Radiotherapy in the Region of the Head and Neck and the Consequential Changes in Normal Tissues / 대한연하장애학회지

Radiotherapy is a crucial non-surgical modality for head and neck cancer. With increasing radiation dose, the possibility of tumor control increases but the probability of toxicity to the surrounding normal tissue also increases. The subsequent changes in the normal tissues after radiotherapy can occur within a few minutes, or even several years. The early effects occur in rapidly proliferating tissue and tend to cause inflammation and are usually reversible. The late effects occur in more slowly proliferating tissues and the pathogenesis includes fibrosis, atrophy, and vascular damage. The early and late responses of the normal tissue can be dose-limiting factors in radiotherapy for head and neck cancer, affecting the therapeutic efficacy and quality of life of cancer survivors. Radiation-induced oral mucositis is the major limiting acute toxicity of radiotherapy for head and neck cancers and can lead to treatment interruption and suboptimal disease control. On the other hand, the most problematic late toxicities in the region of the head and neck are decreased secretion of saliva and dysfunction in swallowing. This review investigated the pathophysiology of radiation-induced toxicity: oral mucositis, xerostomia and dysphagia.

Effects of Concurrent Chemotherapy and Postoperative Prophylactic Paraaortic Irradiation for Cervical Cancer with Common Iliac Node Involvement / 대한방사선종양학회지

PURPOSE: To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. MATERIALS AND METHODS: From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. RESULTS: The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradition group only (0/10 vs. 3/44). CONCLUSION: Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with common iliac nodal involvement showed slightly improved clinical outcomes aside from increased hematologic toxicity, which was statistically insignificant. Considering the relatively small number of patients and short follow-up times, additional studies are needed to obtain more conclusive outcomes.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2009) / 임상검사와정도관리

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2009. All the control materials were sent in specifically-made boxes at the same time. The response rates were 87.5% in general chemistry and 89.3% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2008), change of the methods of analysis was not remarkable. The peer group coefficient of variation and the VIS scores of general chemistry items were slightly improved.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2008) / 임상검사와정도관리

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2008. All the control materials were sent in specifically-made boxes at the same time. The response rates were 93.5% in general chemistry and 88.1% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2007), change of the methods of analysis and the peer group coefficient of variation was not remarkable and the VIS scores of general chemistry items were slightly improved.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2007) / 임상검사와정도관리

Six trials with 3 samples for each of external quality assessment for general chemistry and blood gas were performed in 2007. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 95.5% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2006), the methods of analysis were slightly changed and the coefficient of variation and VIS scores of general chemistry items were not significantly changed.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2005) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2005. All the control materials were sent in specifically-made boxes at the same time. The response rates were 90.1% in general chemistry and 84.8% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2004), the methods of analysis were changed and the coefficient of variation and VIS scores of general chemistry items were increased.

Development of Secondary Order System for Laboratory Tests without Additional Blood Sampling / 대한진단검사의학회지

BACKGROUND: Additional tests ordered by doctors after checking abnormal routine test results for inpatients are usually delayed for one day or more, which in turn delays diagnostic and therapeutic procedures and prolongs length of stay (LOS) for the patients. We at Department of Laboratory Medicine, Asan Medical Center (AMC), established a "secondary order system for laboratory tests without additional blood sampling" to improve the conventional reflexive tests. METHODS: Oracle 8.0 (Oracle Co., Belmont, CA, USA) was used for data base software and Powerbuilder (Powersoft, Burlington, UK) for client development tool. Specimens subjected to "reflexive tests by doctors without additional blood sampling" were SST tubes for routine chemistry and EDTA for routine hematology requested in the morning of additional requests of the laboratory tests. RESULTS: Programs of registration and request for "reflexive tests by doctors without additional blood sampling" and bar code printing were developed for clinicians to check the routine test results and to order additional tests, if necessary, and for laboratory to perform the requested tests using the same samples used for routine chemistry and hematology tests in the morning. Additionally requested tests were done by finding the SST and EDTA samples, putting newly printed bar code, and processing them as usual. In February 2004, right after introducing reflexive tests by doctors without additional blood sampling, 75 additional requests were made for 50 patients, but they increased gradually up to 1,020 tests for 698 patients in December 2004. In 2005, the monthly average number of tests was 1,035 for 742 patients. CONCLUSIONS: The reflexive tests by doctors without additional blood sampling developed at AMC helped establish a rapid reporting of test results, which in turn reduced LOS related to laboratory. It also increased patient satisfactory indices by reducing repeated blood sampling and would also contribute to the financial health of the hospital.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2004) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2004. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 86.0% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2003), the methods of analysis are not changed much and the coefficient of variation and VIS scores of general chemistry items are decreased.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2003) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2003. All the control materials were sent in specifically-made boxes at the same time. The response rates were 90.3% in general chemistry and 91.8% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2002), the methods of analysis are not changed much and the coefficient of variation and VIS scores of general chemistry items are decreased.

