. Besides, the study proposed to build a risk prediction model for these patients. Materials and Methods: Altogether, 750 patients with functionally good hepatic reserve who received TACE as the first-line treatment for single small HCC between 2004 and 2014 were included in the study. These patients were randomly assigned into training (n = 525) and validation (n = 225) sets. Results: According to the results of a multivariable Cox analysis, three pre-TACE imaging findings (tumor margin, tumor location, enhancement pattern) and two clinical factors (age, serum albumin level) were selected and scored to create predictive models for overall, local tumor progression (LTP)-free, and progression-free survival in the training set. The median overall survival time in the validation set were 137.5 months, 76.1 months, and 44.0 months for low-, intermediate-, and high-risk groups, respectively (p < 0.001). Time-dependent receiver operating characteristic curves of the predictive models for overall, LTP-free, and progression-free survival applied to the validation cohort showed acceptable areas under the curve values (0.734, 0.802, and 0.775 for overall survival; 0.738, 0.789, and 0.791 for LTP-free survival; and 0.671, 0.733, and 0.694 for progression-free survival at 3, 5, and 10 years, respectively). Conclusion: Pre-TACE CT or MR imaging findings could predict survival outcomes in patients with small HCC upon treatment with TACE. Our predictive models including three imaging predictors could be helpful in prognostication, identification, and selection of suitable candidates for TACE in patients with single small HCC.

Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer

  • Kwak, Yoo-Kang;Lee, Jong Hoon;Lee, Myung-Ah;Chun, Hoo-Geun;Kim, Dong-Goo;You, Young Kyoung;Hong, Tae-Ho;Jang, Hong Seok
    • Radiation Oncology Journal
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    • v.32 no.2
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    • pp.49-56
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    • 2014
  • Purpose: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Materials and Methods: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. Results: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Conclusion: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.

Oncologic Outcome and Distant Metastasis of Head and Neck Adenoid Cystic Carcinoma (두경부 선낭암종의 예후와 원격 전이)

  • Yoon, Hee Soo;Park, Sang Gyu;Park, Hae Jin;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.23-28
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    • 2018
  • Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.

Quality Characteristics of Bread Prepared with the Addition of Persimmon Peel Powder (감피 첨가 식빵의 품질 특성)

  • 김창섭;정신교
    • Food Science and Preservation
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    • v.8 no.2
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    • pp.175-180
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    • 2001
  • The quality characteristics of bread prepared with the addition of dried persimmon peel powder(PPP) were investigated. Visco-elastic characteristics of dough and texture of bread added PPP was examined by rapid visco-analyzer and texture analyzer. The maximum viscosity of the dough with PPP was lower than that of control at 90$\^{C}$. Final viscosity after cooling to 50$\^{C}$, viscosity of control increased to 134 B.U., but that of the dough with PPP showed 13∼37 B.U. As more PPP was added, gluten formation and mixing time dough were longer. Adhesiveness, springness, cohesiveness and chewiness gradually increased as PPP content increased, while the hardness decreased. Lightness value decreased but redness and yellowness values increased with the addition of PPP, especially, the bread made by 15% PPP treatment showed dark brown color. In sensory evaluation of bread, score of color decreased significantly as more PPP was added but overall acceptability was not significant different(p<0.05) between control and 5% PPP treatment. It is considered that the addition of 5% was appropriate for bread making with PPP.

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The Effects of Alkaline Treatment and Potato-Starch Content on the Quality of Fish Meat Paste Products Prepared from Pacific Sandlance Ammodytes personatus Girard

  • Yoo, Byung-Jin
    • Fisheries and Aquatic Sciences
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    • v.14 no.3
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    • pp.161-167
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    • 2011
  • This study investigated the effects of the number of washes and alkaline treatments ($NaHCO_3$ concentrations) and the concentration of potato starch on the quality of fish meat paste products prepared from sand lance Ammodytes personatus Girard. We found significantly (P<0.05) higher ratings for the all textural parameters (hardness, brittleness, elasticity, and cohesiveness) of the sand-lance meat paste products (SLMPPs) that were washed three times with a 0.5% $NaHCO_3$ concentration. We determined that an 8% concentration of potato starch leads to the best textural properties in SLMPPs. As the amount of potato starch was increased, the redness values of SLMPPs decreased significantly (P<0.05), but the differences in the sensory evaluation parameters (texture, flavor, taste, and overall acceptability) between the SLMPPs were not significant.

Nitrogen Removal in the Multi-stage Bed Attached Growth Process of $A^2/O$ System with Interanal Recycle Ratio (다단층 부착성장 공법($A^2/O$향)에서 순환비에 따른 질소제거)

  • 최규철;윤용수;정일현
    • Journal of environmental and Sanitary engineering
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    • v.12 no.3
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    • pp.95-102
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    • 1997
  • The process which can stabilize water quality of treatment and improve nitrogen removal rate under the condition of high organic loading was developed by charging fibrous HBC media to single sludge nitrification-denitrification process. This process was operated easier, minimized the treatment cost, and shortened the retention time. To improve T-N removal rate, a part of nitrifing liquid at aerobic zone was recycled to anoxic zone by approximate internal recycle ratio. The experimental results are as follows ; T-N removal efficiency in the organic volumetric loading 0.14-0.19 kg/COD/m$^{3}$·d was obtained asmaxium of 85% at internal recycle ratio 2.5 and in more ratio than this it was decreased. Organic removal efficiency was about 91% under the overall experimental conditions and not influenced by recycle ratio.

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Management for locally advanced cervical cancer: new trends and controversial issues

  • Cho, Oyeon;Chun, Mison
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.254-264
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    • 2018
  • This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.