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Results of Conventional Radiotherapy in Oropharyngeal Cancer (구인두암의 방사선 치료 성적)

  • Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.1-8
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    • 1996
  • Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.

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Association of osteoarthritis and bone mineral density in women -The health and nutritional examination survey in Kuri- (여성의 골관절염과 골밀도간의 관련성 분석 -구리시민 건강.영양진단 조사결과를 바탕으로-)

  • Sheen, Seung-Soo;Lee, Soon-Young;Min, Byung-Hyun;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.669-685
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    • 1997
  • Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.

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The Effects of Cattle Slurry Application and Mixed Sowing with legumes on Productivity and Feed Values of Barley and Rye (액상우분뇨와 콩과식물 혼파재배가 보리, 호밀의 생산성과 사료가치에 미치는 영향)

  • Jo, IK-Hwan
    • Korean Journal of Organic Agriculture
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    • v.17 no.3
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    • pp.371-380
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    • 2009
  • This study was conducted to assess effects of supplying different types of nitrogen sources as fertilizers on productivity and feed values of barley and rye as winter forage crops, and ultimately done to get good quality of organic forages with higher fertilization of soil. For barley, N+P+K plots were significantly (P<0.05) higher in annual dry matter (DM) and total digestible nutrients (TDN) yields than other plots. However, cattle manure plots had significantly (P<0.05) higher annual DM and TDN than P+K and non-fertilizer plots. Plots of 50%-cattle manure and mixed sowing with hairy vetch or forage pea were higher than only 50%-cattle manure plot, particularly, these were significantly higher than non-fertilizer, and their crude protein (CP) yields were much higher than other plots. Crude protein contents were significantly higher in N+P+K and 50%-cattle manure slurry plots than non-fertilizer and P+K plots, and plots of mixed sowing with hairy vetch or forage pea in application of 50%-cattle manure had higher CP content than other plots. ADF content was lowest in 50%-cattle manure+forage pea plots, but highest in 100%-cattle manure plots. NDF content was lowest in legumes-mixed sowing, but highest in 100%-cattle manure plots. TDN content was the highest in forage pea plots, and plots of 50%-cattle manure and legumes-mixed sowing had high RFV, but cattle manure plots rich in ADF and NDF content had the lowest TDN and RFV. For rye, plots of 50%-cattle manure+hairy vetch mixed sowing, and N+P+K application had significantly higher annual DM, CP and TDN than other plots except for cattle manure. DM productive efficiency to nitrogen fertilization was markedly higher for cattle manure plots than for chemical fertilizer. This tendency was more conspicuous in plots of 50% cattle manure+legumes-mixed sowing. CP content was higher for N+P+K plot than for all plots, and plots of 50%-cattle manure + legumes-mixed sowing were significantly higher than other plots. On the contrary, forage pea-mixed sowing plot had the lowest ADF and NDF, but TDN and RFV were significantly (P<0.05) higher than other plots. Grass crop cultivation together with legumes by applying livestock manure to soil may lead to higher palatability of livestock, and better quality of forage. Furthermore, cattle manure application increased production yield per ha and CP contents. Thus, when applying forage crops produced by cattle manure application and mixed sowing to organic livestock production, it was conceived that forages produced might become a substitute for foreign organic grain as protein sources.

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The Effect of the Histidine-Tryptophan-Ketoglutarate (HTK) Solution on Myocardial Protection in Isolated Rat Heart (흰쥐의 적출심장에서 HTK 용액의 심근보호 효과)

  • 송원영;장봉현;김규태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.632-643
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    • 2004
  • Background: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high. concentration of histidine biological buffer which confer a buffering capacity superior to that of blood.. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is. exceeding 120 minutes at two different temperature (10 to 12$^{\circ}C$, 22 to 24$^{\circ}C$) using the Langendorff apparatus, Material and Method: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm $H_2O$. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10∼12$^{\circ}C$) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22∼24$^{\circ}C$) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. Result: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02$\pm$0.29, 1.52$\pm$0.26, 1.56$\pm$0.45, 2.22$\pm$0.44 respectively. Conclusion: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22∼ 24$^{\circ}C$). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.

