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Trends of Antimicrobial Susceptibility Test for Bacterias Isolated from Blood, Urine, Stool, and Cerebrospinal Fluid(1997~2001) (혈액 및 일반 세균배양에서 검출된 균종과 항균제 감수성 추이(1997~2001))

  • Hong, Mi Ae;Oh, Kyung Chang;Ahn, Seng In;Kim, Bong Rim;Kim, Yun Ho;Kim, Sung Seop;Chang, Jin Keun;Jeun, Kyoung So;Cha, Sung Ho
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.167-177
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    • 2003
  • Purpose : To know the trends of antimicrobial susceptibility is critical for antimicrobial treatment. We studied the organisms isolated from blood, urine, stool, and cerebrospinal fluid from 1997 to 2001 to reveal the trends of their antimicrobial susceptibility. Methods : We conducted a retrospective study with isolates obtained from 0~18 year old outpatients and inpatients from 1997 to 2001 at Department of Pediatrics, Hanil general hospital. We gathered the data through the laboratory test files and the origin of microorganisms cultured from blood, urine, stool and cerebrospinal fluid and their antimicrobial susceptibility. Results : Microorganisms were isolated from 226(3.3%) out of 6,974 blood cultures, 365 (8.0%) out of 4,549 urine cultures, 50(1.9%) out of 2,593 stool cultures and 9(1.4%) in 655 cerebrospinal fluid cultures. The most frequently isolated organisms from blood cultures was Staphylococcus epidermidis(33.5%) which was followed by Staphylococcus aureus(19.7%), Escherichia coli(13.8%), and Burkholderia cepacia(9.0%). Among the urine cultures, E. coli was the most common(74.7%) which was followed by Group D Enterococcus(11.3%), Klebsiella pneumoniae(7.1%) and Proteus mirabilis(2.5%). The positive stool cultures all yield Salmonella species. Group D Salmonella was obtained most frequently. Among the positive cerebrospinal fluid cultures, Group B Streptococcus was isolated most frequently. Among the 40 cases of S. aureus in blood cultures, 27 cases were methicillin-resistant. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of E. coli isolated from blood cultures were 80%, 100% and 60% in 1997 and 60%, 80% and 60% in 2001. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of K. pnumoniae isolated from urine cultures. were 80%, 100% and 80% in 1997 and 50%, 83% and 50% in 2001 Enterococcus was isolated from 6.7% to 15.8% and vancomycin-resistant Enterococcus was observed in 17% of Group D Enterococcus isolated from urine cultures. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of Group D Salmonella were 96%, 96% and 92% during the study period. Conclusion : Among the blood cultures S. epidermidis, S. aureus, E. coli and B. cepacia were isolated in order of frequency and among the urine cultures E. coli, Group D Enterococcus, K. pneumoniae and P. mirabilis were isolated in order of frequency. During the study period there was no big difference in major organisms isolated from blood and urine. The methicillin-resistant S. aureus was observed in 67% of S. aureus isolated from blood cultures but vancomycin-reistant S. aureus or vancomycin intermediate resistant S. aureus was not observed. The rates of susceptibility to amikacin and the third generation cephalosporin of E. coli isolated from blood cultures and K. pneumoniae from urine cultures have decreased. The isolation rates of Group D Enterococcus and vancomycin resistant Enterococcus have increased.

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A Comparative Study on Awareness of Middle School Students, School Parents, and Human Resources Directors in Industrial Institutions about Admission into Specialized High Schools and Career after Graduating from Specialized High Schools (특성화고 진학 및 졸업 후 진로에 대한 중학생, 학부모, 산업체 인사 담당자의 인식 비교 연구)

