PURPOSE: The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose R ate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The PURPOSE of this report is to evaluate the effects of the High dose rate (HL)R) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. MATERIALS AND METHODS: From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 7 1 patients w -re treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in st;ge III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40-46 Gy (median 43 Gy), And LDR Radium intracavitary irradiation was performed with Henschke applicator, 22-59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage I, 38 in stag <, II and 17 in stage III. The total dose of external radiation was 40-61 Gy(median 45 Gy), daily 1.8-2.0 3y. HDR Co-60 intracavitary irradiation was performed with RALS (Remote Afterloading System), 30-57 Gy (median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. RESULTS: The 5-year overall survival rate in LDR Group was 72.9%, 6 1.9%, 45.0% in stage I, II, III, respectively and corresponding figures for HDR were 87.1%, 58.3%, 41.2%, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in a denocarcinoma of the uterine cervix. There was 1 1% of late complication rates in LDR Group and 27% in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group ( 16.7% vs. 31.6% in stage II, 11. 1% vs. 35.3% in stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. CONCLUSION: There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group it was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.
Adenocarcinoma* ; Brachytherapy ; Cervix Uteri* ; Female ; Humans ; Incidence ; Radiation Oncology ; Radium ; Retrospective Studies ; Survival Rate

PURPOSE: We evaluated the structure, innervation of the extraocular pulley smooth muscle in the rabbit. METHODS: A rabbit was transcardially perfused with physiological saline followed by 4% formalin. The rabbit orbit was dissected en bloc, paraffin processed, and serially sectioned for Hematoxylin-Eosin and Masson's trichrome stain. The distribution of the extraocular pulley smooth muscle was confirmed by immunohistochemistry with human smooth muscle(SM) alpha-actin. RESULTS: We found that the pulley structure consisted of focal condensations of eleastin and collagenous connective tissue in relationship to the rectus muscle in the equatorial Tenon's fascia. The pulley smooth muscle in relation to medial rectus muscle was immunostained with TH and nNOS. CONCLUSIONS: The data support the presence of the extraocular pulley smooth muscle in the rabbit orbit having both parasympathetic and sympathetic innervation.
Actins ; Collagen ; Connective Tissue ; Fascia ; Formaldehyde ; Humans ; Immunohistochemistry ; Muscle, Smooth* ; Orbit ; Paraffin

During the period from January, 1975, to June, 1989, one hundred patients with histopathologically proven polymorphic reticulosis in the upper respiratory tract were treated with radiation therapy and the analysis of treatment results was undertaken. One hundred patients (69 males, 31 females) with a mean age of 46 years (range 12-79 years) were presented. Nasal cavity was the most frequent site of involvement(56%), and 44 cases had multifocal sites of involvement. The incidence of cervical lymph node metastasis at initial diagnosis was 24%. Staging was determined by Ann-Arbor classification, retrospectively. The number of patients of stage IE, IIE, IIIE and IVE were 35, 60, 1, and 4, respectively. The overall 5 year actuarial survival rates were 38.4%. The difference in 5 year survival rates between patients with stage IE and IIE, with solitary and multiple, with CR and PR after irradiation were significant statistically. For the analysis of failure patterns, failure sites include the following: local failure alone(30/55=54.6%), systemic failure alone(9/55=16.4%), both local and systemic failure(16/55=29.0%). Retrograde slide review was available in 29 cases of PMR with respect to histopathologic bases, and immunohistochemical studies were performed using MTI and DACO-UCHL-1 as T-cell markers, MB2 as a B-cell marker and alpha-1-antichymotrypsin as a histiocytic markers. All that 29 cases showed characteristic histologic features similar to those of peripheral T-cell lymphoma and showed positive reactio to the T-cell marker. These findings suggest strongly that quite a significant portion of PMR may be in fact T-cell lymphoma.
B-Lymphocytes ; Classification ; Diagnosis ; Granuloma, Lethal Midline* ; Humans ; Incidence ; Lymph Nodes ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Male ; Nasal Cavity ; Neoplasm Metastasis ; Respiratory System ; Retrospective Studies ; Survival Rate ; T-Lymphocytes

