• Title/Summary/Keyword: 강의

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Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.

Changes of Quality Characteristics of Manufactured Press Ham using Conjugated Linoleic Acid(CLA) Accumulated Pork during Storage Periods (CLA가 축적된 돈육으로 제조된 Press Ham의 저장기간중 품질변화)

  • Lee, J.I.;Ha, Y.J.;Jung, J.D.;Kang, K.H.;Hur, S.J.;Park, G.B.;Lee, J.D.;Do, C.H.
    • Journal of Animal Science and Technology
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    • v.46 no.4
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    • pp.645-658
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    • 2004
  • To investigate the effects of conjugated linoleic acid added diet feeding on CLA accumulation and quality characteristics of manufactured press ham using CLA accwnulated pork loin meat. The CLA used to add in diet was chemically synthesized by alkaline isomerization method with com oil. Pigs were divided into 5 treatment groups(4 pigs/group) and subjected to one of five treatment diets(0, 1.25% CLA for 2weeks, 2.5% CLA for 2weeks, 1.25% CLA for 4weeks and 2.5% CLA for 4weeks, CLA diets; total fed diets) before slaughter. Pork loin were collected from the animals(110kg body weight) slaughtering at the commercial slaughter house. Manufacture press ham using CLA accumulated pork loin meat were vacuum packaged and then stored during 1, 7, 14, 21 and 28 days at 4$^{\circ}C$. Samples were analyzed for general compositions, physico-chemical properties(pH, color, shear force value), TBARS. pH value of CLA treatment(T4) was increased significantly than that of oontrol(P<0.05). pH of control and CLA treatments were increased significantly as the storage period passed(P< 0.05). Crude fat content of CLA treatment groups was significantly higher than the control pork (P<0.05). Meat color(CIE $L^*$, $a^*$$b^*$

Studies on the Cellulase produced by Myriococcum of albomyces (Myriococcum albomyces가 생산하는 Cellulase에 관한 연구)

  • Chung, Dong-Hyo
    • Applied Biological Chemistry
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    • v.14 no.1
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    • pp.59-97
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    • 1971
  • As a study on the cellulase of Myriococcum albomyces the culture media for enzyme formation and properties of its crude preparation were investigated and the crude enzyme preparation was further fractionated. The results are summarized as follows: 1. Wheat bran solid culture produced stronger activities of cellulase than rice bran or defatted soy bean meal solid culture. 2. Shaking culture with wheat bran, rice bran or defatted soy bean meal produced higher cellulase activities than solid culture with the corresponding media. 3. The enzyme formation was higher at $45^{\circ}C$ than at $37^{\circ}C$ or $50^{\circ}C$ regardless of the kind of culture medium. 4. The formation of CMCase activity was more promoted by organic nitrogen source than inorganic nitrogen source. 5. The formation of cellulase activities were increased 1.5 to 3.0-fold by adding CMC, Avicel or cellulose powder as an inducer into 5% wheat bran basal medium. 6. Cellulase production using a tank culture procedure with addition of CMC or Avicel as an inducer was the highest at fifth day and thereafter decreased slightly. 7. The crude enzyme preparation showed pH optimum in 4.0 to 4.5, and pH stability in the range of 3.5 to 8.0. Optimum temperature for the activity was $65^{\circ}C$ which was higher than among other cellulases and it was stable at $60^{\circ}C$ for 120 minutes. 8. Dialyzed crude enzyme was activated by $Ca^{++}$ and $Mg^{++}$, but inhibited by $Hg^{++}$, $Cu^{++}$ and $Ag^{+}$. 9. Four different types of cellulase, i. e., fraction I, fraction II-a, fraction II-b, and fraction III were purified from the culture filtrate of Myriococcum albomyces through a sequence of ammonium sulfate fractionation, and elution chromatography on DEAE-Sephadex A-25, Amberlite CG-25 type 2 and hydroxyapatite columns. 10. These four cellulase fractions were showed to be homogenous by electrophoresis and ultracentrifugation and also gave a typical ultraviolet absorption spectrum of protein. 11. Four purified fraction showed different specificity toward substrates, fraction I has a stronger activity toward Avicel, cellulose powder, and gauze than that of other cellulase fractions. Fraction II-a had a powerful activity toward cellobiose but it was almost inactive agaisnt fibrous cellulose contrary to fraction I. On the contrary, the main component fraction II-b had a fairly higher activity on CMC and Avicel. Activity of fraction II-b toward cellobiose was about one-third of that of fraction II-a and activity on Avicel was lower than that of fraction I. Fraction III had a more powerful activity in decreasing viscosity of CMC. 12. Final hydrolysis products of fibrous cellulose by each fraction were cellobiose and glucose. Whereas oligosaccharides were predominant in the early stage of hydrolysis, prolonged reaction produced more glucose than cellobiose. Fraction I and fraction II-a acted synergically on Avicel. 13. Optimum pH for the activities of cellulase fraction I, fraction II-a, fraction II-b and fraction III were found to be 5.5, 5.0, 4.0 and $4.0{\sim}4.5$, respectively. These fractions were found to be stable in the range of pH $3.0{\sim}7.5$. 14. Optimum temperature for the activities of fraction I, fraction II-a, fraction II-b, and fraction III were $50^{\circ}C$, $55^{\circ}C$, $60^{\circ}C$ and $55^{\circ}C$, respectively. No less of activity was found by heating 120 minutes at $55^{\circ}C$ and fraction II-a was more stable than the others at $60^{\circ}C$. 15. Fraction I and fraction II-b were activated by $Ca^{++}$ and $Mg^{++}$ but inhibited by $Hg^{++}$ and $Ag^{+}$.

