• Title/Summary/Keyword: 원격 치료

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Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy (유도화학요법 및 국소 치료 후 원격전이를 보인 국소 진행성 두경부암 환자군의 임상 특징 및 위험인자에 관한 연구)

  • Lee, Hye-Won;Baek, Dong-Hoon;Lee, Kyung-Nam;Cho, Eun-Jung;Kim, Hyo-Jeong;Seol, Young-Mi;Song, Moo-Kon;Choi, Young-Jin;Shin, Ho-Jin;Chung, Joo-Seop;Cho, Goon-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.177-182
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    • 2011
  • Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma (흉부 식도암의 병기 결정에 있어서 채골상 림프절 전이의 의미)

  • Wu Hong-Gyun;Park Chan Il;Ha Sung Whan;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.108-112
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    • 1999
  • Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

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The Development of X-ray Unit of Remote Emergency medical System (원격응급시스템에 적합한 X-ray 장치 개발)

  • Cho, Dong-Heon;Koo, Kyung-Wan;Yang, Hae-Sool;Han, Man-Seok;Han, Sang-Ok
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.20 no.6
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    • pp.49-54
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    • 2006
  • The X-ray unit developed by this study is to diagnose emergency cases which is too far from a hospital and to classify the patients. We have to use the X-ray in a ambulance or the scene of an accident where we cannot use the AC220 outlet because of the distance from a hospital as well. The X-ray unit developed has a characteristics as follows. First of all, as the unit has a condenser in itself where there is no electric supply, we can use the X-ray inspector in a mountain area or a island. Second, we can detect by digital detector the information taken by X-ray from DC 12[V] electricity and store as a form of file. A control circuit can secure the reliability of the X-ray unit by using the Pic16F84A X-ray and provide various functions. The X-ray unit which suits remote emergency system can be efficiently used for the emergent cases who is too far from a doctor and a hospital or in the situation where it is difficult to diagnose, transcribe and treat simultaneously.

The Role of Postoperative Pelvic Radiation Therapy in Rectal Cancer (직장암에 있어서 수술후 방사선치료의 역할)

  • Ahn, Yong-Chan;Kim, Jae-Sung;Yun, Hyong-Geun;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.93-102
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    • 1991
  • To evaluate the role of postoperative pelvic radiation therapy in rectal cancer, a retrospective analysis was done on 189 patients with modified Astler-Coiler stages B2+3, Cl , and C2+3 who were treated from February 1979 to June 1980. Forty-seven patients were staged as B2+3,17 as Cl, and 125 as C2+3. As a curative resection,41 received low anterior resection,143 received abdomino-perineal resection, and five received pelvic exenteration. The survival and disease-free survival rates of the total patients at five year were $45.3\%\;and\;44.1\%$, respectively. The stage was an important prognostic factor for survival and disease-free survival: the survival rates at five year were $63.4\%$ in stage B2+3, $62.4\%$ in C1, and $37.2\%$ in C2+3 (p<0.005): the disease-free survival rates at five year were $55.7\%$ in B2+3, $65.7\%$ in C1, and $30.4\%$ in C2+3, respectively (p<0.01). The liver was the most frequently involved organ of recurrence followed by the lung and the perineum. The patients who received low anterior resection achieved better disease-free survival but were more prone to late radiation bowel morbidities than those who received abdominoperineal resection. Postperative Pelvic radiation therapy Proved to be effective in locoregional disease control but did not prevent the appearance of distant metastasis, which was of major concern in advanced stages. Patterns of treatment failure, and factros relating to radiation morbidity are discussed, and therapeutic options for better results are proposed.

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Hue Shift Model and Hue Correction in High Luminance Display (고휘도 디스플레이의 색상이동모델과 색 보정)

