• Journal of Wetlands Research
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• v.25 no.4
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• pp.274-283
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• 2023

Buffer zones, an example of nature-based solutions, offer wide range of environmental, social and economic benefits due to their multifunctionality when applied to watershed areas promoting blue-green connectivity. This study evaluated the effects of buffer zone application to the water quality of Yongdam reservoir tributaries. Particularly, the challenges and improvement of the buffer zone design were identified and suggested, respectively. Water and soil samples were collected from a total of six sites in Yongdam reservoir from September 2021 to April 2022. Water quality analyses revealed that among the sites monitored, downstream of Sangjeonmyeon Galhyeonri (SG_W_D2) was found to have the highest concentration for water quality parameters turbidity, total suspended solids (TSS), chemical oxygen demand (COD), total phosphorus (TP) and total nitrogen (TN). This finding was attributed to the algal bloom observed during the sampling conducted in September and October 2021. It was found through the soil analyses that high TN and TP concentrations were also observed in all the agricultural land uses implying that nutrient accumulation in agricultural areas are high. Highest TN concentration was found in the agricultural area of Jeongcheonmyeon Wolpyeongri (JW_S_A) followed by Jucheonmyeon Sinyangri (JS_S_A) while the lowest TN concentration was found in the original soil of Sangjeonmyeon Galhyeonri (SG_S_O). Among the types of buffer zones identified in this study, Type II-A, Type II-B and Type III were found to have blue-green connectivity. However, initially, blue-green connectivity in these buffer zone types were not considered leading to poor design and poor performance. As such, improvement in the design considering blue-green network and renovation must be considered to optimize the performance of these buffer zones. The findings in this study is useful for designing buffer zones in the future.

• Journal of the Korean Society of Marine Environment & Safety
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• v.29 no.7
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• pp.915-929
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• 2023

Improvements in people's quality of life, diversification of leisure activities, and changes in population structure have led to an increase in the demand for tourism and an expansion of the diversification of tourism activities. In particular, for coastal cities where land and marine tourism elements coexist, various factors influence their tourism demands. Tourism requires the construction of infrastructure and content development according to the demand at the tourist destination. This study aims to improve the prediction accuracy and explore influencing factors through time series analysis of tourism scale using agent-based data. Basic local governments in the Busan area were examined, and the data used were the number of tourists and the amount of tourism consumption on a monthly basis. The univariate time series analysis, which is a deterministic model, was used along with the SARIMAX analysis to identify the influencing factor. The tourism consumption propensity, focusing on the consumption amount according to business types and the amount of mentions on SNS, was set as the influencing factor. The difference in accuracy (RMSE standard) between the time series models that did and did not consider COVID-19 was found to be very wide, ranging from 1.8 times to 32.7 times by region. Additionally, considering the influencing factor, the tourism consumption business type and SNS trends were found to significantly impact the number of tourists and the amount of tourism consumption. Therefore, to predict future demand, external influences as well as the tourists' consumption tendencies and interests in terms of local tourism must be considered. This study aimed to predict future tourism demand in a coastal city such as Busan and identify factors affecting tourism scale, thereby contributing to policy decision-making to prepare tourism demand in consideration of government tourism policies and tourism trends.

• Korean Journal of Remote Sensing
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• v.39 no.6_3
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• pp.1779-1790
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• 2023

Satellite-based fog detection algorithms are being developed to detect fog in real-time over a wide area, with a focus on the Korean Peninsula (KorPen). The GEO-KOMPSAT-2A/Advanced Meteorological Imager (GK2A/AMI, GK2A) satellite offers an excellent temporal resolution (10 min) and a spatial resolution (500 m), while GEO-KOMPSAT-2B/Geostationary Ocean Color Imager-II (GK2B/GOCI-II, GK2B) provides an excellent spatial resolution (250 m) but poor temporal resolution (1 h) with only visible channels. To enhance the fog detection level (10 min, 250 m), we developed a fused GK2AB fog detection algorithm (FDA) of GK2A and GK2B. The GK2AB FDA comprises three main steps. First, the Korea Meteorological Satellite Center's GK2A daytime fog detection algorithm is utilized to detect fog, considering various optical and physical characteristics. In the second step, GK2B data is extrapolated to 10-min intervals by matching GK2A pixels based on the closest time and location when GK2B observes the KorPen. For reflectance, GK2B normalized visible (NVIS) is corrected using GK2A NVIS of the same time, considering the difference in wavelength range and observation geometry. GK2B NVIS is extrapolated at 10-min intervals using the 10-min changes in GK2A NVIS. In the final step, the extrapolated GK2B NVIS, solar zenith angle, and outputs of GK2A FDA are utilized as input data for machine learning (decision tree) to develop the GK2AB FDA, which detects fog at a resolution of 250 m and a 10-min interval based on geographical locations. Six and four cases were used for the training and validation of GK2AB FDA, respectively. Quantitative verification of GK2AB FDA utilized ground observation data on visibility, wind speed, and relative humidity. Compared to GK2A FDA, GK2AB FDA exhibited a fourfold increase in spatial resolution, resulting in more detailed discrimination between fog and non-fog pixels. In general, irrespective of the validation method, the probability of detection (POD) and the Hanssen-Kuiper Skill score (KSS) are high or similar, indicating that it better detects previously undetected fog pixels. However, GK2AB FDA, compared to GK2A FDA, tends to over-detect fog with a higher false alarm ratio and bias.

