• Title/Summary/Keyword: 단순 방사선

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Postmastectomy Radiotherapy and Chemotherapy in Patients with Breast Cancer (유방절제술을 시행한 유방암 환자에서 방사선과 항암제 치료성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nam Taek-Keun;Nah Byung-Sik;Song Ju-Young;park Seung-Jin
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.17-24
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    • 2004
  • Purpose: To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. Materials and Methods: The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989 and 1995. The median age was 46 years (range, 23-77): Seventy-seven patients had modified radical mastectomies, 5 radical mastectomies and 1 simple mastectomy. Three patients ($4\%$) had pathologically negative axillae, and the remaining 80 ($96\%$) had positive axillae. Eleven, 23, 44 and 5 patients had pathological stages IIA, IIB, IIIA, and IIIB, retrospectively. Eighty ($96\%$) patients were treated with hockey-stick fields. The median dose of PMRT was 50.4 ey, in 1.8 Gy fractions. Adjuvant systemic chemotherapy was given to 74 patients ($89\%$). CMF-based or doxorubicin-containing regimens were given to 54 patients ($55\%$). The median follow-up time was 82 months (range, 8-171) after the mastectomy. Results: The 5 and 10-year overall survival rates for all patients were 65 and $49\%$, respectively. The univariate and multivariate analyses of the factors affecting the overall survival revealed the stage to be the most significant prognostic factor (p=0.002), followed by the combination of chemotherapy. Thirteen patients $16\%$ developed a LRF, at an interval of 4-84 months after radiotherapy, with a median of 20 months. The only significant prognostic factor affecting LRF was the combination of chemotherapy, in both the univariate and multivariate analyses. With respect to the sequence of chemoradiation, the sequence had no saatistical significance (p=0.90). According to the time interval from mastectomy to the onset of radiotherapy, the LRFR of the patients group treated by RT within or after 6 month postmastectomy 6 months were 14 vs. $27\%$ respectively (p=0.24). One third of the pa41en1s (26/83) developed distant metastasis, in 2-92 months, after radiotherapy, with a median of 21 months. The most commonly involved site was bone in 13 cases. The pathological staging was the only significant prognostic factor in both the univariate and multivariate analyses that affected distant failure. Radiological finding of radiation pneumonitis on a simple chest x-ray was shown in $20\%$ (17/83), with a time interval ranging from 2 to 7 months post-radiotherapy, with a median of 3 months. The stable lung fibrosis settled in 11 patients ($65\%$). Conclusion: It was concluded through this analysis that the combination of PMRT with in chemotherapy resulted in better overall survival and local control than PMRT alone in patients needing PMRT.

Shielding Effect according to the Direction of Control Room Door Opening during Radiography (방사선촬영 중 제어실 문의 열린 방향에 따른 차폐효과)

  • Choi, Weon-Keun;Kim, Jung-Hoon;Kang, Bo-Sun;Bae, Seok-Hwan;Lim, Chang-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3347-3352
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    • 2010
  • It is recommended that the door of control room is closed during radiography to protect a radiologic technologist. However, for those patients such as of emergency or pediatrics, the door must be kept open unavoidably to apply immediate medical administration and treatment on the potential case of emergency which could be happened through the course of radiography. In addition, it could be efficient by reducing patients waiting time when the door is open for a general case. This study was conducted to evaluate practical exposure rate to a radiologic technologist when the door is open during the radiography, and to find out the ways to minimize radiation exposure and to increase the efficiency simultaneously. Measuring practical exposure rate was fulfilled with glass dosimeter, and it was 2.02 mGy/week at the location of radiologic technologist under the condition that the door is open during the radiography, which was about 2.3 times higher than the 100 mR/week. It means that the considerable amount of scattered rays through the door opening, and increase exposure rate at the radiologic technologist. Hence we confirmed that a radiologic technologist probably overexposed if the door is open during the radiography. It was also confirmed by the Monte Carlo simulation that the exposure rate could be reduced up to approximately 1/100 by change only the door opening direction. In conclusion, since the proper door opening direction provides same shielding effect whether it is open or close, the door opening direction need to be considered when it is installed at radiography facilities.

Definitive Radiotherapy of Non-Small Cell Lung Cancer (비소세포 폐암의 근치적 방사선치료)

  • Lee, Jong-Young;Park, Kyung-Ran
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.303-309
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    • 1995
  • Purpose : The effect of dose escalation of up to 6500 cGy on local control and survial was investigated in locally advanced non-small cell lung cancer. Materials and Methods: Ninety eight patients with biopsy-proven unresec-table non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radio-therapy alone. Group A was treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy; and group B was treated with 6500 cGy of same daily fractions. Results : The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B). Conclusion : Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered.

