• Title/Summary/Keyword: 의미 부여

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INDIVIDUALIZED RECONSTRUCTION OF THE LOWER OCCLUSAL PLANE ACCORDING TO SKELETAL PATTERN (안면 골격 형태에 따른 하악 교합평면의 재구성)

  • Hyun, Seong-Wook
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.465-485
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    • 1995
  • The purpose of this study is to locate the proper position of the lower occlusal plane according to individual skeletal pattern. Cephalometric films of 234 subjects of the control group, 358 of the pretreatment group and 358 of the treated group were analyzed to study proper relationships between vertical dimension ratio(VDR) and lower occlusomandibular plane angle(LOM). The control group was divided into two subgroups by the age. The first subgroup consisted of 113 subjects of the age 14 years and under and with the mean age of 10.82 years. The other subgroup consisted of 113 subjects of the age 18 years and above with the mean age of 23.76 years. The pretreatment group was divided into three subgroups by the age. The first subgroup consisted of 274 subjects of the age 14 years and under with the mean age of 11.36 years. The second subgroup consisted of 54 subjects of the age 14 through 18 years with the mean age of 15.4 years. The last subgroup consisted of 30 subjects of the age 18 years and above with the mean age of 21.35 years. The treated group was also divided into three subgroups by the age. The first subgroup consisted of 145 subjects of the age 14 years and under with the mean age of 12.91 years. The second subgroup consisted of 166 subjects of the age 14 through 18 years with the mean age of 15.64 years. The last subgroup consisted of 47 subjects of the age 18 years and above with the mean age of 21.61 years. Cephalometric films of the sample were traced. Measurements were made to a hundredth using a program specifically prepared for this study, and the results were entered into a 486DX PC. Means and Standard deviations of all the veriables were calculated for each group. Correlation coefficients between pertinent variables were calculated. Significance tests on those coefficients, one-way ANOVA and t-tests between variables or groups were performed. On the basis of the results studied above, certain subjects were selected from the control and the treated groups to locate the proper position of the occlusal plane, and designated as the optimal occluaion group. The subjects of this optimal occlusion group had 1-3 mm overbite, 1-3 mm of overjet and less than 1.75 mm of curve of Spee. A total subjects of 187 in this group consisted 104 treated subjects and 83 control group. Regression analysis was carried out between VDR and LOM, and regression equations were tabulated for this optimal occlusion group. The results were as follows : 1. Highly significant correlations were observed between various variables useful for identifying vertical component of skeletal frame, but any one particular variable did not accurately indicate the magnitude of anterior vertical overbite. 2. Of the variables useful identifying vertical component of skeletal frame, The VDR showed the highest correlation to the LOM. 3. Of the total sample, 80 percent had overbite within the normal range, irrespective of VDR. 4. The optimal occlusion group was divided into 9 subgroups by the age and the anteroposterior skeletal pattern, and correlation coefficient and determination coefficient between VDR and LOM of each group were calculated. Correlation coefficients and determination coefficients were found to be significantly high in all groups. 5. Regression equation was induced for each of the optimal occlusion group to find proper LOM according to the VDR. 6. It was found that the mean value of the cant of occlusal plane itself is not enough for a diagnosis and a treatment plan. Rather, It is very important to locate the proper occlusal plane for an Individual skeletal pattern.

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GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Heavy metal concentration of plants in Baekdong serpentine area, western part of chungnam (충남 서부 백동 사문암지역 식물체의 중금속 함량)

