• Title/Summary/Keyword: I/I 분석방법

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The Relationship between Perceived Importance of Space and Users' Satisfaction (치유의 숲 산림명상공간 인자의 중요도와 만족도)

  • Kyung-Mi Jung;Won-Sop Shin
    • Korean Journal of Environment and Ecology
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    • v.37 no.4
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    • pp.273-288
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    • 2023
  • Although many studies have been conducted on techniques and effects that can be applied to forest meditation in domestic forest healing meditation research, there has been little research on the space where forest meditation takes place. Nevertheless, a meditation space is not just a place concept but a forest environment element responsible for the healing function of a forest, i.e., a place containing healing factors, and can be an essential clue to the healing mechanism. Therefore, to determine whether a healing forest meditation space is suitable for meditation, this study selected the attribute items of the meditation space using the Delphi expert survey and then surveyed the user satisfaction of the healing forest meditation space using the IPA (Importance Performance Analysis) technique. The survey was conducted from August to November 2022, targeting 315 adults who used the forest meditation space at the National Center for Forest Therapy, the Saneum Healing Forest, and the Jathyanggi Pureunsup Arboretum in Gyeonggi Province. The result of the IPA analysis showed the average satisfaction with the forest meditation space was relatively high at 4.33 points on a 5-point Likert scale (4.33 points for the National Center for Forest Therapy, 4.34 points for the Saneum Healing Forest, and 4.37 points for the Jathyanggi Pureunsup Arboretum), indicating that the three healing forest meditation spaces were suitable for forest meditation. Satisfaction with the "Sounds of nature" was high in all three forests. On the other hand, all three forests showed a relatively low satisfaction with "Quietness," indicating it to be a priority problem to be addressed. Also, an open-ended questionnaire survey showed that the mediation space's natural elements, such as natural sounds, scenery, air, forest spaces, and scents, had a higher positive impact on meditation satisfaction than artificial elements, such as facilities. Therefore, it is essential to secure sound resources such as the sound of water and birds around the meditation space, and it is also necessary to consider ways to create a meditation forest in an independent area to avoid encounters with visitors and allow only participants in the forest healing meditation program to enter to increase satisfaction with forest meditation.

Development of Tree Carbon Calculator to Support Landscape Design for the Carbon Reduction (탄소저감설계 지원을 위한 수목 탄소계산기 개발 및 적용)

  • Ha, Jee-Ah;Park, Jae-Min
    • Journal of the Korean Institute of Landscape Architecture
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    • v.51 no.1
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    • pp.42-55
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    • 2023
  • A methodology to predict the carbon performance of newly created urban greening plans is required as policies based on quantifying carbon performance are rapidly being introduced in the face of the climate crisis caused by global warming. This study developed a tree carbon calculator that can be used for carbon reduction designs in landscaping and attempted to verify its effectiveness in landscape design. For practical operability, MS Excel was selected as a format, and carbon absorption and storage by tree type and size were extracted from 93 representative species to reflect plant design characteristics. The database, including tree unit prices, was established to reflect cost limitations. A plantation experimental design to verify the performance of the tree carbon calculator was conducted by simulating the design of parks in the central region for four landscape design, and the causal relationship was analyzed by conducting semi-structured interviews before and after. As a result, carbon absorption and carbon storage in the design using the tree carbon calculator were about 17-82% and about 14-85% higher, respectively, compared to not using it. It was confirmed that the reason for the increase in carbon performance efficiency was that additional planting was actively carried out within a given budget, along with the replacement of excellent carbon performance species. Pre-interviews revealed that designers distrusted data and the burdens caused by new programs before using the arboreal carbon calculator but tended to change positively because of its usefulness and ease of use. In order to implement carbon reduction design in the landscaping field, it is necessary to develop it into a carbon calculator for trees and landscaping performance. This study is expected to present a useful direction for ntroducing carbon reduction designs based on quantitative data in landscape design.

