• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10577-10583
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• 2015

Background: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with a poor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling and most authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotype despite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study was aimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCs and categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between two subtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC cases during January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study were differentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers $34{\beta}E12$, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects were collated from clinical records. The comparison of clinicopathological features between two subgroups was done using statistical analyses. The pattern of treatment failure along with its association with prognostic factors was assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBL subtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant association was seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% were with BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was 30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively. Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Disease stage at presentation is an important prognostic factor influencing the treatment failure and survival among TNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinical course than that of NBL as shown by shorter DFS and OS, despite having no statistically significant difference between prognostic parameters. New therapeutic alternatives should be explored for patients with this subtype of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.205-213
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• 2014

The outcomes of first-generation EGFR-TKIs (Gefitnib and Erlotinib) have shown great advantages over traditional treatment strategies in patients with non-small cell lung cancer (NSCLC), but unfortunately we have to face the situation that most patients still fail to respond in the long term despite initially good control. Up to now, the mechanism of acquired resistance to EGFR-TKIs has not been fully clarified. Herein, we sought to compile the available clinical reports in the hope to better understanding the subsequent treatment choices, particularly on whether restoring after a drug holiday or switching to another EGFR-TKI is the better option after failure of one kind of EGFR-TKI.

• Journal of Welding and Joining
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• 제33권4호
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• pp.30-36
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• 2015

Austenite stainless steel(SA213-TP347H) has widely been used for the superheater & reheater tube in USC(ultra-supercritica) coal boiler because of its high creep rupture strength and anti-oxidation. But recently, the short-term failures have happened frequently in heat affected zone for only 4,000~15,000hours of service. Many investigations have been conducted to understand the failure mechanism. The root cause of failure was comfirmed to "strain induce participation hardening crack" or "reheat cracking". This mechanism often occurred due to weld residual stress and precipitation of the Cr, Nb carbides in the stabilized stainless steel such as TP347H. This paper presents an analysis of failure tube and effect of the sample tubes that conducting stabilizing heat treatment in site after 11,380hours & 16,961hours of service. Visual inspection was performed. In addition, microscopic characteristics was identified by O.M, SEM, and hardness test was carried out to find out the heat treatment effects. Failures seem to happen because of being not conducted stabilizing heat treatment in site. And another cause is inadequate weld parameter such as pass, ampere, voltage, inter-pass temperature. Thus, this paper has the purpose to describe that how to prevent similar failures in those weld-joints.

• Radiation Oncology Journal
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• 제2권2호
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• pp.191-202
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• 1984

Biological behavior and treatment results of 33 patients with Adenoid Cystic Carcinoma (ACC) in the Head and Neck at Yonsei Cancer Confer for 10 years between 1971 and 1980 were retrospectively analysed. Most common, primary site was minor salivary glands such as maxillary sinus, nasal cavity and base of tongue. The typical biological behavior of these tumors was very slowly in growth with long time of duration(mean 19 months) from 1 month to 10 years and more frequent of nerve invasion but rare invasion of neck nodes. Local control and failure pattern in the results of treatment, 16 of 17 patients with irradiation alone were seen complete or partial response but 5 cases of locoregional recurrence, 2 cases of failure of neck node and 4 cases of distant metastasis as lung and brain. On the other hand, among 10 cases of surgery and postoperative irradiation, 2 cases of locoregional failure and 3 cases of distant metastasis as lung and bone. 2 of 4 cases with surgery alone were recurred within primary site. Actuarial overall NED survival at 3 ana 10 years were $52.6\%$ and $42.8\%$, respectively. Survival rate of 10 Patients with surgery and Postoperative irradiation was more high than 17 Patients of radiation alone. Therefore, we have known that surgery with postoperative adjunctive irradiation is most effective treatment modality of adenoid cystic carcinoma in the head and neck. Primary site, treatment modality and with or without nerve ana bone invasion have influenced on prognosis.