  • 송석환;김명희;민일식;장인수
    • Journal of Korea Soil Environment Society
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    • v.4 no.2
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    • pp.113-125
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    • 1999
  • Heavy metal elements were analysed to assess degrees of heavy metal contents for the plants, M. sinensis, A. vulgaris and G. oldhamiana, from the Baekdong serpentine area within the western part of Chungnam. The area was divided into two sites ; serpentine area (SP, consisting of serpentinite, SP) and non-serpentine area (NSP, containing amphibole schist, AS and gneiss, GN). Their host rocks(R) and top soils(S) were also collected from the each site. As the results of the study, the plants contain high concentration of Ni Cr, Co in the SP and Fe, Zn in the AS and GN. Plants from the AS of the NSP contain mainly high content in the most of elements. Averages of Ni, Co and Cr for the plants decreased in the order of SP, AS and GN. In the total element contents, M. sinensis and A. vulgaris decreased in the order of Fe > Ni or Cr > Zn > Co > As > Sc within the SP and in the order of Fe > Zn > Cr > Ni, within the GN. Comparing among the parts of plants, root parts were higher in the most of elements than the above grounds. In the relative element ratios of plants collected from the SP and GN (SP/GN) M. sinensis was lower than A. vulgaris in the most of elements, suggesting that the M. sinenis shows low absorption within the infertile serpentine soil and high absorption within the fertile gneiss soil. In the element contents of the top soils and their host rocks, the SP shows higher Ni, Co and Cr contents than the others. Their total contents decreased from SP to AS and GN, suggesting that the soils reflect the composition of their host rocks. Total element contents of the SP decreased in the order of Fe> Cr or Ni> Co> Zn> As> Sc and, for the GN, in the order of Fe> Zn> Cr> Ni> Co or Sc, respectively. In the relative element ratios, R/S of the SP decreased in the order of Cr> As> Fe> Sc> Co> Ni> Zn and for the GN, in the order of Sc> Fe> Ni> Zn> Cr> Co. Comparing with plants within the each site, their top soils were higher than the plants in the most of elements. and their increase and decrease trends for each element are similar. Differences of element contents between the top soils and plants decreased in the order of SP, AS and GN. Plants of the GN were moi-e similar to their soils than those of the others, suggesting that each plant species show different absorptions within the different soils. Comparing with the plants of GN, higher Ni, Co, Cr contents within those of the SP and their survival within the infertile serpentine soil suggest that the M. sinensis, A vulgaris and G. oldhamiana may be the tolerance species in the serpentine soil. Comparisons with the upper crust show that M. sinensis, and A. vulgaris within the SP show high Hi and Cr contents. suggestive of hyperaccumulation. Upper results with the previous studies for the contaminated soils developed as parent materials with the serpentinites suggest additional studies for ecological behaviors for the plant and degrees of accumulations for the elements need to know phytoextraction of the heavy metal elements within the soils.

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Mineralogy and Biogeochemistry of Intertidal Flat Sediment, Muan, Chonnam, Korea (전남 무안 갯벌 퇴적물에 관한 광물학적 및 생지화학적 연구)

  • Park, Byung-No;Lee, Je-Hyun;Oh, Jong-Min;Lee, Seuug-Hee;Han, Ji-Hee;Kim, Yu-Mi;Seo, Hyun-Hee;Roh, Yul
    • Journal of the Mineralogical Society of Korea
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    • v.20 no.1 s.51
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    • pp.47-60
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    • 2007
  • While sedimentological researches on Western coastal tidal flats of Korea have been much pelformed previously, mineralogical and biogeochemical studies are beginning to be studied. The objectives of this study were to investigate mineralogical characteritics of the inter-tidal flat sediments and to explore phase transformation of iron(oxyhydr)oxides and biomineralization by metal-reducing bacteria enriched from the inter-tidal flat sediments from Muan, Jeollanam-do, Korea. Inter-tidal flat sediment samples were collected in Chungkye-myun and Haeje-myun, Muan-gun, Jeollanam-do. Particle size analyses were performed using the pipette method and sedimentation method. The separates including sand, silt and clay fractions were examined by scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM), and X-ray diffiaction (XRD). After enriching the metal-.educing bacteria from the into,-tidal flat sediments, the bacteria were used to study phase transformation of the synthesized iron (oxyhydr)oxides and iron biomineralization using lactate or glucose as the electron donors and Fe(III)-containing iron oxides as the electron accepters. Mineralogical studies showed that the sediments of tidal flats in Chung]rye-myun and Haeje-myun consist of quartz, plagioclase, microcline, biotite, kaolinite and illite. Biogeochemical researches showed that the metal-reducing bacteria enriched from the inter-tidal flat sediments reduced reddish brown akaganeite and mineralized nanometer-sized black magnetite. The bacteria also reduced the reddish brown ferrihydrite into black amorphous phases and reduced the yellowish goethite into greenish with formation of nm-sized phases. These results indicate that microbial Fe(III) reduction may play one of important roles in iron and carbon biogeochemistry as well as iron biomineralization in subsurface environments.

