Solitary fibrous tumors of the pleura are rare, slow-growing benign neoplasm, originating from submesothelial Hbroblasts. Approximately 80% of solitary fibrous tumors of the pleura originate in . the visceral pleura and 20% in the parietal pleura. Many of these tumors are pedunculated, attached to the visceral pleura via a well-vasculariEed stalk, and in size from 1 to 36cm with a mean of 6cm. This case report is of a 48 year old woman who presented with dyspnea and right flank pain. Preoperative chest x-ray showed increased hazy density at right lower lung field, and CT scan showed huge heterogeneous mass which was located in right mid and lower thorax. She underwent surgical resec- tion and a lOX15X loom(2200gm weigh) sized large mass was excised. Final histologic diagnosis was solitary fibrous tumor of the plara. The patient was discharged without any complications postoperately.
Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)
Asymetric system have been introduced in these years by KODAK company nam of Insight system for the purpose of improve the chest image. We have had a problem of chest radiology that it is very difficult to visualize the lung field and modiastinal region at one shot. That's why we are the RT using the technique of high voltage hard quality radiography in chest radiography. Also it is known the c-type wide latitude film can lift up the density of mediastinal structures. Authors investigated the photographic characteristics and physical structure of Insight system. Method 1. Investigated the structure of Emulsion layer. Calculated the particle size of Insight system using SEM(Scanning Electron Microscope). 2. Photographic characteristics has been compared the Insight system with the ortho KM/MG combination in $60{\sim}120kV$ range. Results 1. The particle size of backside film were investigated about 2 times larger that of front side film. 2. The front and backscreen's thickness ratio was detected 1 : 3.87, that the backscreen's thickness was thicker than frontscreen. 3. At the view point of photographic characteristics the frontside of insight system make up the contrast, backside make up the density at low exposure lesion.
Yoon, Jeongmin;Park, Kwangwoo;Kim, Jin Sung;Kim, Yong Bae;Lee, Ho
Progress in Medical Physics
/
v.29
no.1
/
pp.8-15
/
2018
This work reports the acceptance testing and commissioning experience of the Robotic Intensity-Modulated Radiation Therapy (IMRT) M6 system with a newly released $InCise^{TM}2$ Multileaf Collimator (MLC) installed at the Yonsei Cancer Center. Acceptance testing included a mechanical interdigitation test, leaf positional accuracy, leakage check, and End-to-End (E2E) tests. Beam data measurements included tissue-phantom ratios (TPRs), off-center ratios (OCRs), output factors collected at 11 field sizes (the smallest field size was $7.6mm{\times}7.7mm$ and largest field size was $115.0mm{\times}100.1mm$ at 800 mm source-to-axis distance), and open beam profiles. The beam model was verified by checking patient-specific quality assurance (QA) in four fiducial-inserted phantoms, using 10 intracranial and extracranial patient plans. All measurements for acceptance testing satisfied manufacturing specifications. Mean leaf position offsets using the Garden Fence test were found to be $0.01{\pm}0.06mm$ and $0.07{\pm}0.05mm$ for X1 and X2 leaf banks, respectively. Maximum and average leaf leakages were 0.20% and 0.18%, respectively. E2E tests for five tracking modes showed 0.26 mm (6D Skull), 0.3 mm (Fiducial), 0.26 mm (Xsight Spine), 0.62 mm (Xsight Lung), and 0.6 mm (Synchrony). TPRs, OCRs, output factors, and open beams measured under various conditions agreed with composite data provided from the manufacturer to within 2%. Patient-specific QA results were evaluated in two ways. Point dose measurements with an ion chamber were all within the 5% absolute-dose agreement, and relative-dose measurements using an array ion chamber detector all satisfied the 3%/3 mm gamma criterion for more than 90% of the measurement points. The Robotic IMRT M6 system equipped with the $InCise^{TM}2$ MLC was proven to be accurate and reliable.
Reovirus was found to inhabit both the respiratory and the enteric tract of human and animals. The genome of reovirus comprises 10 segments of double-stranded RNA, total size 24 kbp. Nine strains of reovirus were isolated from human and field mice in Korea. Aseptically collected sera from human and lung tissues from field mice were used for virus isolation. For serotype determination, hemagglutination inhibition test was used, and three strains were confirmed to type 2 and six strains to type 3. To determine the genomic diversity and molecular phylogeny of reoviruses isolated in Korea, part of S4 genomic segment of reovirus was enzymatically amplified and directly sequenced. In nucleotide level, Apo98-35 strain showed 15.4%, 19.3%, and 14.4% differences compared to type 1 (T1L, Lang), type 2 (T2J), and type 3 reference strains, respectively. In amino acid level, Apo98-35 strain showed 10.5%, 13.7%, and 9.5% differences compared to type 1, type 2, and type 3 reference strains, respectively. Using the maximum parsimony method based on 285 bp spaning region of the S4 genomic segment, phylogenetic analysis indicated that Apo98-35 from Korea formed different phylogenetic branch. Our data obtained by sequence and phylogenetic analyses of reoviruses are consistent with the distinct geographically dependent evolution of reoviruses in Korea.
