The aim of this study was to evaluate the dose comparison using Radon phantom with 5 mm and 10 mm tissue equivalent materials, FIF, Wedge(15, 30 angle) and IMRT, to reduce the skin dose of the contralateral breast during breast cancer radiation therapy(Total dose: 50.4Gy). The dose was measured for each treatment plan by attaching to the 8 point of the contralateral breast of the treated region using a optical-stimulated luminance dosimeter(OSLD) as a comparative dose evaluation method. Of the OSLD used in the study, 10 were used with reproducibility within 3%. As a result, the average reduction rates of 5 mm and 10 mm in the FIF treatment plan were 37.23 cGy and 41.77 cGy, respectively, and the average reduction rates in the treatment plan using Wedge $15^{\circ}$ were 70.69 cGy and 87.57 cGy, respectively. The IMRT showed a reduction of 67.37 cGy and 83.17 cGy, respectively. The results of using bolus showed that as the thickness of the bolus increased in all treatments, the dose reduction increased. We concluded that mastectomy as well as general radiotherapy for breast cancer would be very effective for patients who are more likely to be exposed to scattered radiation due to a more demanding or complex treatment plan.
Ha, Eun Sil;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Jo, Won Min;Lee, Sang Yeub;Kim, Je-Hyeong;Lee, Eung Seok;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
Tuberculosis and Respiratory Diseases
/
v.60
no.3
/
pp.347-352
/
2006
A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.
Purpose : The aim of this study was to evaluate the usefulness of MRI performed after excisional biopsy to diagnose residual cancer and additional lesions. Materials and Methods : A total of 16 patients who had breast cancer diagnosed by excisional biopsy underwent preoperative breast MRI between March 2005 and August 2007 were included. MRI findings were considered positive for residual cancer if focal, thick, or irregular rim enhancement or adjacent enhancing lesion was identified around the postoperative biopsy cavity. And additional lesions separated from biopsy cavity including multifocal, multicentric, or contralateral lesion were evaluated. We evaluated the diagnostic accuracy of MRI, comparing MRI with histopathologic finding, and the impact of MRI on surgical planning. Results : The sensitivity and specificity of MRI for detecting residual disease considering rim enhancement were 85.7%(6/7) and 55.6%(5/9). Additional lesions including multifocal, multicentric, or contralateral lesion were found in 6 patients. In 7 patients, results of MRI findings changed surgical treatment planning. Conclusion : The pattern of rim enhancement on MRI after excisional biopsy is not differential point to evaluate remnant lesion. But MRI has an important role to help the detection of multifocal or multicentric, or contralateral breast malignancies, resulting in beneficial change in surgical treatment planning.
Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.
In recent observations on vestibular eye movements in mammals, reported by several different workers, it was indicated that the pattern of reflex eye movement from semicircular canal nerve stimulation in rabbits was different from that observed in the other species such as cats and dogs. Observing the different anatomical features of the extraocular muscles of rabbits, Kim ascribed the different pattern of eye movement of rabbits to the functional difference of inferior and superior oblique muscles from those of other species. Present experiment was carried out to elucidate a physiological mechanism underlying in such particular pattern of reflex eye movement in rabbits. An individual canal nerve was selectively stimulated, under a dissecting microscope, by a fine electrode induced into an ampulla through a hole provided on the wall of corresponding osseous canal, and responses of the extraocular muscles were checked by recording the isotonic changes of muscle length. Following results were obtained. 1. Direct stimulation of the superior or inferior oblique muscles Produced upward or downward movement of the eye turning toward medial side respectively. 2. Stimulation of the unilateral canal nerve Produced a marked contraction of a main contracting ocular muscle and simultaneous relaxation of an antagonistic muscle in both eyes. Less potent contraction of an additional ocular muscle was observed and it appeared to augment the function of the main contracting muscle in the ipsilateral eye. 3. Stimulation of superior semicircular canal nerve caused a primary contraction of superior rectus, synergic contraction of superior oblique and relaxation of inferior rectus in ipsilateral eye. Contraction of inferior oblique and relaxation of superior oblique were observed in the contralateral eye. 4. Stimulation of lateral semicircular canal nerve produced a primary contraction of medial rectus, synergic contraction of superior oblique and relaxation of lateral rectus in the ipsilateral eye. Contraction of lateral rectus and relaxation of medial rectus were observed in the contralateral eye. 5. Stimulation of inferior semicircular canal nerve produced a primary contraction of superior oblique, synergic contraction of superior rectus and relaxation of inferior oblique in the ipsilateral eye. Contraction of. inferior rectus and relaxation of superior rectus were observed in the contralateral eye. 6. Upon stimulation of individual canal nerve, the pattern of eye movement in rabbits is different from those of cats, however, the responses of the extraocular muscles appear to be similar in two species. Therefore, it is concluded that the different Pattern of eye movement in both species are not due to the possible difference of vestibule-ocular reflex pathways but to the functional difference of superior and inferior oblique muslces.
