• Journal of Chest Surgery
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• 제29권6호
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• pp.655-659
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• 1996

Primary cardiac tumors are known to be rare. Of the benign primary tumors, rhabdomyoma predominates in neonates and infants. Tuberous sclerosis is found in hall of the patients with rhabdomyomas. Rhabdomyomas demonstrate benign pathological characteristics and may regress spontaneously that resection of the intracavitary obstructing portion of these tumors are recommended. We performed resection of intraatrial rhabdomyoma which had been obstructing mitral valve orifice and caused heart failure in a neonate. Postoperatively, fungal endocarditis developed and after 3 days, rapid growth and extension of the vegetation in the aorta obstructed the flow through the ascending aorta and resulted in hemodynamic deterioration.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7167-7170
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• 2015

Background: Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. Objective: To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. Materials and Methods: This is a prospective institutional study in Southern India carried on from $1^{st}$ June 2012 to $31^{st}$ July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. Results: The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. Conclusions: In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

• Journal of Chest Surgery
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• 제37권9호
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• pp.800-804
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• 2004

폐기종 및 재발성 기흉의 과거력이 있는 67세 남자가 갑자기 악화된 호흡곤란을 주소로 내원하였다. 흉부 전산화 단층촬영상 우하엽에 새로 발생한 폐기낭으로 인하여 심장이 좌측으로 전위되어 있는 소견을 보였다. 폐기낭 흡인술(변형 Monaldi 술식)로 성공적으로 치료되었으며 수술 후 환자의 증상은 개선되었다. 저자들은 거대 폐기낭으로 인해 심폐기능이 악화된 폐기종 환자에서 변형 Monaldi 술식으로 치료하여 좋은 결과를 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국의학물리학회지:의학물리
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• 제6권1호
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• pp.13-18
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• 1995

고선량의 RALS(Remote Afterloding Syetem)를 이용한 근접조사에서 선원의 위치에 따라 선량분포는 거리제곱의 반비례 형태로 변화되므로, 관심점의 흡수선량은 선원의 교정에 의해 크게 영향을 받는다. 자궁경부암 강내치료시 정확한 흡수선량을 결정하고자 선원을 교정하고, 선원의 위치에 따른 선량분포도에 의한 계산값과 반도체 검출기와 전리함을 이용한 설측값과 차이를 비교하고 보정 방법을 논의 하였다. Bulcher-RALS를 이용하여 치료에 사용된 선원의 교정은 공기커마와 사각형 아크랄 팬톰을 이용하여 r 인자에 의한 거리 역자승법칙으로 계산하였고, Co-60 선원의 8cm 거리에서 검교정된 측정기를 이용한 선량율을 비교치로 이용하였다. 선량측정치의 재현성은 팬톰내에서 0.3~1.1% 였으며, 측정치의 분포는 Bulcher-RALS 선량분포도에 의한 계산값과 팬톰측정치의 비교에서 -3~17%, 강내치료를 받은 18 명의 환자를 대상으로한 직장내 흡수선량에서 체내 실측값과 차이는 환자와 선원의 위치에 따라 -6~＋21%로 측정값이 평균 6.3% 높게 나타났다.

• Radiation Oncology Journal
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• 제8권1호
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• pp.133-136
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• 1990

자궁암치료에서 재발되거나 치료가 어려운 종양에 대하여 방사선과 온열요법을 병행함으로서 치료 성과를 다소 향상시킬 수 있었다. 더욱이 방사선 근접조사와 강내온열치료는 주위 건강조직의 피해를 줄이면서 종양에 집중손상을 줄 수 있었으며 강내방사선조사 기구를 공동으로 이용하므로서 시술이 간단하고 치료부위를 정확히 조준할 수 있었다. 그러나 강내조사용 안테나는 그 모양과 구성에 따라 온열 분포가 변하며 재래식 쌍극철심형 안테나는 끝부분 또는 연결부위의 가온이 급증하여 균등한 온열분포를 기대할 수 없었다. 저자들은 안테나의 길이를 마이크로파의 약수 즉 3, 6, 12 cm로 하여 공명이 잘 이루어지도록 하였으며 끝이 굵고 접촉 부위가 가느다란 꼬깔형 (conical) 안테나를 제작하여 사용한 결과 안테나 축에 따라 거의 일정하거나 약간 타원형의 온도분포를 이루었으며 가온 깊이도 $2\~3\;cm$로서 비교적 깊은 곳까지 가열할 수 있어 강내 치료효과를 향상시킬 수 있다고 생각된다.

