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Case Study of Ancient City Wall Renewal in Gongju, a Historic Cultural City (역사문화도시 공주의 고도담장정비 사례 연구)

  • Ohn, Hyoungkeun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.254-269
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    • 2020
  • The purpose of this study is to propose guidance for wall renewal that is appropriate for an ancient city wall through application of advanced research and theories in wall design. It is a streetscape improvement project which forms part of the "Ancient City Image Finding Project". Study methods consist of advanced research classification, wall design theory contemplation, and analysis of the significance of designated ancient city areas and the "Ancient City Image Finding Project" status. Based on these methods, case study candidates were selected, case status and problems were identified, and improvement proposals were analyzed by comparing various features. Advanced wall research was classified into six categories including analysis of wall characteristics; wall design principle applications; wall structure, color, shape, and application; modern reinterpretation; palace walls; and house, temple, and village walls. The wall is an element of the streetscape improvement component of the "Ancient City Image Finding Project", with the characteristic of providing preceding experience in visual and cognitive awareness than interior structure. Case candidates for ancient city wall improvement are based on the composition distribution of the special conservation district in each ancient city as well as the conservation promotion district. Ultimately, the surrounding village of Gongju-si Geumseong-Dong Songsanri-gil, adjacent to the Royal Tomb of King Muryeong, was selected as the candidate. The "Ancient City Image Finding Project" of the surrounding village of Gongju-si Geumseong-Dong Songsanri-gil began with new Hanok construction. However, wall maintenance did not begin concurrently with that new Hanok construction. Support and maintenance took place afterwards as an exterior maintenance project for roadside structures. If the Hanok and wall were evaluated and constructed at the same time, the wall would have been built in unison with the size and design of the Hanok. The layout of the main building and wall of the Hanok is deemed to be a structure that is closed tightly because of its spatial proximity and tall height. Songsan-ri-gil's wall design should create a calm, subtle, and peaceful atmosphere with shapes, colors, and materials that express ancient city characteristics, but it is in an awkward position due to its sharpness and narrowness. The cause of the problem at Gongju-si Geumseong-dong Songsanri-gil, the case candidate, is that it is lacking significantly in terms of the aesthetic factors that traditional walls should possess. First, aesthetic consciousness seems to have disappeared during the selection and application process of the wall's natural materials. Second, the level of completion in design and harmony is absent. Maintenance guidance after analyzing the cause of problems in ancient city wall maintenance at Gongju-si Geumseong-dong Songsanri-gil, the subject area of research, is as follows: First, the Hanok design and layout of the wall and main gate should be reviewed simultaneously. Second, the one-sided use of natural stone wall in the Hanok wall design should be reexamined. Third, a permanent system to coordinate the opinions of citizens and experts during the planning and design phases should be employed. Fourth and finally, the Hanok's individuality shall be collectivized and its value as a cultural asset representing the identity of the community shall be increased.

A STUDY ON THE INFECTION LEVEL OF S. MUTANS AND LACTOBACILLUS AND ITS RELATIVITY WITH CARIES RISK FACTORS IN 18 MONTH-OLD INFANTS (18개월 유아의 S. mutans와 Lactobacillus감염수준과 우식위험요인의 상관성에 관한 연구)

  • Ahn, Jin-Gong;Chung, Jin;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.3
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    • pp.388-400
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    • 2006
  • The time 18 months after birth is very important for the prevention of early childhood caries because this time is proper to assure the completion of weaning and to perform the diet counseling, and caries process is initiated or actively aggravated under the total influence of feeding pattern from this period. For the purpose of examining the infection status of Streptococcus mutans and Lactobacillus of 18 month old infants and their mothers, and analyzing the correlation between infection status versus various caries-risk factors, this study was performed on the 60 infants of 18 months old and their mothers through the microbiological screening of saliva samples and direct questionnaire to mothers about the caries risk factors. And the results were as follows, 1. The higher the mother's infection level of S. muntans, the higher the infant's infection level and transmission rate. 2. Compared with non-caries group, higher infection level of S. mutans in both infants and mothers and transmission rate were revealed in caries group. 3. The higher the infant's infection level of S. mutans, the higher the caries prevalence and deft values, the less the monthly income of the parents, the longer the period of breast feeding, and the higher the consumption rate of sugared snacks. 4. Most of Lactobacillus infected infants were revealed to be infected also with S. mutans and to have caries. 5. The higher deft value, less parents' monthly income, more frequent daily nursing and more irregular snacking patterns were found among Lactobacillus infected group compared with not-infected group.

