• Title/Summary/Keyword: 평균방법

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Assessing forest net primary productivity based on a process-based model: Focusing on pine and oak forest stands in South and North Korea (과정기반 모형을 활용한 산림의 순일차생산성 평가: 남북한 소나무 및 참나무 임분을 중심으로)

  • Cholho Song;Hyun-Ah Choi;Jiwon Son;Youngjin Ko;Stephan A. Pietsch;Woo-Kyun Lee
    • Korean Journal of Environmental Biology
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    • v.41 no.4
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    • pp.400-412
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    • 2023
  • In this study, the biogeochemistry management (BGC-MAN) model was applied to North and South Korea pine and oak forest stands to evaluate the Net Primary Productivity (NPP), an indicator of forest ecosystem productivity. For meteorological information, historical records and East Asian climate scenario data of Shared Socioeconomic Pathways (SSPs) were used. For vegetation information, pine (Pinus densiflora) and oak(Quercus spp.) forest stands were selected at the Gwangneung and Seolmacheon in South Korea and Sariwon, Sohung, Haeju, Jongju, and Wonsan, which are known to have tree nurseries in North Korea. Among the biophysical information, we used the elevation model for topographic data such as longitude, altitude, and slope direction, and the global soil database for soil data. For management factors, we considered the destruction of forests in North and South Korea due to the Korean War in 1950 and the subsequent reforestation process. The overall mean value of simulated NPP from 1991 to 2100 was 5.17 Mg C ha-1, with a range of 3.30-8.19 Mg C ha-1. In addition, increased variability in climate scenarios resulted in variations in forest productivity, with a notable decline in the growth of pine forests. The applicability of the BGC-MAN model to the Korean Peninsula was examined at a time when the ecosystem process-based models were becoming increasingly important due to climate change. In this study, the data on the effects of climate change disturbances on forest ecosystems that was analyzed was limited; therefore, future modeling methods should be improved to simulate more precise ecosystem changes across the Korean Peninsula through process-based models.

Analysis of Effect on Domestic Shipping and Logistics Network due to COVID-19 Pandemic -Focusing on the Small-sized Ports of Coastal Ferry Routes in Jeollanamdo Province- (글로벌 팬데믹에 따른 국내 해운물류 네트워크 변화 분석 -전남지역 연안 여객 항로의 소규모 항만을 중심으로-)

  • Son, Yoo-Mi;Kim, Hwa-Young
    • Journal of Korea Port Economic Association
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    • v.40 no.3
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    • pp.175-186
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    • 2024
  • This study analyzes the changes in the coastal ferry transport network in South Korea due to the significant impact of the COVID-19 pandemic on the domestic shipping and logistics sector. Focusing on the small-sized ports network distributed across mainland and islands that make up the coastal ferry transport network, the research employs Social Network Analysis (SNA) methods to examine the structural changes and characteristics of the network from 2018 to 2021, distinguishing between the periods before and after the COVID-19 pandemic. By utilizing centrality indices such as the degree centrality, closeness centrality, and betweenness centrality, the study assesses the changes in the influence of small-sized ports within the network before and after the COVID-19 pandemic. The scope of this study focuses on Mokpo and Wando region in the Jellanamdo province, which have the largest coastal ferry transport networks and notable passenger transport performance in South Korea. It examines the primary ports in these regions and the small-sized ports located on the islands. Analysis of the Mokpo coastal ferry transport network indicates that the number of connected islands decreased before and after the pandemic, and connectivity to other islands within the network diminished. Factors such as the decline in tourist numbers due to COVID-19, the connecting with land bridges between the mainland and islands, and subsequent closure of ferry sea routes are believed to have impacted these network changes. In the Wando region, the sharp decrease in both island residents and tourists after the pandemic led to the suspension of ferry operations, resulting in disrupted connectivity with some small-sized ports on the coastal ferry transport network. This has affected network characteristics such as concentration and average path length in the Wando region. This study aims to analyze the changes in the domestic shipping and logistics, coastal ferry, network due to the COVID-19 pandemic, providing insights to predict potential network changes caused by uncertain events in the future and contributing to the formulation of proactive policies for effective responses.

