• Title/Summary/Keyword: 간종양

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Usability Assessment of Plan Transfer between TOMO HAD and Radixact : Planning Study (TOMO HDA와 Radixact 치료 계획 간 Transfer에 대한 유용성 평가 : Planning Study)

  • An, Ye Chan;Kim, Jong Sik;Kwon, Dong Yeol;Kim, Jin Man;Choi, Byeong Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.117-128
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    • 2018
  • Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

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Reconstruction of a Large Cricotracheal Defect Using a Sternocleidomastoid Myoperiosteal Flap : A Case of Locally Aggressive Papillary Thyroid Carcinoma with Tracheal Invasion (갑상선 수술 후 흉쇄유돌근 근골막피판을 이용한 큰 기도 결손부 재건 1예)

  • Kim, Sang Min;Kim, Mi Ra;Kim, Yong-Wan;Baek, Moo Jin;Park, Jun-Ook
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.1
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    • pp.18-21
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    • 2015
  • 기관을 침범한 갑상선 악성종양을 제거한 후에 성문하부에 비교적 큰 기관 결손이 발생할 수 있다. 단단문합술은 넓은 부위의 결손부를 재건하는 방법으로 널리 받아들여지고 있지만, 문합부 파열, 반회후두신경마비, 재협착 등의 합병증이 발생할 수 있다. 본 증례는 기도를 침범한 갑상선 유두암종을 제거한 후 윤상연골과 기관연골의 비교적 큰 결손부를 흉쇄유돌근 근골막피판을 사용하여 안전하게 재건한 사례이다. 55세 남자 환자가 기도를 침범한 갑상선 유두상암으로 내원하였으며 기도침범은 윤상연골(둘레의 약 30%)과 4개의 기관연골(둘레의 약 50%)을 해당하는 넓은 부위였다. 수술 전 기관절개술을 시행하여 주위 기관연골의 상태가 좋지 않아 단단문합술 시행 후 문합부 파열 가능성이 있다고 판단하여 흉쇄유돌근 근골막피판을 이용하여 재건하기로 계획하였다. 갑상선 절제술, 경부림프절 절제술, 흉쇄유돌근 근골막피판을 이용한 재건술을 시행하였으며 수술 후 12일째 별다른 문제없이 퇴원하였다. 환자는 수술 후 현재 22개월 간 기도 협착 등의 별다른 합병증 없이 지내고 있다. 흉쇄유돌근 근골막피판은 성문하부나 기관지 전외측벽의 비교적 큰 결손부를 재건하는 데 유용하게 사용될 수 있다.

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Microsurgical Resection of Schwannoma of the Brachial Plexus -A case report - (상완 신경총에 발생한 신경초종의 미세절제술 - 1예 보고 -)

  • Son Byung Chul;Cho Kyu Do;Jo Min Seop;Wang Young Pil;Cho Deog Gon
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.249-252
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    • 2005
  • Neurogenic tumors of the brachial plexus region are relatively rare. We report a recent experience of schwannoma of the right brachial plexus in the inferior trunk, which was successfully treated by microsurgical resection. A 38-year- old man presented a dysesthetic pain in the supraclavicular area and the right forearm of C6, 7 dermatome. Rubbery hard mass was palpated in the right supraclavicular area and magnetic resonance imaging showed a well circumscribed, well enhanced ovoid mass with cystic degeneration on the right brachial plexus portion. The patient underwent complete removal of the mass through the anterior cervicothoracic (modified Dartevelle) approach. At the postoperative 3 months, there is no neurologic deficit.

