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The ecological response of the climate change indicator species, Korean fir (Abies koreana E. H. Wilson) (기후변화 지표종 구상나무(Abies koreana E. H. Wilson)의 생태학적 반응)

  • Yoon Seo Kim;Se Hee Kim;Jung Min Lee;Ji Won Park;Yeo Bin Park;Jae Hoon Park;Eui Joo Kim;Kyeong Mi Cho;Yoon Kyung Choi;Ji Hyun Seo;Joo Hyun Seo;Gyu Ri Kim;Ju Seon Lee;Do Hun Ryu;Min Sun Kim;Young Han You
    • Journal of Wetlands Research
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    • v.26 no.1
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    • pp.62-71
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    • 2024
  • To assess the ecological changes of Korean fir (Abies koreana E. H. Wilson) under climate change conditions, growth and physiological responses were analyzed over a 5-year period in a control group (outdoors) and in a treatment group where the temperature and CO2 levels were elevated to closely resemble RCP 4.5 conditions. The results showed an increasing trend in annual branch length of A.koreana in the climate change treatment group over time. While climate change conditions did not significantly impact the morphological differences of A.koreana leaves, they did influence the biomass of the leaves, suggesting that as climate change progresses, the productivity of A.koreana leaves may decline. On the other hand, the chlorophyll content in A.koreana under climate change conditions was higher in the climate change treatment group, whereas the photosynthesis rate, transpiration rate, water use efficiency and stomatal conductance was higher in the control group. This suggests that an environment with elevated temperature and CO2 could influence an increase in stomatal density, but having a negative impact on photosynthetic reactions. Further research on stomatal density under each environmental treatment will be required to confirm this hypothesis. Additionally, as this study only observed changes in leaf biomass, further empirical research should be considered to understand the changes in biomass of A.koreana under climate change conditions. In conclusion, the environmental adaptability of A.koreana is expected to weaken in the long term under elevated temperatures and CO2.

Evaluation of Fruit Yield and Quality of Netted Melon, Water and Nutrient Use Efficiency in a Closed Hydroponic System (순환식 수경재배 멜론의 수량과 품질, 관개수 및 양분 이용 효율성 평가)

  • Minju Shin;Seungri Yoon;Jin Hyun Kim;Ho Jeong Jeong;Sung Kyeom Kim
    • Journal of Bio-Environment Control
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    • v.32 no.4
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    • pp.492-500
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    • 2023
  • The spectrum of this study was research on the closed hydroponic cultivation of netted melons (Cucumis melo L.) using coir substrate, analyzing the impact of this cultivation method on melon yield, fruit quality, and the efficiency of water and nutrient usage. The experimental results showed that the average fruit weight of the melons grown in a closed system was 71.4 g higher than that of the open system, and the fruit width was on average 0.2 cm larger, showing a statistically significant difference. However, there was no difference in the average sugar content of the fruit flesh and height. Although there is no substantial commercial difference, it is conjectured that the change in the macronutrients ratio in the irrigation has played a role in the statistically significant increase in fruit weight, which is attributed to changes in the crops' nutrient uptake concentrations. This necessitates further research for a more comprehensive understanding. In terms of the productivity of irrigation required to produce the fruit, applying the closed system resulted in an increase of 7.6 kg/ton compared to the open system, saving 31.6% of water resources. Additionally, in terms of nutrients, cultivating in a closed system allowed for savings of approximately 59, 25, 55, 83, 76, and 87% of N, P, K, Ca, Mg, and S, respectively, throughout the entire cultivation period. As the drainage was reused, the ratios of NO3- and Ca2+ increased up to a maximum of 9.6 and 9.1%, respectively, while the ratios of other ions gradually decreased. In summary, these results suggest that closed hydroponic cultivation can effectively optimize the use of water and fertilizer while maintaining excellent fruit quality in melon cultivation.