Exhibition Hall Lighting Design that Fulfill High CRI Based on Natural Light Characteristics - Focusing on CRI Ra, R9, R12 (자연광 특성 기반 고연색성 실현 전시관 조명 설계 - CRI Ra, R9, R12를 중심으로)

  • Ji-Young Lee;Seung-Teak Oh;Jae-Hyun Lim
    • Journal of Internet Computing and Services
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    • v.25 no.4
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    • pp.65-72
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    • 2024
  • To faithfully represent the intention of the work in the exhibition space, lighting that provides high color reproduction like natural light is required. Thus, many lighting technologies have been introduced to improve CRI, but most of them only evaluated the general color rendering index (CRI Ra), which considers eight pastel colors. Natural light provides excellent color rendering performance for all colors, including red and blue, expressed by color rendering index of R9 and R12, but most artificial lighting has the problem that color rendering performance such as R9 and R12 is significantly lower than that of natural light. Recently, lighting technology that provides CRI at the level of natural light is required to realistically express the colors of works including primary colors but related research is very insufficient. Therefore this paper proposes exhibition hall lighting that fulfills CRI with a focus on CRI Ra, R9, and R12 based on the characteristics of natural light. First reinforcement wavelength bands for improving R9 and R12 are selected through analysis of the actual measurement SPD of natural and artificial lighting. Afterward virtual SPDs with a peak wavelength within the reinforcement wavelength band are created and then SPD combination conditions that satisfy CRI Ra≥95, R9, and R12≥90 are derived through combination simulation with a commercial LED light source. Through this, after specifying two types of light sources with 405,630nm peak wavelength that had the greatest impact on the improvement of R9 and R12, the exhibition hall lighting applied with two W/C White LEDs is designed and a control Index DB of the lighting is constructed. Afterward experiments with the proposed method showed that it was possible to achieve high CRI at the level of natural light with average CRI Ra 96.5, R9 96.2, and R12 94.0 under the conditions of illuminance (300-1,000 Lux) and color temperature (3,000-5,000K).

Development of an Automated Algorithm for Analyzing Rainfall Thresholds Triggering Landslide Based on AWS and AMOS

  • Donghyeon Kim;Song Eu;Kwangyoun Lee;Sukhee Yoon;Jongseo Lee;Donggeun Kim
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.9
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    • pp.125-136
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    • 2024
  • This study presents an automated Python algorithm for analyzing rainfall characteristics to establish critical rainfall thresholds as part of a landslide early warning system. Rainfall data were sourced from the Korea Meteorological Administration's Automatic Weather System (AWS) and the Korea Forest Service's Automatic Mountain Observation System (AMOS), while landslide data from 2020 to 2023 were gathered via the Life Safety Map. The algorithm involves three main steps: 1) processing rainfall data to correct inconsistencies and fill data gaps, 2) identifying the nearest observation station to each landslide location, and 3) conducting statistical analysis of rainfall characteristics. The analysis utilized power law and nonlinear regression, yielding an average R2 of 0.45 for the relationships between rainfall intensity-duration, effective rainfall-duration, antecedent rainfall-duration, and maximum hourly rainfall-duration. The critical thresholds identified were 0.9-1.4 mm/hr for rainfall intensity, 68.5-132.5 mm for effective rainfall, 81.6-151.1 mm for antecedent rainfall, and 17.5-26.5 mm for maximum hourly rainfall. Validation using AUC-ROC analysis showed a low AUC value of 0.5, highlighting the limitations of using rainfall data alone to predict landslides. Additionally, the algorithm's speed performance evaluation revealed a total processing time of 30 minutes, further emphasizing the limitations of relying solely on rainfall data for disaster prediction. However, to mitigate loss of life and property damage due to disasters, it is crucial to establish criteria using quantitative and easily interpretable methods. Thus, the algorithm developed in this study is expected to contribute to reducing damage by providing a quantitative evaluation of critical rainfall thresholds that trigger landslides.

