• 제목/요약/키워드: The Young

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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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    • 제28권4호
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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.

The Early Experience with a Totally Laparoscopic Distal Gastrectomy (전(全)복강경하 원위부 위절제술의 초기 경험)

  • Kim Jin Jo;Song Gyo Young;Chin Hyung Min;Kim Wook;Jeon Hae Myoung;Park Cho Hyun;Park Seung Man;Lim Keun Woo;Park Woo Bae;Kim Seung Nam
    • Journal of Gastric Cancer
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    • 제5권1호
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    • pp.16-22
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    • 2005
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. Materials and Methods: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45mm; Ethicon Endosurgery, OH, USA). Results: The operative time was $369.4\pm62.5$ minutes (range $275\∼465$ minutes), and the anastomotic time was 45.1\pm14.4$ minutes (range $32\∼70$ minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was $7.1\pm0.6$. The number of lymph nodes harvested was $31.9\pm13.1$. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8$\pm$0.5 days, and the time to the first food intake was $4.1\pm0.8$ days. There were no early postoperative complications, and the postoperative hospital stay was $10.0\pm3.9$ days. Conclusion: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.

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The Effect of Pleural Thickening on the Impairment of Pulmonary Function in Asbestos Exposed Workers (석면취급 근로자에서 늑막비후가 폐기능에 미치는 영향)

  • Kim, Jee-Won;Ahn, Hyeong-Sook;Kim, Kyung-Ah;Lim, Young;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • 제42권6호
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    • pp.923-933
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    • 1995
  • Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

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Effect of Cellulose Derivatives to Reduce the Oil Uptake of Deep Fat Fried Batter of Pork Cutlet (셀룰로오스 유도체가 돈가스 튀김옷의 흡유량 감소에 미치는 영향)

  • Kim, Byung-Sook;Lee, Young-Eun
    • Korean journal of food and cookery science
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    • 제25권4호
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    • pp.488-495
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    • 2009
  • Pork cutlet is a favorite deep fat fried food item among Korean children, and an excellent protein-containing food, and as well as a simple and economical cuisine. However, the frying process adds a significant amount of calories. We added MC (Methylcellulose) and HPMC (Hydroxypropyl Methylcellulose) to the batter in an effort to reduce oil uptake in prepared pork cutlets. After additions of MC and HPMC at concentrations of 0.5, 1, and 1.5% respectively, we assessed the viscosity of batter, color after frying, the increases in moisture retention and oil uptake, and sensory characteristics, comparing each quality. The viscosity of batter with 0.5% HPMC added (w/w) was similar to that of the controls, but the viscosity of all the batter with added MC was so much higher that it was difficult to use the batter for coating at the same temperature, leading to a failure even to prepare a sample. After frying, the batter with added HPMC provided significantly less oil uptake and more moisture retention than the batter to which MC was added. Additionally, with regard to color and sensory characteristics, the pork cutlet with 0.5% added HPMC was superior to the other samples. According to these results, we concluded that when cellulose derivatives are added in order to reduce oil uptake and to raise the moisture retention of the batter of pork cutlet, HPMC is more useful in this regard than MC. Additionally, the batter with 0.5% HPMC added appears to be the best of the tested choices, for three reasons: first, the viscosity of the batter is similar to that of the controls; second, the taste is not greasy after frying as the result of the reduced oil uptake and higher moisture retention; and third, the sensory characteristics of this sample, such as, color, crispiness, and hardness were the best among samples.