Oh Young Taek;Keum Ki Chang;Chu Seong Sil;Kim Gwi Eon
Radiation Oncology Journal
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v.14
no.4
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pp.323-332
/
1996
Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.
Bond, Vernon;Curry, Bryan Heath;Kumar, Krishna;Pemminati, Sudhakar;Gorantla, Vasavi Rakesh;Kadur, Kishan;Millis, Richard Mark
Journal of Pharmacopuncture
/
v.20
no.1
/
pp.23-28
/
2017
Objectives: Exercise with partially restricted blood flow is a low-load, low-intensity resistance training regimen which may have the potential to increase muscle strength in the obese, elderly and frail who are unable to do high-load training. Restricted blood flow exercise has also been shown to affect blood vessel function variably and can, therefore, contribute to blood vessel dysfunction. This pilot study tests the hypothesis that unilateral resistance training of the leg extensors with partially restricted blood flow increases muscle strength and decreases vascular autoregulation. Methods: The subjects were nine normotensive, overweight, young adult African-Americans with low cardiorespiratory fitness who underwent unilateral training of the quadriceps' femoris muscles with partially restricted blood flow at 30% of the 1-repetition maximum (1-RM) load for 3 weeks. The 1-RM load and post-occlusion blood flow to the lower leg (calf) were measured during reactive hyperemia. Results: The 1-RM load increased in the trained legs from $77{\pm}3$ to $84{\pm}4 kg$ (P < 0.05) in the absence of a significant effect on the 1-RM load in the contralateral untrained legs (P > 0.1). Post-occlusion blood flow decreased significantly in the trained legs from $19{\pm}2$ to $13{\pm}2mL{\cdot}min^{-1}{\cdot}dL^{-1}$ (P < 0.05) and marginally in the contralateral untrained legs from $18{\pm}2$ to $16{\pm}1mL{\cdot}min^{-1}{\cdot}dL^{-1}$ (P = 0.09). Changes in post-occlusion blood flow to the skin overlying the trained and the contralateral untrained muscles were not significant. Conclusion: These results demonstrate that restricted blood flow exercise, which results in significant gains in muscle strength, may produce decrements in endothelial dysfunction and vascular autoregulation. Future studies should determine whether pharmacopuncture plays a role in treatments for such blood vessel dysfunction.
Background: Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficit. Bee venom acupuncture has traditionally been used to treat several inflammatory diseases and chronic pain conditions. Objectives: The aims of this study were to compare the effects of bee venom (general bee venom, BV) and sweet bee venom (allergen-removed bee venom, SBV) acupuncture on the recovery rate of locomotor function, the expression of brain-derived neurotrophic factor (BDNF) in the sciatic nerve, and the expression of c-Fos in the brain following sciatic crushed nerve injury in rats, and to evaluate differences due to administration areas. Method: Walking track analysis, Western blot for BDNF and tyrosine receptor kinase B (TrkB), and immunohistochemistry for c-Fos were performed. In this study, comparative analyses of the effects of BV and SBV acupuncture in relation to administration sites, contralateral side or ipsilateral side, were conducted. Results: In the present result, sciatic function index (SFI) in walking track analysis significantly decreased following sciatic crushed nerve injury. The expressions of BDNF and TrkB in the sciatic nerve increased after induction of sciatic crushed nerve injury. C-Fos expression in the ventrolateral periaqueductal gray (vlPAG) and paraventricular nucleus (PVN) also increased. BV and SBV acupuncture treatment improved the SFI in walking track analysis. Treatment with SBV at 1mg/kg showed more potent enhancing effect on SFI compared to BV. Treatment with 1mg/kg BV or 1mg/kg SBV acupuncture suppressed the BDNF and TrkB expression in the sciatic nerve. BV and SBV acupuncture treatment also suppressed c-Fos expression in the PVN and vlPAG regions. Treatment with SBV at 1mg/kg showed more potent suppressing effect on c-Fos expression compared to BV when injected into the contralateral side of the injured nerve. Generally we could not find significant difference in the effects between contralateral side and ipsilateral side of the injured nerve. Conclusion: We have shown that BV and SBV acupuncture treatment can be used as the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.