Studies on the Effects of Several Factors on Soil Erosion (토양침식(土壤侵蝕)에 작용(作用)하는 몇가지 요인(要因)의 영향(影響)에 관(關)한 연구(硏究))

  • Woo, Bo Myeong
    • Journal of Korean Society of Forest Science
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    • v.29 no.1
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    • pp.54-101
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    • 1976
  • This study was conducted on the major factors affecting soil erosion and surface run-off. In order to investigate the processes and mechanisms of soil erosion on denuded forest-land in Korea, and to systematize the magnitudes of influences and interactions between individual factors, the five major factors adopted in these experiments are soil textures (coarse sand and clay loam), slope steepness ($10^{\circ}$, $20^{\circ}$, $30^{\circ}$ and $40^{\circ}$), rainfall intensities (50, 75 and 100mm/hr), slope mulching methods (bare, coarse straw-mat mulching, grass mulching and anti-erosion liquid mulching) and vegetation densities (sparse, moderate and dense). The processes and mechanisms of soil erosion, and the effects of mulchings on soil erosion as well as surface run-off rates were studied algebraically with four parts of laboratory experiments under the simulated rainfall and another part of field experiment under the natural rainfall. The results in this study are summarized as follows: 1. Experiment factors and surface run-off rates The surface run-off rates under the natural rainfall were resulted about 24.7~28.7% from the bare slopes, about 14.0~16.4% from the straw-mat mulched slopes, about 7.9~9.1% from the liquid mulched slopes, and about 5.6~7.2% from the grass mulched slopes respectively. The surface run-off rates under the simulated rainfall differed greatly according to the rainfall intensity and the mulching method. 2. Magnitudes of influences and interactions of the individual factor on the surface run-off rates. The experimental analyses on the major factors(soils, slopes, rainfalls, mulchings and vegetations) affecting the rates of surface run-off, show that the mean differences of surface run-off rate are significant at 5% level between the soil texture factors, among the slope steepness factors, among the rainfall intensity factors, among the mulching method factors, and among the vegetation density factors respectively. The interactions among the individual factor have a great influence(significant at 1% level) upon the rate of surface run-off, except for the interactions of the factors between soils and slopes; between slopes and vegetations; among soils, slopes and rainfalls; and among soils, slopes and mulchings respectively. On the bare slopes under the simulated rainfall, the magnitude of influences of three factors(soils, slopes and rainfalls) affecting the rate of surface run-off is in the order of the factor of rainfalls, soils and slopes. The magnitude of influences of three factors (soils, rainfalls and mulchings) affecting the rate of surface run-off, on the mulched slopes under the simulated rainfall is in the order of the factor of mulchings, rainfalls and soils and that of influences of the factor of soils, slopes and mulchings is in the order of the factor of mulchings, soils and slopes. On the vegetation growing slopes under the simulated rainfall, the magnitude of influences of three factors (soils, slopes and vegetations) affecting the rate of surface run-off is in the order of the factor of vegetations, soils and slopes. In the same condition of treatments on the field experiment under the natural rainfall, the order of magnitude of influences affecting the rate of surface run-off is the factor of mulchings, soils and slopes. 3. Experiment factors and soil losses The soil losses of the experiment plots differed according to the factors of soil texture, slope steepness, rainfall intensity and mulching method. The soil losses from the coarse soil were increased about 1.1~1.3 times as compared with that of fine soil under the natural rainfall, while the soil losses from the fine soil were increased about 1.2~1.3 times compared with that of coarse soil under the simulated rainfall. The equation of $E=aS^b$ (a, b are constant) between the slope steepness (log S) and soil losses (log E) under the simulated rainfall were developed. The equation of $E=aI^b$ (a, b are constant) between the rainfall intensity (log I) and soil losses (log E) were developed, and b values have a decreasing tendency according to the increase of the slope steepness and rainfall intensity. The soil losses under the natural rainfall were appeared about 38~41% from the coarse straw-mat mulched slopes, about 20~22% from the liquid mulched slopes, about 14~15% from the grass mulched slopes as compared with that of the bare slopes respectively. The soil loss from the vegetation plots showed about 7.1~16.4 times from the sparse plot, about 10.0~17.9 times from the moderate plot and about 11.1~28.1 times from the dense plot as compared with that of the bare slopes. 4. Magnitudes of influences and interactions of the individual factor on the soil erosion. The experimental analyses on the major factors(soils, slopes, rainfalls, mulchings and vegetations) affecting the soil erosion, show that the mean differences of soil losses are highly significant between the soil texture factors, among the slope steepness factors, among the rainfall intensity factors, among the mulching method factors and among the vegetation density factors respectively. The interactions among the individual factor have mostly great influences upon the soil erosion. The magnitude of influences of three factors (soils, slopes and rainfalls) affecting the soil erosion on the bare slopes under the simulated rainfall is in order of the factor of rainfalls, soils and slopes. On the mulched slopes under the simulated rainfall, the magnitude order of influences of three factors(soils, rainfalls and mulchings) affecting the soil erosion is the factor of mulchings, rainfalls and soils, and the order of influences of factor of soils, slopes and mulchings is the factor of mulchings, soils and slopes. On the vegetation growing slopes under the simulated rainfall, the magnitude of influences of three factors (soils, slopes and vegetations) affecting the soil erosion is in the order of the factor of slopes. vegetations and soils. In the same condition of treatments on the field experiment under the natural rainfall, the order of magnitude of influences of three factors (soils, slopes and mulchings) affecting the soil erosion is the factor of mulchings, of slopes and of soils.

