PURPOSE: This study was performed to evaluate survival, failure patterns, and prognositc factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. MATERIALS AND METHODS: A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy form June 1985 to November 1992. There were 19 male and 4 female patients. The patients' age ranged from 17 to 71 years(median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in 30% of the patients. He nasal cavity was most frequently involved. No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total 45~54 Gy(median 50.4 Gy) using 6 MV X-ray. No patients received chemotherapy as initial treatment. RESULTS: Overall 5-year and 10-yar survival rates were 52.4% and 44.1%, respectively. Seventy percent(12/17) of the patients achieved complete response to radiotherapy., and 29.4%(5/17) achieved partial response. The patients with complete response showed a better 5-year survival rate than those with partial response (66.9% vs. 20%, p-0.004). Symptom duration before diagnosis, the presence of systemic symptom, ad the number of primary sites had no influence on survival. The patterns of failure were as flows: local failure(1), failure in adjacent site(1), local and distant failure(1), distant metastasis(2), and conversion to malignant lymphoma(1). W could not find factors associated with the patterns of failure. CONCLUSION: The most important factor associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However, about 50% of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.
Diagnosis ; Drug Therapy ; Female ; Fever ; Humans ; Male ; Nasal Cavity ; Neoplasm Metastasis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Weight Loss

In vivo ethane production in rats was used as an index of oxygen toxicity. The rats were allocated to four exposure conditions; hyperbaric oxygenation (HBO=5 ATA, 100% O2), normobaric oxygenation (NBO=1 ATA, 100% O2), hyperbaric aeration (HBA=5 ATA, 21% O2) and normobaric aeration (NBA=1 ATA, 21% O2). After 120 minutes of exposure, the rats exposed to high concentration and/or high pressure oxygen exhaled significantly larger amounts of ethane than those exposed to NBA, and the differences in ethane production between any two groups were statistically significant (p<0.01). This finding supports the hypothesis that hypothesis that hyperoxia increase oxygen free-radicals and the radicals produce ethane as a result of lipid peroxidation. It is notable that the ethane exhalation level of the HBA group was significantly higher than that of the NBO group. This difference could not be accounted for by the alveolar oxygen partial pressure difference between the two groups.
Animals ; Ethane* ; Exhalation* ; Hyperbaric Oxygenation ; Hyperoxia* ; Lipid Peroxidation* ; Oxygen ; Partial Pressure ; Rats

The purpose of this study was to analyze the quality of meal and dietary habits of college students according to where they reside. This survey included 260 students and was conducted through questionnaires. The subjects were divided into three groups: first group was composed of students who reside in boarding-houses(BH group, N=72), second was students who reside in self-boarding set up(SB group, N=90), and third was those who lived in the same house with their parents(HWP group, N=98). The average age of the students in the BH, SB, and HWP group were 19.7 yrs, 21.1 yrs, and 21.7 yrs, respectively. There were no significant differences in the weight, height and BMI among the three groups. The BH group had significantly higher frequency of skipping breakfast and smoking than those of the SB and HWP groups. The amount of energy, food, carbohydrates, proteins, fats, vitamins and minerals consumed in the BH group were significantly higher than in the SB and HWP groups. Similarly, the NAR(nutrient adequacy ratio), MAR (mean adequacy ratio), ND(nutrient density) and INQ(index of nutritional quality) of the BH group were significantly higher than those in the SB and HWP groups. There was no significant difference in the KDDS(Korean's Diet Diversity Score) between the three groups. From the data obtained, the SB and HWP students appeared to have more dietary problems than the BH students. These results show that nutrition education for SB and HWP students is needed in order for them to learn proper dietary management and help improve the diet of students living in self-boarding arrangements.
Breakfast ; Carbohydrates ; Diet ; Education ; Fats ; Food Habits ; Gangwon-do* ; Humans ; Meals ; Minerals ; Nutritional Status* ; Surveys and Questionnaires ; Smoke ; Smoking ; Vitamins

