• Title/Summary/Keyword: performance studies

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Clinical Features and Prognostic Factors in 41 Patients of Primary Nasal/Nasopharyngeal Non-Hodgkin's Lymphoma: Prognostic Significance of Immunophenotype (비/비인강 비호즈킨 림프종의 임상양상과 예후 인자 : 면역 표현형의 임상적 의의)

  • Park Soon-Seo;Park Jong-Beom;Suh Cheol-Won;Park Ji-Woon;Lim Soo-Duk;Huh Joo-Ryung;Nam Soon-Yuhl;Kim Sang-Yoon;Lee Ho-Gyu;Chang Hye-Sook;Kim Tae-Won;Lee Je-Hwan;Kim Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.149-155
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    • 1999
  • Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

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A Study of Reportable Range Setting through Concentrated Control Sample (약물검사에서 관리시료의 농축을 이용한 보고 가능 범위의 설정에 대한 연구)

  • Chang, Sang Wu;Kim, Nam Yong;Choi, Ho Sung;Park, Yong Won;Yun, Keun Young
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.13-18
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    • 2004
  • This study was designed to establish working range for reoportable range in own laboratory in order to cover the upper and lower limits of the range in test method. We experimented ten times during 10 days for setting of reportable range with between run for method evaluation. It is generally assumed that the analytical method produces a linear response and that the test results between those upper and lower limits are then reportable. CLIA recommends that laboratories verify the reportable range of all moderate and high complexity tests. The Clinical Laboratory Improvement Amendments(CLIA) and Laboratory Accreditation Program of the Korean Society for Laboratory Medicine states reportable range is only required for "modified" moderately complex tests. Linearity requirements have been eliminated from the CLIA regulations and from others accreditation agencies, many inspectors continue to feel that linearity studies are a part of good lab practice and should be encouraged. It is important to assess the useful reportable range of a laboratory method, i.e., the lowest and highest test results that are reliable and can be reported. Manufacturers make claims for the reportable range of their methods by stating the upper and lower limits of the range. Instrument manufacturers state an operating range and a reportable range. The commercial linearity material can be used to verify this range, if it adequately covers the stated linear interval. CLIA requirements for quality control, must demonstrate that, prior to reporting patient test results, it can obtain the performance specifications for accuracy, precision, and reportable range of patient test results, comparable to those established by the manufacturer. If applicable, the laboratory must also verify the reportable range of patient test results. The reportable range of patient test results is the range of test result values over which the laboratory can establish or verify the accuracy of the instrument, kit or test system measurement response. We need to define the usable reportable range of the method so that the experiments can be properly planned and valid data can be collected. The reportable range is usually defined as the range where the analytical response of the method is linear with respect to the concentration of the analyte being measured. In conclusion, experimental results on reportable range using concentrated control sample and zero calibrators covering from highest to lowest range were salicylate $8.8{\mu}g/dL$, phenytoin $0.67{\mu}g/dL$, phenobarbital $1.53{\mu}g/dL$, primidone $0.16{\mu}g/dL$, theophylline $0.2{\mu}g/dL$, vancomycine $1.3{\mu}g/dL$, valproic acid $3.2{\mu}g/dL$, digitoxin 0.17ng/dL, carbamazepine $0.36{\mu}g/dL$ and acetaminophen $0.7{\mu}g/dL$ at minimum level and salicylate $969.9{\mu}g/dL$, phenytoin $38.1{\mu}g/dL$, phenobarbital $60.4{\mu}g/dL$, primidone $24.57{\mu}g/dL$, theophylline $39.2{\mu}g/dL$, vancomycine $83.65{\mu}g/dL$, valproic acid $147.96{\mu}g/dL$, digitoxin 5.04ng/dL, carbamazepine $19.76{\mu}g/dL$, acetaminophen $300.92{\mu}g/dL$ at maximum level.

