Benign prostatic hyperplasia (BPH )is one the most common prostate diseases in middle aged and elderly men. This study was conducted to investigate diet and lifestyle risk factors for benign prostatic hyperplasia in a community-dwelling free-living population group. The dietary data were collected from the 601 male subjects aged 50 -79 years using the 24-hour recall method. The mean age of the BPH group (63.0 +/- 7.9 years )was significantly higher than that of the non-BPH (58.8 +/-7.4 years ). Among many nutrients, the amount of animal fat intake was increased while that of carbohydrate intake decreased in subjects with BPH compared to those with non-BPH. In BPH subjects, the proportion of energy from fat was also greater than in subjects with non-BPH. The logistic regression analysis on the food con-sumption data showed that the consumption of total animal food was increased while that of mushrooms was decreased in patients with BPH compared to the subjects with non-BPH. The age-adjusted odds ratios and 95% confidences limits for BPH incidence in subjects whose milk and milk products, beverages and alcoholic liquors intake was greater than the median were 1.796 (1.167 -2.782 )and 1.738 (1.129 -2.676 )respectively, compared to those in subjects whose intakes were below the median. These results may be applicable in the development of a nutrition intervention and education program toward a reduction in the risk for benign prostatic hyperplasia.
Agaricales ; Aged ; Alcoholics ; Animals ; Beverages ; Diet* ; Education ; Humans ; Incidence ; Life Style* ; Logistic Models ; Male ; Middle Aged ; Milk ; Odds Ratio ; Population Groups ; Prostate ; Prostatic Hyperplasia* ; Risk Factors*

To irradiate the entire neuroaxis, bilateral parallel opposed brain fields and direct posterior spinal field have been utilized and radiation dose at the junction between abutting fields has been extensilvely studied. And several workable methods were reported to achieve uniform dose at a desired depth at the junction between abutting fields whose central axis are coplanar. But the dose distribution at the junction of orthogonal fields has been a persistent problem in radiation oncology. Author describes a new method to solve the junction problem between abutting fields whose central axis are orthogonal. Author utilized split beam/comllimator rotation or collimator/couch rotation to avoid hot or cold spots that may arise from beam divergence. Author achieved accurate and homogeneous dose distribution by matching the 50% isodose line at the junction between orthogonal central axis beam fields.
Axis, Cervical Vertebra ; Brain ; Craniospinal Irradiation* ; Radiation Oncology

Authors have developed highly reproducible calibration method for the Micro-Selection HDR Ir-192 system(Nucletron, Netherland). The new jig has a 10cm radius circular hole in the 30cm x 30cm x 0.2cm acrylic plate, and 5F flexible bronchial tubes are attached around the hole. The source moves along the circle in the tubes an? the ionization chamber is placed vertically at the center of the circular hole(center of the jig). Dose distribution near the center was derived theoretically, and measured with the film dosimetry system. Theoretical calculation and measurement show the error margin below 0.1% for 1mm or 2mm position deviation. We have measured at 12 and 24 points of circle with 1, 6, 11 and 21 second dwell time of source in order to calculate the activity of the source. Measurements have been repeated daily for 50 days. The accuracy and the reproducibility are below 1% error margin. The half life of the source from our measurement is estimated 73.4+/-0.4 days.
Calibration* ; Film Dosimetry ; Half-Life ; Radius

The Comparison of the KAPM Dosimetric Protocol (1990) with the TG-21 and Clambda/C(E) (ICRU-21 and SCRAD protocol) method is studied. The therapetutic range of radiation (photon 4MV-15MV and electron 6MeV-20MeV)and three kinds of the chambers were used in the water phantom. The Results from TG-21 and KAPM Protocol did not show much differences (less than 1%) throughout the whole energy range; N(D) from KAPM protocol and Ngas from TG-21 showed 0.2% deviation mainly from W/e difference between two protocols. But the results from KAPM protocol (1990) and those from Clambda/C(E) Method showed -1.9+/-0.6%(KAPM protocol is higher) deviation for photom beam and +3.3+/-1% (KAPM protocol is lower) deviation for electron beams.
Water

In breast cancer, the treatment volume presents a relatively complex three dimensional structure. Effective radiation therapy requires the delivery of adequate dose to a large target volume using complex beam arrangements. The technique proposed here is our department's method using asymmetric jaw with appropriate couch, collimator and gantry rotation. This technique has the following advantages: 1) all treatments are given in a single clinical set up 2) it dose not require half beam blocks 3) it produces exact geometric match 4) it is very convenient and easy to use 5) it has daily reproducibility.
Breast Neoplasms* ; Breast* ; Jaw

Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 mg/M2/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery(group I), 29 patients were treated with radiotherapy only(groupII) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, 95% response rate with complete response (CR) 47.5% and partial response (PR) 47.5%, was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was 84% (47/56) with 26/27 (96%) in groupI achieved CTC with surgery and 21/29 (72%) patients in group II achieved CTC following 2nd phase. 67% of primary lesions and 70% of nodal diseases in group I showed no tumor in the surgical specimen. 34% of patients who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was 59% and 51% (24/27) of patients who achieved CTC at End phase were alive without any evidence of disease at Median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between groupI and II, between CR and PR group following 1st phase. Only significant prognostic factor in this study was the complete tumor clearance following 2nd phase therapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.
Carcinoma, Squamous Cell* ; Cisplatin* ; Disease-Free Survival ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Neck* ; Pilot Projects ; Radiation-Sensitizing Agents ; Radiotherapy ; Recurrence

Maternal nutritional status has been shown to influence pregnancy outcomes. And the elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes. We investigated the effects of maternal serum levels of B vitamins and homocysteine, and the C677T MTHFR (5, 10-methylenetetrahydrofolate reductase) polymorphism on pregnancy outcomes. In 177 pregnant women of 24-28 wks of gestation, the MTHFR gene mutation, serum B vitamins and homocysteine concentrations were measured, and their pregnancy outcomes were investigated from medical records. The birth length, and 1- and 5-min Apgar scores of neonates in the T/T mothers were 45.4+/-9.3 cm, 7.6+/-3.2 and 8.5+/-3.8, respectively, which were significantly lower than those in the C/T (48.6+/-3.3 cm, 9.0+/-0.2, 10.0+/-0.2) or the C/C mothers (49.4+/-1.9 cm, 9.0+/-0.2, 10.0+/-0.0). The birth weight, birth length and the gestational age of neonates at delivery from hyperhomocysteinemic mothers whose homocysteine levels higher than 15 micromol were 2.5+/-1.3 kg, 43.9+/-9.0 cm, 35.4+/-6.3 wk, respectively, which were significant lower than those from normohomocysteinemic mothers (3.1+/-0.6 kg, 48.8+/-3.6 cm, 38.5+/-2.5 wk). The birth weight and birth length of neonates in mothers whose PLP levels were below the median were significantly lower than those from mothers with the PLP levels above the median. The 1- and 5-min Apgar scores of neonates were lower in mothers with the T/T MTHFR genotype than those with the C/T or C/C only when the serum PLP levels were below the median. The 1-, 5 min Apgar scores and birth length of neonates were lower in mothers with the T/T MTHFR genotype than those with the C/T or C/C only when the serum FMN levels were below the median. In conclusion, maternal B vitamin status, homocysteine and the C677T MTHFR genotype seem to have played an important role on pregnancy outcomes.
Birth Weight ; Female ; Flavin Mononucleotide ; Folic Acid ; Genotype ; Gestational Age ; Homocysteine* ; Humans ; Infant, Newborn ; Medical Records ; Mothers ; Nutritional Status ; Oxidoreductases* ; Parturition ; Plasma ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnant Women ; Vitamin B Complex* ; Vitamins

PURPOSE: To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and lll rectal cancer who had undergone curative resection were randomized to early radiotherapy group (arm I) or 'late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. MATERIALS AND METHODS: From January 1996 to March 1999, 3 13 patients with curatively resected stages II and III rectal cancer have been randomized to early' or late radiation therapy group and recei ved combined chemotherapy (5-FU 375 mg/m/day, leucovorin 20 mg/m, IV bolus daily D1-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was performed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. RESULTS: Local recurrence occurred in 11 patients (9.7%) for arm I and 9 patients (8%) for arm II. There was no significant difference between both groups (p=0.64). However, distant metastasis was found in 22 patients (19.5%) for arm I and 35 patients (31.0%) for arm II and which showed statistically significant difference between the two groups (p=0.046). And neither 3-year disease-free survival (70.2% vs 59.2%, p=0.2) nor overall survival (89.4% vs 88.0%, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3% and 79.9% respectively but leukopenia more than RTOG grade 3 was only 2.1% and 6.0% respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2% vs 4 1.6%, p=0.02) but this complication was controlled with supportive cares. CONCLUSION: Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy a fter curative resection for rectal cancer, local recurrence rate was low with combined chemoradiotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.
Arm ; Chemoradiotherapy ; Chemotherapy, Adjuvant* ; Compliance ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Leucovorin ; Leukopenia ; Neoplasm Metastasis ; Pelvis ; Prospective Studies* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Recurrence ; Survival Rate

