• Title/Summary/Keyword: 이차방사선

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Radiotherapy Treatment Planning in Head and Neck Cancer by CT-Reconstruction (CT 재구성에 의한 두경부 종양의 방사선 치료 계획)

  • Ryu, Sam-Uel;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.141-148
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    • 1987
  • The ultimate goal of radiotherapy is to result in complete local control of tumor while sparing the surrounding normal tissues as much as possible. Since the development of CT in 1970s, patient's anatomical normal tissues and the site and extent of infiltration of tumor were identified almost accurately. In addition, the isodose distribution of delivered radiation to target tumor was shown in each cross-section. In the treatment planning of head and neck cancers, CT-reconstruction provided almost 3-dimensinonal inter-relationship between tumor and normal tissues. The utilization of imaging system of the CT scanner made it possible to illustrate in superposition the patient structure image, the radiation beams, and the isodose distributions. Thus it was possible to deliver radiation enough to control the local disease, and to avoid unnecessary administration of radiation to normal tissue such as spinal cord. CT-reconstructed image in axial, sagittal, and coronal planes suggested 3-dimensional radiotherapy treatment planning be possible and practical instead of conventional 2-dimensional planning at coronal plane.

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A Case of Rapid Cycling Secondary Mania after Gamma-knife Radiosurgery (감마나이프 방사선수술 후 발생한 급속 순환성 이차성 조증 1예)

  • Chung, Chan-Ho;Chae, Jeong-Ho;Kim, Im-Ryol;Lee, Chung-Kyoon;Lee, Kyu-Hang
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.302-308
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    • 1996
  • A case of rapid cycling mania secondary to gamma-knife radiosurgery for the treatment of refractory epilepsy was reported. A 21-year old woman who had a gamma-knife radiosurgical operation for the treatment of refractory seizure two years ago was admitted because of manic episodes. Although seizure was relieved, manic symptoms like decreased need for sleep, elated mood, unprovoked laughing, grandiose delusion and bizarre behaviors were developed 11 months after the operation. These symptoms recurred lour rimes for eight months. There were no past personal and family history of mood disorders. Laboratory examinations including electroencephalogram ana endocrinological study did not show any abnormal findings. The rapid cycling secondary manic was relieved by lithium. She was then discharged after 5 months. Mood change was not significant during follow-up while hypomania emerged by dose reduction. The secondary mania seemed to be caused or triggered by the right temporal lobe damage induced by gamma-knife radiosurgery.

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Delayed Hemorrhage of the Hepatic Artery Caused by Biliary Stenting after Concurrent Chemoradiotherapy (동시항암화학방사선요법 후 담도 스텐트에 의해 발생한 지연성 간동맥 출혈)

  • Joon Ho Cho;Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1216-1221
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    • 2020
  • Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.

Clinical Outcome and Arthroscopic Evaluation of Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과 및 이차적 관절경 소견)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Lee, Kyoung-Jai;Kim, Hyung-Soon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.28-34
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    • 2010
  • Purpose: The aim of this study was to evaluate short-term clinical results and second-look arthroscopic findings after double-bundle anterior cruciate ligament (DB ACL) reconstruction. Materials and Methods: Forty-nine patients, who were followed up for at least 24 months after DB ACL reconstruction, were included. Clinical results, such as, Lysholm knee and Tegner activity scores, and manual laxity and instrumented anterior laxity test results were evaluated. In fifteen patients (15 knees), second-look arthroscopy with staple removal was performed. At second-look arthroscopy, the authors assessed about reconstructed ACL rupture, subjective graft tension and extent of synovial coverage. Results: Lysholm knee scores significantly improved from 67.4 preoperatively to 96.1 at last follow-up (p<0.01). Tegner activity scale improved from 2.0 to 6.1. The Lachman test, at last follow-up, showed normal laxity in 39 (of 49) patients, and the pivot-shift test showed normal laxity in 36 (of 49) patients. Mean side-to-side differences improved significantly from 10.8 mm to 3.3 mm (p<0.01). Second-look arthroscopic findings showed that all patients had a normal or a near normal anteromedial bundle. However, 8 patients (53.3%) were found to have partial or complete posterolateral bundle rupture. Conclusion: Even though double-bundle ACL reconstruction was clinically effective means of restoring knee rotational and anteroposterior stabilities, there were some ruptured posterolateral bundles observed in cases under arthroscopy after double-bundle ACL reconstruction.

