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Contents of Health Education for Pupils and the Perceptibility after Graduation of Primary School (국민학교(國民學校) 교과서내(敎科書內)의 보건교육내용(保健敎育內容) 및 그 습득도(習得度))

  • Jeon, Bo-Yoon;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.99-112
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    • 1985
  • It was measured to check the state of health education by the survey of the items related to the health with the first grade of students in middle school who mastered elementary courses. Totally 50 questions, which were selected from Standard and Dong-A reference books, were given to teachers and have got answered by the students who were totally 959(491 from urban areas and 468 from rural areas). It's done just after they entered middle school for a month, from April 10 to may 10, 1984. There were totally 782 items of health in all subjects of all grades. In contents, the most cases were about mental and emotional health(17.7%), exercise and rest (15.1%), environmental health, health life, personal health care, nutrition and foods, social health and organization, physiology and anatomy, statistics of public health population problem, disease and care, food sanitation, school health, parasitic and communicable disease control, eugenics and heredity(0.4%), etc were followed. In subjects, Korean language had 44.7% of mental and emotional health in 114 cases, arithmetics 46.4% of statistics of public health in 26, sociology, 23.1% of environmental health in 118, natural science, 60.1% of physiology and anatomy in 30, ethics, 40.3% of mental and emotional health in 176, music, 21.8% of mental and emotional health and accidents in 23, art, 42.9% of exercise and rest in 28, physical education, 38.6% of exercise and rest in 201, practical course, 36.2% of nutrition and foods in 61, and there was nothing but only one case in Korean history. Subjects in total cases of health informing items are below: Physical education 25.8, ethics 22.5%, sociology 15.1%, Korean language 14.6%, practical course 7.8%, natural science 3.8%, art 3.6%, arithmetics 3.3%, music 2.9%, Korean history 0.6%. Grades in total cases of health informing items are belows: the sixth grade 29.1%, the fourth grade 21.2%, the fifth grade 18.9%, the third grade 11.6%, the first grade 11.5%, the second grade 7.7%. The sections related to health matters were average 35.4%. According to the grades, the fourth and the sixth grade were 38.2% each other, the highest, and the second grade was 29.3%, the lowest. All scetions in physical education included them. The acceptability to the knowledge for health was belows: 56.3% in urban students and 53.9% in rural students. There was some difference in acceptability between two parties (p<0.005).

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In the Treatment I-131, the Significance of the Research that the Patient's Discharge Dose and Treatment Ward can Affect a Patient's Kidney Function on the Significance of Various Factors (I-131 치료시 환자의 신장기능과 다양한 요인으로 의한 퇴원선량 및 치료병실 오염도의 유의성에 관한 연구)

  • Im, Kwang Seok;Choi, Hak Gi;Lee, Gi Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.62-66
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    • 2013
  • Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

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Study on the Evaluation of Renal Function According to Set a Partial Region of Interest in 99mTc-DMSA scan of the Pediatric Patient with a Duplicated Ureter (중복요관을 가진 소아환자의 99mTc-DMSA 검사에서 부분적 관심영역 설정에 따른 신기능 평가에 관한 연구)

