• Title/Summary/Keyword: trial

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Analysis of Prognostic Factors in Patients with Carcinoma of Uterine Cervix (자궁경부암의 방사선치료시 예후인자의 재분석)

  • Kim Jae Young;Cho Chul Koo;Shim Jae Won;Yoo Seong Yul;Kim Mi Sook;Yun Hyong Geun
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.307-315
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    • 1996
  • Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.

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Radiotherapy of Neck Node Metastases from an Unknown Primary Cancer (원발병소 불명암의 경부림프절 전이에서 방사선치료의 역할)

  • Lee, Jeong-Eun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.219-226
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    • 2007
  • Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.

Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea

  • Yang, J.M.;Bang, S.;Song, S.W.;Youn, B.B.
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.51-66
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    • 1968
  • During a period of about one year(November '66 to December '67), the Yonsei University College of Medicine conducted a field trial of the oral contraceptive(Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang county. We can summarize the outstanding findings from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Most of the reasons for not wanting to use it(352 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs if still in need of a contraceptive methods are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25 of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took one or more tablets we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5 th day as directed for the first three cycles, but the percentages rose sharply to about 80% in later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among acceptors who did not quit between cycles, 80 to 90% were regular users, missing two or less tablets in each cycle. 5) More than 60% of the users felt well and sometimes lost their pre-acceptance symptoms. especially dysmenorrhea. However, 27.4% (58 women) had side effects attributable to the pill compund as nausea, vomiting, indigestion, breast tenderness, decreased lactation or breakthrough bleeding. 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 49.2% (212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months, 6 months and one year, respectively. These rates are lower than in the U.S. studies. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.

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Bladder And Rectum Dose Define 3D Treatment Planning for Cervix Cancer Brachtherapy Comparison of Dose-Volume Histograms for Organ Contour and Organ Wall Contour (자궁경부암의 고선량률 근접치료시 장기묘사 방법에 따른 직장과 방광의 선량비교 분석)

  • Kim, Jong-Won;Kim, Dae-Hyun;Choi, Joon-Yong;Won, Yeong-Jin
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.327-333
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    • 2012
  • Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.

Pulmonary Complications after Surgery for Esophageal Cancer (식도암 수술 후 발생한 호흡기 합병증)

  • Lee, Jang-Hoon;Lee, Jung-Cheul
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.134-139
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    • 2006
  • Background: Complications after surgery for esophageal cancer are various and not rare. Among them, pulmonary complication is well known as one of the most important insults which has negative influence on the postoperative course and results in mortality. So we attempted to analyze the factors which may have relation to postoperative pulmonary complication. Material and Method: The retrospective study was undertaken in 87 patients who underwent curative surgery for esophageal cancer from Jan. 1996 to Aug. 2005. We divided them into two groups, patients with pulmonary complication (group A, n=28), without pulmonary complication (group B, n=59). Statistical analysis was performed with Fisher's exact test. Result: The postoperative pulmonary complication developed in 28 patients ($32\%$). There was no difference between two groups in past medical history, preoperative pulmonary function, surgery time, anastomosis method, pathologic stage, and trial of neoadjuvant therapy. Age and incidence of cervical anastomosis were significantly higher in group A (p=0.001, p=0.023). The rate of routine postoperative ventilator care was significantly higher in group S (p=0.007). Chest tube indwelling time and hospital stay were significantly longer in group A (p=0.011, p=0.001). There were 6 postoperative deaths ($6.8\%$) and 5 deaths were related to pulmonary complication. Pneumonia was the most common cause of death and MRSA (methicillin resistant staphylococcus aureus) was the most common organism in sputum culture. Conclusion: Pulmonary complication after esophageal cancer surgery was the most important cause of death. Pulmonary complication was closely related to patient's age and cervical anastomosis. We think postoperative routine ventilator care is helpful for prevention of pulmonary complications, especially MRSA pneumonia, and reducing mortality.