Studies on the Cryopreservation and Survival after Thawing of Hamster Embryos (Hamster 수정란(受精卵)의 동결보존(凍結保存) 및 생존성(生存性)에 관한 연구(硏究))

  • Oh, Won Jin;Lee, Kyu Seung;Kim, Young Mook
    • Korean Journal of Agricultural Science
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    • 제13권1호
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    • pp.82-89
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    • 1986
  • This experiment was carried out to determine the optimum freezing and thawing rates of the hamster embryos. The female hamsters were induced to superovulate by intraperitoneal injections of 30 i.u. PMSG and mated with males of the same strain of 4 days the PMSG injection. They were killed and embryos were flushed from the oviduct and uterine horn on 3 days after mating. Embryos were flushed with a modified Dulbecco's phosphate-buffered saline and equilibrated with 1.5 M-dimethylsulphoxide by a 3-step procedure. The freezing rates of the samples were $1^{\circ}C/min$ from room temperature to $-6^{\circ}C$ and the samples were seeded at $-6^{\circ}C$. After being held for 3 min at the seeding temperature, the rates were $0.3^{\circ}C/min$ from $-6^{\circ}C$ to $-35^{\circ}C$. From $-35^{\circ}C$ to $-70^{\circ}C$, the rates were divided into $0.1^{\circ}C/min$, $1^{\circ}C/min$ and $10^{\circ}C/min$, respectively. At $-70^{\circ}C$ the samples were plunged directly into liquid nitrogen. The samples were thawed at $4^{\circ}C/min$ and $12^{\circ}C/min$ from $-196^{\circ}C$ to $37^{\circ}C$, and for 2 min in $37^{\circ}C$ water bath, respectively. The average numbers of ovulation points and embryos recovered were 35.1 and 27.0 appearing 77.0% recovery rates. Eight cell embryos in the embryos recovered were 24.8. The survival rates of embryos according to the freezing rates were 55.5~67.7% at $0.1^{\circ}C/min$, 58.8~64.9% at $1^{\circ}C/min$ and 40.5~44.7% at $10^{\circ}C/min$, respectively. The survival rates at $10^{\circ}C/min$ were significantly low. The survival rates of embryos according to the thawing rates were 53.5% at $4^{\circ}C/min$, 53.7% at $12^{\circ}C/min$ and 59.1% in $37^{\circ}C$ water bath. The survival rates, in $37^{\circ}C$ water bath were slightly higher, but we did not find any differences among them. In conclusion, the best freezing rates of hamster embryos were $1^{\circ}C/min$ from the room temperature to $-6^{\circ}C/min$, $0.3^{\circ}C/min$ from $-6^{\circ}C/min$ to $-35^{\circ}C$ and $-0.1^{\circ}C/min$ or $1^{\circ}C/min$ from $-35^{\circ}C$ to $-70^{\circ}C$. The hamster embryos thawed for 2 min in $37^{\circ}C$ water bath showed the best survival rates.

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The Relation Between Work-Related Musculoskeletal Symptoms and Rapid Upper Limb Assessment(RULA) among Vehicle Assembly Workers (자동차 조립 작업자들에서 상지 근골격계의 인간공학적 작업평가(Rapid Upper Limb Assessment) 결과와 자각증상과의 연관성)