  • Lee, Byung-Wook;Ahn, Jae-Yeong;Lee, Chan-Joo;Lee, Sang-Hyun
    • 대한공업교육학회지
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    • v.38 no.2
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    • pp.48-67
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    • 2013
  • This study tried to suggest implications about operation direction of specialized high schools (SHS) by researching awareness of middle school students (MSS), school parents (SP), human resources directors in industrial institutions (HRDII) who will be the main users of SHS education, about entering SHS and career after graduating from SHS. Seniors of middle school, SP and HRDII in Asan, Chungnam were the subject of this survey research. The summary of the result of this study is as follow: First, MSS and SP usually hoped to enter general high schools rather than vocational education schools such as SHS, meister high schools, and MSS considered school records and SP considered aptitude and talent for the factors to choose high school. Second, MSS, SP, and HRDII recognized purposes of SHS as improvement of talent and aptitude, and getting a job. As for positive images of SHS, they recognized it as applying talent and aptitude to life early, getting good jobs easily, fast independence after graduation, and learning excellent technologies, and as for negative images of SHS, they recognized it as social prejudices and discrimination, students with bad school records enter them, disadvantages about promotion and wages, and being unfavorable for entering universities. They also recognized education of SHS as being effective for improvement of basic and executive ability and key competency, development of creative human resources, and improvement of right personality and courteous manners. Third, many MSS and SP showed intention to enter SHS if it is established in Asan. They wished to enter SHS because they would like to apply their aptitude and talent to life early, learn excellent skill, and hope for early employment, on the other hand, they did not wish to enter SHS because it was not suited for their aptitude and talent, awareness about SHS is low, it is unfavorable to enter universities, and there were social prejudices and discrimination. They also similarly hoped for getting jobs and entering universities after graduating from SHS. And the reason they wanted to get a job was usually because they want to be successful by advancing into society early, or because it is still hard to get a job even after graduate from the university, on the other hand, the reason they want to enter university is because is usually in-depth education about major and social discrimination about level of education. The ability to perform duties forms the greatest part of the employment standard that MSS, SP, and HRDII aware. MSS and SP usually hoped for industrial, home economics and housework and commercial majors in SHS, and considered aptitude and talent, the promising future, and being favorable for employment for choosing major. The reason HRDII hire SHS student was to develop student into talent of industrial institution, ability of student, and need for manpower with high school graduation level, and there were also partial answer that they can hire SHS student if they have ability to perform duties. The proposals about operation direction of SHS according to the results above are as follow: SHS should diversify major and curriculum to meet various requirements of student and parents, establish SHS admission system based on career guidance, and improve student's ability to perform duties by establishing work-based learning. The Government should organize work-to-school policy to enable practical career development of students from SHS, and promote relevant policy to reinforcing SHS education rather than quantitative evaluation such as employment rate, and cooperative support from each government departments is required to make manpower with skill related to SHS to get proper evaluation and treatment.

The Impact of e-Store Personality on e-Store Loyalty-Focus on the Mediating Role of Identification, Trust, and Engagement (온라인에서 점포 개성이 점포 충성도에 미치는 영향-동일시, 신뢰, 인게이지먼트의 매개 역할을 중심으로)

  • Park, Hyo-Hyun;Jung, Gang-Ok;Lee, Seung-Chang
    • Journal of Distribution Research
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    • v.16 no.2
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    • pp.57-94
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    • 2011
  • Nowadays, it is common that most consumers are purchasing goods in e-stores. The e-stores eager to attract, revisit, retain, and finally convert them into loyal customers. The e-store marketers have planned and executed numerous marketing efforts. As one of the marketing activities, e-store managers attempt to build web sites that meet customers' functional and psychological needs. A wide array of studies has been done to identify factors that could affect customers' response of web sites. Majority of studies were conducted to verify technology-related and functional variables of the website which facilitate transactions and enhance customer responses such as purchase intention and website loyalty. However, there has been little research on the external cues of website and psychological variables of consumer that could have positive influences on customer response. The purpose of this study is to investigate the influence of e-store personality on e-store loyalty through mediating variables such as e-store identification, e-store trust, and e-store engagement. The authors of this study develop the model and set up the six main hypotheses and a set of sub-hypotheses based on a literature review, shown in