PURPOSE: We performed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1.8~2.0 Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy (56~66 Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclophosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in 2~5 cycles (median 2). RESULTS: Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were 41.5%, 13.7%, and 7%, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, 32.9%, 10.5%, 6% for radiotherapy alone group, and 14 months, 57.8%, 20%, 7.6% for induction chemotherapy group, respectively (p=0.0005). Complete response (CR) to overall treatments was 25% (21/84) in radiotherapy alone and 40.5% (17/42) in induction chemotherapy group (p=0.09). The prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and response to overall treatment(p= 0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). CONCLUSION: Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radio therapy alone. At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.
Carcinoma, Non-Small-Cell Lung* ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Induction Chemotherapy* ; Neoplasm Metastasis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Vinblastine

Discoid meniscus in the knee joint is common. From July 1990 through June 1994, the authors performed arthroscopy on 968 symptomatic knee joints. One hundred and six knees of 102 patients had discoid meniscus. Of the 106 knees, 14(13.2%) cases were associated with other intraarticular anatomic variants. There were 7(6.6%) cases with anomalous insertion of the anterior horn of the medial meniscus into the anterior cruciate ligament, and 7(6.6%) cases with anterior transposition of the insertion of the anterior cruciate ligament below the anterior tibial margin like the insertion of the posterior cruciate ligament. Of the 14 patients, the discoid meniscus were reshaped in 11 knees, partially resected in 2 knees, and one patient was treated with repair of a peripheral tear and reshaping. But had no treatment in associated intraarticular anatomic variants. The follow up was done from 24 to 54 months(average 37 months) after surgery. The results were excellent in 8 knees ; good in 4 knees and fair in 2 knees(Ikeuchi scale, 1982) The patients with excellent or good results were satisfied as were the authors, and these anatomical variants other than the discoid meniscus were not related to the patient's symptoms.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Follow-Up Studies ; Horns ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tears

PURPOSE: Urolithiasis develops more frequently in patients with a family history (FHx). However, little is known about risk factors in stone formers with a FHx. The aim of this study was to examine the clinico-metabolic characteristics of urinary stone formers according to FHx. MATERIALS AND METHODS: A database of 1,068 stone formers who underwent a complete metabolic evaluation was reviewed. The patients were divided into two groups on the basis of the presence of a FHx. Clinical factors and metabolic parameters were compared between the two groups. RESULTS: There were no significant differences in clinical characteristics, such as gender, age, body mass index, stone episodes, or multiple stones, between the two groups (p>0.05, respectively). Compared with stone formers without a FHx, however, serum calcium concentrations were more elevated in stone formers with a FHx. Also, the urinary excretion of calcium was higher in stone formers with a FHx than in those without a FHx. Other urinary metabolites showed no significant differences between the two groups (p>0.05, respectively). CONCLUSIONS: Our study revealed that stone formers with a FHx had increased urinary calcium excretion as well as elevated concentrations of serum calcium. This finding suggests that urolithiasis in stone formers with a FHx may be associated with calcium metabolic abnormalities.
Body Mass Index ; Calcium ; Family Characteristics ; Humans ; Risk Factors ; Urinary Calculi ; Urolithiasis

