• Title/Summary/Keyword: femoral head

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Comparison of Beam Delivery Modes in Prostate Cancer Proton Therapy: A Treatment Planning Comparison Study (전립선암 환자 양성자치료 시 빔 전달방식에 따른 치료계획 비교)

  • Kim, Youn Young;Youm, Doo Seok;Jang, Yo Jong;Kang, Dong Yun;Park, Jeong Hoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.153-158
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    • 2013
  • Purpose: After making two plans, the Double Scattering (DS) Mode and The Pencil Beam Scanning (PBS) Mode, of patients on early prostate cancer, we not only compare the dose conformity and the dose homogeneity by analyzing each DVH, CN and HI, but also evaluate normal structures's sparing effect on each mode. Materials and Methods: Planes about nine patients, who did proton therapy, on prostate cancer was setted using the Eclipse proton external beam planning system. The prescription dose, every $2.5 Gy{\times}28$ fractions=70 Gy, was delivered to the PTV. The CN and the HI were getted by anlazing each DVHs for the DS Plan and the PBS Plan. Also, normal structures' %volumes according to dose of the PBS are campared with those of the DS. Results: The average CN of the PTV is increase 16.63% from DS $0.68{\pm}0.07$ to PBS $0.79{\pm}0.01$, and the average IN of the PTV is decrease -22.66 % from DS $0.12{\pm}0.03$ to PBS $0.09{\pm}0.01$. The PBS has litter %Volumes of normal structures than the DS about every patient except Rectum. The average %Volume of Left Femoral Head receiving ${\geq}30$ Gy shows most high decreasing rate, -79.93%, from DS to PBS and the average %Volume of Rectum receiving ${\geq}70$ Gy shows most low decreasing rate, -3.03%, from DS to PBS. Conclusion: Therefore, the PBS is more effective achieving the dose conformity and the dose Homogeneity than DS, and better to reduce unnecessary dose arriving normal structures, especially the femoral heads.

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Effect of pelvic adjustment on chronic low back pain and spino-pelvic parameters in middle-aged women (골반교정이 중년 여성의 만성요통과 척추골반지표에 미치는 영향)

  • Seo, Yun-Gyo;Kim, Jaehee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.347-355
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    • 2017
  • The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelvic adjustment interventionswereperformed four times a week for 8 weeksin the former group. At baseline and after 8 weeks, the back pain and back function were evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and back flexibility. Additionally, the spino-pelvic radiographic parameters and serum C-reactive protein (CRP) levels were assessed. After 8 weeks, the VAS, ODI, and back flexibility significantly improved in the pelvic adjustment group compared with the control group. It was found that the changes from baseline in the lumbar lordotic angle, sacral slope, pelvic crest unleveling, and femoral head height inequality were significantly greater in the pelvic adjustment group than in the control group. There were no significant changes in the pelvic incidence or serum CRP levels in either group. In conclusion, pelvic adjustment has beneficial effects on chronic low back pain and back function, suggesting that the effects of pelvic adjustment on back pain may at least in part result from changes in the spino-pelvic alignment.

The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone (거대세포종의 치료시 관절 기능의 보존)

  • Bae, Dae-Kyung;Han, Chung-Soo;Sun, Seung-Deok;Baek, Chang-Hee;Rhee, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.145-153
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    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

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Effects of Screw Configuration on Biomechanical Stability during Extra-articular Complex Fracture Fixation of the Distal Femur Treated with Locking Compression Plate (잠김 금속판(LCP-DF)을 이용한 대퇴골 원위부의 관절외 복합골절 치료시 나사못 배열에 따른 생체역학적 안정성 분석)

  • Kwon, Gyeong-Je;Jo, Myoung-Lae;Oh, Jong-Keon;Lee, Sung-Jae
    • Journal of Biomedical Engineering Research
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    • v.31 no.3
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    • pp.199-209
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    • 2010
  • The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

Treatment Strategies for Primary Central Nervous System Lymphoma (원발성 중추신경계 림프종의 치료전략)

  • Kim, Il-Man;Lee, Chang Young;Son, Eun Ik;Kim, Dong Won;Yim, Man Bin;Kim, Sang Pyo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.334-341
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    • 2001
  • Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.