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Risk Analysis of Inorganic Arsenic in Foods (식품 중 무기비소의 위해 분석)

  • Yang, Seung-Hyun;Park, Ji-Su;Cho, Min-Ja;Choi, Hoon
    • Journal of Food Hygiene and Safety
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    • v.31 no.4
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    • pp.227-249
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    • 2016
  • Arsenic and its compounds vary in their toxicity according to the chemical forms. Inorganic arsenic is more toxic and known as carcinogen. The provisional tolerable weekly intake (PTWI) of $15{\mu}g/kg$ b.w./week established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) has been withdrawn, while the EFSA panel suggested $BMDL_{0.1}$ $0.3{\sim}8{\mu}g/kg\;b.w./day$ for cancers of the lung, skin and bladder, as well as skin lesions. Rice, seaweed and beverages are known as food being rich in inorganic arsenic. As(III) is the major form of inorganic arsenic in rice and anaerobic paddy soils, while most of inorganic arsenic in seaweed is present as As(V). The inorganic arsenic in food was extracted with solvent such as distilled water, methanol, nitric acid and so on in heat-assisted condition or at room temperature. Arsenic speciation analysis was based on ion-exchange chromatography and high-performance liquid chromatography equipped with atomic absorption spectrometry and inductively coupled plasma mass spectrometry. However, there has been no harmonized and standardized method for inorganic arsenic analysis internationally. The inorganic arsenic exposure from food has been estimated to range of $0.13{\sim}0.7{\mu}g/kg$ bw/day for European, American and Australian, and $0.22{\sim}5{\mu}g/kg$ bw/day for Asian. The maximum level (ML) for inorganic arsenic in food has established by EU, China, Australia and New Zealand, but are under review in Korea. Until now, several studies have conducted for reduction of inorganic arsenic in food. Inorganic arsenic levels in rice and seaweed were reduced by more polishing and washing, boiling and washing, respectively. Further research for international harmonization of analytical method, monitoring and risk assessment will be needed to strengthen safety management of inorganic arsenic of foods in Korea.

Nontuberculous Mycobacterial pulmonary Infection in Immunocompetent Patients (면역적격자에서 비결핵마이코박테리아의 폐감염)

  • Lee, Hyo-Won;Kim, Mi-Na;Shim, Tae-Sun;Bai, Gill-Han;Pai, Chik-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.173-182
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    • 2002
  • Background : Nontuberculous mycobacteria (NTM) have usually been considered to be contaminants of colonizers when isolated from respiratory specimens in Korea, where there is a high prevalence of tuberculosis and a low rate of HIV infections. Therefore, there has been few studies on the clinical significance of NTM species in immunocompetent patients were investigated. Methods : Thirty-five NTM isolates, for which species identification was requested by the treating physicians during 1999 at the Asan Medical Center, were retrospectively analyzed. They were identified to the species level by mycolic acid analysis using high-performance liquid chromatography. The medical records of the patients with the NTM isolates were reviewed to identify those patients who met the American Thoracic Society (ATS)'s criteria for mycobacterial pulmonary infection. Their antimicrobial susceptibility data were compared with the clinical outcomes. Results : The NTM were identified as M. intracellulare (6 isolates), M. avium (5), M. abscessus (5), M. gordonae (5), M. terrae complex (4), M. szulgai (2), M. kansasii (2), M. fortuitum (2), M. peregrinum (1), M. mucogenicum (1), M. celatum (1), and M. chelonae (1). All 35 patients showed clinical symptoms and signs of chronic lung disease, but none had a HIV infections; 16 (45.7%) patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria, 5 and 4 cases were affected with M. intracellulare and M. abscessus, respectively; 8 patients had a history of pulmonary tuberculosis. 13 patients received antimycobacterial therapy for an average of 21 months and 9 patients were treated with second-line drugs. Only 4 patients had improved radiologically. Conclusion : A NTM should be considered a potential pathogen of pulmonary infections in immunocompetent patients with chronic pulmonary diseases. Most NTM infections were left untreated for a prolonged period and showed a poor outcome as a result, M. intracellulare and M. abscessus were the two most frequent causes of NTM pulmonary infections in this study. Species identification and antimycobacterial susceptibility tests based on the species are needed for the optimum management of a NTM pulmonary infection in patients.

