• 대한두경부종양학회지
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• 제34권2호
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• pp.17-21
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• 2018

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

• 대한방사선기술학회지:방사선기술과학
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• 제46권5호
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• pp.409-415
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• 2023

Although pediatric X-ray examinations are continuously increasing, there are not many studies on the radiation exposure to children and X-ray examination assistants according to X-ray Exposure conditions. Accordingly, we measured the radiation exposure dose of pediatric and X-ray examination assistants according to the standard guidelines and clinical average X-ray Exposure conditions when X-ray examination 10-year-old children. The effective dose and organ dose to pediatric were measured using an Dose area production meter and Monte Carlo-based PCXMC program, and the exposure dose of X-ray examination assistants was measured using an ion-chamber. When performing abdominal supine AP projection, the effective dose to children was up to 2.38 times higher under clinical average X-ray Exposure conditions than the standard guidelines. In addition, during abdominal supine AP projection, the radiation exposure dose to the X-ray examination assistants was highest on the hands at 0.0148 ~ 0.0709 mSv, and exposure dose could be reduced by up to 35% when wearing protective gloves. In conclusion, because the X-ray Exposure conditions used in clinical are unnecessarily high, unnecessary medical radiation exposure could be reduced if appropriate X-ray Exposure conditions and the radiation field area were minimized and the assistant wore shielding gloves.

• 한국임상수의학회지
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• 제41권1호
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• pp.30-36
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• 2024

A 3-year-old, 20.6 kg, neutered male German Shepherd dog was referred to Kyungpook National University Veterinary Medicine Teaching Hospital. Clinical examination revealed chronic diarrhea for 6 weeks and a non-tender, distended abdomen without lethargy, anorexia, and vomiting. Diarrhea was watery and had a waxing and waning course despite symptomatic treatment. A complete blood count identified mild leukocytosis and mild anemia. Serum biochemistry analysis showed elevated alanine aminotransferase and aspartate aminotransferase levels, and mild hypoalbuminemia. Abdominal ultrasound examination revealed mixed echogenicity with absent blood flow at the caudate process of the caudate liver lobe and a small amount of ascites. Computed tomography revealed torsion of the caudate process of the caudate liver lobe and spleen and gas dilatation of the intestine. After establishing a diagnosis of organ torsion on imaging, we deemed the condition an emergency and immediately performed surgery. Given that laparotomy confirmed organ torsion, liver lobectomy, total splenectomy, and prophylactic gastropexy were conducted. The patient was discharged 11 days after surgery without complications. In general, liver lobe torsion and splenic torsion are uncommon in dogs and present with nonspecific clinical signs, such as abdominal pain, lethargy, anorexia, and vomiting. In the current case, torsion of the caudate liver lobe and spleen occurred without other clinical signs except for a distended abdomen. Moreover, no reports in dogs have demonstrated the simultaneous occurrence of both diseases.

• Asian-Australasian Journal of Animal Sciences
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• 제22권5호
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• pp.686-693
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• 2009

A 21- to 42-day feeding study was conducted in Ross male broilers to evaluate the use of dried bakery product (DBP) and the influence of adding fat at different points in the manufacturing process. Six dietary treatments were formulated using a factorial arrangement (3${\times}$2 design) with three levels of fat in the mixer (high: 4.8%, medium: 3.8% and low: 2.8%) with or without DBP (0 and 7%). Additional fat was sprayed on pellets in a post-pelleting liquid application to bring the fat content to a similar level in all diets. Data on pellet quality (before and after post-pelleting fat addition), broiler performance, nutrient digestibility and organ weights were studied. Pellets made with DBP showed higher hardness values when measured before post-pelleting fat addition (p<0.001), although DBP did not affect final pellet hardness or durability. Higher post-pelleting hardness and durability were shown by diets to which a lower level of fat had been added in the mixer (p<0.001). In general, post-pelleting fat application improved durability (p<0.05). However, broiler performance and ileal digestibility were not affected by any of the factors tested. Dietary treatments had a significant but variable effect on carcass yield (p<0.01), although there were no differences among treatments regarding breast and leg yield, abdominal fat or organ weights. The results indicate that up to 7% DBP could be used in the broiler diet without impairing performance, ileal digestibility or organ weights. The place or point of fat addition in the manufacturing process has a strong influence on pellet quality.