  • Kim, Jae-Young;Kim, Hae-Joon;Choi, Jae-Wook
    • Journal of Preventive Medicine and Public Health
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    • 제32권1호
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    • pp.48-59
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    • 1999
  • Objectives. This study was conducted to evaluate the association between upper extremity musculoskeletal symptoms and Rapid Upper Limb Assessment(RULA) in vehicle assembly line workers. The goal of this study is to show the feasibility of RULA as a checklist for work related musculoskeletal symptoms (WMSDs) in Korean workers. Methods. The total number of 199 people from the department of assembly and 115 people from the department of Quality Control(QC) in automotive plant were subjects for this cross sectional study. A standard symptom questionnaire survey has been used for the individual characteristics, work history, musculosketal symptoms and non-occupational covariates. The data were obtained by applying one-on-one interview for the all subjects. RULA has been applied for ergonomic work posture analysis and the primary ergonomic risk sure was computed by RULA method. Association between upper extremity musculoskeletal symptoms and RULA were assessed by multiple logistic regression analysis. Results. A total of 314 workers was examined. The prevalence of musculoskeletal symptoms by NIOSH case definition was 62.4%. The distribution of musculoskeletal symptoms by the part of the body turned out to be following; back:41.4%, neck: 32.8%, shoulder: 26.4%, arm: 10.5% and hand:29.3%. The relationship of the individual RULA scores were statistically significant for the prevalence of musculoskeletal symptoms. As the result of the multiple logistic regressioin analysis, grand final score (OR=2.250 95% CI: 1.402-3.612) was associated with musculoskeletal symptoms in any part of the body.; upper arm score(OR=1.786 95% CI: 1.036-3.079) and posture score A(OR=1.634 95% CI: 1.016-2.626) in neck; muscel use score(OR=3.076 95% CI:1.782-5.310) and posture score A(OR=1.798 95% CI: 1.072-3.017) in shoulder; upper arm score(OR=1.715 95% CI: 1.083-2.715) and muscel use score(OR=2.057 95% CI:1.303-3.248) in neck & shoulder; muscle use score(OR=10.662 95% CI: 3.180-35.742) in arm; writst/wist score(OR=2.068 95% CI: 1.130-3.786) and muscle use score(OR=2.215 95% CI: 1.284-3.819) in hand & wrist.; muscle use score of trunk (OR=2.601 95% CI: 1.147-5.901) in back. Conclusions. Musculoskeletal symptoms of the extremities were strongly associated with individual RULA body score. These results show that RULA can be used as a useful assessment tool for the evaluation of musculoskeletal loading which is known to contribute to work-related musculoskeletal disorders. RULA also can be used as a screening tool or incorporated into a wider ergonomic assessment of epidemiological, physical, mental, environmental and organizational factors. As shown in this study, complement of the analysis system for the other risk factors and characterizing between the upper limb and back part will be needed for future work.

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Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease (좌심실 판막질환 수술 후 동반된 삼첨판패쇄부전증의 경과에 영향을 미치는 요인)

  • Jin, Ung;Kim, Hwan-Wook;Lee, Jong-Ho;Kweon, Jong-Bum;Jo, Min-Seop;Yoon, Jeong-Seob;Moon, Seok-Whan;Sim, Sung-Bo;Park, Kuhn;Kim, Chi-Kyung;Cho, Keon-Hyun;Wang, Young-Pil;Lee, Sun-He;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • 제36권3호
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    • pp.150-156
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    • 2003
  • Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

The Relationship between Expression of EGFR, MMP-9, and C-erbB-2 and Survival Time in Resected Non-Small Cell Lung Cancer (수술을 시행한 비소세포 폐암 환자에서 EGFR, MMP-9 및 C-erbB-2의 발현과 환자 생존율과의 관계)

  • Lee, Seung Heon;Jung, Jin Yong;Lee, Kyoung Ju;Lee, Seung Hyeun;Kim, Se Joong;Ha, Eun Sil;Kim, Jeong-Ha;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa;Kim, Chul Hwan
    • Tuberculosis and Respiratory Diseases
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    • 제59권3호
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    • pp.286-297
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    • 2005
  • Background : Non-small cell lung cancer (NSCLC) is a common cause of cancer-related death in North America and Korea, with an overall 5-year survival rate of between 4 and 14%. The TNM staging system is the best prognostic index for operable NSCLC . However, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9(MMP-9), and C-erbB-2 have all been implicated in the pathogenesis of NSCLC and might provide prognostic information. Methods : Immunohistochemical staining of 81 specimens from a resected primary non-small cell lung cancer was evaluated in order to determine the role of the biological markers on NSCLC . Immunohistochemical staining for EGFR, MMP-9, and C-erbB-2 was performed on paraffin-embedded tissue sections to observe the expression pattern according to the pathologic type and surgical staging. The correlations between the expression of each biological marker and the survival time was determined. Results : When positive immunohistochemical staining was defined as the extent area>20%(more than Grade 2), the positive rates for EGFR, MMP-9, and C-erbB-2 staining were 71.6%, 44.3%, and 24.1% of the 81 patients, respectively. The positive rates of EGFR and MMP-9 stain for NSCLC according to the surgical stages I, II, and IIIa were 75.0% and 41.7%, 66.7% and 47.6%, and 76.9% and 46.2%, respectively. The median survival time of the EGFR(-) group, 71.8 months, was significantly longer than that of the EGFR(+) group, 33.5 months.(p=0.018, Kaplan-Meier Method, log-rank test).. The MMP-9(+) group had a shorter median survival time than the MMP-9(-) group, 35.0 and 65.3 months, respectively (p=0.2). The co-expression of EGFR and MMP-9 was associated with a worse prognosis with a median survival time of 26.9 months, when compared with the 77 months for both negative-expression groups (p=0.0023). There were no significant differences between the C-erbB-2(+) and C-erbB-2 (-) groups. Conclusion : In NSCLC, the expression of EGFR might be a prognostic factor, and the co-expression of EGFR and MMP-9 was found to be associated with a poor prognosis. However, C-erbB-2 expression had no prognostic significance.

