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A Study on Traditional Ideology and the 'Tradition' of the Theatre company Minye in 1970s (1970년대 전통 이념과 극단 민예극장의 '전통')

  • Kim, Ki-Ran
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.45-86
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    • 2020
  • In this article, the "modernization of the tradition" constructed on the cultural politics and the way in which it appropriated in the korean theatre in the 1970s were analyzed. It is trying to reveal its implications. It is also a work to critically review the aspects of self-censorship in the korean theatre in the 70s. To that end, we looked at the theatre company Minye Theatre, which preoccupied the traditional discussions in the 1970s by creating national dramas. Until now, the evaluation of the theatre company Minye Theatre in the 1970s has focused on the achievement on the directing of Heo Gyu, who promoted the succession and transformation of tradition. However, the traditional ideology constructed in the state-led cultural politics in the 70s and the way in which it was operated cannot be evaluated only in terms of artistic achievement. The ideology of tradition is selected according to the selective criteria of the subject to appropriate tradition. What's important is that certain objects are excluded, discarded, re-elected, re-interpreted and re-recognized in the selection process of selected traditional ideology. This is the situation in the '70s, when tradition was constantly re-recognized amid differences between the decadent and the disorder that were then designated as non-cultural, and led to a new way of appropriate. The nation-led traditional discussion of the '70s legalized the tradition with stable values, one of the its way was the national literary and artistic support. Under the banner of modernization of tradition, theatre company Minye preoccupied the discussions on the tradition and presented folk drama as a new theatre. As an alternative to the crisis of korean theatre at the time, the Minye chose the method of inheriting and transforming tradition. It is noteworthy that Heo Gyu, the representative director of the theatre company Minye, recognized the succession and transformation of traditional performance as both a calling and an experiment. For Heo Gyu, tradition was accepted as an irresistible stable value and an unquestionable calling, and as a result, his performance, filled with excessive traditional practices, became overambitious, especially when it failed to reflect the present-here reality, the repeated use of traditional expression tools resulted in skilled craftsmanship, not artistic creation. The traditional ideology of the 70s unfolds in a new aspect of appropriation in the 80s. In 1986, Son Jin-Cheok, Kim Seong-nyeo, and Yoon Mun-sik, who were key members of the theatre company Minye Theatre, left the theatre to create the theatre company Michu, and secured popularity through Madangnori(popular folk yard theatre). Son Jin-Cheok's Madangnori is overbearing through satire and humor. It gained popularity by criticizing and mocking state power. On the other hand, not only the form of traditional performance, but also the university-centered Madanggeuk movement, which appropriated on the spirit of resistance from the people to its traditional values, has rapidly grown. In the field of traditional discussions of the 70s, Madanggeuk was self-born through appropriation in which the spirit of resistance of the people is used as a traditional value. Madanggeuk as well as Michu that achieved the popularization of Madangnori cannot be discussed solely by the artistic achievement of the modernization of tradition. Critics of korean theatre in response to state-led traditional discussions in the 70s was focused only on the qualitative achievement of performing arts based on artistry. I am very sorry for that. As a result, the popular resistance of the Madanggeuk and the Madangnori were established in the 'difference' with the traditions of the theatre company Minye Theatre. Theatre company Minye Theatre was an opportunity for the modernization of tradition, but the fact that it did not continuously produce significant differences. This is the meaning and limitation of the "tradition" of the theatre company Minye Theatre in the history of korean theatre in the 1970s.

A study on Broad Quantification Calibration to various isotopes for Quantitative Analysis and its SUVs assessment in SPECT/CT (SPECT/CT 장비에서 정량분석을 위한 핵종 별 Broad Quantification Calibration 시행 및 SUV 평가를 위한 팬텀 실험에 관한 연구)