• Korean Journal of Remote Sensing
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• v.39 no.5_3
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• pp.997-1008
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• 2023

Ship detection at sea can be performed in various ways. In particular, satellites can provide wide-area surveillance, and Synthetic Aperture Radar (SAR) imagery can be utilized day and night and in all weather conditions. To propose an efficient ship detection method from SAR images, this study aimed to apply the You Only Look Once Version 5 (YOLOv5) model to Sentinel-1 images and to analyze the difference between individual vs. integrated models and the accuracy characteristics by polarization. YOLOv5s, which has fewer and lighter parameters, and YOLOv5x, which has more parameters but higher accuracy, were used for the performance tests (1) by dividing each polarization into HH, HV, VH, and VV, and (2) by using images from all polarizations. All four experiments showed very similar and high accuracy of 0.977 ≤ AP@0.5 ≤ 0.998. This result suggests that the polarization integration model using lightweight YOLO models can be the most effective in terms of real-time system deployment. 19,582 images were used in this experiment. However, if other SAR images,such as Capella and ICEYE, are included in addition to Sentinel-1 images, a more flexible and accurate model for ship detection can be built.

• Clinical and Experimental Reproductive Medicine
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• v.2 no.2
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• pp.27-36
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• 1975

The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

• Journal of forensic and investigative science
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• v.2 no.2
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• pp.5-20
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• 2007

During the period from 2001 to 2005, 29,892 burglaries took place in Korea with the approximate average annual number - 5,978 cases. This study was conducted to analyze the reported burglaries and the result was summarized as follows. There were 8,605 residential invasion burglaries (28.8%) as the most frequent characteristic pattern. The exit was used as the most frequent invasion route for 4,031 invasion burglaries (64.3%), and an unlocked exit door or window was used as the most frequent invasion method for 2,462 invasion burglaries (28.6%). The hours just after midnight (between 00:00 and 04:00) were the most frequent time for invasion burglary to occur. Also, 5,652 burglaries occurred on Wednesday which was twice higher than on Sunday (2,988 burglaries). It was shown that the number of persons injured during burglaries were 260 deaths and 10,610 injuries. The places of the highest occurrence were the street with 10,183 burglaries (34%) and then residential place with 7,527 burglaries (approximately 25%). One-man burglary was the highest complicity: 15,012 offenders (56.1%). The knife was used as the most frequent instrument for 6,498 burglaries (24,3%) what is rare, while no criminal tool or instrument was used for 15,631 burglaries (58.4). During the period from 2001 to 2006, 1,506 burglaries occurred in Daegu and the average annual number was 251 burglaries. Among those,515 residential invasion burglaries (34.2%) took place and the average annual number was approximately 86 cases. The hours just after midnight (between 00:00 and 04:00) were the most frequent time for invasion burglary to occur (194 cases, 37.7%), the place of the highest invasion occurrence was the residential place (259 cases, 50.3%), and the exit was used as the most frequent invasion route (87 cases, 37.7%). An unlocked exit door or window was the most frequent invasion method (65 cases, 25.1%). In addition, pretending to be a delivery man, visitor or following the victim methods were used for 26 burglaries (10%). It is apparent that personal preventive measures against crimes, as well as governmental and social measures, play an important role in preventing burglaries. In particular, based on the analyzed result that an unlocked window or exit door was most frequently used for reported burglaries, it seems that there is a lack of understanding of crime prevention while little effort has been made to prevent crimes. Although everyone knows that locking a door is one of the basic measures to prevent crimes, many people tend to pay little attention to lock a door properly so burglary takes place. This study, therefore, is intended to encourage people to pay more careful attention to crime prevention, in order to help reduce the probability of burglary. With the recent improvement in social understanding of scientific crime investigation, a wide variety of police professions, including crime analysts, crime victim police counselors and coroners, have been prepared to develop the scientific crime investigation and crime analysis. In addition, it is hoped that further this study will contribute to encourage studies on crime prevention to be carried out in the future.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.17 no.4
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• pp.292-302
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• 2012

