PURPOSE: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. MATERIALS AND METHODS: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. RESULTS: The mean radial displacements were 2.26 (+/-1.03) mm in the control group and 3.05 (+/-1.97) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. CONCLUSION: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.
Consensus ; Displacement (Psychology) ; Head ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Masks ; Neck ; Skull Base ; Spine

Postoperative hypoxemia has been well known is adults but not in infants and children, although they are potentially more susceptible to airway closure and to disturbances in pulmonary gas exchange. We measured blood gas parameters of capillary blood in 30 cases of ASA physical status class l infants and children breathing room air, before and after general anesthesis for superficial surgical procedures. The blood samples were taken preoperatively, on arrival and 4~6 minutes later in the recovery room. The results are as follows: 1) The blood gas parameters on arrival in the recovery room showed significant change in pH nad PCO2(p<0.01) and increased PCO2(p<0.01) in comparison with preoperative gases. 2) The blood gas parameters checked at 4~6 minutes later in the recovery room showed insignificant differences from preoperative values of PO2 and SO2, but significantly increased PCO2 and decreased pH(p<0.01). 3) As a results of this study, it is suggested that for the safe management of patients, supplementary oxygen be provided for at least 10 minutes in the early recovery period to all pediatric patients.
Adult ; Anesthesia, General* ; Anoxia* ; Blood Gas Analysis ; Capillaries ; Child* ; Gases ; Humans ; Hydrogen-Ion Concentration ; Infant ; NAD ; Oxygen ; Pulmonary Gas Exchange ; Recovery Room ; Respiration

PURPOSE: The relationship between pathological parameters, such as blood vessel, lymphatic and perineural invasions, and prognosis, are controversial. We retrospectively analyzed the charts of patients with bladder cancer to identify the prognostic significance of these parameters. MATERIALS AND METHODS: A retrospective review of 125 of 181 patients with bladder cancer treated with radical cystectomy was conducted. Patients treated with neoadjuvant or adjuvant chemotherapy and those who were found to have lymph node metastasis after cystectomy were excluded from the study. RESULTS: The mean patient age was 62.5 years(range 39-84) and the overall median follow-up was 40.1months(range 1 to 146). Blood vessel, lymphatic, and perineural invasions were present in 8.8%, 20.8%, 8.8% of the specimens, respectively, and 28% of the patients had at least one of three factors. Univariate analysis revealed that blood vessel lymphatic, and perineural invasions were prognostic predictors of survival. However, only tumor stage and blood vessel invasion were calculated to be independent factors of survival on multivariate analysis. CONCLUSIONS: In this series, the pathological stage and blood vessel invasion are significant parameters of tumor-free survival in patients who have undergone cystectomy for bladder cancer. Our findings suggest that blood vessel, lymphatic, and perineural invasions should be examined more carefully.
Blood Vessels* ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Cystectomy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis* ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: Survivin, a novel inhibitor of apoptosis(IAP), is expressed in many human cancers, but its potential role in prostate cancer is unknown. The expressions of survivin in benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer were investigated. MATERIALS AND METHODS: Immunohistochemical staining of paraffin sections by a monoclonal antibody for survivin using the standard avidin- biotin-peroxidase technique was performed in 19, 20 and 30 cases with benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer, respectively. The relationships between the expression of survivin and the clinicopathological characteristics were analyzed. RESULTS: No survivin expression was found in benign prostate hyperplasia, but not in prostate cancer. The expression of survivin was observed in the cytoplasm of the tumor cells, but not in the neighboring normal tissues. The immunoreactivity of survivin increased from localized prostate cancer (60.0%) to metastatic prostate cancer(76.7%), but did not differ significantly. A statistically significant association was observed between the expression of survivin and the Gleason score(p=0.001). CONCLUSIONS: Survivin is expressed in the majority of Prostate cancers and is related to the Gleason score. Survivin may be a potential target for apoptosis-based therapy.
Apoptosis ; Cytoplasm ; Humans ; Hyperplasia* ; Neoplasm Grading ; Paraffin ; Prostate* ; Prostatic Neoplasms*

Purpose: Exogenous epidermal growth factor (EGF) causes apoptosis in EGF receptor (EGFR)–overexpressing cell lines. The apoptosis-inducing factors could be a therapeutic target. We aimed to determine the mechanism of EGF-induced apoptosis using a genome-wide clustered regularly interspaced short palindromic repeats (CRISPR)-based knockout screen. Materials and Methods: Two-vector system of the human genome-scale CRISPR knockout library v2 was used to target 19,050 genes using 123,411 single guide RNAs (sgRNAs). Recombinant human EGF (100 nM) or distilled water four times was administered to the experimental and control groups, respectively. The read counts of each sgRNA obtained from next-generation sequencing were analyzed using the edgeR algorithm. We used another EGFR-overexpressing cell line (A549) and short hairpin RNAs (shRNAs) targeting five EGF-resistance genes for validation. DUSP1 expression in A431, A549, and HEK293FT cells was calculated using reverse transcription–quantitative polymerase chain reaction. Results: We found 77 enriched and 189 depleted genes in the experimental group using the CRISPR-based knockout screen and identified the top five EGF-resistance genes: DDX20, LHFP, REPS1, DUSP1,<.i> and KRTAP10-12. Transfecting shRNAs targeting these genes into A549 cells significantly increased the surviving fractions after EGF treatment, compared with those observed in the control shRNA-transfected cells. The expression ratio of DUSP1 (inhibits ERK signaling) increased in A431 and A549 cells after EGF treatment. However, DUSP1 expression remained unchanged in HEK293FT cells after EGF treatment. Conclusion The CRISPR-based knockout screen revealed 266 genes possibly responsible for EGF-induced apoptosis. DUSP1 might be a critical component of EGF-induced apoptosis and a novel target for EGFR-overexpressing cancers.

Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and 0.09 mm2 for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.
Academies and Institutes ; Finite Element Analysis ; Indiana ; New Jersey ; Pliability ; Stents

Recently, the mathematical analysis of stent simulation has been improved, with the help of development of various tool which measure mechanical property and location of stent in artery. The most crucial part of the stent modeling is how to design ideal stent and to evaluate the interaction between stent and artery. While there has been great deal of researches on the evaluation of the expansion, stress distribution, deformation of the stent in terms of the various parameters, few verification through computer simulation has been performed about deformation and stress distribution of the stent. In this study, we have produced the corresponding results between experimental test using Universal Testing Machine and computer simulation for the ideal model of stent. Also, we have analyzed and compared stress distribution of stent in the cases of that with membrane and that without membrane. The results of this study would provide minimum change of plan and good quality for ideal stent replacing damaged artery through the analysis using computer simulation in the early stage of stent design.
Alloys ; Arteries ; Collodion ; Computer Simulation ; Exercise Test ; Finite Element Analysis ; Membranes ; Stents

Recently, the mathematical analysis of stent simulation has been improved, with the help of development of various tool which measure mechanical property and location of stent in artery. The most crucial part of the stent modeling is how to design ideal stent and to evaluate the interaction between stent and artery. While there has been great deal of researches on the evaluation of the expansion, stress distribution, deformation of the stent in terms of the various parameters, few verification through computer simulation has been performed about deformation and stress distribution of the stent. In this study, we have produced the corresponding results between experimental test using Universal Testing Machine and computer simulation for the ideal model of stent. Also, we have analyzed and compared stress distribution of stent in the cases of that with membrane and that without membrane. The results of this study would provide minimum change of plan and good quality for ideal stent replacing damaged artery through the analysis using computer simulation in the early stage of stent design.
Alloys ; Arteries ; Collodion ; Computer Simulation ; Exercise Test ; Finite Element Analysis ; Membranes ; Stents

PURPOSE: Since a significant number of patients with locally invasive bladder tumor(T3a/T3b) subsequently develop distant metastases, there have been lots of controversies in deciding treatment modalities. In the past decade, progress has been made in the development of effective chemotherapy for the treatment of advanced transitional cell carcinoma of the urothelium. Thus, we reviewed the effectiveness of the M-VAC(methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy for locally invasive transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: We reviewed 36 patients who were diagnosed as T3a/T3b TCC and treated with aggressive transurethral resection of the bladder tumor(TURBt) and M-VAC chemotherapy Remission was defined in case of complete disappearance of the tumor or downstaging, and progression was defined in case of persistent disease or upstaging. RESULTS: Mean age of the patients was 60.4 years old(33 males; 3 females), and mean follow up was 12.2 +/- 8.9 months. Response rate considering loss of follow up according to the Kaplan-Meyer's method, was 79, 49, 44, 37% at 6, 12, 18, 24th month, respectively. Disease progressions were found in 19 patients during follow up, and the mean duration to progression was 9.2 +/- 5.0(1-19)months. 79% of the patients with disease progression showed progression within 12 months. Lymph node metastases or distant metastases were confirmed in 68% of progressed patients. CONCLUSIONS: M-VAC chemotherapy after aggressive TURBt is limited, but erective treatment modality, and it is also useful in deciding the prognosis of cancer with its responsiveness.
Carcinoma, Transitional Cell* ; Disease Progression ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium ; Vinblastine*

PURPOSE: The purpose of this study was to evaluate whether an exogenous epidermal growth factor (EGF) could induce anti-tumor and radiosensitizing effects in vivo. MATERIALS AND METHODS: BALB/c-nu mice that were inoculated with A431 (human squamous cell carcinoma) cells in the right hind legs were divided into five groups: I (no treatment), II (EGF for 6 days), III (EGF for 20 days), IV (radiotherapy [RT]), and V (RT plus concomitant EGF). EGF was administered intraperitoneally (5 mg/kg) once a day and the RT dose was 30 Gy in six fractions. Hematoxylin and eosin (H&E) stained sections of tumor, liver, lung, and kidney tissues were investigated. Additionally, tumors were subjected to immunohistochemistry staining with caspase-3. RESULTS: EGF for 6 days decreased tumor volume, but it approached the level of the control group at the end of follow-up (p=0.550). The duration of tumor shrinkage was prolonged in group V while the slope of tumor re-growth phase was steeper in group IV (p=0.034). EGF for 20 days decreased tumor volume until the end of the observation period (p < 0.001). Immunohistochemistry revealed that mice in group V showed stronger intensity than those in group IV. There were no abnormal histological findings upon H&E staining of the normal organs. CONCLUSION: EGF-induced anti-tumor effect was ascertained in the xenograft mouse models with A431 cells. Concomitant use of EGF has the potential role as a radiosensitizer in the design of fractionated irradiation.
Animals ; Antineoplastic Agents ; Apoptosis ; Caspase 3 ; Eosine Yellowish-(YS) ; Epidermal Growth Factor* ; Follow-Up Studies ; Hematoxylin ; Heterografts* ; Immunohistochemistry ; Kidney ; Leg ; Liver ; Lung ; Mice* ; Radiation-Sensitizing Agents ; Tumor Burden ; Xenograft Model Antitumor Assays