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A Study on the Current Status of Ecological Restoration Plant Species Use - Focusing on the Ecosystem Conservation Cooperation Fund Return Projects - (생태복원 식물종 사용 실태에 관한 연구 - 생태계보전협력금 반환사업을 중심으로 -)

  • Cho, Dong-gil
    • Korean Journal of Environment and Ecology
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    • v.35 no.5
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    • pp.525-547
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    • 2021
  • The main purpose of this study is to examine the use of plant species in ecological restoration projects. To this end, planting drawings from 58 sites that had completed the return of the ecosystem conservation cooperation fund for the past six years were collected and analyzed. The analysis used the construction completion and design drawings to determine the overall selection status and analyze frequency by classifying planted plants into wild and cultivated plants by nature, size, vegetation climate, and upland and wetland habitat. The investigation and analysis process found many cases of wrong plant names, so an analysis was also performed on the matter. In the 58 investigation sites, 282 plants were used for planting: 91 tree species, 69 shrub species, 11 vine species, and 111 herbal species. The most commonly used plant species was Spiraea prunifolia f. simpliciflora, followed by Sorbus alnifolia, Quercus acutissima, Zoysia japonica, Callicarpa dichotoma, and Weigela subsessilisin that order. The most commonly used tree species was Sorbus alnifolia,followed by Quercus acutissima, Zelkova serrata, Chionanthus retusus, and Cornus officinalis, in that order. The most commonly used shrub species was Spiraea prunifolia f. simpliciflora, followed by Weigela subsessilis, Callicarpa dichotoma, Rhododendron yedoense f. poukhanense. and Euonymus alatusin that order. The most commonly used herbal plant species was Zoysia japonica, followed by Dendranthema zawadskii var. latilobum, Aster koraiensis, Miscanthus sacchariflorus, and Pennisetum alopecuroidesin that order. In the analysis by vegetation climate, Spiraea prunifolia f. simpliciflora, Callicarpa dichotoma, and Sorbus alnifoliawere most used in that order in both the temperate central and the warm temperate forest zones, but the pattern does not properly reflect the climate characteristics. In the analysis by habitat, Miscanthus sacchariflorus and Lythrum salicariawere most used in the wetland. In particular, the ratio of wild plants to cultivated plants was 76% to 24%, indicating the ratio of selecting cultivated plants was high. The names of plants on the drawings were mostly common names that did not appear in the Korea National Arboretum or the National Species List of Korea. It is necessary to use proper plant names in the future. Regarding the use of planting plants for ecological restoration, it is necessary to adopt the approach of diversifying selected plants, selecting plants according to characteristics of climate zones, and lowering the specifications of plants used for ecological restoration. Moreover, it is important to fully understand the ecological characteristics of wetland plants and minimize the ratio of using cultivated plants to ensure the plant selection centered on wild plants.

The cinematic interpretation of pansori and its transformation process (판소리의 영화적 해석과 변모의 과정)

  • Song, So-ra
    • (The) Research of the performance art and culture
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    • no.43
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    • pp.47-78
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    • 2021
  • This study was written to examine the acceptance of pansori in movies based on pansori, and to explore changes in modern society's perception and expectations of pansori. A pansori is getting the love of the upper and lower castes in the late Joseon period, but loses the status at the time of the Japanese colonial rule and Korean War. In response, the country designated pansori as an important intangible cultural asset in 1964 to protect the disappearance of pansori. Until the 1980s, however, pansori did not gain popularity by itself. After the 2000s, Pansori tried to breathe in with the contemporary public due to the socio-cultural demand to globalize our culture. And now Pansori is one of the most popular cultures in the world today, as the pop band Feel the Rhythm of KOREA shows. The changing public perception of pansori and its status in modern society can also be seen in the mass media called movies. This study explored the process of this change with six films based on pansori, from "Seopyeonje" directed by Lim Kwon-taek in 1993 to the film "The Singer" in 2020. First, the films "Seopyeonje" and "Hwimori" were produced in the 1990s. Both of these films show the reality of pansori, which has fallen out of public interest due to the crisis of transmission in the early and mid-20th century. And in the midst of that, he captured the scene of a singer struggling fiercely for the artistic completion of Pansori itself. Next, look at the film "Lineage of the Voice" in 2008 and "DURESORI: The Voice of East" in 2012. These two films depict the growth of children who perform art, featuring contemporary children who play pansori and Korean traditional music. Pansori in these films is no longer an old piece of music, nor is it a sublime art that is completed in harsh training. It is only naturally treated as one of the contemporary arts. Finally, "The Sound of a Flower" in 2015 and "The Singer" in 2020. The two films constructed a story from Pansori's history based on the time background of the film during the late Joseon Dynasty, when Pansori was loved the most by the people. This reflects the atmosphere of the times when traditions are used as the subject of cultural content, and shows the changed public perception of pansori and the status of pansori.

