• Title/Summary/Keyword: 골반방사선치료

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CLEIDOCRANIAL DYSPLASIA : A PRELIMINARY REPORT (쇄골 두개골 이골증)

  • Kim, Il-Kyu;Ha, Soo-Yong;Lee, Seong-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.69-76
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    • 1991
  • A 9-year old boy suffering from cleidocranial dysplasia associated with impacted 4 supernumerary teeth and unerupted all permanent teeth is presented with his mother. The pedigree showed autosomal dominant pattern of inheritance, and the raiographic features of them were very similar in clavicle, skull, vertebrae, peivis and extremities. Although almost of the skeleton was involved with this syndrome, they did not recognize any other problem but except dental problem. In mother, who was wearing removable partial dentures leaving 24 impacted teeth in her jaws, the radiographic abnormalities like cystic lesion were not detected. And in the son, who showed impacted 4 supernumerary and all permanent teeth, we have attempted surgical extraction of the supernumerary teeth and periodic surgical opening of the alveolar bone covering the permanent dentition to induce the eruption of permanent teeth at the proper position, Orthodontic treatment has also been combined to correct class III malocclusion state.

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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Postoperative Adjuvant Chemotherapy and Chemoradiation for Rectal Cancer (직장암의 근치적 절제술 후 보조 화학요법과 보조 화학방사선 병용요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Ik Jae;Kim Ik Yong;Sim Kwang Yong;Kim Dae Sung;Lee Jong Young
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.334-342
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    • 2002
  • Purpose : The aim of this study was to determine if postoperative adjuvant chemotherapy (CT) alone and concurrent chemoradiation (CCRT), following radical surgery, improved the disease free survival (DFS) and overall survival (OS) in rectal cancer AJCC stage II and III patients. Materials and Methods : A total of 144 patients with AJCC stage II and III rectal cancer who had had radical surgery between 1989 and 1999 were included in the study. Of these patients, 72 had been treated with postoperative CT, and the other 72 with postoperative CCRT. The chemotherapy regimen consisted of oral UFT on a daily basis for $1\~12$ months (median 12 months) or 5-FU ($500\;mg/m^2$ for 5 days) intravenous (IV) chemotherapy with 4 week intervals for $1\~18$ cycles (median 6 cycles). Radiation of 4,500 cGy was delivered to the surgical bed and regional pelvic lymph nodes area, followed by $540\~1,440\;cGy$ (median 540 cGy) boost to the surgical bed. The follow-up period ranged from 20 to 150 months, with a median of 44 months. Results : The 5-year OS was $60.9\%\;and\;68.9\%$ (p=0.0915), and the 5-year DFS was $56.1\%\;and\;63.8\%$ (p=0.3510) for postoperative CT and postoperative CCRT, respectively. In the stage nm patients, the 5-year OS was $71.1\%\;and\;92.2\%$, and the 5-year DFS was $57.3\%\;and\;85.4\%$ for postoperative CT and CCRT, respectively. The OS was significantly improved (p=0.0379) but the DFS was not with postoperative CCRT compared to the postoperative CT (p=0.1482). In the stage III patients, the 5-year OS was $52.0\%\;and\;55.0\%$, and the 5-year DFS was $47.8\%\;and\;49.8\%$ for postoperative CT and postoperative CCRT. There were no statistically significant differences between postoperative CT and CCRT (p=0.4280 and p=0.7891) in OS and DFS. The locoregional relapses were $16.7\%\;and\;12.5\%$ for postoperative CT and CCRT, respectively. The distant relapses were $25.0\%\;and\;26.4\%$ for postoperative CT and CCRT, respectively. Conclusion : These results showed that postoperative CCRT compared with CT alone improved OS in stage II patients. Although there was no statistical significance, the addition of postoperative RT to CT reduced locoregional relapses compared to CT alone.