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Studies on the Effect of Low Temperature Treatment at Meiotic, Heading and Seedling Stage in Paddy Rice (수도의 장해형 냉해에 관한 연구)

  • Hong-Suk Lee;Hyung-Yull Cho;Pyeong-Ki Yim;Hoon Heu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.15
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    • pp.85-97
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    • 1974
  • In order to clarify the inducing conditions and cause of sterility in rice plants, 4 varieties were cooled at 3 different levels of temperature combined with 3 different levels of treatment period. And 19 varieties were tested to examine the varietal difference of cold resistance. The results obtained were summarized as follows; 1. There were significant varietal differences in the effect of cooling treatment at meiotic stage. Suwon 213-1 was induced heavy sterility by 3 day cooling treatment at 17.5$^{\circ}C$ whereas Hayayuki, Nongpaik and Jinheung were induced a little sterility by 3 day cooling treatment at 15$^{\circ}C$ and 5 day treatment at 17.5$^{\circ}C$. The per cent of grain fertility was correlated significantly with the delayed days to heading, the degree of panicle extraction (Suwon 213-1, Nongpaik, Jinheung), culm length (Nongpaik, Suwon 213-1), and Auricle distance (Suwon 213-1). The degree of sterility was able to be estimated from the linear regression equation between the degree of panicle extraction (distance from panicle neck to flag leaf) and fertility percentage. In the case of heavy cold damage by the treatment of low temperature at meiotic stage, the rice plant had somewhat lower pollen density per anther, small and ununiform anther and pollen in size, and more sterile pollen grains. Suwon 213-1 showed anthesis in almost all spikelets, while Nongpaik, Jinheung and Hayayuki indicated considerable number of indehisced anther at 5 days after heading. 2. The fertility were not generally higher in cooling treatment at heading stage than at meiotic stage treatment. And significant correlation was found between the percentage of grain fertility treated at above two stages. Nongpaik and Jinheung were not affected in percentage of fertility by 5 day treatment at 15$^{\circ}C$ when these were treated at heading stage. Indehisced anthers were not found in Suwon 213-1 and Hayayuki, but Nongpaik and Jinheung showed more anthers which did not show anthesis 3. There was different varietal response to low temperature which was indicated by the decrease of grain fertility resulted from cooling treatment at meiotic stage. Jaekeun and Jinheung did not show low fertility but Milseong, Suwon 210, Satominoli and Suwon 213-1 showed outstanding decrease in fertility percentage by the cooling treatment at meiotic stage. The varieties which had low fertility were likely to have low pollen density per anther, abnormal anthers, small size po]]en grains and many sterile pollens. 4. Remarkable varietal difference of cold resistance was found in heading stage cooling treatment. Nongpaik, Jinheung, Jaekeun, Paltal, Akibare, Milseung and Palkeong were not affected in grain fertility by cooling treatments but Nonglimna No. 1, Suseong, Hayayuki, Suwon 213-1 and Suwon 210 showed significantly high sterility as treated by cool temperature. Most of the varieties showed higher fertility by cooling treatment at heading stage than meiotic stage but Hayayuki, Suseong and Nonglimna No.1 showed lower fertility when these were treated at heading stage than meiotic stage. There were two grops of varieties in the response to cooling treatment, one was somewhat non-anthesised and the other showed full anthesis. 5. In cold injury test of young seedlings, the result of observation was not accorded with the degree of growth inhibition. As a general, Palkeum and Suseong were highly torelant to cool temperature but Suwon 213-1, Jaekeun, Paltal, Shirogane, Palkeong, Mankyung were highly susceptible. 6. There is no significant correlation between the degree of young seedling cold damage and or the degree of growth retardation at seedling stage and grain fertility resulted from coding treatment both heading and meiotic stage.