Experimental and epidemiological studies on the life cycle of Echinostoma hortense Asada, 1926(Trematoda: Echinostomatidae) (남한강류역(南漢江流域)의 호르텐스극구흡충(棘口吸蟲) 감염실태(感染實態)와 생활사(生活史)에 관(關)한 연구(硏究))

  • Ahn, Yung-Kyum;Ryang, Yong-Suk
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.121-136
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    • 1986
  • Recently there have been some reports on human infections of Echinostoma hortense in Korea. It was found that a few species of freshwater fishes were playing the role of the second intermediate host of E. hortense. However, molluscan intermediate host has not been identified yet in Korea. The present study aimed to establish the life cycle of E. hortense in laboratory. Experimental studies such as egg production from the rat, development of the eggs in vitro, exposure of miracidia to freshwater snails, shedding pattern of cercariae from infected snails, morphology of cercariae, cercarial infection to the second intermediate host and infection of metacercariae to the definitive hosts were done. In addition, epidemiological surveys on the infection status in inhabitants and house rats, and on the natural infection of larval echinostomes in the snails and fishes were carried out along the South Hangang-river. The results obtained were as follows: 1. The eggs deposited from adults in physiological saline were cultivated at room temperature($20{\sim}24^{\circ}C$). The miracidia were firstly observed on 8 days after cultivation, and 85.5% of the eggs contained the mature miracidia on 11 days after cultivation. More than 90% formed the miracidia when cultivated at temperature $22{\sim}27^{\circ}C$. Hatching of the miracidia began on 12 days after cultivation and continued for a week. The size of the miracidia was $103.0{{\times}}51.4{\mu}m$ in average. The motility of the miracidia were active up to 8 hours after shedding, but they were all dead within 10 hours after shedding. 2. A freshwater snail, Radix auricularia coreana was cultivated in aquaria. A hatched $F_1$ snails from the egg masses were exposed to 20 miracidia respectively. Escape of cercariae started on 15 days after infecton. Radix auricularia coreana was experimentally identified as the first intermediate host of E. hortense in Korea. 3. Cercarial shedding started on $15{\sim}20$ days after infection by snail, continued for about 10 days (8.8 days in average). Infected snails were dead within 32 days after the miracidial infection. About 1,335 cercariae($328{\sim}1,994$) per snail were shed in its life, and 119 cercariae in average per snail per day were shed. The cercariae were motile for more than 24 hours, and then squirming at the bottom until death. The body and tail sizes of cercariae were $356{\times}186{\mu}m$ and $510{\times}68{\mu}m$ in average, respectively. The rediae parasitized in the snail hosts were found mainly around the pericardial regions, and their size was $1,575{\times}258{\mu}m$ in average. The numbers of developing cercariae in a mature redia were 14 in average ($7{\sim}20$ in range). The numbers of rediae in a snail were 102 in average on 15 days after miracidial infection and 221 in average on 28 days. 4. Three uninfected Misgurnus anguillicaudatus, less than 6.5cm long were used in for the cercarial infection. They were all exposed with 755 cercariae, and examined at 5-day intervals starting from 10 days after infection. All the fishes were infected with metacercariae of E. hortense and a total of 275 was found infected(36.4%). The metacercariae were fed to rats and the adult worms were obtained on 15 days after infection. 5. The infected rats began to deposit the eggs on 11 days after infection. The number of eggs deposited per day per worm (EPD/worm) was $400{\sim}500$ on 3 weeks after infection and was increased to $1,000{\sim}1,500$ on 4 to 17 weeks, then decreased to 800 on 21 weeks after infection. 6. A total of 745 stool specimens collected from 576 male and 169 female residents of 8 different villages along South Hangang basin was examined. Out of 745 specimens, the eggs of Echinostoma sp. were found in 2 cases (0.3%). Of 34 house rats one showed egg-positive (2.9%). 7. Total 971 Radix auricularia coreana collected from 7 sampling stations were examined for shedding of cercariae. Three snails (0.3%) shed the cercariae of E. hortense. A total of 119 out of 542 freshwater fishes (22.0%) had the metacercariae of E. hortense. The fishes parasitized with the metacercariae were 4 out of 14 examined species. The infection rates of 4 species were 34.1% (106 out of 311) in Misgurnus anguillicaudatus, 30.4% (7 out of 23) in Misgurnus mizolepis, 4.3% (2 out of 46) in Moroco oxycephalus and 22.2% (4 out of 18) in Odontobutis obscura interrupta. In summarizing the above results, the first intermediate host of E. hortense was found as Radix auricularia coreana in Korea. Also, it took about 46 days for the shortest completion of a life cycle of E. hortense in summer; that is, 10 days for miracidial development in eggs, 15 days for cercarial development in the snail, about 10 days for metacercarial development in the second intermediate hosts, and 11 days for the maturation as the adults in the definitive hosts. The natural infection rates of E. hortense in the intermediate hosts were relatively high but those in the definitive hosts were low in the middle areas of South Hangang basin.

