• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.409-423
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• 1998

Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

• Journal of the Korean Society of Costume
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• v.4
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• pp.87-114
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• 1981

A costume reveals the social characteristics of the era in which it is worn, thus we can say that the history of change of the costume is the history of change of the living culture of the era. Since the Three States era, the costume structure of this country had been affected by the costume system of the China's historical dynasties in the form of the grant therefrom because of geographical conditions, which affection was conspicuous for the bureaucrat class, particularly including but not limited to the Kings' familities. Such a grant of the costume for the bureaucrat class (i.e., official uniform) was first given by the Dang-dynasty at the age of Queen Jinduck, the 28th of the Shilla-dynasty. Since then, the costume for the bureaucrats had consecutively been affected as the ages had gone from the unified Shilla, to the Koryo and to the Yi-dynasty. As the full costumes officially used by government officials (generally called "Baek Gwan") in the Yidynasty, there existed Jo-bok, Gong-bok and Sang-bok. Of such official costumes, Gong-bok was worn at the time of conducting official affairs of the dynasty, making a respectful visit for the expression of thanks or meeting diplomatic missions of foreign countries. It appears no study was made yet with regard to the Gong-bok while the studies on the Jo-bok and the Sangbok were made. Therefore, this article is, by rendering a study and research on the styles of costumes of civil servants' stone images erected at the Kings' tombs of the Yi-dynasty, to help the persons concerned understand the Gong-bok, one of the official costume for Baek Kwan of that age and further purports to specifically identify the styles and changes of the Gong-bok, worn by Baek Gwan during the Yi-dynasty, consisting of the Bok-doo (a hat, four angled and two storied with flat top), Po (gown), Dae (belt), and Hol (small and thin plate which was officially held by the government officials in hand, showing the courtesy to and writing brief memorandums before the King) and Hwa (shoes). For that purpose, I investigated by actually visiting the tombs of the Kings of the Yi-dynasty including the Geonwon-neung, the tomb of the first King Tae-jo and the You-neung, the tomb of the 27th King Soon-jong as well as the tombs of the lawful wives and concubines of various Kings, totalling 29 tombs and made reference to relevant books and records. Pursuant. to this study, of the 29 Kings' tombs the costume styles of civil servants' stone images erected at the 26 Kings' tombs are those of Gong-bok for Baek-gwan of the Yi-dynasty wearing Bok-doo as a hat and Ban-ryeong or Dan-ryenog Po as a gown with Dae, holding Hol in hand and wearing shoes. Other than those of the 26 tombs, the costume styles of the Ryu-neung, the tomb of the Moon-jo who was the first son of 23rd King Soon-jo and given the King's title after he died and of the You-neung, the tomb of the 27th King Soon-jong are those of Jobok with Yang-gwan (a sort of hat having stripes erected, which is different from the Bok-doo), and that of the Hong-neung, the tomb of the 26th King Go-jong shows an exceptional one wearing Yang-gwan and Ban-ryeong Po ; these costume styles other than Gongbok remain as the subject for further study. Gong-bok which is the costume style of civil servants' stone images of most of the Kings' tombs had not been changed in its basic structure for about 500 years of the Yi-dynasty and Koryo categorized by the class of officials pursuant to the color of Po and materials of Dae and Hol. Summary of this costume style follows: (1) Gwan-mo (hat). The Gwan-mo style of civil servants' stone images of the 26 Kings' tombs, other than Ryu-neung, Hong-neung and You-neung which have Yang-gwan, out of the 29 Kings' tombs of the Yi-dynasty reveals the Bok-doo with four angled top, having fore-part and back-part divided. Back part of the Bok-doo is double the fore-part in height. The expression of the Gak (wings of the Bokdoo) varies: the Gyo-gak Bok-doo in that the Gaks, roundly arisen to the direction of the top, are clossed each other (tombs of the Kings Tae-jong), the downward style Jeon-gak Bok-doo in that soft Gaks are hanged on the shoulders (tombs of the Kings Joong-jong and Seong-jong) and another types of Jeon-gak Bok-doo having Gaks which arearisen steeply or roundly to the direction of top and the end of which are treated in a rounded or straight line form. At the lower edge one protrusive line distinctly reveals. Exceptionally, there reveals 11 Yang-gwan (gwan having 11 stripes erected) at the Ryu-neung of the King Moon-jo, 9 Yang-gwan at the Hong-neung of the King Go-jong and 11 Yang-gwan at the You-neung of the King Soon-jong; noting that the Yang-gwan of Baek Kwan, granted by the Myeong-dynasty of the China during the Yi-dynasty, was in the shape of 5 Yang-gwan for the first Poom (class) based on the principle of "Yideung Chaegang" (gradual degrading for secondary level), the