PURPOSE: To evaluate the role of fractionated stereotactic radiotherapy (FSRT) in the management of benign brain tumors, we reviewed the clinical, and radiographic responses of patients treated. METHODS AND MATERIALS: Between March 1996 and March 2002, 36 patients with benign brain tumors were treated by FSRT. The pathological diagnoses consisted of pituitary adenomas (12 patients), craniopharyngiomas (5 patients), meningiomas (10 patients), and acoustic neurinomas (9 patients). Radiotherapy doses of 25 to 35 Gy (3~6 Gy/fraction, 5~10 fractions) were prescribed to the 85~90% isodose line, depending upon the location, size and volume of the tumors. The median clinical and radiographical follow- up periods were 31 (range, 2~74) and 21 (range, 4~56) months, respectively. RESULTS: In the 35 patients that could be evaluated for their clinical response, 13 (37.1%) were considered improved, 16 (45.7%) stable and 6 (17.2%) worse. Of the 33 patients who had radiographic studies, tumor shrinkage was noted in 17 (51.5%), tumor stabilization in 13 (39.4%), and tumor progression in 3 (9.1%). Of the 17 tumor shrinkage patients, 7 (21.2%) showed a complete response. Acute radiation-induced complications occurred in 11 (30.6%) patients. CONCLUSION: FSRT is considered a safe and effective treatment method for benign brain tumors, but large numbers of patients, with relatively long follow-up periods are needed to assess the exact role or effect of FSRT.
Brain Neoplasms* ; Brain* ; Craniopharyngioma ; Diagnosis ; Follow-Up Studies ; Humans ; Meningioma ; Neuroma, Acoustic ; Pituitary Neoplasms ; Radiotherapy*

PURPOSE: To evaulate the effects of chlorhexidine and H2O2 on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase(TIMP-1, TIMP-2), Type 1 collagen, fibronectin and UNCL expressions in human periodontal ligament fibroblasts (hPDLF). MATERIALS AND METHODS: 1.2x10(-1)%, 1.2x10(-2)% and 1.2x10(-3)% CHX and 3x10(-3)%, 3x10(-4)% and 3x10(-5)% H2O2 and mixture of CHX and H2O2 were applied to hPDLF for 1 min and 30 min. The mRNA expressions of MMP-1, TIMP-1 and 2, Type 1 collagen, fibronectin and UNCL in hPDLF were analysed by RT-PCR. RESULTS: The result were as follows: 1. The expression of UNCL mRNA was higher than that of other mRNAs. 2. 1.2x10(-3) % CHX increased mRNA expressions of hPDLF as application time increased. 3. H2O2 lower than 3x10(-3) % increased expression of UNCL mRNA, and did not decrease mRNA expression of hPDLF. 4. hPDLF treatment with 1.2x10(-1) % CHX (with or without H2O2) resulted in no gene expression. 5. hPDLF treatment with 1.2x10(-2) % CHX (with or without H2O2) for 30 minutes resulted in no gene expression. CONCLUSION: Because low concentration of CHX and H2O2 increased UNCL mRNA expression of hPDLF, low concentraction of CHX and H2O2 may have an antioxidative effect.
Chlorhexidine ; Collagen Type I ; Fibroblasts ; Fibronectins ; Humans ; Matrix Metalloproteinase 1 ; Periodontal Ligament ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