Clinical Comparison of Complications Between Cervical and Thoracic Esophagogastrostomy After Resection of Esophageal Cancer (식도암 절제술시 식도 위 문합 위치에 따른 조기 합병증의 비교)

  • 박상철;조중구;김공수
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.156-161
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    • 2001
  • 배경: 식도암의 절제술에 있어 식도 위 문합술은 중대한 합병증, 즉 문합부 누출, 양성협착, 종양의 재발 등을 유발한다. 수술 후 재원기간동안 환자가 느끼는 주관적인 증상과 합병증이 식도와 위장관의 문합부 위치에 따라 달라질 수 있으므로 서로간에 비교분석할 필요가 있겠다. 대상 및 방법: 1995년 1월부터 1999년 5월까지 식도암 근치술로 식도 위 문합술을 시행 받은 55명의 환자를 대상으로 문합위치에 따라 경부문합한 23명의 환자와 흉부문합을 한 32명의 환자를 비교 분석하였다. 절제술 후 AJCC분류에 따라 I기 5명, II기 27명, III기 23명으로 판정되었으며, 종양이 상흉부에 위치한 경우 3명, 중흉부 34명, 하흉부 18명이었다. 조직학적으로 55명의 환자 2명의 선암을 제외하고 53명이 편평상피세포암이었다. 55명 전원이 남자였으며 평균연령은 경부문합의 경우 59세였고, 흉부문합은 55세였다. 경부 문합의 경우 1명의 staple봉합을 제외하고 나머지 22명이 수봉합을 하였으며, 흉부문합술의 경우는 9명이 수봉합, 23명이 staple봉합을 하였다. 결과: 수술 후 사망자는 경부문합 1명, 흉부문합 2명이었다. 경부 문합환자의 경우 23명 중 15명에서 호흡기, 소화기등의 합병증 46례가 발생하였고, 흉부 문합환자의 경우 32명중 13명에서 합병증 37례가 발생하였다. 경부문합환자는 중등도 혹은 심한 연하곤란을 나타내는 경우가 11명에서 있었으며, 흉부문합환자는 2명에서 나타났다. 또한 수술 후 20일 이후까지 재원한 경우는 경부문합환자 18명, 흉부문합환자는 13명이었다. 결론: 식도암에서 식도 위 문합술의 경우 호흡기, 소화기, 감염등의 합병증이 발생하였으며, 특히 호흡기 합병증에 의한 사망률이 높았다. 문합부 누출은 staple봉합보다 수봉합에서, 흉부문합보다 경부문합에서 빈도가 높았다. 경부문합의 경우 문합부 누출률이 높고, 연하곤란을 많이 호소하며 재원기간이 의미있게 길었다.

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A Study on Measurements of Optical Absorption Coefficients of Biological tissue (생체조직의 광학적 흡수계수 측정에 관한 연구)

  • 임현수;김남중
    • Journal of Biomedical Engineering Research
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    • v.20 no.2
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    • pp.213-220
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    • 1999
  • In this study, we measured the absorption coefficient of the tissues of mouse (brain, heart, liver, muscle and tumor) and human brain (normal and tumor) in the wavelength between 500nm~900nm. The optical coefficient is a representative of the characteristics of the materials. So, we can characterize the biological tissue with the optical coefficients. Using the spectrograph monometer and PDA(Photo Diode Array), we experimented with quick-frozen sectioned specimens. Because the optical coefficient is concerned with the conformation and biochemical component of the biological tissue, we experimented as the wavelength between 500nm~900nm on the normal and tumor samples of the animal and human. For the mouse, there are distinctive differences of the absorption coefficients between normal tissues and tumor. The absorption coefficient of the normal tissue varies 0.1~0.2cm$^{-1}$ with wavelength. But, the absorption coefficient of the brain tumor is changed round about 0.4~0.5cm$^{-1}$ as the wavelength. The absorption coefficients we measured can be a useful implement to detect diseases.

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Control of X Chromosome Reactivation and Determination of the Ratio of Sex Chromosome to Autosome in Embryonal Carcinoma Cell-Somatic Cell Hybrids (배종양 세포와 체세포 간의 융합 세포에서 X 염색체 재활성화의 조절과 성염색체에 대한 상염색체 비율의 결정)

