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A Study on Nutritional Status of Young Children in Rural Korea (농촌영유아의 영양상태(營養狀態)에 관(關)한 조사연구(調査硏究))

  • Kim, Kyoung-Sik;Kim, Pang-Ji;Nam, Sang-Ok;Choi, Jung-Shin
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.1-28
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    • 1974
  • The writers have conducted the investigation to assess the nutritional status of young rural Korean children aged from 0 to 4 years old in August 1971. The survey areas were Kaejong-myon. Daeya-myon, Okku-gun, Jeonra-bukdo, Korea. These survey areas were typical agricultural plain areas. The total numbers of children examined were 2,706 comprising 1,394 male and 1,312 female. The weight, height, and chest circumference of children were measured and means and standard deviations. were calculated for each measurement. In addition, the nutritional status of each child was classified by the four levels of malnutrition and the Gomez classification, The examination of red blood cell count, haematocrit value, and intestinal parasite infection were carried out at the same time. In general, recent work tend to suggest that environmental influences, especially nutrition, are of great importance than genetic background or other biological factors for physical growth and development. Certainly the physical dimensions of the body are much influenced by nutrition, particularly in the rapidly growing period of early childhood. Selected body measurements can therefore give valuable information concerning protein-calory malnutrition. Growth can also be affected by bacterial, viral, and parasitic infection. For the field workers in a developing country, therefore, nutritional anthropometry appears to be of greatest value in the assessment of growth failure and undernutrition, principally from lack of protein and calories. In order to compare and evaluate the data obtained, the optimal data of growth from the off-spring of the true well-fed, medically and socially protected are needed. So-called 'Standards' that have been compiled for preschool children in Korea, however, are based on measurement of children from middle or lower socio-economic groups, who are, in fact, usually undernourished from six months of age onwards and continuously exposed to a succession of infective and parasitic diseases. So that, the Harvard Standards which is one of the international reference standards was used as the reference standards in this study. Findings of the survey were as follows: A. Anthropometric data: 1) Comparing the mean values for body weight obtained with the Korean standard weight of the same age, the rural Korean children were slightly haevier than the Korean standard values in both sexes. Comparing with the Japanese children values, the rural Korean children were slightly haevier in male and in the infant period of female but lighter in female of the period of 1 to 4 years old than Japanese children. 2) Comparing the mean values for height obtained with the Korean standard height of the same age, the rural Korean children were taller than the Korean standard values except the second half of infatn period in both sexes. Comparing with the Japanese children, the rural Korean children were slightly smaller than Japanese children except the first half of infant peroid in both sexes. 3) Mear values of chest circumference of rural Korean children obtained were less than the Korean standard values of the same ages in both sexes. B. Prevalence of Protein-Calory Malnutrition: Children examined were devided into two groups, i. e., infant(up to the first birthday) and toddler (1 to 4 fears old). 1) Percentages of four levels of malnutrition: a) When the nutrtional status of each child was classified (1) by body weight value, the percentages for male and female of children attained standard growth were 52.8%(infant 83.3%, toddler 44.4%) and 39.7% (infant 74.5%. toddler 30.5%), the first level of malnutrition were 31.9%(infant 13.7%, toddler 36.9%) and 31.7%(infant 15.3%, toddler 36,0%), the second level of malnutrition were 12.3%(infant 1.7%, toddler 15.3%) and 23.3% (infant 7.7%, fodder 27.5%), the third level of malnutrition were 2.7%(infant 0.7%, toddler 3.2%) and 4.6%(infant 1.8%, toddler 5.3%) the fourth level of malnutrition were 0.3% (infant 0.7%, toddler 0.2%) and 0.7% (0.7% for infant and toddler) respectively. (2) by height value, the percentages for male and female of children attained standard growth were 80.3% (infant 97.3%, toddler 75.6%) and 75.1% (infant 96.4%, toddler 69.5), the first level of malnutrition were 17.9% (infant 2.0%, toddler 22.3%) and 23.6% (infants 3.6%, toddler 28.8%), the second level of malnutrition were 1.2% (infant 0.3%, toddler 1.5%) and 1.1% (infant 0%, toddler 1.4%), the third level of malnutrition were 0.4%(infant 0.3%, toddler 0.5%) and 0.2%(infant 0%, toddler 0.3%), the fourth level of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 0% respectively. (3) by body weight in relation to height, the percentages for male and female of children attained standard growth were 87.9% (infant 77.6%, toddler 87.9%) and 78.2% (infant 77.4%, toddler 78.2%), the first level of malnutrition were 12.2% (infant 18.4%, toddler 10.6%) and 18.2% (infant 17.9%, toddler 18.3%), the second level of malnutrition were 1.9%(infant 3.3%, toddler 1.5%) and 3.0%(infant 3.3%, toddler 2.9%), the third level of malnutrition were 0.1%(infant 0%. toddler 0.1%) and 0.5% (infant 0%, toddler 0.6%), the fourth level of malnutrition were 0.1%(infant 0.7%, toddler 0%) and 0.3% (infant 1.5%, toddler 0%) respectively. b) When the nutritional status of each child according to the mother's age at perturition, i. e., young aged mother (up to 30 years old), middle aged mother (31 to 40 years old) and old aged mother (41 years or above) was classified (1) by body weight, among infants and toddlers, at each year of age, with increasing the mother's age, there was an increase in percentage of subjects underweight. This tendency of increasing percentage of underweight was more significant in the infant period than the toddler period. (2) by height value, no significant differences between each mother's age group were found. c) When the nutritional status of each child according to the birth rank, i. e., lower birth rank (first to third) and higher birth rank (fourth or above) was classified (1) by weight value, children of higher birth rank were slightly more often underweight than those of lower birth rank, but not significant. (2) by height value, no differences were found between children of lower and higher birth rank. 2) Gomez Classification: When the nutritional status of each child was classified a) by body weight value, the percentages for male and female of children. attained standard growth were 53.1% (infant 82.6%, toddler 44.9%) and 39.2% (infant 73.4%, toddler 30.1%), the first degree of malnutrition were 39.4% (infant 14.7%, toddler 46.2%) and 47.1% (infant 21.9%, toddler 53.8%), the second degree of malnutrition were 7.3%(infant 2.3%, toddler 8.6%) and 12.9% (infant 4.0%, toddler 15.2%). and the third degree of malnutrition were 0.2%. (infant 0.3%, toddler 0.2%) and 0.8% (infant 0.7%, toddler 0.9%) respectively. b) by height value, the percentages for male and female of children attained standard growth were 80.8% (infant 97.0%, toddler 76.3%) and 73.8%(infant 95.6%, toddler 68.0%), the first degree of malnutrition were 18.5% (infant 2.7%, toddler 22.9%) and 24.6% (infant 4.4%, toddler 30.0%), the second degree of malnutrition were 0.6%(infant 0.3%, toddler 0.7%) and 0.5% (infant 0.1%, toddler 0.7%), and the third degree of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 1.1% (infant 0%, toddler 1.3%) respectively. C. Results of clinical laboratory examination: 1) Red blood cells: The ranges of mean red blood cell counts for male and female were $3,538,000/mm^3\;to\;4,403,000/mm^3\;and\;3,576,000/mm^3\;to\;4,483,000/mm^3$ respectively. The lowest red cell counts were seen at the age of 0-3 months for male and 1-2 months for female. 2) Haematocrit value : The ranges of haematocrit value of male and female were 35.1% to 38.8% and 34.7% to 38.8% respectively. The lowest haematocrit values were seen at the age of 2-3 months for male and 1-2, months for female. 3) The prevalence rates of intestinal parasites for male and female children with Ascaris lumbricoides were 34.1% (infant 18.8%, toddler 38.1%) and 36.0%(infant 18.4%, toddler 40.7%), with Trichocephalus trichiuris were 6.8% (infant 2.9%, toddler 7.9%) and 9.0% (infant 3.0%, toddler 10.6%), with Hookworm were 0.3% (infant 0.5%, toddler 0.2%) and 0.3% (infant 0.5%, toddler 0.3%), with Clonorchis sinensis were 0.4%(infant 0%, toddler 0.5%) and 0.1%(infant 0%, toddler 0.1%) respectively.