• The Journal of Advanced Prosthodontics
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• 제12권5호
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• pp.322-328
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• 2020

PURPOSE. This study evaluated the shear bond strength between 3D printed provisional resin and conventional provisional resin depending on type of conventional provisional resin and different surface treatments of 3D printed resin. MATERIALS AND METHODS. Ninety-six disc-shaped specimens (Ø14 mm × 20 mm thickness) were printed with resin for 3D printing (Nextdent C&B, Vertex-Dental B. V., Soesterberg, Netherlands). After post-processing, the specimens were randomly divided into 8 groups (n=12) according to two types of conventional repair resin (methylmethacrylate and bis-acryl composite) and four different surface treatments: no additional treatment, air abrasion, soaking in methylmethacrylate (MMA) monomer, and soaking in MMA monomer after air abrasion. After surface treatment, each repair resin was bonded in cylindrical shape using a silicone mold. Specimens were stored in 37℃ distilled water for 24 hours. The shear bond strength was measured using a universal testing machine at a crosshead speed of 0.5 mm/min. Failure modes were analyzed by scanning electron microscope. Statistical analysis was done using one-way ANOVA test and Kruskal-Wallis test (α=.05). RESULTS. The group repaired with bis-acryl composite without additional surface treatment showed the highest mean shear bond strength. It was significantly higher than all four groups repaired with methylmethacrylate (P<.05). Additional surface treatments, neither mechanical nor chemical, increased the shear bond strength within methylmethacrylate groups and bis-acryl composite groups (P>.05). Failure mode analysis showed that cohesive failure was most frequent in both methylmethacrylate and bis-acryl composite groups. CONCLUSION. Our results suggest that when repairing 3D printed provisional restoration with conventional provisional resin, repair with bis-acryl composite without additional surface treatment is recommended.

• Restorative Dentistry and Endodontics
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• 제23권1호
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• pp.247-256
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• 1998

To evalutate the change in shear bond strength according to dentin surface treatment, 4 materials were divided into control group(A) and experimental group(B). Group A was treated according to the instruction of manufacture. Group B was treated with 32% phosphoric acid. After dentin surface treatment, each material was bonded and stored in 100% humidity during 7 days, and then, the shear bond strength was evaluated. The results were as follows: 1. In the case of treatment according to the instruction of manufacture, the shear bond strength according to material showed Z-100 to be highest with 12.42 MPa, Compoglass had the lowest shear bond strength with 4.23 MPa and there was significant difference between Compoglass and Z-100, Dyract (p<0.01). 2. The group treated with 32% phosphoric acid showed lower shear bond strength than that of the group treated according to the instruction of manufacture but there was no statistical significance. 3. As a result of observation under SEM, the fracture pattern was a mixture of cohesive and adhesive failure in group 1, and there was more adhesive failure in group 2, and in group 3 and 4 there was cohesive failure of material or tooth structure. From the results above Dyract showed shear bond strength levels between resin and resin -modified glass ionomer but Compoglass showed much lower shear bond strength than that of resin-modified glass ionomer thus indicating that even though they are the same type of material they show evident differences in physical properties. And it is thought that the treatment of dentin surface with phosphoric acid did not increase the shear bond strength, unlike enamel.

• Tuberculosis and Respiratory Diseases
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• 제50권4호
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• pp.473-483
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• 2001

