• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.353-377
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• 2000

This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.692-698
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• 2006

Background: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. Material and Method: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending or age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. Result: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70 : 64 (52% : 48%). The average age was $56.3{\pm}12.26$ years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was $93{\pm}2.4%,\;91{\pm}2.7%,\;89{\pm}3.0%$ at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ and below 64-year-old patient group's was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. Conclusion: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hyper- tension do not make statistically significant effect on the arteriovenous inosculation rate.

• 한국유가공학회:학술대회논문집
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• 2007.09a
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• pp.49-58
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• 2007

Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.247-294
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• 1996

By means of the statistical data which has been collected with newly revised QSCC made use of the outpatient group examined at Kyung-Hee Medical Center and an open ordinary person group, the author proceeded statistical analysis for the validation study of the revised questionnaire itself. First, check the accurate discrimination rate by performing discriminant analysis on the statistical data of the patient group. And next, sought T-score by applying the norms gained in process of standadization of the open ordinary person group to the Sasang scale score of the outpatient group and investigated the distinctive feature between the subpopulations which was devided in the process of multivarite cluster analysis. The result was summarized as follows ; 1. The validity of the questionnaire was established through the fact that the accurate discrimination rate the ratio between predicted group and actual group was figured out 70.08%. 2. At the profile analysis the response to the relevant scale showed notable upward tendency in each constitutional group and therefore it seems to be pertinent in the field of constitutional discrimination. 3. In the observation of the power of expression through the profile analysis of each constitutional group the Soyang group demonstrated the most remarkable outcome, the Soeum group was the most inferior and the Taieum group revealed a sort of dual property. 4. What is called the group of seceder out of three subpopulation of each constitutional group distinguished definitely from the contrasted groups at the point of the distinctive profile feature and the content is like following description. (1) The seceder group of Soyang-in showed considerably passive disposition differently from general character of ordinary Soyang group and an appearance attracting the attention is that they demonstrated comparatively higher response at Soeum scale (2) The seceder group of Taieum-in gained low scores in general that informed the passive disposition of the group and the other way of the general property of Taieum group which showed accompanied ascension in Taiyang-Taieum scales they demonstrated sharply declined score at Taiyang scale (3) The seceder group of Soeum-in demonstrated distinctive property similar to the profile feature of Soyang group and it notifies that the passive property of Soeum group was diluted for the most part. According to the above result, the validity of newly revised questionnaire has been proven successfully and the property of seceder groups could be noticed to some degree through the profile analysis on the course of this study. The result of this study is expected to use as a research materials to produce next edition of the questionnaire and it is regarded that further inquisition about the difference between the seceder group and the contrasted group is required for the promotion of the questionnaire as it refered several times in the contents of the main discourse.

• Journal of Intelligence and Information Systems
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• v.23 no.3
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• pp.69-94
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• 2017

