Septic shock is one of the leading cause of death in hospitalized patients and mortality rates of up to 50 % have been reported. Despite all efforts, no regimen today seems to be successful in the treatment of septic shock. The endogenous opioid system (EOS) includes three major families of peptides: dynorphins, endorphins and enkephalins. Several lines of evidence indicate that EOS is implicated in the pathophysiology of anaphylactic and endotoxic shock. An opioid receptor blocker naloxone has been used extensively in studies for the role of EOS or endogenous opiod peptides (EOP). However, there have been few, if any, detailed investigative studies regarding the effect of naloxone on TNF-a production and the lethality in response to endotoxin, and tumorigenesis. ...continue...
Carcinogenesis* ; Cause of Death ; Dynorphins ; Endorphins ; Enkephalins ; Humans ; Melanoma ; Mortality ; Naloxone* ; Nitric Oxide ; Peptides ; Receptors, Opioid* ; Shock, Septic*

Intracavitary brachytherapy combined hypertermin for utero-cervical cancer seems to be a promising method for salvage treatments in persistent tumors and inoperable or previously irradiated cervical recurrences. In order to heat the vaginal apex and uterus, powerfull conical antennas which are suitable for afterloading cervical applicator have been designed for use in conjuction with intracavitary radition therapy. The antennas were constructed with conical conductive material to feed line and the effective length were designed proportional to microwave length, Power deposition profiles of 2450 MHz of conical antennas were studied in both phantom models and muscle tissue and compared to those of commonly used dipole antenna. Improvement of the heating pattern was found in both phantom and muscle tissue. The heating pattern produced by the conical antenna resembles an ellipsoid and then the temperature distribution in depth was extended to 2~3cm from the effective antenna axis.
Axis, Cervical Vertebra ; Brachytherapy ; Heating ; Hot Temperature ; Microwaves* ; Recurrence ; Uterus

High Dose Rate Remote Afterloading system was installed at Wonkwang Universi-ty Hospital in January 1994. In this report, the calibration of a Gammamed 12-i High Dose Rate Remote Afterloading system and the radiation survey around the facility after design and construct a shieding room are discussed. The radiation survey of the facility indicates that the use of ordinary concrete shielding of existing room will provide adequate shielding. Also, the methodologies for performing source calibra-tion are presented.
Calibration* ; Carboxymethylcellulose Sodium

PURPOSE: The mechanical insights of death of cancer cells by ionizing radiation are not yet clearly defined. Recent evidences have demonstrated that radiation therapy may induce cell death via activation of signaling pathway for apoptosis in target cells. This study is designed whether ionizing radiation may activate the signaling cascades of apoptosis including caspase family cysteine proteases, Bcl2/Bax, cytochrome c and Fas/Fas-L in target cells. MATERIALS AND METHODS: HL-60 cells were irradiated in vitro with 6 MV X-ray at dose ranges from 2 Gy to 32 Gy. The cell viability was tested by MTT assay and the extent of apoptosis was determined using agarose gel electrophoresis. The activities of caspase proteases were measured by proteolytic cleavages of substrates. Western blot analysis was used to monitor PARP, Caspase-3, Cytochrome-c, Bcl-2, Bax, Fas and Fas-L. RESULTS: Ionizing radiation decreases the viability of HL-60 cells in a time and dose dependent manner. Ionizing radiation-induced death in HL-60 cells is an apoptotic death which is revealed as characteristic ladder-pattern fragmentation of genomic DNA over 16 Gy at 4 hours. Ionizing radiation induces the activation of caspase-2, 3, 6, 8 and 9 of HL-60 cells in a time-dependent manner. The activation of caspase-3 protease is also evidenced by the digestion of poly (ADP-ribose) polymerase and procaspase- 3 with 16Gy ionizing irradiation. Anti-apoptotic Bcl2 expression is decreased but apoptotic Bax expression is increased with mitochondrial cytochrome c release in a time- dependent manner. In additon, expression of Fas and Fas-L is also increased in a time dependent manner. CONCLUSION: These data suggest that ionizing radiation-induced apoptosis is mediated by the activation of various signaling pathways including caspase family cysteine proteases, Bcl2/Bax, Fas and Fas-L in a time and dose dependent manner.
Apoptosis ; Blotting, Western ; Caspase 2 ; Caspase 3 ; Cell Death ; Cell Survival ; Cysteine Proteases ; Cytochromes c ; Digestion ; DNA ; Electrophoresis, Agar Gel ; HL-60 Cells* ; Humans ; Peptide Hydrolases ; Radiation, Ionizing

