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Survival and Complication Rate of Radiation Therapy in Stage I and II Carcinoma of Uterine Cervix (병기 I, II 자궁 경부암에서 방사선치료 후 생존율 및 합병증 분석)

  • Ma, Sun-Young;Cho, Heung-Lea;Sohn, Seung-Chang
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.349-357
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    • 1995
  • Purpose : To analyze survival rate and late rectal and bladder complication for patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy Materials and Methods : Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patiens was 56 years (range 31-76). 26 patients were stage IB by FIGO classification, 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions And we evaluated the external radiation dose and midline shield. Results : Actuarial survival rate at 5 years was $92{\%}$ for stage IB, $75{\%}$ for stage IIA, $53{\%}$ for stage IIB and $69{\%}$ in all patients Grade 1 rectal complications were developed in 20 cases ($22{\%}$), grade 2 were in 22 cases ($24{\%}$). 22 cases ($24{\%}$) of grade 1 urinary complications and 17 cases ($19{\%}$) of grade 2 urinary complications were observed But no patient had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications (7608 cGy v 6960cGy. p<0.01) Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without rectal complications (7041cGy v 6269cGy, p<0.01). While there was no significant difference for survival rate or bladder complication incidence as a function of dose to whole pelvis, Grade 2 rectal complication incidence was significantly lower for the patients receiving less than 4500cGy ($6.3{\%}$ v $25.5{\%}$, p<0.05). There was no significant differance between HDR ICRT group and LDR ICRT group for survival rate according to stage, on the other hand complication incidence was higher in the HDR group than LDR group, This was maybe due to different prescription doses between HDR group and LDR group. Midline shield neither improved survival rate nor decreased complication rate. The number of insertion in LDR ICRT group did not affect on survival and compication rate. Conclusion : In stage I and II carcinoma of uterine cervix there was no significant differance for 5 year survival rate by radiation therapy technique. Rectal complication incidence was as a function of dose to whole pelvis and there were positive correlations of maximum dose of rectum and bladder and each complication incidence. So we recommand whole pelvis dose less than 4500cGy and maximum dose of rectum and bladder as low as possible.

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The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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Osteoid Osteoma Around the Hip Joint (고관절 주위에 발생한 유골 골종)

  • Kim, Tai-Seung;Kim, Jong-Heon;Lee, Bong-Gun;Kim, Soon-Myung
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.168-174
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    • 2005
  • Purpose: We experienced 8 cases of osteoid osteoma arising around hip joint which had some characteristics that differ from those arising on long bone. we reports the characteristics of osteoid osteoma arising around the hip joint. Materials and Methods: 8 cases of osteoid osteoma were diagnosed during 1985 to 2004 at hanyang university hospital. all cases were comfirmed patholgically. 6 cases were male, 2 cases were female patients. The mean age was 17 years old (ranged from 8 to 29). They occurred in intertrochanteric area (4 cases), subtrochanteric area (2 cases), acetabulum (1 case) and femoral neck (1 case). We used radiologic tools including magnetic resonance image, computed tomography, bone scintigraphy. clinicopathologic test including erythrocyte sedimentation rate and Creactive protein. Results: The patients expressed various symptoms including thigh pain, knee pain, low back pain and radiating pain respectively. 2 patients had experienced operation on knee joint. 3 patients showed limping gait. Aspirin relieved the pain in 3 patients. The difference in circumference was 1cm between both thighs in 2 cases. Conclusion: Patients with osteoid osteoma arising around hip joint which have various symptoms such as severe knee pain and claudication, differ from infectious disease by clinicopathologic test including erythrocyte sedimentation rate and C- reactive protein and had better diagnostic result in computed tomography.

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Analysis of Treatment and Prognosis in Malignant Melanoma (악성 흑색종의 치료와 예후에 대한 분석)