Efficiency of Staging Work-Ups in the Evaluation of Carcinoma of the Uterine Cervix (자궁경부암에 있어서 병기결정을 위한 검사의 효용성)

  • Kim, Jae-Sung;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.271-276
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    • 1991
  • A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography (IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, $10.7\%$(49/456) and $5.3\%$(24/452) showed abnormality, respectively, but only $0.7\%$(3/413) did on sigmoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six ($5.1\%$) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows; none in stage IB (35), IIA (89) and IIIA (8), $7.9\%$(20/252) in stage IIB (14 patients to FIGO stage IIIB, 6 patients to FIGO stage IVA), and $4.8\%$(6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in $25.2\%$ (85/337) and paraaortic LN enlargement in $7.4\%$(25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in $65.6\%$ (442/674). When compared with endoscopic studeies, CT had much lower positive predictive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-uus may be increased without compromising the appropriate FIGO staging and treatment.

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Pretreatment Prognostic Factors in Carcinoma of the Uterine Cervix (자궁경부암에 있어서의 치료전 예후인자)

  • Ha Sung Whan;Oh Do Hoon;Kim Mi Sook;Shin Kyung Hwan;Kim Jae Sung;Lee Moo Song;Yoo Keun Young
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.387-395
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    • 1993
  • To identify pretreatment prognostic factors in carcinoma of the uterine cervix, a retrospective analysis was undertaken of 510 patients treated with curative radiation therapy in Seoul National University Hospital during the 7 year period, from March 1979 through December 1986. According to FIGO classification,35 patients were stage I B,89 were stage IIA, 232 were stage IIB,8 were stage IIIA, 134 were IIIB, and 12 were stage IVA. Five year locoregional control (LRC) rates in stage I B, II A, II B, IIIA, IIIB, and IVA were $79\%,78\%,70\%,58\%,51\%\;and\;27\%,$ respectively. Five year disease free survival (DFS) rates were $76\%,67\%,60\$,57\%,40\%,\;and\;25\%,$ respectively. Overall survival (OS) rates at five years were $82\%,72\%,67\%,67\%,51\%,\;and\;33\%,$ respectively. In univariate analyses, stage, age, initial hemoglobin level, type of histology, tumor size, and several CT findings including pelvic lymph node (LN) status, paraaortic lymph node (PAN) status, extent of parametrial invasion, bladder invasion, and rectal invasion were significant factors in terms of LRC. All these factors and elevation of BUN or creatinine were associated with DFS. In terms of overall survival, stage, initial hemoglobin level, type of histology, tumor size, elevation of BUN or creatinine, and five CT findings associated with LRC were prognostically significant. In multivariate analysis excluding CT findings, stage IV disease, non-squamous histology, and tumor size $\ge$4 cm were associated with poor LRC and DFS. Stage IV disease and tumor size significantly affected OS. in multivariate analysis including CT findings, histology, tumor size, and pelvic LN status on CT were uniformly significant in terms of LRC, DFS, and 05, PAN status on CT affected overall survival only.

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Evaluation of Ovary Dose for woman of Childbearing age Woman with Breast cancer in tomotherapy (가임기 여성의 유방암 토모치료 시 난소선량 평가비교)

  • Lee, Soo Hyeung;Park, Soo Yeun;Choi, Ji Min;Park, Ju Young;Kim, Jong Suk
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.337-343
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    • 2014
  • Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.

Analysis of Automatic Rigid Image-Registration on Tomotherapy (토모테라피의 자동영상정합 분석)

  • Kim, Young-Lock;Cho, Kwang Hwan;Jung, Jae-Hong;Jung, Joo-Young;Lim, Kwang Chae;Kim, Yong Ho;Moon, Seong Kwon;Bae, Sun Hyun;Min, Chul Kee;Kim, Eun Seog;Yeo, Seung-Gu;Suh, Tae Suk;Choe, Bo-Young;Min, Jung-Whan;Ahn, Jae Ouk
    • Journal of radiological science and technology
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    • v.37 no.1
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    • pp.37-47
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    • 2014
  • The purpose of this study was to analyze translational and rotational adjustments during automatic rigid image-registration by using different control parameters for a total of five groups on TomoTherapy (Accuray Inc, Sunnyvale, CA, USA). We selected a total of 50 patients and classified them in five groups (brain, head-and-neck, lung, abdomen and pelvic) and used a total of 500 megavoltage computed tomography (MVCT) image sets for the analysis. From this we calculated the overall mean value(M) for systematic and random errors after applying the different control parameters. After randomization of the patients into the five groups, we found that the overall mean value varied according to three techniques and resolutions. The deviation for the lung, abdomen and pelvic groups was approximately greater than the deviation for the brain and head-and-neck groups in all adjustments. Overall, using a "full-image" produces smaller deviations in the rotational adjustments. We found that rotational adjustment has deviations with distinctly different control parameters. We concluded that using a combination of the "full-image" technique and "standard" resolution will be helpful in assisting with patients' repositioning and in correcting for set-up errors prior to radiotherapy on TomoTherapy.