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Studies on Nutrio-physiology of Low Productive Rice Plants (수도저위생산력(水稻低位生産力)의 원인구명(原因究明)에 관(關)한 영양생리적연구(營養生理的硏究))

  • Park, Jun-Kyu
    • Applied Biological Chemistry
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    • v.17 no.1
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    • pp.1-30
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    • 1974
  • Present study was undertaken to elucidate the relationship between uptake of nutrients and photosynthetic activities, and the translocation of several mineral nutrients in rice plants which were grown under different cultural conditions, utilizing radioactive tracer technique. Particular emphasis was placed on the analysis of patterns of nutrient uptake, the relationship between nutritional conditions and yield components. For this, rice plants grown on either low or high yielding fields at different growth stage were subjected to this study. The results are summarized as follows; 1. Varietal difference was observed in the uptake of potassium and phosphorus. Kusabue and Jinheung had good capacity but Paldal had rather poor capacity for the uptake of the both nutrients. 2. For rice plants, a high positive correlation was found between the oxidation of alpha plaus-naphthylamine by root and uptake of phosphorus. 3. Carbon assimilation rate repended on rice varieties. It was high in Noindo, Gutaenajuok #3 Suweon #82 and Jinheung but low in Taegujo, Kwanok, Yugu #132 etc. 4. Heavy application of nitrogen increased carbon assimilation in rice plants but this also depressed translocation of certain carbohydrates to ears. 5. Carbon assimilation wan greatly hampered in rice plants deficient in magnesium, phosphorus or potassium. 6. Total dry matter after ear formation stage, was much higher in rice plants grown in high yielding fields than those grown in low yielding fields. 7. Leaf area index(LAI) reached maximum at heading stage and decreased thereafter in high yielding fields. But in low yielding fields, it reached maximum before heading and sharply decreased thereafter due to early senescence of lower leaves. 8. In general, light transmission ratio (LTR) of leaves was higher in the early growth stage and lower in later stages. Higher ratio of LTR to leaf area index, was found in the rice grown in high yielding fields than those in low yielding fields. 9. Net photosynthetic activity decreased with the increase in leaf area index but was higher in high yielding fields than in low yielding fields. 10. After the ear formation stage, nitrogen, potassium and silicon as weil as $K_2O/N$ in straw were higher in high yielding fields than those in low yielding fields. 11. Nitrogen, phosphorus, potassium and magnesium taken up by rice plants in low yielding fields before heading stage were readily translocated to ears than those in high yielding fields. This suggests greater redistribution of nutrients in straw occurs due to lower uptake, in later growth stages, by rice plants grown in low yielding fields and hence results in early senescence due to nutrient deprivation. 12. In the high yielding fields nitrogen uptake by rice was slow but continuous throughout the life of the plants resulting in a large uptake even after heading. But, in low yielding fields the uptake was fast before heading and slow after heading. 13. A high positive correlation was found between the contents of nitrogen and potassium in the straw at heading stage and grain yield. Positive correlation was also found to hold between the contents of potassium, silicon, $K_2O/N$, $SiO_2/N$ in the straw at harvesting stage, and grain yield. 14. Carbon assimilation was greately hampered in rice plants deficient in magensium, phosphorus or potassium. 15. Uptake of nitrogen, phosphorus, potassium, silicon and manganese by rice was considerably higher in high yielding fields and reached maximum at ear formation stage. 16. In rice, a high positive correlation was discovered between total uptake of nitrogen, phosphorus, potassium, calcium, magnesium, silicon, manganese at harvesting stage and grain yield. 17. In rice, a high positive correlation was found between the total uptake of nitrogen, phosphorus, potassium, calcium, magnesium, silicon at harvesting stage, and number of spikelets per $3.3\;m^2$. In addition, a correlation was found between the total uptake of nitrogen and potassium and number of panicles per hill.