  • Hyun Soo, Ko;Jae Min, Choi;Soon Ki, Park
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.2
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    • pp.20-31
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    • 2022
  • Purpose Broad Quantification Calibration(B.Q.C) is the procedure for Quantitative Analysis to measure Standard Uptake Value(SUV) in SPECT/CT scanner. B.Q.C was performed with Tc-99m, I-123, I-131, Lu-177 respectively and then we acquired the phantom images whether the SUVs were measured accurately. Because there is no standard for SUV test in SPECT, we used ACR Esser PET phantom alternatively. The purpose of this study was to lay the groundwork for Quantitative Analysis with various isotopes in SPECT/CT scanner. Materials and Methods Siemens SPECT/CT Symbia Intevo 16 and Intevo Bold were used for this study. The procedure of B.Q.C has two steps; first is point source Sensitivity Cal. and second is Volume Sensitivity Cal. to calculate Volume Sensitivity Factor(VSF) using cylinder phantom. To verify SUV, we acquired the images with ACR Esser PET phantom and then we measured SUVmean on background and SUVmax on hot vials(25, 16, 12, 8 mm). SPSS was used to analyze the difference in the SUV between Intevo 16 and Intevo Bold by Mann-Whitney test. Results The results of Sensitivity(CPS/MBq) and VSF were in Detector 1, 2 of four isotopes (Intevo 16 D1 sensitivity/D2 sensitivity/VSF and Intevo Bold) 87.7/88.6/1.08, 91.9/91.2/1.07 on Tc-99m, 79.9/81.9/0.98, 89.4/89.4/0.98 on I-123, 124.8/128.9/0.69, 130.9, 126.8/0.71, on I-131, 8.7/8.9/1.02, 9.1/8.9/1.00 on Lu-177 respectively. The results of SUV test with ACR Esser PET phantom were (Intevo 16 BKG SUVmean/25mm SUVmax/16mm/12mm/8mm and Intevo Bold) 1.03/2.95/2.41/1.96/1.84, 1.03/2.91/2.38/1.87/1.82 on Tc-99m, 0.97/2.91/2.33/1.68/1.45, 1.00/2.80/2.23/1.57/1.32 on I-123, 0.96/1.61/1.13/1.02/0.69, 0.94/1.54/1.08/0.98/ 0.66 on I-131, 1.00/6.34/4.67/2.96/2.28, 1.01/6.21/4.49/2.86/2.21 on Lu-177. And there was no statistically significant difference of SUV between Intevo 16 and Intevo Bold(p>0.05). Conclusion Only Qualitative Analysis was possible with gamma camera in the past. On the other hand, it's possible to acquire not only anatomic localization, 3D tomography but also Quantitative Analysis with SUV measurements in SPECT/CT scanner. We could lay the groundwork for Quantitative Analysis with various isotopes; Tc-99m, I-123, I-131, Lu-177 by carrying out B.Q.C and could verify the SUV measurement with ACR phantom. It needs periodic calibration to maintain for precision of Quantitative evaluation. As a result, we can provide Quantitative Analysis on follow up scan with the SPECT/CT exams and evaluate the therapeutic response in theranosis.

Bacterial Blight Resistance Genes Pyramided in Mid-Late Maturing Rice Cultivar 'Sinjinbaek' with High Grain Quality (벼흰잎마름병 저항성 유전자 집적 고품질 중만생 벼 '신진백')

  • Park, Hyun-Su;Kim, Ki-Young;Baek, Man-Kee;Cho, Young-Chan;Kim, Bo-Kyeong;Nam, Jeong-Kwon;Shin, Woon-Chul;Kim, Woo-Jae;Ko, Jong-Cheol;Kim, Jeong-Ju;Jeong, Jong-Min;Jeung, Ji-Ung;Lee, Keon-Mi;Park, Seul-Gi;Lee, Chang-Min;Kim, Choon-Song;Suh, Jung-Pil;Lee, Jeom-Ho
    • Korean Journal of Breeding Science
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    • v.51 no.3
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    • pp.263-276
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    • 2019
  • 'Sinjinbaek' is a bacterial blight (BB)-resistant, mid-late maturing rice cultivar with high grain quality. To diversify the resistance genes and enhance the resistance of Korean rice cultivars against BB, 'Sinjinbaek' was developed from a cross between 'Iksan493' (cultivar name 'Jinbaek') and the F1 cross between 'Hopum' and 'HR24670-9-2-1' ('HR24670'). 'Jinbaek' is a BB-resistant cultivar with two BB resistance genes, Xa3 and xa5. 'Hopum' is a high grain quality cultivar with the Xa3 resistance gene. 'HR24670' is a near-isogenic line that carries the Xa21 gene, a resistance gene inherited from a wild rice species O. longistaminata, in the genetic background of japonica elite rice line 'Suweon345'. 'Sinjinbaek' was selected through the pedigree method, yield trials, and local adaptability tests. Using bioassay for BB races and DNA markers for resistance genes, three resistance genes, Xa3, xa5, and Xa21, were pyramided in the 'Sinjinbaek' cultivar. 'Sinjinbaek' exhibited high-level and broad-spectrum resistance against BB, including the K3a race, the most virulent race in Korea. 'Sinjinbaek' is a mid-late maturing rice cultivar tolerant to lodging. It has multiple disease resistance against BB, rice blast, and stripe virus. The yield of 'Sinjinbaek' was similar to that of 'Nampyeong'. 'Sinjinbaek' showed excellent grain appearance, good taste of cooked rice, and enhanced milling performance, and we concluded that it could contribute to improving the quality of BB-resistant cultivars. 'Sinjinbaek' was successfully introgressed with the Xa21 gene without the linkage drag negatively affecting its agronomic characteristics. 'Sinjinbaek' improved the resistance of Korean rice cultivars against BB by introgression of a new resistance gene, Xa21, as well as by pyramiding three resistance genes, Xa3, xa5, and Xa21. 'Sinjinbaek' would be suitable for the cultivation in BB-prone areas since it has been used in breeding programs for enhancing plants' resistance to BB (Registration No. 7273).

