We investigated the radiation exposure caused by DIPS, which is used to identify accurate repositioning and tumor location in pediatric cancer patients proton therapy. To compare and analyze DIPS condition, 50 pediatric cancer patients who underwent proton therapy were selected in Ilsan K cancer-specialized hospital from March 2007 to October 2009. For DIP exposure, 0.09~1.57 mGy is measured in AP and lateral directions and 23.55 mGy is measured in CSI patients. In whole brain patient, the amount of a day DIP exposure dose was 1.13 mGy. During treatment period, who exposed the biggest DIP dose are whole brain patients, 632.71 mGy is exposed. It is 1.13% of prescribed dose, represented dose is adequate because it is not exceeded 2% of recommended dose. Even though the exposed dose is not exceeded more than 2% of prescribed in DIP exposure, we should recognize the radiation damage and genetic influences to pediatric cancer patients, who is much sensitive to radiation and has longer mean residual life time. Therefore, DIPS guideline for pediatric cancer patients should be indicated to minimize the radiation exposure.
In this study, C-Arm equipment is being used as we intend to verify the exposure dose on the operator by the scattering rays during the operation of the C-Arm equipment and to provide an effective method of reducing the exposure dose. Exposure dose is less than the Over Tube method utilizes the C-arm equipment Under Tube the scheme, The result showed that the exposure dose on the operator decreased with a thicker shield, and as the operator moved away from the center line. Moreover, as the research time prolongated, the exposure dose increased, and among the three affixed location of the dosimeter, the most exposure dose was measured at gonadal, then followed by chest and thyroid. However, in consideration of the relationship between the operator and the patient, the distance cannot be increased infinitely and the research time cannot be decreased infinitely in order to reduce the exposure dose. Therefore, by changing the thickness of the radiation shield, the exposure dose on the operator was able to be reduced. If you are using a C-Arm equipment discomfort during surgery because the grounds that the procedure is neglected and close to the dose of radiation shielding made can only increase. Because a separate control room cannot be used for the C-Arm equipment due to its characteristic, the exposure dose on the operator needs to be reduced by reinforcing the shield through an appropriate thickness of radiation shield devices, such as apron, etc. during a treatment.
Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.
Kang, Jong Hwa;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun;Tark, Kwan Chul
Archives of Plastic Surgery
/
v.35
no.4
/
pp.439-445
/
2008
Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.
This study aimed to evaluate the accuracy of breast cancer diagnosis of digital mammography which is in the highest interest of breast imaging test, and to investigate the characteristics of breast cancer patients. For this purpose, 57 breast cancer patients who underwent breast imaging test were examined between May 2010 and June 2011. The average age of the breast cancer patients was 50.8 years old, and the most frequently occurring location was the upper outer quadrant (UOQ), accounting for 33.3%. By age, the highest occurrence rate of breast cancer was the age group of 40~49, accounting for 42.1%. As for the breast composition of the breast cancer patients, fatty breast accounted for 31.6% (18/57) and dense breast for 68.4% (39/57), indicating that nearly 70% of the breast cancer patients have dense breast. It was found that the detection rate of breast cancer was the highest (45.3%) when both microcalcification and mass are simultaneously present in the radiographic lesion of the breast imaging. In dense breast, the mass without microcalcification was lower in detection rate than fatty breast. Accordingly, the mass is the cause of raising the false negative rate in dense breast. The findings show that the false negative rate of digital mammography was 7.0% and the sensitivity 93.0%. Also, the false negative rate of dense breast was 12.8%, and the sensitivity 87.2%, indicating that the sensitivity to breast cancer in this study was higher than the dense breast of previously reported screen film mammography.