Phase II Trial of Irinotecan plus Cisplatin Combination as First Line Therapy for Patients with Small cell Lung Cancer (소세포폐암 환자에서 1차 항암 치료제로서 Irinotecan 과 Cisplatin 병합요법에 관한 2상 연구)

  • Jeong, Hye Cheol;Lee, Sang Yeub;Kim, Jung Ha;Ha, Eun Sil;Jung, Jin Yong;Lee, Kyung Ju;Lee, Seung Hyeun;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Lee, Sung Yong;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.57-64
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    • 2006
  • Background : Recently, there have been several studies showing that irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against extensive disease(ED) small cell lung cancer (SCLC). We conducted a phase II trial to evaluate the efficacy and toxicity of irinotecan plus cisplatin as a 1st line therapy for both limited and extensive disease SCLC. Methods : The study was conducted between January 2002 and June 2004. Patients were treated with $60mg/m^2$ irinotecan on day 1, 8, 15 and $60mg/m^2$ cisplatin on day 1, every 4 weeks. During concurrent thoracic irradiation for limited disease (LD)-SCLC patients, dose of irinotecan was reduced to $40mg/m^2$. Prophylactic cranial irradiation was given to patients with complete remission (CR) after chemotherapy. Results : Median ages of LD- and ED- SCLC were 64 years and performance status (PS) was 0-2. In patients with LD-SCLC, the response rate after concurrent chemoradiotherapy was 85% (CR, 6; Partial response [PR], 11). The median survival was 20 months (95% CIs, 15.6 to 24.4) with 1-and 2-year survival rates of 85% and 35%, respectively. Median progression free survival (PFS) was 12 months (95% CIs, 6.2 to 18.1) with 1- year PFS of 36%. In ED-SCLC, the response rate was 83.4% (CR, 1; PR, 14). The median survival was 14.5 months (95% CIs, 8.8 to 20.1) with 1-year survival rates of 75%. Median PFS was 6.3 months (95% CIs, 5.6 to 7.1) with 1- year PFS of 20%. The major toxicities (grade 3 or 4) of this regimen included leukopenia, anemia, thrombocytopenia, nausea/vomiting, and diarrhea without life threatening complication. Conclusion : Our data shows that the combination of irinotecan plus cisplatin as a first line therapy is effective and tolerable in the treatment of both LD- and ED- SCLC.

Study of the Transition of a Skateboarding Space in an Urban Park (도시공원에서 스케이트보드 활동 공간 발달에 관한 연구)

  • Cho, Han-sol;Son, Young-hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.26-39
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    • 2016
  • This research paper explores the process of developing skateboarding spaces in urban parks. Skateboarding is one of the most popular sport activities representative of urban parks. This research paper will analyze the process of introducing skateboarding activities into park spaces and their acceptance by the general public as well as derive meaningful general implications for park space development planning. The research method is a discourse analysis of newspaper articles regarding skateboarding issued between the 1960s and 2010s. These articles are the main resources to show the creation of a skateboarding culture, generation of skate park spaces, and the extinction of these spaces during the research period. The result of this research is as follows. There are reasons that allowed for the creation of skate park spaces in urban parks. First of all, positive associations that people have regarding skateboarding have influenced the park's users and operators' decisions that a park is proper space for skateboarding activities, and the agreement to remodel the park space. Secondly, skate parks became a space for multiple-uses that can be shared with other emerging sports, which resulted in a building boom of skateboarding spaces in urban parks. Thirdly, urban parks and their new culture of active sports became a marketing tool used by local governments to attract new inhabitants to their new towns. On the contrary, there are three main reasons for the deterioration of skate parks. First of all, within parks in which skateboarding activities collided with other park usage, the skate parks disappeared. Secondly, skate parks built specifically for competitive skateboarding events and without consideration of casual skaters disappeared, as these facilities were not sustainable for use in the long term. Thirdly, the golden age of skate park skateboarding did not last long, as skateboarding trends shifted from trick performance to street skating, where skate parks are no longer needed. For this reasons, the exclusive use of park space for skateboarding activities has faded from public interest. The findings of this research suggest how sport activities should be introduced to urban parks. At first, each park's management needs to identify a sport suitable for long-term development, and not only plan for temporal events or follow fleeting trends. Secondly, the park's management systems should reflect a type of sport activity that would not only be popular at the beginning of the spaces development, but also take into consideration how these activities will change over time. Lastly, in cases where there are conflicts between sport activities and other activities in urban parks, attempts should be made to suggest feasible solutions other than the liquidation of sport spaces. This study explains the development process of sport spaces offered in urban parks, by thorough research of the process of acceptance of skateboarding activities in current urban park systems. This conclusion also indicates further areas for research with the purpose of understanding general best practices in urban parks sport space planning.