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An Analysis of the Research Trends in Safety Education for Home Economics Education (가정과 안전교육의 연구 동향 분석)

  • Kim, Nam Eun
    • Journal of Korean Home Economics Education Association
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    • v.28 no.3
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    • pp.47-63
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    • 2016
  • The purpose of this study is to suggest the basic information for diverse and balanced research and development in this field with understanding research trends related to safety education in home economics. In order to so, this study makes population and sampling by targeting cases which refer to 'safety' on 15 papers of academic journals related to home economics registered in the National Research Foundation from 2001 to 2015, 244 papers related to safety education area and 179 master doctorate thesis by searching keyword as 'safety'. Analysis contents are research trends of papers related to safety education by year and by subject and research trends of safety education by area and by research method. As a result of the study, first, the number of research papers related to safety education by year on home economics curriculum repeated increase and decrease and there have been consistent studies conducted on safety education with 14-52 papers per every year and yearly average 28.2 papers. On the other hand, the most number of studies conducted in 2015 with 52 papers which are twice as much of 26 papers in 2014. This seems to be affected by the announcement of safety comprehensive countermeasures from government and the emphasis of safety subject on 2015 curriculum revision of the Ministry of Education. Second, with regards to research trends by topic, 137 papers are related to safety education (29%), 336 papers are related to safety actual condition (71%). Accidents and recognition had a greater percentage in a paper before 2009 (74.4%) and studies are increased after 2009 (from 21 papers to 53 papers) in terms of development or evaluation of safety education program, development of education materials, development of education method etc. Subject area dealt with the most on the research of safety actual condition is regarding safety accidents or effective variables (23.2%). Subject regarding the variables are researches related to factors influencing family violence, internet addiction, spouse violence, willingness to purchase unsafe food, age harassment, or suicidal attempt etc. Next, researches related to safety recognition (13.9%), safety knowledge and attitude (7.4%), safety behaviors (6.3%), safety consciousness (2.3%) show in sequence. Subject area dealt with the most on the researches regarding safety education is development and evaluation of safety education program (11%) and this appears the most in 2015 by year (21.5%). Third, with regards to eight areas of safety education, there are 143 papers regarding public safety (33.8%), 106 papers regarding violence and personal safety (25.1%), 93 papers regarding general subject on safety or whole safety area (22%) and 58 papers regarding drug and internet addiction (13.7%) in sequence. And there is no paper related to first aid and 1 paper is related to occupational safety (0.2%). Occupational safety area is less researched nevertheless its included in home economic curriculum as relative chapter. First aid does not directly correlate with home economics curriculum but should be studied in preparation for accident which could happen in practical class. Forth, with regards to research trends by research method, quantitative research (89.1%) is mostly used and both research study (70.4%) and experimental research (18.7%) are used the most frequently. In particular, researches on the actual condition of safety education and experimental studies for effectiveness verification take most of research method. As qualitative studies, there are phenomenological study (3.1%) and case study (3.1%) related to actual conditions of safety accidents. 10 papers (2.4%) are mixture of quantitative and qualitative research and some research conducted research study and experimental research at the same time (0.9%). With regards to subject of study, human environments (87.5%) are more than physical environments (12.5) and students (48.4%) are more than teachers and school parents (20.6%). As the subject of physical environments, school (6.5%) is the most but home environment is none. As a result of the study, research for the development of evaluation tool for evaluating safety education, occupational safety and lifelong education should be conducted from this time forward. In addition, the object of study shall be expanded to both human environments in terms of entire life and physical environments for home. An in-depth qualitative research should be needed by observing and meeting with each student.