This paper reviews comparison analysis of current and latest application for stock identification methods of Todarodes pacificus, and the pros and cons of each method and consideration of how to compensate for each other. Todarodes pacificus which migrates wide areas in western North Pacific is important fishery resource ecologically and commercially. Todarodes pacificus is also considered as 'biological indicator' of ocean environmental changes. And changes in its short and long term catch and distribution area occur along with environmental changes. For example, while the catch of pollack, a cold water fish, has dramatically decreased until today after the climate regime shift in 1987/1988, the catch of Todarodes pacificus has been dramatically increased. Regarding the decrease in pollack catch, overfishing and climate changes were considered as the main causes, but there has been no definite reason until today. One of the reasons why there is no definite answer is related with no proper analysis about ecological and environmental aspects based on stock identification. Subpopulation is a group sharing the same gene pool through sexual reproduction process within limited boundaries having similar ecological characteristics. Each individual with same stock might be affected by different environment in temporal and spatial during the process of spawning, recruitment and then reproduction. Thereby, accurate stock analysis about the species can play an efficient alternative to comply with effective resource management and rapid changes. Four main stock analysis were applied to Todarodes pacificus: Morphologic Method, Ecological Method, Tagging Method, Genetic Method. Ecological method is studies for analysis of differences in spawning grounds by analysing the individual ecological change, distribution, migration status, parasitic state of parasite, kinds of parasite and parasite infection rate etc. Currently the method has been studying lively can identify the group in the similar environment. However It is difficult to know to identify the same genetic group in each other. Tagging Method is direct method. It can analyse cohort's migration, distribution and location of spawning, but it is very difficult to recapture tagged squids and hard to tag juveniles. Genetic method, which is for useful fishery resource stock analysis has provided the basic information regarding resource management study. Genetic method for stock analysis is determined according to markers' sensitivity and need to select high multiform of genetic markers. For stock identification, isozyme multiform has been used for genetic markers. Recently there is increase in use of makers with high range variability among DNA sequencing like mitochondria, microsatellite. Even the current morphologic method, tagging method and ecological method played important rolls through finding Todarodes pacificus' life cycle, migration route and changes in spawning grounds, it is still difficult to analyze the stock of Todarodes pacificus as those are distributed in difference seas. Lately, by taking advantages of each stock analysis method, more complicated method is being applied. If based on such analysis and genetic method for improvement are played, there will be much advance in management system for the resource fluctuation of Todarodes pacificus.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.299-305
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• 2003

Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

• Korean Security Journal
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• no.1
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• pp.371-408
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• 1997

This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.339-348
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• 1995

Purpose : Since 1983, authors have conducted a study to evaluate the effect of external radiation therapy and to determine affected factors in management of the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. Materials and Methods : Thirty two patients with malignant obstructive jaundice due to porta hepatis metastasis from gastric cancer were presented. We have analysed 23 patients who were treated with external radiation therapy of more than 3000cGy. The radiation dose, disease extent at developement of jaundice, total bilirubin levels before radiation therapy, differentiation of histology, combind treatment, intent of primary surgery, initial stage of gastric cancer were analyzed to determine affected factors in radiation therapy. External radiation therapy was delivered with a daily dose of 180-300cGy, 5 times a week fractionation using 4 MeV linear accelerator. The radiation field included the porta hepatis with tumor mass by the abdominal ultrasonography or CT scan. In twenty three patients received more than 3000cGy, total irradiation dose was ranged from 3000cGy to 5480cGy, median 3770cGy. Among 23 patients, 13 patients were delivered more than equivalant dose of TDF 65(4140cGy/23fx). Results : Among 23 patients, complete, partial and no response were observed in 13, 5, 5 patients, respectively. The median survival for all patients was 5 momths. The significant prolongation of median survival was observed in complete responders(11 months) as compared to partial and no responders(5 months, 5 months respectively) Out of 13 patients with complete response, 6 patients lived more than a year Among 13 patients receiving more than 4140cGy equivalent dose, complete, partial and no response were observed in 10, 2 and 1 patients, respectively. The median survival for all these patients was 9.5 months. The median survival for complete responders(10/13) was 11.5 months. Among 10 patients receiving less than 4140cGy equivalent dose, complete, partial and no response were observed in 3, 3, 4 patients, respetively. The median survival for all these patients was 4.3 months Therefore, the radiation dose affected the results of treatment. For the complete response with prolongation of survival duration, at least 4140cGy equivalant dose should be delivered to porta hepatis. In evaluation of the disease extent, 7 patients of 13 complete responders showed localized disease in porta hepatis or peripancreatic area, but all patients with partial and no response showed wide extensive disease or persistant disease of primary gastric cancer. Therefore. the patients with the localized disease were the higher probability of complete response and long term survival. This study suggested that the radiation dose and the disease extent at developement of jaundice affected in radiation therapy for malignant obstructive jaundice. There were no serious complications related to external radiation therapy. Conclusion : External radiation therapy only could achieve the palliative effect in the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. This study suggested that the prolongation of survival duration could be achived in complete responders and radiation dose, extent of disease affected the results of treatment of malignant obstructive jaundice.