• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.7-13
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• 2024

The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.

• Journal of Radiation Protection and Research
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• v.32 no.3
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• pp.105-110
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• 2007

Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as Point A, is still used widely. A 3-dimensional ICR plan based on CT image provides dose-volume histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planing system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume$(average{\pm}SD)$ of CTV, rectum and bladder in all of 11 patients is $21.8{\pm}6.6cm^3,\;60.9{\pm}25.0cm^3,\;111.6{\pm}40.1cm^3$ respectively. The volume covered by 100% isodose curve is $126.7{\pm}18.9cm^3$ in ICRU plan and $98.2{\pm}74.5cm^3$ in CTV plan(p=0.0001), respectively. In (On) ICRU planning, $22.0cm^3$ of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of $62.2{\pm}4.8cm^3$ other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was $90.1{\pm}21.3%$ and $68.7{\pm}26.6%$ in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was $86.4{\pm}18.3%$ and $76.9{\pm}15.6%$ in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was $137.2{\pm}50.1%,\;101.1{\pm}41.8%$ in ICRU plan and $107.6{\pm}47.9%,\;86.9{\pm}30.8%$ in CTV plan, respectively. Therefore, the radiation dose to normal organ was lower in CTV plan than in ICRU plan. But the normal tissue dose was remarkably higher than a recommended dose in CTV plan in one patient whose residual tumor size was greater than 4cm. The volume of rectum receiving more than 80% isodose (V80rec) was $1.8{\pm}2.4cm^3$ in ICRU plan and $0.7{\pm}1.0cm^3$ in CTV plan(p=0.02). The volume of bladder receiving more than 80% isodose(V80bla) was $12.2{\pm}8.9cm^3$ in ICRU plan and $3.5{\pm}4.1cm^3$ in CTV plan(p=0.005). According to these parameters, CTV plan could also save more normal tissue compared to ICRU38 plan. Conclusion : An unnecessary excessive radiation dose is irradiated to normal tissues within 100% isodose area in the traditional ICRU plan in case of a small size of cervix cancer, but if we use CTV plan based on CT image, the normal tissue dose could be reduced remarkably without a compromise of tumor dose. However, in a large tumor case, we need more research on an effective 3D-planing to reduce the normal tissue dose.

• Progress in Medical Physics
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• v.23 no.2
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• pp.91-98
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• 2012

Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.305-309
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• 2009

Dens evaginatus is a dental anomaly most commonly seen in premolar teeth in which a tubercle or protuberance projects from either the center of the occlusal surface or the buccal triangular ridge. These tubercles are easily fractured from mastication as the tooth erupts and frequently leads to pulp necrosis as a common complication. To prevent these sequelae, prophylactic treatment soon after the tooth starts erupting is essential. These preventive treatments include, selective grinding and protection of the tubercle by pit and fissure sealant. When the tooth does shows signs of pulp necrosis and apical periodontitis, endodontic procedures are needed. Apexification and apexogenesis are usually the treatment of choice for the affected teeth which have immature apices. Apexogenesis is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end. It involves removal of the inflamed pulp and the placement of calcium hydroxide on the remaining healthy pulp tissue. This case report describes an atypical apexogenesis of a mandibular premolar which showed to be a dens evaginatus. The tooth which was treated with calcium hydroxide shows good results and is planned for permanent root canal filling.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.103-107
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• 2008

Purpose: This paper describes a electron field presence of magnetic field, intensity and shape surface dose variation to clinical application possibility. Materials and Methods: The using 6 MeV electron and $10{\times}10\;cm^2$ field size, 9 hole to shielding block make the by measure the film, when the magnetic field position inside and outside of the X-Omat film and parallel plate ionization chamber using the surface dose measured. Results: Present of 4 cm to the side at angle about 3 degree from beam center, use of ring type magnetic is 0.9% increase the surface dose, lens block located in the magnetic field the surface dose 1.58% increase, half magnetic field's position on the side of them at the field center of the 3.6% increase of the surface dose. Conclusion: Surface dose variation is with magnetic field about the mean electron beam of progress direction change, orbit region patient's is inconvenient without surface dose increase percentage case goodness will be used as a useful way.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.88-95
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• 2004

Purpose: Current treatment for osteoid osteomas is usually surgical excision of the nidus. Various minimal invasive techniques have been reported to overcome the invasiveness of the surgical excision. We treated 22 patients with osteoid osteoma by percutaneous thermoablation of the nidus under computed-tomography guidance. Materials and Methods: Twenty two consecutive patients underwent CT-guided percutaneous radio-frequency thermoablation between April 1999 and May 2004. The mean age was 26.5(7~55) years. In three cases, the diagnosis was confirmed pathologically before the prodedure while the others clinically and radiologically. Computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 80 or 90 degrees C for 6(3~8) minutes. Clinical success was assessed at a mean of 30(4~62) months after the procedure at out patient clinic or by telephone interview. Results: The procedure was technically successful in all cases except a complication. Patients were discharged on 1.9 days after the procedure and resumed normal activities immediately. All patients but three (86%) remained pain free during follow-up (range 4~62 months). A second thermoablation treatment relieved the recurrent symptoms in 2 patients and the remained had persistent pain without a second prodedure. Conclusion: Percutaneous thermoablation appears to be safe and effective for osteoid osteomas, and is a minimally invasive procedure alternative to surgical resection.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.337-343
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• 2020

Molar-incisor malformation (MIM) is a new type of root anomaly reported recently. The characteristics of MIM are dysplastic root formations, constriction of pulp chambers and presence of calcified matrices at the level of cementoenamel junction in permanent first molars and primary second molars. In some cases, permanent maxillary incisors are also affected. The permanent first molars of the patient in this case report were affected with MIM. Generalized pulp stones were observed in overall primary dentition. Micro-computed tomography (micro-CT) imaging and scanning electron microscope-energy dispersive X-ray spectrometer analysis were performed on the extracted mandibular first molar and maxillary primary second molar of the patient. Micro-CT images revealed the discontinuity of enamel directly connected to an accessory canal of the root.

