• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1998년도 제3차 춘계심포지움
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• pp.118-120
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• 1998

• Radiation Oncology Journal
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• 제35권2호
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• pp.121-128
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• 2017

Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusions: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.

• Journal of Chest Surgery
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• 제54권5호
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• pp.433-435
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• 2021

Pleural adhesions are a major challenge in standard and nonintubated video-assisted thoracic surgery. The currently available imaging techniques help to assess the presence and extent of pleural adhesions, but do not provide information on tissue deformability, which is crucial for intraoperative management. In this report, we describe the utilization of real-time elastography mapping of pleural adhesions. This technique enabled us to detect areas with softer adhesions, and helped establish the surgical plan in a difficult case of a patient scheduled for nonintubated video-assisted thoracic surgery.

• Neurospine
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• 제15권4호
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• pp.338-347
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• 2018

Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population. Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Results: A total of 105 patients underwent tumor resection and spinal reconstruction with instrumented fusion for a multitude of pathologies. Twelve of the 105 patients (11.4%) reviewed had intraoperative durotomies. Of these, 3 underwent reoperation for a delayed complication, including 1 epidural hematoma, 1 retained drain, and 1 wound infection. Of the 93 uncomplicated index operations, there were a total of 9 reoperations: 2 for epidural hematoma, 3 for wound infection, 2 for wound dehiscence, and 2 for recurrent primary disease. One patient was readmitted for a delayed spinal fluid leak. The average length of stay for patients with and without intraoperative durotomy was 7.3 and 5.9 days, respectively, with a nonsignificant trend for an increased length of stay in the durotomy cases (p=0.098). Conclusion: Surgery for extradural tumor resections can be complicated by CSF leaks due to the proximity of the tumor to the dura. When encountered, a variety of strategies may be employed to minimize subsequent morbidity.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.153-158
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• 1988

수술중 방사선 치료는 우리나라와 같이 위암환자가 많은 경우에 그 이용 범위가 넓고 특히 국소적으로 진행된 경우에 효과가 있으므로 앞으로 그 이용가치가 높다고 하겠다. 저자들은 국소적으로 진행된 두 명의 위암환자에서 일반외과, 마취과, 치료방사선과가 합동으로 수술중 치료를 시행 하였기에 문헌 고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1131-1135
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• 2012

Objective: To evaluate interoperative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications, cosmetic outcome and recurrence events. Methods: From June 2007 to Dec 2011, 143 early breast cancer patients received breast conservative surgery. Seventy-two (study group) received interoperative radiotherapy, compared with 71 patients (control group) given routine radiotherapy. Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up. Results: The average wound healing time was 13~22 d in the study group and 9~14 d in the control group. In the study group, 2 patients developed lyponecrosis, 16 patients showed wound edema while no such side effects were found in the control group. No infection or hematomas were found in either group. In the study group (59 cases), overall cosmetic outcome in 53 patients was graded as excellent or good, and in 6 as fair or poor. Meanwhile in the control group (56 cases), 42 patients were graded as excellent or good, and 14 as fair or poor (P=0.032). After a follow-up from 3 to 54 months (median: 32 months), two patients (2.78%) in study group developed local relapses, one of them (1.39%) died, 2 patients (2.78%) developed bone metastases. In control group, one patient (1.41%) developed local relapse, 2 patients (2.82%) developed bone metastases, and no one died. Conclusion: Intraoperative radiotherapy is safe and reliable with good cosmetic outcome.

• 대한두개안면성형외과학회지
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• 제25권4호
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• pp.197-200
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• 2024

Ethmoid myoepithelial carcinoma is a rare tumor, with only 14 cases reported to date. This report discusses the largest tumor of this type ever recorded in the ethmoid region. The tumor caused extensive damage to facial structures, complicating treatment. The patient's age and comorbidities increased the risk of intraoperative bleeding, presenting challenges to the complete removal of the tumor and the reconstruction of the damaged structures. To reduce the risk of intraoperative hemorrhage, shorten the surgery time, and manage potential heart-related complications, arterial embolization was performed using gelatin sponges and coils. Definitive surgery was then carried out using a skin flap and mucosal flap to successfully reconstruct the defect. Postoperative radiotherapy was deemed unnecessary. The patient recovered well, with a satisfactory aesthetic outcome. No recurrence was observed during a 3-year follow-up period.