Changes in Growth and Antioxidant Phenolic Contents of Kale according to CO2 Concentration before UV-A Light Treatment (UV-A 조사 전 CO2 농도에 따른 케일의 생육과 항산화적 페놀릭 함량 변화)

  • Jin-Hui Lee;Myung-Min Oh
    • Journal of Bio-Environment Control
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    • v.32 no.4
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    • pp.342-352
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    • 2023
  • Ultra-violet (UV) light is one of abiotic stress factors and causes oxidative stress in plants, but a suitable level of UV radiation can be used to enhance the phytochemical content of plants. The accumulation of antioxidant phenolic compounds in UV-exposed plants may vary depending on the conditions of plant (species, cultivar, age, etc.) and UV (wavelength, energy, irradiation period, etc.). To date, however, little research has been conducted on how leaf thickness affects the pattern of phytochemical accumulation. In this study, we conducted an experiment to find out how the antioxidant phenolic content of kale (Brassica oleracea var. acephala) leaves with different thicknesses react to UV-A light. Kale seedlings were grown in a controlled growth chamber for four weeks under the following conditions: 20℃ temperature, 60% relative humidity, 12-hour photoperiod, light source (fluorescent lamp), and photosynthetic photon flux density of 121±10 µmol m-2 s-1. The kale plants were then transferred to two chambers with different CO2 concentrations (382±3.2 and 1,027±11.7 µmol mol-1), and grown for 10 days. After then, each group of kale plants were subjected to UV-A LED (275+285 nm at peak wavelength) light of 25.4 W m-2 for 5 days. As a result, when kale plants with thickened leaves from treatment with high CO2 were exposed to UV-A, they had lower UV sensitivity than thinner leaves. The Fv/Fm (maximum quantum yield on photosystem II) in the leaves of kale exposed to UV-A in a low-concentration CO2 environment decreased abruptly and significantly immediately after UV treatment, but not in kale leaves exposed to UV-A in a high-concentration CO2 environment. The accumulation pattern of total phenolic content, antioxidant capacity and individual phenolic compounds varied according to leaf thickness. In conclusion, this experiment suggests that the UV intensity should vary based on the leaf thickness (age etc.) during UV treatment for phytochemical enhancement.

Model Evaluation for Predicting the Full Bloom Date of Apples Based on Air Temperature Variations in South Korea's Major Production Regions (기온 변화에 따른 우리나라 사과 주산지 만개일 예측을 위한 모델 평가)

  • Jae Hoon Jeong;Jeom Hwa Han;Jung Gun Cho;Dong Yong Lee;Seul Ki Lee;Si Hyeong Jang;Suhyun Ryu
    • Journal of Bio-Environment Control
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    • v.32 no.4
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    • pp.501-512
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    • 2023
  • This study aimed to assess and determine the optimal model for predicting the full bloom date of 'Fuji' apples across South Korea. We evaluated the performance of four distinct models: the Development Rate Model (DVR)1, DVR2, the Chill Days (CD) model, and a sequentially integrated approach that combined the Dynamic model (DM) and the Growing Degree Hours (GDH) model. The full bloom dates and air temperatures were collected over a three-year period from six orchards located in the major apple production regions of South Korea: Pocheon, Hwaseong, Geochang, Cheongsong, Gunwi, and Chungju. Among these models, the one that combined DM for calculating chilling accumulation and the GDH model for estimating heat accumulation in sequence demonstrated the most accurate predictive performance, in contrast to the CD model that exhibited the lowest predictive precision. Furthermore, the DVR1 model exhibited an underestimation error at orchard located in Hwaseong. It projected a faster progression of the full bloom dates than the actual observations. This area is characterized by minimal diurnal temperature ranges, where the daily minimum temperature is high and the daily maximum temperature is relatively low. Therefore, to achieve a comprehensive prediction of the blooming date of 'Fuji' apples across South Korea, it is recommended to integrate a DM model for calculating the necessary chilling accumulation to break dormancy with a GDH model for estimating the requisite heat accumulation for flowering after dormancy release. This results in a combined DM+GDH model recognized as the most effective approach. However, further data collection and evaluation from different regions are needed to further refine its accuracy and applicability.

Appropriate Working Period and Storage Characteristics Based on Residual Leaf Length of Onion (Allium cepa L.) Harvested with a Blower-type Stem Cutter (송풍식 줄기절단기에 의한 적정 양파 잎 절단 시기 및 잔여 엽장에 따른 양파 저장 특성)