Recently, increase of demand for big data analysis has been driving the vigorous development of related technologies and tools. In addition, development of IT and increased penetration rate of smart devices are producing a large amount of data. According to this phenomenon, data analysis technology is rapidly becoming popular. Also, attempts to acquire insights through data analysis have been continuously increasing. It means that the big data analysis will be more important in various industries for the foreseeable future. Big data analysis is generally performed by a small number of experts and delivered to each demander of analysis. However, increase of interest about big data analysis arouses activation of computer programming education and development of many programs for data analysis. Accordingly, the entry barriers of big data analysis are gradually lowering and data analysis technology being spread out. As the result, big data analysis is expected to be performed by demanders of analysis themselves. Along with this, interest about various unstructured data is continually increasing. Especially, a lot of attention is focused on using text data. Emergence of new platforms and techniques using the web bring about mass production of text data and active attempt to analyze text data. Furthermore, result of text analysis has been utilized in various fields. Text mining is a concept that embraces various theories and techniques for text analysis. Many text mining techniques are utilized in this field for various research purposes, topic modeling is one of the most widely used and studied. Topic modeling is a technique that extracts the major issues from a lot of documents, identifies the documents that correspond to each issue and provides identified documents as a cluster. It is evaluated as a very useful technique in that reflect the semantic elements of the document. Traditional topic modeling is based on the distribution of key terms across the entire document. Thus, it is essential to analyze the entire document at once to identify topic of each document. This condition causes a long time in analysis process when topic modeling is applied to a lot of documents. In addition, it has a scalability problem that is an exponential increase in the processing time with the increase of analysis objects. This problem is particularly noticeable when the documents are distributed across multiple systems or regions. To overcome these problems, divide and conquer approach can be applied to topic modeling. It means dividing a large number of documents into sub-units and deriving topics through repetition of topic modeling to each unit. This method can be used for topic modeling on a large number of documents with limited system resources, and can improve processing speed of topic modeling. It also can significantly reduce analysis time and cost through ability to analyze documents in each location or place without combining analysis object documents. However, despite many advantages, this method has two major problems. First, the relationship between local topics derived from each unit and global topics derived from entire document is unclear. It means that in each document, local topics can be identified, but global topics cannot be identified. Second, a method for measuring the accuracy of the proposed methodology should be established. That is to say, assuming that global topic is ideal answer, the difference in a local topic on a global topic needs to be measured. By those difficulties, the study in this method is not performed sufficiently, compare with other studies dealing with topic modeling. In this paper, we propose a topic modeling approach to solve the above two problems. First of all, we divide the entire document cluster(Global set) into sub-clusters(Local set), and generate the reduced entire document cluster(RGS, Reduced global set) that consist of delegated documents extracted from each local set. We try to solve the first problem by mapping RGS topics and local topics. Along with this, we verify the accuracy of the proposed methodology by detecting documents, whether to be discerned as the same topic at result of global and local set. Using 24,000 news articles, we conduct experiments to evaluate practical applicability of the proposed methodology. In addition, through additional experiment, we confirmed that the proposed methodology can provide similar results to the entire topic modeling. We also proposed a reasonable method for comparing the result of both methods.

• Journal of Intelligence and Information Systems
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• v.25 no.4
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• pp.141-154
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• 2019

Rapid growth of internet technology and social media is progressing. Data mining technology has evolved to enable unstructured document representations in a variety of applications. Sentiment analysis is an important technology that can distinguish poor or high-quality content through text data of products, and it has proliferated during text mining. Sentiment analysis mainly analyzes people's opinions in text data by assigning predefined data categories as positive and negative. This has been studied in various directions in terms of accuracy from simple rule-based to dictionary-based approaches using predefined labels. In fact, sentiment analysis is one of the most active researches in natural language processing and is widely studied in text mining. When real online reviews aren't available for others, it's not only easy to openly collect information, but it also affects your business. In marketing, real-world information from customers is gathered on websites, not surveys. Depending on whether the website's posts are positive or negative, the customer response is reflected in the sales and tries to identify the information. However, many reviews on a website are not always good, and difficult to identify. The earlier studies in this research area used the reviews data of the Amazon.com shopping mal, but the research data used in the recent studies uses the data for stock market trends, blogs, news articles, weather forecasts, IMDB, and facebook etc. However, the lack of accuracy is recognized because sentiment calculations are changed according to the subject, paragraph, sentiment lexicon direction, and sentence strength. This study aims to classify the polarity analysis of sentiment analysis into positive and negative categories and increase the prediction accuracy of the polarity analysis using the pretrained IMDB review data set. First, the text classification algorithm related to sentiment analysis adopts the popular machine learning algorithms such as NB (naive bayes), SVM (support vector machines), XGboost, RF (random forests), and Gradient Boost as comparative models. Second, deep learning has demonstrated discriminative features that can extract complex features of data. Representative algorithms are CNN (convolution neural networks), RNN (recurrent neural networks), LSTM (long-short term memory). CNN can be used similarly to BoW when processing a sentence in vector format, but does not consider sequential data attributes. RNN can handle well in order because it takes into account the time information of the data, but there is a long-term dependency on memory. To solve the problem of long-term dependence, LSTM is used. For the comparison, CNN and LSTM were chosen as simple deep learning models. In addition to classical machine learning algorithms, CNN, LSTM, and the integrated models were analyzed. Although there are many parameters for the algorithms, we examined the relationship between numerical value and precision to find the optimal combination. And, we tried to figure out how the models work well for sentiment analysis and how these models work. This study proposes integrated CNN and LSTM algorithms to extract the positive and negative features of text analysis. The reasons for mixing these two algorithms are as follows. CNN can extract features for the classification automatically by applying convolution layer and massively parallel processing. LSTM is not capable of highly parallel processing. Like faucets, the LSTM has input, output, and forget gates that can be moved and controlled at a desired time. These gates have the advantage of placing memory blocks on hidden nodes. The memory block of the LSTM may not store all the data, but it can solve the CNN's long-term dependency problem. Furthermore, when LSTM is used in CNN's pooling layer, it has an end-to-end structure, so that spatial and temporal features can be designed simultaneously. In combination with CNN-LSTM, 90.33% accuracy was measured. This is slower than CNN, but faster than LSTM. The presented model was more accurate than other models. In addition, each word embedding layer can be improved when training the kernel step by step. CNN-LSTM can improve the weakness of each model, and there is an advantage of improving the learning by layer using the end-to-end structure of LSTM. Based on these reasons, this study tries to enhance the classification accuracy of movie reviews using the integrated CNN-LSTM model.