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Studies on the Mechanical Properties of Weathered Granitic Soil -On the Elements of Shear Strength and Hardness- (화강암질풍화토(花崗岩質風化土)의 역학적(力學的) 성질(性質)에 관(關)한 연구(硏究) -전단강도(剪斷强度)의 영향요소(影響要素)와 견밀도(堅密度)에 대(對)하여-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.66 no.1
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    • pp.16-36
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    • 1984
  • It is very important in forestry to study the shear strength of weathered granitic soil, because the soil covers 66% of our country, and because the majority of land slides have been occured in the soil. In general, the causes of land slide can be classified both the external and internal factors. The external factors are known as vegetations, geography and climate, but internal factors are known as engineering properties originated from parent rocks and weathering. Soil engineering properties are controlled by the skeleton structure, texture, consistency, cohesion, permeability, water content, mineral components, porosity and density etc. of soils. And the effects of these internal factors on sliding down summarize as resistance, shear strength, against silding of soil mass. Shear strength basically depends upon effective stress, kinds of soils, density (void ratio), water content, the structure and arrangement of soil particles, among the properties. But these elements of shear strength work not all alone, but together. The purpose of this thesis is to clarify the characteristics of shear strength and the related elements, such as water content ($w_o$), void ratio($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$), and the interrelationship among related elements in order to decide the dominant element chiefly influencing on shear strength in natural/undisturbed state of weathered granitic soil, in addition to the characteristics of soil hardness of weathered granitic soil and root distribution of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands. For the characteristics of shear strength of weathered granitic soil and the related elements of shear strength, three sites were selected from Kwangju district. The outlines of sampling sites in the district were: average specific gravity, 2.63 ~ 2.79; average natural water content, 24.3 ~ 28.3%; average dry density, $1.31{\sim}1.43g/cm^3$, average void ratio, 0.93 ~ 1.001 ; cohesion, $ 0.2{\sim}0.75kg/cm^2$ ; angle of internal friction, $29^{\circ}{\sim}45^{\circ}$ ; soil texture, SL. The shear strength of the soil in different sites was measured by a direct shear apparatus (type B; shear box size, $62.5{\times}20mm$; ${\sigma}$, $1.434kg/cm^2$; speed, 1/100mm/min.). For the related element analyses, water content was moderated through a series of drainage experiments with 4 levels of drainage period, specific gravity was measured by KS F 308, analysis of particle size distribution, by KS F 2302 and soil samples were dried at $110{\pm}5^{\circ}C$ for more than 12 hours in dry oven. Soil hardness represents physical properties, such as particle size distribution, porosity, bulk density and water content of soil, and test of the hardness by soil hardness tester is the simplest approach and totally indicative method to grasp the mechanical properties of soil. It is important to understand the mechanical properties of soil as well as the chemical in order to realize the fundamental phenomena in the growth and the distribution of tree roots. The writer intended to study the correlation between the soil hardness and the distribution of tree roots of Pinus rigida Mill. planted in 1966 and Pinus rigida ${\times}$ taeda in 199 to 1960 in the denuded forest lands with and after several erosion control works. The soil texture of the sites investigated was SL originated from weathered granitic soil. The former is situated at Py$\ddot{o}$ngchangri, Ky$\ddot{o}$m-my$\ddot{o}$n, Kogs$\ddot{o}$ng-gun, Ch$\ddot{o}$llanam-do (3.63 ha; slope, $17^{\circ}{\sim}41^{\circ}$ soil depth, thin or medium; humidity, dry or optimum; height, 5.66/3.73 ~ 7.63 m; D.B.H., 9.7/8.00 ~ 12.00 cm) and the Latter at changun-long Kwangju-shi (3.50 ha; slope, $12^{\circ}{\sim}23^{\circ}$; soil depth, thin; humidity, dry; height, 10.47/7.3 ~ 12.79 m; D.B.H., 16.94/14.3 ~ 19.4 cm).The sampling areas were 24quadrats ($10m{\times}10m$) in the former area and 12 in the latter expanding from summit to foot. Each sampling trees for hardness test and investigation of root distribution were selected by purposive selection and soil profiles of these trees were made at the downward distance of 50 cm from the trees, at each quadrat. Soil layers of the profile were separated by the distance of 10 cm from the surface (layer I, II, ... ...). Soil hardness was measured with Yamanaka soil hardness tester and indicated as indicated soil hardness at the different soil layers. The distribution of tree root number per unit area in different soil depth was investigated, and the relationship between the soil hardness and the number of tree roots was discussed. The results obtained from the experiments are summarized as follows. 1. Analyses of simple relationship between shear strength and elements of shear strength, water content ($w_o$), void ratio ($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$). 1) Negative correlation coefficients were recognized between shear strength and water content. and shear strength and void ratio. 2) Positive correlation coefficients were recognized between shear strength and dry density. 3) The correlation coefficients between shear strength and specific gravity were not significant. 2. Analyses of partial and multiple correlation coefficients between shear strength and the related elements: 1) From the analyses of the partial correlation coefficients among water content ($x_1$), void ratio ($x_2$), and dry density ($x_3$), the direct effect of the water content on shear strength was the highest, and effect on shear strength was in order of void ratio and dry density. Similar trend was recognized from the results of multiple correlation coefficient analyses. 2) Multiple linear regression equations derived from two independent variables, water content ($x_1$ and dry density ($x_2$) were found to be ineffective in estimating shear strength ($\hat{Y}$). However, the simple linear regression equations with an independent variable, water content (x) were highly efficient to estimate shear strength ($\hat{Y}$) with relatively high fitness. 3. A relationship between soil hardness and the distribution of root number: 1) The soil hardness increased proportionally to the soil depth. Negative correlation coefficients were recognized between indicated soil hardness and the number of tree roots in both plantations. 2) The majority of tree roots of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands distributed at 20 cm deep from the surface. 3) Simple linear regression equations were derived from indicated hardness (x) and the number of tree roots (Y) to estimate root numbers in both plantations.