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Development of B4C Thin Films for Neutron Detection (스퍼터링 코팅기법을 이용한 중성자 검출용 B4C 박막 개발)

  • Lim, Chang Hwy;Kim, Jongyul;Lee, Suhyun;Cho, Sang-Jin;Choi, Young-Hyun;Park, Jong-Won;Moon, Myung Kook
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.79-86
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    • 2015
  • $^3He$ gas has been used for neutron monitors as the neutron converter owing to its advantages such as high sensitivity, good ${\gamma}$-discrimination capability, and long-term stability. However, $^3He$ is becoming more difficult to obtain in last few years due to a global shortage of $^3He$ gas. Accordingly, the cost of a neutron monitor using $^3He$ gas as a neutron converter is becoming more expensive. Demand on a neutron monitor using an alternative neutron conversion material is widely increased. $^{10}B$ has many advantages among various $^3He$ alternative materials, as a neutron converter. In order to develop a neutron converter using $^{10}B$ (actually $B_4C$), we calculated the optimal thickness of a neutron converter with a Monte Carlo simulation using MCNP6. In addition, a neutron converter was fabricated by the Ar sputtering method and the neutron signal detection efficiencies were measured with respect to various thicknesses of fabricated a neutron converter. Also, we developed a 2-dimensional multi-wire proportional chamber (MWPC) for neutron beam profile monitoring using the fabricated a neutron converter, and performed experiments for neutron response of the neutron monitor at the 30 MW research reactor HANARO at the Korea Atomic Energy Research Institute. The 2-dimensional MWPC with boron ($B_4C$) neutron converter was proved to be useful for neutron beam monitoring, and can be applied to other types of neutron imaging.

Imaging of the Small Airway Diseases (소기도 질환의 영상소견)

  • Chung, Myung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.133-141
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    • 2005
  • "소기도"라 일컬어지는 해부학적 부위는 말단부 막성 세기관지와 호흡성 세기관지로 구성된 직경 3 mm 이하의 기도부위이다. 방사선학적으로는 고해상 전산화단층촬영(CT)에서 흉막직하의 직경 약 1.0 cm으로 이루어진 2차 소엽내의 중심부에 위치하게 된다. 그러므로 이 부위의 질환때에는 중심소엽성 세기관지내의 가득찬 물질로 인해 나타나는 중심소엽성 결절들과 선상음영들이 보인다. 이외의 소견으로는 중심소엽성 폐기종, 모자이크 모양의 폐음영, 분절하 무기폐등이 있고, 호기시 CT 촬영에서 나타나는 공기포획이 있다. 최근에는 다검출기형식의 CT (multidetector CT)의 발전으로 인하여 이차원 재구성 (2 dimension reformat) 관상면, 시상면 CT 스캔을 매우 명확하고 빨리 얻을 수 있고, 기관지에 대한 삼차원 볼륨 영상 (3 dimentional volume rendering image) 등을 얻어서 가시적인 효과를 높이고 진단의 정확성에 보다 더 접근하게 되었다. 소기도를 침범하는 질환은 일차적인 것과 이차적인 것이 있는데, 병리조직학적으로는 원인별로 흡연으로 인한 소기도 질환, 세포성 세기관지염, 수축성 세기관지염, 증식성 세기관지염등으로 구분하며 여기에는 이와 같은 병리질환을 일으키는 다양한 원인들이 포함된다. 이외에도 드문 질환으로 미만성 범세기관지염, 광물질에 의한 소기도 질환등이 있다.

Results of Radiation Therapy in Early Glottic Cancer (초기성문암의 방사선 치료 성적)

  • Ahn Sung Ja;Chung Woong Ki;Nam Taek Keun;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.181-186
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    • 1992
  • A retrospective analysis was undertaken for 22 patients with early glottic cancer ($T_1N_0M_0$; 17, $T_2N_0M_0$; 5) who completed curative radiotherapy at the Department of Therapeutic Radiology, Chonnam University Hospital between November 1985 and December 1990. Median follow-up period was 39 months. The 3 year actuarial survival rate of T1, T2 was $81\%$ and $80\%$. respectively. Three patients ($13\%$) showed second malignant tumors and the site of the new primary was esophagus in two patients and lung in the other one. They were excluded from the local control analysis. The local control rate of T1. T2 group was $66\%$ and $50\%$. respectively. The surgical salvage rate and the ultimate local control rate of T1 group was $80\%$ (4/5) and $93\%$. and that of T2 group was $100\%\;(2/2)\;and\;75\%$. respectively. The local control rates of T1 stage were evaluated according to the various parameters. The local control rate of the superficial and exophytic lesion was better than that of the ulcerative and infiltrative one, and the involvement of anterior commissure was not seemed to be adverse prognostic factor. But the protracted treatment time showed the adverse effect on the local control of the disease. All of the eleven patients controlled by primary radiation therapy have maintained their voice well without any significant complication.