PURPOSE: The mechanical insights of death of cancer cells by ionizing radiation are not yet clearly defined. Recent evidences have demonstrated that radiation therapy may induce cell death via activation of signaling pathway for apoptosis in target cells. This study was designed whether ionizing radiation may activate the signaling cascades of apoptosis including caspase family cystein proteases, mitogen-activated protein (MAP) kinases, and transcriptional activation factors in target cells eventually leading to death. MATERIALS AND METHODS: HL-60 cell line in the log phase was used in this study and the culture media was RPMI 1640. The irradiation was done using the linear accelarator and the radiation does was 10 Gy, 20 Gy, and 30 Gy, respectively. The cell viability was tested by MTT assay and apoptosis was identified by the DNA fragmentation assay. JNK1 (cJun N-terminal kinase) and ERK (extracellular-signal regulated protein kinase) activity was analyzed by the in vitro Ig complex kinase assay. NF- kB (Nuclear Factor- kB) and AP-1 (activator protein-1) activity was assayed by the electrophoretic mobility sbift assay. RESULTS: Ionizing radiation decreased the viability of HL-60 cells in a time and dose dependent manner. Ionizing radiation-induced cell death of HL-60 cells may be an apo- ptotic death which was evidenced as apoptotic characteristic ladder pattern fragmentation of DNA over 20 Gy at 4 hours. Ionizing radiation specifically induced the activation of CPP32-like cystein protease rather than ICE-like protease of HL-60 cells in a time and dose dependent manner. The activation of CPP32-like cystein protease was also evidenced by the digestion of poly (ADP-ribose) polymerase with 30 Gy ionizing irradiation at 2 hours. The activity of JNK1 was transiently increased up to 3.6 fold by 30 Gy ionizing radiation at 2 hours. Ionizing radiation also rapidly activated the transcriptional activation factors including AP-1 and NF- kB at 10 or 30 min. CONCLUSION: These data suggested that ionizing radiation-induced apoptosis was mediated by the activation of CPP32-like cystein protease, JNK1, and transcriptional activation factors
Apoptosis ; Cell Death ; Cell Survival ; Culture Media ; Digestion ; DNA ; DNA Fragmentation ; HL-60 Cells ; Humans ; Peptide Hydrolases ; Phosphotransferases ; Radiation, Ionizing ; Transcription Factor AP-1 ; Transcriptional Activation

PURPOSE: The dose calculation program for the Buchler type remote afterloading system was developed. This program also can be used to calculate dose for various sealed sources. METHODS AND MATERIALS: We determined the source length and distribution by dividing the program disk to 72 points. The dose rate for the each program disk and source was calculated. The dose rate table for the xy coordinate was established. The dose rate for the interesting points of the patient were calculated by using this table. We also made isodose curve from this calculations. RESULTS: The storage size for the dose rate table were increased.But the calculation of the dose rate for the patient were carried out rapidly. So we could get real time calculation. CONCLUSION: By using this program, we could calculate the dose rate for the various oints of the patient quickly and accurately. This program will be useful for the treatment with various linear sources.
Brachytherapy ; Humans