The Investigation and Conservation of Central Asia Wall Painting (No. 4074 and 4096) (중앙(中央) 아세아(亞細亞) 벽화(壁畵) 보존처리(保存處理)(I) - 벽화(壁畵)(본(本)4074, 본(本)4096)의 상웅조사(狀熊調査) -)

  • Kang, Hyung-tae;Yi, Yong-hee;Yu, Hei-sun;Kim, Yeon-mi;Jo, Yeon-tae;Aoki, Shigo;Yamamoto, Noriko;Ohbayashi, Kentaro
    • Conservation Science in Museum
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    • v.3
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    • pp.43-50
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    • 2001
  • This article is about a joint project carried out by the National Museum of Korea and the Tokyo Cultural Properties Research Institute for the conservation of central Asia Wall painting that has been selected for the exhibition at the new Seoul National Museum of Korea at Yongsan. The investigation of the wall painting revealed very useful information. This includes the condition of the object, and the identification of evident damage, such as cracks, loss of pigment, plus materials and methods employed during the object's creation, as well as previous conservation treatment. The object was mainly made by applying plaster to the body (wall) that consisted of a mixture of soils and rice straws. Then, on the surface of the wall-painting, pigments were used to draw and to colour it. As a part of the investigation, radiocarbon dating was conducted using straw samples taken from the object. The result indicates that the object is probably dated form between the end of the 10th Century and the beginning of the 13th Century. The result of X-ray diffraction also revealed the composition of the pigments used on the surface. These are 1. gypsom [Ca(SO4)·2H2O], CaSO4 and Calcite (CaCO3) and Calcite (CaCO3) that were used for the white background. 2. Pb3O4 and led Arsenate [Pb(As2O6) that were used for the red colouring. 3. Cuprite (Cu2O), Arsenolite (As2O3) and Arsenic Oxide (As2O4) that were used for the green colouring.

Concurrent Validity of the Self-Report and Proxy-Report Versions of a Health-Related Quality of Life Measure: A Focus Group Study (초등학교 아동과 보호자에게 적용한 삶의 질 평가도구의 동시타당도 연구: 표적집단 파일럿연구)

  • Choi, Bongsam
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.2
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    • pp.45-57
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    • 2023
  • Objective : The purpose of this study was to investigate the concurrent validity of the self- and proxy-report versions of the KIDSCREEN-10 quality of life questionnaire. Methods : A total of nine children and nine parents were selected to represent a cohort registered for a school-based wellness program. Two versions of the KIDSCREEN-10 questionnaire (self- and proxy reports) were administered to the children and their parents. The Rasch rating scale model was applied to determine the dimensionality and item difficulty of the two versions of the questionnaire. Moreover, the item-person matching map and Spearman's rho were compared to confirm the concurrent validity of the two versions. Results : All items, except four items (i.e., autonomy, home life, concentration/learning, and peers/social support), fit the Rasch rating scale model of the children's self-report version of the questionnaire. With regard to the parent's proxy-report version, two items misfit the model. While the items of the self- and proxy-report versions showed similar item difficulties, the parents had a tendency to be more severe in their ratings than the children. The correlation between the two versions was relatively low (Spearman's rho = .533, p > .05). The scatterplots between the two versions showed differences in the item difficulties of the physical and psychological well-being and self-perception items. Conclusion : These findings suggest that the three identified items should be taken into consideration when measuring children's health-related quality of life using the KIDSCREEN-10 questionnaire.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

Studies on the Foliar Application of Urea as Nitrogen Source of Rice Plant Nutrition (요소엽면살포(尿素葉面撒布)에 따른 수도(水稻)의 질소영양(窒素營養)에 관(關)한 연구(硏究))