Comparison of Different Methods of Aortic Valve Conduit Xenograft Preservation in an Animal Experiment Model; Fresh Cryopreservation versus Acellularized Cryopreservation (동물 실험 모델에서 적용한 이종대동맥판막도관의 조직보존방법 비교; 신선 냉동보존과 무세포화 냉동보존)

  • Kim, Chang Young;Kim, Kyung-Hwan;Moon, Kyung Chul;Kim, Woong-Han;Sung, Si-Chan;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.11-19
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    • 2010
  • Background: The commercially used vascular xenografts have some problems such as calcification, fibrosis and tissue degeneration that are associated with inflammatory and immunologic reactions. We compared two methods of xenograft preservation (fresh cryopreservation versus acellularized cryopreservation) of goat aorta. Material and Method: Aortic valved xenografts were harvested from adult pigs, and these were preserved using fresh cryopreservation (FC group, n=4) or acellularized crypreservation (AC group, n=4). These xenografts were implanted into adult goats. There were 2 short-term survivors (less than 100 days) and 2 long-term survivors in each group. These xenografts were explanted and they underwent microscopic examination. Result: The goats survived 31, 40, 107 and 411 days in the FC group and the other goats survived 5, 40, 363 and 636 days in the AC group. All the short-term survivors in each group expired because of rupture at the proximal anastomosis site. Marked neutrophil infiltration was observed in the FC group FC and lymphocytes were observed in the AC group. There were no differences in the occurrence of calcification, fibrosis and thrombosis among the groups. Conclusion: Some goats survived more than 100 days after the xenograft implantation irrespective of the methods of preservation. Because severe tissue degeneration developed in both groups, we think these methods are not appropriate for xenograft preservation of aorta. It was worth a preliminary trial for improving the preservation method or to modify the processing of xenografts.

Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( II ): Mapping of Human Working Memory ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(II): 작업 기억의 지도 작성)

  • Lee, Jae-Sung;Lee, Dong-Soo;Lee, Sang-Kun;Nam, Hyun-Woo;Kim, Seok-Ki;Park, Kwang-Suk;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.238-249
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    • 1998
  • Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

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Effects of Organic TMR with Whole Barley Silage on Feed Intake, Nutrient Digestibility and Blood Characteristics in Korean Black Goats (총체 보리사일리지를 첨가한 유기 TMR 급여가 흑염소의 사료섭취량, 영양소 소화율 및 혈액성상에 미치는 영향)

  • Kim, Kwang-Kook;HwangBo, Soon;Jo, Ik-Hwan
    • Korean Journal of Organic Agriculture
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    • v.15 no.4
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    • pp.413-424
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    • 2007
  • This trial was carried out to determine effects of TMR(Total Mixed Ration) in comparison to conventional diet on feed intake, digestibility, and nitrogen retention in Korean black goats. Twelve Korean black goats were allotted to treatments in four groups of three goats and the they were housed in separate metabolism cages for 21 days. Treatments included conventional diet(A: rice straw and commercial concentrates) as a control group and three TMR groups(B: rice straw and commercial TMR; C: 30% organic whole barley silage and rice straw with organic grain; D: 60% organic whole barley silage with organic grain). The results obtained are summarized as follows. Dry matter intake, fecal excreta, digestible dry matter, metabolic intake and feed intake of BW were significantly higher(p<0.05) compared with A, B, C treatment. The digestibility for most of nutrients except NFC was significantly higher(p<0.05) for D treatment than the others. On the other hand, the digestibility of NFC was higher for B treatment than for the others, even if it was not significantly different across treatments. Nitrogen intake was lower for D treatment, but the significant differences were not found across treatments. N retention rate was higher for B treatment with significant difference. For the blood composition, HDL cholesterol and Immunoglobulin G were significantly higher(p<0.05) for C, D treatment than the others. The results showed that, in comparison with A treatment(conventional diet) and B treatment(commercial TMR), dry matter intake, nutrient digestibility and N retention rate were not lower in C treatment(30% organic whole barley silage) and HDL cholesterol was increased after experiment. Therefore, it could be concluded that TMR with organic whole barley silage might contribute to the production of a high quality and safer meat in goat production.

