• Title/Summary/Keyword: Treatment modality

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Treatment Results of Hypopharyngeal Carcinoma (하인두암의 방사선치료 성적)

  • Lee Chang Gul;Loh John J.K.;Ryu Sam Youl;Park Kyung Ran;Suh Chang Ok;Kim Gew Earn;Hong Won Pyo;Kim Byung Soo
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.23-33
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    • 1988
  • A rerospective review of fifty patients with carcinoma of hypopharynx treated with $RT{\pm}surgery$ was studied for eleven-year period from 1974 to 1984. Of the 50 patients,46 were pyriform sinus in origin, 4 were posterior pharyngeal wall. Eighty-eight percent of patients were locoregionally advanced(stage III, IV) and 78% of patients presented conical lymphadenopathy. 5-year disease-free survival rate of the pyriform sinus ca. was $25.4\%$ in RT alone group, $80\%$ in combined modality group and $30.6\%$ in overall. Local control rate with RT alone in early stage (II) was excellent $(100\%)$, however combined modality appears to be better for local control$(80\%)$ in advanced stage (III, IV) as compared with that of RT alone group $(32\%).$ On basis of this study, RT alone is effective in terms of local control and functional preservation in treatment of early stage of pyriform sinus ca. while surgery can be reserved for salvage purpose when RT fails and combined modality is recommended in patients with locally advanced stage for better local control and survival.

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Heavily T2-Weighted Magnetic Resonance Myelography as a Safe Cerebrospinal Fluid Leakage Detection Modality for Nontraumatic Subdural Hematoma

  • An, Sungjae;Jeong, Han-Gil;Seo, Dongwook;Jo, Hyunjun;Lee, Si Un;Bang, Jae Seung;Oh, Chang Wan;Kim, Tackeun
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.13-21
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    • 2022
  • Objective : Nontraumatic subdural hematoma (SDH) is a common disease, and spinal cerebrospinal fluid (CSF) leakage is a possible etiology of unknown significance, which is commonly investigated by several invasive studies. This study demonstrates that heavily T2-weighted magnetic resonance myelography (HT2W-MRM) is a safe and clinically effective imaging modality for detecting CSF leakage in patients with nontraumatic SDH. Methods : All patients who underwent HT2W-MRM for nontraumatic SDH workup at our institution were searched and enrolled in this study. Several parameters were measured and analyzed, including patient demographic data, initial modified Rankin Scale (mRS) score upon presentation, SDH bilaterality, hematoma thickness upon presentation, CSF leakage sites, treatment modalities, follow-up hematoma thickness, and follow-up mRS score. Results : Forty patients were identified, of which 22 (55.0%) had CSF leakage at various spinal locations. Five patients (12.5%) showed no change in mRS score, whereas the remaining (87.5%) showed decreases in follow-up mRS scores. In terms of the overall hematoma thickness, four patients (10.0%) showed increased thickness, two (5.0%) showed no change, 32 (80.0%) showed decreased thickness, and two (5.0%) did not undergo follow-up imaging for hematoma thickness measurement. Conclusion : HT2W-MRM is not only safe but also clinically effective as a primary diagnostic imaging modality to investigate CSF leakage in patients with nontraumatic SDH. Moreover, this study suggests that CSF leakage is a common etiology for nontraumatic SDH, which warrants changes in the diagnosis and treatment strategies.

Role of Contrast-Enhanced Ultrasound as a Second-Line Diagnostic Modality in Noninvasive Diagnostic Algorithms for Hepatocellular Carcinoma

  • Hyo-Jin Kang;Jeong Min Lee;Jeong Hee Yoon;Joon Koo Han
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.354-365
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    • 2021
  • Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar's test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion: The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

Anterior teeth alignment for aesthetic dentistry (심미치료를 위한 전치부 부분교정)

  • Park, Chul-Wan
    • The Journal of the Korean dental association
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    • v.56 no.9
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    • pp.512-520
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    • 2018
  • As the demand for natural and beautiful smiles increases, the demand for anterior aesthetic treatment is increasing. Orthodontic treatment is often necessary for esthetic, healthy and natural treatment outcome. Particularly, in the case of middle-aged patients, minor tooth movement limited to anterior teeth is more effective than comprehensive orthodontic treatment which requires a long-term treatment period. Clinician who is in charge of aesthetic dentistry should have the ability to select a case that can be treated with partial orthodontic treatment and to determine the most effective treatment method. This article provides decision flowchart for case selection and choosing the best treatment modality for anterior teeth alignment.

