• Radiation Oncology Journal
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• v.13 no.4
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• pp.369-375
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• 1995

Purpose : To evaluate the efficacy of hydroxyurea with radiation in carcinoma of the cervix, huge exophytic or endophytic stage IIA and IIb. Materials and Methods : Sixty four patients with carcinoma of the cervix stage IIA (29 patients) with exophytic ($\geq$3cm in diameter) or huge endophytic mass and IIB (35 patients) treated with radiation and hydroxyurea at the Department of Radiation Oncology, Dongsan Hospital, Keimyung University. School of Medicine from Aug, 1989 to May, 1991. The maximum and mean follow up durations were 68 and 57 months respectively. The radiation therapy consisted of external irradiation to the whole pelvis(3600-5400cGy) and boost parametrial doses (for a total of 4500-6300cGy) with midline shield ($4{\times}10$ cm), and combined with intracavitary irradiation (3000-3500 cGy to point A). Hydroxyurea was to be taken in a single oral dose of 1.0gm/day during radiation therapy. Results : The control rate was 89.1%. The actuarial overall five year survival rate was 78.8% for stage IIA and 72.8% for stageIIB. The overall recurrence rate was 25% (16/64). Tewnty-three percent of the patients developed leukopenia ($\geq$grade 3) and four percent of the patients developed grade 3 or greater thrombocytopenia. Grade 3 or greater GI, GU complication and anemia were not noted. There was no treatment related death noted. Conclusion : We considered that hydroxyurea and radiation therapy may improve survival rate in huge exophytic and endophytic stage IIa cervical carcinoma with acceptible morbidity.

• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.87-98
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• 1989

Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.120-123
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• 2001

Objectives : The present study was performed to analyze results of hydroxyurea treatment for unresectable and recurrent meningiomas as adjuvant chemotherapeutic agent. Material and Methods : Among 87 cases of meningioma patients who treated surgically between Jauary 1988 and December 1997 in our department, unresectable and recurrent cases were 4 cases. Histologically, 3 cases were meningothelial type, 1 case was angiomatous type. Tumor orgin was cerebellopontine angle(CPA) in 3 cases, cavernous sinus in 1 case. Three of 4 cases received radiation treatment. All patients received a daily dosage of 20mg/kg/day of hydroxyurea. Hematological monitorning was performed monthly and tumor measurement was assessed by MR imaging before treatment and every 6 months. Mean follow-up period was 34 months. Rerults : All cases showed no enlargement of tumor mass without any shrinkage. Trigeminal neuralgia in 1 case was improved and external herniation of brain on craniectomy site in 1 case was shrunken. None of the patients had any serious side effects. White blood cell count fell below $3000/{\mu}l$ in 1 case, but recovered 2 weeks later with cessation of medication. Conclusion : Hydroxyurea stopped cell growth by triggering the apoptotic cascade. Our preliminary data indicate that hydroxyurea provides adjuvant medical treatment in patients of unresectable and recurrent meningiomas

• Progress in Medical Physics
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• v.20 no.2
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• pp.112-118
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• 2009

The source position and source dwelling time in a given source arrangement in the applicators is very high effect to determine the expose time which in general is derived from the brachytherapy planning system. In high dose rate (HDR) intracavitary radiation therapy (ICRT), the treatment is often performed in based out-patient during the whole fractionation irradiations. However, the patient should be waited on coutch for ICR treatment in first start fraction as unconvinent and immobilized state until perform the dose plannings. In our experiments, the HDR source contributed dose for$55.89{\pm}4.20%$ for straight tandem source, $38.14{\pm}4.46%$ for the right ovoid soucre on the fornix and$5.97{\pm}0.50%$ for left ovoid source. It also showed the $60.33{\pm}6.53%$ for the tandem, $33.10{\pm}6.74%$ for right ovoid and $6.58{\pm}0.30%$ for the left ovoid source in 10 degrees of applicator. The authors designed the source template dose planning software for ICRT of uterine cervix results average $-0.55{\pm}2.15%$ discrepancy of the full charged brachytherapy dose planning. Developed Source temperate ICRT plaanning software guide a minimized the complains and operating times within a ${\pm}3%$ of dose discrepancies.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.85-92
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• 1997

Background : The standard treatment of recurrent, symptomatic malignant pleural effusion is intrapleural instillation of a chemical agent in an attempt to achieve a sterile inflammation and pleurodesis. There are many drugs used as pleural sclerosing agents, but the efficiency and side effects are different. The present study was undertaken to compare the commonly used drugs, doxycycline and bleomycin. Methods : Thirty-four patients with malignant pleural effusion who needed repeated thoracentesis were randomized to receive treatment with intrapleural instillation of doxycycline or bleomycin Fluid volumes before and after pleurodesis, drainge time, and side effects were analyzed, and the response to treatment was evaluated by clinical examination and chest radiography during admission in the hospital. Also median survival rime were evaluated according to the responses. Results : The response rate was higher in the patients receiving doxycycline than in those receiving bleomycin (87.5% vs 50.0%, p=0.02), and fever, nausea and vomiting were more common in the patients receiving bleomycin. The median survival time was significantly longer in the patients who responded to the sclerotherapy regardless of sclerosing agents. Conclusions : Chemical pleurodesis with doxycycline or bleomycin could reduce or stop pleural effusions and prolong the median survival rimes in these patients. Doxycycline appeared to be more efficient as sclerosing agent than bleomycin in the short-term follow-up periods. But a prospective study with a larger number of patients is warranted.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.9-14
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• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.95-101
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• 1985