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Effect of Seeding Date and Varieties of Italian Ryegrass on Forage Yield and Quality of Early Spring-seeded at Paddy Field in Southern Region (남부지역 논에서 봄파종시 이탈리안 라이그라스 품종 및 파종시기가 수량과 사료가치에 미치는 영향)

  • Kim, Ki Soo;Lee, Suk Kyung;Choi, Young Sun;Park, Do Hwan;Ji, Hee Jung;Jung, Jong Seong;Choi, Ki Choon;Kim, Won Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.35 no.1
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    • pp.50-56
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    • 2015
  • Italian ryegrass is generally cultivated by a winter forage in a paddy field, the harvest season overlaps with rice transplantion in some cases. In addition, farmers can miss the optimal seedtime for Italian ryegrass because of the rainy season. Therefore, this research was conducted between October 2012 and June 2013 in Kwangjin, Korea to examine the effect of spring-seeding on the yields and quality of Italian ryegrass for the determination of an alternative if the optimal seedtime is missed. This trial consists of four different seeding dates (15 February, 25 February, 5 March, and 15 March) and three varieties (Kowinmaster, Kowinearly, and Green farm). The Italian ryegrass varieties "Kowinmaster," "Kowinearly," and "Green farm" were sown on February 15. The heading date of each variety showed from May 12 to May 9 and interval time of five days but the Treatment of March 15 planting date showed three days interval. The Kowinmaster variety, planted on February 15, was 93.0 cm taller on March 15 with a height of 105.7 cm. The Kowinearly and Green farm varieties planted on February 15 were of a similar height on February 25 and received a poor lodging score when planted quickly. The dry matter (DM) yield of the Kowinearly planted on February 15 was high but that of Green farm was low at 6,609 kg/ha and a difference was not shown between the varieties. The DM yield was different for those varieties planted on February 15 and March 15 (P<0.05). The crude protein content (CPC) of those varieties planted on February 15 showed an average of 8.8%, while those that were planted on March 15 showed an average that was about 2.3% higher at 11.1%; furthermore, the latter also showed lower acid detergent fiber (ADF) and total digestible nutrient (TDN) contents, by 2.1% and 1.5%, respectively. The relative feed value was about 5.9% higher, depending on the seeding date, as well as being slower and showing less difference between the varieties. According to this study, Italian ryegrass planted in a paddy field of the southern region of Korea on February 25 will produce a high-quantity yield with nutritive value.

Effects of Physically Effective Neutral Detergent Fiber Content of TMR Feed on the Productivity and Carcass Characteristics in Hanwoo (Bos taurus coreanae) Steers (TMR 사료의 물리적 유효 NDF 함량이 한우 거세비육우의 생산성과 도체특성에 미치는 영향)

  • Jeon, Byong Tae;Park, Jae Hyun;Cho, Won Mo;Kim, Sang Woo;Jang, Se Young;Moon, Sang Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.35 no.1
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    • pp.12-16
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    • 2015
  • This study was carried out to evaluate accurately physical characteristics of total mixed rations (TMR) by investigating the effects of physically effective neutral detergent fiber content on the growth performance and carcass characteristics in fattening steers. Twelve Hanwoo (Bos Taurus coreanae) steers aged 26 months were used in this trial. Steers were offered one of two total mixed ration (TMR) diets - High or Low physically effective neutral detergent fiber (peNDF) content groups-that were differentiated by mixing time. The carcass traits of the experimental animals were evaluated by Korea Institute for Animal Products Quality Evaluation (KAPE) after slaughter. Body weight gain during the experimental period was significantly higher (P<0.05) in the High group ($30.00{\pm}10.27kg$) compared with the Low group ($17.20{\pm}6.34kg$), and daily weight gain was also high in the former. Although there was no significant difference, the carcass weight was higher in the High group ($414.60{\pm}34.28kg$) compared with the Low group ($377.80{\pm}11.97kg$). However, the beef quality grade of the Low group ($1^{++}$) was higher than that of the High group ($1^+$). Increases in body weight gain, daily gain, and carcass weight for the High group were mainly influenced by a high level of dry matter (DM) intake and digestibility; consequently, back-fat thickness increased and the beef quality grade was lowered. Because growth performance and carcass characteristics were affected by the physical traits of the diet, we suggested that proper peNDF content is also needed for fattening steers.