• Radiation Oncology Journal
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• 제9권2호
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• pp.265-270
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• 1991

대장-직장암은 한국에서 남녀 모두 4위의 비교적 높은 빈도를 보이고 있으며 점점 증가되는 추세에 있다. 근치적 수술요법이 주 치료방법으로 사용되어 왔으나 그 생존율은 $20\~50\%$에 불과하다. 국소재발은 특히 직장암에서 가장 흔한 실패의 원인으로서 근치적 복합요법의 발달에도 불구하고 $40\~92\%$의 높은 국소재발율이 보고되고 있어 생존율를 높이고 생존의 질을 높이기 위하여는 국소재발을 줄이는 노력이 필수적이다. 수술중 방사선 치료는 수술중에 원하는 부위에만 다량의 방사선을 한번에 조사하는 방법으로 최근 보고에서 국소재발율을 $5\%$까지 줄일 수 있었다고 보고되고 있다. 영남대학병원 치료방사선과에서는 국내에서는 처음으로 91년 5월 30일 직장암 환자에 수술중 방사선 치료를 실시한 후 현재까지 6명의 대장 직장암 환자에 수술중 방사선 치료를 실시하였기에 환자선택, 치료선량, 선량분포, 수술 및 방사선치료과정등을 보고하고저 한다.

• Radiation Oncology Journal
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• 제10권1호
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• pp.85-93
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• 1992

수술중 방사선치료를 환자에 적용하기에 앞서 본원이 보유하고있는 LID를 이용한 전자선의 선량분포 특성을 연구하였다. 이러한 선량 특성에 대한 자료는 적절한 Cone의 모양이나 크기, 에너지를 결정하게하며 빠르고 정확한 계산을 위하여 필요하다. 따라서, 본 저자들은 3-Dimensional Water Phantom Dosimetry System를 이용하여 Cone의 크기, Cone의 모양, 보상필터 사용 유무에 따라 Cone의 출력인자, 조직표면선량, 선축상 최대치 지점, $90\%$의 깊이, 대칭도와 편평도, SSD 보상인자, 선량분포 등을 측정하여 다음과 같은 결과를 얻었다. 1) Cone의 출력인자는 Cone모양에 따라 각각 측정하였으며 Cone의 크기와 에너지가 작을수록 급격하게 감소하는 결과를 보였다. 2) 보상 필터의 하나인 Flattening Filter를 사용한 결과 포면 선량이 6 MeV, 9 MeV, 12 MeV에 대하여 각각 $85.3\%$, $89.2\%$, $93.4\%$였고, 이 보상 필터를 사용하므로 선량률과 beam의 투과율은 감소하지만 치료부위에 따라 beam의 모양을 변형시키며 특히, 표면선량을 $90\%$나 그 이상으로 증가시킬수 있었다. 3) 3차에 걸친 beam의 collimation과 보상 필터를 결합하여 사용한 결과 매우 좋은 beam의 균일성과 편평도 뿐만아니라 $90\%$ 등선량곡선 넓이가 커지는 결과를 보였다. 4) 치료를 위하여 중요한 간격인 SSD 100cm에서 SSD 110cm까지의 출력인자는 측정치와 계산치가 Cone의 크기와 모양, 에너지에 따라 $1\~3\%$의 차이를 보였다.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.415-423
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• 2018

Objective : To identify the perioperative factors associated with instrument failure in patients undergoing a partial corpectomy with instrumentation (PCI) for spinal metastasis. Methods : We assessed the one hundred twenty-four patients with who underwent PCI for a metastatic spine from 1987 to 2011. Outcome measure was the risk factor related to implantation failure. The preoperative factors analyzed were age, sex, ambulation, American Spinal Injury Association grade, bone mineral density, use of steroid, primary tumor site, number of vertebrae with metastasis, extra-bone metastasis, preoperative adjuvant chemotherapy, and preoperative spinal radiotherapy. The intraoperative factors were the number of fixed vertebrae, fixation in osteolytic vertebrae, bone grafting, and type of surgical approach. The postoperative factors included postoperative adjuvant chemotherapy and spinal radiotherapy. This study was supported by the National Research Foundation grant funded by government. There were no study-specific biases related to conflicts of interest. Results : There were 15 instrumentation failures (15/124, 12.1%). Preoperative ambulatory status and primary tumor site were not significantly related to the development of implant failure. There were no significant associations between insertion of a bone graft into the partial corpectomy site and instrumentation failure. The preoperative and operative factors analyzed were not significantly related to instrumentation failure. In univariable and multivariable analyses, postoperative spinal radiotherapy was the only significant variable related to instrumentation failure (p=0.049 and 0.050, respectively). Conclusion : When performing PCI in patients with spinal metastasis followed by postoperative spinal radiotherapy, the surgeon may consider the possibility of instrumentation failure and find other strategies for augmentation than the use of a bone graft for fusion.