• Title/Summary/Keyword: Intracavitary

Search Result 154, Processing Time 0.028 seconds

Rapid Growing Fungal Ball after Resection of Cardiac Rhabdomyoma (심장 횡문근종 절제 후 급속히 성장한 진균성 증식조직)

  • 박한기;박영환
    • Journal of Chest Surgery
    • /
    • v.29 no.6
    • /
    • pp.655-659
    • /
    • 1996
  • Primary cardiac tumors are known to be rare. Of the benign primary tumors, rhabdomyoma predominates in neonates and infants. Tuberous sclerosis is found in hall of the patients with rhabdomyomas. Rhabdomyomas demonstrate benign pathological characteristics and may regress spontaneously that resection of the intracavitary obstructing portion of these tumors are recommended. We performed resection of intraatrial rhabdomyoma which had been obstructing mitral valve orifice and caused heart failure in a neonate. Postoperatively, fungal endocarditis developed and after 3 days, rapid growth and extension of the vegetation in the aorta obstructed the flow through the ascending aorta and resulted in hemodynamic deterioration.

  • PDF

High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience

  • Ghosh, Saptarshi;Rao, Pamidimukkala Bramhananda;Kotne, Sivasankar
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.16
    • /
    • pp.7167-7170
    • /
    • 2015
  • Background: Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. Objective: To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. Materials and Methods: This is a prospective institutional study in Southern India carried on from $1^{st}$ June 2012 to $31^{st}$ July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. Results: The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. Conclusions: In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

Treatment of Localized Large Emphyssematous Bullae with Intracavitary Drainage Modified Monaldi Procedure -1 Case Report- (폐기종 환자에서 기낭내 흡인술 [변형 Monaldi 술식]를 이용한 거대 폐기낭의 치료 -1예 보고-)

  • Lee, Song-Am;Kim, Kwang-Taik;Son, Ho-Sung;Lee, Sung-Ho;Park, Sung-Min;Sun, Kyung;Kim, Yo-Han
    • Journal of Chest Surgery
    • /
    • v.37 no.9
    • /
    • pp.800-804
    • /
    • 2004
  • A 67-year-old male with a 6-year history of emphysema was admitted with severe dyspnea. On chest computed tomographic scan, a newly developed large bulla was detected in right lower hemithorax. This bulla was sucessfully managed by intracavitary drainage [modified Monaldi procedure] with symptomatic improvement. We report this case with review of the literature.

Dose Distribution&Calibration in HDR Intracavitary Irradiation for Uterine Cervical Cancer (자궁경부암의 강내치료를 위한 선량측정)

  • 김진기;김정수;김형진;권형철
    • Progress in Medical Physics
    • /
    • v.6 no.1
    • /
    • pp.13-18
    • /
    • 1995
  • Dose distribution of HDR-RALS source represents an inverse square law as the distance. Difference of measurement value and calculation value according of brachytherapy. Therefore, in HDR-RALS dose calibration and calculation have an important effect in treatment of uterine cervical cancer and absorbed dose of interesting points. In intracavitary therapy, particula attention is paid for precise determination of the doses to be applied. In this report, we have discussed that the calibration of a HDR-RALS, differences between calculation dose use of isodose chart and measurement in rectum. Dose rate calibration of radiation sources are obtained from air kerma and Г factor with calibraed ion chamber for cobalt source. and used semiconductor detector for compared with measurement in phantom. Eighteen patients were treated with a HDR-RALS for intrcavitarty irradiation (ICR) using a cobalt-cesium source. Repoductivity of dose measurements were 0.3 -1.1% in phantom. The means of dose distribution was -6- +21% between calculation of isodose chart and measurement of recyum, and was same mean value upper 6.3% in measurement value than calculation does.

  • PDF

Disign and Thermal Distribution of Intra-hyperthermia Microwave Antennas for Utero-cervical Applicators (자궁강내 온열치료를 위한 마이크로파 안테나의 제작과 온열 분포)

  • Chu, Sung-Sil;Moon, Sun-Rock
    • Radiation Oncology Journal
    • /
    • v.8 no.1
    • /
    • pp.133-136
    • /
    • 1990
  • Intracavitary brachytherapy combined hypertermin for utero-conical cancer seems to be a promising method for salvage treatments in persistent tumors and inoperable or previously irradiated cervical recurrences. In order to heat the vaginal apex and uterus, powerfull conical antennas which are suitable for afterloading cervical applicator have been designed for use in conjuction with intracavitary radiation therapy. The antennas were constructed with conical conductive material to feed line and the effective lenght were designed proportional to microwave length, Power deposition profiles of 2450 MHz of conical antennas were studied in both phantom models and muscle tissue and compared to those of commonly used dipole antenna. Improvement of the heating pattern was found in both phantom and muscle tissue. The heating pattern produced by the conical antenna resembles an ellipsoid and then the temperature distribution in depth was extended to $2\~3\;cm$ from the effective antenna axis.

