• 제목/요약/키워드: Organs at risk

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Variations of azygos vein: a cadaveric study with clinical relevance

  • Ananya Priya;Shalom Elsy Philip;Anjali Jain;Aparajita Sikka
    • Anatomy and Cell Biology
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    • 제56권4호
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    • pp.448-455
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    • 2023
  • The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

분말활성탄을 이용한 극미량 농도 Nitrosomethylamine의 흡착 제거 (Removal of Nitrosomethylamine at Extremely Low Concentration by Powdered Activated Carbon)

  • 이성범;윤여민;최창규;김문일
    • 한국방재학회:학술대회논문집
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    • 한국방재학회 2008년도 정기총회 및 학술발표대회
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    • pp.413-416
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    • 2008
  • Recently, the results of vital tissue test showed that nitrosodimethylamine (NDMA) as a disinfection by-product (DBP), could be regarded as a carcinogen because a tumor was observed in organs. U.S.EPA indicated 0.7 ng/L as exposure concentration of NDMA based on a risk assessment target with a lifetime cancer risk of $10^{-6}$. Several recent studies have shown that UV oxidation could remove NDMA. However, UV oxidation is uneconomical and can reform NDMA after treating. In addition, the treatment mechanism of adsorption has not been founddue to the uncertainty of NDMA pathway. In addtion, NDMA has a radioisotope $^{14}C$-labeled which can be analyzed at low concentration of NDMA by Liquid Scintillation Counter (LSC). This study has investigated NDMA determination using LSC at an extremely low range from 1 to 100 ng/L and NDMA removal by powdered activated carbon (PAC) adsorption. For $^{14}C$-NDMA by LSC, the highest correlation over 99% between count number and NDMA concentrationwas obtained with possibility of $^{14}C$-NDMA concentration up to 1 ng/L. In the presence of PAC ranging from 50 to 10,000 mg/L, $^{14}C$-NDMA was removed from 18% to 97% for Sigma-Aldrich corporation (S-A co.) and from 9% to 93% by PAC for Daejung corporation (Dj co.). Hence it was found that the removal efficiency by PAC adsorption could vary depending on PAC types from different companies. For PAC adsorption capacity of $^{14}C$-NDMA using the Freundlich isotherm, $K_f$ and 1/n of PAC from S-A co. were $2.67\times10^{-3}$ ng/mg and 1.009, while those of PAC from Dj co. were $1.30\times10^{-3}$ ng/mg and 0.994, respectively. Thus, PAC from S-A co. showed twice higher adsorption capacity than Dj co.

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A predictive model to guide management of the overlap region between target volume and organs at risk in prostate cancer volumetric modulated arc therapy

  • Mattes, Malcolm D.;Lee, Jennifer C.;Elnaiem, Sara;Guirguis, Adel;Ikoro, N.C.;Ashamalla, Hani
    • Radiation Oncology Journal
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    • 제32권1호
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    • pp.23-30
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    • 2014
  • Purpose: The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum ($Rectum_{overlap}$) or PTV and bladder ($Bladder_{overlap}$) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Materials and Methods: Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. Results: The percentage $Rectum_{overlap}$ and $Bladder_{overlap}$ correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum $V_{45}$ and bladder $V_{50}$ with $R^2$ = 0.78 and $R^2$ = 0.83, respectively, and predicted the boost plan rectum $V_{30}$ and bladder $V_{30}$ with $R^2$ = 0.53 and $R^2$ = 0.81, respectively. The optimal cutoff value of boost $Rectum_{overlap}$ to predict rectum $V_{75}$ >15% was 3.5% (sensitivity 100%, specificity 94%, p < 0.01), and the optimal cutoff value of boost $Bladder_{overlap}$ to predict bladder $V_{80}$ >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). Conclusion: The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.