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The Clinical Characteristics, Diagnosis, Treatment, and Outcomes of Patients with Tuberculosis at a Private University Hospital in Korea (국내 한 민간종합병원에서 결핵 환자의 진료 실태)

  • Jung, Young Ju;Park, I-Nae;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.194-204
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    • 2006
  • Background : Even though tuberculosis (TB) is still a major public concern in Korea, there is little data on the management of TB patients and its outcomes in the private sector. This study evaluated the status of TB treatment in the private sector. Methods : Sixteen-hundred-sixty-six TB patients who were notified in a private university hospital from 2001 to 2002 were enrolled in this study. The patients were divided into pulmonary ($TB_P$), extrapulmonary ($TB_E$), and combined ($TB_{P+E}$) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared. Results : The mean age of the 1,666 patients was 48.9 years and the male-to-female ratio was 1.3:1. The number of patients in the initial and retreatment groups of $TB_P$, and those of ($TB_E+TB_{P+E}$) were 809, 276, 480, 101, respectively. A bacteriological study was performed in 92.0% of cases, and a positive culture was confirmed in 58.1% and 31.7% of patients with TBP and ($TB_E+TB_{P+E}$), respectively (p<0.05). The AFB smear was positive in 45.4 % of the $TB_P$ patients. PCR was carried out in 60.4% of the ($TB_E+TB_{P+E}$) group. The MDR was detected in 14.0% of isolates. Overall, the treatment completion, default, and death rates were 70.2%, 13.5% and 1.9%, respectively. Conclusion : Even though the management of TB patients in a private hospital was satisfactory in terms of the national guidelines, the high default rate was is still a problem. Efforts to decrease the default rate either independently or in cooperation with the public sector will be needed.

The Actual Conditions and Improvement of the Eco-Forests Mater Plan, South Korea (우리나라 생태숲조성 기본계획 실태 및 개선방향)