Objectives: This study aimed 1) to investigate high school students’ reliability on COVID-19 responses in schools and private academies and 2) to identify the differences in COVID-19 prevention practice. Methods: This cross-sectional survey collected data from 200 high school respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from July 2 to 17, 2020 in this study. Chi-square tests were conducted to analyze the differences in preventative practices and practice rates between schools and private academies. Binary logistics regression analysis was conducted to identify the factor affecting the reliability of COVID-19 response. Results: These high school students reliabilityed the schools’ COVID-19 response more than the private academy. In addition, students who studied only at school did more COVID-19 prevention practices than students who studied both at school and academy. There was a significant difference in avoiding public transportation (p=.028), sitting in one row while having a meal (p=.011) in the practice rates depending on the schools’ COVID-19 response. A significant difference in Covering the mouth when coughing and sneezing (p-.041) was also found in the practice rates depending on the private academies’ COVID-19 response. Conclusion The reason why schools were more reliable than private academies was that there are health teachers. Because schools are supervised by the ministry of education, the Ministry of education and local government need to work together to manage and monitor the COVID-19 response in the academies through cooperation between two organizations. In addition, it is necessary to arrange a temporary circulation health teacher who will provide the COVID-19 prevention education at the academies.

Aging populations and the increasing mental health issues among them have set a new challenge for the international community, governments, and people. Given this, society’s role is very important, and involving the local community in resolving the problems can play a pivotal role. The current study presented the systematic review of the financing mechanism and cost-effectiveness of the “social prescribing” (SP) project in the United Kingdom and how SP can be adapted for other settings. The data showed comparatively low running costs and the overall effectiveness of SP projects. The running cost of SP projects varied between £54,525 and £1.1 million. The cost-effectiveness of the projects reported as 12% and the return of investment was about 50% depending on the type of analysis and the activities implemented. This type of intervention can be one of the options that support solving the issues of aging populations and their accompanying mental disorders.

PURPOSE: The aim of this study was to investigate the impact of the visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery on operative outcomes such as number of retrieved lymph nodes (LNs) and operative time. METHODS: We retrospectively reviewed the medical records and the CT scans of 597 patients with gastric cancer who underwent laparoscopy assisted distal gastrectomy (LADG) with partial omentectomy and LN dissection (>D1 plus beta). Patients were stratified by gender, VFA, and body mass index (BMI), and the clinicopathologic characteristics and operative outcomes were evaluated. Multiple linear regression analysis was used to assess the effects of VFA and BMI on the number of retrieved LNs and operative time in male and female patients. RESULTS: The mean number of retrieved LNs was significantly decreased for both male and female patients with high VFA. The operative time was significantly longer for both male and female patients with high VFA. The number of retrieved LNs had a statistically significant negative correlation with VFA in both men and women, but not with BMI. The operative time had a statistically significant positive correlation with VFA in men, whereas the operative time had a statistically significant positive correlation with BMI in women. CONCLUSION: The preoperative VFA of male patients with gastric cancer who undergo LADG may affect the number of retrieved LNs and operative time. VFA was more useful than BMI for predicting outcomes of LADG.
Body Mass Index ; Female ; Gastrectomy* ; Humans ; Intra-Abdominal Fat* ; Laparoscopy ; Linear Models ; Lymph Nodes ; Male ; Medical Records ; Obesity* ; Operative Time ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, X-Ray Computed

Smooth muscle cell metaplasia is an extremely rare form of stromal differentiation in fibroadenomas. We describe a case of fibroadenoma with exuberant smooth muscle cells in a 72-year-old woman. The mass was located in the upper central portion of the left breast. It was well circumscribed and its greatest dimension was 3 cm. Histologically, the glandular elements resembled the appearance of fibroadenoma, but the stromal elements were composed of spindle cell bundles with abundant eosinophilic cytoplasm and elongated cigar-shaped nuclei. Neither mitotic activity nor cellular atypia was seen. The stromal cells were immunohistochemically positive for smooth muscle actin, calponin, desmin, and estrogen receptor-beta, but negative for CD34, S-100 protein, p63, CD10, estrogen receptor-alpha, progesterone receptor and cytokeratin. These results proved that the stromal cells showed features of smooth muscle cells.
Actins ; Aged ; Breast ; Calcium-Binding Proteins ; Cytoplasm ; Desmin ; Eosinophils ; Estrogens ; Female ; Fibroadenoma ; Humans ; Keratins ; Metaplasia ; Microfilament Proteins ; Muscle Cells ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Receptors, Progesterone ; S100 Proteins ; Stromal Cells