  • 이광호
    • The Korean Journal of Zoology
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    • v.39 no.1
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    • pp.75-88
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    • 1996
  • OTF9-63 (OTF9) and P19S1O1A1 (P19) embryonal carcinoma (EC) cells were examined for their ability to produce the readivation of inactive X chromosomes from somatic cells. They were hybridized with various somatic cells and resulting HATr EC-somatic cell clones were analysed for their morphology, chromosomal replication pafterns and expression proffies of X-linked and distantiy located genes, Hprt and Pgk-1. The results demonstrated that 0RF9 cells could reactivate the inactive X chromosome whereas P19 cells could not. In adition, EC-somatic cell hybrids tended to reduce the number of sex chromosomes in long-term culture, resulting m 1:2 ratio of sex chromosomes to autosomes The use of EC cell hybrids provides an experimental system for studying the mechanism(s) of the X-reactivatio that is initiated and maintained from meiotic prophase of oogenesis to early embryogenesis.

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치료중 실시간 모니터링을 위한 투과형 빔측정장치 개발

  • Kim, Jae-Hong;Swanepoel, M.W.;Dekock, E.A.;Park, Yeon-Su;Yang, Tae-Geon
    • Proceedings of the Korean Vacuum Society Conference
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    • 2010.08a
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    • pp.315-315
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    • 2010
  • 양성자 빔을 이용하여 두경부 암 치료를 South Africa의 iTHEMBA에서 시행하고 있다. 200 MeV의 양성자 빔라인으로부터 진공에서 대기로 인출하여 노즐을 통과하여 종양세포에 조사된다. 치료계획에 적합하게 빔에너지와 모양을 변환하고, 빔을 모니터링하는 기계적 장치들이 노즐에 구성된다. 빔라인에는 이온챔버, Steering Magnet, Multi-wire 이온챔버, Range trimmer plates, lead scattering plate, Double-wedge energy degrader, Multi-layer Faraday cup, Range modulator, Range monitor, occluding ring, Shielding collimators, Quadrant and monitor ionization chamber, Treatment collimator, 그리고 Wellhofer dosimetry tank로 구성되어 있다. 총길이는 6.6m이며 노즐 끝에서 환자의 isocenter 까지는 30cm 정도 아래에 위치한다. 상기의 배치를 갖는 시스템의 양성자 scattering system의 성능을 MCNPX v2.5.0 Monte Carlo simulation을 실시하였다. 또한 정확한 선량을 실시간으로 측정하는 방법인 투과형 검출기를 개발하여 치료와 빔 특성을 동시에 수행하는 기술개발연구가 보고되고 있다. 본 연구에서는 Multileaf Faraday Cup (MLPC) 검출기 설계구조와 데이터 측정방법에 관한 연구를 수행하고자 한다. 빔의 전송 방향으로 3개층의 $4{\times}4$ 배열의 구조로 48 channel의 전류값을 측정하여 입자빔의 분포를 실시간으로 관측하고, 측정된 전류는 ADC를 거쳐 치료계획에 의해 선택된 영역의 SOBP를 유지하도록 range modulation propeller를 조절하는 feed-back system을 갖춘 방사선치료빔 실시간 측정장치 개발에 관한 결과를 보고하고자 한다.

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Hepatitis B Virus Reactivation after Partial Hepatic Irradiation Alone: A Case Report (부분 간조사만을 시행받은 환자에서의 B형 간염바이러스의 재활성화: 증례보고)

  • Kim, Bo-Kyong
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.106-110
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    • 2010
  • Reactivation of the hepatitis B virus (HBV) is a well-recognized complication in patients with chronic HBV infection who receive cytotoxic or other immunosuppressive therapy. In cases of patients treated by radiotherapy however, only a few of such reports exist and most of these include the patients previously treated by chemotherapy or transarterial chemoembolization. The results of this study point to a case of a patient with reactivation of HBV after radiotherapy alone. This study shows the possibility of HBV reactivation by partial hepatic irradiation alone hence, special attention should be paid to patients with HBV disease.