  • Cho, Seoung-Jin
    • Applied Biological Chemistry
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    • v.9
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    • pp.125-147
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    • 1968
  • This experiment was carried out as a part of the studies on reasonable application of nitrogen in rice plant to determine: (I) Nitrogen absorption. and rooting of rice seedlings as affected by urea foliar application at late seedling stage (II) Effect of leaf prunning and foliar application of urea at late heading stage on the maturation and yield of rice (III) Effect of foliar application of urea and its time during the stage of ear formation on yield of rice plant. Results obtained are summarized as follows. Exp.I: Nitrogen absorption and rooting of rice seedlings as affected be urea foliar application at late seedling stage. 1 : The foliar application of urea plots$(T_{1},T_2)$ snowed mare N-content than non-urea foliar application plot(T0) at lane seedling stage, being significant among treatments and foliar application of urea seemed more effective in increasing the N-content of seedlings. and promoted root settlement and early growth alter the transplanting. 2 : The carbon contents of the plants of $T_1$, and $T_2$ at late seedling stage increased than T0, and the carbon contents. of $T_1$ and $T_2$ plots became higher in amount in proportion to the nitrogen absorption as compared with those of $T_0$. 3 : C/N ratio appeared significant among soil application plots($N_1, \;N_2$) and foliar application of urea plots ($T_1$, $T_2$ and $T_0$). C/N ratio was lower in case of increased amount of nitrogen. The higher contents of nitrogen and carbon and lower C/N ratio resulted in the increment of root numbers and root lengths. Exp.II: Effect of leaf prunning and foliar application of urea at late heading stage on the maturation and yield of rice. 1 : There was a highly significant decrease in the maturing rate by severe leaf prunning. In the mean time, significant increase in maturing rate was observed with urea foliar application and it was found the more frequent application the more effective for higher maturing rate with a moderate significance. A correlationship between the level of prunning and maturing rate was enumerated to 0.961 of correlation coefficient, which indicated an increased maturing rate by the increased number of remaining leaves. 2 : The 1.000 grain weight, grain weight and hulled rice yield increased by leaf prunning in order (plot a$A_1$, $A_3$, $A_2$ and $A_0$ were 89.8%, 89.4%, 87.8% and 87.5% respectively, showing the highest of rate in $A_1$ and $A_3$ in methods of ear fertilization and being highly significant between its treatment. 3 : 1000 grain weights were highly significant between time of application, showing a tendency of increase of weights with the time lagging until days before earings as that of maturing rates. High significance was recognized between methods of ear fertilization, showing the highest in $A_2$ 23.18 gr. 4 : Yields per $3.3m^2$ were not significant between time of ear fertilization, whereas were highly significant between methods of ear fertilization. Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 1.486 kg, 1.491 kg, 1.381 kg and 1.328 kg, respectively, showing the highest in $A_1$ and $A_3$. 5 : Hulling ratios showed significant different between time of ear fertilization, showing the highest in $T_2$, whereas those of methods of ear fertilization were highly significant between its treatment, Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 84.72%, 84.06%, 83.29%, and 82.56% respectively, showing the highest m $A_2$ and $A_3$ among others. 6 : Yields of hulled rice per $3.3m^2$ showed significant different between time of ear fertilization, showing the highest in $T_1$ 1.192 kg. Whereas, those were highly significant between methods of ear fertilization. Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 1.259 kg, 1.254 kg, 1.149 kg and 1.095 kg, respectively, showing the highest in $A_1$ and $A_2$. 7 : Contents of nitrogen on rice plant increased in case of nitrogen application as ear fertilizer and showed that the case of urea foliar application was more effective than that of soil application, showing the increased nitrogen content of rice plant was accompanied by carbon content.