Adjuvant Radiotherapy after Breast Conserving Treatment for Breast Cancer:A Dosimetric Comparison between Volumetric Modulated Arc Therapy and Intensity Modulated Radiotherapy

  • Liu, Zhe-Ming;Ge, Xiao-Lin;Chen, Jia-Yan;Wang, Pei-Pei;Zhang, Chi;Yang, Xi;Zhu, Hong-Cheng;Liu, Jia;Qin, Qin;Xu, Li-Ping;Lu, Jing;Zhan, Liang-Liang;Cheng, Hong-Yan;Sun, Xin-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3257-3265
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    • 2015
  • 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.

사물탕의 용량별 투여가 임신 랫드와 태자에 미치는 독성학적 연구 (Toxicological Effect of Samultang (Herbal Medicine) Administration in the Pregnant Rats and Fetuses - Focusing on dose-response Relationship -)

  • 전성진;신헌태;김경태;박해모;이선동
    • 대한예방한의학회지
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    • 제14권3호
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    • pp.1-12
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    • 2010
  • Objective : Samulatang (herbal description) is much used for women's disease in Korean Traditional Medicine. The aim of this study is to evaluate reproductive toxic effect by Samultang in pregnant rats and fetuses, and ascertain a dose-response relationship Method : Pregnant Sprague-Dawley rats were administered with the Samultang at single, double and quadruple dose for 20 days, orally. Pregnant rats were sacrificed at 20th day of gestation, and observed internal and reproductive organs. Live fetuses of gestation were randomly selected and fixed in 95% ethanol. Fetuses were stained with alcian blue and alizarin red S. We observe maternal body weight,, index associated pregnancy, and skeletal malformations in fetus Result : Maternal body weight of Samultang treated group has increased, side effect was not found in maternal body compared to that of control group. There were no significant difference in internal and reproductive organs. Double concentration administered group had lowest value in number of implantation, live fetuses, implantation rate and delivery rate, Also double concentration administered group showed higher early and late resorption rate than the other group. But, these are not significant. In the sex ratio, number of females, bigger than number of males in all Samultang administered groups. The fetuses of dams treated with Samultang didn't showed external and skeletal malformation. Vertebral and sternal variations were observed in single, double and quadruple concentration administered group but, compared to the control, those variations were insignificant. There were no significant changes in number of ribs, cervical, thoracic, lumber, sacral and caudal vertebrae Conclusion : Samultang is not expected to affect on pregnant rats and fetus about maternal body weight and number of live fetuses. There were no significant changes in organ weight, reproductive organs. Although skeletal variations were showed in vertebrae and sternum, treated groups were shown insignificant changes in skeletal variation

응급환자의 중증도 예측을 위한 APACHE II 기반 CAOPI 시스템 (A CAOPI System Based on APACHE II for Predicting the Degree of Severity of Emergency Patients)

  • 이영호;강운구;정은영;윤은실;박동균
    • 한국컴퓨터정보학회논문지
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    • 제16권1호
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    • pp.175-182
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    • 2011
  • 본 연구에서는 환자의 중증도 분류 및 인체 주요 장기의 상태 예측을 위하여 APACHE II(Acute Physiology And Chronic Health Evaluation) 기반 CDSS 도구인 CAOPI(Computer Aided Organ Prediction Index) 시스템을 제안한다. 기존 ICU 환자의 중증도 평가방법은 APACHE II를 이용하여 특정 시점의 중환자 위험도를 특정한 시점 데이터를 이용하여 산출하는 방식이었으나, 실시간으로 변화하는 환자의 상태에 맞춰 조치를 취하는데는 한계가 있다. CAOPI 시스템은 중환자실에 입실하는 환자들의 질병 중증도를 정확히 분류하고, 환자의 사망예측 뿐만 아니라장기 상태를 시각화 하여 위험도를 수치화 하였다. 또한 위험도를 특정 장기별로 구분하여 담당의 사가 환자의 상태에 맞는 맞춤형 응급조치를 취할 수 있도록 설계 및 개발 하였다.

