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Physio-Ecological Studies on Stevia(Stevia rebaudiana Bertoni) (스테비아(Stevia rebaudiana Bertoni)에 관한 생리 생태적 연구)

  • Kwang-He Kang;Eun-Woong Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.26 no.1
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    • pp.69-89
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    • 1981
  • Stevia (Stevia rebaudiana Bertoni) is a perennial herb widely distributed in the mountainous area of Paraguay. It belongs to the family Compositae and contains 6 to 12 percent stevioside in the leaves. Stevioside is a glucoside having similar sweetening character to surgar and the degree of sweetness is approximately 300 times of sugar. Since Korea does not produce any sugar crops, and the synthetic sweetenings are potentially hazardous for health, it is rather urgent to develop an economical new sweetener. Consequently, the current experiments are conducted to establish cultural practices of stevia, a new sweetening herbs, introduced into Korea in 1973 and the results are summarized as followings: 1. Days from transplanting of cuttings to the flower bud formation of 6 stevia lines were similar among daylengths of 8, 10 and 12 hours, but it was much greater at daylengths of 14 or 24 hour and varietal differences were noticable. All lines were photosensitive, but a line, 77013, was the most sensitive and 77067 and Suweon 2 were less sensitive to daylength. 2. Critical daylength of all lines seemed to be approximately 12 hours. Growth of plants was severely retarded at daylengths less than 12 hours. 3. Cutting were responded to short daylength before rooting. Number of days from transplanting to flower bud formation of 40-day old cuttings in the nursery bed was 20 days and it was delayed as duration of nursery were shorter. 4. Number of days from emergence to flower bud formation was shortest at short day treatment from 20 days after emergence. It was became longer as initiation of short day treatment was earlier or later than 20 days. 5. Plant height, number of branches, and top dry weight of stevia were reduced as cutting date was delayed from March 20 to May 20. The highest yield of dry leaf was obtained at nursery duration of 40-50 days in march 20 cutting, 30-40 days in April 20 cutting, and 30 days in May 20 cutting. 6. An asymptotic relationship was observed between plant population and leaf dry weight. Yield of dry leaf increased rapidly as plant population increased from 5,000 to 10,000 plants/10a with a reduced increasing rate from 10,000 to 20,000 plants/l0a, and levelled off at the plant population higher than 20,000 plants/l0a. 7. Stevia was adaptable in Suweon, Chengju, Mokpo and Jeju and drought was one of the main factors reducing yield of dry leaf. Yield of dry leaf was reduced significantly (approximately 30%) at June 20 transplanting compared to optimum transplanting. 8. Yield of dry leaf was higher in a vinyl house compared to unprotected control at long daylength or natural daylength except at short day treatment at March 20. Higher temperature ill a vinyl house does not have benefital effects at April 20 transplanting. 9. The highest content of stevioside was noted at the upper leaves of the plant but the lowest was measured at the plant parts of 20cm above ground. Leaf dry weight and stevioside yield was mainly contributed by the plant parts of 60 to 120cm above ground but the varietal differences were also significant. 10. Delayed harvest by the time of flower bud formation increased leaf dry weight remarkably. However, there were insignificant changes of yield as harvests were made at any time after flower bud formation. Content of stevioside was highest at the time of flower bud formation and earlier or later harvest than this time was low in its content. The optimum harvesting time determined by leaf dry weight and stevioside content was the periods from flower bud formation to right before flowering that would be the period from September 10 to September 15 in Suweon area. 11. Stevioside and rebaudioside content in the leaves of Stevia varieties were ranged from 5.4% to 14.3% and 1.5% to 8.3% respectively. However, no definit relationships between stevioside and rebaudioside were observed in these particular experiments.