• Progress in Medical Physics
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• v.14 no.4
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• pp.234-239
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• 2003

We examined the variation of percent depth dose (PDD) curves for 10 MV X-rays in the presence of magnetic fields. The EGS4 Monte Carlo code was applied and modified to take account of the effect of electron deflection under magnetic field was used. We defined and tested DI (dose improvement) and DR (dose reduction) to describe variation of PDD curves under various magnetic fields. For a magnetic field of 3 T applied at the depth region of 5-10 cm and field size of 10${\times}$10 $\textrm{cm}^2$, the DI is 1.56 (56% improvement) and DR is 0.68 (32% reduction). We explained the results from the Lorentz law and the concept of electron equilibrium. We suggested that the dose optimization in radiotherapy can be achieved from using the characteristics of dose distributions under magnetic fields.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.53-56
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• 2021

Sebaceous carcinoma (SC) is a rare malignant tumor, with an estimated incidence of approximately 1 to 2 per 1,000,000 per year. Approximately 75% of SCs are reported to occur in eyelids. Most of these tumors are diagnosed at age 40 or over and exhibit a wide variety of patterns in addition to the general appearance previously reported. SC is difficult to diagnose clinically, but can be diagnosed by accompanying biopsy. In cases of SC, additional examinations, such as endoscopy and computed tomography, may be necessary because of its association with Muir-Torre Syndrome. We present the case of a 22-year-old Asian man who complained of a rapidly growing chin tumor. The tumor was treated by surgical resection and adjuvant radiation therapy.

• 한국신재생에너지학회:학술대회논문집
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• 2005.06a
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• pp.586-591
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• 2005

우리나라는 에너지의 안정적 공급과 에너지이용 과정에서 발생하는 환경적, 안보적 외부성을 최소화하는 에너지수급 구조를 마련하기 위해 2003년 12월 '제2차 신재생에너지 기술개발 및 이용보급 기본계획(2003-2012)'을 발표하였다. 이 계획에서는 2011년까지 전체 TPES의 $5\%$를 신재생에너지로 공급하는 것을 정책목표로 수립하고 수소, 태양광 그리고 풍력기술을 중점적으로 추진하기로 하였다. 특히 수소부문에서는 주택 및 건물용, 발전용, 수송용 연료전지의 개발을 중심으로 개발하여 세계 기술시장의 $20\%$를 확보한다는 계획을 발표하였다. 이러한 기술 잠재력을 기반으로 우리 정부도 미국이나 일본과 같이 수소경제로의 전환을 준비하고 있으며 2020년대 이후 우리나라의 에너지부문은 새로운 국면에 접어들 것으로 전망된다. 에너지나 환경기술의 효과적 인 개발을 위해서는 이들 기술의 직접적인 비용측면에 대한 분석 즉 경제성 평가와 새로운 기술변화로 인한 중장기적인 사회경제적 영향평가가 선행되어야 한다. 이러한 평가는 대상 기술의 사회경제적 파급효과가 광범위할수록 더욱 복잡한 분석이 요구된다. 본 연구의 주제인 수소에너지기술은 지금까지 이용되던 것과는 전혀 새로운 에너지캐리어(carrier)를 개발하는 것으로 에너지부문 및 여타 다른 산업부문이 공유하고 있는 에너지 관련 인프라의 전면적인 조정이 요구되며 에너지 이용과 관련된 사회경제적 측면의 급속한 변화를 수반한다. 본 연구는 수소경제로의 이행에 대한 사회경제적 영향평가의 방법론적 요소들과 기법을 제시한다."중등도 독성"으로 나타났다 이상의 결과는 전기도금을 이용하여 교정용 선재의 직경을 증가시키는 방법이 임상에 적용되기 위해서는 세포독성을 줄이기 위한 추가의 연구가 필요함을 시사하였다.의하게 가장 낮은 정지. 운동 마찰력을 보였고 브라켓-호선 각도가 증가함에 따라 유의하게 정지, 운동 마찰력도 증가하였다 (P<0.001)%$ 낮추지만(p value=0.260) 평균 $D_{max}$는 거의동일 하여($0.3\%$ 감소, p value=0.867), 전통적인 방법보다 우수성이 크게는 없는 것으로 평가되었다. 그러나 환자의 체곡선이 보상체와 잘 일치하는 경우에는 DII가 $18\%$까지 감소하였다. 결론 : Multistatic field 방법은 모든 환자에 대하여 선량분포의 균일성을 전반적으로 향상시키는 효과적인 방법으로 평가되는 반면 공용보상체의 사용은 보상체의 크기가 환자의 체 윤곽과 잘 일치하는 경우만 효과적으로, 적용의 범위에는 한계가 있는 방법으로 평가되었다.비교하여 계통에 따르는 차이가 있음을 알 수 있었다. 그러므로 가임기 여성의 방사선 진단 및 치료시 Rugh의 10일 법칙을 적용하여 착상전기 방사선 조사로 인한 부작용들을 적극적으로 예방하는 것이 매우 중요하다고 생각한다.equirements of the prematured infants during the early weeks of life. 모든 치근단 수준에서 비표준화 medium 크기 master cone 사용군이 ISO 표준화 규격의 master cone 사용군에 비해