• Title/Summary/Keyword: 암 전이

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Concurrent Chemoradiotherapy in Locally Advanced Carcinoma of The Uterine Cervix : A Phase I/II Prospective Study (국소적으로 진행된 자궁경부암의 방사선치료와 복합 항암화학요법의 동시치료 결과)

  • Kang One Chul;Choi Eun Kyung;Chung Weon Kuu;Kim Jong Hoon;Chang Hyesook;Kim Yong Man;Kim Young Tak;Nam Joo Hyun;Mok Jung-Eun;Lee Moo-Song
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.311-323
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    • 1998
  • Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

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The Early Experience with a Totally Laparoscopic Distal Gastrectomy (전(全)복강경하 원위부 위절제술의 초기 경험)

  • Kim Jin Jo;Song Gyo Young;Chin Hyung Min;Kim Wook;Jeon Hae Myoung;Park Cho Hyun;Park Seung Man;Lim Keun Woo;Park Woo Bae;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.16-22
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    • 2005
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. Materials and Methods: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45mm; Ethicon Endosurgery, OH, USA). Results: The operative time was $369.4\pm62.5$ minutes (range $275\∼465$ minutes), and the anastomotic time was 45.1\pm14.4$ minutes (range $32\∼70$ minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was $7.1\pm0.6$. The number of lymph nodes harvested was $31.9\pm13.1$. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8$\pm$0.5 days, and the time to the first food intake was $4.1\pm0.8$ days. There were no early postoperative complications, and the postoperative hospital stay was $10.0\pm3.9$ days. Conclusion: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.

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Outcomes after Radiotherapy in Inoperable Patients with Squamous Cell Lung Cancer (수술이 불가능한 편평상피성 폐암의 방사선치료 성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nah Byung-Sik;Nam Tack-Keun;Kim Young-Chul;Park Kyung-Ok
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.216-223
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    • 2001
  • Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.

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Comparison of Growth Charateristics, Forage Yield and Growth Analysis in Corn Hybrids for Silage Production (Silage용 옥수수의 생육특성, 수량 및 생육해석의 품종간 비교)

  • 김창호;박상철;이효원;강희경
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.18 no.2
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    • pp.79-88
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    • 1998
  • This experiment was conducted from May to August in 1997 to selected the wrn hybrids being suitable for silage at farm in the Kongju National University through the comparison of growth characteristics, forage yield and growth analysis about native and imported corn hybrids for silage production. In this experiment, trial design was a randomized block design with three replication, testing varieties were 4 hybrids (Suwon 19, Kwanganok, Whengsungok, Suwonok ) of native corn hybrids and 13 hybrids (P 3156, P 3352, P 3144w, DK 501, DK 689, DK 713, DK 729, H 643.99, H 545.64, H 645.12, HC 7466, H 644.18, H ALISEO) of imported corn hybrids. The results obtained are summarized as follows; 1. The emergence rate of H643.99 was the highest with 97.0%. In rice black streaked dwarf virus(RBSOV), the hybrid of HC 7466 was lower infected with 1.6% than other hybrids. The plant hight of P 3144w was the highest with 339 cm and the stem length of P 3156 was the highest with 261 cm. In native com hybrids, the plant height and stem length of Kwanganok were recorded with 306 cm and 235 cm, respectively. 2. Leaf number and leaf area of Kwanganok were the greatest with 16 sheet per plant and $5,180\;{\textrm{m}^2}/l0a$, respectively. H 645.12 and H 545.64 had the greatest in ear to total dry matter ratio with 49.5% and 49.4%, respectively. 3. The fresh matter yield was significantly difference between growth stage, So Suwon 19 had the most level at 15 days before silking, P 3352 had the most level at silking date, Kwananok had the most level at 35 days a after silking. The fresh matter yield of native com hybrids such as Suwon 19 and Kwanganok was not apparent diffreences as compared with imported corn hybrids. 4. As the results of survey with dry weight, the quantity of dry matter accumulation were increase after silking. The varieties of P 3352, P 3156, Kwanganok, OK 713 were more quantity of dry matter production than DK 501, HC 7466. The Kwanganok of native com hybrid and Pioneer strain with high percentage of dry matter were higher dry weight than Limagrain strain. 5. HC 7466 had the largest LAR with $6.53\;{\textrm{cm}^2}/g$, H545.12 had the lowest LAR with $3.30\;{\textrm{cm}^2/g}$. P 3144 had the largest LAI, DeKalb strain including DK 713 were larger apparently than Limagrain strain including HC 7466 with 3.15. 6. The RGR of testing varieties was little difference of statistical significantly, but DK 501, and HC 7466 were lower than other corn hybrids. The CGR of native and American varieties was no apparent differences, but that of Limagrain strains were a large variation. According to the results obtained by this experiment, the eary growth such as emergence rate and RBSDV infection rate of Limagrain strains was more excellent than other strains. P 3156, P 3352, P 3144w, DK 713 and HC 7466 were suitable for silage condition such as dry matter yield, percentage of dry matter and % ear to total dry matter. The fresh and dry matter yield of native corn hybrids such as Suwon 19 and Kwanganok were not apparent differences as compared with imported corn hybrids, but percentage of dry matter was lower than other imported corn hybrids.