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Correlation analysis of radiation therapy position and dose factors for left breast cancer (좌측 유방암의 방사선치료 자세와 선량인자의 상관관계 분석)

  • Jeon, Jaewan;Park, Cheolwoo;Hong, Jongsu;Jin, Seongjin;Kang, Junghun
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.37-48
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    • 2017
  • Purpose: The most basic conditions of radiation therapy is to prevent unnecessary exposure of normal tissue. The risk factors that are important o evaluate the dose emitted to the lung and heart from radiation therapy for breast cancer. Therefore, comparing the dose factors of a normal tissue according to the radion treatment position and Seeking an effective radiation treatment for breast cancer through the analysis of the correlation relationship. Materials and Methods: Computed tomography was conducted among 30 patients with left breast cancer in supine and prone position. Eclipse Treatment Planning System (Ver.11) was established by computerized treatment planning. Using the DVH compared the incident dose to normal tissue by position. Based on the result, Using the SPSS (ver.18) analyzed the dose in each normal tissue factors and Through the correlation analysis between variables, independent sample test examined the association. Finally The HI, CI value were compared Using the MIRADA RTx (ver. ad 1.6) in the supine, prone position Results: The results of computerized treatment planning of breast cancer in the supine position were V20, $16.5{\pm}2.6%$ and V30, $13.8{\pm}2.2%$ and Mean dose, $779.1{\pm}135.9cGy$ (absolute value). In the prone position it showed in the order $3.1{\pm}2.2%$, $1.8{\pm}1.7%$, $241.4{\pm}138.3cGy$. The prone position showed overall a lower dose. The average radiation dose 537.7 cGy less was exposured. In the case of heart, it showed that V30, $8.1{\pm}2.6%$ and $5.1{\pm}2.5%$, Mean dose, $594.9{\pm}225.3$ and $408{\pm}183.6cGy$ in the order supine, prone position. Results of statistical analysis, Cronbach's Alpha value of reliability analysis index is 0.563. The results of the correlation analysis between variables, position and dose factors of lung is about 0.89 or more, Which means a high correlation. For the heart, on the other hand it is less correlated to V30 (0.488), mean dose (0.418). Finally The results of independent samples t-test, position and dose factors of lung and heart were significantly higher in both the confidence level of 99 %. Conclusion: Radiation therapy is currently being developed state-of-the-art linear accelerator and a variety of treatment plan technology. The basic premise of the development think normal tissue protection around PTV. Of course, if you treat a breast cancer patient is in the prone position it take a lot of time and reproducibility of set-up problems. Nevertheless, As shown in the experiment results it is possible to reduce the dose to enter the lungs and the heart from the prone position. In conclusion, if a sufficient treatment time in the prone position and place correct confirmation will be more effective when the radiation treatment to patient.

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NFC-based Smartwork Service Model Design (NFC 기반의 스마트워크 서비스 모델 설계)

  • Park, Arum;Kang, Min Su;Jun, Jungho;Lee, Kyoung Jun
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.157-175
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    • 2013
  • Since Korean government announced 'Smartwork promotion strategy' in 2010, Korean firms and government organizations have started to adopt smartwork. However, the smartwork has been implemented only in a few of large enterprises and government organizations rather than SMEs (small and medium enterprises). In USA, both Yahoo! and Best Buy have stopped their flexible work because of its reported low productivity and job loafing problems. In addition, according to the literature on smartwork, we could draw obstacles of smartwork adoption and categorize them into the three types: institutional, organizational, and technological. The first category of smartwork adoption obstacles, institutional, include the difficulties of smartwork performance evaluation metrics, the lack of readiness of organizational processes, limitation of smartwork types and models, lack of employee participation in smartwork adoption procedure, high cost of building smartwork system, and insufficiency of government support. The second category, organizational, includes limitation of the organization hierarchy, wrong perception of employees and employers, a difficulty in close collaboration, low productivity with remote coworkers, insufficient understanding on remote working, and lack of training about smartwork. The third category, technological, obstacles include security concern of mobile work, lack of specialized solution, and lack of adoption and operation know-how. To overcome the current problems of smartwork in reality and the reported obstacles in literature, we suggest a novel smartwork service model based on NFC(Near Field Communication). This paper suggests NFC-based Smartwork Service Model composed of NFC-based Smartworker networking service and NFC-based Smartwork space management service. NFC-based smartworker networking service is comprised of NFC-based communication/SNS service and NFC-based recruiting/job seeking service. NFC-based communication/SNS Service Model supplements the key shortcomings that existing smartwork service model has. By connecting to existing legacy system of a company through NFC tags and systems, the low productivity and the difficulty of collaboration and attendance management can be overcome since managers can get work processing information, work time information and work space information of employees and employees can do real-time communication with coworkers and get location information of coworkers. Shortly, this service model has features such as affordable system cost, provision of location-based information, and possibility of knowledge accumulation. NFC-based recruiting/job-seeking service provides new value by linking NFC tag service and sharing economy sites. This service model has features such as easiness of service attachment and removal, efficient space-based work provision, easy search of location-based recruiting/job-seeking information, and system flexibility. This service model combines advantages of sharing economy sites with the advantages of NFC. By cooperation with sharing economy sites, the model can provide recruiters with human resource who finds not only long-term works but also short-term works. Additionally, SMEs (Small Medium-sized Enterprises) can easily find job seeker by attaching NFC tags to any spaces at which human resource with qualification may be located. In short, this service model helps efficient human resource distribution by providing location of job hunters and job applicants. NFC-based smartwork space management service can promote smartwork by linking NFC tags attached to the work space and existing smartwork system. This service has features such as low cost, provision of indoor and outdoor location information, and customized service. In particular, this model can help small company adopt smartwork system because it is light-weight system and cost-effective compared to existing smartwork system. This paper proposes the scenarios of the service models, the roles and incentives of the participants, and the comparative analysis. The superiority of NFC-based smartwork service model is shown by comparing and analyzing the new service models and the existing service models. The service model can expand scope of enterprises and organizations that adopt smartwork and expand the scope of employees that take advantages of smartwork.