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Information Privacy Concern in Context-Aware Personalized Services: Results of a Delphi Study

  • Lee, Yon-Nim;Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.63-86
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    • 2010
  • Personalized services directly and indirectly acquire personal data, in part, to provide customers with higher-value services that are specifically context-relevant (such as place and time). Information technologies continue to mature and develop, providing greatly improved performance. Sensory networks and intelligent software can now obtain context data, and that is the cornerstone for providing personalized, context-specific services. Yet, the danger of overflowing personal information is increasing because the data retrieved by the sensors usually contains privacy information. Various technical characteristics of context-aware applications have more troubling implications for information privacy. In parallel with increasing use of context for service personalization, information privacy concerns have also increased such as an unrestricted availability of context information. Those privacy concerns are consistently regarded as a critical issue facing context-aware personalized service success. The entire field of information privacy is growing as an important area of research, with many new definitions and terminologies, because of a need for a better understanding of information privacy concepts. Especially, it requires that the factors of information privacy should be revised according to the characteristics of new technologies. However, previous information privacy factors of context-aware applications have at least two shortcomings. First, there has been little overview of the technology characteristics of context-aware computing. Existing studies have only focused on a small subset of the technical characteristics of context-aware computing. Therefore, there has not been a mutually exclusive set of factors that uniquely and completely describe information privacy on context-aware applications. Second, user survey has been widely used to identify factors of information privacy in most studies despite the limitation of users' knowledge and experiences about context-aware computing technology. To date, since context-aware services have not been widely deployed on a commercial scale yet, only very few people have prior experiences with context-aware personalized services. It is difficult to build users' knowledge about context-aware technology even by increasing their understanding in various ways: scenarios, pictures, flash animation, etc. Nevertheless, conducting a survey, assuming that the participants have sufficient experience or understanding about the technologies shown in the survey, may not be absolutely valid. Moreover, some surveys are based solely on simplifying and hence unrealistic assumptions (e.g., they only consider location information as a context data). A better understanding of information privacy concern in context-aware personalized services is highly needed. Hence, the purpose of this paper is to identify a generic set of factors for elemental information privacy concern in context-aware personalized services and to develop a rank-order list of information privacy concern factors. We consider overall technology characteristics to establish a mutually exclusive set of factors. A Delphi survey, a rigorous data collection method, was deployed to obtain a reliable opinion from the experts and to produce a rank-order list. It, therefore, lends itself well to obtaining a set of universal factors of information privacy concern and its priority. An international panel of researchers and practitioners who have the expertise in privacy and context-aware system fields were involved in our research. Delphi rounds formatting will faithfully follow the procedure for the Delphi study proposed by Okoli and Pawlowski. This will involve three general rounds: (1) brainstorming for important factors; (2) narrowing down the original list to the most important ones; and (3) ranking the list of important factors. For this round only, experts were treated as individuals, not panels. Adapted from Okoli and Pawlowski, we outlined the process of administrating the study. We performed three rounds. In the first and second rounds of the Delphi questionnaire, we gathered a set of exclusive factors for information privacy concern in context-aware personalized services. The respondents were asked to provide at least five main factors for the most appropriate understanding of the information privacy concern in the first round. To do so, some of the main factors found in the literature were presented to the participants. The second round of the questionnaire discussed the main factor provided in the first round, fleshed out with relevant sub-factors. Respondents were then requested to evaluate each sub factor's suitability against the corresponding main factors to determine the final sub-factors from the candidate factors. The sub-factors were found from the literature survey. Final factors selected by over 50% of experts. In the third round, a list of factors with corresponding questions was provided, and the respondents were requested to assess the importance of each main factor and its corresponding sub factors. Finally, we calculated the mean rank of each item to make a final result. While analyzing the data, we focused on group consensus rather than individual insistence. To do so, a concordance analysis, which measures the consistency of the experts' responses over successive rounds of the Delphi, was adopted during the survey process. As a result, experts reported that context data collection and high identifiable level of identical data are the most important factor in the main factors and sub factors, respectively. Additional important sub-factors included diverse types of context data collected, tracking and recording functionalities, and embedded and disappeared sensor devices. The average score of each factor is very useful for future context-aware personalized service development in the view of the information privacy. The final factors have the following differences comparing to those proposed in other studies. First, the concern factors differ from existing studies, which are based on privacy issues that may occur during the lifecycle of acquired user information. However, our study helped to clarify these sometimes vague issues by determining which privacy concern issues are viable based on specific technical characteristics in context-aware personalized services. Since a context-aware service differs in its technical characteristics compared to other services, we selected specific characteristics that had a higher potential to increase user's privacy concerns. Secondly, this study considered privacy issues in terms of service delivery and display that were almost overlooked in existing studies by introducing IPOS as the factor division. Lastly, in each factor, it correlated the level of importance with professionals' opinions as to what extent users have privacy concerns. The reason that it did not select the traditional method questionnaire at that time is that context-aware personalized service considered the absolute lack in understanding and experience of users with new technology. For understanding users' privacy concerns, professionals in the Delphi questionnaire process selected context data collection, tracking and recording, and sensory network as the most important factors among technological characteristics of context-aware personalized services. In the creation of a context-aware personalized services, this study demonstrates the importance and relevance of determining an optimal methodology, and which technologies and in what sequence are needed, to acquire what types of users' context information. Most studies focus on which services and systems should be provided and developed by utilizing context information on the supposition, along with the development of context-aware technology. However, the results in this study show that, in terms of users' privacy, it is necessary to pay greater attention to the activities that acquire context information. To inspect the results in the evaluation of sub factor, additional studies would be necessary for approaches on reducing users' privacy concerns toward technological characteristics such as highly identifiable level of identical data, diverse types of context data collected, tracking and recording functionality, embedded and disappearing sensor devices. The factor ranked the next highest level of importance after input is a context-aware service delivery that is related to output. The results show that delivery and display showing services to users in a context-aware personalized services toward the anywhere-anytime-any device concept have been regarded as even more important than in previous computing environment. Considering the concern factors to develop context aware personalized services will help to increase service success rate and hopefully user acceptance for those services. Our future work will be to adopt these factors for qualifying context aware service development projects such as u-city development projects in terms of service quality and hence user acceptance.

