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Individualized Determination of Lower Margin in Pelvic Radiation Field after Low Anterior Resection for Rectal Cancer Resulted in Equivalent Local Control and Radiation Volume Reduction Compared with Traditional Method (하전방 절제술을 시행한 직장암 환자에서 방사선조사 영역 하연의 개별화)

  • Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.194-199
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    • 2000
  • Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

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Analytical Studies on Yield and Yield Components in Barley (대맥의 수량 및 수량구성요소에 관한 해석적 연구)

  • Chung-Yun Park
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.18
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    • pp.88-123
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    • 1975
  • To obtain useful fundamental informations for improving cultural practices of barley, an investigation was made on the influences of different fertilizer level and seeding rate as well as seeding date on yield and yield components and their balancing procedure using barley variety Suwon # 18, and at the same time, 8 varieties including Suwon # 18 were also tested to clarify the varietal responses in terms of their yield and yield components under different seeding date at Crop Experiment Station, Suwon, during the period of 1969 and 1970. The results obtained were summarized as follows; 1. Days to emergence of barley variety Suwon # 18 at Suwon, took 8 to 19 days in accordance with given different seeding date (from Sept. 21 to Oct. 31). Earlier emergence was observed by early seeding and most of the seeds were emerged at 15$0^{\circ}C$ cumulated soil temperature at 5cm depth from surface under the favorable condition. 2. Degree of cold injury in different seeding date was seemed to be affected by the growth rate of seedlings and climatic condition during the wintering period. Over growth and number of leaves less than 5 to 6 on the main stem before wintering were brought in severe cold damage during the wintering period. 3. Even though the number of leaves on the main stem were variable from 11 to 16 depending upon the seeding date. this differences were occurred before wintering and less variation was observed after wintering. Particularly, differences of the number of main stem leaves from September 21 to October 11 seeding date were occurred due to the differences of number of main stem leaves before wintering. 4. Dry matter accumulation before wintering was high in early seeded plot and gradually decreased in accordance with delayed seeding date and less different in dry matter weight was observed after wintering. However, the increment rate of this dry matter was high from regrowth to heading time and became low during the ripening period. 5. Number of tillers per $\m^2$ was higher in early seeding than late one and dense planting was higher in the number of tillers than sparse planting. Number of tillers per plant was lower in number and variation in dense planting, and reverse tendency was observed in sparse planting. By increasing seedling rate in early seeding date the number of tiller per plant was remarkably decreased, but the seeding rate didn't affect the individual tillering capacity in the late seeding date. 6. Seedlings were from early planting reached maximum tillering stage earlier than those from the late planting and no remarkable changes was observed due to increased seeding rate. However. increased seeding rate tends to make it earlier the maximum tillering stage early. 7. Stage of maximum tillering was coincided with stage of 4-5 main stem leaves regardless the seeding date. 8. Number of heads per $\m^2$ was increased with increased seeding rate but considerable year variation in number of heads was observed by increased fertilizer level. Therefore, it was clear that there is no difficulties in increasing number of heads per $\m^2$ through increasing both fertilizer level and seeding rate. This type of tendency was more remarkable at optimum seeding time. In the other hand, seeding at optimum time is more important than increasing seeding rate, but increasing seeding rate was more effective in late seeding for obtaining desirable number of heads per $\m^2$. 9. Number of heads per $\m^2$ was decreased generally in all varieties tested in late seeding, but the degree of decrease by late seeding was lower in Suwon # 18. Yuegi, Hangmi and Buheung compared with Suwon # 4, Suwon # 6, Chilbo and Yungwolyukak. 10. Highly significant positive correlations were obtained between number of head and tillers per $\m^2$ from heading date in September 21 seeding, from before-wintering in October 1 seeding and in all growth period from October 11 to October 31 seeding. However, relatively low correlation coefficient was estimated between number of heads and tillers counted around late March to early April in any seeding date. 11. Valid tiller ratio varied from 33% to 76% and highest yield was obtained when valid tiller ratio was about 50%. Therefore, variation of valid tiller ratio was greater due to seeding date differences than due to seeding rate. Early seeding decreased the valid tiller ratio and gradually increased by delaying seeding date but decreased by increasing seeding rate. Among the varieties tested Suwon # 18, Hangmi, Yuegi as well as Buheung should be high valid tiller ratio not only in late seeding but also in early seeding. In contrast to this phenomena, Chilbo, Suwon # 4, Suwon # 6 and Yungwolyukak expressed low valid tiller ratio in general, and also exhibited the same tendency in late seeding date. 12. Number of grains per spike was increased by increasing fertilizer level and decreased by increasing seeding rate. Among the seeding date tested. October 21 (1969) and October 11 (1970) showed lowest number of grains per spike which was increased in both early seeding and late seeding date. There were no definite tendencies observed along with seeding date differences in respective varieties tested. 13. Variation of 1000 grain weight due to fertilizer level applied, seeding date and seeding rate was not so high as number of grains per spike and number of heads per $\m^2$, but exhibited high year variation. Increased seeding rate decreased the 1000 grain weight. Among the varieties tested Chilbo and Buheung expressed heavy grain weight, while Suwon # 18, Hangmi and Yuegi showed comparatively light grain weight. 14. Optimum seeding date in Suwon area was around October 1 to October 11. Yield was generally increased by increasing fertilizer level. Yield decrease due to early seeding was compensated in certain extent by increased fertilizer application. 15. Yield variations due to seeding rate differences were almost negligible compare to the variations due to fertilizer level and seeding date. In either early seeding or law fertilizer level yield variation due to seeding rate was not so remarkable. Increment of fertilizer application was more effective for yield increase especially at increased seeding rate. And also increased seeding rate fairly compensated the decrease of yield in late seeding date. 16. Optimum seeding rate was considered to be around 18-26 liters per 10a at N-P-K=10.5-6-6 kg/10a fertilizer level considering yield stabilization. 17. Varietal differences in optimum seeding date was quite remarkable Suwon # 6, Suwon # 4. Buheung noted high yield at early seeding and Suwon # 18, Yuegi and Hangmi yielded higher in seeding date of October 10. However, Buheung showed late seeding adaptability. 18. Highly significant positive correlations were observed between yield and yield components in all treatments. However, this correlation coefficient was increased positively by increased fertilizer level and decreased by increased seeding rate. Significant negative correlation coefficients were estimated between yield and number of grains per spike, since increased number of heads per m2 at the same level of fertilizer tends to decrease the number of grains per spike. Comparatively low correlation coefficients were estimated between 1000 grain weight and yield. 19. No significant relations in terms of correlation coefficients was observed between number of heads per $\m^2$ and 1000 grain weight or number of grains per head.