Pipetting Stability and Improvement Test of the Robotic Liquid Handling System Depending on Types of Liquid (용액에 따른 자동분주기의 분주능력 평가와 분주력 향상 실험)

  • Back, Hyangmi;Kim, Youngsan;Yun, Sunhee;Heo, Uisung;Kim, Hosin;Ryu, Hyeonggi;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.62-68
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    • 2016
  • Purpose In a cyclosporine experiment using a robotic liquid handing system has found a deviation of its standard curve and low reproducibility of patients's results. The difference of the test is that methanol is mixed with samples and the extractions are used for the test. Therefore, we assumed that the abnormal test results came from using methanol and conducted this test. In a manual of a robotic liquid handling system mentions that we can choose several setting parameters depending on the viscosity of the liquids being used, the size of the sampling tips and the motor speeds that you elect to use but there's no exact order. This study was undertaken to confirm pipetting ability depending on types of liquids and investigate proper setting parameters for the optimum dispensing ability. Materials and Methods 4types of liquids(water, serum, methanol, PEG 6000(25%)) and $TSH^{125}I$ tracer(515 kBq) are used to confirm pipetting ability. 29 specimens for Cyclosporine test are used to compare results. Prepare 8 plastic tubes for each of the liquids and with multi pipette $400{\mu}l$ of each liquid is dispensed to 8 tubes and $100{\mu}l$ of $TSH^{125}I$ tracer are dispensed to all of the tubes. From the prepared samples, $100{\mu}l$ of liquids are dispensed using a robotic liquid handing system, counted and calculated its CV(%) depending on types of liquids. And then by adjusting several setting parameters(air gap, dispense time, delay time) the change of the CV(%)are calcutated and finds optimum setting parameters. 29 specimens are tested with 3 methods. The first(A) is manual method and the second(B) is used robotic liquid handling system with existing parameters. The third(C) is used robotic liquid handling system with adjusted parameters. Pipetting ability depending on types of liquids is assessed with CV(%). On the basis of (A), patients's test results are compared (A)and(B), (A)and(C) and they are assessed with %RE(%Relative error) and %Diff(%Difference). Results The CV(%) of the CPM depending on liquid types were water 0.88, serum 0.95, methanol 10.22 and PEG 0.68. As expected dispensing of methanol using a liquid handling system was the problem and others were good. The methanol's dispensing were conducted by adjusting several setting parameters. When transport air gap 0 was adjusted to 2 and 5, CV(%) were 20.16, 12.54 and when system air gap 0 was adjusted to 2 and 5, CV(%) were 8.94, 1.36. When adjusted to system air gap 2, transport air gap 2 was 12.96 and adjusted to system air gap 5, Transport air gap 5 was 1.33. When dispense speed was adjusted 300 to 100, CV(%) was 13.32 and when dispense delay was adjusted 200 to 100 was 13.55. When compared (B) to (A), the result increased 99.44% and %RE was 93.59%. When compared (C-system air gap was adjusted 0 to 5) to (A), the result increased 6.75% and %RE was 5.10%. Conclusion Adjusting speed and delay time of aspiration and dispense was meaningless but changing system air gap was effective. By adjusting several parameters proper value was found and it affected the practical result of the experiment. To optimize the system active efforts are needed through the test and in case of dispensing new types of liquids proper test is required to check the liquid is suitable for using the equipment.