  • Byeonggyu Min;Jiyoung Son;Mijin Lee;Jinseong Moon;Juhee Baek;Jaecheol Seo;Jungho Shin;Seunggwi Kwon;Soonjung Hong;Sanghee Lee
    • Journal of Bio-Environment Control
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    • v.33 no.1
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    • pp.30-36
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    • 2024
  • This study was conducted to determine the optimal working conditions when a recently developed blower-type onion stem cutter is utilized for cutting onion leaves at harvest time. The June 20 leaf cutting treatment group had the highest leaf dryness among the treatment groups (leaf dryness: 66.3%; leaf moisture content: 50.5%); the residual leaf length was 6.7 ± 3.5 cm. It is considered to have the best mechanical leaf cutting performance among the treatment groups because it is included in the optimal range of 4-10 cm. The average working speed of mechanical onion leaf cutting using the stem cutter was 0.17 m·s-1, which is approximately 3.4 times faster than the average working speed of 0.05 m·s-1 in the human leaf cutting treatment group. This is expected to save approximately 2.6 hours compared to human labor (based on one person) when working on a 10a area using this machine. In addition, the incidence of damaged bulbs in the machine leaf cutting treatment group was 1.3%, compared to 0.0% in the manual leaf cutting treatment group. This suggests that the mechanical leaf cutting treatment group had a higher average onion bulb decay rate during storage than the manual leaf cutting treatment group. When the storage characteristics of each treatment group were examined, the decay rate by bulb part (leaf connected or root connected) after 8 months of storage was higher in the treatment group with a residual leaf length of less than 5.0 cm after mechanical leaf cutting than in the treatment with a residual leaf length of more than 5.0 cm. This is thought to be due to the fact that treatments with a residual leaf length of less than 5.0 cm are more susceptible to infection by pathogens that cause decay during storage than treatments with a residual leaf length of 5.0 cm or more. Based on the results of this experiment, performance target of the experimental machine (residual leaf length after operation: 5 cm), and existing research on the optimal residual leaf length for onion harvesting, it is recommended to cut onion leaves so that the residual leaf length is 5-10 cm when using the stem cutter.

Characteristics of Fruit Quality and Seed Formation Influenced by Pollen Donors in Kiwifruit 'Sunfl' and 'Garmhwang' (수분수 종류에 따른 키위프루트 '선플'과 '감황'의 과실 품질과 종자 형성)

  • Mockhee Lee;Yeon Jin Jang;Seong-Cheol Kim;Hong Lim Kim;Jae-Ho Joa;Jin Gook Kim
    • Journal of Bio-Environment Control
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    • v.33 no.3
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    • pp.148-155
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    • 2024
  • This study aimed to assess the characteristics of fruit quality and seed formation resulting from pollination by four different pollen donors: 'SKK2', 'Deliwoong', 'Pohwa', and 'Chieftain'. The objective was to identify the most effective pollen donor for yielding commercially viable fruits in two cultivars of kiwifruit (Actinidia chinensis var. chinensis): 'Sunfl' and 'Garmhwang'. Over a two-year period, the fruit setting rate for 'Sunfl' and 'Garmhwang' kiwifruit, pollinated by the four donors, consistently exceeded 96%. For 'Sunfl', the heaviest fruit weight was observed when pollinated with 'Deliwoong' for both years, while the lightest fruit was associated with 'Pohwa' in 2021 and 'Chieftain' in 2022. For 'Garmhwang', there was a yearly variation with the heaviest fruit weight linked to 'Deliwoong' in 2021 and 'Chieftain' in 2022. When examining the fruit characteristics of 'Sunfl', the dry matter content was highest when pollinated by 'SKK2', and the soluble solids content peaked with 'Chieftain' in 2021, although no significant differences were observed in 2022. Total and immature seed numbers in 'Sunfl' were highest with hexaploid pollen donors, while the 1000-seed weight was highest with tetraploid pollen donors. For the fruit characteristics of 'Garmhwang', the dry matter content and titratable acidity were highest when pollinated by 'SKK2'. Soluble solids content showed annual variation. Mature and total seed number in 'Garmhwang' were highest with 'Deliwoong' and 'Chieftain', while the immature seed number was lowest with 'SKK2'.

Field Studios of In-situ Aerobic Cometabolism of Chlorinated Aliphatic Hydrocarbons