  • Nam-Koong, Hyuk;Oh, Shin Hyun;Kim, Jung Yul;Choi, Yoon Jung;Kim, Jae Sam;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.43-47
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    • 2013
  • Purpose: A duplicated ureter is congenital renal malformations with ureter in two. Patients with duplicated ureter are in force to $^{99m}Tc-DMSA$ scan at surgery before and after. In existing examination, at produce result after $^{99m}Tc-DMSA$ scan, didn't compare to upper pole and lower pole with malformed kidney and compared to only relative uptake ratio. Therefore, this study will examine about utility of set a partial region of interest and to functional recovery of renal cell through change of upper pole uptake ratio of malformed kidney by setting each partial region of interest in upper pole and lower pole of malformed kidney in $^{99m}Tc-DMSA$ examination in surgery before and after. Materials and Methods: Pediatric patients with malformed kidney of incomplete duplicated ureter, 15 patients were enrolled in this study. Scanning were scan 3 to 4 hours after injection of $^{99m}Tc-DMSA$ 1.5 ~ 1.9 MBq/kg. Region of interest were each set in normal kidney, upper pole and lower pole with malformed kidney. Region of interest were set with same condition and method to images of surgery before and after that radio technologist 1 person, resident of nuclear medicine 1 person and doctor of urology together. Therefore, this study were compared to uptake ratio (A: B: C) that normal kidney (A), lower pole of malformed kidney (B) and upper pole of malformed kidney (C) about uptake ratio changes of malformed kidney in follow-up examination of surgery before and after. Results: When compared to 15 patients, uptake ratios were increased 7 persons and decreased 8 persons. Among increased 7 persons, it were periods of follow-up examination that 2 persons were 14 months, 4 persons were 12 months and 1 person was 8 months after surgery. Among decreased 8 persons, it were periods of follow-up examination that 4 persons were 12 months 3 persons were 6 months and 1 persons were 4 months after surgery. Conclusion: Existing study could not see the exact uptake ratio changes of malformed kidney because using only the overall Left-Right kidney uptake ratios. But a setting partial region of interest was able to see exactly what changes in the uptake of each upper pole and lower pole of malformed kidney. Because recovery of renal parenchymal cells is difficult in an evaluation of short period of time, follow-up examination should be made in long period of time. How to set up partial region of interest be thought that it would be useful.

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Development of Supplemental Equipment to Reduce Movement During Fusion Image Acquisition (융합영상(Fusion image)에서 움직임을 줄이기 위한 보정기구의 개발)

  • Cho, Yong Gwi;Pyo, Sung Jae;Kim, Bong Su;Shin, Chae Ho;Cho, Jin Woo;Kim, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.84-89
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    • 2013
  • Purpose: Patients' movement during long image acquisition time for the fusion image of PET-CT (Positron Emission Tomography-Computed Tomography) results in unconformity, and greatly affects the quality of the image and diagnosis. The arm support fixtures provided by medical device companies are not manufactured considering the convenience and safety of the patients; the arm and head movements (horizontal and vertical) during PET/CT scan cause defects in the brain fundus images and often require retaking. Therefore, this study aims to develop patient-compensation device that would minimize the head and arm movements during PET/CT scan, providing comfort and safety, and to reduce retaking. Materials and Methods: From June to July 2012, 20 patients who had no movement-related problems and another 20 patients who had difficulties in raising arms due to shoulder pain were recruited among the ones who visited nuclear medicine department for PET Torso scan. By using Patient Holding System (PHS), different range of motion (ROM) in the arm ($25^{\circ}$, $27^{\circ}$, $29^{\circ}$, $31^{\circ}$, $33^{\circ}$, $35^{\circ}$) was applied to find the most comfortable angle and posture. The manufacturing company was investigated for the permeability of the support material, and the comfort level of applying bands (velcro type) to fix the patient's head and arms was evaluated. To find out the retake frequency due to movements, the amount of retake cases pre/post patient-compensation were analyzed using the PET Torso scan data collected between January to December 2012. Results: Among the patients without movement disorder, 18 answered that PHS and $29^{\circ}$ arm ROM were the most comfortable, and 2 answered $27^{\circ}$ and $31^{\circ}$, respectively. Among the patients with shoulder pain, 15 picked $31^{\circ}$ as the most comfortable angle, 2 picked $33^{\circ}$, and 3 picked $35^{\circ}$. For this study, the handle was manufactured to be adjustable for vertical movements. The material permeability of the patient-compensation device has been verified, and PHS and the compensation device were band-fixed (velcro type) to prevent device movements. A furrow was cut for head fixation to minimize the head and neck movements, fixing bands were attached for the head, wrist, forearm, and upper arm to limit movements. The retake frequency of PET Torso scan due to patient movements was 11.06% (191 cases/1,808 patients) before using the movement control device, and 2.65% (48 cases/1,732 patients) after using the device; 8.41% of the frequency was reduced. Conclusion: Recent change and innovation in the medical environment are making expensive medical image scans, and providing differentiated services for the customers is essential. To secure patient comfort and safety during PET/CT scans, ergonomic patient-compensation devices need to be provided. Therefore, this study manufactured a patientcompensation device with vertically adjustable ergonomic ROM according to the patient's body shape and condition during PET Torso scan. The defects in the basal ganglia images due to arm movements were reduced, and retaking was decreased.