    . This model is composed of four paths such as dimensions of e-store personality${\rightarrow}$e-store identification, e-store identification${\rightarrow}$e-store loyalty, e-store identification ${\rightarrow}$e-store trust${\rightarrow}$e-store loyalty, and e-store identification${\rightarrow}$e-store engagement${\rightarrow}$e-store loyalty. II. Research Method Ladies under 30s were the respondents of this survey. Data were collected from January 20th to February 26th in 2010. A total of 200 questionnaires were distributed and 169 respondents were analysed finally to test hypotheses because 31 questionnaires had incorrect or missing responses. SPSS 12.0 and LISREL 7.0 program were used to test frequency, reliability, factor, and structural equation modeling analysis. III. Result and Conclusion According to results from factor analysis, eigen value was over 1.0 and items which were below 0.6 were deleted. Consequently, 9 factors(% of total variance is 72.011%) were searched. All Cronbach's ${\alpha}$ values are over the recommended level(${\alpha}$ > 0.7). The overall fit indices are acceptable such as ${\chi}^2$=2028.36(p=0.00), GFI=0.87, AGFI=0.82, CFI=0.81, IFI=0.92, RMR=0.075. All factor loadings were over the recommended level. As the result of discriminant validity check with chi-square difference test between paired constructs, each construct has good discriminant validity. The overall fit indices of final model are acceptable such as ${\chi}^2$=340.73(df=36, p=0.00), GFI=0.92, AGFI=0.81, CFI=0.91, IFI=0.91, RMR=0.085. As test results, 5 out of 6 hypotheses are supported because there are statistically significant casual relationships in structural equation model, shown in . First of all, hypothesis 1 is partially supported because sub-hypothesis 1-1 and 1-2 are supported, whereas sub-hypothesis 1-3, 1-4, and 1-5 are rejected. Specifically, it reveals that warmth and sophistication dimensions in e-store personality have positive influence on e-store identification, however, activity, progressiveness, and strictness does not have any significant relationship on e-store identification. Secondly, hypothesis 2 was supported. Therefore, it can be said that e-store identification has a positive impact on e-store trust. Thirdly, hypothesis 3 is also supported. Hence, there is a positive relationship between e-store identification and e-store engagement. Fourthly, hypothesis 4 is supported too. e-store identification has a positive influence on e-store loyalty. Fifthly, hypothesis 5 is also accepted. This indicates that e-store trust is a precedent variable which positively affects e-store loyalty. Lastly, it reveals that e-store engagement has a positive impact on e-store loyalty. Therefore, hypothesis 6 is supported. The findings of the study imply that some dimensions of e-store personality have a positive influence on e-store identification, and that e-store identification has direct and indirect influence on e-store loyalty through e-store trust and e-store engagement positively. These results also suggest that the e-store identification in e-store personality is a precedent variable which positively affects e-store loyalty directly and indirectly through e-store trust and engagement as a mediating variable. Therefore, e-store marketers need to implement website strategy based on e-store personality, e-store identification, e-store trust, and e-store engagement to meet customers' psychological needs and enhance e-store loyalty. Finally, the limitations and future study directions based on this study are discussed.

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  • Late Rectal Complication in Patients treated with High Dose Rate Brachytherapy for Stage IIB Carcinoma of the Cervix (FIGO병기 IIB 자궁경부암에서 고선량 강내 방사선치료후의 후기 직장 합병증)

    • Chung, Eun-Ji;Kim, Gwi-Eon;Suh, Chang-Ok;Keum, Ki-Chang;Kim, Woo-Cheol
      • Radiation Oncology Journal
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      • v.14 no.1
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      • pp.41-52
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      • 1996
    • Purpose : This paper reports a dosimetric study of 88 patients treated with a combination of external radiotherapy and high dose rate ICR for FIGO stage IIB carcinoma of the cervix. The purpose is to investigate the correlation between the radiation doses to the rectum, external radiation dose to the whole pelvis, ICR reference volume, TDF BED and the incidence of late rectal complications, retrospectively. Materials and Methods : From November 1989 through December 1992, 88 patients with stage IIB cervical carcinoma received radical radiotherapy at Department of Radiation Oncology in Yonsei University Hospital. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam irradiation plus high dose rate intracavitary brachytherapy with 5 Gy per fraction twice a week to a total dose of 30 Gy on point A. The maximum dose to the rectum by contrast(r, R) and reference rectal dose by ICRU 38(dr, DR) were calculated. The ICR reference volume was calculated by Gamma Dot 3.11 HDR planning system, retrospectively The time-dose factor(TDF) and the biologically effective dose (BED) were calculated. Results : Twenty seven($30.7\%$) of the 88 patients developed late rectal complications:12 patients($13.6\%$) for grade 1, 12 patients($13.6\%$) for grade 2 and 3 patients($3.4\%$) for grade 3. We found a significant correlation between the external whole pelvis irradiation dose and grade 2, 3 rectal complication. The mean dose to the whole pelvis for the group of patients with grade 2, 3 complication was Higher, $4093.3\pm453.1$ cGy, than that for the patients without complication, $3873.8\pm415.6$ (0.05$7163.0\pm838.5$ cGy, than that for the Patients without rectal complication, $0772.7\pm884.0$ (p<0.05). There was no correlation of the rate of grade 2, 3 rectal complication with the iCR rectal doses(r, dr), ICR reference volume, TDF and BED. Conclusion : This investigation has revealed a significant correlation between the dose calculated at the rectal dose by ICRU 38(DR) or the most anterior rectal dose by contrast(R) dose to the whole pelvis and the incidence of grade 2, 3 late rectal complications in patients with stage IIB cervical cancer undergoing external beam radiotherapy and HOR ICR. Thus these rectal reference points doses and whole pelvis dose appear to be useful Prognostic indicators of late rectal complication in high dose rate ICR treatment in cervical carcinoma.

