• Radiation Oncology Journal
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• v.18 no.1
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• pp.32-39
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• 2000

Purpose :The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose Rate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The purpose of this report is to evaluate the effects of the High dose rate (HDR) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. : From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 71 patients were treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in stage III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40$\~$46Gy (median 48 Gy). And LDR Radium intracavitary irradiation was peformed with Henschke applicator, 22$\~$59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage 1, 38 in stage II and 17 in stage III. The total dose of external radiation was 40$\~$61 Gy(median 45 Gy), daily 1.8$\~$2.0 Gy. HDR Co-60 intracavitary irradiation was peformed with RALS (Remote Afterloading System), 30 $\~$ 57 Gy(median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. Conclusion : The 5-year overall survival rate in LDR Group was 72.9$\%$, 61.9$\%$, 45.0$\%$ in stage I, II, III, respectively and corresponding figures for HDR were 87.1$\%$, 58.3$\%$, 41.2$\%$, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in adenocarcinoma of the uterine cervix. There was 11$\%$ of late complication rates in LDR Group and 27$\%$ in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group(16.7$\%$ vs. 31.6$\%$ in stage II, 11.1$\%$ vs. 35.3$\%$ In stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. Conclusion : There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group It was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.17-25
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• 2000

Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

• 한국해양학회지
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• v.30 no.4
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• pp.279-287
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• 1995

The vertical profiles of natural ²¹⁰Pb, ²¹⁰Po and ²³⁴Th activities were measured for the upper 100 m of water column at three stations in the middle region of the Korean East Sea during May 1992. And the distribution of these radionuclides was discussed associated with the formation of warm eddy or water mass. The main thermocline was maintained between the depth of 50 and 100 m at the southern station (Sta. A1), and between the depth of 10 to 50 m at the coastal station of Sockcho (Sta. B10). Contrastingly, a main thermocline at Sta. A10, which locates near the center of warm eddy, was observed below 230 m depth. Between 50 and 220 m depth of Sta. A10 is there a relatively homogeneous water mass of 10.1${\pm}$0.5$^{\circ}C$, which is significantly higher in temperature and lower in nutrient than the other two stations. It seems to be due to sinking of the warm surface water in which nutrients were completely consumed. Both ²¹⁰Pb and ²¹⁰Po show the highest concentration at Sta. A1 and the lowest at Sta. B10 among the three stations. Also, the ²¹⁰Pb activity is generally higher in the upper layer than in the lower layer, while ²¹⁰Po activity represents the reversed pattern at all three stations. At Sta. A1 and Sta. B10, the activities of ²¹⁰Po relative to its parent ²¹⁰Pb were deficient in the water column above the main thermocline, but were excess below the thermocline. However, the station near the center of warm eddy(Sta. A10), shows no excess of ²¹⁰Po in the depths below 50 m, although its defficiency is found in the upper layer like the other stations. At Sta. A1 and b10. ²³⁴Th activities are slightly lower in the surface mixed layer than in the deeper region However, at Sta. A10, ²³⁴Th activity in the upper 30 m is higher than below 50 m or in the same depth of the other stations, probably because of the high concentration of particulate matter. The residence time of ²¹⁰Po in the surface mixed layer at Sta. A10 is 0.4 year, much shorter than at the other two stations(about one year). Above 100 m depth, the residence times of ²³⁴Th range from 18 to 30 other two stations(about on year). Above 100 m depth, the residence times of ²³⁴Th range from 18 to 30 days at all stations, without significant regional variation. The percentages of recycled ²¹⁰Po within the thermocline are 39% and 92% at Sta. A1 and Sta. B10, respectively. Much higher value at Sta. B10 may be due to a thin thickness of the mixed layer as well as the slower recycling rate of ²¹⁰Po in the main thermocline.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.5 no.1
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• pp.37-46
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• 2000

We investigated the temporal and spatial variations in heterotrophic dinoflagellates (hereafter HTD) and ciliates from June to September 1997 in the waters off Kohung, Korea where red tides dominated by harmful dinoflagellates had occurred from August to October since 1995. We took water samples five times from 5-7 depths at 3 stations in this study period. A total of 17 HTD species were present and of these species in the genus Protoperidinium were 11. The species number of tintinnids (hereafter TIN) present totalled 15 and several naked ciliate (hereafter NC) species were observed. The species numbers of HTD and TIN rapidly increased between August 1st and 21st and then reached to the maximum numbers of 13 and 10, respectively, on August 27 when red tides dominated by Gyrodinium impudicum were first observed in the study area. However the species numbers drastically decreased on September 22. The maximum densities of HTD, TIN, and NC were 45, 39, 57 cells $ml^{-1}$, respectively. ADAS, calculated by averaging the densities of a certain species in the all samples collected from all depths and stations at a sampling period, most increased between August 1st and 21st and then reached to the maximum density of f cells $ml^{-1}$ on August 27 for HTD, while did between August 21st and 27th and up to 7 cells $ml^{-1}$ for TIN. Unlike ADAS of HTD and TIN, that of NC did not change much with the maximum of 8 cells $ml^{-1}$ on August 27th. The pattern of the temperal variation in the species number and ADAS of HTD was similar to that of diatoms and the distributions of Protoperidinium spp. and diatoms had a strong positive correlation. This evidence suggests that HTD, in particular Protoperidinium spp. be a grazer on diatom. In general, the densities of HTD, TIN, and NC decreased with going to stations located in the outer bay. Therefore, the availability of suitable prey and distance from the coastal line might be responsible for the distribution of HTD, TIN, and NC. The results of the present study provide a basis for further experiments for the feeding by dominant HTD, TIN, and NC on dominant phytoplankton including red tide species and for understanding food webs in the planktonic community before, during, and after the red tide outbreak.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.133-143
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• 1996