A Study on the Landscape Philosophy of Hageohwon Garden (별업 하거원(何去園) 원림에 투영된 조영사상 연구)

  • Shin, Sang-Sup;Kim, Hyun-Wuk;Kang, Hyun-Min
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.46-56
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    • 2012
  • The research results of tracing the Landscape Philosophy of Hageowon garden(何去園) in Musu-dong, Daejon of Youhwadang, Kwon, Iijin(權以鎭, 1668-1734) is as below. The ideological background of the protagonist reflected in Hageowon is the Hyoje Ideology(filial piety and brotherly love, 孝弟) of Sinjongchuwon(painstakingly caring for one's ancestors), Musil ideology(pursuing ethical diligence and truthful mind, 務實) based on sadistic tradition and ethical rationalism, Confucionist Eunil Ideology(ideology on seclusion, 隱逸) of Cheonghanjiyeon(quiet relaxation, 淸閒之燕), and the Pungryu ideology(appreciation for the arts, 風流) of Taoism in the Taoist style. Thus, by substituting these ideological values into a space called Hageowon, the Byulup gardens(別業) such as the Symbolic garden(象徵園), meaning gaeden(意園), and miniascape garden(縮景園) were able to be constructed. 2) The space organization system of Hageowon is generally classified into three phases considering the hierarchy. The first territory is the transitional space having residential features, which is an area to reach peach tree - road(Taoist world 桃經) from Youhwadang(有懷堂). The second territory is a monumental memorial space where the Yocheondae(繞千臺), Jangwoodam(丈藕潭), Hwagae(花階), and the ancestral graves take place, centering on the yards of Sumanheon(收漫軒), and the third territory is the secluded space in the eastern outer garden where the mountain stream flows from the north to south and which is the vein of the left-hand blue dragon(靑龍) of the guardian mountain of Hageowon. 3) Symbolically, the first phase has symbolized the space as a meaningful scenery by overlapping the Confucionist place of Youhwadang - Gosudae(孤秀臺) - Odeokdae(五德臺), and the mystic world of Jukcheondang(竹遷堂) - peach tree - road(桃徑). The second phase, which is the space of Sumanheon(收漫軒), Yocheondae, and Jangwoodam, the symbolical value of Sinjongchuwon(愼終追遠) and the remembrance and longing for one's parents are reflected. The third phase, which is the eastern outer garden of Hageowon and where the mountain stream flows from the north to south, is composed of the east valley(東溪) - Hwalsudam(活水潭) - Sumi Waterfall(修眉瀑布). More specifically, (1) Mongjeong symbolizes the life of gaining knowledge through studying to realize one's foolishness, (2) Hwalsudam symbolizes a transcending attitude in life refusing to pursue wealth and fame, and (3) Jangwoodam symbolizes the gateway to the fairyland to enter the world of mystic gods. 4) The rationale behind Hageowon is that the two algorithms of Confucionism and Taoist Theory appear repeatedly and in an overlapping way. The Napoji(納汚池) and Hwalsudam, which pertains to the prelude of space development, has symbolized Susimyangseong(修心養成, meditating one's mind and improving one's nature), which is based on ethical rationalism. Moreover, if the Monjeong sphere pertaining to the eastern outer garden of Hageowon takes the Confucionist value system as its theme, including moral training, studying, and researching, Jangwudam, Sumi Waterfalls, and Unwa can be understood as a taste of Cheokbyeon(滌煩, eliminating troubles) for the arts where the mystic world is substituted as a meaningful scenery. 5) The miniascape technique called artificial mountain was substituted to Hageowon to construct a mystic world like the 12 peaks of Mt. Mu(巫山). By borrowing the symbolic meaning expressed in old poems, it has been named 'Habang(1/何放), Hwabong(2, 3/和峯), Chulgun(4, 5, 6/出群), Sinwan(7/神浣), Chwhigyu(8, 9, 10/聚糾), Cheomyo(11/處杳), Giyung(12/氣融).' The representative poet reciting artificial mountain were Wangeui(汪醫), Nosamgang(魯三江), Dubo(杜甫), Hanyou(韓愈), Jeonheaseong(錢希聖), and Beomseokho(范石湖). They related themselves with literature by transcending time and space and attempted to sing about the richness of the mental world by putting the mystic world and culture of appreciating the arts they pursued in the vacation home called Hageowon.

