• 제목/요약/키워드: Cervical approach

검색결과 231건 처리시간 0.025초

고선량률 강내 근접치료시 열형광량계를 이용한 선량측정법 (TLD Dosimetry in HDR Intracavitary Brachytherapy)

  • Kim, Chang-Seon;Yang, Dae-Sik;Kim, Chul-Yong;Park, Myung-Sun
    • 한국의학물리학회지:의학물리
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    • 제11권2호
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    • pp.109-116
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    • 2000
  • 자궁경부암 환자의 방사선 조사시 고려하여야 할 사항 중 한가지는 결정 장기인 방광 및 직장의 부작용이다. 강내 고선량률 근접 치료시 방광과 직장의 흡수선량을 열형광량계 선량측정법을 이용하여 간접적으로 측정하였다 방광 및 직장의 부작용을 줄일 수 있는 방법이 제안되었다. 방사선 치료 후 예후관찰 중인 200명의 자궁경부암 환자의 자기공명 영상에서 자궁경부의 중심축에서 방광 및 직장 그리고 자궁벽의 두께를 측정하였다. 밀봉시킨 열형광량계를 오보이드의 팩킹거즈 위에 놓고 씨물레이션 필름 상에서 오보이드의 중심에서부터의 거리를 측정한 후 실제의 방광과 직장의 흡수선량을 계산하였다. 발표된 연구결과들에서 방광 및 직장의 최대 견딤선량을 계산하였고 고선량률 근접치료 1회당의 허용선량을 토대로 양방향의 팩킹두께를 알아냈다 방광과 직장방향의 최소의 팩킹두께는 각각 0.43 과 0.92 cm 이었다. 이 결과를 마이스버거 다항식을 이용한 계산결과와 비교하였다. 본 연구에서 제시한 방법이 임상에서 고선량률 근접 치료시 방광과 직장 같은 결정장기의 흡수선량을 평가하는 방법으로 사용되기를 바란다.

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귀전우, 백화사설초, 와송 추출물을 처치한 난소암과 자궁경부암 세포에서의 단백질 발현 변화 (Altered Protein Expression in Ovarian and Cervical Cancer Cells by the Treatment of Extracts from Euonymus alatus Sieb, Oldenlandia diffusa (Willd.) Roxburgh, and Orostachys japonicus A. Berger)

  • 김경순;예성철;유병철;조종관;이연월;유화승
    • 대한한방내과학회지
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    • 제32권1호
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    • pp.33-42
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    • 2011
  • Background : Despite recent advances in cancer management, prognosis of ovarian cancer is poor. Anticancer effects of herbal medicine, such as Euonymus alatus Sieb, Oldenlandia diffusa (Willd.) Roxburgh, and Orostachys japonicus A. Berger, have been reported in treatment of ovarian and cervical cancers, but the systematic approaches to explain their molecular mechanism(s) have not yet been established. Objectives : To establish a basis of understanding for anti-cancer mechanisms of herbal medicine, we profiled protein expression in human ovarian and cervical cancer cells treated with the extracts from Euonymus alatus Sieb, Oldenlandia diffusa (Willd.) Roxburgh and Orostachys japonicus A. Berger. Methods : Human ovarian cancer cell line NIH:OVCAR-3, and human cervical cancer cell line HeLa were employed in the present study. Whole protein was obtained from the cells harvested at 48 hours after the treatment with herbal water-extract, and analyzed by 2DE-based proteomic approach. Results : Various changes of protein expression induced by the herbal treatment were monitored : down-regulation of molecular chaperone (calreticulin variant), glycolytic enzymes (D-3-phosphoglycerate dehydrogenase, glyceraldehyde 3-phosphate dehydrogenase and alpha-enolase), RNA processing molecules (hnRNP A2/B1), and antioxidant protein (peroxiredoxin 1). Conclusions : Repression of glycolysis has been accepted as the mechanism to increase anticancer reagent's effect. Thus, down-regulation of glycolytic enzymes by the herbal extracts suggested a possible synergistic effect of herbs in the presence of platinum-based therapeutics. In further study, as well as the synergistic effect of the herbs, it has to be further validated whether artificial regulation of hnRNP A2/B1 in ovarian cancer cells affects various cancer survival factors, since RNA processing can be interrupted by deranged expression of hnRNP subtypes, and it results in an inhibition of cancer cell growth.

Optomizing Transfection Efficiency of Cervical Cancer Cells Transfected by Cationic Liposomes LipofectamineTM2000

  • Huang, Fei;Zhao, Feng;Liang, Li-Ping;Zhou, Mei;Qu, Zhi-Ling;Cao, Yan-Zhen;Lin, Chen
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7749-7754
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    • 2015
  • Background: Currently, cationic liposome has become the commonly used vehicles for gene transfection. Furthermore, one of the most significant steps in microRNAs expression studies is transferring microRNAs into cell cultures successfully. In this study we aim to approach the feasibility of transfection of cervical cancer cell lines mediated by liposome and to obtain the optimized transfection condition for cervical cancer cell lines. Materials and Methods: $Lipofectamine^{TM}2000$ as the carrier, miR-101 mimic was transfected into Hela cells and Siha cells. Using green fluorescent protein as reporter gene, to set different groups according to cell seeding density, the amount of miRNA, miRNA and the proportion of Liposomes, Whether to add serum into medium to study their impact on the liposomal transfection efficiency. Finally, MTT assay was used to analyze the relative minimal cell toxicity of liposome reagents. Results: The seeding density of Hela cell line and Siha are $1.5{\times}10^4$ (per well of 24 well plates), miRNA amount is 1ul of both, the ratio of miRNA and liposome is 1:0.5 of Hela cell line; 1:0.7 of Siha cell line respectively, after 24 hours we can get the highest transfection efficiency. Compared with serum medium, only Siha cells cultured with serum-free medium obtained higher transfection efficiency before transfection (P<0.01). MTT assay showed that according to the above conditions which has the lowest cytotoxicity. Conclusions: The method of Liposome to transfected is a suitable way and it can be an efficient reagent for miRNA delivery for Hela cells and Siha cells in vitro. It may serve as a reference for the further research or application.