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Response of Potassium on Main Upland Crops (주요(主要) 전작물(田作物)에 대(對)한 가리성분(加里成分)의 비교(肥效))

  • Ryn, In Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.10 no.3
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    • pp.171-188
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    • 1977
  • The response and effect on main upland crops to potassium were discussed and summarized as follows. 1. Adequate average amounts of potash per 10a were 32kg for forage crop; 22.5kg for vegetable crops; 17.3kg for fruit trees; 13.3kg for potatoes; and 6.5kg for cereal crops. Demand of potassium fertilizer in the future will be increased by expanding the acreage of forage crops, vegetable crops and fruit trees. 2. On the average, optimum potash rates on barley, wheat, soybean, corn, white potato and sweet potato were 6.5, 6.9, 4.5, 8.1, 8.9, and 17.7kg per 10a respectively. Yield increaments per 1kg of potash per 10a were 4-5kgs on the average for cereal crops, 68kg for white potato, and 24kg for sweet potato. 3. According to the soil testing data, the exchangeable potassium in the coastal area was higher than that in the inland area and medium in the mountainous area. The exchangeable potassium per province in decreasing order is Jeju>Jeonnam>Kangweon>Kyongnam. Barley : 4. The response of barley to an adequate rate of potassium seemed to be affected more by differences in climatic conditions than to the nature of the soil. 5. The response and the adequate rate of potassium in the southern area, where the temperature is higher, were low because of more release of potassium from the soil. However, the adequate rate of phosphorus was increased due to the fixation of applied phosphorus into the soil in high temperature regions. The more nitrogen application would be required in the southern area due to its high precipitation. 6. The average response of barley to potassium was lower in the southern provinces than northern provinces. Kyongsangpukdo, a southern province, showed a relatively higher response because of the low exchangeable potassium content in the soil and the low-temperature environment in most of cultivation area. 7. Large annual variations in the response to and adequate rates of potassium on barley were noticed. In a cold year, the response of barley to potassium was 2 to 3 times higher than in a normal year. And in the year affected by moisture and drought damage, the responses to potassium was low but adequate rates was higher than cold year. 8. The content of exchangeable potassium in the soil parent materials, in increasing order was Crystalline Schist, Granite, Sedimentary and Basalt. The response of barley to potash occurred in the opposite order with the smallest response being in Crystalline Schist soil. There was a negative correlation between the response and exchangeable potassium contents but there was nearly no difference in the adequate rates of potassium. 9. Exchangeable potassium according to the mode of soil deposition was Alluvium>Residium>Old alluvium>Valley alluvium. The highest response to potash was obtained in Valley alluvium while the other s showed only small differences in responses. 10. Response and adequate rates of potassium seemed to be affected greatly by differences in soil texture. The response to potassium was higher in Sandy loam and Loam soils but the optimum rate of potassium was higher in Clay and Clay loam. Especially when excess amount of potassium was applied in Sandy loam and Loam soils the yield was decreased. 11. The application of potassium retarded the heading date by 1.7 days and increased the length of culm. the number of spikelet per plant, the 1,000 grain weight and the ratio of grain weight to straw. Soybean : 12. Average response of soybean to potassium was the lowest among other cereal crops but 28kg of grain yield was incrased by applying potash at 8kg/10a in newly reclaimed soils. 13. The response in the parent materials soil was in the order of Basalt (Jeju)>Sedimentay>Granite>Lime stone but this response has very wide variations year to year. Corn : 14. The response of corn to potassium decreased in soils where the exchangeable potassium content was high. However, the optimum rate of applied potassium was increased as the soil potassium content was increased because corn production is proportional to the content of soil potassium. 15. An interaction between the response to potassium and the level of phosphorus was noted. A higher response to potassium and higher rates of applied potassium was observed in soils contained optimum level of phosphorus. Potatoes : 16. White potato had a higher requirement for nitrogen than for potassium, which may imply that potato seems to have a higher capability of soil potassium uptake. 17. The yield of white potato was higher in Sandy loam than in Clay loam soil. Potato yields were also higher in soils where the exchangeable potassium content was high even in the same soil texture. However, the response to applied potassium was higher in Clay loam soils than in Sandy loam soils and in paddy soil than in upland soil. 18. The requirement for nitrogen and phosphorus by sweet potato was relatively low. The sweet potato yield is relatively high even under unfavorable soil conditions. A characteristics of sweet potatoes is to require higher level of potassium and to show significant responses to potassium. 19. The response of sweet potato to potassium varied according to soil texture. Higher yields were obtained in Sandy soil, which has a low exchangeable potassium content, by applying sufficient potassium. 20. When the optimum rate of potassium was applied, the yields of sweet potato in newly reclaimed soil were comparable to that in older upland soils.