  • Semprini, Lewts
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2004.04a
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    • pp.3-4
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    • 2004
  • Results will be presented from two field studies that evaluated the in-situ treatment of chlorinated aliphatic hydrocarbons (CAHs) using aerobic cometabolism. In the first study, a cometabolic air sparging (CAS) demonstration was conducted at McClellan Air Force Base (AFB), California, to treat chlorinated aliphatic hydrocarbons (CAHs) in groundwater using propane as the cometabolic substrate. A propane-biostimulated zone was sparged with a propane/air mixture and a control zone was sparged with air alone. Propane-utilizers were effectively stimulated in the saturated zone with repeated intermediate sparging of propane and air. Propane delivery, however, was not uniform, with propane mainly observed in down-gradient observation wells. Trichloroethene (TCE), cis-1, 2-dichloroethene (c-DCE), and dissolved oxygen (DO) concentration levels decreased in proportion with propane usage, with c-DCE decreasing more rapidly than TCE. The more rapid removal of c-DCE indicated biotransformation and not just physical removal by stripping. Propane utilization rates and rates of CAH removal slowed after three to four months of repeated propane additions, which coincided with tile depletion of nitrogen (as nitrate). Ammonia was then added to the propane/air mixture as a nitrogen source. After a six-month period between propane additions, rapid propane-utilization was observed. Nitrate was present due to groundwater flow into the treatment zone and/or by the oxidation of tile previously injected ammonia. In the propane-stimulated zone, c-DCE concentrations decreased below tile detection limit (1 $\mu$g/L), and TCE concentrations ranged from less than 5 $\mu$g/L to 30 $\mu$g/L, representing removals of 90 to 97%. In the air sparged control zone, TCE was removed at only two monitoring locations nearest the sparge-well, to concentrations of 15 $\mu$g/L and 60 $\mu$g/L. The responses indicate that stripping as well as biological treatment were responsible for the removal of contaminants in the biostimulated zone, with biostimulation enhancing removals to lower contaminant levels. As part of that study bacterial population shifts that occurred in the groundwater during CAS and air sparging control were evaluated by length heterogeneity polymerase chain reaction (LH-PCR) fragment analysis. The results showed that an organism(5) that had a fragment size of 385 base pairs (385 bp) was positively correlated with propane removal rates. The 385 bp fragment consisted of up to 83% of the total fragments in the analysis when propane removal rates peaked. A 16S rRNA clone library made from the bacteria sampled in propane sparged groundwater included clones of a TM7 division bacterium that had a 385bp LH-PCR fragment; no other bacterial species with this fragment size were detected. Both propane removal rates and the 385bp LH-PCR fragment decreased as nitrate levels in the groundwater decreased. In the second study the potential for bioaugmentation of a butane culture was evaluated in a series of field tests conducted at the Moffett Field Air Station in California. A butane-utilizing mixed culture that was effective in transforming 1, 1-dichloroethene (1, 1-DCE), 1, 1, 1-trichloroethane (1, 1, 1-TCA), and 1, 1-dichloroethane (1, 1-DCA) was added to the saturated zone at the test site. This mixture of contaminants was evaluated since they are often present as together as the result of 1, 1, 1-TCA contamination and the abiotic and biotic transformation of 1, 1, 1-TCA to 1, 1-DCE and 1, 1-DCA. Model simulations were performed prior to the initiation of the field study. The simulations were performed with a transport code that included processes for in-situ cometabolism, including microbial growth and decay, substrate and oxygen utilization, and the cometabolism of dual contaminants (1, 1-DCE and 1, 1, 1-TCA). Based on the results of detailed kinetic studies with the culture, cometabolic transformation kinetics were incorporated that butane mixed-inhibition on 1, 1-DCE and 1, 1, 1-TCA transformation, and competitive inhibition of 1, 1-DCE and 1, 1, 1-TCA on butane utilization. A transformation capacity term was also included in the model formation that results in cell loss due to contaminant transformation. Parameters for the model simulations were determined independently in kinetic studies with the butane-utilizing culture and through batch microcosm tests with groundwater and aquifer solids from the field test zone with the butane-utilizing culture added. In microcosm tests, the model simulated well the repetitive utilization of butane and cometabolism of 1.1, 1-TCA and 1, 1-DCE, as well as the transformation of 1, 1-DCE as it was repeatedly transformed at increased aqueous concentrations. Model simulations were then performed under the transport conditions of the field test to explore the effects of the bioaugmentation dose and the response of the system to tile biostimulation with alternating pulses of dissolved butane and oxygen in the presence of 1, 1-DCE (50 $\mu$g/L) and 1, 1, 1-TCA (250 $\mu$g/L). A uniform aquifer bioaugmentation dose of 0.5 mg/L of cells resulted in complete utilization of the butane 2-meters downgradient of the injection well within 200-hrs of bioaugmentation and butane addition. 1, 1-DCE was much more rapidly transformed than 1, 1, 1-TCA, and efficient 1, 1, 1-TCA removal occurred only after 1, 1-DCE and butane were decreased in concentration. The simulations demonstrated the strong inhibition of both 1, 1-DCE and butane on 1, 1, 1-TCA transformation, and the more rapid 1, 1-DCE transformation kinetics. Results of tile field demonstration indicated that bioaugmentation was successfully implemented; however it was difficult to maintain effective treatment for long periods of time (50 days or more). The demonstration showed that the bioaugmented experimental leg effectively transformed 1, 1-DCE and 1, 1-DCA, and was somewhat effective in transforming 1, 1, 1-TCA. The indigenous experimental leg treated in the same way as the bioaugmented leg was much less effective in treating the contaminant mixture. The best operating performance was achieved in the bioaugmented leg with about over 90%, 80%, 60 % removal for 1, 1-DCE, 1, 1-DCA, and 1, 1, 1-TCA, respectively. Molecular methods were used to track and enumerate the bioaugmented culture in the test zone. Real Time PCR analysis was used to on enumerate the bioaugmented culture. The results show higher numbers of the bioaugmented microorganisms were present in the treatment zone groundwater when the contaminants were being effective transformed. A decrease in these numbers was associated with a reduction in treatment performance. The results of the field tests indicated that although bioaugmentation can be successfully implemented, competition for the growth substrate (butane) by the indigenous microorganisms likely lead to the decrease in long-term performance.