• Journal of Animal Science and Technology
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• 제56권1호
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• pp.4.1-4.7
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• 2014

The effect of sodium and sodium salts on carcass and body organ characteristics of broilers under a four phase feeding program were investigated. A basal diet (0.08% dNa with NaCl) was formulated and one of two sources of dNa ($NaHCO_3$ and $Na_2SO_4$) were supplemented to obtain four different percentages of dNa (0.17, 0.26, 0.35, and 0.44%) for each treatment. There was a linear decrease in dressing percentage (DP) with source ${\times}$ level interaction ($p{\leq}0.001$), while there was a linear increase in breast yield and thigh yield with increasing dNa supplementation ($p{\leq}0.001$). Chicks fed 0.35% $NaHCO_3$ and 0.44% dNa $Na_2SO_4$ supplemental salts had lower abdominal fat ($p{\leq}0.04$). Chicks that received increasing levels of dNa (from 0.17 to 0.44%) showed increasing gizzard weight ($p{\leq}0.02$) and decreasing spleen weight ($p{\leq}0.02$). When both salts were supplemented at 0.26% dNa, the chicks showed their lowest bursa weight ($p{\leq}0.001$). Consequently, chicks at higher dNa showed an increase in breast and thigh meat yield, and increasing capacity of their digestive organ. The higher levels of dNa should be tested with other cations and anions to fully understand acid base homoeostasis.

• 대한방사선치료학회지
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• 제24권2호
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• pp.157-165
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• 2012

목 적: 간에 발생한 절제 불가능한 원발성 및 전이성 종양에서 토모테라피를 이용한 정위적 방사선치료를 시행하기 위해 사용된 복부압박장치의 유용성을 평가하고자 하였다. 대상 및 방법: 2011년 11월부터 2012년 3월까지 토모테라피(Hi-Art Tomotherapy, USA)를 시행받기 위해 본원에 내원한 간암환자 중 복부압박장치(diaphragm control, elekta, sweden)를 사용하였을 때 움직임이 1 cm 이상 줄어든 환자를 대상으로 하였다. 4D CT (somatom sensation, siemens, germany)를 통해 치료계획영상과 4차원 단층촬영영상을 촬영하고, 육안적으로 보이는 종양과 종양의 움직임을 고려하여 육안적 종양체적(gross tumor volume, GTV)으로 설정하였고, GTV 주변으로 균일하게 5~7 mm의 여유를 주어 치료계획용 종양체적(planning target volume, PTV)으로 설정하였다. 손상위험장기(organs at risk) 중 십이지장, 위, 대장의 거리가 종양으로부터 최소 1 cm 이상인 환자들을 1군($d{\geq}1$)으로, 1 cm 미만인 환자들을 2군(d<1)으로 분류하고 각각 4~5회의 정위적 방사선치료와 20회의 방사선치료를 계획하였다. Mega-voltage computed tomograpy (MVCT)와 kilo-voltage computed tomograpy (KVCT)를 일차적으로 골격구조셋팅(bone-technique)으로 융합(fusion)한 뒤, 이차적으로 간을 보며 영상을 재조정 하였다. 치료 후 얻은 MVCT 영상을 영상변형이 가능한 Mim_vista (Mimsoftware, ver. 5.4 USA)로 보내고, 간을 비교하여 다시 묘사(delineate)하고, 손상위험장기 중 십이지장, 위, 소장, 대장을 합쳐서 대장장기(bowel_organ)로 정의하여 다시 묘사하였다. 보정방사선 치료계획시스템을 통하여 보정영상의 치료계획 선량과 보정된 선량의 차이를 평가하였다. 첫 번째, 치료 시작일부터 각각 1군($d{\geq}1$)은 4회, 2군(d<1)은 10회까지의 MVCT와 KVCT간의 영상 융합을 통한 셋업오차를 분석하였다. 두 번째, 보정영상에서 종양 즉, GTV, PTV의 치료계획선량과 보정선량의 3%의 선량차이를 나타내는 체적($V_{diff3%}$)과 5%의 선량차이를 나타내는 체적($V_{diff3%}$)을 비교하였고, 손상위험장기 중 대장장기의 최대선량의 차이율을 비교하였다. 결 과: MVCT를 통해 분석한 평균 셋업오차는 $-0.66{\pm}1.53$ mm (좌-우), $0.39{\pm}4.17$ mm (상-하), $0.71{\pm}1.74$ mm (전-후), $-0.18{\pm}0.30$ degrees (roll)였다. 1군($d{\geq}1$)과 2군(d<1)의 셋업오차는 유사하였다. 1군($d{\geq}1$)에서 보정방사선 치료계획을 통한 $V_{diff3%}$ 중 GTV는 $0.78{\pm}0.05%$, PTV는 $9.97{\pm}3.62%$, $V_{diff5%}$ 중 GTV는 0.0%, PTV는 $2.9{\pm}0.95%$, 대장장기의 최대선량의 차이율은 $-6.85{\pm}1.11%$였다. 2군(d<1)에서 $V_{diff3%}$ 중 GTV는 $1.62{\pm}0.55%$, PTV는 $8.61{\pm}2.01%$, $V_{diff5%}$ 중 GTV는 0.0%, PTV는 $5.33{\pm}2.32%$, 대장장기의 최대선량의 차이율은 $28.33{\pm}24.41%$였다. 결 론: 복부압박장치를 통한 간암의 방사선치료시 MVCT를 통한 환자 셋업오차는 평균 ${\pm}5$ mm 이하였고, 복부 압박장치를 사용하고 투시영상을 통해 확인한 횡경막의 움직임이 최소 5 mm 이상이라는 것을 감안하면, 환자 셋업오차는 그 안에 있음을 알 수 있었다. 1군($d{\geq}1$)과 2군(d<1)에서 GTV, PTV의 선량차이율은 오차범위 안에 있었고, 1군($d{\geq}1$)과 2군(d<1)의 대장장기 최대선량의 차이율은 최대 35% 이상의 차이를 보였고, 1군($d{\geq}1$)이 2군(d<1)보다 오차범위가 작았다. 따라서 간내 종양과 손상위험장기의 거리가 최소 1 cm 이상 유지된다면 정위적 방사선치료를 진행함에 복부압박장치가 도움이 될 수 있을 것으로 사료된다.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.261-266
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• 2012

