• Radiation Oncology Journal
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• v.11 no.2
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• pp.377-385
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• 1993

Five hundred and fifty patients treated for carcinoma of the uterine cervix at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1986, were analyzed retrospectively for late bladder complications. Of them,468 patients received primary radiotherapy for the cervix cancer in intact uterus, and the other 82 patients were treated postoperatively. The cumulative incidence of radiation induced bladder complication of grade 2 or 3 was $2.5\%$ at five years. The mean bladder dose for the group of patients with complication was higher than that of the group without complication, and the difference was statistically significant (p<0.01). But relationship between mean bladder dose and severity of complication was not found. The frequency of complication (grade I, II, III) increased as a function of radiation dose to bladder from $5.0\%$ for patients with bladder dose less than 6,500 cGy to $27.7\%$ for patients with bladder dose higher than 8,000 cGy. Among various factors, the age of patient and the distance between ovoids turned out to have significant effect on the complication.

• Journal of the Korean Society of Radiology
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• v.16 no.6
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• pp.735-740
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• 2022

In order to reduce side effects such as rectal bleeding in the Brachytherapy, the rectal retractor and wet gauze have been used to increase the distance between the rectum and the tandem. However, there were disadvantages that it was difficult to insert through a narrow entrance into the vagina and poor reproducibility. Also, based on the CT image of the selected catheter, the distance from the tandem to the rectum with or without the balloon catheter was checked and the reduction of the dose to the rectum was confirmed. As a result of the experiment, catheter No. 7 was selected considering the maximum balloon size at a level that does not affect the distance between the start point of the balloon and the end of the catheter, and the ovoid applicator. Based on the CT image of the selected catheter, the degree of expansion according to the presence or absence of the balloon catheter was compared, and it was found that the distance difference was 0.3 - 1 cm. In addition, it was confirmed that a decrease of about 32% was observed due to this distance difference. Therefore, the actual clinical application of the selected catheter can be used as a substitute for the existing rectal retractor and wet gauze.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.327-333
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• 2012

Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.

• Journal of Korean Elementary Science Education
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• v.24 no.3
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• pp.259-267
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• 2005

This study was to investigate the elementary students' preconception on the brightness of electric bulb and degree of consistency on their preconceptions. Participants were 160 students of fifth graders in Seoul area. They had already teamed about the brightness of series circuit and parallel circuit of batteries. After they solved six problems in the same context, we provided them a pair of circuit which was an anomalous situation. And then they conducted CCLT (Cognitive Conflict Level Test). Elementary school students showed various preconceptions when they explained the light of bulb of two Simple electric Circuits. Many Students Consistently Showed the Scientific misconceptions like 'the light of bulb of two simple electric circuits was that the more batteries and the fewer bulbs were brighter.' The level of consistency that students presented scientific misconceptions was grouped all of four, such as 'high, middle, low, and nothing.' Therefore the higher scientific achievement they have, the higher consistency they have. As the students had high consistency level, they revealed high cognitive conflict level significantly. This high consistency will help them to change their preconception on the brightness of electric bulb and their cognitive conflict.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.378-383
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• 1993