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New Trends in the Production of One Hundred Fans Paintings in the Late Joseon Period: The One Hundred Fans Painting in the Museum am Rothenbaum Kulturen und Künste der Welt in Germany and Its Original Drawings at the National Museum of Korea (조선말기 백선도(百扇圖)의 새로운 제작경향 - 독일 로텐바움세계문화예술박물관 소장 <백선도(百扇圖)>와 국립중앙박물관 소장 <백선도(百扇圖) 초본(草本)>을 중심으로 -)

  • Kwon, Hyeeun
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.239-260
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    • 2019
  • This paper examines the circulation and dissemination of painting during and after the nineteenth century through a case study on the One Hundred Fans paintings produced as decorative folding screens at the time. One Hundred Fans paintings refer to depictions of layers of fans in various shapes on which pictures of diverse themes are drawn. Fans and paintings on fans were depicted on paintings before the nineteenth century. However, it was in the nineteenth century that they began to be applied as subject matter for decorative paintings. Reflecting the trend of enjoying extravagant hobbies, fans and paintings on fans were mainly produced as folding screens. The folding screen of One Hundred Fans from the collection of the Museum am Rothenbaum Kulturen und Künste der Welt (hereafter Rothenbaum Museum) in Germany was first introduced to Korean in the exhibition The City in Art, Art in the City held at the National Museum of Korea in 2016. Each panel in this six-panel folding screen features more than five different fans painted with diverse topics. This folding screen is of particular significance since the National Museum of Korea holds the original drawings. In the nineteenth century, calligraphy and painting that had formerly been enjoyed by Joseon royal family members and the nobility in private spaces began to spread among common people and was distributed through markets. In accordance with the trend of adorning households, colorful decorative paintings were preferred, leading to the popularization of the production of One Hundred Fans folding screens with pictures in different shapes and themes. A majority of the Korean collection in the Rothenbaum Museum belonged to Heinrich Constantin Eduard Meyer(1841~1926), a German businessman who served as the Joseon consul general in Germany. From the late 1890s until 1905, Meyer traveled back and forth between Joseon and Germany and collected a wide range of Korean artifacts. After returning to Germany, he sequentially donated his collections, including One Hundred Fans, to the Rothenbaum Museum. Folding screens like One Hundred Fans with their fresh and decorative beauty may have attracted the attention of foreigners living in Joseon. The One Hundred Fans at the Rothenbaum Museum is an intriguing work in that during its treatment, a piece of paper with the inscription of the place name "Donghyeon" was found pasted upside down on the back of the second panel. Donghyeon was situated in between Euljiro 1-ga and Euljiro 2-ga in present-day Seoul. During the Joseon Dynasty, a domestic handicraft industry boomed in the area based on licensed shops and government offices, including the Dohwaseo (Royal Bureau of Painting), Hyeminseo (Royal Bureau of Public Dispensary), and Jangagwon (Royal Bureau of Music). In fact, in the early 1900s, shops selling calligraphy and painting existed in Donghyeon. Thus, it is very likely that the shops where Meyer purchased his collection of calligraphy and painting were located in Donghyeon. The six-panel folding screen One Hundred Fans in the collection of the Rothenbaum Museum is thought to have acquired its present form during a process of restoring Korean artifacts works in the 1980s. The original drawings of One Hundred Fans currently housed in the National Museum of Korea was acquired by the National Folk Museum of Korea between 1945 and 1950. Among the seven drawings of the painting, six indicate the order of their panels in the margins, which relates that the painting was originally an eight-panel folding screen. Each drawing shows more than five different fans. The details of these fans, including small decorations and patterns on the ribs, are realistically depicted. The names of the colors to be applied, including 'red ocher', 'red', 'ink', and 'blue', are written on most of the fans, while some are left empty or 'oil' is indicated on them. Ten fans have sketches of flowers, plants, and insects or historical figures. A comparison between these drawings