• Journal of Yeungnam Medical Science
• /
• v.10 no.2
• /
• pp.380-387
• /
• 1993

Local excision and axillary dissection followed by radiation therapy to the breast has been shown to achieve equivalent local control and survival as mastectomy in an prospective randomized trials. We analyzed 28 cases of early breast cancer in order to evaluate the therapeutic effects of conservative surgery and definitive radiotherapy in the management of early breast cancer as possible alternative of simple mastectomy, retrospectively. Obtained results were as follows : 1. Treatment related acute side reactions are more prominant in the case of chemoradiotherapy group than radiotherapy alone group. 2. There were no cases of primary, regional or systemic failures on the last follow up examination. 3. Cosmetic results after treatment were satisfactory in 26 cases out of 28 cases on the last follow up examination. 4. There were no demonstrable differences of tumor control and cosmetic results between the treatment groups. Although, these results suggested that definitive radiotherapy after local excision would be a possible and desirable alternative instead of total mastectomy in the management of early breast cancers, analyzed cases were too small and follow up period was too short to evaluate the therapeutic effect of primary radiotherapy after local excision, exactly.

• Radiation Oncology Journal
• /
• v.14 no.4
• /
• pp.323-332
• /
• 1996

Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.

• Radiation Oncology Journal
• /
• v.19 no.2
• /
• pp.142-145
• /
• 2001

Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.

• Progress in Medical Physics
• /
• v.24 no.1
• /
• pp.1-24
• /
• 2013

As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

• The Journal of the Korean bone and joint tumor society
• /
• v.20 no.1
• /
• pp.22-26
• /
• 2014

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.

• Journal of Korean Foot and Ankle Society
• /
• v.1 no.2
• /
• pp.75-80
• /
• 1997

Radiographs were made of the feet of one hundred and twenty four normal children who were ranged in age from 1 to 13 years. On lateral radiographs that were made with the feet in standing, the talo-first metatarsal, calcaneal pitch and calcaneo-fifth metatarsal angles and arch ratio were measured. Most of the children in this study revealed flattened feet in earlier ages and the mean values were changed with age up to normal range later in the early school ages. These data might provide one of the standard for assessment of the flatfoot in children. However, the diagnosis and treatment of the flatfoot should be based on clinical assessment and radiographic values should not determine clinical management even if the values are beyond the normal range.

• Journal of radiological science and technology
• /
• v.21 no.1
• /
• pp.29-34
• /
• 1998

The purpose of simple abdomen erect projection is to see the fluid level which indicates gastrointestinal ileus or free air due to perforation. we do not have to insist on low kVp technique in simple abdomen erect position as long as we can detect the fluid level and free air shadow. Therefore, the author tried to decrease patient dose by high kVp technique and to improve the image quality due to motion artifact by reduction of exposure time. [Methods] Experiment 1. * screen/film SRO1000/HRH * exposure factor : $140\;kvp{\pm}5\;kv$ with added filters, 200 mA, 0.01 sec * phantom : Acryles : 15.0 cm(equivalent to 17 cm body thickness) 17.5 cm(equivalent to 21 cm body thickness) 20.0 cm (equivalent to 25 cm body thickness) With the exposure factor for same film density($D=0.8{\pm}0.1$) and with the materials above, we tried to find out entrance skin dose and gonad dose for both male and female. Experiment 2. Burger's phantom radiography were checked to see whether there was any change of image quality according to the kVp and the added filters. Experiment 3. Using rotating meter(self made), we examined the motion artifact and the exposure time limitation. [Results and conculution] 1. Using high voltage technique of 140 kVp with added filter, Skin dose, testicle dose and ovary dose decrease to 89.3%, 47% and 71.4% respectively compare to 70 kVp technique, 2. No great changes of Burger's phantom image has detected as from 70 kVp to 140 kVp and the air hole size of Burger's phantom over 0.028 cc(Diameter 3 mm, hight 4 mm) can be distinghished. 3. 0.01 sec(1 pulse) exposure time is possible in the single phase full wave rectification that why we can quitely reduce the unsharness caused by patient's movement.

• Journal of the Korean Society of Radiology
• /
• v.15 no.5
• /
• pp.649-656
• /
• 2021

The purpose of this study was to evaluate the appropriateness of transverse cerebellar diameter and abdominal circumference (TCD/AC ratio) as variables to evaluate intrauterine growth restriction of the fetus. From April 2019 to March 2021, 784 pregnant women who underwent ultrasound as a regular checkup at I hospital were retrospectively analyzed using the transverse cerebellar diameter and abdominal circumference measurements. In simple regression analysis, transverse cerebellar diameter and abdominal circumference had an effect of 97.2% and 97.5% on gestational age (p<0.001). In addition, the percentile of the TCD/AC ratio for each gestational age group was calculated through frequency analysis, and the 95th percentile of intrauterine growth restriction prediction was 14.2. As a result, it is thought that the TCD/AC ratio can be used as a useful variable to evaluate the normal growth of the fetus and predict the IUGR.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.6
• /
• pp.491-497
• /
• 2021

Purpose: To investigate the prevalence of osteoporosis or osteopenia via dual-energy X-ray absorptiometry bone mineral density (DEXA BMD) in adult males who showed radiolucent lumbar vertebra on the plain radiographs. Materials and Methods: The DEXA BMD values of 98 adult males, who showed radiolucent vertebrae on plain X-rays, were compared with those of the control group (n=168) and osteoporosis-related fracture group (n=113) by statistical analysis. The World Health Organization (WHO) method (lower value between the mean lumbar and femur neck) and the Hansen's method (lowest lumbar vertebra) were used to determine osteoporosis. Results: The mean and standard deviation of the BMD value of each group was -1.4 (±1.2) in the suspicious group, -0.8 (±1.1) in the control group, and -2.4 (±1.0) in the fracture group, respectively; the difference was statistically significant. Using the WHO method, the prevalence ratio of osteoporosis was 17.3% in the suspicious group, 8.3% in the control group, and 45.1% in the fracture group, respectively. Osteopenia was observed in 40.8% of the suspicious group. Hansen's method (lowest lumbar vertebra) revealed the prevalence of osteoporosis in 30.6% of the suspicious group, 17.9% of the control group, and 62.0% of the fracture group. Conclusion: Approximately 17.3% of the suspicious group was diagnosed with osteoporosis, and 40.8% were osteopenic by a confirmative BMD study (WHO criteria) among the adult males showing apparent radiolucency on plain X-rays. The control group also showed an 8% prevalence of osteoporosis. These results suggest that males also are vulnerable to osteoporosis. Therefore, a BMD study should also be used for males, especially for the people showing lumbar vertebrae with radiolucent features.

• Journal of the Korean Arthroscopy Society
• /
• v.10 no.1
• /
• pp.53-60
• /
• 2006

Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.