Changes of Brain Natriuretic Peptide Levels according to Right Ventricular HemodynaMics after a Pulmonary Resection (폐절제술 후 우심실의 혈역학적 변화에 따른 BNP의 변화)

  • Na, Myung-Hoon;Han, Jong-Hee;Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Choi, Jae-Sung;Yoon, Seok-Hwa;Choi, Si-Wan
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.593-599
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    • 2007
  • Background: The correlation between levels of brain natriuretic peptide (BNP) and the effect of pulmonary resection on the right ventricle of the heart is not yet widely known. This study aims to assess the relationship between the change in hemodynamic values of the right ventricle and increased BNP levels as a compensatory mechanism for right heart failure following pulmonary resection and to evaluate the role of the BNP level as an index of right heart failure after pulmonary resection. Material and Method: In 12 non small cell lung cancer patients that had received a lobectomy or pnemonectomy, the level of NT-proBNP was measured using the immunochemical method (Elecsys $1010^{(R)}$, Roche, Germany) which was compared with hemodynamic variables determined through the use of a Swan-Garz catheter prior to and following the surgery. Echocardiography was performed prior to and following the surgery, to measure changes in right ventricular and left ventricular pressures. For statistical analysis, the Wilcoxon rank sum test and linear regression analysis were conducted using SPSSWIN (version, 11.5). Result: The level of postoperative NT-proBNP (pg/mL) significantly increased for 6 hours, then for 1 day, 2 days, 3 days and 7 days after the surgery (p=0.003, 0.002, 0.002, 0.006, 0.004). Of the hemodynamic variables measured using the Swan-Ganz catheter, the mean pulmonary artery pressure after the surgery when compared with the pressure prior to surgery significantly increased at 0 hours, 6 hours, then 1 day, 2 days, and 3 days after the surgery (p=0.002, 0,002, 0.006, 0.007, 0.008). The right ventricular pressure significantly increased at 0 hours, 6 hours, then 1 day, and 3 days after the surgery (p=0.000, 0.009, 0.044, 0.032). The pulmonary vascular resistance index [pulmonary vascular resistance index=(mean pulmonary artery pressure-mean pulmonary capillary wedge pressure)/cardiac output index] significantly increased at 6 hours, then 2 days after the surgery (p=0.008, 0.028). When a regression analysis was conducted for changes in the mean pulmonary artery pressure and NT-proBNP levels after the surgery, significance was evident after 6 hours (r=0.602, p=0.038) and there was no significance thereafter. Echocardiography displayed no significant changes after the surgery. Conclusion: There was a significant correlation between changes in the mean pulmonary artery pressure and the NT-proBNP level 6 hours after a pulmonary resection. Therefore, it can be concluded that changes in NT-proBNP level after a pulmonary resection can serve as an index that reflects early hemodynamic changes in the right ventricle after a pulmonary resection.