Studies of the Properties of Commercial Woods Grown in the Southern Part of Korea (한국산(韓國産) 유용목재(有用木材)의 기초재질(基礎材質)에 관(關)한 연구(硏究))

  • Chung, Byung-Jae;Lee, Jyung-Seuk;Kim, Yoon-Soo
    • Journal of the Korean Wood Science and Technology
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    • v.6 no.2
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    • pp.3-19
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    • 1978
  • Five species, Abies koreana Wilson (A. koreana), Castanopsis cuspidata var. Sieboldii Nakai (C. Cuspidata). Machilus thunbergii Sieb. et Zucc. (M. thunbergii), Styrax japonica (S. japonica), and Quercus acuta Thunberg(Q. acuta) growing in the southern part of Korea were selected for the investigation of wood properties. In order to evaluate the wood properties of these five species, anatomical, physical, mechanical, chemical and pulping characteristics were investigated. And this study also covered wood technological problems related to the drying, gluing, debarking, flooring, and wood workability so that these species might serve to the best advantage. The results obtained were summarized as follows: 1. The trunk of A. koreana with many knots was straight. However, the trunks of S. japonica and C. cuspidata were crooked. 2. A. koreana showed the longest and the widest ill the fiber morphology; 2.97mm in length, 39.3${\mu}$ in width. In general, fiber width of all the species investigated were greater than those of other Korean hardwoods. 3. The specific gravity of Q. acuta was 0.74${\pm}$0.03, and that of A.koreana was 0.34${\pm}$0.02. The range of specific gravity of the other species was 0.47-0.52. 4. The adsorption of water was propotioned inversely with the specific gravity, but the adsorption of humidity was proportioned with the specific gravity. In spite of their medium density, S. japonica showed the greatest adsorption, and M. thunbergii the least. The water adsorption of cross section was twice greater than that of lateral direction, and there was a slight difference in between the radial and the tangential direction. 5. Shrinkage for tested five species was ranged from 5.36 to 10.24% in tangential direction, and 2.83~6.13% in radial direction. Q. acuta recorded the greatest shrinkage rate, and A. koreana the least. The greater was the specific gravity, the larger was the shrinkage rate. 6. The mechanical properties of Q. acuta were similar to those of Quercus mongolica which grow in Kangwon-Do. Strength properties of C. cuspidata, M. thunbergii, A. koreana were equivalent to those of other Korean commercial woods with similar specific gravity, except S. japonica which showed slightly higher strength than that of other species with similar density. 7. Higher glue joint strength for urea and phenol adhesieves was recorded in the species of M. thunbergii and C. cuspidata, however, high-density species(Q. acuta) and even low-density species(A. koreana) did not show good joint strength. 8. The attractive figure of M. thunbergii in texture seemed to he appreciated for decoration. And the grain and texture of other species were proper for furniture and building materials. 9. All of the species except Q. acuta were considered good for wood workability. 10. The denser the specific gravity was, the longer the drying time took. However, severe drying defects were formed in M. thunbergii whose density was medium. 11. All the species were considered suitable for the flooring wood expect A. koreana whose density was light. 12. Pentosan component in all the species was great, and the amount of extractives in Q. acuta was worth noticing. 13. Yield in kraft pulp was above the level of economic pulp yield, i.e. 45% in all species. 14. Debarking was easy in the species of A. koreana and M. thunbergii, and debarking after being boiled in water was the most efficient in all species.

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Analysis of Forestry Structure and Induced Output Based on Input - output Table - Influences of Forestry Production on Korean Economy - (산업관련표(産業關聯表)에 의(依)한 임업구조분석(林業構造分析)과 유발생산액(誘發生産額) -임업(林業)이 한국경제(韓國經濟)에 미치는 영향(影響)-)