내시경 갑상샘 절제술 후 발생한 경부 근긴장이상증의 보툴리늄 A 독소를 이용한 치료: 증례보고 (Botulinum Toxin A Treatment for Cervical Dystonia Resulting in Endoscopic Thyroidectomy: A Case Report)

  • 오화영;최환준;남두현;김준혁;이영만
    • Archives of Plastic Surgery
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    • 제38권2호
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    • pp.207-211
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    • 2011
  • Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

종격동경 검사의 임상적 의의 (A Clinical Evaluation of Mediastinoscopy)

  • 고영상;조중구;김공수
    • Journal of Chest Surgery
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    • 제26권9호
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    • pp.705-709
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    • 1993
  • The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

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전방 경경부접근술을 통한 상구종양 절제술 (Anterior Transcervical Approach to Supperior Sulcus Tumor)

  • 최호;이철주;홍준화;강준규;최진욱;윤유상
    • Journal of Chest Surgery
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    • 제34권5호
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    • pp.426-429
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    • 2001
  • Superior sulcus or pancoase tumor refers to any primarty lung cancer locating in thoracic inlet and causing pain in the periscapular region or aim. These originate inperipheral, and involve th extrapulmonary structures more than parenchyma of the lung. We experienced l case of superior sulcus tumor radically resected via anterior transcervical approach, which provide more safe exposure of cervical structures of thoracic inlet than classis posterolateral thoracotomy. Therefore were report this case with review of literature.

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흉쇄유돌근에서 기인한 Low-Grade Myofibroblastic Sarcoma 1예 (Low Grade Myofibroblastic Sarcoma of the Sternocleidomastoid Muscle)

  • 심남석;홍현준;송기재;최성은;서연석;이은정
    • 대한두경부종양학회지
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    • 제30권1호
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    • pp.23-27
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    • 2014
  • Low-grade myofibroblastic sarcoma is a rare disorder of malignant soft tissue tumor and is usually occurred various regions that often manifests in the head and neck region. The most common clinical presentation of this entity is non-tender cervical lymphadenopathy. This disease usually presents high possibility of local recurrence and low possibility of distant metastasis. We report a rare case of low-grade myofibroblastic sarcoma occurring in the sternocleidomastoid muscle and invading to the mastoid tip. A 56-year-old male visited the clinic with a complaint of slowly growing postauricular mass for 6 months. Mass originating from sternomastoid muscle and invasion to mastoid tip was observed by imaging studies. Surgical complete excision with simple mastoidectomy was performed via modified facelift approach. The histopathologic findings revealed malignant spindle cell tumor with positive staining with smooth muscle actin. The patient has no recurrence for 2years without any complication.

선행화학요법을 시행한 식도암 환자의 외과적 고찰 (Surgery of Advanced Esophageal Cancer after Chemotherapy)

  • 임수빈;이종목
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.536-541
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    • 1996
  • Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.

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Ultrasound Imaging in Active Surveillance of Small, Low-Risk Papillary Thyroid Cancer

  • Sangeet Ghai;David P Goldstein;Anna M Sawka
    • Korean Journal of Radiology
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    • 제25권8호
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    • pp.749-755
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    • 2024
  • The recent surge in the incidence of small papillary thyroid cancers (PTCs) has been linked to the widespread use of ultrasonography, thereby prompting concerns regarding overdiagnosis. Active surveillance (AS) has emerged as a less invasive alternative management strategy for low-risk PTCs, especially for PTCs measuring ≤1 cm in maximal diameter. Recent studies report low disease progression rates of low-risk PTCs ≤1 cm under AS. Ongoing research is currently exploring the feasibility of AS for larger PTCs (<20 mm). AS protocols include meticulous ultrasound assessment, emphasis on standardized techniques, and a multidisciplinary approach; they involve monitoring the nodules for size, growth, potential extrathyroidal extension, proximity to the trachea and recurrent laryngeal nerve, and potential cervical nodal metastases. The criteria for progression, often defined as an increase in the maximum diameter of the PTC, warrant a review of precision and ongoing examinations. Challenges exist regarding the reliability of volume measurements for defining PTC disease progression. Although ultrasonography plays a pivotal role, challenges in assessing progression and minor extrathyroidal extension underscore the importance of a multidisciplinary approach in disease management. This comprehensive overview highlights the evolving landscape of AS for PTCs, emphasizing the need for standardized protocols, meticulous assessments, and ongoing research to inform decision-making.

The Transmanubrial Approach for Cervicothoracic Junction Lesions : Feasibility, Limitations, and Advantages

  • Park, Jong-Hyun;Im, Soo Bin;Jeong, Je Hoon;Hwang, Sun Chul;Shin, Dong-Seung;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • 제58권3호
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    • pp.236-241
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    • 2015
  • Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.