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GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Comparison of Dietary Patterns, Health, and Blood Parameters of Elderly Women and College Women in the Seoul Area (노화 과정에 따른 노인과 여대생의 식생활, 건강 상태 및 혈액 성상 비교 연구)

  • Shin, Kyung-Ok;Chung, Keun-Hee;Choi, Kyung-Soon
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.5
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    • pp.703-712
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    • 2009
  • The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

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Nitrogen Removal Rate of A Subsurface Flow Treatment Wetland System Constructed on Floodplain During Its Initial Operating Stage (하천고수부지 수질정화 여과습지의 초기운영단계 질소제거)

  • Yang, Hong-Mo
    • Korean Journal of Environmental Agriculture
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    • v.22 no.4
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    • pp.278-283
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    • 2003
  • This study was carried out to examine the nitrogen removal rate of a subsurface-flow treatment wetland system which was constructed on floodplain of the Kwangju River from May to June 2001. Its dimensions were 29m in length, 9m in width and 0.65m in depth. A bottom layer of 45cm in depth was filled with crushed granite with about $15{\sim}30\;mm$ in diameter and a middle layer of 10cm in depth had pea pebbles with about 10 mm in diameter. An upper layer of 5 cm in depth contained course sand. Reeds (Phragmites australis) were transplanted on the surface of the system. They were dug out of natural wetlands and stems were cut at about 40 cm height from their bottom ends. Water of the Kwangju River flowed into it via a pipe by gravity flow and its effluent was funneled back into the river. The height of reed stems was 44.2 cm in July 2001 and 75.3cm in September 2001. The number of stems was increased from $80\;stems/m^2$ in July 2001 to $136\;stems/m^2$ in September 2001. Volume and water quality of inflow and outflow were analyzed from July 2001 through December 2001. Inflow and outflow averaged 40.0 and $39.2\;m^3/day$, respectively. Hydraulic detention time was about 1.5 days. Average nitrogen uptake by reeds was $69.31\;N\;mg/m^2/day$. Removal rate of $NO_3-N$, $NH_3-N$, T-N averaged 195.58, 53.65, and $628.44\;mg/m^2/day$, respectively. Changes of $NO_3-N$ and $NH_3-N$ abatement rates were closely related to those of wetland temperatures. The lower removal rate of nitrogen species compared with that of subsurface-flow wetlands operating in North America could be attributed to the initial stage of the system and inclusion of two cold months into the six-month monitoring period. Increase of standing density of reeds within a few years will develop both root zones suitable for the nitrification of ammonia and surface layer substrates beneficial to the denitrification of nitrates into nitrogen gases, which may lead to increment in the nitrogen retention rate.

The Study on Usefulness of LEAP Collimator in Lung Ventilation SPECT (Lung Ventilation SPECT에서 LEAP Collimator의 유용성에 관한 연구)

  • Kim, Jung Soo;Kim, Soo Mee;Kim, Jin Eui;Lee, Jae Sung;Lee, Dong Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.18-24
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    • 2012
  • Purpose : Although lung ventilation SPECT (LV-SPECT) has a good sensitivity in detection of deep lung lesions, it is difficult to apply the LV-SPECT to patients having breathing problems due to limited examination time. In this study, we evaluated the usefulness of LEAP collimator, which provides high detection sensitivity and tolerable resolution, for the LV-SPECT in terms of diagnostic accuracy and examination time. Materials and Methods : Four volunteers inhaled Technegas (370 MBq) and the lung ventilation planar scan (LVPS, 300 counts/view (cpv)) with LEHR collimator was performed using Siemens E.cam scanner as a reference test. LV-SPECT scans were performed with three collimators, LEHR, LEUHR, and LEAP, in low (7 kcpv) and high (70 kcpv) counting modes. The count ratios of left (LT) and right (RT) lung segments were calculated on the geometric mean view of anterior and posterior images for LVPS and on the summed coronal images of LV-SPECT, respectively. Comparing to LVPS, the usefulness of three different collimators for LV-SPECT was evaluated through statistical analysis (paired t-test), on count ratios of lung segments. Results : The average LT:RT ratio in LVPS was 47:53. For LV-SPECT, there were negligible difference of the LT:RT ratios (48:52 on average) among three different collimators in low and high counting modes. Comparing to standard LVPS with LEHR, all LV-SPECTs with different collimators resulted in similar diagnostic accuracy through paired t-test (p>0.05). The scan time in LVPS (6 views) was 17.3 min. For LV-SPECT (128 views) in low counting mode, it took 18.7 (LEUHR), 15.0 (LEHR), and 12.3 min (LEAP), respectively. Conclusion : Comparing to standard LVPS, the LV-SPECT with LEAP in low counting mode provided the comparable diagnostic accuracy in addition to shortened scan time.

