• The Korean Journal of Nuclear Medicine
• /
• v.7 no.2
• /
• pp.27-34
• /
• 1973

Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

• Radiation Oncology Journal
• /
• v.36 no.1
• /
• pp.63-70
• /
• 2018

Purpose: The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose. Materials and Methods: We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed. Results: Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart $V_{30}$ (p = 0.039), $V_{40}$ (p = 0.040), and $V_{50}$ (p = 0.032). Conclusion: Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung $V_{10}$, $V_{20}$, and $V_{30}$ than in 3D-CRT, but could not be proven superior in lung $V_5$. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.

• Biomolecules & Therapeutics
• /
• v.25 no.4
• /
• pp.411-416
• /
• 2017

Paclitaxel (PTX) is a effectively chemotherapeutic agent which is extensively able to treat the non-small cell lung, pancreatic, breast and other cancers. But it is a practically insoluble drug with water solubility less than $1{\mu}g/mL$, which restricts its therapeutic application. To overcome the problem, hyaluronic acid-complexed paclitaxel nanoemulsions (HPNs) were prepared by ionic complexation of paclitaxel (PTX) nanoemulsions and hyaluronic acid (HA) to specifically target non-small cell lung cancer. HPNs were composed of ${\small{DL}}-{\alpha}$-tocopheryl acetate, soybean oil, polysorbate 80, ferric chloride, and HA and fabricated by high-pressure homogenization. The HPNs were $85.2{\pm}7.55nm$ in diameter and had a zeta potential of $-35.7{\pm}0.25mV$. The encapsulation efficiency was almost 100%, and the PTX content was 3.0 mg/mL. We assessed the in vivo antitumor efficacy of the HPNs by measuring changes in tumor volume and body weight in nude mice transplanted with CD44-overexpressing NCI-H460 xenografts and treated with a bolus dose of saline, $Taxol^{(R)}$, PTX nanoemulsions (PNs), or HPNs at a dose of 25 mg/kg. Suppression of cancer cell growth was higher in the PN- and HPN-treated groups than in the $Taxol^{(R)}$ group. In particular, HPN treatment dramatically inhibited tumor growth, likely because of the specific tumor-targeting affinity of HA for CD44-overexpressed cancer cells. The loss of body weight and organ weight did not vary significantly between the groups. It is suggest that HPNs should be used to effective nanocarrier system for targeting delivery of non-small cell lung cancer overexpressing CD44 and high solubilization of poorly soluble drug.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.4
• /
• pp.1545-1549
• /
• 2014

Background: Published studies on clinical outcome of helical tomotherapy for lung cancer are limited. The purpose of this study was to evaluate clinical outcomes and treatment-related toxicity in inoperable non-small cell lung cancer (NSCLC) patients treated with helical tomotherapy in Korea. Materials and Methods: Twenty-seven patients with NSCLC were included in this retrospective study. Radiotherapy was performed using helical tomotherapy with a daily dose of 2.1-3 Gy delivered at 5 fractions per week resulting in a total dose of 62.5-69.3 Gy. We assessed radiation-related lung and esophageal toxicity, and analyzed overall survival, locoregional recurrence-free survival, distant metastasis-free survival, and prognostic factors for overall survival. Results: The median follow-up period was 28.9 months (range, 10.1-69.4). The median overall survival time was 28.9 months, and 1-, 2-, and 3-year overall survival rates were 96.2%, 92.0%, and 60.0%. The median locoregional recurrence-free survival time was 24.3 months, and 1-, 2-, and 3-year locoregional recurrence-free survival rates were 85.2%, 64.5%, and 50.3%. The median distant metastasis-free survival time was 26.7 months, and 1-, 2-, and 3-year distant metastasis-free survival rates were 92.3%, 83.9%, and 65.3%, respectively. Gross tumor volume was the most significant prognostic factor for overall survival. No grade 4 or more toxicity was observed. Conclusions: Helical tomotherapy in patients with inoperable NSCLC resulted in high survival rates with an acceptable level of toxicity, suggesting it is an effective treatment option in patients with medically inoperable NSCLC.

• Radiation Oncology Journal
• /
• v.35 no.1
• /
• pp.55-64
• /
• 2017

Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

• Journal of Chest Surgery
• /
• v.44 no.3
• /
• pp.229-235
• /
• 2011

Background: Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer. Materials and Methods: 316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort. Results: Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome. Conclusion: Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.