  • Heo, Jae-Yong;Kim, Do-Gyun;Jeong, Jeong-Chae;Lee, Jeong
    • Korean Journal of Environment and Ecology
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    • v.24 no.3
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    • pp.235-248
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    • 2010
  • This study was carried out to the actual conditions and improvement of the eco-forests master plan in South Korea, and suggested its problems and improvement direction. Results from survey and analysis of limiting factors or constraints in the construction plans of eco-forests in Korea revealed that there were highly frequent problems involving site feasibility, topographic aspect, and existing vegetation. The results of survey on the status of land use indicated that the average ratio of the use of private estate was 29.7%, so then it was estimated that a great amount of investment in purchase of eco-forest site would be required. Results from survey on major introduced facilities showed that there was high frequency of introduction of infrastructure, building facility, recreational facility, convenience facility, and information facility, and that there was low frequency of introduction of plant culture system, ecological facility, structural symbol and sculpture, and the likes. There was just one eco-forest park where more than 500 species of plants grew, and the result of investigation indicated that the diversity of plant species in 11 eco-forest parks was lower than the standards for construction of eco-forest. Results from analysis of the projects costs revealed that investment cost in facilities was higher than planting costs, and that a large amount of investment was made in the initial stage of the project. There was no planned budget for the purpose of cultivating and maintaining the plants and vegetation after construction of eco-forest. The basic concepts in construction of eco-forests were established according to the guidelines presented by the Korea Forest Service; however, the detailed work of the project was planned with its user-oriented approach. Then the construction of eco-forest was being planned following the directions, which would lead to development of a plant garden similar to arboretum or botanical garden. Therefore, it is required that the architect who designs eco-forest as well as the public officer concerned firmly establish the concepts of eco-forest, and that, through close analysis of development conditions, a candidate site to fit the purpose of constructing eco-forest be selected, and also a substantive management plan be established upon completion of construction of eco-forest.

Hsp90 Inhibitor Induces Cell Cycle Arrest and Apoptosis of Early Embryos and Primary Cells in Pigs

  • Son, Myeong-Ju;Park, Jin-Mo;Min, Sung-Hun;Hong, Joo-Hee;Park, Hum-Dai;Koo, Deog-Bon
    • Reproductive and Developmental Biology
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    • v.35 no.1
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    • pp.33-45
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    • 2011
  • Heat shock protein 90 (Hsp90) is ATPase-directed molecular chaperon and affects survival of cancer cell. Inhibitory effect of Hsp90 by inducing cell cycle arrest and apoptosis in the cancer cell was reported. However, its role during oocyte maturation and early embryo development is very insufficient. In this study, we traced the effects of Hsp90 inhibitor, 17-allylamino-17-demethoxygeldanamycin (17-AAG), on meiotic maturation and early embryonic development in pigs. We also investigated several indicators of developmental potential, including structural integrity, gene expression (Hsp90-, cell cycle-, and apoptosis-related genes), and apoptosis, which are affected by 17-AAG. Then, we examined the roles of Hsp90 inhibitor on viability of primary cells in pigs. Porcine oocytes were cultured in the NCSU-23 medium with or without 17-AAG for 44 h. The proportion of GV arrested oocytes was significantly different between the 17-AAG treated and untreated group (78.2 vs 34.8%, p<0.05). After completion of meiotic maturation, the proportion of MII oocytes was lower in the 17-AAG treated group than in the control group (27.9 vs 71.0%, p<0.05). After IVF, the percentage of penetrated oocytes was significantly lower in the 17-AAG treated group (25.2%), resulting in lower normal pronucleus formation (2PN of 14.6%). Therefore, the inhibition of meiotic progression by Hsp90 inhibitor played a critical role in fertilization status. Porcine embryo were cultured in the PZM-3 medium with or without 17-AAG for 6 days. In result, significant differences in developmental potential were detected between the embryos that were cultured with or without 17-AAG. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) showed that the number of containing fragmented DNA at the blastocyst stage increased in the 17-AAG treated group compared with control (7.5 vs 4.4, respectively). Blastocysts that developed in the 17-AAG treated group had low structural integrity and high apoptotic nuclei than those of the untreated control, resulting in decrease the embryonic qualities of preimplantation porcine blastocysts. The mRNA expressions of cell cycle-related genes were down-regulated in the 17-AAG treated group compared with control. Also, the expression of the pro-apoptotic gene Bax increased in 17-AAG treated group, whereas expression of the anti-apoptotic gene Bel-XL decreased. However, the expression of ER stress-related genes did not changed by 17-AAG. Cultured pESF cells were treated with or without 17-AAG and used for MIT assay. The results showed that viability of pESF cells were decreased by treatment of 17-AAG ($2{\mu}M$) for 24 hr. These results indicated that 17-AAG decreased cell proliferation and increased cell death. Expression patterns Hsp90 complex genes (Hsp70 and p23), cell cycle-related genes (cdc2 and cdc25c) and apoptosis-related genes (Bax and Bcl-XL) were significantly changed by using RT-PCR analysis. The spliced form of pXbp-1 product (pXbp-1s) was detected in the tunicamycin (TM) treated cells, but it is not detected in 17-AAG treated cells. In conclusion, Hsp90 appears to play a direct role in porcine early embryo developmental competence including structural integrity of blastocysts. Also, these results indicate that Hsp90 is closely associated with cell cycle- and apoptosis-related genes expression in developing porcine embryos.

