PURPOSE: One of the most controversial aspects of surgery for esophageal cancer is the appropriate extent of lymphadenectomy to achieve the best outcome. The purpose of this study was to clarify the effects of an extended lymphadenectomy (complete 2-field lymphadenectomy; complete 2-FL or 3-field lymphadenectomy; 3-FL) in esophageal cancer surgery. MATERIALS AND METHODS: In order to prevent a local recurrence and improve the long-term survival following surgery, an extended lymphadenectomy has systematically been performed at four hospitals of the Catholic University College of Medicine since 1995. And since that time, until the end of 2001, a total of 98 patients have undergone the procedure. Their clinical results were compared with those of 54 esophageal cancer patients who received an incomplete 2-field lymphadenectomy (incomplete 2-FL), between 1990 and 1994, at the same hospitals. RESULTS: After an extended lymphadenectomy a recurrence was noted in 41 cases (44.6%), a local recurrence occurred in 23 cases (25.0%) and a metastatic recurrence in 18 (19.6%), with the 5-year survival rate improved to 39.5%, than the 29% of the incomplete 2-FL. There was no difference in the morbidity of the fatal complications and the mortality between the two groups. CONCLUSION: The long survival rate was improved with an extended lymphadenectomy, but the morbidity and mortality rate had not increased.
Esophageal Neoplasms* ; Humans ; Lymph Node Excision ; Mortality ; Recurrence ; Survival Rate

Myasthenia gravis (MG) is relatively rare occuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150~180 cGy consisting of 10 cGy per fraction, three times a week, for 5~6 weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4~6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy.
Autoimmune Diseases ; Female ; Follow-Up Studies ; Humans ; Immunotherapy ; Myasthenia Gravis* ; Neuromuscular Junction ; Particle Accelerators ; Recurrence ; Thymectomy ; Thymoma* ; Vomiting ; Whole-Body Irradiation*

It was the purpose of present study to develop a new thermoseed for heating deep-seated tumors and assessment of the effect of magnetic control on thermoseeds. Aqueous suspension of iron micro spheres (Ferropolysaccharide) was injected directly into the VX-2 hepatoma and heated with 1.2 MHz inductive radiofrequency unit. Aqueous thermoseed suspension was delivered to the tumor by simple percutaneous injection. The limitation of the thermoseed heating method is the positional change of thermoseed particles in the tumor after implantation. The thermoseed particles could enter the systemic blood circulation and cause a severe embolization of a critical organ. To minimize this limitation, we have used the magnetic control after loading the thermoseed in the tumor. When ferropolysaccharides were exposed to a strong magnetic field, they magnetized and subsequently exerted a magnetic force on each other, forming larger aggregates of particles. The size of aggregated particles were too big to enter the systemic blood circulation. Thus, unlike other thermoseed method, we hold the thermoseed particles stationary in the tumor. The temperature of the injected site and immediate vicinity elevated by 4-5degree C. The temperature of the surrounding normal hepatic tissue elevated by 1-2degree C only. The heating effect within the tumor was variable depending on the density of ferromagnetic aqueous suspension. Our results suggest that inductive heating of tumor injected with ferropolysaccharide solution offers the possibility of effective heat delivery to the defined tumor volume, which is difficult to heat with other heating devices.
Blood Circulation ; Carcinoma, Hepatocellular* ; Fever* ; Heating ; Hot Temperature* ; Iron ; Magnetic Fields ; Magnets ; Tumor Burden