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Change of Morphologic Pelvis and Deviation According to Gender, Age -Radiological Pelvimetry- (성별과 나이에 따른 골반 형태 변화와 골반 변위 -방사선영상을 이용한 골반 계측-)

  • Kang, Yeong-Han;Kim, Seon-Chil
    • Journal of radiological science and technology
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    • v.34 no.2
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    • pp.91-96
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    • 2011
  • The purpose of this study was to analyze the change of morphologic pelvis according to age and gender. Pelvis AP(anterior-posterior) projection were taken from 382 individuals (men: 194, women: 188) at the age of twenty and older. We measured four values of pelvis using CR (computed radiological system) including maximum pelvic breadth (MPB), sacral breadth (SB), transverse diameter of pelvic inlet (TD), and distance between femoral heads (DFH). Average (t-test, ANOVA) and Pearson correlation were calculated for comparison. While there was no significant difference of gender in case of MPB, significant differences were observed in SB (men 97.76 mm, women 102.00 mm), TD (men 138.0 mm, women 149.79 mm), and DFH (men 141.94 mm, women 150.39 mm). The DFH values were negatively correlated with the age (men r=-0.280, women r=-0.207). The morphological changes of pelvis were measured high in the men of 50's and in the women of 60's and 70's. The SB, TD and DFH were greater in the women than in the man. As the ages get higher, the deviation of pelvis were gradually increased, which indicates that the morphological changes of pelvis with respect to the age reflects an aging process.

Infiltrating Intramuscular Lipoma (침윤성 근육내 지방종)

  • Suh, Jeung-Tak;Kim, Jeung-Il;Cheon, Sang-Jin;Lee, Choon-Key;Ku, Ja-Gyung;Kim, Young-Goun
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.40-45
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    • 2005
  • Purpose: To suggest an accurate diagnosis and treatment of infiltrating intramuscular lipoma by analysis of the clinical, biological, radiological and pathological features. Materials & Methods: 20 patients who treated at our hospital for infiltrating intramuscular lipoma from 1998. to 2001 were selected for this study. Mean age was 45.8 years old. Four were male and eight female. All cases were checked preoperative radiographs, MRI and diagnosed by biopsy. The methods of surgical treatment included excision of tumor and peripheral tissue. We assessed the recurrence by follow up. Results: Tumors located in upper limbs 5 cases, lower limbs 3 cases, abdomen 3 cases, gluteal region 1 case. In preoperative radiographs, infiltrating intramuscular type were 7 cases. In 11 cases, tumors were completely excied with peripheral tissue. 1 cases was incompletely excised because it was very huge mass and infiltrated lung. Encapsulated tumors were 3cases and uncapsulated tumors 9 cases. There were no recurrence excepts 1 case that was infiltrated lung. Conclusion: Infiltrating intramuscular lipoma was wrongly diagnosed as well differentiated liposarcoma. To increase the rate of correct diagnosis, preoperative radiographs, MRI and pathologic diagnosis were performed. Careful wide excision is necessary to prevent the recurrence.

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Results of Concurrent Chemoradiotherapy and Intraluminal Brachytherapy in Esophageal Carcinoma - Retrospective Analysis with Respect to Survival - (식도암에서 동시 항암화학방사선요법과 관내근접치료의 결과 -생존율을 중심으로 한 후향적 분석-)

  • Nam Taek-Keun;Nah Byung-Sik;Chung Woong-Ki;Ahn Sung-Ja;Song Ju-Young
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.25-32
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    • 2004
  • Purpose : Evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival. Materials and Methods : From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was peformed using 6 or 10 MV X-rays, with a dose range of $46.8~\69.6$ Gy (median; 59.4). The ILB was peformed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin $(75\;mg/m^2)$ was given on each first day of weeks 1, 5, 9 and 13, and 5-FU $(1,000\;mg/m^2)$ as a continuous infusion for the first 4 days of each course. Results : The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and $20.7\%$, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and $27.3\%$, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and $0\%$, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis. Conclusion : This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.