Application of OECD Agricultural Water Use Indicator in Korea (우리나라에 적합한 OECD 농업용수 사용지표의 설정)

  • Hur, Seung-Oh;Jung, Kang-Ho;Ha, Sang-Keun;Song, Kwan-Cheol;Eom, Ki-Cheol
    • Korean Journal of Soil Science and Fertilizer
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    • v.39 no.5
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    • pp.321-327
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    • 2006
  • In Korea, there is a growing competitive for water resources between industrial, domestic and agricultural consumer, and the environment as many other OECD countries. The demand on water use is also affecting aquatic ecosystems particularly where withdrawals are in excess of minimum environmental needs for rivers, lakes and wetland habits. OECD developed three indicators related to water use by the agriculture in above contexts : the first is a water use intensity indicator, which is expressed as the quantity or share of agricultural water use in total national water utilization; the second is a water stress indicator, which is expressed as the proportion of rivers (in length) subject to diversion or regulation for irrigation without reserving a minimum of limiting reference flow; and the third is a water use efficiency indicator designated as the technical and the economic efficiency. These indicators have different meanings in the aspect of water resource conservation and sustainable water use. So, it will be more significant that the indicators should reflect the intrinsic meanings of them. The problem is that the aspect of an overall water flow in the agro-ecosystem and recycling of water use not considered in the assessment of agricultural water use needed for calculation of these water use indicators. Namely, regional or meteorological characteristics and site-specific farming practices were not considered in the calculation of these indicators. In this paper, we tried to calculate water use indicators suggested in OECD and to modify some other indicators considering our situation because water use pattern and water cycling in Korea where paddy rice farming is dominant in the monsoon region are quite different from those of semi-arid regions. In the calculation of water use intensity, we excluded the amount of water restored through the ground from the total agricultural water use because a large amount of water supplied to the farm was discharged into the stream or the ground water. The resultant water use intensity was 22.9% in 2001. As for water stress indicator, Korea has not defined nor monitored reference levels of minimum flow rate for rivers subject to diversion of water for irrigation. So, we calculated the water stress indicator in a different way from OECD method. The water stress indicator was calculated using data on the degree of water storage in agricultural water reservoirs because 87% of water for irrigation was taken from the agricultural water reservoirs. Water use technical efficiency was calculated as the reverse of the ratio of irrigation water to a standard water requirement of the paddy rice. The efficiency in 2001 was better than in 1990 and 1998. As for the economic efficiency for water use, we think that there are a lot of things to be taken into considerations to make a useful indicator to reflect socio-economic values of agricultural products resulted from the water use. Conclusively, site-specific, regional or meteorogical characteristics as in Korea were not considered in the calculation of water use indicators by methods suggested in OECD(Volume 3, 2001). So, it is needed to develop a new indicators for the indicators to be more widely applicable in the world.

Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea (한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구)

  • Choi Doo Ho;Kim Eun Seog;Kim Yong Ho;Kim Jin Hee;Yang Dae Sik;Kang Seung Hee;Wu Hong Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.61-70
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    • 2005
  • Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.

Postoperstive Chemoradiotherapy in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 수술 후 화학방사선요법)