Kim, Moo-Pil;Choe, Hwan;Park, Se-Jin;Chung, Eun-Jae;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Lee, Nam-Joon;Jung, Kwang-Yoon
Korean Journal of Head & Neck Oncology
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v.25
no.1
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pp.12-17
/
2009
Background and Objectives : Branchial anomaly is a common neck pathology seen by otolaryngologist. Although there is still controversy regarding the origin, almost all surgeon agree that branchial anomalies result from incomplete involution of the branchial apparatus. Depending on its anatomic location, branchial anomalies can be classified into first, second, third and fourth anomaly. The purpose of this study is to evaluate the incidence of different categories of branchial anomalies and to determine proper method of diagnosis and treatment. Subjects and Method : A retrospective chart review was conducted for 72 patients with branchial anomalies operated on at the Korea University Anam Hospital from 1996 to 2007. The patient's sex, age, presenting symptoms, classification, site of lesion, diagnostic studies, surgical therapy and post-operative surgical complication were reviewed. Results : Patients were commonly seen in the 3rd decades. Eleven patients(15.3%) were first branchial anomalies, 52(72.2%) were second, 1(1.4%) was third, and 8(11.1%) were fourth. Of the types of anomalies, cyst were most commonly seen. In cases of 3rd and 4th branchial anomalies, barium contrast study can delineate the course of sinus or fistula. All cases was operated on for branchial anomalies, there were no major post-operative complication. Conclusion : Cervical mass and recurrent cervical infection or abscess are suspect for branchial anomalies. Especially, clinical history of dysphagia, and recurrent painful swelling in the thyroid region in young patients should raise the suspicion of 3rd and 4th branchial anomalies. Careful history, clinical examination and radiographic study were essential parts in diagnosis of branchial anomalies. Although surgical management of branchial anomalies depend on its type, nature and extent, complete excision is the major surgical procedure.
Park, Ji-Hoon;Kim, Jin-Wook;Kwon, Tae-Geon;Kim, Chin-Soo
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.37
no.3
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pp.176-183
/
2011
Introduction: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. Materials and Methods: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation, this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. Results: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. Conclusion: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.5
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pp.535-542
/
2007
Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.
Park, Woong-Kyu;Lee, Jae-Kwan;Chang, Beom-Seok;Um, Heung-Sik
Journal of Periodontal and Implant Science
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v.39
no.1
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pp.59-70
/
2009
Purpose: The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance. Materials and methods: Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance. Results: Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time. Conclusion: Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.
Park Sun Young;Kim Jong-Keun;Kim In Jin;Choi Bong Kyu;Jung Kyu Yong;Lee Seoul;Park Kyung Jin;Chairoungdua Arthit;Kanai Yoshikatsu;Endou Hitoshi;Kim Do Kyung
Archives of Pharmacal Research
/
v.28
no.4
/
pp.421-432
/
2005
In order to understand the renal reabsorption mechanism of neutral amino acids via amino acid transporters, we have isolated human L-type amino acid transporter 2 (hLAT2) and human T-type amino acid transporter 1 (hTAT1) in human, then, we have examined and compared the gene structures, the functional characterizations and the localization in human kidney. Northern blot analysis showed that hLAT2 mRNA was expressed at high levels in the heart, brain, placenta, kidney, spleen, prostate, testis, ovary, lymph node and the fetal liver. The hTAT1 mRNA was detected at high levels in the heart, placenta, liver, skeletal muscle, kidney, pancreas, spleen, thymus and prostate. Immunohistochemical analysis on the human kidney revealed that the hLAT2 and hTAT1 proteins coexist in the basolateral membrane of the renal proximal tubules. The hLAT2 transports all neutral amino acids and hTAT1 transports aromatic amino acids. The basolateral location of the hLAT2 and hTAT1 proteins in the renal proximal tubule as well as the amino acid transport activity of hLAT2 and hTAT1 suggests that these transporters contribute to the renal reabsorption of neutral and aromatic amino acids in the basolateral domain of epithelial proximal tubule cells, respectively. Therefore, LAT2 and TAT1 play essential roles in the reabsorption of neutral amino acids from the epithelial cells to the blood stream in the kidney. Because LAT2 and TAT1 are essential to the efficient absorption of neutral amino acids from the kidney, their defects might be involved in the pathogenesis of disorders caused by a disruption in amino acid absorption such as blue diaper syndrome.
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