• Title/Summary/Keyword: IT기반

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Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • 제23권3호
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

Characteristic on the Layout and Semantic Interpretation of Chungryu-Gugok, Dongaksan Mountain, Gokseong (곡성 동악산 청류구곡(淸流九曲)의 형태 및 의미론적 특성)

  • Rho, Jae-Hyun;Shin, Sang-Sup;Huh, Joon;Lee, Jung-Han;Han, Sang-Yub
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • 제32권4호
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    • pp.24-36
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    • 2014
  • The result of the research conducted for the purpose of investigating the semantic value and the layout of the Cheongryu Gugok of Dorimsa Valley, which exhibits a high level of completeness and scenic preservation value among the three gugoks distributed in the area around Mt. Dongak of Gogseong is as follows.4) The area around Cheongryu Gugok shows a case where the gugok culture, which has been enjoyed as a model of the Neo-Confucianism culture and bedrock scenery, such as waterfall, riverside, pond, and flatland, following the beautiful valley, has been actually substituted, and is an outstanding scenery site as stated in a local map of Gokseong-hyeon in 1872 as "Samnam Jeil Amban Gyeryu Cheongryu-dong(三南第一巖盤溪流 淸流洞: Cheongryu-dong, the best rock mooring in the Samnam area)." Cheongryu Gugok, which is differentiated through the seasonal scenery and epigrams established on both land route and waterway, was probably established by the lead of Sun-tae Jeong(丁舜泰, ?~1916) and Byeong-sun Cho(曺秉順, 1876~1921) before 1916 during the Japanese colonization period. However, based on the fact that a number of Janggugiso of ancient sages, such as political activists, Buddhist leaders, and Neo-Confucian scholars, have been established, it is presumed to have been utilized as a hermit site and scenery site visited by masters from long ago. Cheongryu Gugok, which is formed on the rock floor of the bed rock of Dorimsa Valley, is formed in a total length of 1.2km and average gok(曲) length of 149m on a mountain type stream, which appears to be shorter compared to other gugoks in Korea. The rock writings of the three gugoks in Mt. Dongak, such as Cheongryu Gugok, which was the only one verified in the Jeonnam area, total 165 in number, which is determined to be the assembly place for the highest number of rock writings in the nation. In particular, a result of analyzing the rock writings in Cheongryu Gugok totaling 112 places showed 49pieces(43.8%) with the meaning of 'moral training' in epigram, 21pieces (18.8%) of human life, 16pieces(14.2%) of seasonal scenery, and 12pieces(10.6%) of Janggugiso such as Jangguchur, and the ratio occupied by poem verses appeared to be six cases(3.6%). Sweyeonmun(鎖烟門), which was the first gok of land route, and Jesiinganbyeolyucheon(除是人間別有天) which was the ninth gok of the waterway, corresponds to the Hongdanyeonse(虹斷烟鎖) of the first gok and Jesiinganbyeolyucheon of the ninth gok established in Jaecheon, Chungbuk by Se-hwa Park(朴世和, 1834~1910), which is inferred to be the name of Gugok having the same origin. In addition, the Daeeunbyeong(大隱屛) of the sixth gok. of land route corresponds to the Chu Hsi's Wuyi-Gugok of the seventh gok, which is acknowledged as the basis for Gugok Wollim, and the rock writings and stonework of 'Amseojae(巖棲齋)' and 'Pogyeongjae(抱經齋)' between the seventh gok and eighth gok is a trace comparable with Wuyi Jeongsa(武夷精舍) placed below Wuyi Gugok Eunbyeon-bong, which is understood to be the activity base of Cheongryu-dong of the Giho Sarim(畿湖士林). The rock writings in the Mt. Dongak area, including famous sayings by masters such as Sunsaeuhje(鮮史御帝, Emperor Gojong), Bogahyowoo(保家孝友, Emperor Gojong), Manchunmungywol(萬川明月, King Joengjo), Biryeobudong(非禮不動, Chongzhen Emperor of the Ming Dynasty)', Samusa(思無邪, Euijong of the Ming Dynasty), Baksechungpwoong(百世淸風, Chu Hsi), and Chungryususuk-Dongakpungkyung(淸流水石 動樂風景, Heungseon Daewongun) can be said to be a repository of semantic symbolic cultural scenery, instead of only expressing Confucian aesthetics. In addition, Cheongryu Gugok is noticeable with its feature as a cluster of cultural scenery of the three religions of Confucian-Buddhism-Taoism, where the Confucianism value system, Buddhist concept, and Taoist concept co-exists for mind training and cultivation. Cheongryu Gugok has a semantic feature and spatial character as a basis for history and cultural struggle for the Anti-Japan spirit that has been conceived during the process of establishing and utilizing the spirit of the learning, loyalty for the Emperor and expulsion of barbarians, and inspiration of Anti-Japan force, by inheriting the sense of Dotong(道統) of Neo-Confucianism by the Confucian scholar class at the end of the Joseon era that is represented by Ik-hyun Choi(崔益鉉, 1833~1906), Woo Jeon(田愚, 1841~1922), Woo-man Gi(奇宇萬, 1846~1916), Byung-sun Song(宋秉璿, 1836~1905), and Hyeon Hwang(黃玹, 1855~1910).