Gingival fibroblasts(GF) and periodontal ligament fibroblasts(PDLF) are the major cellular components of periodontal soft connective tissues, but the precise molecular biological differences between these cells are not yet known. In the present study, we investigated the expression of S100A4, S100A2 calcium-binding protein and osteoblast-specific factor 2(OSF-2, Periostin) mRNA in GF and PDLF in vitro through the process of reverse transcription-polymerase chain reaction(RT-PCR) and Northern blot analysis in each. Human GF and PDLF were isolated from the gingival connective tissue and the middle third of freshly extracted healthy third molars. They were cultured in Dulbecco's Modified Eagle Medium(DMEM) containing 10% fetal bovine serum and cells in the third passage were used in the experiments. After extracting total RNA from cultured cells, RT-PCR and Northern analysis were performed using S100A4-, S100A2- and Periostin-specific oligonucleotide primers and subcloned cDNA probes in each. In RT-PCR and Northern analysis, the expression of S100A4 and Periostin mRNA in GF was slightly detectable. Interestingly, the expression of S100A4 and Periostin mRNA in PDLF was much higher than that in GF. On the other hand, S100A2 mRNA was highly expressed in both GF and PDLF. Since there was a marked difference of S100A4 and Periostin expression between GF and PDLF in vitro, these data suggest that S100A4 and Periostin could be used as a useful marker for distinguishing cultured gingival fibroblasts and periodontal ligament cells.
Blotting, Northern ; Carrier Proteins* ; Cells, Cultured ; Connective Tissue ; DNA Primers ; DNA, Complementary ; Eagles ; Fibroblasts* ; Hand ; Humans* ; Molar, Third ; Periodontal Ligament* ; RNA ; RNA, Messenger*

In total body irradiation (TBI) for leukemia, we have a two methode. One is a AP (anterior-posterior) method and the other is a Lateral methode. Our hospital used lateral methode. TBI must consider about body contour, because of homogeneous dose distribution. For compensation about irregular body contour, we use compensator. For TBI treatment, we must be considered, accurate manufacture of compensator and accurate calculation of dose. We developed the automatic program for TBI. This program accomplished for compensator design and dose calculation for irregular body. This program was developed for uses to use in a windows environment using the IDL language. In this program, it use energy data for each energy: TMR, output factor, inverse square law, spoiler, field size factor. This program reduces the error to happen due to the manual. As a development of program, we could decrease the time of treatment plan and care the patient accurately.
Compensation and Redress ; Humans ; Jurisprudence ; Leukemia ; Whole-Body Irradiation*

Reactive oxygen species (ROS) have been implicated in the pathogenesis of various diseases. And vitamin C has shown a protective effect for the tissues. The aim of this study was to evaluate the effects of H2O2 and ascorbic acid on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase (TIMP: TIMP-1, TIMP-2), Type 1 collagen, fibronectin, and PDLs22 level in human periodontal ligament fibroblasts (hPDLF) via reverse transcription-polymerase chain reaction (RT-PCR). hPDLF was obtained from a healthy periodontium and cultured in Dulbecco's modified Eagles's medium plus 10% fetal bone serum. The concentration of ascorbic acid in hPDLF was 50 microgram/ml, and that of H2O2 in hPDLF was 0.03% and 0.00003%. Ascorbic acid only, H2O2 only and mixture of ascorbic acid and H2O2 were applied with hPDLF for 1-, 3-, and 30-min., respectively. The gene expression of MMP-1-, TIMP-1-, TIMP-2-, Type 1 collagen-, fibronectin-, and PDLs22-mRNA in hPDLF was analysed via RT-PCR. The results were as follows; 1. hPDLF in response to 30-min. incubation with 0.03% H2O2 did not show any gene expression. 2. In all the experimental groups, the gene expression of fibronectin mRNA showed the decreased tendency compared to control. 3. In all the experimental groups, the gene expression of TIMP-1 mRNA showed the tendency similar to control. 4. hPDLF in response to 30-min. incubation with 0.03% H2O2 and ascorbic acid increased mRNA induction for MMP-1. 5. In all the experimental groups, hPDLF increased mRNA induction for PDLs22, collagen type I, and TIMP-2 compared to control. Within the limited experiments, H2O2 and ascorbic acid increased mRNA induction for PDLs22, collagen type I, and TIMP-2 in hPDLF. More research will be needed in order to confirm the relative importance of the different roles of ROS and antioxidants in hPDLF from a periodontal regeneration or repair standpoint.
Antioxidants ; Ascorbic Acid* ; Collagen Type I* ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans* ; Matrix Metalloproteinase 1 ; Periodontal Ligament* ; Periodontium ; Reactive Oxygen Species ; Regeneration ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2*