Extraskeletal Ewing's Sarcoma Arising in the Chest Wall (흉벽에 발생한 골외 Ewing's Sarcoma)

  • Kim, Hyung-Woo;Sohn, Hong-Ju;Joo, Mee;Kang, Yun-Kyung;Jeon, Woo-Ki;Lee, Hyuk-Pyo;Kim, Joo-In;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1158-1165
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    • 1997
  • Extraskeletal Ewing's sarcoma is a very rare tumor which was first reported by Angervall and Enzinger in 1975. The common sites of extraskeletal Ewing's sarcoma are bony structures of lower extremities, paravertebral region, and pelvis, but rarely chest wall. Microscopically, extraskeletal Ewing's sarcoma is indistinguishable from the Ewing's sarcoma of bone. We present here a case of extraskeletal Ewing's sarcoma of the left lateral chest wall in a 19-year-old male. Wide extirpation and postoperative combined chemotherapy were done, and we discuss the clinical picture, histopathology, therapeutic management, and prognosis with review of the literature.

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Secondary Chondroblastic Osteosarcoma from Polyostotic Fibrous Dysplasia Initially Misdiagnosed as Low Grade Chondrosarcoma Provoking Fallacy in Treatment Strategy (저 악성도 연골육종으로 악성 변화한 섬유성 이형성증으로 오진하여 치료방침의 오류가 발생한 연골 모세포형 골육종 - 증례 보고 -)

  • Lee, Seung-Jun;Koh, Jae-Soo;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.62-67
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    • 2008
  • Malignant degeneration of fibrous dysplasia is rare and involves transformation into osteosarcoma, fibrosarcoma and chondrosarcoma. The most frequent sites involved in malignant transformation were craniofacial bones, proximal femur, humerus, pelvis, tibia and scapula in a decreasing order of frequency. An 41-year-old man with a history of polyostotic fibrous dysplasia presented with increasing left arm pain. Plain radiograph showed expansile destructive lesion along the humeral shaft. As initial biopsy report was low grade chondrosarcoma, he underwent marginal resection. However, he developed local recurrence 7 month later and subsequent pathologic finding was chondroblastic osteosarcoma. We report one case of secondary chondroblastic osteosarcoma from polyostotic fibrous dysplasia initially misdiagnosed as low grade chondrosarcoma that caused fallacy in treatment strategy.

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Dose Distribution of Total Body Irradiation for Bone Marrow Transplantation in Leukemia (백혈병에서 골수이식을 위한 전신방사선조사시 선량분포 특성)

  • 김성규;김명세;신세원
    • Progress in Medical Physics
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    • v.7 no.2
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    • pp.47-55
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    • 1996
  • Total Body Irradiation(TBI) is one of the essential treatment modalities in bone marrow transplantation for leukemia and lymphoma. Various techniques and dose regimens were introduced with sevelal advantages and disadvantages. In TBI, lung block could reduce lung dose to 75% of original beam for decreasing lung dose with homogenous total body irradiation. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. When performed in total body irradiation, the problem obtain uniform dose distribution in brain, neck, lung, umbilicus, pelvis and leg. Authors compared to dose distribution with method 1 and method 2. The method 1 used compensating filters for homogeneous dose distribution(Minesota University Method). The method 2 used fixing frame made in aeryl developing authors. Results were following. 1. Method 1 was showed dose distribution from 95.6% to 100%, method 2 showed dose distribution from 95.4% to 100%. 2. Method 2 was showed different to 3.4% at skin region and midline in the brain. In the neck, showed different to 1.5%. In the umbilicus. showed different to 2.3%.

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