  • Chai, Gyu-Young;Kang, Ki-Mun;Choi, Sang-Gyeong
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.221-227
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    • 2002
  • Purpose : To evaluate the role of postoperative chemoradiotherapy in locally advanced rectal cancer, we retrospectively analyzed the treatment results of patients treated by curative surgical resection and postoperative chemoradiotherapy. Materials and Methods : From April 1989 through December 1998, 119 patients were treated with curative surgery and postoperative chemoradiotherapy for rectal carcinoma in Gyeongsang National University Hospital. Patient age ranged from 32 to 73 years, with a median age of 56 years. Low anterior resection was peformed in 59 patients, and abdominoperineal resection in 60. Forty-three patients were AJCC stage II and 76 were stage III. Radiation was delivered with 6 MV X rays using either AP-PA two fields, AP-PA both lateral four fields, or PA both lateral three fields. Total radiation dose ranged from 40 Gy to 56 Gy. In 73 patients, bolus infusions of 5-FU $(400\;mg/m^2)$ were given during the first and fourth weeks of radiotherapy. After completion of radiotherapy, an additional four to six cycles of 5-FU were given. Oral 5-FU (Furtulone) was given for nine months in 46 patients. Results : Forty $(33.7\%)$ of the 119 patients showed treatment failure. Local failure occurred in 16 $(13.5\%)$ patients, 1 $(2.3\%)$ of 43 stage II patients and 15 $(19.7\%)$ of 76 stage III patients. Distant failure occurred in 31 $(26.1\%)$ patients, among whom 5 $(11.6\%)$ were stage II and 26 $(34.2\%)$ were stage III. Five-year actuarial survival was $56.2\%$ overall, $71.1\%$ in stage II patients and $49.1\%$ in stage III patients (p=0.0008). Five-year disease free survival was $53.3\%$ overall, $68.1\%$ in stage II and $45.8\%$ in stage III (p=0.0006). Multivariate analysis showed that T stage and N stage were significant prognostic factors for five year survival, and that T stage, N stage, and preoperative CEA value were significant prognostic factors for five year disease free survival. Bowel complication occurred in 22 patients, and was treated surgically in 15 $(12.6\%)$, and conservatively in 7 $(5.9\%)$. Conclusion : Postoperative chemoradiotherapy was confirmed to be an effective modality for local control of rectal cancer, but the distant failure rate remained high. More effective modalities should be investigated to lower the distant failure rate.

Treatment Results of Radical Radiotherapy in Uterine Cervix Cancer (자궁경부암 환자의 근치적 방사선치료성적)

  • Huh Seung Jae;Kim Bo Kyong;Lim Do Hoon;Shin Seong Soo;Lee Jeong Eun;Kang Min Kyu;Ahn Yong Chan
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.237-245
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    • 2002
  • Purpose : This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Materials and Methods : Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radio-therapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range $30.6\~50.4\;Gy$ to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of $24\~28\;Gy$ with $6\~7$ fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Results : Early responses of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was $82\%,\;and\;73\%$, and the disease free survival (DFS) rate was $72\%,\;and\;69\%$, at 3, and 5 years, respectively. The pelvic control rate (PCR) was $79\%$ at both 3 and 5 years. According to the FIGO stage,3 and 5 year OS were $100\%\;and\;50\%$ in CIS/IA, $100\%\;and\;100%$ in IB, $83\%\;and\;69\%$ in IIA, $87\%\;and\;80\%$ in IIB, and $62\%\;and\;62\%$ in III, respectively. The 3 year OS in 4 patients with stage IVA was $100\%$. Three-year DFS were $80\%$ in CIS/IA, $88\%$ in IB, $100\%$ in IIA, $64\%$ in IIB, $58\%$ in III, and $75\%$ in IVA. Three-year PCR were $100\%$ in CIS/IA, $94\%$ in IB, $100\%$ in IIA, $84\%$ in IIB, $69\%$ in III, and $50\%$ in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate, treatment response and OTT were significant factors. By multivariate analysis, FIGO stage had a borderline significance for OS (p=0.0825) and treatment response had a borderline significance for DFS (0=0.0872). A total of 14 patients $(13\%)$ experienced rectal bleeding, which occurred from 3 to 44 months (median, 13 months) after the completion of radiotherapy. Conclusion : HDR brachytherapy protocol of Samsung Medical Center combined with properly optimal external beam pelvic irradiation is a safe and effective treatment for patients with uterine cervix cancer. The authors found that OTT of less than 55 days had a positive impact on pelvic control and survival rate.

Study about Vaccination of Patients Diagnosed by Antimeasles Antibody in Measles Out break between 2000 and 2001 (2000~2001년 홍역 유행시 홍역 항체 유무로 진단된 환아의 홍역백신 접종 여부에 관한 연구)

  • Kang, Kye Wool;Yoon, Hwa Jun;Park, Seok Won;Kim, Hwang Min;Kim, Jong Soo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.67-73
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    • 2002
  • Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

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