In this work, we evaluated the characteristics of flow field and uniformity of the nose-only exposure chambers for the inhalation toxicity test. Computational fluid dynamics (CFD) modeling was carried out to demonstrate uniformity of the nose-only exposure chambers. Because it is very important in the inhalation toxicity experiments that test materials are distributed uniformly to each holder of the chamber. The test was done with these 3 types of chamber with different form to develop inhalation toxicity evaluation system, easy-to-operate system among exposure chamber used for evaluating inhalation toxicity of environmental chemical mixtures. Through CFD interpretation, nose-only exposure chamber was made with the selection of the optimal conditions. For its evaluation, one type of fragrance was selected and measured particle size distribution of each port. The gene becoming luminous to green fluorescence was combined with GPT-SPE, a type of tGFP vector, to be inhaled to the mouse. Based on this, luminous intensity was checked. As a result, total particle number concentration of each port had average value of $3.17{\times}10^6{\sharp}/cm^3$ and range of the highest and lowest concentration value was approximately ${\pm}4.8%$. Autopsy of lung tissues of mouse showed that it had clearly better delivery of gene compared to the control group.
Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
Radiation Oncology Journal
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v.15
no.1
/
pp.27-36
/
1997
Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well established as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy has been used increasingly in relation to advance and the safty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safety from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle(Manan medical products, USA). A diagnosis was made in 27 of 44 cases(61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required. The sensitivity of PTNB by one session was 61%(27/44). The sensitivity of malignancy was 79%(19/24) and benignancy was 40%(8/20). These results suggest the usefulness of PTNB using fine needles be increased in earlier diagnosis and improved staging of pulmonary nodular lesions without significant complications.
Background : Pulmonary tuberculosis with a remaining cavitary lesion is considered to be a problem with the course of treatment. In particular, re-treatment cases tend to respond poorly to current anti-tuberculosis agents. Therefore the factors that are related with the poor closure of a cavitary lesion in pulmonary tuberculosis during treatment were evaluated. Methods : A retrospective review of the medical records and chest X -ray films of 68 patients who had chemotherapy for the pulmonary tuberculosis with cavitary lesions was made. All the patients had been followed up for more than 12 months at National Masan Tuberculosis Hospital as of Aug. 2000. Results : The male to female ratio was 3.9:1.72.4% of the patients were between 20 to 50 years of age. 66.2% of the cavitary lesions on the chest X-ray films were confined to the upper lung fields : 36.8% in the right upper lung field and 29.4% in the left upper lung field. 82.4% of the cavities were less than 40 mm in their size, and 83.8% were less than 6 mm thick. The cavitary lesions were closed in 48 cases and remained in 20 cases during a follow-up period of more than 12 months. The factors that are thought to affect to the outcomes of the cavities were age, past medication history, the number of unused drugs, and the number of sensitive drugs. Conclusion : In the treatment courses of pulmonary tuberculosis with cavitary lesions, the following factors are associated with less desirable outcome:an age over 45, a past medication history of more than 2 courses of treatment, The number of unused drugs not exceeding average 6 and the number of sensitive drugs not exceeding average 7.
Kim, Ju-Ho;Jo, Jeong-Hui;Lee, Seok;Jeon, Byeong-Cheol;Park, Jae-Il
The Journal of Korean Society for Radiation Therapy
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v.13
no.1
/
pp.38-46
/
2001
Purpose : The aim of this study is to investigate the effect of tissue inhomogeneities when appling to contrast medium among Homogeneous, Batho and ETAR dose calculation method in RTP system. Method and Material : We made customized heterogeneous phantom it filled with water or contrast medium slab. Phantom scan data have taken PQ 5000 (CT scanner, Marconi, USA) and then dose was calculated in 3D RTP (AcQ-Plan, Marconi, USA) depends on dose calculation algorithm (Homogeneous, Batho, ETAR). The dose comparisons were described in terms of 2D isodose distribution, percent depth dose data, effective path length and monitor unit. Also dose distributions were calculated with homogeneous and inhomogeneous correction algorithm, Batho and ETAR, in each patients with different clinical sites. Results : Result indicated that Batho and ETAR method gave rise to percent depth dose deviation $1.5{\sim}2.7\%,\;2.3{\sim}3.5\%$ (6MV, field size $10{\times}10cm^2$) in each status with and without contrast medium. Also show that effective path lengths were more increase in contrast status (23.14 cm) than Non-contrast (22.07 cm) about $4.9\%$ or 10.7 mm (In case Hounsfield Unit 270) and these results were similary showned in each patient with different clinical site that was lung. prostate, liver and brain region. Concliusion : In conclusion we shown that the use of inhomogeneity correction algorithm for dose calculation in status of injected contrast medium can not represent exact dose at GTV region. These results mean that patients will be more irradiated photon beam during radiation therapy.
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