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Comparison of SUV for PET/MRI and PET/CT (인체 각 부위의 PET/MRI와 PET/CT의 SUV 변화)

  • Kim, Jae Il;Jeon, Jae Hwan;Kim, In Soo;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.10-14
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    • 2013
  • Purpose: Due to developed simultaneous PET/MRI, it has become possible to obtain more anatomical image information better than conventional PET/CT. By the way, in the PET/CT, the linear absorption coefficient is measured by X-ray directly. However in case of PET/MRI, the value is not measured from MRI images directly, but is calculated by dividing as 4 segmentation ${\mu}-map$. Therefore, in this paper, we will evaluate the SUV's difference of attenuation correction PET images from PET/MRI and PET/CT. Materials and Methods: Biograph mCT40 (Siemens, Germany), Biograph mMR were used as a PET/CT, PET/MRI scanner. For a phantom study, we used a solid type $^{68}Ge$ source, and a liquid type $^{18}F$ uniformity phantom. By using VIBE-DIXON sequence of PET/MRI, human anatomical structure was divided into air-lung-fat-soft tissue for attenuation correction coefficient. In case of PET/CT, the hounsfield unit of CT was used. By setting the ROI at five places of each PET phantom images that is corrected attenuation, the maximum SUV was measured, evaluated %diff about PET/CT vs. PET/MRI. In clinical study, the 18 patients who underwent simultaneous PET/CT and PET/MRI was selected and set the ROI at background, lung, liver, brain, muscle, fat, bone from the each attenuation correction PET images, and then evaluated, compared by measuring the maximum SUV. Results: For solid $^{68}Ge$ source, SUV from PET/MRI is measured lower 88.55% compared to PET/CT. In case of liquid $^{18}F$ uniform phantom, SUV of PET/MRI as compared to PET/CT is measured low 70.17%. If the clinical study, the background SUV of PET/MRI is same with PET/CT's and the one of lung was higher 2.51%. However, it is measured lower about 32.50, 40.35, 23.92, 13.92, 5.00% at liver, brain, muscle, fat, femoral head. Conclusion: In the case of a CT image, because there is a linear relationship between 511 keV ${\gamma}-ray$ and linear absorption coefficient of X-ray, it is possible to correct directly the attenuation of 511 keV ${\gamma}-ray$ by creating a ${\mu}$map from the CT image. However, in the case of the MRI, because the MRI signal has no relationship at all with linear absorption coefficient of ${\gamma}-ray$, the anatomical structure of the human body is divided into four segmentations to correct the attenuation of ${\gamma}-rays$. Even a number of protons in a bone is too low to make MRI signal and to localize segmentation of ${\mu}-map$. Therefore, to develope a proper sequence for measuring more accurate attenuation coefficient is indeed necessary in the future PET/MRI.

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Retrospective Study on Surgical Repair of 31 Canine Pelvic Fracture Cases (골반 골절의 수술적 교정을 실시한 31두 개에서의 후향연구)

  • Lee, Seung-Hoon;Park, Sung-Su;Kang, Byung-Jae;Kim, Yong-Sun;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.8-11
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    • 2012
  • The results of surgical repair for pelvic factures in 31 dogs were reviewed. Lameness and weight bearing scores were used to evaluate functional recovery of the hind limbs. Simple fracture occurred in sacroiliac joint (n = 5) and ilium (n = 3). Pelvic fractures had acetabular (n = 7) and non-acetabular fractures (n = 23). Acetabular fracture cases were composed of additional surgical treatments with femoral head and neck ostectomy (FHNO) (n = 4) and only acetabular rim fixation (n = 3). Simple fractures had more rapid initial and complete recovery times than multiple fractures. Non-acetabular fracture cases (initial recovery time: 2.7 weeks, complete recovery time: 9.1 weeks) had more rapid initial and complete recovery times than acetabular fracture cases (8.4, 12.5 weeks) (p < 0.05). In addition, the cases of additional surgical treatment with FHNO (5.3, 7 weeks) had more rapid mean recovery times than surgical treatment without FHNO (11.1, 16.3 weeks). Surgical approach with FHNO in acetabular fracture was an alternative method to treat pelvic fractures in small breed dogs.

