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The Role of Radiotherapy for Carcinomas of the Gall Bladder and Extrahepatic Biliary Duct: Retrospective Analysis (담낭 및 간외담도계 악성종양의 방사선치료결과)

  • Jeong Hyeon Ju;Lee Hyun Ju;Yang Kwang Mo;Suh Hyun Suk;Kim Re Hwe;Kim Sung Rok;Kim Hong Ryong
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.43-49
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    • 1998
  • Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

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The Value and Growing Characteristics of the Dicentra Spectabilis Community in Daea-ri, Wanju-gun, Jeollabuk-do as a Nature Reserve (전북 완주군 대아리 금낭화 Dicentra spectabilis 군락지의 천연보호구역적 가치와 생육특성)

  • Lee, Suk Woo;Rho, Jae Hyun;Oh, Hyun Kyung
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.72-105
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    • 2011
  • This study explores the value of the Dicentra spectabilis community as a nature reserve in provincial forests at San 1-2, Daea-ri, Dongsang-myeon, Wanju-gun, Jellabuk-do, also known as Gamakgol, while defining the appropriateness of its living environment and eventually providing basic information to protect this area. For these reasons, we investigated 'morphological and biological features of Dicentra spectabilis' and the 'present situation and problems of designing a herbaceous nature reserve in Korea.' Furthermore, we researched and analyzed the solar, soil and vegetation condition here through a field study in order to comprehend its nature reserve value. The result is as follows. According to the analytic result for information on the domestic wild Dicentra spectabilis community, it is evenly spread throughout mountainous areas, and there is one particularly outstanding in size in Wanju Gamakgol. Upon the findings from literature and the field study about its dispersion, Gamakgol has been discovered as an ideal district for Dicentra spectabilis since it meets all the conditions this plant requires to grow vigorously, such as a quasi-high altitude and rich precipitation during its period of active growth duration in May. Dicentra spectabilis grows in rocky soil ranging from 300~375m above sea level, 344.5m on average, towards the north, northwest and dominantly in the northeast. The mean inclination degree is $19.5^{\circ}$. Also, upon findings from analyzing solar conditions, the average light intensity during its growth duration, from Apr. to Aug., is 30,810lux on average and it tends to increase, as it gets closer to the end. This plant requires around 14,000~18,000lux while growing, but once bloomed, fruits develop regardless of the degree of brightness. The soil pH has shown a slight difference between the topsoil, at 5.2~6.1, and subsoil, at 5.2~6.2. Its mean pH is 5.54 for topsoil and 5.58 for subsoil. These results are very typical for Dicentra spectabilis to grow in, and other comparative areas also present similar conditions. Given the facts, the character of the soil in Gamakgol has been evaluated to have high stability. Analysis of its vegetation environment shows a wide variation of taxa numbering from 13 to 52 depending on area. The total number of taxa is 126 and they are a homogenous group while showing a variety of species as well. The Dicentra spectabilis community in the Daea-ri Arboretum is an herbaceous community consisting of dominantly Dicentra spectabilis, Cardamine leucantha, Boehmeria tricuspi and Impatiens textori while having many differential species such as Impatiens textori, Pueraria thunbergiana, Rubus crataegifolius vs Staphylea bumalda, Securinega suffruticosa, and Actinidia polygama. It suggests that it is a typical subcolony divided by topographic features and soil humidity. Considering the above results on a comprehensive level, this area is an excellent habitat for wild Dicentra spectabilis providing beautiful viewing enjoyment. Additionally, it is the largest wild colony of Dicentra spectabilis in Korea whose climate, topography, soil conditions and vegetation environment can secure sustainability as a wild habitat of Dicentra spectabilis. Therefore, We have determined that the Gamakgol community should be re-examined as natural asset owing to its established habitat conditions and sustainability.

The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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A Study on Dance Historical Value of Jaein Line Dance by Han Seong-jun (한성준을 통해 본 재인 계통춤의 무용사적 가치 연구)