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A Study of Equipment Accuracy and Test Precision in Dual Energy X-ray Absorptiometry (골밀도검사의 올바른 질 관리에 따른 임상적용과 해석 -이중 에너지 방사선 흡수법을 중심으로-)

  • Dong, Kyung-Rae;Kim, Ho-Sung;Jung, Woon-Kwan
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.17-23
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    • 2008
  • Purpose : Because there is a difference depending on the environment as for an inspection equipment the important part of bone density scan and the precision/accuracy of a tester, the management of quality must be made systematically. The equipment failure caused by overload effect due to the aged equipment and the increase of a patient was made frequently. Thus, the replacement of equipment and additional purchases of new bonedensity equipment caused a compatibility problem in tracking patients. This study wants to know whether the clinical changes of patient's bonedensity can be accurately and precisely reflected when used it compatiblly like the existing equipment after equipment replacement and expansion. Materials and methods : Two equipments of GE Lunar Prodigy Advance(P1 and P2) and the Phantom HOLOGIC Spine Road(HSP) were used to measure equipment precision. Each device scans 20 times so that precision data was acquired from the phantom(Group 1). The precision of a tester was measured by shooting twice the same patient, every 15 members from each of the target equipment in 120 women(average age 48.78, 20-60 years old)(Group 2). In addition, the measurement of the precision of a tester and the cross-calibration data were made by scanning 20 times in each of the equipment using HSP, based on the data obtained from the management of quality using phantom(ASP) every morning (Group 3). The same patient was shot only once in one equipment alternately to make the measurement of the precision of a tester and the cross-calibration data in 120 women(average age 48.78, 20-60 years old)(Group 4). Results : It is steady equipment according to daily Q.C Data with $0.996\;g/cm^2$, change value(%CV) 0.08. The mean${\pm}$SD and a %CV price are ALP in Group 1(P1 : $1.064{\pm}0.002\;g/cm^2$, $%CV=0.190\;g/cm^2$, P2 : $1.061{\pm}0.003\;g/cm^2$, %CV=0.192). The mean${\pm}$SD and a %CV price are P1 : $1.187{\pm}0.002\;g/cm^2$, $%CV=0.164\;g/cm^2$, P2 : $1.198{\pm}0.002\;g/cm^2$, %CV=0.163 in Group 2. The average error${\pm}$2SD and %CV are P1 - (spine: $0.001{\pm}0.03\;g/cm^2$, %CV=0.94, Femur: $0.001{\pm}0.019\;g/cm^2$, %CV=0.96), P2 - (spine: $0.002{\pm}0.018\;g/cm^2$, %CV=0.55, Femur: $0.001{\pm}0.013\;g/cm^2$, %CV=0.48) in Group 3. The average error${\pm}2SD$, %CV, and r value was spine : $0.006{\pm}0.024\;g/cm^2$, %CV=0.86, r=0.995, Femur: $0{\pm}0.014\;g/cm^2$, %CV=0.54, r=0.998 in Group 4. Conclusion: Both LUNAR ASP CV% and HOLOGIC Spine Phantom are included in the normal range of error of ${\pm}2%$ defined in ISCD. BMD measurement keeps a relatively constant value, so showing excellent repeatability. The Phantom has homogeneous characteristics, but it has limitations to reflect the clinical part including variations in patient's body weight or body fat. As a result, it is believed that quality control using Phantom will be useful to check mis-calibration of the equipment used. A value measured a patient two times with one equipment, and that of double-crossed two equipment are all included within 2SD Value in the Bland - Altman Graph compared results of Group 3 with Group 4. The r value of 0.99 or higher in Linear regression analysis(Regression Analysis) indicated high precision and correlation. Therefore, it revealed that two compatible equipment did not affect in tracking the patients. Regular testing equipment and capabilities of a tester, then appropriate calibration will have to be achieved in order to calculate confidential BMD.