Stomata Variation of Rice and Weeds (수도(水稻) 및 잡초(雜草)의 기공형태(氣孔形態)와 분포(分布))

  • Kim, S.C.;Lee, S.K.;Chung, G.S.
    • Korean Journal of Weed Science
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    • v.9 no.1
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    • pp.46-55
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    • 1989
  • Stomatal variation was observed at the Yeongnam Crop Experiment Station in 1988 using 42 rice cultivars and 30 weed species. The shape, density or size of stomata was varied depending on the species. Two general trends, however, were found that more number of stomata was found at lower leaf epidermis than upper leaf epidermis and stomata number was negatively correlated with stomata size. Aneilema japonica and Portulaca oleracea had the least number of stomata having 17-20 stomata per $m^2$ for upper leaf epidermis and 17-54 stomata for lower leaf epidermis while Polygonum conspicuum had the greatest number of stomata (449 for upper leaf epidermis and 511 for lower leaf epidermis). Soybean, Aeschynomene indica, Ludwigia prostrata and Lactuca indica had the smallest in stomata size while the biggest stomata was found at P. oleracea and A. Japonica that had the least number of stomata. Cyperus species such as C. difformis, C. iria and C. serotinus had no stomata at upper leaf epidermis. The stomata were distributed only at lower leaf epidermis for these species. Potamogeton distinctus, on the other hand, had stomata almost at upper leaf epidermis and thus, hardly found the stomata at lower leaf epidermis. Among rice cultivars, Tongil-type had the greatest number of stomata followed by Indica-type and Japonica-type, in order. Cultivars released after 1960 had more stomata than cultivars released before 1960 for Japonica-type cultivars while stomata size had reversed trend. Jinheung had the least number of stomata (${\fallingdotseq}$ 150 per $mm^2$) while Yushin had the greatest number of stomata (350 for upper and 449 for lower leaf epidermis, respectively) among rice cultivars. Other cultivars having more than 350 stomata per $mm^2$ were Samgangbyeo, Milyang 23, Woonbongbyeo, etc.

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Optimum Harvest Stage of Italian Ryegrass 'Kowinearly' According to One and Two Harvests During Spring Season (이탈리안 라이그라스 '코윈어리'의 봄철 1회 및 2회 이용에 따른 수확적기 구명)

  • Seo, Sung;Kim, Meing Jooung;Kim, Won Ho;Lee, Sang Hak;Jung, Min Woong;Kim, Ki Yong;Ji, Hee Chung;Park, Hyung Soo;Kim, Jong Geun;Choi, Gi Jun
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.33 no.1
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    • pp.15-20
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    • 2013
  • This study was carried out to determine the optimum harvest stage of Italian ryegrass (Lolium multiflorum Lam., IRG) for maximum forage production during the spring season in Suwon, 2010. The variety of IRG was the early maturity type, 'Kowinearly', and six harvest stages (treatments) were first heading (T1), heading (T2), late heading to early bloom (T3), bloom to late bloom (T4), ripeness (T5), and late ripeness stage (T6). The dates of the first heading and heading of 'Kowinearly' were seen on 4 to 5 May, and 14 May, respectively. Plant length and dry matter (DM) percentage at first harvest were from 69 cm and 14.8% at T1 stage to 103 cm and 35.0% at T6 stage, respectively. The content of crude protein (CP) and in vitro DM digestibility (IVDMD) of T1, T2, T3, T4, T5 and T6 at first harvest were 15.6%, 10.6%, 10.1%, 8.1%, 7.3% and 5.4%, and 81.8%, 72.1%, 64.8%, 63.8%, 61.4% and 59.0%, respectively. The content of neural detergent fiber (NDF) and acid detergent fiber (ADF) were increased continuously with delayed harvest. A significantly higher yield of DM, CP and in vitro digestible DM (IVDDM) were observed for T3, and T4 (p<0.05). DM yield of 3,526 kg, 6,278 kg, 7,842 kg, 8,984 kg, 8,346 kg and 8,008 kg/ha, CP yield of 549 kg, 665 kg, 795 kg, 725 kg, 608 kg and 430 kg/ha, and IVDDM of 2,883 kg. 4,526 kg, 5,083 kg, 5,728 kg, 5,124 kg and 4,722 kg/ha at first harvest were recorded in T1, T2, T3, T4, T5 and T6, respectively. Regrowth yield of DM, CP and IVDDM were shown to be higher at T1 and T2 (p<0.05). However, no significant differences were observed between the two stages. Daily DM and DDM production of regrowth IRG were higher at T2, followed by T1. The total yield (at first and at regrowth) of DM, CP and IVDDM were significant higher for T2, followed by T3, T4 and T1 in order. At T2 stage, the yield was 11,089 kg, 1,254 kg, and 7,669 kg/ha in DM, CP, and IVDDM. In conclusion, the late heading to bloom stage was determined to be the optimum harvest stage for a single harvest, while the heading stage was a suitable stage of first harvest of 'Kowinearly' where two harvests were sought in a single year.