The Relationship Between Chewing Ability and Health Status in the Long-lived Elderly of Kyungpook Area (경북지역 장수노인의 저작능력과 건강상태)

  • Lee, Hee-Kyung;Lee, Young-Kwon
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.200-207
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    • 1999
  • Background: The objective of this study is to evaluate the effect of the dental and general health in relation to the state of dentition and chewing ability by surveying oral condition and anthropometric measure in order to provide primary statistics for the development of a program which may lead to an improvement in the long-lived elderly health status in a rural community. Materials and Methods: The subjects of this study were 97 rural long-lived elderly(27 males and 70 females) who were over 85 years-old (average age of subjects are $88.14{\pm}3.20$ year old) in Sungju-Gun, Kyungpook Province. Data were collected by using questionnaires and direct measurement of anthropometrics, and oral examination from all 97 subjects on July, 1999. Results: The following results were obtained: 1. 53.6% of all subjects believe that they are healthy. The average values of height, weight, BMI, body fat, lean body fat and total water were $148.8{\pm}11.2cm$, $46.9{\pm}10.5kg$, $21.2{\pm}3.5kg/m^2$, $26.7{\pm}6.9%$, $73.0{\pm}7.1%$, and $53.4{\pm}5.2%$, respectively. 2. The average number of teeth remaining in the subjects were $3.50{\pm}5.71$; the number of maxillary teeth remaining were $1.08{\pm}2.88$; and the number of mandibular teeth remaining were $2.41{\pm}3.76$. The maximum number of teeth remaining among subjects were 22 teeth, and the fully edentulous(no natural teeth) people were 76.3%. The oral conditions of the subjects were 52.6% using denture, 23.7% using natural teeth, and 23.7% masticating edentulous ridge without denture. 3. In terms of oral condition in self-assessment of health, digestive ability, and chewing ability ; On self-assessment of health, 47.1% of those wearing denture group responded as feeling good, 56.5% of those in the group of edentulous without denture, and 65.2% in group of natural teeth only. On self-assessment of digestive ability, 82.4% of those in group of denture responded as feeling good, 65.2% of those in group of no teeth and no denture, and 73.9% of those in group of natural teeth only. On self-assessment of chewing ability, 90.2% of those in the group wearing a denture, 60. 9% of those in the group of no teeth and no denture, and 65.2% of those in the group of natural teeth only. 4. In terms of oral condition in anthropometric measurements; The height, weight, body fat, lean body mass, and total water according to oral conditions were $150.0{\pm}10.7cm$, $49.0{\pm}10.9kg$, $26.9{\pm}6.6%$, $72.7{\pm}7.0%$, $53.2{\pm}5.1%$, respectively, in group wearing a denture, $142.7{\pm}6.0cm$, $43.2{\pm}5.5kg$, $29.5{\pm}7.2%$, $70.8{\pm}6.9%$, $51.8{\pm}5.0%$, respectively, in the group of no teeth and no denture, and $152.3{\pm}14.1cm$, $45.9{\pm}12.6kg$, $23.4{\pm}6.0%$, $75.9{\pm}6.9%$, $55.6{\pm}5.1%$, respectively, in the group of natural teeth only. Conclusion: The subjective measurements of good health were higher denture user, and natural teeth.

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The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • 제19권4호
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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