The Effects of Entrepreneurship Mentoring on Entrepreneurial Will and Mentoring Satisfaction: Focusing on Opus Entrepreneurship Education (창업 멘토링 기능이 창업의지와 멘토링 만족도에 미치는 영향: 오퍼스 창업교육을 중심으로)

  • Kim, Ki-Hong;Lee, Chang-Young;Joe, Jee-Hyung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.3
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    • pp.211-226
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    • 2023
  • As we transition into the post-COVID era, economic activities that were stagnant are regaining momentum. In particular, there is a growing trend of technology entrepreneurship driven by the opportunities of digital transformation in the Fourth Industrial Revolution. However, entrepreneurship education content is struggling to keep up with the rapid pace of technological change. This study aims to emphasize the importance of entrepreneurship mentoring as a crucial component of entrepreneurship education content that requires adaptation and advancement due to the increasing demand for technology entrepreneurship. This study redefines startup mentoring, which is differentiated from general mentoring, at the present time when the demand for startups, which increases with the declining employment rate, increases, and the development of quality startup education contents and securing professional startup mentors are required. According to the start-up stage, it is divided into preliminary entrepreneurs and early entrepreneurs, and the effect of entrepreneurship knowledge and self-efficacy among start-up mentoring functions on entrepreneurial will and mentoring satisfaction is improved by empirically researching the effects of start-up mentoring functions in the case of initial entrepreneurs as a moderating effect. To confirm the importance of entrepreneurship mentoring effect for. To this end, among the mentoring functions, entrepreneurship knowledge and self-efficacy were set as independent variables, and entrepreneurial will and mentoring satisfaction were set as dependent variables. The research model was designed and hypotheses were established. In addition, empirical analysis was conducted by conducting a questionnaire survey on trainees who received entrepreneurship mentoring education at ICCE Startup School and Opus Startup School. To summarize the results of the empirical analysis, first, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on entrepreneurial will. Second, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on mentoring satisfaction. Third, it was analyzed that entrepreneurship had no significant moderating effect on entrepreneurial knowledge and entrepreneurial will. Fourth, it was analyzed that entrepreneurship had no significant moderating effect on mentoring satisfaction. Fifth, it was found that entrepreneurship had a significant moderating effect between self-efficacy and will to start a business. As a result of the research analysis, the first implication is that the mentoring function in start-up education is analyzed to produce meaningful results for both the initial entrepreneurs and the prospective entrepreneurs in the will to start a business and satisfaction. . Second, it was analyzed that there was no significant relationship between whether a business was started and the mentoring function and effect. However, it was analyzed that the will to start a business through improvement of self-efficacy through mentoring was significantly related to whether or not to start a business. turned out to be helpful. Many start-up education programs currently conducted in Korea educate both early-stage entrepreneurs and prospective entrepreneurs at the same time for reasons such as convenience. However, through the results of this study, even in small-scale entrepreneurship mentoring, it is suggested that customized mentoring through detailed classification such as whether the mentee has started a business can be a method for successful entrepreneurship and high satisfaction of the mentee.

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Regulation of ER Stress Response on 1,2,3-Trichloropropane-Induced Hepatotoxicity of Sprague Dawley Rats (1,2,3-Trichloropropane으로 유도된 SD랫드의 간독성에서 ER 스트레스 반응의 조절)

  • Tae Ryeol Kim;You Jeong Jin;Ji Eun Kim;Hee Jin Song;Yu Jeong Roh;Ayun Seol;Eun Seo Park;Ki Ho Park;Su Jeong Lim;Su Ha Wang;Yong Lim;Dae Youn Hwang
    • Journal of Life Science
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    • v.34 no.2
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    • pp.113-121
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    • 2024
  • Endoplasmic reticulum (ER) stress responses are markedly induced during toxic responses caused by various chemical substances, including difenoconazole, but no research has been conducted on 1,2,3-trichloropropane (TCP), a chemical that is generally used in agriculture and industry, which induces hepatotoxicity. Therefore, in this study, the changes in indicators for hepatotoxicity, apoptosis, and ER stress were analyzed in TCP-treated Sprague Dawley (SD) rats to study the regulatory mechanism of ER stress during the hepatotoxicity. The TCP-treated group decreased in body weight and dietary intake compared to the vehicle-treated group, and necrosis and vacuolation increased significantly in liver histology. In addition, the expression of apoptosis-related factors, including Bax/Bcl-2 and cleaved caspase (Cas)-3/Cas-3 increased significantly in the TCP-treated group compared to the vehicle-treated group. In the analysis of ER stress response indicators, the expression of C/EBP homologous protein (CHOP), phospho-eukaryotic translation initiation factor 2 alpha subunit (eIF2α), and phospho-inositol-requiring enzyme 1α (IRE1α) increased only in the TCP100-treated group and decreased in the TCP200-treated group. However, the transcriptions of growth arrest and DNA damage-34 (GADD34) increased in the TCP200-treated group, while Spliced X-box binding protein-1 (XBP1s) and unspliced XBP1(XBP1u) decreased in the same group. These results suggest that the ER stress response is successfully triggered during the hepatotoxicity induced by TCP treatment through the alternative regulation of the unfolded-protein response (UPR) pathway.

