• Title/Summary/Keyword: Comparison Analysis

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A Pilot Study for the Feasibility of F-18 FLT-PET in Locally Advanced Breast Cancer: Comparison with F-18 FDG-PET (국소진행성 유방암에서 F-18 FLT-PET 적용 가능성에 대한 예비 연구: F-18 FDG-PET와 비교)

  • Hyuen, Lee-Jai;Kim, Euy-Nyong;Hong, Il-Ki;Ahn, Jin-Hee;Kim, Sung-Bae;Ahn, Sei-Hyun;Gong, Gyung-Yup;Kim, Jae-Seung;Oh, Seung-Jun;Moon, Dae-Hyuk;Ryu, Jin-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.29-38
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    • 2008
  • Purpose: The aim of this study was to investigate the feasibility of 3 ' -[F-18]fluoro-3 ' -deoxythymidine positron emission tomography(FLT-PET) for the detection of locally advanced breast cancer and to compare the degree of FLT and 2' -deoxy-2 ' -[F-18]fluoro-d-glucose(FDG) uptake in primary tumor, lymph nodes and other normal organs. Material & Methods: The study subjects consisted of 22 female patients (mean age; $42{\pm}6$ years) with biopsy-confirmed infiltrating ductal carcinoma between Aug 2005 and Nov 2006. We performed conventional imaging workup, FDG-PET and FLT PET/CT. Average tumor size measured by MRI was $7.2{\pm}3.4$ cm. With visual analysis, Tumor and Lymph node uptakes of FLT and FDG were determined by calculation of standardized uptake value (SUV) and tumor to background (TB) ratio. We compared FLT tumor uptake with FDG tumor uptake. We also investigated the correlation between FLT tumor uptake and FDG tumor uptake and the concordant rate with lymph node uptakes of FLT and FDG. FLT and FDG uptakes of bone marrow and liver were measured to compare the biodistribution of each other. Results: All tumor lesions were visually detected in both FLT-PET and FDG-PET. There was no significant correlation between maximal tumor size by MRI and SUVmax of FLT-PET or FDG-PET (p>0.05). SUVmax and $$SUV_{75} (average SUV within volume of interest using 75% isocontour) of FLT-PET were significantly lower than those of FDG-PET in primary tumor (SUVmax; $6.3{\pm}5.2\;vs\;8.3{\pm}4.9$, p=0.02 /$SUV_{75};\;5.3{\pm}4.3\;vs\;6.9{\pm}4.2$, p=0.02). There is significant moderate correlation between uptake of FLT and FDG in primary tumor (SUVmax; rho=0.450, p=0.04 / SUV75; rho=0.472, p=0.03). But, TB ratio of FLT-PET was higher than that of FDG-PET($11.7{\pm}7.7\;vs\;6.3{\pm}3.8$, p=0.001). The concordant rate between FLT and FDG uptake of lymph node was reasonably good (33/34). The FLT SUVs of liver and bone marrow were $4.2{\pm}1.2\;and\;8.3{\pm}4.9$. The FDG SUVs of liver and bone marrow were $1.8{\pm}0.4\;and\;1.6{\pm}0.4$. Conclusion: The uptakes of FLT were lower than those of FDG, but all patients of this study revealed good FLT uptakes of tumor and lymph node. Because FLT-PET revealed high TB ratio and concordant rate with lymph node uptakes of FDG-PET, FLT-PET could be a useful diagnostic tool in locally advanced breast cancer. But, physiological uptake and individual variation of FLT in bone marrow and liver will limit the diagnosis of bone and liver metastases.

