• The Journal of Korean Society for Radiation Therapy
• /
• v.20 no.2
• /
• pp.83-89
• /
• 2008

Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.

• Clinics in Shoulder and Elbow
• /
• v.13 no.2
• /
• pp.237-243
• /
• 2010

Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

• Radiation Oncology Journal
• /
• v.18 no.2
• /
• pp.85-91
• /
• 2000

Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

• Journal of radiological science and technology
• /
• v.32 no.3
• /
• pp.271-276
• /
• 2009

The aim of this study was to evaluate the effect of Bone Mineral Density(BMD) at mandible. So, we studied how to measure the BMD at mandible using DEXA(Dual energy X-ray absorptiometry, DEXA) by Horner er al (1996) and knew reproducibility of the measurements. Thirty-five patients (13 men, 22 women, mean age : 25.4 years) were examined using the GE Lunar Prodigy Advance(LUNAR Corporation, madison, USA). They were examined in Semiprone position of their body and true lateral position of their mandible selected the Lumbar lateral mode. We used the custom mode in analysis when ROI (area $30{\times}2.5\;mm^2$). Three ROIs ($30{\times}2.5\;mm^2$, $50{\times}2.5\;mm^2$, $20{\times}2.5\;mm^2$) were located each at the two different sites of the mandible (angle of mandible and mental symphysis) and BMD was measured. Differences in BMD measurement was statistically compared according to the size and location of ROI. BMD was $1.320{\pm}0.358g/cm^3$ in men and was $1.152{\pm}0.340g/cm^3$ in women. BMD at the angle of mandible was $1.201{\pm}0.361g/cm^3$ in men and was $1.025{\pm}0.377g/cm^3$ in women. BMD of men at the mental symphysis was $1.434{\pm}0.341g/cm^3$ and that of women was $1.19{\pm}0.358g/cm^3$. With the ROI of $20{\times}2.5\;mm^2$, BMD was $1.262{\pm}0.384g/cm^3$ in men and was $1.113{\pm}0.357g/cm^3$ in women. With the ROI of $50{\times}2.5\;mm^2$, BMD of men was $1.320{\pm}0.358g/cm^3$ and that of women was $1.129{\pm}0.340g/cm^3$. There was a statistically significant difference of BMD according to the size and location of ROI. When measuring mandible BMD, there are good for increasing ROI and locate between ramus and mental symphysis. Especially following exam, refer to same size and location with fore exam. According to study which measure mandible BMD, It's correct to measure better a portion of mandible then whole of BMD. Using DEXA protocol is studied good for the additional study to compare the BMD at mandible. Later date, It will be good for measurement value in implant and bone graft quantitatively. Using DEXA method gain BMD threshold value in korean.

• Radiation Oncology Journal
• /
• v.21 no.2
• /
• pp.112-117
• /
• 2003

Purpose: The effects of hypefractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Materials and Methods: Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department of Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 : 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 75.8 Gy). Follow-up periods ranged between 3 and 136 months, with the median of 52 months. Results: The overall survival rates at 3 and 5 years in all patients were 66.7$\%$, and 52.4$\%$. The disease-free survival rates at 3 and S years (3YDFS, 5YDFS) in all patients were 66.7$\%$ and 47.6$\%$. The 3YDFS and 5YDFS in stage III patients were 81.8$\%$ and 63.6$\%$, and those in stage IV patients were 53.8$\%$ and 32.3$\%$. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25$\%$) died due to distant metastasis and 12.5$\%$ died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteo-radionecrosis of the mandible 58 months after treatment. Conclusion: Although this study was peformed on small patients group, we considered hypefractionated radiation therapy for the treatment of advanced stage head and neck cancer might improve the disease free survival and decrease the local failure with no increase in late complications despite of the slight Increase in acute complications.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.4
• /
• pp.374-381
• /
• 1998

Purpose: I-131 labeled (2'-deoxy-2'-iodo-${\beta}$-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and it's feasibility for scintigraphic tumor imaging. Materials and Methods: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected with 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was performed after 2 and 24h. Then, rat body was fixed and microtomized slice was placed on radiographic film for autoradiography. Results: %ID/g of tumor was 0.74 (0.5h),0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0.69), muscle (0.14), bone (0.33) and intestine (0.51). However, %ID/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. Conclusion: This results suggest that IAD may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.1
• /
• pp.130-138
• /
• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.1
• /
• pp.98-105
• /
• 1994