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Clinical Findings of Mycoplasma pneumoniae pneumonia under 3 Year-Old Children (3세 이하 Mycoplasma pneumoniae 폐렴환자의 임상적 고찰)

  • Lee, Sung-Soo;Youn, Kyung-Lim;Kang, Hyeon-Ho;Cho, Byoung-Soo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.78-85
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    • 1999
  • Purpose : Mycoplasma pneumoniae pneumonia has been to be developed frequently in school age children and adolescence and hard to see under 3 year-old children. But it seems to be increased in number of patients with Mycoplasma pneumoniae pneumonia under 3-year old in clinical practice in these days. We have aimed to examine the characteristics of clinical findings of Mycoplasma pneumonia under 3 year-old children. Methods : We had performed retrospective review of medical records of 30 patients with Mycoplasmal pneumonia under 3-year old children who admitted to Department of Pediatrics, Kyunghee University Hospital from Jan. 1994 to Dec. 1997. The diagnostic criteriae was Cold agglutinin titer>1:64 or Mycoplasma antibody titer>1:80. Results : Mycoplasmal pneumonia was 30 out of 235 cases(12.7%) of total pneumonia under 3 year old children. Male female ratio was 1.3 : 1 and age distributions were 0~1y : 0, 1~2y : 8, 2~3y : 22 cases. Clinical symptoms and signs were cough(100.0%), sputum(83.3%), fever(80.0%) rhinorrhea(33.3%), vomiting(33.3%), moist rale(86.7%), decreased breathing sound(26.7%), wheezing(20.0%), and pharyngeal injection(30.0%). Thirteen out of 30 cases(43.3%) had unilateral infiltration, 10 cases(33.4%) had bilateral infiltration, 1 case(3.3%) had pleural effusion, and 6 cases(20.0%) had negative findings on chest radiography and there was no cases of atelectasis. On laboratory findings, 6 out of 30 cases(20.0%) had leukocytosis, 1 case(3.3%) had neutrophilia, 10 cases(30.0%) had eosinophilia, 17 cases(56.7%) had increased ESR, and 18 cases(60.6%) had positive CRP. Positive cold agglutinin titers(>1 : 64) were 19 cases(63.3%), and positive mycoplasma antibody(M-ab) titers(>1 : 80) were 27 cases(93.3%). Mycoplasma antibody test was more valuable than cold agglutinin test for the diagnosis of Mycoplasmal pneumonia and there was no correlation between cold agglutinin titer and mycoplasma antibody titer. Mycoplasma-polymerase chain reaction(M-PCR) was done with 13 cases, 12 out of 13 cases(92.3%) were positive. M-PCR test was valuable to the diagnosis of Mycoplasmal pneumonia but it will be needed to further study for their clinical application. Among 30 cases, 5 cases(16.7%) had complications, 3 cases(10.0%) had skin rash, 1 case(3.3%) had pleural effusion, 1 case(3.3%) had arthralgia, but all complications were mild and recovered without residual sequelae. Conclusion : The occurrence of Mycoplasmal pneumonia under 3 year-old children was not rare from this study. Clinical characteristics of Mycoplasmal pneumonia under 3-year old were normal radiologic findings in many cases, low complication rate, mild clinical course, and tend to rapid recovery compared with general manifestations of Mycoplasmal infectionsin children and adolescence. There were likely to be missed patients with Mycoplasmal pneumonia which did not diagnose by conventional serologic tests that had low sensitivity and specificity. We have to pay attention to the Mycoplasmal infection of the young children with pneumonia during epidemic periods of Mycoplasmal infection.

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The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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