The purpose of this study was to evaluate the eating behaviors and dietary quality of various aged adults. This study conducted through questionnaire and dietary survey by 24-hr recall to 850 adults residing in Samcheok. Subjects were divided into four groups according to the age in male and female, which included 20~29 yrs group (male n = 94, female n = 66), 30~49 yrs group (male n = 201, female n = 216), 50~64 yrs group (male n = 88, female n = 96), and >or = 65 yrs group (n = 46, female n = 43). In male, 20~29 yrs group had a larger proportion of subjects who skipped breakfast, lunch and dinner compared to other groups (p<0.001, p<0.05, p<0.01). The daily food and energy intakes in > or = 50 yrs group were significantly lower than those of < 50 yrs. Protein and fat intakes of 20~29 yrs group were significantly higher than those of the other groups. But ND (Nutrient Density) of minerals as like calcium, iron and plant iron in 20~29 yrs group were significantly lower than those of other groups. The KDDS (Korean's Dietary Diversity Score) of 20~29 yrs group, 30~49 yrs group, 50~64 yrs group and > or = 65 yrs group in male were 4.1, 3.8, 3.7 and 3.5 respectively and there was significant difference (p < 0.001). In female, skipping breakfast and dinner were significantly higher in 20~29 yrs group than in other groups (p<0.001, p<0.001). And the use of nutrient supplementation was higher in 30~49 yrs group than that of other groups (p<0.05). The daily energy intakes was higher in 20~49 yrs group than that of >or = 65 yrs group. The ND (Nutrient Density) of animal protein, vitamins A and B1 in 20~29 yrs group were significantly lower than those of other groups. The KDDS of 20~29 yrs group, 30~49 yrs group, 50~64 yrs group and > or = 65 yrs group in female were 4.0, 3.9, 3.9 and 3.6 respectively and >or = 65 yrs group was significant lower than other groups. According to these results, >or = 65 yrs and 20~29 yrs group had more dietary habit problems and poor nutrition status than 30~64 yrs group. The results of this study revealed that nutritional management and education for adequate meals should be emphasized in adults and elderly.
Adult ; Aged ; Animals ; Breakfast ; Calcium ; Eating ; Feeding Behavior ; Female ; Food Habits ; Humans ; Iron ; Lunch ; Male ; Meals ; Minerals ; Nutritional Status ; Plants ; Vitamins ; Surveys and Questionnaires

PURPOSE: We performed a retrospective analysis to compare short term results of induction chemotherapy-radiotherapy versus concurrent chemo-radiotherapy in patients with locally advanced nasopharyngeal carcinoma. MATERIALS AND METHODS: From Oct. 1989 to May 1998, 62 patients with locally advanced nasopharyngeal carcinoma were treated with induction chemotherapy followed by radiotherapy (induction group) or concurrent chemo-radiotherapy (concurrent group). Induction chemotherapy was done for 50 patients, and concurrent chemotherapy for 12 patients. Age, sex, performance status, and pathologic types were evenly distributed between two groups. Stage distribution showed 32% with IIB, 30% with III, and 38% with IV in induction group, and 50%, 33.3%, and 16.7% in concurrent group, respectively. Chemotherapy regimen was CF (cisplatin and 5-FU) in both groups, and drug delivery method also same. Cisplatin 100 mg/m2 was intravenously infused on day 1, and 5-FU 1,000 mg/m2 on day 2~6. This was repeated at 3 weeks interval. At the end of radiotherapy, total cycles of chemotherapy were 1~3 (median 2) in both groups. Conventionally fractionated radiotherapy with daily fraction size 1.8~2.0 Gy and 5 fractions/week was done. Total dose was 69.4~86 Gy(median 73.4 Gy) for induction group, and 69.4~75.4 Gy (median 70.8 Gy) for concurrent group. Follow-up time was 9~116 months (median 40.5 months) for induction group, 14~29 months (median 21 months) for concurrent group, respectively. RESULTS: Overall 2 year survival rate (2YSR) for all patients was 78.7%. According to treatment modality, 2YSR were 77% for induction group, 87% for concurrent group (p>0.05). 2 year disease-free survival rate were 56% and 81% (p>0.05), respectively. Complete response to treatment were 75.5% for induction group and 91.7% for concurrent group, but there was no statistical difference. The incidence of grade 3~4 hematologic toxicity during radiotherapy was not differ between two groups, but grade 2 leukopenia was more frequent in concurrent group (18% vs 66.7%). Grade 3~4 mucositis was more frequent in concurrent group (4.0% vs 33.3%). Overall incidence of grade 3~4 acute toxicity during radiotherapy was more frequent in concurrent group (6.0% vs 41.7%, p=0.005). CONCLUSION: Concurrent chemo-radiotherapy showed a trend of improvement in short-term survival and in treatment response when compared with induction chemotherapy-radiotherapy in locally advanced nasopharyngeal carcinoma. More controlled randomized trial are needed.
Cisplatin ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Incidence ; Induction Chemotherapy ; Leukopenia ; Mucositis ; Radiotherapy ; Retrospective Studies ; Survival Rate