The effect of Big-data investment on the Market value of Firm (기업의 빅데이터 투자가 기업가치에 미치는 영향 연구)

  • Kwon, Young jin;Jung, Woo-Jin
    • Journal of Intelligence and Information Systems
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    • v.25 no.2
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    • pp.99-122
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    • 2019
  • According to the recent IDC (International Data Corporation) report, as from 2025, the total volume of data is estimated to reach ten times higher than that of 2016, corresponding to 163 zettabytes. then the main body of generating information is moving more toward corporations than consumers. So-called "the wave of Big-data" is arriving, and the following aftermath affects entire industries and firms, respectively and collectively. Therefore, effective management of vast amounts of data is more important than ever in terms of the firm. However, there have been no previous studies that measure the effects of big data investment, even though there are number of previous studies that quantitatively the effects of IT investment. Therefore, we quantitatively analyze the Big-data investment effects, which assists firm's investment decision making. This study applied the Event Study Methodology, which is based on the efficient market hypothesis as the theoretical basis, to measure the effect of the big data investment of firms on the response of market investors. In addition, five sub-variables were set to analyze this effect in more depth: the contents are firm size classification, industry classification (finance and ICT), investment completion classification, and vendor existence classification. To measure the impact of Big data investment announcements, Data from 91 announcements from 2010 to 2017 were used as data, and the effect of investment was more empirically observed by observing changes in corporate value immediately after the disclosure. This study collected data on Big Data Investment related to Naver 's' News' category, the largest portal site in Korea. In addition, when selecting the target companies, we extracted the disclosures of listed companies in the KOSPI and KOSDAQ market. During the collection process, the search keywords were searched through the keywords 'Big data construction', 'Big data introduction', 'Big data investment', 'Big data order', and 'Big data development'. The results of the empirically proved analysis are as follows. First, we found that the market value of 91 publicly listed firms, who announced Big-data investment, increased by 0.92%. In particular, we can see that the market value of finance firms, non-ICT firms, small-cap firms are significantly increased. This result can be interpreted as the market investors perceive positively the big data investment of the enterprise, allowing market investors to better understand the company's big data investment. Second, statistical demonstration that the market value of financial firms and non - ICT firms increases after Big data investment announcement is proved statistically. Third, this study measured the effect of big data investment by dividing by company size and classified it into the top 30% and the bottom 30% of company size standard (market capitalization) without measuring the median value. To maximize the difference. The analysis showed that the investment effect of small sample companies was greater, and the difference between the two groups was also clear. Fourth, one of the most significant features of this study is that the Big Data Investment announcements are classified and structured according to vendor status. We have shown that the investment effect of a group with vendor involvement (with or without a vendor) is very large, indicating that market investors are very positive about the involvement of big data specialist vendors. Lastly but not least, it is also interesting that market investors are evaluating investment more positively at the time of the Big data Investment announcement, which is scheduled to be built rather than completed. Applying this to the industry, it would be effective for a company to make a disclosure when it decided to invest in big data in terms of increasing the market value. Our study has an academic implication, as prior research looked for the impact of Big-data investment has been nonexistent. This study also has a practical implication in that it can be a practical reference material for business decision makers considering big data investment.

Preliminary Results of 3-Dimensional Conformal Radiotherapy for Primary Unresectable Hepatocellular Carcinoma (절제 불가능한 원발성 간암의 입체조형 방사선치료의 초기 임상 결과)

  • Keum Ki Chang;Park Hee Chul;Seong Jinsil;Chang Sei Kyoung;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.123-129
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    • 2002
  • Purpose : The purpose of this study 띤as to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Materials and Methods : Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from $36\~60\;Gy$ (median; 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at $4\~8$ weeks following the completion of treatment. The acute and subacute toxicities were monitored. Results : An objective response was observed in 11 out of 17 patients, giving a response rate of $64.7\%$. The actuarial survival rate at 2 years was $21.2\%$ from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 30-CRT were gastro-duodenitis $(\geq\;grade\;2)$ in 2 patients. There were no treatment related deaths and radiation induced hepatitis. Conclusion : The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.