연구배경 : 항결핵제에 의한 치료실패의 원인으로 약제내성균, 환자의 규칙적인 약제 복용, 감염 결핵균 종의 차이, 환자의 면역상태 등이 복합적으로 작용한다. 이에 저자들은 흉부 및 경부결핵환자들은 대상으로 항결핵제에 의한 다각적인 치료실패 원인을 분석하고자 본 연구를 시행하였다. 방 법 : 폐결핵환자 204명과 경부결핵환자 53명을 대상으로, 객담, 경부임파선 및 혈액을 채취하여 결핵균을 배양하고 변역상태를 측정하였다. 인형결핵균과 비인형결핵균의 감별, RFLP 양상 분석 및 항결핵제 감수성검사 등을 시행하였고, IL-$1{\beta}$, IL-12, $IFN{\gamma}$ 및 $TNF{\alpha}$ 등의 혈중 농도를 측정하였다. 항결핵제 치료 후 18개월까지 정기적인 경과관찰을 시행하여 완치 유무를 결정하였다. 결 과 : 결핵균의 RFLP에 따른 결핵의 난치성 여부는 관찰할 수 없었다. 총 204례의 환자들 중 31.9%(65 례)가 난치성으로 판정되었으며 난치군은 평균연령이 비교적 높고, 남자 및 재발 예가 많았다. 65례의 난치원인을 모두 추정할 수 있었으며, 혈중 IL-12 농도저하(59.4%), 다제내성균 (54.7% ), 불규칙한 항결핵제복용(15.4%), 비인형 결핵균(6.2%) 및 중감염 (4.6%) 등의 원인을 관찰할 수 있었다. 완치군과 난치군의 혈중 IL-12의 평균 농도는 $227.6{\pm}78.2$ 및 $148.9{\pm}79.7\;pg/mL$로서 난치군이 유의(p<0.01)하게 낮았다. IL-12는 165.0 pg/mL에서 최대민감도 64.7% 및 최대특이도 75.4%를 나타내였다. 53명의 임파성 결핵환자들은 대부분 완치되어 난치원인을 분석할 수 없었다. 결 론 : 결핵의 난치원인 분석에서 혈중 IL-12 농도 저하 및 약제 내성균에 의한 감염이 가장 주요한 원인으로 간주되었고, 그 외 불규칙한 약복용, 비인형 결핵균에 의한 감염 및 중감염 등의 순으로 나타났다. 한편 국내에서는 균주군에 의한 감염이 빈번하였으나 균주군 및 비균주군에 의한 약제 내성율 차이는 관찰할 수 없었다.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.15-26
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• 2019

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.99-105
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• 2018

Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

• Journal of Chest Surgery
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• 제23권1호
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• pp.95-106
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• 1990

Between May 1979 and April 1989, 213 patients with esophageal injuries visited the Department of the Thoracic and cardiovascular surgery Department, Yonsei University College of Medicine. There were 159 non perforated esophageal injuries accompanied by hematemesis, and 54 perforated esophageal injuries. The causes of non perforated esophageal injuries were Mallory-Weise Syndrome [%], corrosive esophagitis [54], esophageal carcinoma [4], foreign bodies [2], sclerotherapy due to esophageal varices [3]. The causes of perforated esophageal injuries were esophageal anastomosis[13], malignancies[17], esophagoscopy or bougienage[5], chest trauma[5], foreign bodies[5], paraesophageal surgery[3], others[6] In esophageal perforation due to foreign bodies, esophagoscopy or bougienage, there were 6 cervical esophageal perforations and 9 thoracic esophageal perforations. There were no mortalities in the treatment of the cervical esophageal perforations and 5 deaths resulted in the treatment of 9 thoracic esophageal perforations. And four of six patients with thoracic esophageal perforations died in the initiation of treatment over 24 hours, after trauma. There were another 12 deaths in the patients with chest trauma, malignancies or chronic inflammation except esophageal injuries due to foreign bodies or instruments during the hospital stay or less than 30 days after esophageal injuries. One patient with esophageal carcinoma died due to bleeding and respiratory failure after irradiation. Another patient with esophago gastrostomy due to esophageal carcinoma died of sepsis due to EG site leakage. One patient with a mastectomy due to breast cancer followed by irradiation died of sepsis due to an esophagopleural fistula. Two patients with Mallory-Weiss syndrome died; of hemorrhagic shock in one and of respiratory failure due to massive transfusion in the other. One patient with TEF died of respiratory failure and another died of pneumonia and respiratory failure. One patient with esophageal perforation due to blunt chest trauma died of brain damage accompanied with chest trauma.