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A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.127-135
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    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

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A Study on Public Interest-based Technology Valuation Models in Water Resources Field (수자원 분야 공익형 기술가치평가 시스템에 대한 연구)

  • Ryu, Seung-Mi;Sung, Tae-Eung
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.177-198
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    • 2018
  • Recently, as economic property it has become necessary to acquire and utilize the framework for water resource measurement and performance management as the property of water resources changes to hold "public property". To date, the evaluation of water technology has been carried out by feasibility study analysis or technology assessment based on net present value (NPV) or benefit-to-cost (B/C) effect, however it is not yet systemized in terms of valuation models to objectively assess an economic value of technology-based business to receive diffusion and feedback of research outcomes. Therefore, K-water (known as a government-supported public company in Korea) company feels the necessity to establish a technology valuation framework suitable for technical characteristics of water resources fields in charge and verify an exemplified case applied to the technology. The K-water evaluation technology applied to this study, as a public interest goods, can be used as a tool to measure the value and achievement contributed to society and to manage them. Therefore, by calculating the value in which the subject technology contributed to the entire society as a public resource, we make use of it as a basis information for the advertising medium of performance on the influence effect of the benefits or the necessity of cost input, and then secure the legitimacy for large-scale R&D cost input in terms of the characteristics of public technology. Hence, K-water company, one of the public corporation in Korea which deals with public goods of 'water resources', will be able to establish a commercialization strategy for business operation and prepare for a basis for the performance calculation of input R&D cost. In this study, K-water has developed a web-based technology valuation model for public interest type water resources based on the technology evaluation system that is suitable for the characteristics of a technology in water resources fields. In particular, by utilizing the evaluation methodology of the Institute of Advanced Industrial Science and Technology (AIST) in Japan to match the expense items to the expense accounts based on the related benefit items, we proposed the so-called 'K-water's proprietary model' which involves the 'cost-benefit' approach and the FCF (Free Cash Flow), and ultimately led to build a pipeline on the K-water research performance management system and then verify the practical case of a technology related to "desalination". We analyze the embedded design logic and evaluation process of web-based valuation system that reflects characteristics of water resources technology, reference information and database(D/B)-associated logic for each model to calculate public interest-based and profit-based technology values in technology integrated management system. We review the hybrid evaluation module that reflects the quantitative index of the qualitative evaluation indices reflecting the unique characteristics of water resources and the visualized user-interface (UI) of the actual web-based evaluation, which both are appended for calculating the business value based on financial data to the existing web-based technology valuation systems in other fields. K-water's technology valuation model is evaluated by distinguishing between public-interest type and profitable-type water technology. First, evaluation modules in profit-type technology valuation model are designed based on 'profitability of technology'. For example, the technology inventory K-water holds has a number of profit-oriented technologies such as water treatment membranes. On the other hand, the public interest-type technology valuation is designed to evaluate the public-interest oriented technology such as the dam, which reflects the characteristics of public benefits and costs. In order to examine the appropriateness of the cost-benefit based public utility valuation model (i.e. K-water specific technology valuation model) presented in this study, we applied to practical cases from calculation of benefit-to-cost analysis on water resource technology with 20 years of lifetime. In future we will additionally conduct verifying the K-water public utility-based valuation model by each business model which reflects various business environmental characteristics.

Prediction Formulas of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Nonsmoking and Smoking Adults and Effect of Smoking on Pulmonary Function Parameters (비흡연 및 흡연 성년 한국인에서의 노력성호기곡선을 이용한 폐활량측정법 검사지표들의 추정상치 및 이에 대한 흡연의 효과)

  • Cho, Won-Kyoung;Kim, Eun-Ok;Myung, Seung-Jae;Kwak, Seung-Min;Koh, Youn-Suck;Kim, Woo-Sung;Lee, Moo-Song;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.521-530
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    • 1994
  • Background : The past studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. Methods We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respitatory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. Result : 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with $FEV_1$/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with $FEV_1$ and $FEV_1$/FVC. Conclusion : We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.

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Radiotherapy in Small Cell Carcinoma of the Uterine Cervix (자궁경부 소세포암종의 방사선치료)

  • Chung Eun Ji;Lee Yong Hee;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.369-377
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    • 1997
  • Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.

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