  • Lee, Sung-Yoon
    • Journal of the Korean Wood Science and Technology
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    • v.2 no.4
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    • pp.4-14
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    • 1974
  • The total forest land area in Korea accounts for some 67 percent of the nation's land total. Its productivity, however, is very low. Consequently, forest production accounts for only about 2 percent of the gross national product and a minor proportion of no more than about 5 percent versus primary industry. In this case, however, only the direct income from forestry is taken into account, making no reference to the forestry output induced by other industrial sectors. The value added Or the induced forestry output in manufacturing the primary wood products into higher quality products, makes a larger contribution to the economy than direct contribution. So, this author has tried to analyze the structure of forestry and compute the repercussion effect and the induced output of primary forest products when utilized by other industries for their raw materials, Hsing the input-output table and attached tables for 1963 and 1966 issued by the Bank of Korea. 1. Analysis of forestry structure A. Changes in total output Durng the nine-year period, 1961-1969, the real gross national product in Korea increased 2.1 times, while that of primary industries went up about 1. 4 times. Forestry which was valued at 9,380 million won in 1961, was picked up about 2. 1 times to 20, 120 million won in 1969. The rate of the forestry income in the GNP, accordingly, was no more than 1.5 percent both in 1961 and 1962, whereas its rate in primary industries increased 3.5 to 5.4 percent. Such increase in forestry income is attributable to increased forest production and rise in timber prices. The rate of forestry income, nonetheless, was on the decrease on a gradual basis. B. Changes in input coefficient The input coefficient which indicates the inputs of the forest products into other sectors were up in general in 1966 over 1963. It is noted that the input coefficient indicating the amount of forest products supplied to such industries closely related with forestry as lumber and plywood, and wood products and furniture, showed a downward trend for the period 1963-1966. On the other hand, the forest input into other sectors was generally on the increase. Meanwhile, the input coefficient representing the yolume of the forest products supplied to the forestry sector itself showed an upward tendency, which meant more and more decrease in input from other sectors. Generally speaking, in direct proportion to the higher input coefficient in any industrial sector, the reinput coefficient which denotes the use of its products by the same sector becomes higher and higher. C. Changes in ratio of intermediate input The intermediate input ratio showing the dependency on raw materials went up to 15.43 percent m 1966 from 11. 37 percent in 1963. The dependency of forestry on raw materials was no more than 15.43 percent, accounting for a high 83.57 percent of value added. If the intermediate input ratio increases in any given sector, the input coefficient which represents the fe-use of its products by the same sector becomes large. D. Changes in the ratio of intermediate demand The ratio of the intermediate demand represents the characteristics of the intermediary production in each industry, the intermediate demand ratio in forestry which accunted for 69.7 percent in 1963 went up to 75.2 percent in 1966. In other words, forestry is a remarkable industry in that there is characteristics of the intermediary production. E. Changes in import coefficient The import coefficient which denotes the relation between the production activities and imports, recorded at 4.4 percent in 1963, decreased to 2.4 percent in 1966. The ratio of import to total output is not so high. F. Changes in market composition of imported goods One of the major imported goods in the forestry sector is lumber. The import value increased by 60 percent to 667 million won in 1966 from 407 million won in 1963. The sales of imported forest products to two major outlets-lumber and plywood, and wood products and furniture-increased to 343 million won and 31 million won in 1966 from 240million won and 30 million won in 1963 respectively. On the other hand, imported goods valued at 66 million won were sold to the paper products sector in 1963; however, no supply to this sector was recorded in 1963. Besides these major markets, primary industries such as the fishery, coal and agriculture sectors purchase materials from forestry. 2. Analysis of repercussion effect on production The repercussion effect of final demand in any given sector upon the expansion of the production of other sectors was analyzed, using the inverse matrix coefficient tables attached to the the I.O. Table. A. Changes in intra-sector transaction value of inverse matrix coefficient. The intra-sector transaction value of an inverse matrix coefficient represents the extent of an induced increase in the production of self-support products of the same sector, when it is generated directly and indirectly by one unit of final demand in any given sector. The intra-sector transaction value of the forestry sector rose from 1.04 in 1963 to 1, 11 in 1966. It may well be said, therefore, that forestry induces much more self-supporting products in the production of one unit of final demand for forest products. B. Changes in column total of inverse matrix coefficient It should be noted that the column total indicates the degree of effect of the output of the corresponding and related sectors generated by one unit of final demand in each sector. No changes in the column total of the forestry sector were recorded between the 1963 and 1966 figures, both being the same 1. 19. C. Changes in difference between column total and intra-sector transaction amount. The difference between the column total and intra-sector transaction amount by sector reveals the extent of effect of output of related industrial sector induced indirectly by one unit of final demand in corresponding sector. This change in forestry dropped remarkable to 0.08 in 1966 from 0.15 in 1963. Accordingly, the effect of inducement of indirect output of other forestry-related sectors has decreased; this is a really natural phenomenon, as compared with an increasing input coefficient generated by the re-use of forest products by the forestry sector. 3. Induced output of forestry A. Forest products, wood in particular, are supplied to other industries as their raw materials, increasng their value added. In this connection the primary dependency rate on forestry for 1963 and 1966 was compared, i. e., an increase or decrease in each sector, from 7.71 percent in 1963 to 11.91 percent in 1966 in agriculture, 10.32 to 6.11 in fishery, 16.24 to 19.90 in mining, 0.76 to 0.70 in the manufacturing sector and 2.79 to 4.77 percent in the construction sector. Generally speaking, on the average the dependency on forestry during the period 1963-1966 increased from 5.92 percent to 8.03 percent. Accordingly, it may easily be known that the primary forestry output induced by primary and secondary industries increased from 16, 109 million won in 1963 to 48, 842 million won in 1966. B. The forest products are supplied to other industries as their raw materials. The products are processed further into higher quality products. thus indirectly increasing the value of the forest products. The ratio of the increased value added or the secondary dependency on forestry for 1963 and 1966 showed an increase or decrease, from 5.98 percent to 7.87 percent in agriculture, 9.06 to 5.74 in fishery, 13.56 to 15.81 in mining, 0.68 to 0.61 in the manufacturing sector and 2.71 to 4.54 in the construction sector. The average ratio in this connection increased from 4.69 percent to 5.60 percent. In the meantime, the secondary forestry output induced by primary and secondary industries rose from 12,779 million Wall in 1963 to 34,084 million won in 1966. C. The dependency of tertiary industries on forestry showed very minor ratios of 0.46 percent and 0.04 percent in 1963 and 1966 respectively. The forestry output induced by tertiary industry also decreased from 685 million won to 123 million won during the same period. D. Generally speaking, the ratio of dependency on forestry increased from 17.68 percent in 1963 to 24.28 percent in 1966 in primary industries, from 4.69 percent to 5.70 percent in secondary industries, while, as mentioned above, the ratio in the case of tertiary industry decreased from 0.46 to 0.04 percent during the period 1963-66. The mining industry reveals the heaviest rate of dependency on forestry with 29.80 percent in 1963 and 35.71 percent in 1966. As it result, the direct forestry income, valued at 8,172 million won in 1963, shot up to 22,724 million won in 1966. Its composition ratio lo the national income rose from 1.9 percent in 1963 to 2.3 per cent in 1966. If the induced outcome is taken into account, the total forestry production which was estimated at 37,744 million won in 1963 picked up to 105,773 million won in 1966, about 4.5 times its direct income. It is further noted that the ratio of the gross forestry product to the gross national product. rose significantly from 8.8 percent in 1963 to 10.7 percent in 1966. E. In computing the above mentioned ratio not taken into consideration were such intangible, indirect effects as the drought and flood prevention, check of soil run-off, watershed and land conservation, improvement of the people's recreational and emotional living, and maintenance and increase in the national health and sanitation. F. In conclusion, I would like to emphasize that the forestry sector exercices an important effect upon the national economy and that the effect of induced forestry output is greater than its direct income.