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    Parotid Gland Sparing Radiotherapy Technique Using 3-D Conformal Radiotherapy for Nasopharyngeal CarcinomB (비인강암에서 방사선 구강 건조증 발생 감소를 위한 3차원 입체조형치료)

    • Lim Jihoon;Kim Gwi Eon;Keum Ki Chang;Suh Chang Ok;Lee Sang-wook;Park Hee Chul;Cho Jae Ho;Lee Sang Hoon;Chang Sei Kyung;Loh Juhn Kyu
      • Radiation Oncology Journal
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      • v.18 no.1
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      • pp.1-10
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      • 2000
    • Purpose : Although using the high energy Photon beam with conventional Parallel-opposed beams radiotherapy for nasopharyngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-D CRT) in an effort to prevent the radiation-induced xerostomia. Materials and Methods : We peformed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54 Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator; shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was peformed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, DO5, V95, VOS, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. Results : For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69$\%$ for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96$\~$100$\%$, 79$\~$99$\%$, 51$\~$72$\%$ for each plan-A, B and C). Conclusion : We conclude that the new technique employing 3-D conformal radiotherapy at the beginning of radiotherapy and cone down using non-coplanar beams with early spinal cord block is highly recommended to spare parotid glands for node-negative nasopharygeal cancer patients.

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    Genetic Environments of the High-purity Limestone in the Upper Zone of the Daegi Formation at the Jeongseon-Samcheok Area (정선-삼척 일대 대기층 상부 고품위 석회석의 생성환경)

    • Kim, Chang Seong;Choi, Seon-Gyu;Kim, Gyu-Bo;Kang, Jeonggeuk;Kim, Kyeong Bae;Kim, Hagsoo;Lee, Jeongsang;Ryu, In-Chang
      • Economic and Environmental Geology
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      • v.50 no.4
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      • pp.287-302
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      • 2017
    • The carbonate rocks of the Daegi Formation are composed of the limestone at the upper and lower zones, and the dolomite at the middle zone, in which the upper zone has higher CaO content than others. The colors of carbonate rock in the Daegi Formation can be divided into five types; white, light brown, light gray, gray, and dark gray. The white to light gray colored rocks correspond to the high purity limestone with 53.15 ~ 55.64 wt. % CaO, and the light brown colored rocks contain 20.71 ~ 21.67 wt. % MgO. The bleaching of carbonate rocks are not related to CaO composition of the rocks, as light gray rocks tend to be higher in CaO content than those of the white rocks at the lower zone. The pelitic components are also occasionally increased in white limestone than light grey one. $Al_2O_3$ is one of the most difficult content to remove during hydrothermal processes, so the interpretation that the limestone is purified together with hydrothemral bleaching, has little merit. The wide range (over 16 ‰) of ${\delta}^{18}O_{SMOW}$, smaller variation (within 2 ‰) of ${\delta}^{13}C_{PDB}$ are apparent in both the upper and lower zones, which indicate the Daegi Formation had been affected overall by hydrothermal fluids. The K-Ar isotopic age of hydrothermal alteration in the GMI limestone mine is $85.1{\pm}1.7Ma$. Gradual change from grey through light grey to white limestone is accompaned by lower oxygen stable isotope values, which is major evidence that the hydrothermal effect is the main process of the bleaching. Although the Daegi Formation has suffered from hydrothermal activity and increase in whiteness, there is no clear evidence demonstrating the relationship between bleaching and high purity of limestone. The purification of limestone has nothing to do with the hydrothermal activity in this area. Instead, it should be considered that the change of sedimentary environment related to see-level fluctuation which can prevent deposition of pelitic components especially $Al_2O_3$ contrbuted to the formation of the high purity limestone in the upper zone of the Daegi Formation. Considering the evidences such as increase in CaO content of limestone by depth, gradual change from calcite to dolomite at the lower zones, and occurring the high purity limestone at the upper zone, the interpretation of sequence stratigraphic aspect to the formation of the high purity Daegi limestone appears to be more suitable than that of hydrothermal alteration origin.