• Journal of Intelligence and Information Systems
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• v.25 no.1
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• pp.21-41
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• 2019

Thanks to the rapid development of information technologies, the data available on Internet have grown rapidly. In this era of big data, many studies have attempted to offer insights and express the effects of data analysis. In the tourism and hospitality industry, many firms and studies in the era of big data have paid attention to online reviews on social media because of their large influence over customers. As tourism is an information-intensive industry, the effect of these information networks on social media platforms is more remarkable compared to any other types of media. However, there are some limitations to the improvements in service quality that can be made based on opinions on social media platforms. Users on social media platforms represent their opinions as text, images, and so on. Raw data sets from these reviews are unstructured. Moreover, these data sets are too big to extract new information and hidden knowledge by human competences. To use them for business intelligence and analytics applications, proper big data techniques like Natural Language Processing and data mining techniques are needed. This study suggests an analytical approach to directly yield insights from these reviews to improve the service quality of hotels. Our proposed approach consists of topic mining to extract topics contained in the reviews and the decision tree modeling to explain the relationship between topics and ratings. Topic mining refers to a method for finding a group of words from a collection of documents that represents a document. Among several topic mining methods, we adopted the Latent Dirichlet Allocation algorithm, which is considered as the most universal algorithm. However, LDA is not enough to find insights that can improve service quality because it cannot find the relationship between topics and ratings. To overcome this limitation, we also use the Classification and Regression Tree method, which is a kind of decision tree technique. Through the CART method, we can find what topics are related to positive or negative ratings of a hotel and visualize the results. Therefore, this study aims to investigate the representation of an analytical approach for the improvement of hotel service quality from unstructured review data sets. Through experiments for four hotels in Hong Kong, we can find the strengths and weaknesses of services for each hotel and suggest improvements to aid in customer satisfaction. Especially from positive reviews, we find what these hotels should maintain for service quality. For example, compared with the other hotels, a hotel has a good location and room condition which are extracted from positive reviews for it. In contrast, we also find what they should modify in their services from negative reviews. For example, a hotel should improve room condition related to soundproof. These results mean that our approach is useful in finding some insights for the service quality of hotels. That is, from the enormous size of review data, our approach can provide practical suggestions for hotel managers to improve their service quality. In the past, studies for improving service quality relied on surveys or interviews of customers. However, these methods are often costly and time consuming and the results may be biased by biased sampling or untrustworthy answers. The proposed approach directly obtains honest feedback from customers' online reviews and draws some insights through a type of big data analysis. So it will be a more useful tool to overcome the limitations of surveys or interviews. Moreover, our approach easily obtains the service quality information of other hotels or services in the tourism industry because it needs only open online reviews and ratings as input data. Furthermore, the performance of our approach will be better if other structured and unstructured data sources are added.