From July 1979 through March 1985,112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-137. The treatment consisted of 3600rad-5200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-200rad per day. Parametrial boost with 400-800rad was given in 60 patients. 2 intracavitary Cs-137 radiation using TAO applicator were done with 7-10 days interval. Total treatment times were 40-65 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899ra0 with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. $9(8\%)$ had stage $14(12.5\%)$ had stage IIa, $50(44.6\%)$ had stage IIb, $33(29.5\%)$ had stage III, $6(5.4\%)$ had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were $61.8\%$ for the entire group, $84.6\%$ for stage Ib,$77.8\%$ for stage IIa, $56.7\%$ for stage IIb, $60\%$ for stage III, $33.3\%$ for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in $7/18(38.9\%)$ failure (=death) in contrast to 25/94 $(26.5\%)$ failure with dose over 8000rad. RT dose to lateral parametrium (point B) below 6000ra0 yielded 20/63 $(34.9\%)$ failure compared to $10/49(20.4\%)$ failure with dose over 6000rad. Poor survival group of age were between 40-49 years with failure of $14/41(34.1\%)$. There was no increased failure rate below age of 40 with failure of $2111(13.9\%)$. The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.41-49
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• 2011

Purpose: This study is designed to investigate radiotherapic valuation of Paraffin Wax, which is newly formed for this study and generally utilized in dentistry, and Mouth Piece and Putty impression, which are commonly used in radiotherapy, for oral cavity as a compensator. Materials and Methods: Each compensator was formed by $10{\times}10{\times}1cm$ and measured radiation dose attenuation ratio with reference of water phantom which is made of tissue-equivalent materials. Two patients with oral cancer underwent DRR (Digitally Reconstructed Radiogrph) of Offline Review Program of Aria System and Portal vision for 5 times for each material to evaluate reproducibility by each filling materials. Moreover, MU (monitor unit) changes by dose absorption were considered in the case of inevitable implication of an filling materials in the range for radiotherapy. Results: Radiation dose attenuation ratios were shown -0.7~+3.7% for Mouth Piece, +0.21~+0.39% for Paraffin Wax and -2.71~-1.76% for Putty impression. Error ranges of reproducibility of positions were measured ${\pm}3mm$ for Mouth Piece, ${\pm}2mm$ for Paraffin Wax and ${\pm}2mm$ mm for Putty impression. Difference of prescription MU from dose absorption with an filling material increased +7.8% (250 MU) in Putty impression and -0.9% (230 MU) in Paraffin Wax as converted into a percentage from the standard phantom, Water 232 MU. Conclusion: Dose reduction of boundary between cavity and tissue was observed for Mouth Piece. Mouth Piece also had low reproducibility of positions as it had no reflection of anatomy of oral cavity even though it was a proper material to separate Maxilla and Mandible during therapy. On the other hand, Putty impression was a suitable material to correctly re-position oral cavity as before. However, it risked normal tissues getting unnecessary over irradiation and it caused radiation dose decrease by -2.5% for 1cm volume in comparison of it of water phantom. Dose reduction in Paraffin Wax, Fat Tissue-Equivalent Material, was smaller than other impressions and position reproducibility of it was remarkable as it was possible to make an anatomy reflected impression. It was also well fitted to oral cavity to transfer radiation dose planned in radiotherapy. Thus, Paraffin Wax will be an ideal material in radiotherapy for patients with oral cancer.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.349-356
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• 1997

Purpose : To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb Materials and Materials : Fourty one patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University. School of Medicine from Jul, 1991 to Apr, 1994. According to FIGO s1aging system, therewere stage Ib (3 patients) IIa (6 patients) with exophytic ($\geq$5cm in dinmeter) and huge endophytic mass. and IIb (32 patients) with median age of 55 yeavs old. Radiation therapy consisted of hyperfractionated external irradition to the whole pelvis (120cGy/fraction, 2 fraction/day (minimum interval of 6 hours), 3600-5520cGy) and boost parametrial doses (for a total of 4480-6480cGy) with midline shield $(4\times10cm)$, and combined with intracavitary irradiation (up to 7480-8520cGy in Ib, IIa and 8480-9980cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively . Results : Five year local control rate was $78\%$ and the actuarial overall five year survival rate was $66.1\%$ for all patients, $44.4\%$ for stage Ib, IIa and $71.4\%$ for stage IIb. In bulky IIb (above 5cm in tumor size, 11 patients) five year local control rate and five rear survival rate was $88.9\%,\;73\%$ respectively Pelvic lymph node status (negative : $74\%,\;positive:25\%$, p=0.0015) was significant Prognostic factor affecting to five rear survival rate. There was marginally significant survival difference by total dose to A point ($>84Gy\;:\;70\%,\;>84Gy\;:\;42.8\%$, p=0.1). We consider that the difference of total dose to A point by stage (mean Ib,IIa : 79Gy. IIb 89Gy P=0.001) is one of the causes in worse local control and survival of Ib,IIa than IIb The overall recurrence rate was $39\%$ (16/41). The rates of local failure alone. distant failure alone. and combined local and distant failure were $9.7\%,\;19.5\%,\;and\;9.7\%$, respectively. Two Patients developed leukopenia ($\geq$ grade 3) and Three patients develoued grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. Conclusion : We thought that it may be necessary to increase A point dose to more than 85Gy in hyperfractionated radiotherapy of huge exophytic and endophvtic stage Ib,IIa. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.226-229
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• 1998

Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.