Healing Effect of 'Creative Writing' on Individual and on Our Age - Focused on the 'Man of Darkness (Vampire)' Symbol - ('창조적 글쓰기'가 개인 및 시대에 미치는 치유적 작용 - '어둠의 남자(Vampire)' 상징을 중심으로 - )

  • Kye-Hee Kim;Ki-Won Kim;Eun-Seun Han
    • Sim-seong Yeon-gu
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    • v.28 no.1
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    • pp.1-49
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    • 2013
  • This article started with 'encounter'. Both authors met around the middle of February and discussed the subject for the inhospital conference presentation scheduled at the break of June. Having conversation like "Movies similar to fairytales heard from childhood are standing out conspicuously among commercial films which are attracting audiences and receiving fervent response these days. This phenomenon is marvelous and mysterious." together, and sharing this and that, the conversation turned naturally to 'Bram Stoker's Dracula', 'Series of Twilight', and 'Warm Bodies', both authors found out the fact that we saw these movies in common with propound impression. Feeling our hearts beating high, bit of fear and hesitation followed simultaneously at the moment when both of us encountered the idea to choose subject of conference presentation related to this and expressed one in words. While preparing for the conference, presenting to others, and having discussion with the audience, our hearts have been filled with Presentation was finished after active discussion beyond fixed hour and it also brought audience (among those present) to show strong emotional response both positively and negatively. At first, we just had a thought to put aside the content of presentation, but we felt lack of something else, lingering in our minds. We finally decided to accomplish our work into an article leading to submission, based on the advice and recommendation from one of the audience. This article is a small 'creative writing' born by sharing both authors' passion and enthusiasm. In the first part of this article, we have introduced the dream of 31-year-old woman's which led to the 'creative writing' and spotlighted her personal life, before and after the dream. In the second part, we have examined the consequence (way of realization) and meaning of creative impulse shown from or experienced from personal unconsciousness (dream, fantasy) together. Creative impulse shown from the individual appeared to bring creative transformation of individual personality through the process of 'introversion'. Otherwise it also appeared to be delivered as a masterpiece through 'creative writing' or from the process of 'extroversion'. Sometimes both consequences happened at once. We tried to examine and interpret the dream of 31-year-old woman's, which was introduced in the first part of this article, that is to say, the dream of 'Stephenie Meyer's, the author of the 'love between vampire boy and ordinary human girl' themed novel 'Twilight Series', in a psychoanalytic perspective. In the third part, highlighting individual dreams and three different movies 'Bram Stoker's Dracula', 'Twilight Series', and 'Warm Bodies', we found the transformation of symbol 'Man of Darkness, vampire' seen in each individual dreams and in some specific popular arts, such as novels and movies, receiving fervent response from people. We also found love between this symbol and humane woman, bearing fruit together with very impressive change shown in the attitude of 'Man of Darkness' (vampire)'s conscious ego and mutual relationship pattern. We contemplated this phenomenon, the reason why these events happen, and what kind of association presents among these events, individual, and this era and discussed the effects on individuals and this era, at present. 'Creative impulse', originated in the deep structure of human mind is realized as a 'transformation of individual personality' or masterpiece through artistic creation. If it has a chance to make a match with this era, shared by a lot of contemporary people, it also appears to bring positive effect as healing and salvation to each individual or to each era. From this article, we mainly highlighted positive and healing aspects of individual 'creative impulse'. We hope to deal with the negative consequences and their reason coming from 'creative impulse', if the occasion arises, in the future with a new article.

Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type (성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가)

  • Kim, Jung-In;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.54-61
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    • 2016
  • Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

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Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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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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    • v.23 no.3
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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.

Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion (농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성)

  • Park, Jeong Woo;You, Seung Min;Seol, Won Jong;Paik, Eun Ki;Lee, Kyu Hoon;Seo, Joon Beom;Jeong, Seong Hwan;An, Chang Hyeok;Lim, Youg Hee;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.219-229
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    • 2003
  • Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.