  • Lee, Tae-Hyoung;Kwon, Oh-Seol;Park, Tae-Yong;Ha, Yeong-Ho
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.44 no.4 s.316
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    • pp.60-69
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    • 2007
  • The human eye usually experiences a loss of color sensitivity when it is subjected to high levels of luminance, and perceives a discrepancy in color between high and normal-luminance displays, generally known as a hue shift. Accordingly, this paper models the hue-shift phenomenon and proposes a hue-correction method to provide perceptual matching between high and normal-luminance displays. The value of hue-shift is determined by perceived hue matching experiments. At first the phenomenon is observed at three lightness levels, that is, the ratio of luminance is the same between high and normal-luminance display when the perceived hue matching experiments we performed. To quantify the hue-shift phenomenon for the whole hue angle, color patches with the same lightness are first created and equally spaced inside the hue angle. These patches are then displayed one-by-one on both displays with the ratio of luminance between two displays. Next, the hue value for each patch appearing on the high-luminance display is adjusted by observers until the perceived hue for the patches on both displays appears the same visually. After obtaining the hue-shift values, these values are fit piecewise to allow shifted-hue amounts to be approximately determined for arbitrary hue values of pixels in a high-luminance display and then used for correction. Essentially, input RGB values of an image is converted to CIELAB values, and then, LCh (lightness, chroma, and hue) values are calculated to obtain the hue values for all the pixels. These hue values are shifted according to the amount calculated by the functions of the hue-shift model. Finally, the corrected CIELAB values are calculated from corrected hue values, after that, output RGB values for all pixels are estimated. For evaluation, an observer's preference test was performed with hue-shift results and Almost observers conclude that the images from hue-shift model were visually matched with images on normal luminance display.

Analysis of the Environmental Index and Situation Naturalized Plants in the Stream of Downtown Jeonju (전주 도심 하천의 귀화식물 현황과 환경지수 분석)

  • Oh, Hyun-Kyung;Beon, Mu-Sup
    • Korean Journal of Environmental Biology
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    • v.24 no.3
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    • pp.248-257
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    • 2006
  • Total naturalized plant species in the streams of Jeonju were listed as 109 taxa; 24 families, 75 genera, 106 species, 3 varieties. Dividing by stream, Jeonju stream has 75 taxa; 20 families, 55 genera, 73 species, 2 varieties. Samcheon stream has 86 taxa; 19 families, 64 genera, 84 species, 2 varieties. Soyang stream has 80 taxa; 21 families, 60 genera, 77 species, 3 varieties. Urbanization Index (UI) of total streams (109 taxa) was 40.2%. UI was 27.7% in Jeonju stream (75 taxa), 31.7% in Samcheon stream (86 taxa), 29.5% in Soyang stream (80 taxa). Dividing by degree of naturalization classification, 25 taxa (9.2%) were found in class 5, 17 taxa (6.2%) in class 4, 32 taxa (11.8%) in class 3, 27 taxa (9.9%) in class 2 and 8 taxa (2.9%) in class 1. Dividing by introduction period, 48 taxa (44%) aye in period I, 19 taxa (17%) in period II, 42 taxa (39%) in period III. Dividing by growth type, 48 taxa (44%) are annuals, 25 taxa (23%) are biennials, 33 taxa (30%) are perennials. Dividing by the place of origin, 39 taxa (35%) are from Euyope, 33 taxa (30%) from North America, 11 taxa (10%) from Tropic America, 9 taxa (8%) from Europe Asia,5 taxa (5%) from South America, 5 taxa (5%) from China.

A Study on Music Summarization (음악요약 생성에 관한 연구)

  • Kim Sung-Tak;Kim Sang-Ho;Kim Hoi-Rin;Choi Ji-Hoon;Lee Han-Kyu;Hong Jin-Woo
    • Journal of Broadcast Engineering
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    • v.11 no.1 s.30
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    • pp.3-14
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    • 2006
  • Music summarization means a technique which automatically generates the most importantand representative a part or parts ill music content. The techniques of music summarization have been studied with two categories according to summary characteristics. The first one is that the repeated part is provided as music summary and the second provides the combined segments which consist of segments with different characteristics as music summary in music content In this paper, we propose and evaluate two kinds of music summarization techniques. The algorithm using multi-level vector quantization which provides a repeated part as music summary gives fixed-length music summary is evaluated by overlapping ration between hand-made repeated parts and automatically generated summary. As results, the overlapping ratios of conventional methods are 42.2% and 47.4%, but that of proposed method with fixed-length summary is 67.1%. Optimal length music summary is evaluated by the portion of overlapping between summary and repeated part which is different length according to music content and the result shows that automatically-generated summary expresses more effective part than fixed-length summary with optimal length. The cluster-based algorithm using 2-D similarity matrix and k-means algorithm provides the combined segments as music summary. In order to evaluate this algorithm, we use MOS test consisting of two questions(How many similar segments are in summarized music? How many segments are included in same structure?) and the results show good performance.