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Cardioprotective Effect of Calcium Preconditioning and Its Relation to Protein Kinase C in Isolated Perfused Rabbit Heart (적출관류 토끼 심장에서 칼슘 전처치에 의한 심근보호 효과와 Protein Kinase C와의 관계)

  • 김용한;손동섭;조대윤;양기민;김호덕
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.603-612
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    • 1999
  • Background : It has been documented that brief repetitive periods of ischemia and reperfusion (ischemic preconditioning, IP) enhances the recovery of post-ischemic contractile function and reduces infarct size after a longer period of ischemia. Many mechanisms have been proposed to explain this process. Recent studies have suggested that transient increase in the intracellular calcium may have triggered the activation of protein kinase C(PKC); however, there are still many controversies. Accordingly, the author performed the present study to test the hypothesis that preconditioning with high concentration of calcium before sustained subsequent ischemia(calcium preconditioning) mimics IP by PKC activation. Material and Method : The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) Method: The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45-minute global ischemia followed by a 120-minute reperfusion with IP(IP group, n=13) or without IP(ischemic control, n=10). IP was induced by single episode of 5-minute global ischemia and 10-minute reperfusion. In the Ca2+ preconditioned group, perfusate containing 10(n=10) or 20 mM(n=11) CaCl2 was perfused for 10 minutes after 5-minute ischemia followed by a 45-minute global ischemia and a 120-minute reperfusion. Baseline PKC was measured after 50-minute perfusion without any treatment(n=5). Left ventricular function including developed pressure(LVDP), dP/dt, heart rate, left ventricular end-diastolic pressure(LVEDP) and coronary flow(CF) was measured. Myo car ial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific pepetide. The infarct size was determined using the TTC (tetrazolium salt) staining and planimetry. Data were analyzed using one-way analysis of variance(ANOVA) variance(ANOVA) and Tukey's post-hoc test. Result: IP increased the functional recovery including LVDP, dP/dt and CF(p<0.05) and lowered the ascending range of LVEDP(p<0.05); it also reduced the infarct size from 38% to 20%(p<0.05). In both of the Ca2+ preconditioned group, functional recovery was not significantly different in comparison with the ischemic control, however, the infarct size was reduced to 19∼23%(p<0.05). In comparison with the baseline(7.31 0.31 nmol/g tissue), the activities of the cytosolic PKC tended to decrease in both the IP and Ca2+ preconditioned groups, particularly in the 10 mM Ca2+ preconditioned group(4.19 0.39 nmol/g tissue, p<0.01); the activity of membrane PKC was significantly increased in both IP and 10 mM Ca2+ preconditioned group (p<0.05; 1.84 0.21, 4.00 0.14, and 4.02 0.70 nmol/g tissue in the baseline, IP, and 10 mM Ca2+ preconditioned group, respectively). However, the activity of both PKC fractions were not significantly different between the baseline and the ischemic control. Conclusion: These results indicate that in isolated Langendorff-perfused rabbit heart model, calcium preconditioning with high concentration of calcium does not improve post-ischemic functional recovery. However, it does have an effect of limiting(reducing) the infart size by ischemic preconditioning, and this cardioprotective effect, at least in part, may have resulted from the activation of PKC by calcium which acts as a messenger(or trigger) to activate membrane PKC.