Characteristics and classification of paddy soils on the Gimje-Mangyeong plains (김제만경평야(金堤萬頃平野)의 답토양특성(沓土壤特性)과 그 분류(分類)에 관(關)한 연구(硏究))

  • Shin, Yong Hwa
    • Korean Journal of Soil Science and Fertilizer
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    • 제5권2호
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    • pp.1-38
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    • 1972
  • This study, designed to establish a classification system of paddy soils and suitability groups on productivity and management of paddy land based on soil characteristics, has been made for the paddy soils on the Gimje-Mangyeong plains. The morphological, physical and chemical properties of the 15 paddy soil series found on these plains are briefly as follows: Ten soil series (Baeggu, Bongnam, Buyong, Gimje, Gongdeog, Honam, Jeonbug, Jisan, Mangyeong and Suam) have a B horizon (cambic B), two soil series (Geugrag and Hwadong) have a Bt horizon (argillic B), and three soil series (Gwanghwal, Hwagye and Sindab) have no B or Bt horizons. Uniquely, both the Bongnam and Gongdeog series contain a muck layer in the lower part of subsoil. Four soil series (Baeggu, Gongdeog, Gwanghwal and Sindab) generally are bluish gray and dark gray, and eight soil series (Bongnam, Buyong, Gimje, Honam, Jeonbug, Jisan, Mangyeong and Suam) are either gray or grayish brown. Three soil series (Geugrag, Hwadong and Hwagye), however, are partially gleyed in the surface and subsurface, but have a yellowish brown to brown subsoil or substrata. Seven soil series (Bongnam, Buyong, Geugrag, Gimje, Gongdeog, Honam and Hwadong) are of fine clayey texture, three soil series (Baeggu, Jeonbug and Jisan) belong to fine loamy and fine silty, three soil series (Gwanghwal, Mangyeong and Suam) to coarse loamy and coarse silty, and two soil series (Hwagye and Sindab) to sandy and sandy skeletal texture classes. The carbon content of the surface soil ranges from 0.29 to 2.18 percent, mostly 1.0 to 2.0 percent. The total nitrogen content of the surface soil ranges from 0.03 to 0.25 percent, showing a tendency to decrease irregularly with depth. The C/N ratio in the surface soil ranges from 4.6 to 15.5, dominantly from 8 to 10. The C/N ratio in the subsoil and substrata, however, has a wide range from 3.0 to 20.25. The soil reaction ranges from 4.5 to 8.0. All soil series except the Gwanghwal and Mangyeong series belong to the acid reaction class. The cation exchange cpacity in the surface soil ranges from 5 to 13 milliequivalents per 100 grams of soil, and in all the subsoil and substrata except those of a sandy texture, from 10 to 20 milliequivalents per 100 grams of soil. The base saturation of the soil series except Baeggu and Gongdeog is more than 60 percent. The active iron content of the surface soil ranges from 0.45 to 1.81 ppm, easily-reduceable manganese from 15 to 148 ppm, and available silica from 36 to 366 ppm. The iron and manganese are generally accumulated in a similar position (10 to 70cm. depth), and silica occurs in the same horizon with that of iron and manganese, or in the deeper horizons in the soil profile. The properties of each soil series extending from the sea shore towards the continental plains change with distance and they are related with distance (x) as follows: y(surface soil, clay content) = $$-0.2491x^2+6.0388x-1.1251$$ y(subsoil or subsurface soil, clay content) = $$-0.31646x^2+7.84818x-2.50008$$ y(surface soil, organic carbon content) = $$-0.0089x^2+0.2192x+0.1366$$ y(subsoil or subsurface soil, pH) = $$-0.0178x^2-0.04534x+8.3531$$ Soil profile development, soil color, depositional and organic layers, soil texture and soil reaction etc. are thought to be the major items that should be considered in a paddy soil classification. It was found that most of the soils belonging to the moderately well, somewhat poorly and poorly drained fine and medium textured soils and moderately deep fine textured soils over coarse materials, produce higher paddy yields in excess of 3,750 kg/ha. and most of the soils belonging to the coarse textured soils, well drained fine textured soils, moderately deep medium textured soils over coarse materials and saline soils, produce yields less than 3,750kg/ha. Soil texture of the profile, available soil depth, salinity and gleying of the surface and subsurface soils etc. seem to be the major factors determining rice yields, and these factors are considered when establishing suitability groups for paddy land. The great group, group, subgroup, family and series are proposed for the classification categories of paddy soils. The soil series is the basic category of the classification. The argillic horizon (Bt horizon) and cambic horizon (B horizon) are proposed as two diagnostic horizons of great group level for the determination of the morphological properties of soils in the classification. The specific soil characteristics considered in the group and subgroup levels are soil color of the profile (bluish gray, gray or yellowish brown), salinity (salic), depositonal (fluvic) and muck layers (mucky), and gleying of surface and subsurface soils (gleyic). The family levels are classified on the basis of soil reaction, soil texture and gravel content of the profile. The definitions are given on each classification category, diagnostic horizons and specific soil characteristics respectively. The soils on these plains are classified in eight subgroups and examined under the existing classification system. Further, the suitability group, can be divided into two major categories, suitability class and subclass. The soils within a suitability class are similar in potential productivity and limitation on use and management. Class 1 through 4 are distinguished from each other by combination of soil characteristics. Subclasses are divided from classes that have the same kind of dominant limitations such as slope(e), wettness(w), sandy(s), gravels(g), salinity(t) and non-gleying of the surface and subsurface soils(n). The above suitability classes and subclasses are examined, and the definitions are given. Seven subclasses are found on these plains for paddy soils. The classification and suitability group of 15 paddy soil series on the Gimje-Mangyeong plains may now be tabulated as follows.

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