• Journal of Venture Innovation
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• v.5 no.3
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• pp.57-70
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• 2022

In modern industrial capitalism, the relationship between the provision of work and the receipt of wages has become an important principle governing society. According to the labor contract, the wages provided by entrusting the right to dispose of one's labor to the employer are directly compensated, and human life should be guaranteed and reproduced with proper rest. The establishment of labor relations under free contracts represents a problem in protecting workers, and accordingly, the maximum of working hours is set as a minimum right for workers, and the standard for minimum rest is set and assigned. The reduction of working hours is very important in terms of the quality of life of workers, but it is also an important issue in efficient corporate activities. As of 2020, Korea has 1,908 hours of annual working hours, the third lowest among OECD 37 countries in the happiness index surveyed by the Sustainable Development Solution Network(SDSN), an agency under the United Nations. Accordingly, the necessity of reducing working hours has been recognized, and the maximum working hours per week has been limited to 52 hours since 2018. In this situation, various working hours are legally excluded as a way to maintain the company's value-added creation and meet the diverse needs of workers, and Korea's Labor Standards Act restricts flexible working hours within three months, flexible working hours exceeding three months, selective working hours, and extended working hours. However, in the discussion on the application of the revised flexible working hours system in 2021 and the expansion of the settlement unit period recently discussed, there is a problem with the flexible working hours system, which needs to be improved. Therefore, this paper aims to examine the problems of the flexible working hours system and improvement measures. The flexible working hours system is a system that does not violate working hours even if the legal working hours are exceeded on a specific day or week according to a predetermined standard, and does not have to pay additional wages for excessive overtime work. It is mainly useful as a form of shift work in manufacturing, sales service, continuous business or electricity, gas, water, and transportation for long-term operations. It is also used as a way to shorten working hours, such as expanding holidays through short working days. However, if the settlement unit period is expanded, it is disadvantageous to workers as the additional wages that workers can receive will not be received. Therefore, First, in order to expand the settlement unit period currently under discussion, additional wages should be paid for the period expanded from the current standard. Second, it is necessary to improve the application of the flexible working hours system to individual workers to have sufficient consultation with individual workers in a written agreement with the worker representative, Third, clarify the allowable time for extended work during the settlement unit period, and Fourth, limit the daily working hours or apply to continuous rest. In addition, since the written agreement of the worker representative is an important issue in the application of the flexible working hours system, it is necessary to secure the representation of the worker representative.

• Journal of Wetlands Research
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• v.18 no.4
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• pp.474-480
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• 2016