Impact of Cyclooxygenase-2 Expression on the Survival of Glioblastoma (다형성아교모세포종 환자에서 Cyclooxygenase-2 발현이 생존율에 미치는 영향)

  • Choi, Young-Min;Kim, Dae-Cheol;Kim, Ki-Uk;Song, Young-Jin;Lee, Hyung-Sik;Hur, Won-Joo;Choi, Sun-Seob;Seo, Su-Yeong
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.145-150
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    • 2007
  • Purpose: To investigate the degree and effect of cyclooxygenase (COX)-2 expression on the survival of patients with glioblastoma multiforme (GM). Materials and Methods: Between 1997 and 2006, thirty consecutive GM patients treated with surgery and postoperative radiotherapy (dose range: $44{\sim}65.1$ Gy, median dose: 61.2 Gy) were included in the study. Three patients were excluded that discontinued radiotherapy before receiving a dose of 40 Gy due to mental deterioration. The expression of the COX-2 protein in surgical specimens was examined by immunohistochemical analysis. Survival analysis and verification were performed with respect to sex, age, performance status, resection extent, radiotherapy dose, and degree of COX-2 expression using the Kaplan-Meier method and the log rank test. Results: The median length of follow-up was 13.3 months (range:$6{\sim}83$ months). Staining for COX-2 was positive in all patient samples. Staining for COX-2 that was positive for over 75% of the tumor cells was found in 24 patients. Staining for COX-2 that was positive in less than 25% of tumor cells was found in 3 patients (10.0%), staining for COX-2 that was positive in 25 to 50% of tumor cells was found in 1 patient (3.3%), staining for COX-2 that was positive in 50 to 75% of tumor cells was found in 2 patients (6.7%) and staining for COX-2 that was positive in 75 to 100% of tumor cells was found in 24 patients (80.0%). The median survival and two-year survival rate were 13.5 months and 17.5%, respectively. The survival rate was influenced significantly by the degree of resection (tumor removal by 50% or more) and radiotherapy dose (59 Gy or greater) (p<0.05). The median survival of patients with staining for COX-2 that was positive in less than 75% of tumor cells and in at least 75% of tumor cells was 15.5 and 13.0 months, respectively (p>0.05), and the two-year survival for these groups was 33.3 and 13.3%, respectively (p>0.05). Conclusion: The absence of a statistical correlation between the degree of COX-2 expression and survival in GM patients, despite the high rate of COX-2 positive tumor cells in the GM patient samples, requires further studies with a larger series to ascertain the prognostic value of the degree of COX-2 expression in GM patients.

Numerical and Experimental Study on the Coal Reaction in an Entrained Flow Gasifier (습식분류층 석탄가스화기 수치해석 및 실험적 연구)