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Radiation Therapy and Chemotherapy after Breast Conserving Surgery for Invasive Breast Cancer: An Intermediate Result (침윤성 유방암에서 유방보존수술 후 방사선치료 및 항암화학 병용치료의 성적 및 위험인자 분석)

  • Lee, Seok-Ho;Choi, Jin-Ho;Lee, Young-Don;Park, Heoung-Kyu;Kim, Hyun-Young;Park, Se-Hoon;Lee, Kyu-Chan
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.16-25
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    • 2007
  • [ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

Usefulness of Abdominal Compressor Using Stereotactic Body Radiotherapy with Hepatocellular Carcinoma Patients (토모테라피를 이용한 간암환자의 정위적 방사선치료시 복부압박장치의 유용성 평가)

  • Woo, Joong-Yeol;Kim, Joo-Ho;Kim, Joon-Won;Baek, Jong-Geal;Park, Kwang-Soon;Lee, Jong-Min;Son, Dong-Min;Lee, Sang-Kyoo;Jeon, Byeong-Chul;Cho, Jeong-Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.157-165
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    • 2012
  • Purpose: We evaluated usefulness of abdominal compressor for stereotactic body radiotherapy (SBRT) with unresectable hepatocellular carcinoma (HCC) patients and hepato-biliary cancer and metastatic liver cancer patients. Materials and Methods: From November 2011 to March 2012, we selected HCC patients who gained reduction of diaphragm movement >1 cm through abdominal compressor (diaphragm control, elekta, sweden) for HT (Hi-Art Tomotherapy, USA). We got planning computed tomography (CT) images and 4 dimensional (4D) images through 4D CT (somatom sensation, siemens, germany). The gross tumor volume (GTV) included a gross tumor and margins considering tumor movement. The planning target volume (PTV) included a 5 to 7 mm safety margin around GTV. We classified patients into two groups according to distance between tumor and organs at risk (OAR, stomach, duodenum, bowel). Patients with the distance more than 1 cm are classified as the 1st group and they received SBRT of 4 or 5 fractions. Patients with the distance less than 1 cm are classified as the 2nd group and they received tomotherapy of 20 fractions. Megavoltage computed tomography (MVCT) were performed 4 or 10 fractions. When we verify a MVCT fusion considering priority to liver than bone-technique. We sent MVCT images to Mim_vista (Mimsoftware, ver .5.4. USA) and we re-delineated stomach, duodenum and bowel to bowel_organ and delineated liver. First, we analyzed MVCT images to check the setup variation. Second we compared dose difference between tumor and OAR based on adaptive dose through adaptive planning station and Mim_vista. Results: Average setup variation from MVCT was $-0.66{\pm}1.53$ mm (left-right) $0.39{\pm}4.17$ mm (superior-inferior), $0.71{\pm}1.74$ mm (anterior-posterior), $-0.18{\pm}0.30$ degrees (roll). 1st group ($d{\geq}1$) and 2nd group (d<1) were similar to setup variation. 1st group ($d{\geq}1$) of $V_{diff3%}$ (volume of 3% difference of dose) of GTV through adaptive planing station was $0.78{\pm}0.05%$, PTV was $9.97{\pm}3.62%$, $V_{diff5%}$ was GTV 0.0%, PTV was $2.9{\pm}0.95%$, maximum dose difference rate of bowel_organ was $-6.85{\pm}1.11%$. 2nd Group (d<1) GTV of $V_{diff3%}$ was $1.62{\pm}0.55%$, PTV was $8.61{\pm}2.01%$, $V_{diff5%}$ of GTV was 0.0%, PTV was $5.33{\pm}2.32%$, maximum dose difference rate of bowel_organ was $28.33{\pm}24.41%$. Conclusion: Despite we saw diaphragm movement more than 5 mm with flouroscopy after use an abdominal compressor, average setup_variation from MVCT was less than 5 mm. Therefore, we could estimate the range of setup_error within a 5 mm. Target's dose difference rate of 1st group ($d{\geq}1$) and 2nd group (d<1) were similar, while 1st group ($d{\geq}1$) and 2nd group (d<1)'s bowel_organ's maximum dose difference rate's maximum difference was more than 35%, 1st group ($d{\geq}1$)'s bowel_organ's maximum dose difference rate was smaller than 2nd group (d<1). When applicating SBRT to HCC, abdominal compressor is useful to control diaphragm movement in selected patients with more than 1 cm bowel_organ distance.

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