In this study, formation background of biodiversity and its changes in the process of geologic history, and effects of climate change on biodiversity and human were discussed and the alternatives to reduce the effects of climate change were suggested. Biodiversity is 'the variety of life' and refers collectively to variation at all levels of biological organization. That is, biodiversity encompasses the genes, species and ecosystems and their interactions. It provides the basis for ecosystems and the services on which all people fundamentally depend. Nevertheless, today, biodiversity is increasingly threatened, usually as the result of human activity. Diverse organisms on earth, which are estimated as 10 to 30 million species, are the result of adaptation and evolution to various environments through long history of four billion years since the birth of life. Countlessly many organisms composing biodiversity have specific characteristics, respectively and are interrelated with each other through diverse relationship. Environment of the earth, on which we live, has also created for long years through extensive relationship and interaction of those organisms. We mankind also live through interrelationship with the other organisms as an organism. The man cannot lives without the other organisms around him. Even though so, human beings accelerate mean extinction rate about 1,000 times compared with that of the past for recent several years. We have to conserve biodiversity for plentiful life of our future generation and are responsible for sustainable use of biodiversity. Korea has achieved faster economic growth than any other countries in the world. On the other hand, Korea had hold originally rich biodiversity as it is not only a peninsula country stretched lengthily from north to south but also three sides are surrounded by sea. But they disappeared increasingly in the process of fast economic growth. Korean people have created specific Korean culture by coexistence with nature through a long history of agriculture, forestry, and fishery. But in recent years, the relationship between Korean and nature became far in the processes of introduction of western culture and development of science and technology and specific natural feature born from harmonious combination between nature and culture disappears more and more. Population of Korea is expected to be reduced as contrasted with world population growing continuously. At this time, we need to restore biodiversity damaged in the processes of rapid population growth and economic development in concert with recovery of natural ecosystem due to population decrease. There were grand extinction events of five times since the birth of life on the earth. Modern extinction is very rapid and human activity is major causal factor. In these respects, it is distinguished from the past one. Climate change is real. Biodiversity is very vulnerable to climate change. If organisms did not find a survival method such as 'adaptation through evolution', 'movement to the other place where they can exist', and so on in the changed environment, they would extinct. In this respect, if climate change is continued, biodiversity should be damaged greatly. Furthermore, climate change would also influence on human life and socio-economic environment through change of biodiversity. Therefore, we need to grasp the effects that climate change influences on biodiversity more actively and further to prepare the alternatives to reduce the damage. Change of phenology, change of distribution range including vegetation shift, disharmony of interaction among organisms, reduction of reproduction and growth rates due to odd food chain, degradation of coral reef, and so on are emerged as the effects of climate change on biodiversity. Expansion of infectious disease, reduction of food production, change of cultivation range of crops, change of fishing ground and time, and so on appear as the effects on human. To solve climate change problem, first of all, we need to mitigate climate change by reducing discharge of warming gases. But even though we now stop discharge of warming gases, climate change is expected to be continued for the time being. In this respect, preparing adaptive strategy of climate change can be more realistic. Continuous monitoring to observe the effects of climate change on biodiversity and establishment of monitoring system have to be preceded over all others. Insurance of diverse ecological spaces where biodiversity can establish, assisted migration, and establishment of horizontal network from south to north and vertical one from lowland to upland ecological networks could be recommended as the alternatives to aid adaptation of biodiversity to the changing climate.

• Journal of Radiation Protection and Research
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• v.32 no.3
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• pp.105-110
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• 2007

Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as Point A, is still used widely. A 3-dimensional ICR plan based on CT image provides dose-volume histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planing system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume$(average{\pm}SD)$ of CTV, rectum and bladder in all of 11 patients is $21.8{\pm}6.6cm^3,\;60.9{\pm}25.0cm^3,\;111.6{\pm}40.1cm^3$ respectively. The volume covered by 100% isodose curve is $126.7{\pm}18.9cm^3$ in ICRU plan and $98.2{\pm}74.5cm^3$ in CTV plan(p=0.0001), respectively. In (On) ICRU planning, $22.0cm^3$ of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of $62.2{\pm}4.8cm^3$ other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was $90.1{\pm}21.3%$ and $68.7{\pm}26.6%$ in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was $86.4{\pm}18.3%$ and $76.9{\pm}15.6%$ in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was $137.2{\pm}50.1%,\;101.1{\pm}41.8%$ in ICRU plan and $107.6{\pm}47.9%,\;86.9{\pm}30.8%$ in CTV plan, respectively. Therefore, the radiation dose to normal organ was lower in CTV plan than in ICRU plan. But the normal tissue dose was remarkably higher than a recommended dose in CTV plan in one patient whose residual tumor size was greater than 4cm. The volume of rectum receiving more than 80% isodose (V80rec) was $1.8{\pm}2.4cm^3$ in ICRU plan and $0.7{\pm}1.0cm^3$ in CTV plan(p=0.02). The volume of bladder receiving more than 80% isodose(V80bla) was $12.2{\pm}8.9cm^3$ in ICRU plan and $3.5{\pm}4.1cm^3$ in CTV plan(p=0.005). According to these parameters, CTV plan could also save more normal tissue compared to ICRU38 plan. Conclusion : An unnecessary excessive radiation dose is irradiated to normal tissues within 100% isodose area in the traditional ICRU plan in case of a small size of cervix cancer, but if we use CTV plan based on CT image, the normal tissue dose could be reduced remarkably without a compromise of tumor dose. However, in a large tumor case, we need more research on an effective 3D-planing to reduce the normal tissue dose.