PURPOSE: The changed expressions of TGF-beta1, as a key cytokine in the fibrotic process, due to melatonin with potent antioxidative effects, were investigated in the irradiated lung using fibrosis-sensitive C57BL/6 mice. MATERIALS AND METHODS: Female C57BL/6 mice were divided into control irradiation-only, and melatonin (300 mg/kg i.p. 1 hr before irradiation) pretreatment groups. The thoraces of the mice were irradiated with a single dose of 12 Gy. The mRNA expressions of TGF-beta1 in the lung tissue 2 and 4 weeks after irradiation were quantified using semiquantitive RT-PCR, and the cellular origin and expression levels of TGF-beta1 protein were identified using immunohistochemical staining. RESULTS: The relative mRNA expression levels in the irradiation-only and melatonin pretreatment groups 2 and 4 weeks after irradiation were 1.92- and 1.80-fold (p=0.064) and 2.38- and 1.94-fold (p=0.004) increased, respectively compared to those in the control group. Increased expressions of TGF-beta1 protein were prominently detected in regions of histopathological radiation injury, with alveolar macrophages and septal epithelial cells serving as important sources of TGF-beta1 expression. At 2 and 4 weeks after irradiation, the expression levels of protein were 15.8% vs. 16.9% (p=0.565) and 36.1% vs. 25.7% (p=0.009), respectively. CONCLUSION: The mRNA and protein expressions of TGF-beta1 in the lung tissue following thoracic irradiation with 12 Gy were significantly decreased by melatonin pretreatment at 4 weeks. These results indicate that melatonin may have a possible application as an antifibrotic agent in radiation-induced lung injury.
Animals ; Epithelial Cells ; Female ; Fibrosis ; Humans ; Lung Injury ; Lung* ; Macrophages, Alveolar ; Melatonin* ; Mice ; Radiation Injuries ; RNA, Messenger ; Thorax ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

PURPOSE: The changed expressions of TGF-beta1, as a key cytokine in the fibrotic process, due to melatonin with potent antioxidative effects, were investigated in the irradiated lung using fibrosis-sensitive C57BL/6 mice. MATERIALS AND METHODS: Female C57BL/6 mice were divided into control irradiation-only, and melatonin (300 mg/kg i.p. 1 hr before irradiation) pretreatment groups. The thoraces of the mice were irradiated with a single dose of 12 Gy. The mRNA expressions of TGF-beta1 in the lung tissue 2 and 4 weeks after irradiation were quantified using semiquantitive RT-PCR, and the cellular origin and expression levels of TGF-beta1 protein were identified using immunohistochemical staining. RESULTS: The relative mRNA expression levels in the irradiation-only and melatonin pretreatment groups 2 and 4 weeks after irradiation were 1.92- and 1.80-fold (p=0.064) and 2.38- and 1.94-fold (p=0.004) increased, respectively compared to those in the control group. Increased expressions of TGF-beta1 protein were prominently detected in regions of histopathological radiation injury, with alveolar macrophages and septal epithelial cells serving as important sources of TGF-beta1 expression. At 2 and 4 weeks after irradiation, the expression levels of protein were 15.8% vs. 16.9% (p=0.565) and 36.1% vs. 25.7% (p=0.009), respectively. CONCLUSION: The mRNA and protein expressions of TGF-beta1 in the lung tissue following thoracic irradiation with 12 Gy were significantly decreased by melatonin pretreatment at 4 weeks. These results indicate that melatonin may have a possible application as an antifibrotic agent in radiation-induced lung injury.
Animals ; Epithelial Cells ; Female ; Fibrosis ; Humans ; Lung Injury ; Lung* ; Macrophages, Alveolar ; Melatonin* ; Mice ; Radiation Injuries ; RNA, Messenger ; Thorax ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

The usefulness of hypertemie for cancer therapy have well been established. The purpose of the present investigation was to ascess the effect of step-up (42 degrees C -> 44 degrees C sequence ) and step-down (44 degrees C -> 42 degrees C sequence) heating on the skin of the hind foot of the mouse. Hyperthermic treatments were given by immersion the hind foot of the mouse in circulating water baths. Skin response was studied by the leg reaction, which was scored according to a numerical scoring system proposed by Urano et al (1980). The results were as follws 1.The sking damage of 44 degrees C control group was more severe than 42degree C control group (p<0.0.5), except for 15min. heating group. 2. The skin damage of step-down group was more severe than step-up group (p<0.0.5). 3. The skin damage of 44 degrees C control group was more severe than step-up group when there is no difference in 44 degrees C heatingtime of step-up group from 44degree C control group (p<0.0.5). 4. In step-down group, the skin damage was more severe than 44degree C control group after preheating 45 min at 44 degrees C (p<0.0.5). Therefore, the above findings suggest the normal tissue damaged by step-up heating was correlated with heating time of post step-up. The dropping of heating temperature in late phase had more severe damage of the skin than that in early phase during hyperthermia, and so contineous control of satisfactory temperature should be considered as the one of the most important factor for prognosis, complications of clinical hyperthermia
Animals ; Baths ; Fever* ; Foot ; Heating ; Hot Temperature ; Immersion ; Leg ; Mice* ; Prognosis ; Skin* ; Water