and the folding screen of One Hundred Fans at the Rothenbaum Museum has revealed that their size and proportion are identical. This shows that the Rothenbaum Museum painting follows the directions set forth in the original drawings. The fans on the folding screen of One Hundred Fans at the Rothenbaum Museum are painted with images on diverse themes, including landscapes, narrative figures, birds and flowers, birds and animals, plants and insects, and fish and crabs. In particular, flowers and butterflies and fish and crabs were popular themes favored by nineteenth century Joseon painters. It is noteworthy that the folding screen One Hundred Fans at the Rothenbaum Museum includes several scenes recalling the typical painting style of Kim Hong-do, unlike other folding screens of One Hundred Fans or Various Paintings and Calligraphy. As a case in point, the theme of "Elegant Gathering in the Western Garden" is depicted in the Rothenbaum folding screen even though it is not commonly included in folding screens of One Hundred Fans or One Hundred Paintings due to spatial limitations. The scene of "Elegant Gathering in the Western Garden" in the Rothenbaum folding screen bears a resemblance to Kim Hong-do's folding screen of Elegant Gathering in the Western Garden at the National Museum of Korea in terms of its composition and style. Moreover, a few scenes on the Rothenbaum folding screen are similar to examples in the Painting Album of Byeongjin Year produced by Kim Hong-do in 1796. The painter who drew the fan paintings on the Rothenbaum folding screen is presumed to have been influenced by Kim Hong-do since the fan paintings of a landscape similar to Sainsam Rock, an Elegant Gathering in the Western Garden, and a Pair of Pheasants are all reminiscent of Kim's style. These paintings in the style of Kim Hong-do are reproduced on the fans left empty in the original drawings. The figure who produced both the original drawings and fan paintings appears to have been a professional painter influenced by Kim Hong-do. He might have appreciated Kim's Painting Album of Byeongjin Year or created duplicates of Painting Album of Byeongjin Year for circulation in the art market. We have so far identified about ten folding screens remaining with the One Hundred Fans. The composition of these folding screens are similar each other except for a slight difference in the number and proportion of the fans or reversed left and right sides of the fans. Such uniform composition can be also found in the paintings of scholar's accoutrements in the nineteenth century. This suggests that the increasing demand for calligraphy and painting in the nineteenth century led to the application of manuals for the mass production of decorative paintings. As the demand for colorful decorative folding screens with intricate designs increased from the nineteenth century, original drawings began to be used as models for producing various paintings. These were fully utilized when making large-scale folding screens with images such as Guo Ziyi's Enjoyment-of-Life Banquet, Banquet of the Queen Mother of the West, One Hundred Children, and the Sun, Cranes and Heavenly Peaches, all of which entailed complicated patterns. In fact, several designs repeatedly emerge in the extant folding screens, suggesting the use of original drawings as models. A tendency toward using original drawings as models for producing folding screens in large quantities in accordance with market demand is reflected in the production of the folding screens of One Hundred Fans filled with fans in different shapes and fan paintings on diverse themes. In the case of the folding screens of One Hundred Paintings, bordering frames are drawn first and then various paintings are executed inside the frames. In folding screens of One Hundred Fans, however, fans in diverse forms were drawn first. Accordingly, it must have been difficult to produce them in bulk. Existing examples are relatively fewer than other folding screens. As discussed above, the folding screen of One Hundred Fans at the Rothenbaum Museum and its original drawings at the National Museum of Korea aptly demonstrate the late Joseon painting trend of embracing and employing new painting styles. Further in-depth research into the Rothenbaum painting is required in that it is a rare example exhibiting the influence of Kim Hong-do compared to other paintings on the theme of One Hundred Fans whose composition and painting style are more similar to those found in the work of Bak Gi-jun.