A Study on the Penetration of Dexamethasone into Oral Mucosa with the Use of Iontophoresis (이온영동법에 의한 Dexamethasone의 구강점막에의 침투에 관한 연구)

  • Sung-Woo Lee;Young-Ku Kim;Hong-Seop Kho
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.9-23
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    • 1991
  • 이온 영동법은 전기력의 도움으로 이온화된 물질의 신체조직내 침투를 증가시키는 술식으로서 전신적 부작용은 줄어드는 반면, 국소부위의 약물농도를 증가시킬 수 있다는 장점 때문에 효과적인 국소요법으로 인정받고 있다. 치의학 분야에서는 과민상아질의 치료를 위해 불소 이온영동법이 빈번히 이용되어져 왔으며, 국소마취제나 항바이러스 제재의 도포시에도이용되었다.또,이온 영동법에 의한 스테로이드 투여로 피부나 구강점막의 염증성 질환의 효과적 치료를 보고한 많은 문헌이 있으나, 이온영동법에 의한 스테로이드의 구강점막에의 침투량이나 분포에 관해서는 거의 소개된 바가 없는 실정이다. 본 연구는 방사선 동위원소가 부착된 dexamethasone을 이온영동법을 이용하여 가토의 협점막에 침투시킨후 자기방사선 술식에 의해 그 침투량과 분포를 대조군과 비교 평가하였으며 다음과 같은 결과를 얻었다. 1. 이온영동법은 단순 국소도포에 비해 dexamethasone과 0.1M 인산소다 완충용액의 혼합액(dexamethasone in 0.1M sodium phosphate buffer solution)의 가토 협점막 침투량을 증가시켰으며, 양극을 사용하였을 때 더 효과적이었다. 2. Dexamethasone과 0.1M 인산소다 완충용액의 혼합액 투여 4시가, 24시간후 까지도 양극 잉온영동법이 효과적이었으며 은입자의 감소는 투여 4시간부터 24시간 후 사이에 주로 일어났다. 3. 인산소다 완충용액의 첨가는 양극 및 음극에 의한 이온영동법 모두에 효과적이었으며, 양극에 가장 효과적이었고 단순도포군에는 영향을 미치지 않았다. 4. 이온영동법에 의한 스테로이드 투여는 피부뿐만 아니라구강점막 염증성 병소의 효과적 치료술식으로 여거질 수 있다. 시와 maximal clenching시 사이의 치아 접촉시간에서도 유의한 상관관계를 보였다.

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Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report- (골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Kim, Jeong-Cheol
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.242-247
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    • 2011
  • Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.

Solitary Fibrous Tumor of the Diaphragmatic Pleura (횡격흉막에서 발생한 고립성 섬유성 종양)

  • Lee, Chul-Burm;Lim, Hyoun-Soo;Jee, Heng-Ok;Park, Choong-Ki;Park, Yong-Wook;Kim, Hyuck;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.568-572
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    • 2002
  • We present a case of a 47-year-old woman with benign solitary fibrous tumor of the pleura originated in the diaphragm which was discovered incidentally on a chest radiograph. Chest radiograph, sonograph, computed tomographic scan and magnetic resonance image studies proved a well circumscribed and lobulated fibrous tumor of the pleura. During the subsequent right thoracotomy, the tumor was found to be encapsulated and consisted of firm mass. It was connected to the diaphragm with $5{\times}4$cm area by pedicle. Most of the tumor was free of adhesion. It was excised completely together with attached diaphragm. The tumor measured $23.5{\times}13.5{\times}8.0$cm and the pathologic diagnosis was benign solitary fibrous tumor and the attached diaphragm was free of disease.

Calcific Tendinits at the Origin of Common Extensor Tendons of the Forearm - A Report of Two Cases - (전완부 총 신근 건 기시부의 석회화 건염 - 2예 보고 -)

  • Kim, Young-Kyu;Cho, Seung-Hyun;Moon, Sung-Hoon;Kim, Nam-Ki
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.84-88
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    • 2011
  • Purpose: We report here on two cases of calcific tendinitis at the origin of the common extensor tendons of the forearm. Materials and Methods: A 42 year-old female complained of left elbow pain and flexion contracture. After obtaining the simple radiographs and MRI, surgical excision of the calcific deposits was done under the diagnosis of calcific tendinitis. A 25 year-old female complained of right elbow pain and a limited range of motion. Simple radiographs showed a calcific deposit just distal to the lateral epicondyle, and then she was managed with extracorporeal shock wave therapy. Results: The pain disappeared completely and both patients regained a full range of motion after treatments. Conclusion: Calcific tendinitis at the origin of the common extensor tendons of the forearm should be included in the differential diagnosis of the lateral elbow diseases that cause pain and a limited range of motion.