  • Choung, Soung Sook
    • (The) Research of the performance art and culture
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    • no.19
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    • pp.347-378
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    • 2009
  • Those who were from Jaeincheon and Jaein line entertainers played great roles during transition period from traditional society to modern society, and even at present the dances of them are the representative traditional dances of Korea and the matrix of Korean originality. Nevertheless, Korea dance field has given little importance to these dances, but too much importance to Gibang dance in studying traditional dances, which causes the studies on Jaein line danced to be superficial or separate. Therefore, the aims of this article are to analyze the dances of Jaein line by Han Seong-jun, who was representative for the dances, and to appraise the historical value of them. Han Seong-jun(1874-1942) was the most influential dummer and dancer of his day in Japanese colonial times, and has been recognized as one of the masters of traditional dances. He established autonomy of traditional dances by reorganizing, collecting and stage-formalizing the dances, and systemized transmitting ways for various folk dances including a Buddhist dance, which made it possiblefor those dances to be traditional dances of Korea and the bases for creative dances. The values of Jaein line dances, which were transmitted through Han, are the following: First, the dances have been designated as national or regional intangible cultural assets, and, as the representative traditional arts, we proudly show them to the world. Second, the dances, as one of the genres of Korean dances, are the subjects of younger scholars' studies. Third, the dances become one of the representative examples of revivals of traditional dances, which tend to be extinct during modernization times, and contribute to establishing national identity and subjectivity. In addition, they contribute to discovering and transmitting other traditional dances. Fourth, the dances enable many dancers to make association, that is, Association for Preservation of Traditional Dances,for the transmitting the dances, and to distribute the dances and get many dancers to transmit the dances. Furthermore, as new performance repertories, they give another pleasure to the audience. In addition to the above, as a base for expansion of Korean creative dances, Han's dances have other values such as the following: First, in searching for a new methodology for creation, he played an important role in rediscovering the foundation in the tradition, and tried to discover nationalidentity by employing the traditional dances for expression of theme. Second, he contributed to drastically dissolving the genres by expanding the gesture language from motion factors of traditional dances, which can be compared to the modern dance. Third, he tried new challenging approaches to re-create the tradition, and contributed to pursuing the simple elements of our traditional dances as traditional aesthetics. While the dances of Jaein line have such values as the above, there are also some problems around the dances, such as the confusion in the process of transmission resulted from different transmission forms and transmitters, which we must no longer leave as it is. Furthermore, it is urgent that the rest of Jaein line dances be recovered and designated as intangible cultural assets for the sound transmission of the traditional dances.

The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

A Time Series Graph based Convolutional Neural Network Model for Effective Input Variable Pattern Learning : Application to the Prediction of Stock Market (효과적인 입력변수 패턴 학습을 위한 시계열 그래프 기반 합성곱 신경망 모형: 주식시장 예측에의 응용)

  • Lee, Mo-Se;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.167-181
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    • 2018
  • Over the past decade, deep learning has been in spotlight among various machine learning algorithms. In particular, CNN(Convolutional Neural Network), which is known as the effective solution for recognizing and classifying images or voices, has been popularly applied to classification and prediction problems. In this study, we investigate the way to apply CNN in business problem solving. Specifically, this study propose to apply CNN to stock market prediction, one of the most challenging tasks in the machine learning research. As mentioned, CNN has strength in interpreting images. Thus, the model proposed in this study adopts CNN as the binary classifier that predicts stock market direction (upward or downward) by using time series graphs as its inputs. That is, our proposal is to build a machine learning algorithm that mimics an experts called 'technical analysts' who examine the graph of past price movement, and predict future financial price movements. Our proposed model named 'CNN-FG(Convolutional Neural Network using Fluctuation Graph)' consists of five steps. In the first step, it divides the dataset into the intervals of 5 days. And then, it creates time series graphs for the divided dataset in step 2. The size of the image in which the graph is drawn is $40(pixels){\times}40(pixels)$, and the graph of each independent variable was drawn using different colors. In step 3, the model converts the images into the matrices. Each image is converted into the combination of three matrices in order to express the value of the color using R(red), G(green), and B(blue) scale. In the next step, it splits the dataset of the graph images into training and validation datasets. We used 80% of the total dataset as the training dataset, and the remaining 20% as the validation dataset. And then, CNN classifiers are trained using the images of training dataset in the final step. Regarding the parameters of CNN-FG, we adopted two convolution filters ($5{\times}5{\times}6$ and $5{\times}5{\times}9$) in the convolution layer. In the pooling layer, $2{\times}2$ max pooling filter was used. The numbers of the nodes in two hidden layers were set to, respectively, 900 and 32, and the number of the nodes in the output layer was set to 2(one is for the prediction of upward trend, and the other one is for downward trend). Activation functions for the convolution layer and the hidden layer were set to ReLU(Rectified Linear Unit), and one for the output layer set to Softmax function. To validate our model - CNN-FG, we applied it to the prediction of KOSPI200 for 2,026 days in eight years (from 2009 to 2016). To match the proportions of the two groups in the independent variable (i.e. tomorrow's stock market movement), we selected 1,950 samples by applying random sampling. Finally, we built the training dataset using 80% of the total dataset (1,560 samples), and the validation dataset using 20% (390 samples). The dependent variables of the experimental dataset included twelve technical indicators popularly been used in the previous studies. They include Stochastic %K, Stochastic %D, Momentum, ROC(rate of change), LW %R(Larry William's %R), A/D oscillator(accumulation/distribution oscillator), OSCP(price oscillator), CCI(commodity channel index), and so on. To confirm the superiority of CNN-FG, we compared its prediction accuracy with the ones of other classification models. Experimental results showed that CNN-FG outperforms LOGIT(logistic regression), ANN(artificial neural network), and SVM(support vector machine) with the statistical significance. These empirical results imply that converting time series business data into graphs and building CNN-based classification models using these graphs can be effective from the perspective of prediction accuracy. Thus, this paper sheds a light on how to apply deep learning techniques to the domain of business problem solving.