PURPOSE: The human genetic disorder ataxia-telangiectasia (AT) is a multisystem disease characterized by extreme radiosensitivity. The recent identification of the gene mutated in AT, ATM, and the demonstration that it encodes a homologous domain of phosphatidylinositol 3-kinase (PI3-K), the catalytic subunit of an enzyme involved in transmitting signals from the cell surface to the nucleus, provide support for a role of this gene in signal transduction. Although ionizing radiation was known to induce c-fos transcription, nothing is known about how ATM or PKCI mediated signal transduction pathway modulates the c-fos gene transcription and gene expression. Here we have studied the effect of PKCI on radiation sensitivity and c-fos transcription in normal and AT cells. MATERIALS AND METHODS: Normal (LM217) and AT (AT5BIVA) cells were transfected with PKCI expression plasmid and the overexpression and integration of PKCI was evaluated by northern blotting and polymerase chain reaction, respectively. 5 Gy of radiation was exposed to LM and AT cells transfected with PKCI expression plasmid and cells were harvested 48 hours after radiation and investigated apoptosis with TUNEL method. The c-fos transcription activity was studied by performing CAT assay of reporter gene after transfection of c-fos CAT plasmid into AT and LM cells. RESULTS: Our results demonstrate for the first time a role of PKCI on the radiation sensitivity and c-fos expression in LM and AT cells. PKCI increased radiation induced apoptosis in LM cells but reduced apoptosis in AT cells. The basal c-fos transcription activity is 70 times lower in AT cells than that in LM cells. The c-fos transcription activity was repressed by overexpression of PKCI in LM cells but not in AT cells. After induction of c-fos by Ras protein, overexpression of PKCI repressed c-fos transcription in LM cells but not in AT cells CONCLUSION: Overexpression of PKCI increased radiation sensitivity and repressed c-fos transcription in LM cells but not in AT cells. The results may be a reason of increased radiation sensitivity of AT cells. PKCI may be involved in an ionizing radiation induced signal transduction pathway responsible for radiation sensitivity and c-fos transcription. The data also provided evidence for novel transcriptional difference between LM and AT cells.
Animals ; Apoptosis ; Ataxia Telangiectasia ; Blotting, Northern ; Catalytic Domain ; Cats ; Gene Expression ; Genes, fos ; Genes, Reporter ; Humans ; In Situ Nick-End Labeling ; Phosphatidylinositol 3-Kinase ; Plasmids ; Polymerase Chain Reaction ; Protein Kinase C* ; Protein Kinases* ; Radiation Tolerance* ; Radiation, Ionizing ; Signal Transduction ; Transfection

PURPOSE: Intracranial germinoma is the most radiocurable tumor of the primary intracranial neoplasm. But, the optimum radiation dose and target volume remain controversial. In this retrospective study, we analysed the spreading pattern at presentation and the pattern of the failure and survival of intracranial germinoma. MATERIALS AND METHODS: From 1989 to 1996, 23 patients were treated for intracranial germinoma at Department of Radiation Oncology. Twenty-one patients were treated at their initial presentation and 2 patients were treated for recurrent disease. Six patients had multiple tumor masses on MRI and 7 patients had ventricular seeding on MRI. The examination of cerebrospinal fluid cytology was done in 15 patients and 3 out of 15 patients had positive cerebrospinal cytology. In tumor marker study of alpha-FP and beta-hCG, 6 patients had mildly elevated beta-hCG in serum or cerebrospinal fluid. Twenty-one patients were treated with whole craniospinal axis irradiation and 2 patients were given whole ventricular radiation therapy. The total dose was ranged between 4500cGy and 5600cGy to primary tumor site (median 5580 cGy). Dose to the entire ventricular system ranged from 1980cGy to 3960 cGy (median 2700cGy) and dose to the spinal axis ranged from 2160cGy to 3900cGy (median 2700cGy). RESULTS: Of 23 patients, 21 patients are alive without evidence of disease for median 4 years follow-up. One patient who had markedly elevated alpha-FP and beta-hCG suffered from persistent disease after radiation therapy and received 2 cycles of chemotherapy. She died 9 months after chemotherapy. One patient who developed ventricular seeding after gamma-knife was treated with whole craniospinal irradiation, he died after 1 year due to probably brain necrosis. The hematologic toxicity of 3 or 4 grade were seen in 7 patients, and patient's endocrinologic dysfunction was not deteriorated after radiation therapy. One patient had been treated with growth hormone replacement due to short stature. CONCLUSIONS: This retrospective study has confirmed the excellent result of radiation therapy in intracranial germinoma. The complication rate during or after radiation therapy is considered within acceptable range. It is necessary to further investigate the optimal dose and treatment volume of radiation therapy. The role of chemotherapy in the treatment of intracranial germinoma should be further investigated.
Axis, Cervical Vertebra ; Brain ; Brain Neoplasms ; Cerebrospinal Fluid ; Craniospinal Irradiation ; Drug Therapy ; Follow-Up Studies ; Germinoma* ; Growth Hormone ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Radiation Oncology ; Retrospective Studies