Purpose: Traumatic pancreatic injury is not common in abdominal trauma injury. However, the morbidity and the mortality rates of patients with pancreatic injury, which are related with difficulties of initial assessment, establishment of diagnosis, and treatment are relatively high. The aim of this study is to review our institution's experience and suggest a diagnosis and therapeutic algorithm for use in cases involving traumatic pancreatic injury. Methods: Eighteen(18) patients with blunt pancreatic injury from January, 2004 to October 2012 were included in this study. We analyzed treatment and diagnosis method, other organ injury, treatment interval, hospital stay and complications retrospectively. Results: Nine patients were treated with conservative medication and another nine patients were treated surgically. Complications occurred in nine patients, and one patient died due to intraventricular hemorrhage and subdural hemorrhage with multiple organ failure. Delayed surgery was performed in three cases. The early and delayed surgery groups showed difference in hospital stay and intensive care unit stay. Delayed surgery was associated with a longer hospital stay (p=0.007) than immediate surgery. Conclusion: In blunt pancreatic trauma, proper early diagnosis and prompt treatment are recommended necessity. Based on this review of our experience, we also suggest the adoption of our institution's algorithm for cases involving traumatic pancreatic injury.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.88-92
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• 2012

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.86-89
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• 2002

The purpose is to develop a system to reduce the organ movement from the respiration during the 3DCRT or IMRT. This research reports the experience of utilizing personally developed system for mobile tumors. The patients clinical database was structured for 10 mobile tumors and patient setup error measurement and immobilization device effects were investigated. The RMRD system is composed of the respiratory motion reduction device utilized in prone position and abdominal strip device(ASD) utilized in the supine position, and the analysis program, which enables the analysis on patients setup reproducibility. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the normal tissue volume, field margins and dose volume histogram(DVH) using fluoroscopy and CT images. And, reproducibility of patients setup verify by utilization of digital images. When patients breathed freely, average movement of diaphragm was 1.2 cm in prone position in contrast to 1.6 cm in supine position. In prone position, difference in diaphragm movement with and without RMRDs was 0.5 cm and 1.2 cm, respectively, showing that PTV margins could be reduced to as much as 0.7 cm. With RMRDs, volume of the irradiated normal tissue (lung, liver) reduced up to 20 % in DVH analysis. Also by obtaining the digital image, reproducibility of patients setup verify by visualization using the real-time image acquisition, leading to practical utilization of our software. Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.