Studies on the Organo-mercury Residues in Rice Grain -I. Mercury residues in rice seeds treated with organo-mercury fungicide- (수도(水稻)에 처리(處理)된 유기수은제(有機水銀劑)의 잔류성(殘留性)에 관(關)한 연구(硏究) -제1보(第1報) 침지용유기수은제(浸漬用有機水銀劑)로 처리(處理)된 수도종자중(水稻種子中)의 수은잔류량(水銀殘留量)에 관(關)하여-)

  • Lee, Dong-Suk
    • Applied Biological Chemistry
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    • v.8
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    • pp.87-93
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    • 1967
  • 1) For the micro-analysis of mercury in plant materials, the method of Furutani was shown to be the simplest and most efficient way and the recovery of the assay was about 98%. 2) When the rice grain was soaked in 1/1000 diluted solution of organo-mercury fungicide for 8 hours at the end of March, the amounts of mercury residues in the brown rice and unhulled rice were 8.8 to $9.5\;{\mu}g/g$ seeds and 10.1 to $10.7\;{\mu}g/g$ seeds, respectively. 3) By washing the treated rice seeds with running water for three days, tile residual mercury concentration was reduced to 1/4 to 1/5; thus the mercury residues were 1.86 to $1.92\;{\mu}g/g$ for brown rice and 1.96 to $2.93\;{\mu}g/g$ for unhulled rice. 4) The residual mercury was present more in the unhulled rice than in the brown rice, either before or after washing of the treated seeds. 5) Among the different rice varieties, no difference was observed in mercury residues by seed treatment and washing.

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A Survey on Physical Complaints Related with Farmers' Syndrome of Vinylhouse and Non-vinylhouse Farmers (비닐하우스 재배농민과 일반농민의 농부증 관련 신체증상 호소율 조사)

  • Lee, Ju-Young;Park, Jung-Han;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.258-273
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    • 1994
  • To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 vinylhouse and 142 non-vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than the non-vinylhouse farmers. The frequency of pesticide spray of the vinylhouse farmers was 3.4 times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot, shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7% for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, the prevalence in female was about 2 times higher than that of male. When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased in both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year. Adjusted odds ratio for Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.1 times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with tile common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide or may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.

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Radiation Therapy Alone for Early Stage Non-small Cell Carcinoma of the Lung (초기 비소세포폐암의 방사선 단독치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.323-327
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    • 2002
  • Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.

Radiotherapy in Small Cell Carcinoma of the Uterine Cervix (자궁경부 소세포암종의 방사선치료)

  • Chung Eun Ji;Lee Yong Hee;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.369-377
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    • 1997
  • Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.

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