Possibility of Establishing an International Court of Air and Space Law (국제항공우주재판소의 설립 가능성)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.2
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    • pp.139-161
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    • 2009
  • The idea of establishing an International Court of Air and Space Law (hereinafter referred to ICASL) is only my academic and practical opinion as first proposal in the global community. The establishment of the International Court of Air and Space Law can promote the speed and promote fairness of the trial in air and space law cases. The creation of an ICASL would lead to strengthening of the international cooperation deemed essential by the global community towards joint settlement in the transnational air and space cases, claims and would act as a catalyst for the efforts and solution on aircraft, satellite and space shuttle's accidents and cases and all manpower, information, trial and lawsuit to be centrally managed in an independent fashion to the benefit of global community. The aircraft, satellite and spacecraft's accidents attributes to the particular and different features between the road, railway and maritime's accidents. These aircraft, satellite and spacecraft's accidents have incurred many disputes between the victims and the air and space carriers in deciding on the limited or unlimited liability for compensation and the appraisal of damages caused by the aircraft's accidents, terror attack, satellite, space shuttle's accidents and space debris. This International Court of Air and Space Law could hear any claim growing out of both international air and space crash accidents and transnational accidents in which plaintiffs and defendants are from different nations. This alternative would eliminate the lack of uniformity of decisions under the air and space conventions, protocols and agreements. In addition, national courts would no longer have to apply their own choice of law analysis in choosing the applicable liability limits or un-limit for cases that do not fall under the air and space system. Thus, creation of an International Court of Air and Space Law would eliminate any disparity of damage awards among similarly situated passengers and shippers in nonmembers of air and space conventions, protocols, agreements and cases. Furthermore, I would like to explain the main items of the abovementioned Draft for the Convention or Statute of the International Court of Air and Space Law framed in comparison with the Statute of the International Court of Justice, the Statue of the International Tribunal for the Law of the Sea and the Statute of the International Criminal Court. First of all, in order to create the International Court of Air and Space Law, it is necessary for us to legislate a Draft for the Convention on the Establishment of the International Court of Air and Space Law. This Draft for the Convention must include the elected method of judges, term, duty and competence of judge, chambers, jurisdiction, hearing and judgment of the ICASL. The members of the Court shall be elected by the General Assembly and Council of the ICAO and by the General Assembly and Legal Committee of the UNCOPUOS from a list of persons nominated by the national groups in the six continent (the North American, South American, African, Oceania and Asian Continent) and two international organization such as ICAO and UNCOPUOS. The members of the Court shall be elected for nine years and may be re-elected as one time. However, I would like to propose a creation an International Court of Air and Space Law in extending jurisdiction to the International Court of Justice at the Hague to in order to decide the air and space convention‘s cases. My personal opinion is that if an International Court on Air and Space Law will be created in future, it will be settled quickly and reasonably the difficulty and complicated disputes, cases or lawsuit between the wrongdoer and victims and the injured person caused by aircraft, satellite, spacecraft's accidents or hijacker and terrorists etc. on account of deciding the standard of judgment by judges of that’s court. It is indeed a great necessary and desirable for us to make a new Draft for the Convention on a creation of the International Court of Air and Space Law to handle international air and space crash litigation. I shall propose to make a new brief Draft for the Convention on the Creation of an International Court of Air and Space Law in the near future.

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Studies on the Shade Tolerance, Light Requirement, and Water Relations of Economic Tree Species(III) - Analysis of Pressure-Volume Curves on the Changes of Tissue Water Relations of Five Deciduous Hardwood Species Subjected to Artificial Shading Treatments - (주요경제수종(主要經濟樹種)의 내음성(耐陰性) 및 광선요구도(光線要求度)와 수분특성(水分特性)에 관한 연구(III) - 인공피음처리하(人工被陰處理下)에서 자라는 활엽수(闊葉樹) 5수종(樹種)의 수분특성(水分特性) 변화(變化)에 대한 P-V곡선(曲線) 분석(分析) -)