간엽유착과 담낭염을 동반한 선천성 복막심낭 횡격막 허니아의 효과적 수술처치 (Surgical Correction of Congenital Peritoneopericardial Diaphragmatic Hernia with Adhered Hepatic Lobes and Cholecystitis)

  • 남현숙;곽호현;이세호;박경미;박인철;한정희;우흥명
    • 한국임상수의학회지
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    • 제29권1호
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    • pp.87-92
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    • 2012
  • A six months old, male Shih Tzu dog was referred to the Veterinary Medical Teaching Hospital at Kangwon National University, for lethargy, respiratory embarrassment. Survey radiography revealed enlarged cardiac silhouette due to displacement of gas-filled intestine in the pericardium. Although there were no specific clinical signs, this case was diagnosed as peritoneopericardial diaphragmatic hernia (PPDH) based on the results of positive contrast radiography and thoracic ultrasonograpic findings. In addition, the thickened gall bladder wall observed in ultrasonography, increase of alkaline phosphatase and neutrophils indicated cholecystitis. Two hepatic lobes and gall bladder were severely necrotized and adhere to the diaphragm. Direct reduction of the herniated organs might cause hepatic hemorrhage and bile juice leakage which may induce very poor prognosis. To solve the problems, the adhered organs were dissected with part of diaphragm, and lobectomy with cholecystectomy was performed for prevention of some possible complications including peritonitis. This is case report describing resection of part of diaphragm adhered to herniated organ reduce the risk of possible hepatic hemorrhage during surgical correction of PPDH followed bycholecystectomy and lobectomy.

Subchronic Inhalation Toxicity of Trichloroacetonitrile on the Sprague Dawley Rats

  • Han, Jeong-Hee;Chung, Yong-Hyun;Lim, Cheol-Hong
    • Toxicological Research
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    • 제31권2호
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    • pp.203-211
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    • 2015
  • Trichloroacetonitrile is used as an intermediate in insecticides, pesticides, and dyes. In Korea alone, over 10 tons are used annually. Its oral and dermal toxicity is classified as category 3 according to the globally harmonized system of classification and labelling of chemicals, and it is designated a toxic substance by the Ministry of Environment in Korea. There are no available inhalation toxicity data on trichloroacetonitrile. Thus, the present study performed inhalation tests to provide data for hazard and risk assessments. Sprague-Dawley rats were exposed to trichloroacetonitrile at concentrations of 4, 16, or 64 ppm for 6 hour per day 5 days per week for 13 weeks in a repeated study. As a result, salivation, shortness of breath, and wheezing were observed, and their body weights decreased significantly (p < 0.05) in the 16 and 64 ppm groups. All the rats in 64 ppm group were dead or moribund within 4 weeks of the exposure. Some significant changes were observed in blood hematology and serum biochemistry (e.g., prothrombin time, ratio of albumin and globulin, blood urea nitrogen, and triglycerides), but the values were within normal physiological ranges. The major target organs of trichloroacetonitrile were the nasal cavity, trachea, and lungs. The rats exposed to 16 ppm showed moderate histopathological changes in the transitional epithelium and olfactory epithelium of the nasal cavity. Nasal-associated lymphoid tissue (NALT) and respiratory epithelium were also changed. Respiratory lesions were common in the dead rats that had been exposed to the 64 ppm concentration. The dead animals also showed loss of cilia in the trachea, pneumonitis in the lung, and epithelial hyperplasia in the bronchi and bronchioles. In conclusion, the no-observed-adverse-effect level (NOAEL) was estimated to be 4 ppm. The main target organs of trichloroacetonitrile were the nasal cavity, trachea, and lungs.