above-mentioned Yang-gwans are very contrary to the principle and I do not touch such issue in this study, leaving for further study. (2) Po (gown). (a) Git (collar). Collar style of Po was the Ban-ryeong (round collar) having small neck-line in the early stage and was changed to the Dan-ryeong (round collar having deep neck-line) in the middle of the: dynasty. In the Dan-ryeong style of the middle era (shown at the tomb of the King Young-jo); a, thin line such as bias is shown around the internal side edge and the width of collar became wide a little. It is particularly noted that the Ryu-neung established in the middle stage and the You-neung in the later stage show civil servants in Jo-bok with the the Jikryeong (straight collar) Po and in case of the Hong-neung, the Hong-neung, the tomb of the King Go-jong, civil servants, although they wear Yang-gwan, are in the Ban-ryeong Po with Hoo-soo (back embroidery) and Dae and wear shoes as used in the Jo-bok style. As I could not make clear the theoretical basis of why the civil servants' costume styles revealed, at these tombs of the Kings are different from those of other tombs, I left this issue for further study. It is also noted that all the civil servants' stone images show the shape of triangled collar which is revealed over the Godae-git of Po. This triangled collar, I believe, would be the collar of the Cheomri which was worn in the middle of the Po and the underwear, (b) Sleeve. The sleeve was in the Gwan-soo (wide sleeve) style. having the width of over 100 centimeter from the early stage to the later stage arid in the Doo-ri sleeve style having the edge slightly rounded and we can recognize that it was the long sleeve in view of block fold shaped protrusive line, expressed on the arms. At the age of the King Young-jo, the sleeve-end became slightly narrow and as a result, the lower line of the sleeve were shaped curved. We can see another shape of narrow sleeve inside the wide sleeve-end, which should be the sleeve of the Cheom-ri worn under the Gong-bok. (c) Moo. The Moo revealed on the Po of civil servants' stone images at the age of the King Sook-jong' coming to the middle era. Initially the top of the Moo was expressed flat but the Moo was gradually changed to the triangled shape with the acute top. In certain cases, top or lower part of the Moo are not reveald because of wear and tear. (d) Yeomim. Yeomim (folding) of the Po was first expressed on civil servants' stone images of the Won-neung, the tomb of the King Young-jo and we can seemore delicate expression of the Yeomim and Goreum (stripe folding and fixing the lapel of the Po) at the tomb of the Jeongseong-wanghoo, the wife of the King Young-jo, At the age of the King Soon-jo, we can see the shape of Goreum similar to a string rather than the Goreum and the upper part of the Goreum which fixes Yeomim was expressed on the right sleeve. (3) Dae. Dae fixed on the Po was placed half of the length of Po from the shoulders in the early stage. Thereafter, at the age of the King Hyeon-jong it was shown on the slightly upper part. placed around one third of the length of Po. With regard to the design of Dae, all the civil servants' stone images of the Kings' tombs other than those of the Geonwon-neung of the King Tae-jo show single or double protrusive line expressed at the edge of Dae and in the middle of such lines, cloud pattern, dangcho (a grass) pattern, chrysanthemum pattern or other various types of flowery patterns were designed. Remaining portion of the waist Dae was hanged up on the back, which was initially expressed as directed from the left to the right but thereafter expressed. without orderly fashion,. to the direction of the left from the right and vice versa, Dae was in the shape of Yaja Dae. In this regard, an issue of when or where such a disorderly fashion of the direction of the remaining portion of waist Dae was originated is also presented to be clarified. In case of the Ryuneung, Hong-neung and You-neung which have civil servants' stone images wearing exceptional costume (Jo-bok), waist Dae of the Ryu-neung and Hong-neung are designed in the mixture of dual cranes pattern, cosecutive beaded pattern and chrvsenthemum pattern and that of You-neung is designed in cloud pattern. (4) Hol. Although materials of the Hol held in hand of civil servants' stone images are not identifiable, those should be the ivory Hol as all the Baek Gwan's erected as stone images should be high class officials. In the styles, no significant changes were found, however the Hol's expressed on civil servants' stone images of the Yi-dynasty were shaped in round top and angled bottom or round top and bottom. Parcicularly, at the age of the King Young-jo the Hol was expressed in the peculiar type with four angles all cut off. (5) Hwa (shoes). As the shoes expressed on civil servants' stone images are covered with the lower edges of the Po, the styles thereof are not exactly identifiable. However, reading the statement "black leather shoes for the first class (1 Poom) to ninth class (9 Poom)," recorded in the Gyeongkook Daejon, we can believe that the shoes were worn. As the age went on, the front tips of the shoes were soared and particularly, at the Hong-neung of the King Go-jong the shoes were obviously expressed with modern sense as the country were civilized.