  • Choi, Jeong Ho;Kwon, Ki Won
    • Journal of Korean Society of Forest Science
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    • v.90 no.4
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    • pp.524-534
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    • 2001
  • The pressure-volume curve parameters were investigated to elucidate the effects of shading treatment on the water relations of the one year old seedlings of Betula platyphylla var. japonica, Betula schmidtii, Zelkova serrata, Acer mono and Prunes sargentii subjected to five levels of artificial shading treatments. The osmotic potentials at full turgor(${\phi}_{{\pi}o}$) measured under full sunlight changed with species and growing season in the ranges of -1.04~-1.27MPa, -1.03~-1.48MPa, -0.94~-1.44MPa in first year treatment, and -0.90~-1.37MPa, -1.05~-1.79MPa, -0.99~-1.30MPa in second year treatment in June, July, and September, respectively. The osmotic potentials at full turgor increased with increment of shading level in the ranges of -0.90~-1.79MPa in full sunlight and -0.58~-1.23MPa in nearly full shading level(E) through the growing seasons in all the species studied. The osmotic potentials at turgor loss point(${\phi}_{{\pi}p}$) measured in full sunlight changed in the ranges of -1.64~-2.11MPa, -1.67~-2.15MPa, -1.47~-2.11MPa, and -1.45~-2.04MPa, -1.30~-2.00MPa, -1.28~-2.33MPa in June, July, and September of first and second years, respectively. Most of ${\phi}_{{\pi}p}$ measurements were lower within about 0.5MPa in comparison with those of ${\phi}_{{\pi}o}$. The measurements of ${\phi}_{{\pi}p}$ also increased with increment of shading level, and the differences in ${\phi}_{{\pi}p}$ among shading levels were generally greater than those in ${\phi}_{{\pi}o}$ by species and by growing season. Most of the osmotic potentials at turgor loss point as like as at full turgor were lowered in July than in June and September. The measurements of relative water content at turgor lass point(RWCp) in full sunlight were in the similar ranges of 81~88%, 71~86%, 75~84%, and 82~87, 72~84%, 76~86% in June, July, and September of first and second years, respectively. The RWCp were a little higher in A. mono and P. sargentii than in B. platyphylla var. japonica, B. schmidtii, and Z. serrata. The RWCp also decreased from 71~88% in full sunlight to 48~77% in nearly full shading treatment with increment of shading level. Even if there were some exceptions by species or by growing season, the shading effects on the changes in some P-V parameters were distinctly observed in the present study. The change in P-V parameters following shading treatment may be presumably inferred on the changes in solute accumulation, membrane elasticity, symplasmic water volume, and so on. But much more experiments should be necessarily continued for getting detailed informations on the physiological mechanism of shading effects relating to the changes in P-V parameters.

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Environmental Changes after Timber Harvesting in (Mt.) Paekunsan (백운산(白雲山) 성숙활엽수림(成熟闊葉樹林) 개벌수확지(皆伐收穫地)에서 벌출직후(伐出直後)의 환경변화(環境變化))

  • Park, Jae-Hyeon
    • Journal of Korean Society of Forest Science
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    • v.84 no.4
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    • pp.465-478
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    • 1995
  • The objective of this study was to investigate the impacts of large-scale timber harvesting on the environment of a mature hardwood forest. To achieve the objective, the effects of harvesting on forest environmental factors were analyzed quantitatively using the field data measured in the study sites of Seoul National University Research Forests [(Mt.) Paekunsan] for two years(1993-1994) following timber harvesting. The field data include information on vegetation, soil mesofauna, physicochemical characteristics of soil, surface water runoff, water quality in the stream, and hillslope erosion. For comparison, field data for each environmental factor were collected in forest areas disturbed by logging and undisturbed, separately. The results of this study were as follows : The diversity of vegetational species increased in the harvested sites. However, the similarity index value of species between harvested and non-harvested sites was close to each other. Soil bulk density and soil hardness were increased after timber harvesting, respectively. The level of organic matter, total-N, avail $P_2O_5$, CEC($K^+$, $Na^+$, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$) in the harvested area were found decreased. While the population of Colembola spp., and Acari spp. among soil mesofauna in harvested sites increased by two to seven times compared to those of non-harvested sites during the first year, the rates of increment decreased in the second year. However, those members of soil mesofauna in harvested sites were still higher than those of non-harvested sites in the second year. The results of statistical analysis using the stepwise regression method indicated that the diversity of soil mesofauna were significantly affected by soil moisture, soil bulk density, $Mg^{{+}{+}}$, CEC, and soil temperature at soil depth of 5(0~10)cm in the order of importance. The amount of surface water runoff on harvested sites was larger than that of non-harvested sites by 28% in the first year and 24.5% in the second year after timber harvesting. The level of BOD, COD, and pH in the stream water on the harvested sites reached at the level of the domestic use for drinking in the first and second year after timber harvesting. Such heavy metals as Cd, Pb, Cu, and organic P were not found. Moreover, the level of eight factors of domestic use for drinking water designated by the Ministry of Health and Welfare of Korea were within the level of the first class in the quality of drinking water standard. The study also showed that the amount of hillslope erosion in harvested sites was 4.77 ton/ha/yr in the first year after timber harvesting. In the second year, the amount decreased rapidly to 1.0 ton/ha/yr. The impact of logging on hillslope erosion in the harvested sites was larger than that in non-harvested sites by seven times in the first year and two times in the second year. The above results indicate that the large-scale timber harvesting cause significant changes in the environmental factors. However, the results are based on only two-year field observation. We should take more field observation and analyses to increase understandings on the impacts of timber harvesting on environmental changes. With the understandings, we might be able to improve the technology of timber harvesting operations to reduce the environmental impacts of large-scale timber harvesting.