• Tuberculosis and Respiratory Diseases
• /
• v.39 no.6
• /
• pp.548-553
• /
• 1992

The Unilateral absence of a pulmonary artery (UAPA) is an uncommon congenital anomaly. Approximately 160 cases have been reported in the literature since Frantzel's first report in 1968. Most of the patients with UAPA are asymptomatic but some patients may suffer from recurrent respiratory infections, hemoptysis, or pulmonary hypertension. The diagnosis could be suspected from the chest roentgenogram and lung scan, and definitely confirmed by pulmonary angiography. We experienced a case of UAPA in a 39-year-old male with the recurrent hemoptysis. Chest X-ray revealed that the left lung volume was moderately decreased and the heart and mediastinum were displaced to the left side. Lung perfusion scan showed that the left lung was not perfused. Pulmonary angiography revealed the absence of the left main pulmonary artery. Aortic arch and descending aorta on aortogram were right sided. Blood supply to the left lung was originated from numerous systemic collaterals from intercostal and brachiocephalic origin. No other intrinsic or internal abnormalities of the cardiac chambers were noted.

• Journal of KIISE:Software and Applications
• /
• v.32 no.1
• /
• pp.41-49
• /
• 2005

In this Paper, we Propose an automatic lung registration technique using local distance propagation for correcting the difference between two temporal images by a patient's movement in abdomen CT image obtained from the same patient to be taken at different time. The proposed method is composed of three steps. First, lung boundaries of two temporal volumes are extracted, and optimal bounding volumes including a lung are initially registered. Second, 3D distance map is generated from lung boundaries in the initially taken volume data by local distance propagation. Third, two images are registered where the distance between two surfaces is minimized by selective distance measure. In the experiment, we evaluate a speed and robustness using three patients' data by comparing chamfer-matching registration. Our proposed method shows that two volumes can be registered at optimal location rapidly. and robustly using selective distance measure on locally propagated 3D distance map.

• The Korean Journal of Physiology
• /
• v.1 no.2
• /
• pp.185-191
• /
• 1967

In order to evaluate the elimination of CO through the lung comparing with the decrease of CO content in the blood, authors had induced acute CO poisoning on 9 dogs. Arterial CO-Hb saturation, CO concentration, %, in expired gas and eliminated CO amount through the lung were measured at 1,5,10,30,60, and 120 minutes after acute CO poisoning in 6 dogs breathing room air and 3 dogs breathing room air and oxygen alternately. Results obtained are summarized as follows. In room air breathing group, arterial CO-Hb saturation averaged 50.8% , and 53.67 ml of CO was blew off through the lung during 120 minutes and in alternately air and oBygen breathing group, the arterial CO-Hb saturation averaged 65.6% and 95.6 ml of CO was blew off through the lung. The amount of CO eliminated in expired gas for 120 minute was much less than the amount of decreased CO in arterial blood which was calculated with the decreased CO-Hb content in the estimated circulating blood volume. Such difference between the amount of eliminated CO in expired gas and the decreased CO in blood might be attributed to the oxidation of CO to $CO_2$ in the tissues. Concentration of CO in expired gas was markedly increased and the rate of decrease in arterial CO-Hb saturation is enhanced by oxygen breathing. In early period of recovery from acute CO poisoning, neither the CO concentration in expired gas, nor, the rate of CO elimination (unlit 2 minutes after CO poisoning) showed close correlation with the blood CO-Hb saturation level. The reason seemed to be due to irregularly depressed or unevenly stimulated respiration which were induced by acute CO poisoning.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.13 no.10
• /
• pp.2163-2170
• /
• 2009

We present an automated, energy minimized-based method for Lung parenchyma segmenting Chest Computed Tomography(CT) datasets. Deformable model is used for energy minimized segmentation. Quantitative knowledge including expected volume, shape of Chest CT provides more feature constrain to diagnosis or surgery operation planning. Segmentation subdivides an lung image into its consistent regions or objects. Depends on energy-minimizing, the level detail image of subdivision is carried. Segmentation should stop when the objects or region of interest in an application have been detected. The deformable model that has attracted the most attention to date is popularly known as snakes. Snakes or deformable contour models represent a special case of the general multidimensional deformable model theory. This is used extensively in computer vision and image processing applications, particularly to locate object boundaries, in the mean time a new type of external force for deformable models, called gradient vector flow(GVF) was introduced by Xu. Our proposed algorithm of deformable model is new external energy of GVF for exact segmentation. In this paper, Clinical material for experiments shows better results of proposal algorithm in Lung parenchyma segmentation on Chest CT.