Spatio-temporal Fluctuations with Influences of Inflowing Tributary Streams on Water Quality in Daecheong Reservoir (대청호의 시공간적 수질 변화 특성 및 호수내 유입지천의 영향)

  • Kim, Gyung-Hyun;Lee, Jae-Hoon;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.45 no.2
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    • pp.158-173
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    • 2012
  • The objectives of this study were to analyze the longitudinal gradient and temporal variations of water quality in Daecheong Reservoir in relation to the major inflowing streams from the watershed, during 2001~2010. For the study, we selected 7 main-stream sites of the reservoir along the main axis of the reservoir, from the headwater to the dam and 8 tributary streams. In-reservoir nutrients of TN and TP showed longitudinal declines from the headwater to the dam, which results in a distinct zonation of the riverine ($R_z$, M1~M3), transition ($T_z$, M4~M6), and lacustrine zone ($L_z$, M7) in water quality, as shown in other foreign reservoirs. Chlorophyll-a (CHL) and BOD as an indicator of organic matter, were maximum in the $T_z$. Concentration of total phosphorus (TP) was the highest (8.52 $mg\;L^{-1}$) on March in the $R_z$, and was the highest (165 ${\mu}g\;L^{-1}$) in the $L_z$ on July. Values of TN was the maximum (377 ${\mu}g\;L^{-1}$) on August in the $R_z$, and was the highest (3.76 $mg\;L^{-1}$) in the $L_z$ on August. Ionic dilution was evident during September~October, after the monsoon rain. The mean ratios of TN : TP, as an indicator of limiting factor, were 88, which indicates that nitrogen is a surplus for phytoplankton growth in this system. Nutrient analysis of inflowing streams showed that major nutrient sources were headwater streams of T1~T2 and Ockcheon-Stream of T5, and the most influential inflowing stream to the reservoir was T5, which is located in the mid-reservoir, and is directly influenced by the waste-water treatment plants. The key parameters, influenced by the monsoon rain, were TP and suspended solids (SS). Empirical models of trophic variables indicated that variations of CHL in the $R_z$ ($R^2$=0.044, p=0.264) and $T_z$ ($R^2$=0.126, p=0.054) were not accounted by TN, but were significant (p=0.032) in the $L_z$. The variation of the log-transformed $I_r$-CHL was not accounted ($R^2$=0.258, p=0.110) by $I_w$-TN of inflowing streams, but was determined ($R^2$=0.567, p=0.005) by $I_w$-TP of inflowing streams. In other words, TP inputs from the inflowing streams were the major determinants on the in-reservoir phytoplankton growth. Regression analysis of TN : TP suggested that the ratio was determined by P, rather than N. Overall, our data suggest that TP and suspended solids, during the summer flood period, should be reduced from the eutrophication control and P-input from Ockcheon-Stream should be controlled for water quality improvement.

A Study on the Passengers liability of the Carrier on the Montreal Convention (몬트리올협약상의 항공여객운송인의 책임(Air Carrier's Liability for Passenger on Montreal Convention 1999))

  • Kim, Jong-Bok
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.31-66
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    • 2008
  • Until Montreal Convention was established in 1999, the Warsaw System is undoubtedly accepted private international air law treaty and has played major role on the carrier's liability in international aviation transport industry. But the whole Warsaw System, though it was revised many times to meet the rapid developments of the aviation transport industry, is so complicated, tangled and outdated. This thesis, therefore, aim to introduce the Montreal Convention by interpreting it as a new legal instrument on the air carrier's liability, specially on the passenger's, and analyzing all the issues relating to it. The Montreal Convention markedly changed the rules governing international carriage by air. The Montreal Convention has modernized and consolidated the old Warsaw System of international instruments of private international air law into one legal instrument. One of the most significant features of the Montreal Convention is that it sifted its priority to the protection of the interest of the consumers from the protection of the carrier which originally the Warsaw Convention intended to protect the fledgling international air transport business. Two major features of the Montreal Convention adopts are the Two-tier Liability System and the Fifth Jurisdiction. In case of death or bodily injury to passengers, the Montreal Convention introduces a two-tier liability system. The first tier includes strict liability up to 100,000SDR, irrespective of carriers' fault. The second tier is based on presumption of fault of carrier and has no limit of liability. Regarding Jurisdiction, the Montreal Convention expands upon the four jurisdiction in which the carrier could be sued by adding a fifth jurisdiction, i.e., a passenger can bring suit in a country in which he or she has their permanent and principal residence and in which the carrier provides a services for the carriage of passengers by either its own aircraft or through a commercial agreement. Other features are introducing the advance payment, electronic ticketing, compulsory insurance and regulation on the contracting and actual carrier etc. As we see some major features of the Montreal Convention, the Convention heralds the single biggest change in the international aviation liability and there can be no doubt it will prevail the international aviation transport world in the future. Our government signed this Convention on 20th Sep. 2007 and it came into effect on 29th Dec. 2007 domestically. Thus, it was recognized that domestic carriers can adequately and independently manage the change of risks of liability. I, therefore, would like to suggest our country's aviation industry including newly-born low cost carrier prepare some countermeasures domestically that are necessary to the enforcement of the Convention.