  • Kwon, Young-Ho;Kim, Jeong-Ryoul;Lee, Young-Gu;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.141-147
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    • 2005
  • Purpose: The most important thing in curing Malignant melanoma is surgical excision, operating method is wide excision. The author et al. studied 5-year survival rate of each stage and appropriate surgical margin after operating wide excision and immuno-chemotherapy. Materials and methods: From March 1995 to August 2003, wide excision and immunochemotherapy were operated to 35 patients (17 males and 18 females) who were diagnosed as malignant melanoma and followed up. Excision was done around 2 cm from edge of tumor regardless of the size or effected degree of the skin, and flap or full thickness skin graft was used for skin deficit that was not covered after excision. As for immuno-chemotherapy, method that prescribes 400 mg of dacarbazine (DTIC) and 3 million IU of interferone-${\alpha}$ in combination was used. Immuno-chemotherapy was operated to patients in over stage III. We used AJCC stage that was revised in 2002. Local recurrence, local metastasis and distant metastasis were investigated for these patients as well as the 5-year survival rate of each stage. Results: Most frequently 15 cases(42.8%) occurred in foot, 5 cases(14.2%) occured in ankle, 2 cases(5.7%) in leg, 2 cases(5.7%) in thigh and 5 cases(14.2%) in hand. The incidence of each stage were 8 cases(22.8%) in IA, 9 cases(25.7 %) in IB, 4 cases(11.4%) in IIA, 2 cases(5.7%) in IIB, 1 cases(2.8%) in IIIA, 2 cases(5.7%) in IIIB, 2 cases(5.7%) in IIIC and 7 cases(20.0%) in stage IV. 5-year survival rate of each stage were 94.1% in stage I, 66.8% in stage II, 40% in stage III and 14.3% in stage IV. Conclusion: 5-year survival rate of stage IV was low in malignant melanoma. In treatment of malignant melanoma, staging before operation is important as operation methods are different from each stage. We recommend wide excision which remove around 1~3 cm from margin of tumor up to each thickness.

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Science Integrated Process Skill of the Students in Science Education Center for the Gifted (과학영재교육원 학생들의 과학 통합 탐구 능력)

  • Jeong, Eunyoung;Kwon, Yi-young;Yang, Joo-sung;Ko, Yu-mi
    • Journal of Science Education
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    • v.37 no.3
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    • pp.525-537
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    • 2013
  • The purpose of this study was to investigate science integrated process skill of the students in science education center for the gifted. In order to do this, 'free-response test for the assessment of science process skills' developed by Yu-Hyang Kim(2013) was administered to 102 students(15 in elementary school science class, 58 in middle school science class I, and 29 in middle school science class II) who attend the program of science education center for the gifted in C university. The assessment tool measured 9 skills ; formulating inquiry questions, recognizing variables, formulating hypotheses, designing experiment, transforming data, interpreting data, drawing conclusions, formulating generalizations, and evaluating the designed experiments. As a result, the students in science education center for the gifted had relatively high scores in the area of 'formulating hypotheses' and 'recognizing variables', but they had relatively low scores in the area of 'transforming data', 'interpreting data', and 'evaluating the designed experiments'. The 2 items' percentage of correct answers were below 40% ; one is about a drawing a line graph in 'transforming data', and the other requires finding improvements of the experimental design in 'evaluation'. There was no significant difference between boys' scores and girls's one, and between the scores of students in the field of biology and those of students in the other fields(physics, chemistry, and earth science) in science integrated process skills. And there was significant difference according to the periods receiving the gifted education in 'formulating generalizations'. The teaching and learning has to focus on improving science integrated process skills in the program of science education center for the gifted and teaching and learning materials needs to be developed.

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Metal artifact SUV estimation by using attenuation correction image and non attenuation correction image in PET-CT (PET-CT에서 감쇠보정 영상과 비감쇠보정 영상을 통한 Metal Artifact 보정에 대한 고찰)

  • Kim, June;Kim, Jae-II;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.21-26
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    • 2016
  • Purpose Because of many advantages, PET-CT Scanners generally use CT Data for attenuation correction. By using CT based attenuation correction, we can get anatomical information, reduce scan time and make more accurate correction of attenuation. However in case metal artifact occurred during CT scan, CT-based attenuation correction can induce artifacts and quantitative errors that can affect the PET images. Therefore this study infers true SUV of metal artifact region from attenuation corrected image count -to- non attenuation corrected image count ratio. Materials and Methods Micro phantom inserted $^{18}F-FDG$ 4mCi was used for phantom test and Biograph mCT S(40) is used for medical test equipment. We generated metal artifact in micro phantom by using metal. Then we acquired both metal artifact region of correction factor and non metal artifact region of correction factor by using attenuation correction image count -to- non attenuation correction image count ratio. In case of clinical image, we reconstructed both attenuation corrected images and non attenuation corrected images of 10 normal patient($66{\pm}15age$) who examined PET-CT scan in SNUH. After that, we standardize several organs of correction factor by using attenuation corrected image count -to- non attenuation corrected count ratio. Then we figured out metal artifact region of correction factor by using metal artifact region of attenuation corrected image count -to- non attenuation corrected count ratio And we compared standard organs correction factor with metal artifact region correction factor. Results according to phantom test results, metal artifact induce overestimation of correction factor so metal artifact region of correction factors are 12% bigger than the non metal artifact region of correction factors. in case of clinical test, correction factor of organs with high CT number(>1000) is $8{\pm}0.5%$, correction factor of organs with CT number similar to soft tissue is $6{\pm}2%$ and correction factor of organs with low CT number(-100>) is $3{\pm}1%$. Also metal artifact correction factors are 20% bigger than soft tissue correction factors which didn't happened metal artifact. Conclusion metal artifact lead to overestimation of attenuation coefficient. because of that, SUV of metal artifact region is overestimated. Thus for more accurate quantitative evaluation, using attenuation correction image count -to-non attenuation correction image count ratio is one of the methods to reduce metal artifact affect.