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Change of Seed Dormancy and Viability of Chinese Milk Vetch (Astragalus sinicus L.) in Rice Field (토양속에서 자운영 종자의 휴면성 및 종자활력 변화)

  • Kim, Sang-Yeol;Hwang, Woon-Ha;Lee, Jong-Hee;Oh, Seong-Hwan;Cho, Jun-Hyeon;Han, Sang-Ik;Jeong, Kuk-Hyun;Park, Sung-Tae;Choi, Kyung-Jin;Kim, Jeong-Il;Lee, Ji-Yoon;Song, You-Cheon;Yeo, Un-Sang;Kang, Hang-Won
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.55 no.1
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    • pp.76-82
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    • 2010
  • Experiments were conducted to investigate seed persistence of Chinese milk vetch(CMV) in naturally reseeded rice field in 2007~2009. The seed and pods with seeds were buried in rice field at 0, 5 and 10 cm depths and retrieved from the field at one to three month intervals from July to the following year March and determined change of seed dormancy and viability. In the second experiment, persistence of the CMV seeds in the naturally reseeded rice field at different tillage methods and soil depths were also investigated after rice harvest in autumn. Burial depths and durations affected recovery rate, dormancy and viability of CMV seed. The viability loss was faster and greater in the seed than the pod with seeds and on the soil surface than the 5 or 10 cm burial depths. The recovery rate of CMV seed was decreased starting from one month as seed burial and it was significantly decreased to 52~65% for the seed in September. However, unlike the seed burial, the nearly 100% CMV seeds were recovered for burial as pod with seeds even after four months burial in both 0 and 5 cm depths. However, the recovery rate was sharply declined to below 30% at October in 2007 in both seed and pods with seeds and in the 2008/2009 experiment. the 15~47% of CMV seeds still remained even after October. The CMV had high seed dormancy of 95%, showing only 4~5% germination at the beginning in June but the seed germination increased to 25 to 35% in seed and 55 to 61% in pod with seeds in September due to breakage of hard seed dormancy. The viability loss was faster in the seed than in the pod with seeds regardless of depths of placement in the soil base on decayed seeds. Also the seed placed on the soil surface lost viability faster than the 5~10 burial depths. On the other hand, field observation in the naturally reseeded CMV rice field showed that as many as 917~2,185 CMV seeds $m^2$ were from the 0~15 cm soil depth in the rotary tillage and 250~10,105 CMV seeds in minimum tillage treatmints. The recovered seed germinated 25~33%, 23~43% but still had high percentage of hard seed having 64~72% and 51~77% even after rice harvest in autumn. These results indicate that freshly harvested CMV seeds had high level of primary dormancy and the dormancy was gradually broken in soil with time during rice cultivation periods and appreciable number of CMV seeds remained even 4 month after burial in soil. CMV plant regenerated naturally from the remained seed bank at rice harvest time in autumn. The CMV seedling still emerged even after 2 years of continuous destructive killing of emerged CMV plant by rotary tillage in naturally reseeded CMV plant in rice field, indicating that CMV seeds do persistent as least two years in soil.

Effects of Crude Protein Levels in Total Mixed Rations on Dry Matter Intake, Digestibility and Nitrogen Balance in Early Pregnant Korean Black Goats (섬유질배합사료 내 조단백질 수준이 임신초기 흑염소의 건물섭취량, 소화율 및 질소출납에 미치는 영향)