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The Study in Objectification of the diagnosis of Sasang Constitution(According to Analysis of the Past Questionnaires) (사상체질진단(四象體質診斷)의 객관화(客觀化)에 관한 연구(硏究)(기존(旣存) 설문지(說問紙)의 분석(分析)을 중심(中心)으로))

  • Kim, Young-woo;Kim, Jong-won
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.151-183
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    • 1999
  • The object of this study was 200 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 9 months from Jan. 1999 to sept. 1999. We proceeded the judgment of Sasang Constitution according to 'Questionnaire of Sasang Constitution Classification (I)', and 'Questionnaire of Sasang Constitution Classification II(QSCCII)' and the diagnosis by a medical specialist. The following conclusion were made in comparison with Sasang Constitution and Questionnaire. 1. We selected the 84 subjects what had the statistical value out of the 196 subjects('Questionnaire of Sasang Constitution Classification (I)' had the 71 subjects and 'Questionnaire of Sasang Constitution Classification II(QSCCII)', had the 121 subjects). And we selected again the 73 subjects('Questionnaire of Sasang Constitution Classification (I)', had the 33 subjects and 'Questionnaire of Sasang Constitution Classification II (QSCC II)' had the 40 subjects) out of the 84 subjects, because it had a repeated subjects. 2. We made the Questionnaire what has the 85 subjects, including the subjects what was approved its statistical value by 'A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE' and 'A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION'. The subject what ask the physique and the body form was 7, the subject what ask the external appearance and the posture was 7, the subject what ask the habit and the character was 3, the subject what ask the physiology and the pathology was 3, the subject what ask the phenomenon that he has frequency was 4, the subject what ask the eating was 3, the subject what ask the symptom that he has frequency was 14, the subject what ask the work and the qualities-defects was 6, the subject what ask the friendly intercourse was 7, the subject what ask the usual mind was 5, the subject what ask the emotional inclination was I, the subject what ask the behavioral inclination was 10, the subject what ask the character was 15. 3. In the new Questionnaire, the subject what has relevance to Soyang was 84, the subject what has relevance to Soeum was 87, the subject what has relevance to Taeeum was 70. And we made the point of subject with the statistical ratio. The total point of Soyang was 7785.04, the total point of Soeum was 7742.80, the total point of Taeeum was 7746.60. 4. As a result of judgment of Sasang Constitution between the clinical diagnosis by a medical specialist and the new Questionnaire, the diagnostic accuracy of new Questionnaire was 73.33%. The diagnostic accuracy of Soyang was low, the others was high. And the Taeyang was excepted.

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