Background: In recent reports, it has been reported that increased coagulation and decreased fibrinolytic activity has been responsible for abnormal fibrin turnover in exudative pleural effusion. In the cases of empyema, the fibrinopurulent stage is characterized by the fibrin deposition resulting in formation of limiting membranes in the visceral and parietal pleura. Recently attention has been focused on intrapleural fibrinolytic therapy capable of removing intrapleural fibrin deposits by urokinase (UK) in the treatment of empyema. However, these clinical trials have provided the clinical evidences for resolution of pleural loculation after intrapleural urokinase injection (UK-injection), the profiles of fibrinolytic activity following the treatment were still not investigated. Therefore in order to demonstrate the fibrinolytic evidences behind the clinical efficacy of intracavitary UK-injection, we examined intrapleural plasminogen activator activity (PA-activity) and D-dimer (D-Di) concentrations before and after each repeated UK-injection into the pleura in subjects with loculated empyema cavity. Methods: In a group of 14 patients with multiple loculated empyema cavity, PA-activity and D-Di concentrations were measured before and after repeated UK-injection. One hundred thousand IU of UK was injected at each time and all sujects had at least two times of UK injection accoring to clinical decisions. Nine out of 14 sujects had three times of UK-injection. Results: The mean (${\pm}SE$) PA-activity prior to treatemnt was $10.5{\pm}7.0$ and it was increased to $91.9{\pm}27.0,\;432.3{\pm}177.1,\;170.0{\pm}85.3$ IU tPA/ml after first, second and third time of UK-injection respectively (p<0.01). D-Di concentrations were also increased from $4.16{\pm}1.06{\times}10^5$ to $9.62{\pm}1.54{\times}10^5,\;12.31{\pm}1.89{\times}10^5,\;8.54{\pm}1.56{\times}10^5$ ng/ml in the same order as above (p<0.05). Conclusion: The suppressed fibrinolytic activity in the empyema cavity get removed sinificantly after inrracavitary injection of urokinase by generation of additional intrapleural plasmin.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.123-129
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• 2015

Purpose : The goal of this study was to verify and analyze the source position according to the curvature of the universal applicator and 4 different angle applicators when using RALS(Remote After Loading System). Materials and Methods : An interval of 1 cm and 15 second dwell times in each source position were applied for plan. To verify the accuracy of source position, we narrowed the distance between MultiSource container and GAFCHROMIC$^{(R)}$ EBT3 film by 5 cm, 10 cm, 20 cm so that the universal applicator transfer tube had some curvature. Also 4 applicators(Intrauterine tube: $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, Ovoid tube: $65^{\circ}$) were used in the same condition. The differences between desired and actual source position were measured by using Image J. Results : In case of using 4 different angles of applicator with the straight universal applicator transfer tube, the average error was the lowest for $0^{\circ}$ applicator, greatest for $65^{\circ}$ applicator. However, All average errors were within ${\pm}2mm$ recommended in TG-56. When MultiSource container was moved 5 cm, 10 cm, 20 cm towards the EBT3 film, the average errors were beyond ${\pm}2mm$. The first dwell position was relatively located in accuracy, while the second and third dwells were displaced by an increasing magnitude with increasing curvature of the transfer tube. Furthermore, with increasing the angle of applicators, the error of all other dwell positioning was increased. Conclusion : The results of this study showed that both the curvature of universal applicator transfer tube and the angle of applicators affect the source dwell position. It is recommended that using straight universal applicator transfer tubes is followed in all cases, in order to avoid deviations in the delivered source dwell position. Also, It is advisable to verify the actual dwell position, using video camera quality control tool prior to all treatments.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.16-22
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• 1999