  • PDF

The Role of High Dose Rate (HDR) Intracavitary Radiation Therapy for the Management of Nasopharyngeal Carcinoma (비인강암 환자의 고선량 강내 방사선 치료의 효과)

  • Cho, Jeong-Gill;Chang, Hye-Sook;Choi, Eun-Kyung
    • Radiation Oncology Journal
    • /
    • v.11 no.1
    • /
    • pp.91-96
    • /
    • 1993
  • From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.

  • PDF

Current Status of High Dose Rate Brachytherapy in Cervical Cancer in Korea and Optimal Treatment Schedule (자궁 경부암 고선량율 강내조사 치료의 국내 현황과 적정 치료방법)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
    • /
    • v.16 no.4
    • /
    • pp.357-366
    • /
    • 1998
  • Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week. 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as. 78-86$\%$ for Stage 1, 68-85$\%$ for stage 11, and 38-56$\%$ for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.

  • PDF

Dose comparison between prescription methods according to anatomical variations in intracavitary brachytherapy for cervical cancer

  • Choi, Euncheol;Kim, Jae Ho;Kim, Ok Bae;Byun, Sang Jun;Kim, Jin Hee;Oh, Young Kee
    • Radiation Oncology Journal
    • /
    • v.36 no.3
    • /
    • pp.227-234
    • /
    • 2018
  • Purpose: We compared how doses delivered via two-dimensional (2D) intracavitary brachytherapy (ICBT) and three-dimensional (3D) ICBT varied anatomically. Materials and Methods: A total of 50 patients who received 30 Gy of 3D ICBT after external radiotherapy (RT) were enrolled. We compared the doses of the actual 3D and 2D ICBT plans among patients grouped according to six anatomical variations: differences in a small-bowel V2Gy, small bowel circumference, the direction of bladder distension, bladder volume, sigmoid V3.5Gy, and sigmoid circumference. Seven dose parameters were measured in line with the EMBRACE recommendations. Results: In terms of bladder volume, the bladder and small-bowel D2cc values were lower in the 150-250 mL bladder volume subgroup; and the rectum, sigmoid, and bladder D2mL values were all lower in the >250 mL subgroup, for 3D vs. 2D ICBT. In the sigmoid V3.5Gy >2 mL subgroup, the sigmoid and bladder D2mL values were significantly lower for 3D than 2D ICBT. The bladder D2mL value was also significantly lower for 3D ICBT, as reflected by the sigmoid circumference. In patients with a small bowel V2.0Gy >10 mL or small bowel circumference >15%, most dose parameters were significantly lower for 3D than 2D ICBT. The bladder distension direction did not significantly affect the doses. Conclusion: Compared to 2D ICBT, a greater bladder volume can reduce the internal 3D ICBT organ dose without affecting the target dose.

Conjunction of a Fungus Ball and a Pulmonary Tumourlet in a Bronchiectatic Cavity

  • Yazgan, Serkan;Gursoy, Soner;Turk, Figen;Dinc, Zekiye Aydogdu
    • Journal of Chest Surgery
    • /
    • v.51 no.2
    • /
    • pp.138-141
    • /
    • 2018
  • Herein, we describe the case of a 67-year-old female patient who presented with cough and haemoptysis. Chest computed tomography revealed destruction of the left lower lobe and multiple fungus balls in a bronchiectatic cavity. A left lower lobectomy was performed via thoracotomy. Histopathological examination of the lung showed a concomitant aspergilloma and multiple tumourlets in the large bronchiectatic cavity. Pulmonary intracavitary aspergilloma and concomitant tumourlets are quite rare. Our report presents this interesting case that manifested with haemoptysis.

Pulmonary Aspergillosis - Pulmonary Aspergillosis - (폐 Aspergillosis -6예 보고-)

  • 김치경
    • Journal of Chest Surgery
    • /
    • v.12 no.1
    • /
    • pp.1-8
    • /
    • 1979
  • Pulmonary aspergillosis is being recognized with increasing frequency in recent years and the-rising incidence of this infection parallels certain medical advances in antibiotics, chemotherapeutic and immunosuppressive therapy. The cavities of lungs resulting from tuberculosis, histoplasmosis or neoplasm are apt, to be infected by one of the species of the genus Aspergillus and eventually mycetomas are formed within the cavities. Authors have experienced 6 cases of pulmonary aspergillosis forming mycetoma in Dept. of Thoracic Surgery, Catholic Medical Center from Aug. 1976 to Feb. 1979. Hemoptysis or blood tinged sputum, the predominant symptom, occurred in all cases. All patients underwent pulmonary resection, 1 pneumonectomy, 3 lobectomies, 1 lobectomy with segmental resection and 1 segmental resection and survived well without death or complication. Primary aspergillosis was in 2 cases and underlying diseases were present in 4 cases: 3 pulmonary tuberculosis, 1 bronchiectasis. The common diagnostic study of intracavitary mycetoma was the posterioanterior chest roentgenogram; in cavities suspected of being diseased or in doubtful cases, tomography was most available to find fungus ball with air-meniscus shadow.

  • PDF