  • HwangBo, Soon;Choi, Sun-Ho;Lee, Sung-Hoon;Kim, Sang-Woo;Kim, Young-Keun;Sang, Byung-Don;Jo, Ik-Hwan
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.27 no.2
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    • pp.93-100
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    • 2007
  • This study was conducted to determine the effects of different levels (10, 12 and 15%) of crude protein (CP) in total mixed ration (TMR) on dry matter intake, digestibility and nitrogen balance of Korean black goats in the stage of early pregnancy and to obtain information on their optimal dietary levels of CP. In the present study, 12 Does of Korean black goats in the early pregnancy were allotted to four unreplicated groups by dietary level of CP and then they were housed in individual metabolism cages with completely randomized design throughout 30 days with 20 days adaptation and 10 days collection periods. Does in Control were fed a conventional diet and does in TMR10, TMR12 and TMR15 were fed a diet adjusted to about 10, 12 and 15% CP, respectively. Dry matter(DM) contents ranged from 89 to 91% in treatments. There were no differences fur fiber contents among three CP levels of TMR, showing that ADF and NDF had 18.57 to 19.85, and 53.41 to 54.80, respectively. Crude protein contents for three TMR treaements had 10.61, 12.15 and 14.97%, respectively. However, non-fibrous carbohydrate (NFC) contents decreased with increasing CP levels in treatments. Meanwhile, Intakes of DM, nutrients and digestible nutrients were significantly (p<0.05) higher in TMR15 and control than in TMR10 and TMR12. Moreover, DM intake per metabolic body weight and theit ratio per body weight was significantly (p<0.05) higher for control and TMR15 than other treatments. DM digestibility was not significantly different among treatments, but ether extract digestibility of treatments was significantly (p<0.05) higher than that of control, but there was no significant difference among treatments. Nitrogen retention significantly (p<0.05) increased with increasing CP levels in TMR, and TMR15 was highest among treatments. Our results showed that the increasing CP levels in TMR increased DM intake and nitrogen retention and suggested that the optimal dietary CP levels under TMR feeding system in early pregnant Korean black goats could be estimated for at least 15%.

Structural and Compositional Characteristics of Skarn Zinc-Lead Deposits in the Yeonhwa-Ulchin Mining District, Southeastern Taebaegsan Region, Korea Part II : The Yeonhwa II Mine (연화(蓮花)-울진광산지대(蔚珍鑛山地帶) 스카른연(鉛)·아연광상(亞鉛鑛床)의 구조적(構造的) 및 성분적(成分的) 특징(特徵) 기이(其二) : 제2연화광산(第二蓮花鑛山))

  • Yun, Suckew
    • Economic and Environmental Geology
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    • v.12 no.3
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    • pp.147-176
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    • 1979
  • The Yeonhwa II zinc-lead mine is characterized by a dozen of moderately dipping tabular orebodies of skarn and zinc-lead sulfides, developed in accordance with the ENE-trending bedding thrusts and bedding planes of the Pungchon Limestone and underlying Myobong Formation, mostly along the contacts of a ENE-trending sill and a NW-trending dike of quartz mononite porphyry. The orebodies occur in three groups: (1) the footwall Wolgok orebodies with respect to the sill, (2) the hangingwall Wolgok orebodies, and (3) the Seongok orebodies extended from dike contacts into carbonate beds. Mineral compositions of these orebodies are dominated by calc-silicates (skarn) associated with ore minerals of sphalerite, galena, and chalcopyrite, as well as sulfide gangue of pyrrhotite. A pair of exo- and endo-skerns in the Wolgok footwall contact aureole between the Pungchon Limestone and quartz monzonite porphyry on the -120 level represents a well-developed symmetrical pattern of mineral zoning: a garnet/quartz zone in the center of exoskarn, two zones of pyroxene with ore minerals on both sides of the garnet/quartz zone, further outwards-an epidote/chlorite-bearing hornfelsic zone in the Myobong slate beyond a zone of unaffected limestone, and an epidote-dominated zone of endo skarn on the opposite side toward fresh quartz monzonite porphyry. These features indicate a combination of two effects on the skarn formation: (1) differences in composition of the host rocks(sedimentary and ignous), and (2) progressive outward migration of inner zones on outer zones on the course of metasomatic replacement of the pre-existing minerals. Microprobe analyses of garnet, pyroxene, pyroxenoids, epidote, and chlorite for nine major elements on a total of 23 mineral grains revealed that: the pyroxenes are hedenbergitic, in most zones, with a gradual decrease of Fe- and Mn-contents toward the central zone, whereas the garnets are andraditic in outer zones, but are grossularitic in the central zone. This indicates a reverse relationship of Fe-contents between pyroxene and garnet across the exoskarn zones. Pyroxenoids are lacking in wollastonite but are dominated by pyroxmangite, rhodonite and bustamite, indicating a Mn-rich nature in bulk chemistry. Pseudomorphic fluorite after garnet occurs abundantly reflecting a fluorine-enhanced evidence of the skarn-forming fluids. Epidote contains 0.19-0.25mole fraction of pistacite, and chlorite is Mn-rich but is Mg-poor. Sulfide mineralization took place with the most Fe-rich pyroxene rather than with garnet as indicated by the fact that the highest value of hedenbergite mole fraction occurs in the ore-bearing pyroxene zone. The Yeonhwa II ores are characterized by high zinc and low lead in metal grade, with minor quantity of copper content in almost constant grade. The hangingwall Wolgok and Seongok orebodies, that formed in a more open environment with respect to their local configurations of geologic setting, are more variable in metal grades and ratios, than are the footwall Wolgok orebodies formed in a more closed condition in a narrow interval of sedimentary beds.