Autonomic dysfunction commonly occurs in Parkinson's disease, but the pathogenesis of autonomic dysregulation remains uncertain. Autonomic functions regulating the cardiovascular system have been investigated in Parkinson's disease, but those involving the extremities has not been well demonstrated. To compare autonomic dysfunctions of the cardiovascular system with those of the extremities, we performed sympathetic skin response (SSR) and cardiovascular autonomic function tests (CAFT) - 30:15 ratio, E:I ratio, Valsalva ratio, isometric exercise test (IET) - in 37 patients with Parkinson's disease and 33 age- and sex-matched healthy controls. The patients were asked to stop antiparkinsonian medications for at least 12 hours prior to the tests. SSR was measured at the right hand and foot after electrical stimulation of the right median and posterior tibial nerves. Absent SSR at either one or both extremities and CAFT beyond normal ranges were regarded as abnormal. Abnormal SSR was observed in 59% of patients, while abnormal CAFT were found in the range of 32%-81%. Patients with abnormal SSR showed more frequent and severe CAFT abnormalities than did patients with normal SSR. Among the CAFT, IET was well correlated with the SSR. The results suggest that parkinsonian sympathetic dysfunction involving either the cardiovascular system or the extremities may have the same pathophysiology.
Adult ; Aged ; Aged, 80 and over ; Autonomic Nervous System/physiopathology* ; Cardiovascular System/innervation* ; Extremities/innervation ; Female ; Galvanic Skin Response/physiology* ; Human ; Male ; Middle Age ; Parkinson Disease/physiopathology*

PURPOSE: To retrospectively evaluate the outcome and toxicity of total lymphoid irradiation (TLI) based conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in severe aplastic anemia (SAA) patients who experienced an engraftment failure from prior HSCT or were heavily transfused. MATERIALS AND METHODS: Between 1995 and 2006, 20 SAA patients received TLI for conditioning of HSCT. All patients were multi-transfused or had long duration of disease. Fifteen (75%) patients had graft failure from prior HSCT. In 18 (90%) patients, the donors were human leukocyte antigen identical siblings. The stem cell source was the peripheral blood stem cell in 15 (75%) patients. The conditioning regimen was composed of antithymocyte globulin plus TLI with a median dose of 750 cGy in 1 fraction. The graft-versus-host disease (GVHD) prophylaxis used cyclosporine with methotrexate. RESULTS: With a median follow-up of 10.8 years, graft failures developed in 6 patients. Among them, 3 patients received their third HSCT to be engrafted finally. The Kaplan-Meier overall survival rate was 85.0% and 83.1% at 5 and 10 years, respectively. The incidence of acute and chronic GVHD was 20% and 20%, respectively. None of the patients have developed a malignancy after HSCT. CONCLUSION: In our study, TLI based conditioning in allogeneic HSCT was feasible with acceptable rates of GVHD in SAA patients who experienced graft failure from prior HSCT or was at a high risk of graft rejection. We achieved relatively better results of engraftment and survival with a long term follow-up.
Anemia, Aplastic ; Antilymphocyte Serum ; Cyclosporine ; Follow-Up Studies ; Graft Rejection ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Incidence ; Leukocytes ; Lymphatic Irradiation ; Retrospective Studies ; Siblings ; Stem Cells ; Survival Rate ; Tissue Donors ; Transplants