The search for tumor-avid agents for use in nuclear medicine imaging or therapy is a field of ongoing importance. Metallothionein (MT) is an intracellular protein that binds many metals with isotopes having imaging or radiotherapeutic potential. The purpose of the study was to determine whether uptake of radioisotopes that bind to MT is increased in tumor. We measured the uptake of Cd-109 and Ga-67 in tumor and normal tissues of sarcoma-bearing mice. Tumors were grown subcutaneously in female Balb/C mice from cultured Balb/3T3 cells transformed by the Moloney murine sarcoma virus (MMSV). When the tumors reached about 1 cm in diameter, mice were injected subcutaneously with Cd-109 and Ga-67. Eighteen and seventy-two hours later, the mice were sacrified. Organs and tissues were removed, weighed, and activity per mg tissue determined by gamma well-counting. Uptake of Cd-109 by MMSV tumors exceeded that by normal tissues examined, with the exception of liver and kidney (the organs known to be richest in MT). The tumor-to-tissue ratios of uptake for Cd-109 were far greater than those for Ga-67 for many normal tissues of great importance in terms of background activity (bone, intestine, fat, muscle, and blood). We concluded that metals that bind to MT may be useful for oncologic imaging or rediotherapy of cancer.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.4
• /
• pp.541-547
• /
• 1996

The previous monoclonal antibody labeling method for bone marrow immunoscintigrapy was complicated and laborious for clinical application. Also it showed a relatively low labeling efficiency. To improve this procedure, we compared several direct labeling methods of $^{99m}Tc$. 1) The labeling efficiency in the method using gluconate as a transchelator was low (40-70%), but immunoscintigraphy using this radiotracer produced a clear image. 2) To improve labeling efficiency, ${\beta}$-mercaptoethanol was removed after reduction. The labeling efficiency was improved up to 70-80%, but the radioactivity of the blood pool was high. 3) The higest labeling efficiency (>90%) and best quality images could be obtained by using MDP as a transchelating agent. It did not require additional procedures for separation of labeled antibodies. The immunoreactivity of this antibody was 60%. Residual MDP which can be taken up by the bone could be removed by PD-10 column. The reduced antibodies were stable with a high labeling efficiency (>90%) for up to 47 days by deep freezing. We concluded that the improved procedure for $^{99m}Tc$ labeling of anti-NCA-95 monoclonal antibody using MDP as a transchelating agent will be a simple and useful method for clinical application.

• Journal of the Mineralogical Society of Korea
• /
• v.19 no.3 s.49
• /
• pp.171-187
• /
• 2006

The status of heavy metal contamination was investigated using chemical analyses of stream waters and sediments obtained from Samsanjeil and Sambong Cu mining area in Goseong-gun, Gyeongsangnam-do. In addition, the degree and the environmental risk of heavy metal contamination in stream sediments was assessed through pollution index (Pl) and danger index (DI) based on total digestion by aqua regia and fractionation of heavy metal contaminants by sequential extraction, respectively. Not only the degree of heavy metal contamination was significantly higher in Samsanjeil area than in Sambong area, but its environmental risk was also revealed much more serious in Samsanjeil area than in Sambong area. The differences in status and level of contamination and environmental risk between both two mining areas may be attributed to existence of contamination source and geology. Acid mine drainage is continuously discharged and flows into the stream in Samsanjeil mining area, and it makes the heavy metal contamination in the stream more deteriorated than in Sambong mining area in which acid mine drainage is not produced. In addition, the geology of Samsanjeil mining area is mainly comprised of andesitic rocks including a small amount of calcite and having lower pH buffering capacity fer acid mine drainage, and it is likely that the heavy metal contamination cannot be naturally attenuated in streams. On the contrary, the main geology of Sambong mining area consists of pyroclastic sedimentary Goseong formation containing a high content of carbonates, particularly calcite, and it seems that these carbonates of high pH buffering capacity prevent the heavy metal contamination from proceeding downstream in stream within that area.