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Bond-strength of several metal-meramic alloys and meneered-porcelain (수종 합금의 도재 결합강도)

  • Lee, Kwang-Hoon;Cho, Young-Bum;Chung, Chae-Heon;Kim, Hee-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.191-196
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    • 2011
  • Purpose: In this study, we evaluated the bond-strength between a few metal ceramic-alloys and veneered-porcelain and found if the bond strength of metal-ceramic alloy with lower gold content than the presently used gold alloy was high enough. Materials and methods: For this study, after plasticizing porcelain only for gold alloy, metal specimen was fabricated using Ni-Cr alloy and gold alloy with different gold content. Three point flexural test were performed to measure their bond-strength. Results: The bonding strength of Group 1 to porcelain was $40.62{\pm}3.32$ MPa, which was the highest (P<.05). In sequence of decreasing value, Group 2 (75%) was $37.47{\pm}1.57$ MPa, Group 3 (52%) $35.85{\pm}1.48$ MPa, Group 4 (51.5%) $35.04{\pm}1.34$ MPa, Group 5 (32%) $33.17{\pm}1.62$ MPa, Group 6 (10%) $30.75{\pm}1.21$ MPa. Bonding strength of Group 3 and Group 4 to porcelain did not show statistically significant difference with comparison to that of Group 5 (Duncan's test, P>.05), while there was a significant difference between that of Group 2, Group 3 and Group 4 and that of Group 6 (Duncan's test, P<.05). The bonding strength between gold alloy and porcelain increased according to the content of gold. In all experimental groups showed higher value than 25 MPa, which is the least value recommended by ISO 9693. Conclusion: In all groups, bonding strength was higher than 25 MPa, which is the least value of ISO9693. Therefore, it is considered that metal gold alloy with low gold content is clinically usable.

Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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Study on Computerized Treatment Plan of Field-in-Field Intensity Modulated Radiation Therapy and Conventional Radiation Therapy according to PBC Algorithm and AAA on Breast Cancer Tangential Beam (유방암 접선조사에서 PBC 알고리즘과 AAA에 따른 Field-in-Field Intensity Modulated Radiation Therapy와 Conventional Radiation Therapy 전산화 치료계획에 대한 고찰)

  • Yeom, Mi-Suk;Bae, Seong-Soo;Kim, Dae-Sup;Back, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.11-14
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    • 2012
  • Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.

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Clay Mineralogy of the Soils Derived from Gray Shale (회색혈암(灰色頁岩)에서 유래(由來)된 토양점토(土壤粘土) 광물(鑛物)의 특성(特性))

  • Um, Myung-Ho;Jung, Pil-Kyun;Um, Ki-Tae;Lim, Hyung-Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.26 no.1
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    • pp.1-9
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    • 1993
  • A study was carried out to investigate the genesis and mineralogical characteristics of clay minerals in three different types of soil derived from the gray shale distributed in Kyeongbuk Province in Korea. The soils have been developed from parent materials of residuum (Daegu series, Sirye series), colluvium(Banho series), and alluvium (Bigog series) of the same origin of parent rock with a topographical sequence. The investigation mainly focussed on the mineralogical aspects of primary minerals of asnd and silt fractions, identification and quantification of clay minerals, and characterization of hydroxy-interlayered mineral (HIM) along with their chemical composition. The identification was done through analyses of chemical, X-ray diffraction, and thermal methods. The major clay minerals in the soils are illite, vermiculite, kaolin and HIM, while chlorite and mixed layer minerals such as illite/chlorite and illite/vermiculite were coexisted as a subsidiary minerals. The distribution of clay minerals, however, varies according to the location and types of parent material. In the soils derived from the parent material of residuum, the upper soil (Daegu series) shows higher of 2:1 type minerals such as illite, vermiculite, and HIM than 1:1 type mineral rich in the lower soil(Sirye series). Soils developed from the parent material of colluvium and alluvium were high in illlte and mixed layer minerals, but low in HIM compared with the residual soils. The predominant weathering sequence of the clay minerals in each soil could be inferred as follows according to the minerlogical distribution and quantification of clay minerals : Daegu series, illite ${\rightarrow}$ vermiculite ${\rightarrow}$ HIM ; Sirye series, vermiculite ${\rightarrow}$ kaolin minerals ; Banho sereies and Bigog series, illite ${\rightarrow}$ illlte/vermiculite and/or illite/chlorlte mixed layer ${\rightarrow}$ vermiculite.

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