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Overview of Utilization of Four-wheel Tractor in Korea(I) -Ownership and Annual Use by Different Farm Groups- (농용(農用)트랙터 이용(利用)에 관(關)한 조사연구(調査硏究)(I) -경영형태별(經營形態別) 농작업이용실태분석(農作業利用實態分析)-)

  • Park, Ho Seok;Kim, Kyong Su;Lee, Yong Kook;Han, Sung Kum
    • Journal of Biosystems Engineering
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    • v.6 no.2
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    • pp.20-32
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    • 1982
  • This survey was conducted to investigate the present status of farm tractor utilization for obtaining a basic reference to the establishment of the government's agricultural mechanization strategies. Thirty two counties from the eight provinces except Jeju were covered in this study. From these selected areas, 433 sample farms having farm tractor were taken to obtain the general informations by the enquete, and 93 sample farms among them to investigate the status of daily tractor use in the year of 1980. The analyzed results are summarized as follows: 1. Farm tractors owned by the rice-oriented farms holds 71.5 percent of the total number of tractors the livestock-oriented farms 17.0 percent, and the orchard-oriented farms 7.0 percent. Among the farm tractors 64.3 percent was a large size (46ps) and 35.7 percent a small size(19~23ps). 2. Most of the tractors surveyed were equipped with the essential attachments such as plow and rotavator. About 18 percent of the tractor owners had no trailer, which seemed too high considering the large percentage of tractor use for transportation. The availability of other attachments was very low except a grader on the rice-oriented farms and a hay harvester and a front loader on the livestock-oriented farms. 3. The average size of farm was 3.9 hectare for the rice-oriented farms, 13.9 hectare for the livestock-oriented farms and 7.4 hectare for the orchard-oriented farms. It was obious that the average farm size of was too small compared to the theoretical machine capacity of the tractors. 4. About 70 percent of the tractor operators were in the age of twenties and thirties. About 90 percent of them had an educational level of middle school graduate or above even though their technical level was very low. 5. Any particular problem in tractor use was not found in this survey. From the farmer's preference for purchasing a new tractor, however, it is estimated the demand on a 20-30ps tractor will be more increased. 6. The average annual use of tractor was of about 100 days or 400 hours. It appeared that the rice-oriented farms used most with 412.4 hours per year, and followed by the livestock-oriented farms with 403.6 hours, the orchard oriented farms with 377.7 hours. 7. Among the total hours of tractor use, 47.3 percent was for transportation, and 41.6 percent was for plowing and rotary tillage. The largest portion of the annual tractor use was taken by transportation on the livestock-oriented farms, by land preperation on the rice-oriented farms, and by loading and chemical spraying on the orchard-oriented farms. 8. The hours of tractor use had a peak in May. The hours of use for own farm was remarkably different among the different farm oriented, but there was no considerable difference between the too different sizes of tractor. 9. The hours of tractor use decreased as the age of the operator or the educational level increased. The reason might be that the operators who had a high educational level or were older had a tendency of disliking custom works. 10. The average custom use of tractor was 171.3 hours per year, and the ratio of custom work was 63.7 percent on the rice-oriented farms, 31.7 percent on the livestock-oriented farms and 22.4 percent on the orchard-oriented farms. Among the custom works, the most popular one was the grader leveling. 11. The charge on custom work was about 40,000 Won per hectare for plowing and rotary tillage, and it was the most expensive in the southeastern region, and next followed by the southwestern region. 12. The average plowing capacity of the small tractor was 7.8 hours per hectare in the paddy field, and that of the large tractors was 4.3 hours per hectare. The average rotary-tilling capacities of the small and the large tractors were 6.5 and 4.3 hours per hectare, in the paddy field respectively.