PURPOSE: We retrospectively reviewed the results of radiotherapy for localized ocular adnexal MALT lymphoma (OAML) to investigate the risk factors of cataract. METHODS: Sixty-seven patients with stage IE OAML treated with radiotherapy at Seoul St. Mary's Hospital from 2001 to 2016 were included. Median treatment dose was 30 Gy. Lens protection was done in 52 (76%) patients. Radiation therapy (RT) extent was as follows: superficial (82.1%), tumor mass (4.5%), and entire orbital socket (13.4%). The risk factors for symptomatic cataract were analyzed using the Cox proportional hazard model. RESULTS: Median follow-up time was 50.9 months (range, 1.9 to 149.4 months). All patients were alive at the time of analysis. There were 7 recurrences and there was no local recurrence. Median time to recurrence was 40.4 months. There were 14 cases of symptomatic cataract. Dose >30 Gy had hazard ratio of 3.47 for cataract (p = 0.026). Omitting lens protection showed hazard ratio of 4.10 (p = 0.008). CONCLUSIONS: RT achieves excellent local control of ocular MALT lymphoma. Consideration of RT-related factors such as lens protection and radiation dose at the stage of RT planning may reduce the risk of RT-induced cataract after radiotherapy.
Cataract* ; Follow-Up Studies ; Humans ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Orbit ; Proportional Hazards Models ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Risk Factors ; Seoul ; Treatment Outcome*

PURPOSE: We retrospectively reviewed the results of radiotherapy for localized ocular adnexal MALT lymphoma (OAML) to investigate the risk factors of cataract. METHODS: Sixty-seven patients with stage IE OAML treated with radiotherapy at Seoul St. Mary's Hospital from 2001 to 2016 were included. Median treatment dose was 30 Gy. Lens protection was done in 52 (76%) patients. Radiation therapy (RT) extent was as follows: superficial (82.1%), tumor mass (4.5%), and entire orbital socket (13.4%). The risk factors for symptomatic cataract were analyzed using the Cox proportional hazard model. RESULTS: Median follow-up time was 50.9 months (range, 1.9 to 149.4 months). All patients were alive at the time of analysis. There were 7 recurrences and there was no local recurrence. Median time to recurrence was 40.4 months. There were 14 cases of symptomatic cataract. Dose >30 Gy had hazard ratio of 3.47 for cataract (p = 0.026). Omitting lens protection showed hazard ratio of 4.10 (p = 0.008). CONCLUSIONS: RT achieves excellent local control of ocular MALT lymphoma. Consideration of RT-related factors such as lens protection and radiation dose at the stage of RT planning may reduce the risk of RT-induced cataract after radiotherapy.
Cataract* ; Follow-Up Studies ; Humans ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Orbit ; Proportional Hazards Models ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Risk Factors ; Seoul ; Treatment Outcome*

PURPOSE: The purpose of this animal study was to perform a histological and histomorphometric analysis in order to elucidate the effect of fibroblast growth factor-2 (FGF-2) on injured periodontal ligament (PDL) and cementum after tooth replantation in dogs. METHODS: The roots of 36 mandibular premolars from six mongrel dogs were used in this study. The roots were randomly divided into three groups: (1) a positive control group (n=12), in which the PDL was retained; (2) a negative control group (n=12), in which the PDL and the cementum between the notches were removed; and (3) an experimental group (n=12), in which the PDL and the cementum between the notches were removed and the roots were soaked in an FGF-2 solution (30 microg/0.1 mL). After treating the root surfaces, the extracted roots were replanted into extraction sockets. The animals were sacrificed four and eight weeks after surgery for histologic and histomorphometric evaluation. RESULTS: At four and eight weeks, normal PDLs covered the roots in the positive control group. In the negative control group, most replanted roots showed signs of replacement resorption. In the experimental group, new PDL-like tissue and cementum-like tissue were observed to partially occupy the region between the root surfaces and the newly formed bone. Histomorphometric analysis showed that the mean length of the newly formed cementum-like tissue on the roots treated with FGF-2 was significantly greater than that of the tissue on the roots in the negative control group (four weeks, P=0.008; eight weeks, P=0.042). However, no significant differences were observed between the roots treated with FGF-2 and the negative control roots with respect to newly formed PDL-like tissue. CONCLUSIONS: The results of this study suggest that use of FGF-2 on injured root surfaces promotes cementogenesis after tooth replacement in dogs.
Animals ; Bicuspid ; Cementogenesis ; Dental Cementum* ; Dogs* ; Fibroblast Growth Factor 2 ; Fibroblast Growth Factors* ; Periodontal Ligament* ; Periodontium ; Regeneration ; Tooth ; Tooth Replantation*