PURPOSE: The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. METHODS AND MATERIALS: The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its gantry. AP or PA field portal images were only analyzed. Radiation therapy field included the tumor, mediastinum, and supraclavicular lymph nodes. A total of 103 portal images wereanalyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. RESULTS: The average values of setup displacements in the x, y direction was 1.41 mm, 1.78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11mm along the x,y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm CONCLUSION: The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x,y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be madeand analyzed during first week of treatment, individually.
Axis, Cervical Vertebra ; Humans ; Immobilization ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Mediastinum ; Particle Accelerators ; Respiration ; Supine Position ; Thorax

OBJECTIVE: The purpose of this study was to compare one-step 2 hour 75 gm oral glucose tolerance test (OGTT) proposed by the World Health Organization (WHO) with two-step 3 hour 100 gm OGTT of National Diabetes Data group (NDDG) criteria for determining gestational diabetes. METHODS: Data for 111 pregnant Korean women who were diagnosed of gestational diabetes either by 75 gm OGTT or 100 gm OGTT and 100 normal controls were reviewed and analyzed retrospectively. The effectiveness of the two tests was determined by comparing the frequency of diabetes-related pregnance outcomes such as macrosomia, cesarean delivery, and preterm birth. Chi-square, Fisher's Exact test, and T-tests were used for statistical analysis. RESULTS: Among 111 gestational diabetic women, 59 (53.2%) were diagnosed by WHO criteria of 75 gm OGTT and 52 (46.8%) were diagnosed by 100 gm OGTT of NDDG criteria. Frequency of macrosomia and cesarean section was higher in 75 gm test group than in 100 gm test group (12.3% vs 5.8% and 35.1% vs 21.2%, respectively), but the difference was statistically not significant. When compared to the control group, 75 gm test group reached statistical significance in having higher incidence of macrosomia (12.3% vs 3%, p<0.05) whereas 100gm test group did not. CONCLUSION: Efficacy of the diagnostic criteria of WHO was comparable to that of NDDG for diagnosing gestational diabetes. This suggests WHO's 75 gm OGTT to be an efficient diagnostic tool for gestational diabetes in Korean women.
Cesarean Section ; Diabetes, Gestational* ; Female ; Glucose Tolerance Test* ; Humans ; Incidence ; Pregnancy ; Premature Birth ; Retrospective Studies ; World Health Organization

OBJECTIVE: The purpose of this study was to compare one-step 2 hour 75 gm oral glucose tolerance test (OGTT) proposed by the World Health Organization (WHO) with two-step 3 hour 100 gm OGTT of National Diabetes Data group (NDDG) criteria for determining gestational diabetes. METHODS: Data for 111 pregnant Korean women who were diagnosed of gestational diabetes either by 75 gm OGTT or 100 gm OGTT and 100 normal controls were reviewed and analyzed retrospectively. The effectiveness of the two tests was determined by comparing the frequency of diabetes-related pregnance outcomes such as macrosomia, cesarean delivery, and preterm birth. Chi-square, Fisher's Exact test, and T-tests were used for statistical analysis. RESULTS: Among 111 gestational diabetic women, 59 (53.2%) were diagnosed by WHO criteria of 75 gm OGTT and 52 (46.8%) were diagnosed by 100 gm OGTT of NDDG criteria. Frequency of macrosomia and cesarean section was higher in 75 gm test group than in 100 gm test group (12.3% vs 5.8% and 35.1% vs 21.2%, respectively), but the difference was statistically not significant. When compared to the control group, 75 gm test group reached statistical significance in having higher incidence of macrosomia (12.3% vs 3%, p<0.05) whereas 100gm test group did not. CONCLUSION: Efficacy of the diagnostic criteria of WHO was comparable to that of NDDG for diagnosing gestational diabetes. This suggests WHO's 75 gm OGTT to be an efficient diagnostic tool for gestational diabetes in Korean women.
Cesarean Section ; Diabetes, Gestational* ; Female ; Glucose Tolerance Test* ; Humans ; Incidence ; Pregnancy ; Premature Birth ; Retrospective Studies ; World Health Organization