• Radiation Oncology Journal
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• 제11권1호
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• pp.91-96
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• 1993

From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.

• Radiation Oncology Journal
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• 제16권4호
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• pp.357-366
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• 1998

Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week. 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as. 78-86$\%$ for Stage 1, 68-85$\%$ for stage 11, and 38-56$\%$ for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.

• Radiation Oncology Journal
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• 제36권3호
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• pp.227-234
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• 2018

Purpose: We compared how doses delivered via two-dimensional (2D) intracavitary brachytherapy (ICBT) and three-dimensional (3D) ICBT varied anatomically. Materials and Methods: A total of 50 patients who received 30 Gy of 3D ICBT after external radiotherapy (RT) were enrolled. We compared the doses of the actual 3D and 2D ICBT plans among patients grouped according to six anatomical variations: differences in a small-bowel V_2Gy, small bowel circumference, the direction of bladder distension, bladder volume, sigmoid V_3.5Gy, and sigmoid circumference. Seven dose parameters were measured in line with the EMBRACE recommendations. Results: In terms of bladder volume, the bladder and small-bowel D_2cc values were lower in the 150-250 mL bladder volume subgroup; and the rectum, sigmoid, and bladder D_2mL values were all lower in the >250 mL subgroup, for 3D vs. 2D ICBT. In the sigmoid V_3.5Gy >2 _mL subgroup, the sigmoid and bladder D_2mL values were significantly lower for 3D than 2D ICBT. The bladder D_2mL value was also significantly lower for 3D ICBT, as reflected by the sigmoid circumference. In patients with a small bowel V_2.0Gy >10 mL or small bowel circumference >15%, most dose parameters were significantly lower for 3D than 2D ICBT. The bladder distension direction did not significantly affect the doses. Conclusion: Compared to 2D ICBT, a greater bladder volume can reduce the internal 3D ICBT organ dose without affecting the target dose.

• Journal of Chest Surgery
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• 제51권2호
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• pp.138-141
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• 2018

Herein, we describe the case of a 67-year-old female patient who presented with cough and haemoptysis. Chest computed tomography revealed destruction of the left lower lobe and multiple fungus balls in a bronchiectatic cavity. A left lower lobectomy was performed via thoracotomy. Histopathological examination of the lung showed a concomitant aspergilloma and multiple tumourlets in the large bronchiectatic cavity. Pulmonary intracavitary aspergilloma and concomitant tumourlets are quite rare. Our report presents this interesting case that manifested with haemoptysis.

• Journal of Chest Surgery
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• 제12권1호
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• pp.1-8
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• 1979

Pulmonary aspergillosis is being recognized with increasing frequency in recent years and the-rising incidence of this infection parallels certain medical advances in antibiotics, chemotherapeutic and immunosuppressive therapy. The cavities of lungs resulting from tuberculosis, histoplasmosis or neoplasm are apt, to be infected by one of the species of the genus Aspergillus and eventually mycetomas are formed within the cavities. Authors have experienced 6 cases of pulmonary aspergillosis forming mycetoma in Dept. of Thoracic Surgery, Catholic Medical Center from Aug. 1976 to Feb. 1979. Hemoptysis or blood tinged sputum, the predominant symptom, occurred in all cases. All patients underwent pulmonary resection, 1 pneumonectomy, 3 lobectomies, 1 lobectomy with segmental resection and 1 segmental resection and survived well without death or complication. Primary aspergillosis was in 2 cases and underlying diseases were present in 4 cases: 3 pulmonary tuberculosis, 1 bronchiectasis. The common diagnostic study of intracavitary mycetoma was the posterioanterior chest roentgenogram; in cavities suspected of being diseased or in doubtful cases, tomography was most available to find fungus ball with air-meniscus shadow.