A Comprehensive Analysis of Deformable Image Registration Methods for CT Imaging

  • Kang Houn Lee;Young Nam Kang
    • 대한의용생체공학회:의공학회지
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    • 제44권5호
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    • pp.303-314
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    • 2023
  • This study aimed to assess the practical feasibility of advanced deformable image registration (DIR) algorithms in radiotherapy by employing two distinct datasets. The first dataset included 14 4D lung CT scans and 31 head and neck CT scans. In the 4D lung CT dataset, we employed the DIR algorithm to register organs at risk and tumors based on respiratory phases. The second dataset comprised pre-, mid-, and post-treatment CT images of the head and neck region, along with organ at risk and tumor delineations. These images underwent registration using the DIR algorithm, and Dice similarity coefficients (DSCs) were compared. In the 4D lung CT dataset, registration accuracy was evaluated for the spinal cord, lung, lung nodules, esophagus, and tumors. The average DSCs for the non-learning-based SyN and NiftyReg algorithms were 0.92±0.07 and 0.88±0.09, respectively. Deep learning methods, namely Voxelmorph, Cyclemorph, and Transmorph, achieved average DSCs of 0.90±0.07, 0.91±0.04, and 0.89±0.05, respectively. For the head and neck CT dataset, the average DSCs for SyN and NiftyReg were 0.82±0.04 and 0.79±0.05, respectively, while Voxelmorph, Cyclemorph, and Transmorph showed average DSCs of 0.80±0.08, 0.78±0.11, and 0.78±0.09, respectively. Additionally, the deep learning DIR algorithms demonstrated faster transformation times compared to other models, including commercial and conventional mathematical algorithms (Voxelmorph: 0.36 sec/images, Cyclemorph: 0.3 sec/images, Transmorph: 5.1 sec/images, SyN: 140 sec/images, NiftyReg: 40.2 sec/images). In conclusion, this study highlights the varying clinical applicability of deep learning-based DIR methods in different anatomical regions. While challenges were encountered in head and neck CT registrations, 4D lung CT registrations exhibited favorable results, indicating the potential for clinical implementation. Further research and development in DIR algorithms tailored to specific anatomical regions are warranted to improve the overall clinical utility of these methods.

방사선(학)과 임상실습생의 수시출입자 피폭선량에 대한 고찰: C 대학병원 사례 연구 (A Study on the Radiation Exposure Dose of Clinical Trainees in the Department of Radiology: A Case Study at C University Hospital)

  • 이주아
    • 한국방사선학회논문지
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    • 제17권2호
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    • pp.249-255
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    • 2023
  • 본 연구는 방사선작업종사자, 방사선관계종사자 그룹의 방사선사들과 수시출입자로 분류된 예비 방사선사인 재학생의 임상실습 과정에서의 피폭선량을 측정하였다. 2021년 1월부터 1년 동안 인천소재의 C 대학병원의 방사선구역에서 근무하였던 방사선사들과 동 의료기관에서 7월 1일부터 8월 31일까지 임상실습을 이수한 121명의 학생들을 연구대상으로 하였다. 방사선 피폭선량으로 인하여 손상위험장기인 폐의 피폭선량으로 인한 부작용 발생확률을 평가하기 위하여 ICRP 103[12]에 의거한 명목위험계수(Nominal Risk Factor)를 사용하였다. 임상실습기간 중 수시출입자로 분류된 방사선(학)과 학생들의 표층선량은 0.98 ± 0.14 mSv, 심부선량은 0.93 ± 0.14 mSv였다. 즉, 표층선량은 1,000,000당 6.7명, 심부선량은 6.4명이 폐의 피폭선량으로 인한 부작용 발생률이 있음이 나타났다. 이는 1년 피폭선량의 환산 값으로 방사선(학)과 교육과정이 3년 혹은 4년임을 고려하였을 때, 임상실습을 나가는 예비 방사선종사자들에 대한 체계적인 관리와 관심이 필요하며, 방사선의 확률적 영향과 관련하여 방사선 안전관리를 위한 기초자료로 활용될 것으로 사료된다.