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Measurement of Bone mineral density According to Middle aged Women with Low Back Pain (중년여성의 요통에 따른 골밀도 측정)

  • Kang, Jeom-Deok;Kim, Jong-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.5-28
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    • 2001
  • Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

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A study on the factors to affect the career success among workers with disabilities (지체장애근로자의 직업성공 요인에 관한 연구)

  • Lee, Dal-Yob
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.185-216
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    • 2003
  • This study was aimed at investigating important factors influencing career success among regular workers. The current researcher scrutinized the degree to which variables and factors affect the career success and occupational turnover rates of the research participants. At the same tune, two hypothetical path models established by the researcher were examined using linear multiple regression methods and the LISREL. After examining the differences among the factors of career success, a comparison was made between the disabled worker group and the non-disabled worker group. A questionnaire using the 5-point Likert scale was distributed to a group of 374 workers with disabilities and 463 workers without disabilities. For the data analysis purpose, the structural equation model, factor analysis, correlation analysis, and multiple regression analysis were carried out. The results of this study ran be summarized as follows. First, the results of factor analysis showed important categories of conceptual themes of career success. The initial conceptual factor model did not accord with the empirical one. A three-factorial model revealed categories of personal, family, and organizational factor respectively. The personal factor was composed of the self-esteem and self-efficiency. The family factor was consisted of the multi-roles stress and the number of children. Finally, the organizational factor was composed of the capacity for utilizing resources, networking, and the frequency of mentoring. In addition, the total 10 sub areas of career success were divided by two important aspects; the subjective career success and the objective career success. Second, both research participant groups seemed to be influenced by their occupational types. However, all predictive variables excluding the wage rate and the average length of work years had significant impact on job success for the disabled work group, while all the variables excluding the frequency of advice and length of working years had significant impact on job success for the non-disabled worker group. Third, the turnover rate was significantly influenced by the age and the experience of turnover of the research participants. However, the number of co-workers was the strongest predictive variable for the worker group with disabilities, but the occupation choice variable for the worker group without disabilities. For the disabled worker group, the turnover rate was differently influenced by the type of occupation, the length of working years, while multi-role stress and the average working years at the time of turnover for the worker group without disabilities. Fifth, as a result of verifying the hypothetical path model, it showed that the first model was somewhat proper and could predict the career success on both research participant groups. In the second model, the Chi-square, the degree of freedom (($x^2=64.950$, df=61, P=0.341), and the adjusted Goodness of Fit Index (AGFI) were .964, and the Comparative Fit Index (CFI) were .997, and the Root Mean Squared Residual (RMR) was respectively. .038. The model was best fitted and could predict the career success more highly because the goodness of fit index in the whole models was within the allowed range. In conclusion, the following research implications can be suggested. First, the occupational type of research participants was one of the most important variables to predict the career success for both research participant groups. It means that people with disabilities require human development services including education. They need to improve themselves in this knowledge-based society. Furthermore, for maintaining the career success, people with disabilities should be approached by considering the subjective career success aspects including wages and the promotion opportunities than the objective career success aspects.

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Characteristics of Everyday Movement Represented in Steve Paxton's Works: Focused on Satisfyin' Lover, Bound, Contact at 10th & 2nd- (스티브 팩스톤(Steve Paxton)의 작품에서 나타난 일상적 움직임의 특성에 관한 연구: , , 를 중심으로)