Surgical Treatments of Osteosarcoma around the Knee in Children (소아 슬관절 주위 골육종의 수술적 치료)

  • Nam, Kwang-Woo;Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Cho, Whan-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.1-12
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    • 2004
  • Purpose: The current study was performed to analyze the oncological and functional results, and the patient, the limb and the prosthesis survival of osteosarcoma around the knee in children according to the treatment options. Materials and Methods: From 1982 to 2002, 63 patients with osteosarcoma around the knee underwent surgical treatments before 16 years of age. Surgical treatment options were amputation, endoprosthetic replacement, and implantation of low heat-treated autogenous bone graft after wide resection of tumor. The mean age of patients was 11.5 years (4.4~16), and the mean follow-up period was 6.1 years (2.1~16.8). All patients had neoadjuvant and adjuvant chemotherapy. All endoprosthses were extendible types. Anatomical locations of osteosarcoma were distal femur in 40 patients, and proximal tibia in 23 patients. As regard to Enneking stage, 4 patients had stage $II_A$, 50 patients had stage $II_B$, and 9 patients had stage III tumors. Results: The 5 year survival rate of stage $II_B$ patients was 72.7% in amputation, 83.7% in endoprosthesis, and 100% in low heat-treated autogenous bone graft. The 5 year survival rate of salvaged limb was 84.4% in endoprosthesis, and 80% in low heat-treated autogenous bone graft. The survival rate of prosthesis was 92.7% at 5 years, 67.4% at 10 years in endoprosthesis, and 75% at 5 years in low heat-treated autogenous bone graft. Mean functional outcome scores were 8.7 points in amputation, 20.6 points in endoprosthesis, and 16 points in low heat-treated autogenous bone graft. Distant metastasis occurred 15.8% in amputation, 27% in endoprosthesis and local recurrence occurred 8.1% in endoprosthesis, 14.3% in low heat-treated autogenous bone graft. Major complications happened 26.3% in amputation, 35.1% in endoprosthesis, and 28.6% in low heat-treated autogenous bone graft. Conclusion: Limb salvage procedure had functionally better results than amputation in children with osteosarcoma around the knee. Reconstruction with endoprosthesis after resection of tumor had good results in children as adults. In certain circumstances as too small bone for endoprosthesis or minimal bony destruction or too skeletally immature patient, low heat-treated autogenous bone graft may be a good treatment option. Low heat-treated autogenous bone graft may be considered as not only a substitute for endoprosthesis but also a temporary method before endoprosthesis.

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Combined Chemoradiotherapy vs Radiotherapy Alone for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (국소적으로 진행된 두경부 편평상피세포종양의 방사선- 항암화학 병용요법과 방사선단독치료의 비교)

  • Jeong, Hyeon-Ju;Suh, Hyun-Suk;Kim, Chul-Soo;Kim, Re-Hwe;Kim, Sung-Rok
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.9-15
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    • 1996
  • Purpose: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer Provides anticipated cure rates of $10-65\%$ depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer. Materials and Methods : November 1983 to October 1994. 31 Patients with Stage III and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone, and IS patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy (median 7010 cGy). In combined group, 7 patients were treated with cisplatin plus 5-FU 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. Results : Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient ($66.6\%$) of the RT alone group and 14 patient ($93.3\%$) of the chemoradiation group. There was no statistical difference in CR rate between the two groups The overall survival rates at 5 years were $23.4\%$ in the radiation alone group, $23.5\%$ in the chemoradiation group Disease-free survival rates at 3 years were $44.5\%$ in the radiation alone group, $40\%$ in the chemoradiation group. There was no statistical differences in overall survival rates and disease-free survival rates between the two groups. Local recurrences occurred in $71.5\%$ of the radiation alone group, $72.7\%$ of the chemoradiation group and distant metastasis occurred in $14.4\%$ of radiation alone group, $9.1\%$ of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity Conclusion : Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-un may be necessary to confirm the present result of combined chemotherapy and radiotherapy.

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Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.