    Relationship between Vaginal Cytology and Reproductive Hormone during the Estrous Cycle and Optimal Mating Time in Beagle Dogs (비글개에서 발정 주기 및 교배 적기 동안 질세포상과 번식 호르몬의 관계)

    • Lee K.C.;Kang H.G.;Cheun H.M.;Kim I.H.
      • Journal of Embryo Transfer
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      • v.21 no.2
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      • pp.109-119
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      • 2006
    • This study was conducted to examine relationship between vaginal cytology and reproductive hormones during the estrous cycle and to provide basic data to estimate for ovulation time and optimal mating time in 6 beagle dogs The duration of proestrus, estrus and diestrus were $8.5{\pm}1.4,\;10.0{\pm}1.4\;and\;54.0{\pm}2.8$ days at pregnant respectively, and $7.9{\pm}2.1,\;9.5{\pm}0.7\;and\;62.0{\pm}11.3$ days at non-pregnant respectively. The duration of interestrous intervals were $246.2{\pm}24.5$ days at pregnancy, and $175.3{\pm}34.5$ days at non-pregnancy. The duration of interestrous intervals at pregnancy was longer than that of non-pregnancy. A characteristic features of vaginal cytology during the estrous cycle were the high proportion of superficial cell, anuclear cell and erythrocyte in proestrus and estrus, parabasal cell, small intermediate cell and leukocyte in diestrus, and parabasal cell and small intermediate cell in anestrus, respectively. Cornification index (CI) in proestrus and estrus were significantly higher than that of CI in diestrus and anestrus. Plasma progesterone concentration was below 1.0 ng/ml at the first day of vulval bleeding at pregnancy and non-pregnancy, and then it was above 2.0 ng/ml at Day -2 in all bitches. When plasma progesterone concentration was first increased above 4.0 ng/ml, it was the second day after the first day of male acceptance. Plasma progesterone concentration showed above 40 ng/ml on Day $20{\sim}22$ in all bitches, and then it was gradually decreased until Day 35. Plasma progesterone concentration at pregnancy was higher than that of non-pregnancy from Day 35 to Day 63. Plasma estradiol-$17\;{\beta}$ concentration was above 9.0 pg/ml at the first day of vulval bleeding, and it showed 26.4 pg/ml on Day -2. When it was timed from the first day of male acceptance (Day 0), plasma estradiol-$17{\beta}$ concentration showed a peak on Day 0 and plasma progesterone concentration was first increased above 4.0 ng/ml on Day 2 which was the third day after plasma estradiol-$17{\beta}$ peak. CI was first increased above 80 and 90% on Day -1 and Day 1, respectively. CI was maintained above 80% from Day -1 to Day 8 (10 days) and above 90% from Day 1 to Day 6 (6 days), respectively. CI was maintained above 80% from Day 0 to Day 8 (9 days) and above 90% from Day 1 to Day 6 (6 days), respectively. Plasma progesterone concentration was first increased above 4.0 ng/ml on the second day after the day which CI was first increased above 90%. In conclusion, beagle bitches ovulated on the second day after the day which CI was first increased above 90% and on the day which plasma progesterone concentration was first increased 4.0 ng/ml, and it was estimated that the optimal mating time was the day which the second day after CI was first increased above 90% and plasma concentration was between $2{\sim}25ng/ml$. The measurement of plasma progesterone was used to determine of and accurate ovulation time and the optimal mating time, but vaginal cytology is low-priced and simple method to estimate estrous cycle, optimal mating time and ovulation time.