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Nonpharmacological treatment of arrhythmia (소아 부정맥의 비약물적 치료)

  • Bae, Eun-Jung
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.930-936
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    • 2006
  • Although antiarrhythmic medication has been the main treatment modality for arrhythmia in children, in recent decades technological development and computerization have made great advances in nonpharmacological therapy. This article reviews the transcatheter radiofrequency ablation for tachycardia in children, recent advances of device therapy for bradycardia, antitachycardia pacing, implantable cardioverter defibrillator. As a new field of device therapy, cardiac resynchronization therapy for congestive heart failure is also mentioned.

Intensity-modulated radiation therapy: a review with a physics perspective

  • Cho, Byungchul
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.1-10
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    • 2018
  • Intensity-modulated radiation therapy (IMRT) has been considered the most successful development in radiation oncology since the introduction of computed tomography into treatment planning that enabled three-dimensional conformal radiotherapy in 1980s. More than three decades have passed since the concept of inverse planning was first introduced in 1982, and IMRT has become the most important and common modality in radiation therapy. This review will present developments in inverse IMRT treatment planning and IMRT delivery using multileaf collimators, along with the associated key concepts. Other relevant issues and future perspectives are also presented.

The Current Status of Adenovirus-based Cancer Gene Therapy

  • Shirakawa, Toshiro
    • Molecules and Cells
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    • v.25 no.4
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    • pp.462-466
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    • 2008
  • Adenoviruses are the most commonly used gene-delivery vectors due to the efficiency of their in vivo gene transfer. Since 1993, about 300 protocols using an adenoviral vector have been performed, although they have yet to be proven effective in clinical trials. The adenovirus-based vector has been continuously improved by modification of the adenoviral genome and capsid, and novel adenovirus-delivery systems, such as the carrier-cell delivery system, have been recently proposed. Adenovirus-based cancer gene therapy is fast becoming one component of a multi-modality treatment approach to advanced cancer, along with surgery, radiotherapy, and chemotherapy.

Mucoepidermoid carcinoma of the lung (Mucoepidermoid Carcinoma 치험 1예)

  • 백광제
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.484-488
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    • 1986
  • Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

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Biological behavior and Treatment of Adenoid Cystic Carcinoma in The Bead and Neck (두경부 선낭암의 생물학적 특성과 치료)

  • Oh W. Y.;Cho K. H.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.191-202
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    • 1984
  • Biological behavior and treatment results of 33 patients with Adenoid Cystic Carcinoma (ACC) in the Head and Neck at Yonsei Cancer Confer for 10 years between 1971 and 1980 were retrospectively analysed. Most common, primary site was minor salivary glands such as maxillary sinus, nasal cavity and base of tongue. The typical biological behavior of these tumors was very slowly in growth with long time of duration(mean 19 months) from 1 month to 10 years and more frequent of nerve invasion but rare invasion of neck nodes. Local control and failure pattern in the results of treatment, 16 of 17 patients with irradiation alone were seen complete or partial response but 5 cases of locoregional recurrence, 2 cases of failure of neck node and 4 cases of distant metastasis as lung and brain. On the other hand, among 10 cases of surgery and postoperative irradiation, 2 cases of locoregional failure and 3 cases of distant metastasis as lung and bone. 2 of 4 cases with surgery alone were recurred within primary site. Actuarial overall NED survival at 3 ana 10 years were $52.6\%$ and $42.8\%$, respectively. Survival rate of 10 Patients with surgery and Postoperative irradiation was more high than 17 Patients of radiation alone. Therefore, we have known that surgery with postoperative adjunctive irradiation is most effective treatment modality of adenoid cystic carcinoma in the head and neck. Primary site, treatment modality and with or without nerve ana bone invasion have influenced on prognosis.

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