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Anti-Allergic Inflammatory Effect of Bacteria Isolated from Fermented Soybean and Jeotgal on Human Mast Cell Line (HMC-1) (장류 및 젓갈 분리 균주 추출물의 비만세포 매개 항염증효과)

  • Ko, Yu-Jin;Kim, Hui-Hun;Kim, Eun-Jung;Kim, Jin-Yong;Kang, Sang-Dong;Son, Yong-Hwi;Choi, Sin-Yang;Cha, Seong-Kwan;Kim, Jong-Won;Lee, Jeong-Ok;Ryu, Chung-Ho
    • Journal of Life Science
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    • v.21 no.3
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    • pp.393-399
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    • 2011
  • The mast cell is one of the major effector cells in inflammatory reactions and can be found in most tissues throughout the body. Activated mast cells can produce histamine, as well as a wide variety of other inflammatory mediators such as eicosanoids, proteoglycans, proteases, and several pro-inflammatory cytokines, such as tumor necrosis factor (TNF)-${\alpha}$, and interleukins (IL-6), IL-8, IL-4, IL-13. In the present study, we isolated two bacterial strains (J80 and G147) from fermented soybean and Jeotgal, and investigated the inhibitory effects of their extracts which were prepared by several pretreatment methods (sonication for 20 min, heating at $100^{\circ}C$ for 30 min, autoclaving at $121^{\circ}C$ for 15 min) on the mast cell-mediated inflammatory response. The pretreated bacterial extracts had no cytotoxicity against Human Mast Cell (HMC-1). Among various pretreatments, the extracts treated at $100^{\circ}C$ showed highest inhibition of histamine release (J80, 28.46%; G147, 41.14%). The J80 and G147 extracts treated at $100^{\circ}C$ resulted in the inhibition of IL-6 secretion by 38.46% and 56.45%, respectively. The J80 extract treated at $100^{\circ}C$ resulted in the inhibition of TNF-${\alpha}$ secretion by 66.67%, but G147 extract showed the highest inhibition effect by 41.1% when treated with sonication. These results suggest that bacterial extracts treated at $100^{\circ}C$ have a higher level of anti-inflammatory effects than other treatments such as sonication or autoclaving.

Breathing Reserve Index at Anaerobic Threshold of Cardiopulmonary Exercise Test in Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환의 운동부하 심폐기능검사에서 무산소역치 예비호흡지수의 의의)

  • Lee, Byoung-Hoon;Kang, Soon-Bock;Park, Sung-Jin;Jee, Hyun-Suk;Choi, Jae-Chol;Park, Yong-Bum;Ahn, Chang-Hyuk;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.795-802
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    • 1999
  • Objective : Cardiopulmonary exercise test is a useful tool to evaluate the operative risk and to plan exercise treatment for the patients with chronic obstructive pulmonary disease(COPD). In cardiopulmonary exercise test, most of the measured parameters are recorded at the time of peak exercise, which are hard to attain in COPD patients. So we evaluated the usefulness of the parameter, breathing reserve index(BRI=minute ventilation [$V_E$]/maximal voluntary ventilation[MVV]) at the time of anaerobic threshold($BRI_{AT}$) for the differentiation of COPD patients with normal controls. Methods : Thirty-six COPD patients and forty-two healthy subjects underwent progressive, incremental exercise test with bicycle ergometer upto possible maximal exercise. All the parameters was measured by breath by breath method. Results : The maximal oxygen uptake in COPD patients (mean$\pm$SE) was $1061.2{\pm}65.6ml/min$ which was significantly lower than $2137.6{\pm}91.4ml/min$ of normal subjects(p<0.01). Percent predicted maximal oxygen uptake was 54.3% in COPD patients and 86.0% in normal subjects(p<0.01). Maximal exercise(respiratory quotient; $VCO_2/VO_2{\geq}1.09$) was accomplished in 7 of 36 COPD patients(19.4%) and in 18 of 42 normal subjects(42.9%). The $BRI_{AT}$ of COPD patients was higher($0.50{\pm}0.03$) than that of control subject($028{\pm}0.02$, p<0.01), reflecting early hyperventilation in COPD patient during exercise. The correlation between $BRI_{AT}$ and BRI at maximal exercise in COPD patients was good(r=0.9687, p<0.01). Conclusion : The $BRI_{AT}$ could be a useful parameter for the differentiation of COPD patients with normal controls in the submaximal cardiopulmonary exercise test.

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Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.