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The Comparison of Quantitative Indices by Changing an Angle of LAO View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 좌전사위상 각도의 변화에 따른 정량적 지표 비교)

  • Yoon, Soon-Sang;Nam, Ki-Pyo;Ryu, Jae-Kwang;Kim, Seong-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.57-61
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    • 2012
  • Purpose: The multi-gated cardiac blood pool scan is to evaluate the function of left ventricle (LV) and usefully observe a value of ejection fraction (EF) for a patient who is receiving chemotherapy. To calculate LVEF, we should adjust an angle of left anterior oblique (LAO) view to separate both ventricles. And by overlapped ventricles, it is possible to affect LVEF. The purpose of this study is to investigate and compare quantitative indices by changing an angle of LAO view. Materials and methods: We analyzed the 49 patients who were examined by multi-gated cardiac blood pool scan in department of nuclear medicine at Asan Medical Center from June to September 2011. Firstly, we acquired "Best septal" view. And then, we got images by addition and subtraction of angle for LAO view to anterior and lateral. We compared three LAO views for 20 people by 5 degrees and 39 people by 10 degrees. And we analyzed quantitative indices, EF, end diastole and end systole counts, by automated and manual region of interest (ROI) modes. Results: Firstly, we analyzed quantitative indices by automated ROI mode. In case of 5 degrees, the averages of EF are $61.0{\pm}7.5$, $62.1{\pm}7.1$, $60.9{\pm}6.7%$ ($p$=0.841) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $62.4{\pm}9.5$, $62.3{\pm}10.8$, $61.6{\pm}.9.3%$ ($p$=0.938) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Secondly, we analyzed quantitative indices by manual ROI mode. In case of 5 degrees, the averages of EF are $62.8{\pm}7.1$, $63.6{\pm}7.5$, $62.7{\pm}7.3%$ ($p$=0.903) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $65.5{\pm}9.0$, $66.3{\pm}8.7$, $63.5{\pm}.9.3%$ (p=0.473) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Conclusion: When an image is nearly "Best septal" view, the difference of LAO angle would not affect to change LVEF. Although there was no difference in quantitative analysis, deviations could happen when to interpret wall motion qualitatively by reading physicians.