Purpose : This study was done to analyze prognostic factors and patterns of failure of patients with histologically confirmed adenocarcinoma of the uterine cervix. Materials and Methods : From June 1988 to December 1990, a retrospective analysis was undertaken for 45 patients who were treated with curative radiation therapy for adenocarcinoma of the uterine cervix at the department of Therapeutic Radiology of Keimyung University Hospital. According to FIGO staging classification, f2 patients were stage Ib, 9 patients were lla, 19 patients were IIB, and 5 patients were lIIb. Median age of the patients was 54 years. The radiation therapy consisted of a combination of external and intracavitary irradiation. Only the pelvis was treated for external irradiation, but 6 patients were treated with extended field irradiation including paraaortic nodes. Intracavitary irradiation was performed with high dose rate sources (Co-60). Neoadiuvant chemotherapy was undertaken for 10 patients. Median and maximum follow-up duration was 64 and 116 months, respectively. Results : The overall 5-year survival rate was 55.2$\%$, and the 5-year survival rates for stage Ib, IIa, IIb, and IIIb were 100$\%$, 50.8$\%$, 46.8$\%$, and 40$\%$ (3-year survival rate), respectively. Of the many clinicopathologic variables evaluated for prognosis, only the stage and the tumor size were significant prognostic factors. Statistically, pelvic failure rates for stage Ib, IIa, IIb, and IIIb were 0$\%$, 33.3$\%$, 57.9$\%$, and 60$\%$, respectively. Distant metastasis rates were 0$\%$, 33.3$\%$, 21.1$\%$, and 40$\%$ for stage Ib, IIa, IIb, and IIIb, respectively. Especially the 6 patients who were irradiated with extended field to treat the paraaortic nodes were free of distant metastasis all. But, 9 patients (23.1$\%$) of the 39 patients who were not irradiated the paraaortic nodes were suffered and expired from uncontrolled distant metastasis. Conclusions : As compared with other studies, the survival rates were similar, but distant metastasis rates including paraaortic nodes metastasis were likely somewhat higher than expected, especially for patients with stage II. So, we think that the effect of prophylactic paraaortic nodes irradiation should be studied prospectively, especially for patients with pelvic nodes involvement or advanced stage of disease.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.307-315
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• 1996

Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.224-229
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• 2001

Purpose : The aim of this study is to analyze the treatment failure patterns and the risk factors for locoregional or distant failure of uterine cervical carcinoma treated with radiation therapy. Materials and methods . A retrospective analysis was undertaken of 154 patients treated with curative radiation therapy in Gyeongsang National University Hospital from April 1989 through December 1997. According to FIGO classification, 12 patients were stage IB, 24 were IIA, 98 were IIB, 1 were IIIA, 17 were IIIB, 2 were IVA. Results : Overall treatment failure rate was $42.1\%$ (65/154), and that of complete responder was $31.5\%$ (41/130). Among 65 failures, 25 failed locoregionally, another 25 failed distantly, and 15 failed locoregionally and distantly. Multivariate analysis confirmed tumor size (>4 cm) as risk factor for locoregional failure, and tumor size (>4 cm), pelvic lymph node involvement as risk factors for distant failure. Conclusion : On the basis of results of our study and recent published data of prospective randomized study for locally advanced uterine cervical carcinoma, we concluded that uterine cervical carcinoma with size more than 4 cm or pelvic lymph node involvement should be treated with concurrent chemoradiation.

• Development and Reproduction
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• v.2 no.2
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• pp.213-221
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• 1998

Intracytoplasmic sperm injection (ICSI) has been widely used to treat couples with infertility due to severely impaired sperm charateristics and for whom conventional in-vitro fertilization (IVF) had failed. The extent to which the morphology of the oocyte at the light microscopy level is related to the results of ICSI vis controversial. In this study, oocytes from 44 patients were reviewed. The ICSI procedure was recorded through CCD camera. The oocytes were divided into five groups according to the presence of cytoplasmic inclusions, the width of perivitelline space (PVS), the presence of cell debris in PVS, the status of first polar body and the flexibility of oolemma. The results showed that the fertilization rate and embryonic development were not associated with the morphological criteria of oocyte. The degeneraton rate of oocytes after ICSI was significantly higher (P<0.001) in the oocytes whose membranes were broken at the moment of insertion (17.7%) than the oocytes whose membranes were broken by aspiration of cytoplasm (1.6%). More oocytes with cytoplasmic inclusions (48.4% vs. 25.1%, p<0.001), wide PVS (35.2% vs. 19.0%, p<0.001), or cell debris in PVS (53.3% vs. 38.4%, p<0.05) were observed in patients with female factor infertility compared to patients with male factor infertility. These results .suggest that the fertilization rate and embryonic development after ICSI are not correlated with oocyte morphology based on the presence of cytoplasmic inclusions, size of PVS, the presence of cell debris in PVS and the status of polar body. And the degeneration rate of oocytes after ICSI was associated with the flexibility of oolemma.