  • Kim, Hey-Suk;Choi, Seung-Hee;Hwang, Min-Jung;Song, Woo-Young;Shin, Mi-Soo;Jang, Dong-Soon;Yun, Sang-June;Choi, Young-Chan;Lee, Gae-Goo
    • Journal of Korean Society of Environmental Engineers
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    • v.32 no.2
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    • pp.165-174
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    • 2010
  • The numerical modeling of a coal gasification reaction occurring in an entrained flow coal gasifier is presented in this study. The purposes of this study are to develop a reliable evaluation method of coal gasifier not only for the basic design but also further system operation optimization using a CFD(Computational Fluid Dynamics) method. The coal gasification reaction consists of a series of reaction processes such as water evaporation, coal devolatilization, heterogeneous char reactions, and coal-off gaseous reaction in two-phase, turbulent and radiation participating media. Both numerical and experimental studies are made for the 1.0 ton/day entrained flow coal gasifier installed in the Korea Institute of Energy Research (KIER). The comprehensive computer program in this study is made basically using commercial CFD program by implementing several subroutines necessary for gasification process, which include Eddy-Breakup model together with the harmonic mean approach for turbulent reaction. Further Lagrangian approach in particle trajectory is adopted with the consideration of turbulent effect caused by the non-linearity of drag force, etc. The program developed is successfully evaluated against experimental data such as profiles of temperature and gaseous species concentration together with the cold gas efficiency. Further intensive investigation has been made in terms of the size distribution of pulverized coal particle, the slurry concentration, and the design parameters of gasifier. These parameters considered in this study are compared and evaluated each other through the calculated syngas production rate and cold gas efficiency, appearing to directly affect gasification performance. Considering the complexity of entrained coal gasification, even if the results of this study looks physically reasonable and consistent in parametric study, more efforts of elaborating modeling together with the systematic evaluation against experimental data are necessary for the development of an reliable design tool using CFD method.

Experimental Study on Structural Behavior of Precast PSC Curved Girder Bridge (프리캐스트 PSC 곡선 거더교의 구조거동에 대한 실험적 연구)

  • Kim, Sung Jae;Kim, Sung Bae;Uhm, Ki Ha;Kim, Jang Ho Jay
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.34 no.6
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    • pp.1731-1741
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    • 2014
  • Recently, many overpasses, highway, and advanced transit systems have been constructed to distribute the traffic congestion, thus small size of curved bridges with small curvature such as ramp structures have been increasing. Many of early curved bridges had been constructed by using straight beams with curved slabs, but curved steel beams have replaced them due to the cost, aesthetic and the advantage in building the section form and manipulating the curvature of beams, thereby large portion of curved bridges were applied with steel box girders. However, steel box girder bridges needs comparatively high initial costs and continuous maintenance such as repainting, which is the one of the reason for increasing the cost. Moreover, I-type steel plate girder which is being studied by many researchers recently, seem to have problems in stability due to the low torsional stiffness, resulting from the section characteristics with thin plate used for web and open section forms. Therefore, in recent studies, researchers have proposed curved precast PSC girders with low cost and could secured safety which could replace the curved steel girder type bridges. Hence, this study developed a Smart Mold system to manufacture efficient curved precast PSC girders. And by using this mold system a 40 m 2-girder bridge was constructed for a static flexural test, to evaluate the safety and performance under ultimate load. At the manufacturing stage, each single girder showed problems in the stability due to the torsional moment, but after the girders were connected by cross beams and decks, the bridge successfully distributed the stress, thereby the stability was confirmed. The static loading test results show that the initial crack was observed at 1,400 kN when the design load was 450 kN, and the load at the allowable deflection by code was 1,800 kN, which shows that the safety and usability of the curved precast PSC bridge manufactured by Smart Mold system is secured.

High VPP Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer (진행된 비소세포 폐암에 대한 High-VPP 복합화학요법의 효과)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Lee, Jong-Jin;Cho, Hai-Jeong;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.367-377
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    • 1993
  • Background: The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based polychemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study. Method: Thirty-five patients above stage III, diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 $mg/m^2$) and/or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients' records. Results: 1) The overall objective response rate was 47%(9/19) with one complete remission. 2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100%, 70% and 40%. 3) In patients who received polychemotherapy, the response rate was 33% (3/9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78%, 67% and 33%. 4) Overall, treated patients survived significantly longer (p<0.05) than non-treated patients (median survival 307 days versus 95 days). 5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates. 6) The toxicities were nausea and/or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (16%) and neurotoxicity (5%). Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considerd that we select the patients with proper indications and treat them with effective chemotherpy and radiation therapy. But, because improvement related to high VPP ploychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases.

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