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

• The Korean Journal of Nuclear Medicine
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• v.38 no.4
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• pp.325-329
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• 2004

Purpose: Usefulness of mouse liver S9 fraction was evaluated for the measurement of the metabolites in the in vitro metabolism study of $^{18}F$-labeled radiotracers. Materials and Methods: Mouse liver S9 fraction was isolated at au early step in the course of microsome preparation. The in vitro metabolism studies were tarried out by incubating a mixture containing the radiotracer, S9 fraction and NADPH at $37^{\ciirc}C$, and an aliquot of the mixture was analyzed at the indicated time points by radio-TLC. Metabolic defluorination was further confirmed by the incubation with calcium phosphate, a bone mimic. Results: The radiotracer $[^{18}F]1$ underwent metabolic defluorination within 15 min, which was consistent with the results of the in vivo method and the in vitro method using microsome. Radiotracer $[^{18}F]2$ was metabolized to three metabolites including $4-[^{18}F]fluorobenzoic$ acid within 60 min. It is likely that the one of these metabolites at the origin of radio-TLC was identical with the one that obtained from the in vivo and in vitro (microsome) method. Compared with the in vitro method using microsome, the method using S9 fraction gave a similar pattern of the metabolites but with a different ratio, which can be explained by the presence of cytosol in the S9 fraction. Conclusion: These results suggest that the findings of the in vitro metabolism studies using S9 fraction can reflect the in vivo metabolism of novel radiotracers in the liver. Moreover, this method can be used as a tool to determine metabolic defluorination along with calcium phosphate absorption method.

• Korean Journal of Poultry Science
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• v.18 no.2
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• pp.97-119
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• 1991

Effect of Streptococcus faecium(SF) and an antibiotic, Colistin(Col), supplemented to diets singly or in combination, on the performances and changes of intestinal population of microflora of broiler chicks studied. A total of 252, day-old chicks(Arbor Acre) of mixed sex(M：F＝1：1) were alloted into six groups. A diet with no Col and SF was referred as a control diet. The basal diets were added with two levels of SF, 0.04 and 0.08%, singly or in combination with Col 10ppm Another diet was prepared by adding only Col 10 ppm. Numbers of the microorganism in diets added with SF 0.04% and 0.08% were 7$\times$10$^{4}$ and 1.4$\times$10$^{5}$ /g diet respectively The diets consisting of corn and soybean meal as major ingredients were fed for a period of seven weeks . During the feeding trial, fresh excreta were sampled at the end of every week in a sterilized condition to count microbial changes from each dietary group. Microbial changes of large intestine were also measured from nine birds sacrificed at the end of the 4th and 7th weeks each time per dietary group. Excreta from all the groups were also collected quantitatively at the end of 3rd and 6th weeks to measure digestibility of the diets, At the end of 7th week, nine birds from each group were also sacrificed to measure weight changes of gastrointestinal tracts . Average body weight gains of broilers fed the diets added with SF 0.08% (2.37kg) or SF 0. 08%+col 10ppm(2.34kg) were significantly larger than that of the control(2.18kg). The weight gains of the other groups were not statistically different from that of the control Feed/gain ratios of the supplemental groups were better than that of control (P＜0.05) except that of birds fed the diet added only with SF 0.04%. Digestibilities of nutrients such as dry matter, crude protein, crude fat and total carbohydrates were not altered by the consumption of the diets added with SF and/or Col throughout the whole feeding period. As expected, the numbers of Streptococci in the excreta from birds fed diets added with SF increased significantly with a statistical difference between groups with SF 0.04% and SF 0.08% most of the time. However. addition of Colistin to the diets supplemented with SF did not give any effects on the number of the microorganism. Numbers of coliforms in the excreta were apparently reduced by feeding the diets added with SF and/or Col(P＜0.05). There were, however, no additive effects observed between the two feed additives in this regard when supplementing Col to the SF diets. Distributions of intestinal microflora exhibited exactly the same pattern as those of the excreta. Length of small intestine of the birds fed diets added with SF 0.08% with or without Col 10 ppm became significantly longer with a range of about 10% than those of the birds fed diets without SF. However, the empty weight of the small inestine of the former group was lighter than that of control These changes resulted in a significant reduction in weight/unit length of the intestine of the birds fed diets supplemented with Col and SF singly or in combination. In overall conclusion, diet added with SF 0.08% appeared most effective in improving broiler performances. Colistin added at a level of 10ppm was not beneficial at all in itself or in combination with SF in terms of broiler performances or changes of intestinal microflora population. The efficacy of SF and Col could be attributed to the changes of wall thickness of the small intestine.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.359-368
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• 1995

Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.195-202
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• 1999

Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.76-81
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• 2014

Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.