  • KIM, Hyunhee
    • Trans-
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    • v.3
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    • pp.109-135
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    • 2017
  • The purpose of this thesis is to analyze characteristics of everyday movement showed in performances of Steve Paxton. A work of art has been realized as a special object enjoyed by high class people as high culture for a long time. Therefore, a gap between everyday life and art has been greatly existed, and the emergence of everyday elements in a work of art means that public awareness involving social change is changed. The postmodernism as the period when a boundary between art and everyday life is uncertain was a postwar society after the Second World War and a social situation that rapidly changes into a capitalistic society. Changes in this time made scholars gain access academically concepts related to everyday life, and affected artists as the spirit of the times of pluralistic postmodernism refusing totality. At the same period of the time, modern dance also faced a turning point as post-modern dance. After the Second World War, modern dance started to be evaluated as it reaches the limit, and at this juncture, headed by dancers including the Judson Dance Theatre. Acting as a dancer in a dance company of Merce Cunningham, Steve Paxton, one of founders of the Judson Dance Theatre, had a critical mind of the conditions of dance company with the social structure and the process that movement is made. This thinking is showed in early performances as an at tempt to realize everyday motion it self in performances. His early activity represented by a walking motion attracted attention as a simple motion that excludes all artful elements of existing dance performances and is possible to conduct by a person who is not a dancer. Although starting the use of everyday movement is regarded as an open characteristic of post-modern dance, advanced researches on this were rare, so this study started. In addition, studies related to Steve Paxton are skewed towards Contact Improvisation that he rose as an active practician. As the use of ordinary movement before he focused on Contact Improvisation, this study examines other attempts including Contact Improvisation as attempts after the beginning of his performances. Therefore, the study analyzes Satisfyin' Lover, Contact at 10th & 2nd and Bound that are performances of Steve Paxton, and based on this, draws everyday characteristics. In addition, related books, academic essays, dance articles and reviews are consulted to consider a concept related to everyday life and understand dance historical movement of post-modern dance. Paxton attracted attention because of his activity starting at critical approach of movement of existing modern dance. As walking of performers who are not dancers, a walking motion showed in Satisfyin' Lover gave esthetic meaning to everyday movement. After that, he was affected by Eastern ideas, so developed Contact Improvisation making a motion through energy of the natural laws. In addition, he had everyday things on his performances, and used a method to deliver various images by using mundane movement and impromptu gestures originating from relaxed body. Everyday movement of his performances represents change in awareness of performances of the art of dancing that are traditionally maintained including change of dance genre of an area. His activity with unprecedented attempt and experimentation should be highly evaluated as efforts to overcome the limit of modern dance.

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Treatment Results of Radical Radiotherapy in Uterine Cervix Cancer (자궁경부암 환자의 근치적 방사선치료성적)

  • Huh Seung Jae;Kim Bo Kyong;Lim Do Hoon;Shin Seong Soo;Lee Jeong Eun;Kang Min Kyu;Ahn Yong Chan
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.237-245
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    • 2002
  • Purpose : This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Materials and Methods : Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radio-therapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range $30.6\~50.4\;Gy$ to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of $24\~28\;Gy$ with $6\~7$ fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Results : Early responses of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was $82\%,\;and\;73\%$, and the disease free survival (DFS) rate was $72\%,\;and\;69\%$, at 3, and 5 years, respectively. The pelvic control rate (PCR) was $79\%$ at both 3 and 5 years. According to the FIGO stage,3 and 5 year OS were $100\%\;and\;50\%$ in CIS/IA, $100\%\;and\;100%$ in IB, $83\%\;and\;69\%$ in IIA, $87\%\;and\;80\%$ in IIB, and $62\%\;and\;62\%$ in III, respectively. The 3 year OS in 4 patients with stage IVA was $100\%$. Three-year DFS were $80\%$ in CIS/IA, $88\%$ in IB, $100\%$ in IIA, $64\%$ in IIB, $58\%$ in III, and $75\%$ in IVA. Three-year PCR were $100\%$ in CIS/IA, $94\%$ in IB, $100\%$ in IIA, $84\%$ in IIB, $69\%$ in III, and $50\%$ in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate, treatment response and OTT were significant factors. By multivariate analysis, FIGO stage had a borderline significance for OS (p=0.0825) and treatment response had a borderline significance for DFS (0=0.0872). A total of 14 patients $(13\%)$ experienced rectal bleeding, which occurred from 3 to 44 months (median, 13 months) after the completion of radiotherapy. Conclusion : HDR brachytherapy protocol of Samsung Medical Center combined with properly optimal external beam pelvic irradiation is a safe and effective treatment for patients with uterine cervix cancer. The authors found that OTT of less than 55 days had a positive impact on pelvic control and survival rate.