This paper describes the basic date measurements for total body irradiation with 6 Mv photon beam including compensators designs. The technique uses bilateral opposing field with tissue compensators for the head, neck, lungs, and legs from the hip to toes. In vivo dosimetry was carried out for determining absorbed dose at various regions in 7 patients using diode detectors (MULTIDOSE, Model 9310, MULTIDATA Co., USA). As a results, the dose uniformity of+/-3.5%(generally, within+/-10%) can be achieved with our total body irradiation technique.
Head ; Hip ; Humans ; Leg ; Lung ; Neck ; Toes ; Whole-Body Irradiation*

PURPOSE: To improve the treatment results of locally advanced nonsmallcell lung cancer (NSCLC) patient, we treated those paients with regional hyperthermia combined with radiotherapy. And we conducted a retrospective analysis of the results. METHODS AND MATERIALS: Thirty two nonsmall cell lung cancer patients treated at the Department of Radiation Oncology, St. Mary's hospital. Catholic University Medical College were the base of this analysis. Fourteen patients of above them were treated with hyperthermia and radiotherapy of more than 3000 cGy in radiation dose. Radiofrequency capacitive hyperthermia was administered twice weekly, immediately after radiotherapy. Total sessions of hyperthermia ranged from 3 to 13 times (mean 7,8). Eighteen patient received an external radiation therapy alone. Median radiation dose was 5580 cGy (range, 3000-7000 cGy) in fraction of 180-300 cGy, 5 fractions per week. RESULTS: The results of themoradiotherapy group (HTRT group) were compared with radiation alone group (RT group). There were no complete response (CR) and 12 partial responses (PR) (CR rate 0%, response rate 85.7%) in HTRT group, whereas there were 2 CRs, 8 PRs and 8 no responses (CR rate 11.1%, response rate 55.6%) in RT group. There was significant differece in local response rate of the tumors between RT group and HTRT group (p<0.05). Overall 2 year survival rate and mean survival were 7.1% and 10.5 months for HTRT group, and 0% 8.1 months for RT group. However, by the number of hyperthermia, in cases with more than or equal to 10 sessions of hyperthermia, there were significant improvement in 2 year survival rate and mean survival (40.0% and 18.2 months) compared with those in cases with less than 10 sessions of hyperhtemia (7.4% and 7.4 months) (p<0.05). CONCLUSION: Thermoradiotherapy in locally advanced NSCLC patients increased their response rate but not 2 year survival and mean survival, therefore thermoradiotherpy with enough number of hyperthermia is suggested that may be one of the effective palliative treatments of those patients. And in cases with more than 10 sessions of hyperthermai, there showed improved 2 year survival rate and mean survival. But the number of the cases was small, further study in this aspect is required.
Carcinoma, Non-Small-Cell Lung* ; Fever ; Humans ; Lung Neoplasms ; Palliative Care ; Radiation Oncology ; Radiotherapy ; Retrospective Studies ; Survival Rate

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*

Currently, many computer systems are used in many areas of medicine including radiation oncology. For the most part, the computer system has proved to be useful in radiotherapeutic planning and dose calculation. There has been attempts to develop computer system including information management of patients, patient tracing, and office automation in radiation oncology department. But some of these available commercial systems have shortcomings. We developed a management system of patients in our radiation oncology department that integrated most of items for the evaluation of patents. In particular, the data were stored in a natural language (noncoded) and made themselves easily understandable by all clinical groups. In addition, the data could be isolated in files from which the computer could generate graphs and static data by the use of some simple commands. The system provided us with not only the functions of case review but functions of preparation of conferences, lectures and resident teaching.
Computer Systems ; Congresses as Topic ; Humans ; Information Management ; Lectures ; Office Automation ; Radiation Oncology*