    Studies on the Cropping system of the Field Crop in Chungnam Area (충남지방(忠南地方)의 전작물(田作物) 작부체계확립(作付體系確立)에 관(關)한 연구(硏究))

    • Choi, Chang Yeol;Kim, Dal Ung;Lee, Jae Chang;Kim, Young Rae
      • Korean Journal of Agricultural Science
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      • v.3 no.1
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      • pp.39-51
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      • 1976
    • As an accempt to increase thc efficiency of land use and the food production to achieve the national goal in the food self-sufficiency, nine cropping systems on the upper-land were examined in pure-stand and in mixtures of soybean, corn, potato and radish. The important conclusions of this study were summarized as follows; 1. The flowering date of soybean was two or three days earlier in pure-stand than in the mixture with corn. The maturing date two days earlier in the pure-stand than in the mixture with corn. The flowering and maturing dates were not different among various cropping systems in corn. 2. The stem length of soybean was significantly different among various cropping systems. Soybean in pure-stand was shorter in stem length than with corn. 3. The number of pods per soybean plant did not give any significant differences among various cultivation methods. 4. The length of internode and the number of nodes per soybean plant in the mixture with corn were greater than in the pure-stand. In the number of branches per plant this was reversed. 5. The average stem dry weight of soybean per 10a was not significantly different among various cultivation methods. 6. The soybean yield per 10a in the pure-stand was obviously greater than the mixture and there were significant differences among cultivation method within the mixture with corn in soybean yield. 7. The 1,000-grain weight of soybean was significantly different and those in the pure-stand was heavier than those in the mixture with corn. 8. Grain weight per soybean plant and the stem diameter in the pure-stand were significantly lesser than those in the mixture with corn. 9. In the comparisons of corn in the pure-stand and in the mixture with soybean, plant height, number of ear per 10a, mean ear weight and remember of grain per plant, 100-grain weight, ear length, ear girth and number of ear pel plant were not significantly different among various cultivation methods except for the grain yield per 10a. 10. In the economic analysis, the mixture with soybean and corn gave the greatest gross income. The combination 7 was the best which was 47.6% increase income comparing with the soybean pure-stand. 11. As it can be assumed, soybean plant was influenced greatly than corn by various cropping system. It is necessary to study more complex cropping system finding and giving more desirable multiple cropping system for the farmer.

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    The Efficacy of the Change in Belly Board Aperture Location by the Addition of Bladder Compression Device for Radiotherapy of Rectal Cancer (직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향)

    • Yoon, Hong-In;Chung, Yoon-Sun;Kim, Joo-Ho;Park, Hyo-Kuk;Lee, Sang-Kyu;Kim, Young-Suk;Choi, Yun-Seon;Kim, Mi-Sun;Lee, Ha-Yoon;Chang, Jee-Suk;Cha, Hye-Jung;Seong, Jin-Sil;Keum, Ki-Chang;Koom, Woong-Sub
      • Radiation Oncology Journal
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      • v.28 no.4
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      • pp.231-237
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      • 2010
    • Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45~75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased ($174.3{\pm}89.5mL$ vs. $373.3{\pm}145.0mL$, p=0.001, $1282.6{\pm}218.7mL$ vs. $1,571.9{\pm}158mL$, p<0.001, respectively). Bladder volume within the treated volume increased with BCD ($222.9{\pm}117.9mL$ vs. $153.7{\pm}95.5mL$, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD ($33.5{\pm}14.7%$) increased considerably compared to patients without a BCD ($27.5{\pm}13.1%$) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD ($13.9{\pm}7.6%$ vs. $24.2{\pm}10.2%$, p<0.001). The ratios of the irradiated SB volume and irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.

    Treatment Results of Ovarian Dysgerminoma (난소 미분화세포종의 치료 결과)

    • Chung, Eun-Ji;Suh, Chang-Ok;Seong, Jin-Sil;Keum, Ki-Chang;Kim, Gwi-Eon
      • Radiation Oncology Journal
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      • v.14 no.3
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      • pp.221-228
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      • 1996
    • Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the Patterns of failure in ovarian dysgerminoma retrospectively According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Materials and Methods : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY) Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy (group 2). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass (20) pelvic discomfort or pain (5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy/l-2weeks 1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease ($100\%$). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four Patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one Patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 Patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were $96.6\%$ (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation. So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). Conclusion : The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.

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