This study was performed to investigate the relationship between mandibular midline shift and anteroposterior first molar occlusal relation, and their effects on the mandibular height and the occlusal plane angle. For this study, 49 patients with temporomandibular disorders were selected. They did not show facial asymmetry and their facial midline coincide with maxillary dental midline. Upper and lower mandibular impression were taken and the casts were fabricated. Amount and direction of the mandibular midline shift and the anteroposterior shift between the two occluding first molars were measured on the casts. Several items related to height such as mandibular height from top of the articular surface of the condyle to curve changing point between antegonial notch and mandibular angle, condylar height which was the vertical distance from the articular surface to retroepicondyle of the condyle, and sigmoid height from the deepest point of sigmoid notch to the curve changing point and the occlusal plane angle were also measured on the panoramic and on the transcranial radiographs. Correlation between midline shift and anteroposterior first molar relation and comparison between right and left mandibular height by the midline shift and the first molar relation were analysed by SPSS windows program. The results of this study were as follows : 1. Mean amount of midline shift in the subjects with midline shift were 2.0mm for both side, respectively. The first molar relation of the ipsilateral side of midline shift showed Angle class II tendency and the contralateral side showed Angle class III tendency, which meant drift of the dentition to the side of the midline shift. 2. The occlusal plane angle on the panoramic radiograph were $13.0^{\circ}$ in right, and $12.5^{\circ}$ in left side, and their were no correlation between occlusal plane angle and mandibular midline shift and the first molar occlusal relation. 3. Angle's classification for both sides of the first molar relation were same in about half of all the subjects. Amount of deviation from class I first molar relation, however, were decreased in the contralateral side of observed side. 4. Mandibular height of the ipsilateral side to which mandibular midline shift showed tendency of lower than that of the contralateral side, and there was a tendency that the height was higher in class III subjects, then class II subjects, and lower in class I subjects. However, condylar height did not show any difference in the subjects with midline shift and also show no difference by the first molar occlusal relation.
Kim, Eun Young;Youn, Inyoung;Lee, Kwan Ho;Yun, Ji-Sup;Park, Yong Lai;Park, Chan Heun;Moon, Juhee;Choi, Seon Hyeong;Choi, Yoon Jung;Ham, Soo-Youn;Kook, Shin Ho
Journal of Breast Cancer
/
v.21
no.4
/
pp.453-462
/
2018
Purpose: This study aimed to compare the diagnostic performance of contrast-enhanced digital mammography (CEDM) and contrast-enhanced magnetic resonance imaging (CEMRI) in preoperative evaluations, and to evaluate the effect of each modality on the surgical management of women with breast cancer. Methods: This single-center, prospective study was approved by the Institutional Review Board, and informed consent was obtained from all patients. From November 2016 to October 2017, 84 patients who were diagnosed with invasive carcinoma (69/84) and ductal carcinoma in situ (15/84), and underwent both CEDM and CEMRI, were enrolled. Imaging findings and surgical management were correlated with pathological results and compared. The diagnostic performance of both modalities in the detection of index and secondary cancers (multifocality and multicentricity), and occult cancer in the contralateral breast, was compared. The authors also evaluated whether CEDM or CEMRI resulted in changes in the surgical management of the affected breast due to imaging-detected findings. Results: Eighty-four women were included in the analysis. Compared with CEMRI, CEDM demonstrated a similar sensitivity (92.9% [78/84] vs. 95.2% [80/84]) in detecting index cancer (p=0.563). For the detection of secondary cancers in the ipsilateral breast and occult cancer in the contralateral breast, no significant differences were found between CEDM and CEMRI (p=0.999 and p=0.999, respectively). Regarding changes in surgical management, CEDM resulted in similar changes compared with CEMRI (30.9% [26/84] vs. 29.7% [25/84], p=0.610). Regarding changes in surgical management due to false-positive findings, no significant differences were found between CEDM and CEMRI (34.6% [9/26] vs. 44.0% [11/25], p=0.782). Conclusion: CEDM demonstrated a diagnostic performance comparable with CEMRI in depicting index cancers, secondary cancers, and occult cancer in the contralateral breast. CEDM demonstrated similar changes in surgical management compared with CEMRI.
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