The Performance Evaluation of Yeongdong URiSCAN GEN 10SGL Urine Dipstick Strip Using Other Quantitative, Microscopic, and Culture Methods / 대한임상병리학회지

BACKGROUND: The previous performance tests of URiSCAN GEN 10SGL dipstick reagent strip (Yeongdong pharmaceutical Co., Seoul, Korea) were mainly done by comparison with the approved urine strips. However, adequate comparison was inavailable because the grading systems were different among the manufacturers. We evaluated the correlation of new generation URiSCAN GEN 10SGL urine strip with known quantitative, microscopic, and culture methods. METHODS: We used urine specimens which were collected for the urinalysis and culture from November 2000 to Mars 2001. We evaluated the correlation between the results of URiSCAN GEN 10SGL and the quantitative methods by comparing the mean of change of reflectance rate (change %R) with the result of the corresponding quantitative method for protein, glucose, bilirubin, urobilinogen, pH, and specific gravity. To calculate the sensitivity and specificity, we used microscopic examination for leukocytes and erythrocytes, and used urine culture for nitrite test. RESULTS: The correlation coefficients between the change %R of URiSCAN GEN 10SGL and the corresponding quantitative method exceeded 0.81, except bilirubin and specific gravity (P<0.01; respectively). The agreements of identical or neighboring concentration block were more than 90%, except urobilinogen and specific gravy. The sensitivity and specificity of URiSCAN GEN 10SGL were 63.6% and 94.2% for leukocytes; 92.8% and 74.1% for erythrocytes; 74.4% and 85.0% for nitrite producing organisms. CONCLUSTIONS: URiSCAN GEN 10SGL had acceptable accuracy and agreement compared with the corresponding quantitative methods and culture result. Also, it had improved sensitivity and specificity of leukocytes and erythrocytes detection compared with previous URiSCAN urine dipstick strip.

Establishment of Multi-Drug Resistance Functional Assay and Correlation of Multi-Drug Resistance Activity and Chemotherapeutic Outcomes in Patients with Acute Leukemia / 대한혈액학회지

BACKGROUND: Multi-drug resistance (MDR) is one of the most important obstacles in the chemotherapy of acute leukemia, so the modulators of MDR have been developed and tried. METHODS: We measured MDR function and expressoin (surface and cytoplasmic p-glycoprotein and cytoplasmic multidrug-resistance associated protein (MRP)) and inhibitory effects of MDR modulators (cyclosporine and verapamil) by flow cytometry with MDR positive cell line and bone marrow aspirates of patients with acute leukemia (128 specimen). We compared these methods, and tried to clarify the effects of MDR on chemotherapy in patients with acute leukemia. RESULTS: The MDR functional assay and the detection method for inhibitory effects of MDR modulators (cyclosporine and verapamil) by flow cytometry using rhodamine 123 were established. These MDR functional assay was more sensitive, accurate, relatively simple and very economic, compared with the immunofluorescence assays of surface and cytopla-smic p-glycoprotein and cytoplasmic MRP. The positivity of MDR functional assay was observed in about 60% of patients with acute leukemia, and MDR activity (%) was inversely correlated with the complete remission rate and mean survival time. About 60% of the patients showing positive MDR activity revealed MDR inhibitory responses by cyclosporine and/or verapamil, especially all cases of acute myeloid leukemia in persistence after chemotherapy showed MDR inhibitory effect of cyclosporine. CONCLUSION: The chemotherapeutic out- comes of acute leukemia can be expected by MDR functional assay. And it is possible to overcome MDR by the administration of MDR modulator selected according to the results of the functional assay for MDR inhibitory effect in acute leukemia patients with MDR positivity.

Filtration Effects of Leukocyte Removal Filter for Platelet Concentrates / 대한수혈학회지

Some variables can influence the efficiency of leukocyte removal filter for red cell concentrates. We performed this study to evaluate whether the filtration efficiency for platelet concentrates(PCs) can be influenced by bedside filter(PXL8K, Pall Corporation, USA) used, platelet storage time and transient stopping of platelet agitation, and to measure the amount of cytokines released from donor leukocytes in PCs during the storage time. In addition, we examined the effect of leukocyte reduction by filtration before the storage of PCs on the subsequent generation of cytokines. Any of the above mentioned variables did not make significant differences. From day 1 to day 5, there were significant increases in IL-1 beta (<1 vs. 8.6 pg/mL, p<0.05), IL-8 (<10 vs. 455.3 pg/mL, p<0.05) and TNF-alpha (<4 vs. 16.6 pg/mL, p<0.05) in unflltered PCs, whereas no increased revels of cytokines were found in the cases of prestorage filtration.

Seroprevalence of anti-HCV according to EIA in korean blood donors: comparison of EIA results with confirmatory tests / 대한수혈학회지

No abstract available.

Seroprevalence of anti-HCV according to EIA in korean blood donors: comparison of EIA results with confirmatory tests / 대한수혈학회지

No abstract available.