Tre Effect of UW Solution for Protection of Ischemic Injury in Free Myocutaneous Flaps of the Rabbit (가토 근피판에서 허혈성 손상 방지를 위한 UW 관류제 사용의 효과)

  • Suh Woo-Suk;Kwun Woo-Heung;Kim Sang-Woon;Lee Su-Jung;Kwun Koing-Bo
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.1
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    • pp.3-9
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    • 1993
  • The benficial effects for perfusion in the preservation of free flaps have been controversial in the clinical and experimental field until now. This study was undertaken to observe the effect of UW solution. a recently developed. high molecular weight. organ perfusion solution. for protection of ischemic injury in normothermic free myocutaneous flaps. Forty rabbits were used in this sutdy. A 1x2x1cm sized gastrocnemius myocutaneous flap based on the feeding vessel from common femoral artery was made. The author set up the ischemic time for 12 hours in these flaps. The flap was washed out with normal saline(control grop, n=10), urokinase(comparative group I, n=10), UW solution before ischemic time(comparative group II, n=10) and UW solution before ischemic time and pentoxifylline before reperfusion(comparative group III, n=10). Afterthen, reperfusion was made for 12 hours. After this procedure, we checked the degree of ischemia and necrosis of myocutaneous flap by gross finding, electrical stimulation test of muscle, triphenyltetrazolium chloride staining and wet/dry weight ratio. The degree of necrosis of comparative group II and III were lesser than control and urokinase group in gross finding(p<0.05). In the electrical stimulation test of muscle, there was no statistical difference between control($1.76{\pm}1.01$) and urokinase($2.36{\pm}\1.02$) group however the muscular power of comparative group II($3.54{\pm}0.93$) and III($3.49{\pm}1.37gm/mm^2$) demonstrated significantly higher than control group(p<0.05). The ischemic findings were found in seven cases of control group and three cases of urokinase group but there were no ischemic findings in comparative group II and III in TIC stain(p<0.05). In the wet/dry weight ratio of flaps in order to evaluate the tissue edema. there was no statistical difference between control($4.55{\pm}0.29$) and III($3.75{\pm}0.48$) were scored significantly lesser than control and urokinase group (p<0.05). These results suggest that perfusion washout with UW solution improves the viability of normothermic free myocutaneous flap by inhibition of cellular swelling.

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Partial transmission block production for real efficient method of block and MLC (Partial transmission block 제작 시 real block과 MLC를 이용한 방법 중 효율적인 방법에 대한 고찰)

  • Choi JiMin;Park JuYoung;Ju SangGyu;Ahn JongHo
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.19-24
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    • 2004
  • Introduction : The Vaginal, the urethra, the vulva and anal cancer avoid the many dose to femur head and the additional treatment is necessary in inguinal LN. The partial transmission block to use inguinal LN addition there is to a method which it treats and produce partial transmission block a method and the MLC which to it analyzes. Material & Methode : The Inguinal the LN treatment patient partial transmission it used block and the MLC in the object and with solid water phantom with the patient it reappeared the same depth. In order to analyze the error of the junction the EDR2 (Extended dose range, the Kodak and the U.S) it used the Film and it got film scanner it got the beam profile. The partial transmission block and the MLC bias characteristic, accuracy and stability of production for, it shared at hour and comparison it analyzed. Result : The partial the transmission block compares in the MLC and the block production is difficult and production hour also above 1 hours. The custom the block the place where it revises the error of the junction is a difficult problem. If use of the MLC the fabrication will be break and only the periodical calibration of the MLC it will do and it will be able to use easily. Conclusion : The Inguinal there is to LN treatment and partial transmission block and the MLC there is efficiency of each one but there is a place where the junction of block for partial transmission block the production hour is caught long and it fixes and a point where the control of the block is difficult. like this problem it transfers with the MLC and if it treats, it means the effective treatment will be possible.

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Effects of Floor Type and Increasing Market Weight on Performance and Pork Quality of Finishing Pigs (돈방바닥과 출하체중 증가가 비육돈의 생산효율과 돈육품질에 미치는 영향)

  • Kim D. H.;Kang J. D.;Ha D. M.
    • Journal of Animal Environmental Science
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    • v.11 no.3
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    • pp.153-160
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    • 2005
  • This study was conducted to determine the effect of floor type of finishing building and increasing market weight of finishing Pigs on Performance, carcass traits and pork quality. Four hundred and forty-four finishing pigs were confined and administered with different floor type(concrete slat and bedded with sawdust) and increasing market weight(110kg to 130kg) of finishing building. The result obtained from this study were summarized as follows; 1. There was no significant difference between the floor type of finishing building in the body weight gain, feed intake and gain per feed. And also increasing market weight of finishing pigs was not affected the performance of finishing pigs. 2. Increasing market weight of finishing pigs affect the carcass yield. The market weight at 130kg showed more amount of each cut of carcass, especially the belly portion was higher, but backfat thickness was not different. 3. Carcass traits did not show any significant difference due to the difference of market weight of finishing pig and floor type of finishing building. 4. There was no significant difference in the chemical compositions and meat color of pork loin between the floor type of finishing building and increasing market weight of finishing pigs.

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