PURPOSE: We compared the calculated percent depth dose curves of 6 MeV electron beam to that of measured to evaluate the usefulness of Monte-Carlo simulation method in radiation physics. MATERIALS AND METHODS: The radiation dose values of 6 MeV electron beam using EGS4 code with one million histories in water were compared values that were measured form the depth dose curve of electron beam irradiated by medical accelerator ML6M. The central exis dose values were calculated according the changing field size, such as 5 X 5, 10 X 10, 15 X 15, 20 X 20 cm2. RESULTS: The value calculated showed a very similar shape to depth dose curve. The calculated and measured value of Dmax at 10 X 10cm2 cone is 15mm and 14mm respectively. The calculated value of the surface radiation dose rate is 65.52% and measured one is 76.94%. The surface radiation dose rate has vaied from 64.43% to 66.99. The calculated values of Dmax are in the range between 15mm and 18mm. The calculated value was fitted well with measured value around the Dmax area, excluding build up range and below the 90% depth dose area. CONCLUSION: This result suggested that the calculation of dose value can be replace the direct measurement of the dose for radiation therapy. Also, EGS4 may be a very convenient program to assess the effect of radiation dose using by personal computers.
Microcomputers ; Water

PURPOSE: To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer. MATERIALS AND METHODS: One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients(95%) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus, and concurrent esophageal irradiation to 30 Gy. After that patients received 5-Fu continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000 mg/m2 administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100 mg/m2 bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrent chemoradiation, twenty-six patients underwent radical esophagectomy. RESULTS: ninety-three patients could be examined for response assessment. By treatment modality, response rates were 85.1% for radiation alone group and 86.3% for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was 61.9%. Ther pathologic complete response were 15.4% in operation group. Overall median survival was 11 months and actuarial 5-year survival rate was 8%. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognositc factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, siginificantly better survival was associated with clinical stage, tumor response, radiation dose, and peration. CONCLUSION: Compared with radiotherapy alone, combined mulimodlity may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.
Bleomycin ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Esophageal Neoplasms* ; Esophagectomy ; Esophagus ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Methotrexate ; Mitomycin ; Protestantism ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Vinblastine

Thymic carcinoma is a rare neoplasm arising in the thymic epithelium. The prognosis of thymic carcinoma is often poor with an aggressive histologic appearance and clinical course. However, few studies about efficacy of treatment modalities have been published because of the rarity of this tumor. Although resection of tumor is the first choice in the treatment of thymic carcinoma, the optimal adjuvant therapy has yet to be defined. A case showed that a patient with thymic carcinoma should be treated by tumor resection followed by radiotherapy alone. And we consider proper management for thymic carcinoma with reviewing literatures
Drug Therapy ; Epithelium ; Humans ; Prognosis ; Radiotherapy* ; Thymoma*

One hundred and thirty five patients with carcinoma of the nasopharyx were treated by radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University between August 1977 and July 1987. Of the 30 patients omitted: 8 had distant metastases at initial diagnosis or during radiotherapy; 18 patients refused or did not received a full course of radiation therapy, and four had not been confirmed histologically. The remaining 105 patients were analyzed to determine the incidence and patter of distant metastases. Diagnosis of distant metastases was made based on clinical signs and radiography, even though histologic confirmation was not made. Twenty-six patients developed distant metastases after definite irradiation of nasopharyx and neck, an incidence rate of 24.8%. The common sites of distant metastases were, in descending order, bone, lung, liver, and brain. There was a strong correlation between Ho's N stage and distant metastases rate. But sex, age, histologic subtype (squamous cell and undifferentiated cell), AJC T and N stage, treatment modalities (radiotherapy alone and radiotherapy combined with chemotherapy) were not significant. Of those patients who developed distant metastases, 80.8% were discovered within 2 years of their radical radiotherapy. The prognosis for nasopharyngeal carcinoma patients developing distant metastases was poor: median survival was nine months and 80% of those patients died within two years of the initial diagnosis of distant metastasis.
Brain ; Diagnosis ; Humans ; Incidence ; Liver ; Lung ; Neck ; Neoplasm Metastasis* ; Prognosis ; Radiation Oncology ; Radiography ; Radiotherapy