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A study of the plan dosimetic evaluation on the rectal cancer treatment (직장암 치료 시 치료계획에 따른 선량평가 연구)

  • Jeong, Hyun Hak;An, Beom Seok;Kim, Dae Il;Lee, Yang Hoon;Lee, Je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.171-178
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    • 2016
  • Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

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A study on the improvement of distribution system by overseas agricultural investment (해외농업투자에 따른 유통체계 개선방안에 관한 연구)

  • Sun, Il-Suck;Lee, Dong-Ok
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.17-26
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    • 2010
  • Recently concerns have been raised due to the unbalanced supply of crops: the price of crops has been unstable and at one point the price went up so high that the word Agflation(agriculture+ inflation) was coined. Korea, in particular, is a small-sized country and needs to secure the stable supply of crops by investing in the produce importation at a national level. Investment in foreign produce importation is becoming more important as a measure for sufficient supply of crops, limited supply of domestic crops, weakened farming conditions worldwide, as well as recent changes in the use of crops due to the development of bio-fuels, influence of carbon emission on crops, the price increase in crops, and influx of foreign hot money. However, there are many problems with investing in foreign produce importation: lack of support from the government; lack of farming information and technology; difficulty in securing the capital; no immediate pay-off from the investment and insufficient management. Although foreign produce is originally more price-competitive than domestic produce, it loses its competiveness in the process of importation (due to high tariffs) and poor distribution system, which makes it difficult to sell in Korea. Therefore, investment in foreign produce importation is being questioned for feasibility; to make it possible, foreign produce must maintain the price-competitiveness. Especially, harvest of agricultural products depends on natural and geographical conditions of each country and those products have indigenous properties, so distribution system according to import and export of agricultural products should be treated more carefully than that of other industries. Distribution costs are differentiated into each item and include cost of sorting and wrapping, cost of wrapping materials, cost of domestic transport, cost of international transport and cost of clearing customs for import and export. So transporting and storing agricultural products generates considerable costs compared with other products. Also, due to upgrade of dietary life, needs for stability, taste and visible quality toward food including agricultural products are being raised and wrong way of storage causes decomposition of food and loss of freshness, making the storage more difficult than that in room temperature, so storage and transport in distribution of agricultural products needs specialty. In addition, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. However, existing distribution system of agricultural products is exposed to various problems including problems in distribution channel, making distribution and strategy for distribution and those problems are as follows. First, in case of investment in overseas agricultural industry, stable supply of the products is difficult because areas of production are dispersed widely and influenced by outer factors due to including overseas distribution channels. Also, at the aspect of quality, standardization of products is difficult, distribution system is quite complicated and unreasonable due to long distribution channels according to international trade and financial and institutional support is not enough. Especially, there are quite a lot of ineffective factors including multi level distribution process, dramatic gap between production cost and customer's cost, lack of physical distribution facilities and difficulties in storage and transport due to lack of wrapping containers. Besides, because import and export of agricultural products has been manages under the company's own distribution according to transaction contract between manufacturers and exporting company, efficiency is low due to excessive investment in fixed costs and lack of specialty in dealing with agricultural products causes fall of value of products, showing the limit to lose price-competitiveness. Especially, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. Second, among tangible and intangible services which promote the efficiency of the whole distribution, a function building distribution environment which includes distribution information, system for standard and inspection, distribution finance, system for diversification of risks, education and training, distribution administration and tax system is wanted. In general, such a function building distribution environment is difficult to be changed and supplement innovatively because its effect compared with investment does not appear immediately despite of its necessity. Especially, in case of distribution of agricultural products, as a function of collecting and distributing is performed individually through various channels, the importance of distribution information and standardization is getting more focus due to the problem of repetition of work and lack of specialty. Also, efficient management of distribution is quite difficult due to lack of professionals in distribution, so support to professional education is needed. Third, though effort to keep self-sufficiency ratio of staple food, rice is regarded as important at the government level, level of dependency on overseas of others crops is high. Therefore, plan for stable securing food resources aside from staple food is also necessary. Especially, governmental organizations of agricultural products distribution in Korea are production-centered and have unreasonable structure whose function at the aspect of distribution and consumption is quite insufficient. And development of new distribution channels which can deal with changes in distribution environment and they do not achieve actual results of strategy for distribution due to non-positive strategy for price distribution. That is, it implies the possibility that base for supply will become vulnerable because it does not mediate appropriate interests on total distribution channels such as manufacturers, wholesale dealers and vendors by emphasizing consumer protection excessively in the distribution of agricultural products. Therefore, this study examined fundamental concept and actual situation for our investment to overseas agriculture, drew necessities, considerations, problems, etc. of overseas agricultural investment and suggested improvements at the level of distribution for price competitiveness of agricultural products cultivated in overseas under five aspects; government's indirect support, distribution's modernization and distribution information function's strengthening, government's political support for distribution facility, transportation route, load and unloading works' improvement, price competitiveness' securing, professional manpower's cultivation by education and training, etc. Here are some suggestions for foreign produce importation. First, the government should conduct a survey on the current distribution channels and analyze the situation to establish a measure for long-term development plans. By providing each agricultural area with a guideline for planning appropriate production of crops, the government can help farmers be ready for importation, and prevent them from producing same crops all at the same time. Government can sign an MOU with the foreign government and promote the importation so that the development of agricultural resources can be stable and steady. Second, the government can establish a strategy for an effective distribution system by providing farmers and agriculture-related workers with the distribution information such as price, production, demand, market structure and location, feature of each crop, and etc. In order for such distribution system to become feasible, the government needs to reconstruct the current distribution system, designate a public organization for providing distribution information and set the criteria for level of produce quality, trade units, and package units. Third, the government should provide financial support and a policy to seek an efficient distribution channel for foreign produce to be delivered fresh: the government should expand distribution facilities (for selecting, packaging, storing, and processing) and transportation vehicles while modernizing old facilities. There should be another policy to improve the efficiency of unloading, and to lower the cost of distribution. Fourth, it is necessary to enact a new law covering exceptional cases for importing produce in order to maintain the price competitiveness; currently the high tariffs is keeping the imported produce from being distributed domestically. However, the new adjustment should be made carefully within the WTO regulations since it can create a problem from giving preferential tariffs. The government can also simplify the distribution channels in order to reduce the cost in the distribution process. Fifth, the government should educate distributors to raise the efficiency and to modernize the distribution system. It is necessary to develop human resources by educating people regarding the foreign agricultural environment, the produce quality, management skills, and by introducing some successful cases in advanced countries.

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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.