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Evaluation of Standardized Uptake Value and Metabolic Tumor Volume between Reconstructed data and Re-sliced data in PET Study (PET 검사 시 Reconstructed data와 Re-sliced data의 표준섭취계수와 Metabolic Tumor Volume의 비교 평가)

  • Do, Yong Ho;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.3-8
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    • 2016
  • Purpose SUV is one of the parameters that assist diagnosis in origin, metastasis and staging of cancer. Specially, it is important to compare SUV before and after chemo or radiation therapy to find out effectiveness of treatment. Storing PET data which has no quantitative change is needed for SUV comparison. However, there is a possibility to loss the data in external hard drive or MINIpacs that are managed by department of nuclear medicine. The aim of this study is to evaluate SUV and metabolic tumor volume (MTV) among reconstructed data (R-D) in workstation, R-D and re-sliced data (S-D) in PACS. Materials and Methods Data of 20 patients (aged $60.5{\pm}8.3y$) underwent $^{18}F-FDG$ PET (Biograph truepoint 40, mCT 40, mCT 64, mMR, Siemens) study were analysed. $SUV_{max}$, $SUV_{peak}$ and MTV were measured in liver, aorta and tumor after sending R-D in workstation, R-D and S-D in PACS to syngo.via software. Results R-D of workstation and PACS showed the same value as mean $SUV_{max}$ in liver, aorta and tumor were $2.95{\pm}0.59$, $2.35{\pm}0.61$, $10.36{\pm}6.15$ and $SUV_{peak}$ were $2.70{\pm}0.51$, $2.07{\pm}0.43$, $7.67{\pm}3.73$(p>0.05) respectively. Mean $SUV_{max}$ of S-D in PACS were decreased by 5.18%, 7.22%, 12.11% and $SUV_{peak}$ 2.61%, 3.63%, 10.07%(p<0.05). Correlation between R-D and S-D were $SUV_{max}$ 0.99, 0.96, 0.99 and $SUV_{peak}$ 0.99, 0.99, 0.99. And 2SD in balnd-altman analysis were $SUV_{max}$ 0.125, 0.290, 1.864 and $SUV_{peak}$ 0.053, 0.103, 0.826. MTV of R-D in workstation and PACS show the same value as $14.21{\pm}12.72cm^3$(p>0.05). MTV in PACS was decreased by 0.12% compared to R-D(p>0.05). Correlation and 2SD between R-D and S-D were 0.99 and 2.243. Conclusion $SUV_{max}$, $SUV_{peak}$, MTV showed the same value in both of R-D in workstation and PACS. However, there was statistically difference in $SUV_{max}$, $SUV_{peak}$ of S-D compare to R-D despite of high correlation. It is possible to analyse reliable pre and post SUV if storing R-D in main hospital PACS system.

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Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

Eating Traits and General Psychopathology of Korean Males Who Show High Score on the Korean Version of Eating Attitudes Test-26 (한국판(韓國版) 식사태도(食事態度) 검사(檢査)-26에서 고득점(高得點)을 보인 한국(韓國) 일반(一般) 남성군(男性群)의 식사특성(食事特性)과 일반정신병리(一般精神病理))