Apraxia of speech (AOS) is the impairment of motor programming. However, the exact nature of this deficit remains unclear. In particular, AOS without other speech-language deficit is called pure AOS, but it is very rare. When diagnosing AOS, the characteristic of articulation is considered a crucial criterion, which has been proposed for differentiating AOS from phonological and dysarthric disorders. The present study reports on pure AOS in a 37-year-old right-handed male after a left insular, front, temporal infarction. This report may be useful for further AOS study and diagnosis in the clinical setting.
Adult ; Apraxias ; Humans ; Infarction ; Male

PURPOSE: This study was to evaluate survival, failure patterns, and prognostic factors of patients with metastatic neck nodes from an unknown primary site. MATERIALS AND METHODS: A retrospective analysis was done for 35 patients with metastatic neck nodes from an unknown primary site who were treated with radiation from January 1986 to September 1994. There were 26 male and 9 female patients. Patients' age ranged from 41 to 74 years (median 58 years). Stage distribution showed 1 patient with N1, 27 with N2, and 7 with N3. Amomg these patients, 7 with a supraclavicular lymph node alone were included. The histologic type was squamous cell carcinoma in 22 patients, undifferentiated carcinoma in 6, adenocarcinoma in 4. We could not classify a histologic type in 3 patients. Radiation therapy alone was done in 7 patients, induction chemotherapy and radiation therapy in 10, and postoperative radiation therapy in 18. Radiation therapy fields included both neck and pharyngeal axis, and total dose was 40-95.6Gy (median 60Gy) using 6MV X-ray. Chemotherapy consisted of 2 cycles of 5-fluorouracil and cisplatin. Surgical methods were a radical neck dissection in 17 patients and an excisional biopsy in 1 patient. Follow-up time ranged from 2 to 95 months, median 15 months. RESULTS: Overall and disease-free survival rate at 4 years were 33.4% and 33.9%, respectively. The factors associated with the overall survival rate were histologic type(adenocarcinoma vs. non-adenocarcinoma, p=0.0005), N stage(p=0.023), and the site of involved nodes(p=0.021). According to the treatment modality, 2-year survival rate was 14.3% in radiation therapy alone group, 35.8% in induction chemotherapy and radiation thrapy, and 37.5% in postoperative radiation therapy(Fig. 4, p=0.05), which might be due to the difference of N stage distribution. The failure patterns were analyzed in 25 patients with a complete response to the treatment. Local failure wasnoted in 7 patients, distant metastases in 6, local failure and distantmetastases in 1. Excluding the 7 patients with supraclavicular lymph node metastaes alone, 28%(7/25) of the patients had distant metastases. During the follow-up period, 11%(3/35) of the patients showed a delayed primary site, 1 in oral cavity, 1 in nasopharynx, and 1 in hypopharynx. CONCLUSION: N stage, the site of involved node, and histologic type were associated with survival rate. In patients with advanced N stage, curative rather than inductive chemotherapy is needed because combined surgery and radiation therapy achieved poor results and considerable patients developed distant metastases.
Adenocarcinoma ; Axis, Cervical Vertebra ; Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Female ; Fluorouracil ; Follow-Up Studies ; Humans ; Hypopharynx ; Induction Chemotherapy ; Lymph Nodes ; Male ; Mouth ; Nasopharynx ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Radiotherapy* ; Retrospective Studies ; Survival Rate