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Effects of Hysteroscopic Septotomy on Pregnancy in Patients with History of Infertility or Recurrent Spontaneous Abortion (불임 또는 습관성 유산 환자에서 중격자궁의 치료가 임신에 미치는 영향)

  • Koo, Hwa-Seon;Cha, Sun-Hwa;Yang, Kwang-Moon;Bae, Ju-Youn;Ahn, Hyun-Suk;Han, Ae-Ra;Park, Chan-Woo;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.361-368
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    • 2010
  • Objective: The aim of this study was to evaluate the influences of uterine septum and their elimination on the reproductive outcomes in women who have history of recurrent spontaneous abortion (RSA) and/or infertility. Methods: The medical records of reproductive outcomes in patients who have had history of RSA and infertility who were diagnosed with uterine septum only by hysterosalpingogram (HSG) between January 2008 and December 2009 were retrospectively analyzed. The subjects who have had severe male factor, tubal factors, other uterine factors, endocrine abnormalities, peritoneal factors, and abnormal karyotyping among both partners were excluded. In 27 patients, confirmation of diagnosis by laparoscopy and elimination of uterine septum by trans-vaginal hysteroscopy was done. Seventeen patients were strongly suspected to uterine septum on HSG but tried to get pregnancy without any other procedure for evaluation and management of uterine anomaly. Age matched 42 patients who have history of RSA and/or infertility and diagnosed to normal HSG finding at same period were randomly selected as control. The medical records of reproductive outcomes were analyzed and compared between groups. Results: The mean time of observation after diagnosis was 21.8 months (10 to 32). 55.6% (15/27) of patients in patients who received trans-vaginal hysteroscopic uterine septotomy were success to get pregnancies and was significantly higher than that of 17 patients who did not receive proper management (23.5%, 4/17, p<0.05). In control population, 40.5% (17/42) were success to pregnancies and the differences were not statistically significant compared to both two study groups. The live birth rate which was excluded pregnancy loss by abnormal fetal karyotyping and congenital anomaly were 75% (9/12) in treated septated uterus group and 84.6% (11/13) in control group each which have no statistically significant different. In patients with septated uterus who did not receive proper management showed lower delivery rate (50%, 2/4) than that of other groups but was not statistically significant. Conclusion: According to present data, women with a uterine septum have an increased chance of successful pregnancy with improved obstetric outcome after proper management of the uterine cavity. And these results were showed in patients with no regard to their reproductive history. But, in case of failed to receive proper management, uterine septum can affect not only pregnancy ongoing but successful pregnancy too.

Radiotherapy in Medically Inoperable Early Stage Non-small Cell Lung Cancer (내과적 문제로 수술이 불가능한 조기 비소세포성 폐암에서의 방사선치료)

  • Kim, Bo-Kyoung;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.257-264
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    • 2000
  • Purpose: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. Materials and Method : We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wail invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included souamous (24), adenocarcinoma (6) and unclassiried squamous cell (2). The clinical stages of the patients were 71 in 5, 72 in 25, 73 in 2 patients. Initial tumor size was 3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. Ail patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 0.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. Results : The overall survival rate was 44.6$\%$ at 2 years and 24.5$\%$ at 5 years, with the median survival time of 23 months. of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0$\%$ at 2 years and 33.5$\%$ at 5 years. The disease-free survival rate was 38.9$\%$ at 2 years and 28.3$\%$ at 5 years. The local-relapse-free survival rate was 35.1$\%$, 28.1$\%$, respectively. On univariate analysis, tumor size was significant variable of overall survival (p=0.0015, 95$\%$ C.1.; 1.4814-5.2815), disease-free survival (P=0.0022, 95$\%$ C.1., 1.4707-5.7780) and local-relapse-free survival (p=0.0015, 95$\%$ C.1., 1.2910- 4.1197). 7 stage was significant variable of overall survival (p=0.0395, 95$\%$ C.1.; 1.1084-55.9112) and had borderline significance on disease-free survival (p=0.0649, 95$\%$ C.1.; 0.8888-50.7123) and local-relapse-free survival (p=0.0582, 95$\%$ C,1.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival (p=0.6919, 955 C.1., 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95$\%$ C.1.; 0.9720-4.9657). Tumor size was also significant variable of disease-free survival (p=0.0317, 95% C.1.; 1.1028-8.4968). Conclusion : Radical radiotherapy is an effective treatment for small (71 or f3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hypefractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.

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