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Prosthetic treatment for patient with upper lip cancer and severe periodontitis: Maxillary complete denture with denture adhesive and mandibular double crown-retained removable partial denture (구순암 환자에서의 의치접착제를 이용한 상악 총의치와 심한 치주 상태에서의 하악 이중관의치를 이용한 수복 증례)

  • Choi, Hyun-Suk;Lee, Cheong-Hee;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.74-80
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    • 2015
  • When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident$^{(R)}$ denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.

Radiation Therapy of Early Glottic Cancer (초기성문암의 방사선치료)

  • Ahn, Yong-Chan;Park, Charn-Il;Kim, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.51-57
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    • 1990
  • Retrospective analyses were done of 48 patients with early glottic cancer, 31 with T1NOMO and 17 with T2NOMO, who received radiation therapy from March 1979 to August 1984 at Seoul National University Hospital with the prescribed full dosage. The median follow-up period was 67 months (range: 34 months$\~$126 months), and the percent follow-up for longer than five years was $85.4\%$ The five-year actuarial overall and recurrence-free survival rates of the whole patient group were $83.2\%\;and\;69.4\%$, respectively. The five-year actuarial overall and recurrence-free survival rates of the T1 group were $87.1\%\;and\;76.0\%$, and those of the T2 group were $76.5\%\;and\;58.2\%$, respectively. Possible causes of the failures to radiation therapy, the dose-response relationship, association with the second malignant tumors, and some recommendations for better treatment outcome are analyzed and discussed.

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Effect of Low Magnetic Field on Dose Distribution in the Partial-Breast Irradiation (부분유방 방사선조사 시 저자기장이 선량분포에 미치는 영향)

  • Kim, Jung-in;Park, So-Yeon;Lee, Yang Hoon;Shin, Kyung Hwan;Wu, Hong-Gyun;Park, Jong Min
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.208-214
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    • 2015
  • The aim of this study is to investigate the effect of low magnetic field on dose distribution in the partial-breast irradiation (PBI). Eleven patients with an invasive early-stage breast carcinoma were treated prospectively with PBI using 38.5 Gy delivered in 10 fractions using the $ViewRay^{(R)}$ system. For each of the treatment plans, dose distribution was calculated with magnetic field and without magnetic field, and the difference between dose and volume for each organ were evaluated. For planning target volume (PTV), the analysis included the point minimum ($D_{min}$), maximum, mean dose ($D_{mean}$) and volume receiving at least 90% ($V_{90%}$), 95% ($V_{95%}$) and 107% ($V_{107%}$) of the prescribed dose, respectively. For organs at risk (OARs), the ipsilateral lung was analyzed with $D_{mean}$ and the volume receiving 20 Gy ($V_{20\;Gy}$), and the contralateral lung was analyzed with only $D_{mean}$. The heart was analyzed with $D_{mean}$, $D_{max}$, and $V_{20\;Gy}$, and both inner and outer shells were analyzed with the point $D_{min}$, $D_{max}$ and $D_{mean}$, respectively. For PTV, the effect of low magnetic field on dose distribution showed a difference of up to 2% for volume change and 4 Gy for dose. In OARs analysis, the significant effect of the magnetic field was not observed. Despite small deviation values, the average difference of mean dose values showed significant difference (p<0.001), but there was no difference of point minimum dose values in both sehll structures. The largest deviation for the average difference of $D_{max}$ in the outer shell structure was $5.0{\pm}10.5Gy$ (p=0.148). The effect of low magnetic field of 0.35 T on dose deposition by a Co-60 beam was not significantly observed within the body for PBI IMRT plans. The dose deposition was only appreciable outside the body, where a dose build-up due to contaminated electrons generated in the treatment head and scattered electrons formed near the body surface.