  • Han, Ki-Seok;Lee, Young-Ho;Rhee, Min-Kyu;Park, Se-Hyun;Sohn, Chang-Ho;Chung, Young-Cho;Hong, Sung-Kook;Lee, Byung-Kwan;Chang, Phi-Lip;Yoon, A-Rhee
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.87-102
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    • 1999
  • Objectives : The purposes of this study were to estimate the prevalence rate of eating disorders in Korean males and to clarify their characteristics in sociodemograhic data, the eating traits, and general psychopathology through the comparison with those of female high scored group on the Korean version of Eating Attitudes Test-26(KEAT-26). Methods : Using a multi-stage questionnaire sampling method including area sampling, proportionated stratified sampling, and quota sampling, we surveyed a total of 4,400 Korean adults over 18 in a nationwide area(9 kus, 10 middle or small cities, and 17 kuns), obtaining usable responses on 3,896. Of the 3,062 subjects(1249 males and 1813 females) who were available for analysis, we ascertained 52 males and 208 females who had high score($\geq$ cutoff point 21) on the KEAT-26. Results : 1) The proportion of this high score group was 1.7% in male and 6.8% in female with a sex ratio(male versus female) of 1 : 4. 2) The mean age was higher in the male group than in the female group, although it was not statistically significant(p=0.0514). Mean Body Mass Index(BMI) of the male group was significantly higher than that of female group, and the number of male subjects with below 20 of BMI was also significantly lower than in the female group. 3) There were no significant difference in past history of physical illness between two groups. However, frequency of smoking and alcohol use, and mean amount of alcohol consumption per month were significantly higher in the male group than in the female group. There were no significant differences between the two groups on various socio-demographic correlates such as economic status, total duration of education, number of family, marital status, religious status, and area of residence, but the exception of being occupational status. 4) The 'Eating Habits Scale' score and score of 'preference for vegetables and fish, and dislike for sweet-tasting food' of the male group were significantly lower than those of the female group. Although there was no significant difference between the two groups in total scores of the KEAT-26, the mean score on 'pursuit of thinness' subscale was higher in the female group than in the male group, while scores of 'food preoccupation' and 'self-control' subscales were higher in the male group than in the female group. 5) Scores on 'psychoticism' was significantly higher in the male group than in the female group, although there were no significant differences between the two groups on 'locus of control for weight', 'depression' and 'hypochondriasis'. Conclusion : These results support a possibility of a high prevalence of eating disorders in Korean males. These results suggest that eating related characteristics of high scorer on the EAT are different by sex in spite of the same high score on the EAT, and also suggest that male patients with eating disorders have more serious personality pathology than female patients with eating disorders.

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Clinical Results after Repair of Rotator Cuff Tear in Patients with Accompanying AC Joint Pathology: Clinical Comparison of Non-operative Treatment (회전근개 파열과 동반된 견봉 쇄골 관절 병변이 회전근개 봉합술 후 결과에 미치는 영향: 비수술적 치료를 통한 임상적 비교)

  • Yoo, Moon-Jib;Seo, Joong-Bae;Lee, Dae-Hee;Kim, Sung-Jin
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.86-90
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    • 2012
  • Purpose: We studied the need for distal clavicle resection by comparing rotator cuff tear patients who underwent non-surgical treatment with and without acromioclavicular joint pathology. Materials and Methods: 45 cases that had been under follow up care for at least 9 months after receiving rotator cuff repair in our hospital between Jan. 2005 and Jun. 2011 had been studied. Acromioclavicular joint pathology group and control group were classified by physical examination and MRI findings. The temporal changes in shoulder joint abduction, internal and external rotation strength, ASES and KSS score of the two groups were measured and analyzed. Results: The acromioclavicular joint pathology complicated rotator cuff injury group's strength measurements for abduction, internal rotation, external rotation were each 8.05 (${\pm}4.54$), 11.33 (${\pm}6.05$), 10.24 (${\pm}5.27$) preoperatively and improved to 13.26 (${\pm}5.50$), 17.51 (${\pm}6.80$), 15.60 (${\pm}5.37$) post operatively while the KSS score and ASES score were each 49.07 (${\pm}15.28$) and 48.65 (${\pm}13.27$) preoperatively, improving to 84.48 (${\pm}10.96$) and 84.65. (${\pm}9.86$). The measurements for the group without complicating acromioclavicular pathology are as follows. The strength for abduction, internal rotation, external rotation was each 6.42 (${\pm}3.11$), 7.59 (${\pm}4.81$) and 7.93 (${\pm}4.49$) preoperatively, improving to 15.85 (${\pm}7.35$), 19.18 (${\pm}9.14$), 16.95 (${\pm}5.70$) post operatively, while the KSS score and ASES score each went from 42.12 (${\pm}6.43$) and 41.37 (${\pm}7.42$) to 83.44 (${\pm}6.30$) and 83.17 (${\pm}7.01$) respectively. The measurements for the two groups, however, did not show a statistically significant difference (p>0.05). Conclusion: Analysis of the rotator cuff injury groups with and without AC joint pathology showed that both groups had improved strength, ASES and KSS scores with no statistical difference difference among the groups. As such, it thought that conservative treatment is an acceptable alternative to distal clavicle resection.

Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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