Combined Chemoradiotherapy vs Radiotherapy Alone for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (국소적으로 진행된 두경부 편평상피세포종양의 방사선- 항암화학 병용요법과 방사선단독치료의 비교)

  • Jeong, Hyeon-Ju;Suh, Hyun-Suk;Kim, Chul-Soo;Kim, Re-Hwe;Kim, Sung-Rok
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.9-15
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    • 1996
  • Purpose: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer Provides anticipated cure rates of $10-65\%$ depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer. Materials and Methods : November 1983 to October 1994. 31 Patients with Stage III and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone, and IS patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy (median 7010 cGy). In combined group, 7 patients were treated with cisplatin plus 5-FU 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. Results : Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient ($66.6\%$) of the RT alone group and 14 patient ($93.3\%$) of the chemoradiation group. There was no statistical difference in CR rate between the two groups The overall survival rates at 5 years were $23.4\%$ in the radiation alone group, $23.5\%$ in the chemoradiation group Disease-free survival rates at 3 years were $44.5\%$ in the radiation alone group, $40\%$ in the chemoradiation group. There was no statistical differences in overall survival rates and disease-free survival rates between the two groups. Local recurrences occurred in $71.5\%$ of the radiation alone group, $72.7\%$ of the chemoradiation group and distant metastasis occurred in $14.4\%$ of radiation alone group, $9.1\%$ of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity Conclusion : Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-un may be necessary to confirm the present result of combined chemotherapy and radiotherapy.

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The Results of Combined External Radiotherapy and Chemotherapy in the Management of Esophageal Cancer (식도암의 방사선-항암화학 병용치료결과)

  • Lee Hyun Joo;Suh Hyun Suk;Kim Jun Hee;Kim Chul Soo;Kim Sung Rok;Kim Re Hwe
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.17-23
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    • 1996
  • Purpose : To evaluate the role of combination therapy of external radio-therapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. Materials and Methods : A retrospective review of evaluable 55 esophageal cancer patients referred to the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul, 1983 and Dec. 1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group (ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fifty patients had squamous cell carcinomas. Radiation doses of 2520-6480c0y were delivered over a period of 4-7weeks, using 4MV LINAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1, 2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. Resuts : Median follow up Period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months (20 days-73 months) in B group. The 1, 2 YSRs were $26.7\%$, $8.9\%$ in A group, $12.7\%$, $4.3\%$ in B group (p>0.05), respectively. The 1, 2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose (5000cGymore or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were $43.8\%$. $25.0\%$, respectively. Complete response rate of $25.0\%$ in A and $8.3\%$ in B were achieved. The local failure and distant metastsis were $52.4\%$. $23.8\%$ in A group, $64.3\%$, $14.3\%$ in 8 group, respectively. The combination therapy revealed more frequent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to moderate. Conclusion : The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.

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Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.

Prevalence of Enteyobius vermiculuris infection and preventive effects of masts treatment among children in rural and urban areas, and children in orphanages (농촌, 도시 및 집단생활 아동의 요충 감염과 집단 구충에 의한 예방 효과)

  • Kim, Jong-Su;Lee, Hae-Yong;An, Yeong-Gyeom
    • Parasites, Hosts and Diseases
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    • v.29 no.3
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    • pp.235-244
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    • 1991
  • An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg Positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1, 262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11 9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2~32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4~5 days interval were higher (70.8%) than those from single anal swabs (50.0~59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%) . 5. A total of 2, 609 (male : female=1 : 12.4) worms were collected from 17 egg-positive cases treated with anthelinintics. The mean number of worms per child was 153 (range: 4-824) . 6. The egg-positive cases in several studied groups (180 children) were treated with anthelmintics 6 times at 3-week intervals. In this case, the overall positive rate was decreased from 54.8% to 2.2% at 15 weeks after the treatments, but no complete negative conversion was experienced. However, in a group of children (154 children) including egg Positive and negative cases who were both treated with anthelmintics at 3-week interval, a complete egg-negative conversion was observed in the 9th week after treatments. 7. The egg-detection rate in the brothers or sisters of egg Positive children was 70.0% (28 out of 40 examined), and the egg-positive rate according to the family unit was 69.7%. In summarizing the above results, it is concluded that Enterobius vermicularis infection is still highly prevalent among children in Korea, and that repeated mass treatments of more than 3 times will be effective for control of this infection.

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