Evaluation on Usefulness of Abdomen and Chest Motion Control Device (ABCHES) for the Tumor with a Large Respiratory Motion in Radiotherapy (호흡으로 인한 움직임이 큰 종양의 방사선치료 시 Abdomen and Chest Motion Control Device (ABCHES)의 유용성 평가)

  • Cho, Yoon-Jin;Jeon, Mi-Jin;Shin, Dong-Bong;Kim, Jong-Dae;Kim, Sei-Joon;Ha, Jin-Sook;Im, Jung-Ho;Lee, Ik-Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.85-93
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    • 2012
  • Purpose: It is essential to minimize the respiratory-induced motion of involved organs in the Tomotherapy for tumor located in the chest and abdominal region. However, the application of breathing control system to Tomotherapy is limited. This study was aimed to investigate the possible application of the ABCHES system and its efficacy as a means of breathing control in the tomotherapy treatment. Materials and Methods: Five subjects who were treated with a Hi-Art Tomotherapy system for lung, liver, gallbladder and pancreatic tumors. All patients undertook trained on two breathing methodes using an ABCHES, free breathing methode and shallow breathing methode. When the patients could carry out the breathing control, 4D-CT scan was a total of 10 4D tomographic images were acquired. A radiologist resident manually drew the tumor region, including surrounding nomal organs, on each of CT images at the inhalation phase, the exhalation phase and the 40% phase (mid-inhalation) and average CT image. Those CT images were then exported to the Tomotherapy planning station. Data exported from the Tomotherapy planning station was analyzed to quantify characteristics of dose-volume histograms and motion of tumors. Organ motions under free breathing and shallow breathing were examined six directions, respectively. Radiation exposure to the surrounding organs were also measured and compared. Results: Organ motion is in the six directions with more than a 5 mm displacement. A total of 12 Organ motions occurred during free breathing while organ motions decreased to 2 times during shallow breathing under the use of Abches. Based on the quantitative analysis of the dose-volume histograms shallow breathing showed lower resulting values, compared to free breathing, in every measure. That is, treatment volume, the dose of radiation to the tumor and two surrounding normal organs (mean doses), the volume of healthy tissue exposed to radiation were lower at the shallow breathing state. Conclusion: This study proposes that the use of ABCHES is effective for the Tomotherapy treatment as it makes shortness of breathing easy for patients. Respiratory-induced tumor motion is minimized, and radiation exposure to surrounding normal tissues is also reduced as a result.

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FDG Uptake and a Contrast Enhancement According to Histopathologic Types in Lung Cancers (폐암의 조직학적 분류에 따른 종양의 FDG 섭취와 CT 조영증강정도에 관한 연구)

  • Han, You-Mie;Choe, Jae-Gol;Kim, Young-Chul;Park, Eun-Kyung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.19-25
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    • 2009
  • Purpose: The aims of this study were to analyze correlation between the maximum standardized uptake value (SUVmax) of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) on positron emission computed tomography (PET-CT) scan and the degree of contrast enhancement on computed tomography (CT) scan in lung cancers, and to recognize the difference in SUVmax and CT enhancement between groups of different histopathologic subtypes. Materials and Methods: Our study included 53 patients of pathologically confirmed primary lung cancer, who were performed PET-CT and post-contrast chest CT. We calculated initial and delayed SUVmax (SUV1, SUV2), difference between SUV1 and SUV2 (SUVd), retention index (RI), and the degrees of CT contrast enhancement of lung cancers. We analyzed these variables for subtypes of lung cancers. Results: The values (mean$\pm$ standard deviation) were $8.3{\pm}4.4$ for SUV1, $10.7{\pm}5.7$ for SUV2, $2.4{\pm}1.6$ for SUVd, $30{\pm}14$ for RI and $47.1{\pm}14.8$ HU (Hounsfield Unit) for degree of CT contrast enhancement. The difference of SUV1 and degree of CT enhancement between subtypes was not meaningful. SUV1 showed positive correlations with SUVd (r=0.74, p<0,01) and tumor size (r=0.58, p<0.01), but no significant correlation with degree of CT enhancement (r=0.06, p=0.69). In 10 cases, there was discrepancy in the same mass between the area of highest FDG-uptake and the area of highest contrast enhancement. Conclusion: We suggest that FDG uptake in lung cancer does not have a positive linear correlation with degree of CT enhancement. And there is no significant difference in FDG uptake and degree of CT enhancement between different subtypes of lung cancers.