• Title/Summary/Keyword: pelvis

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Adjuvant external beam radiation and brachytherapy for vaginal resection margin positive cervical cancer

  • Kim, Donghyun;Ki, Yongkan;Kim, Wontaek;Park, Dahl;Lee, Joohye;Lee, Jayoung;Jeon, Hosang;Nam, Jiho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.147-152
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    • 2018
  • Purpose: To evaluate the treatment outcomes of adjuvant external beam radiation therapy (EBRT) and vaginal brachytherapy (VB) following radical hysterectomy in cervical cancer patients with involved vaginal resection margin (VRM). Materials and Methods: We retrospectively reviewed the medical records of 21 patients treated with postoperative EBRT and VB for positive VRM FIGO stage IB-IIA cervical cancer between 2003 and 2015. Concurrent platinum-based chemotherapy was administered to all patients. Results: The median whole pelvis EBRT dose was 50.4 Gy (range, 45 to 50.4 Gy). In the VB, the median dose per fraction, number of fractions, and total dose delivered were: 4 Gy (range, 3.0 to 4.0 Gy), 4 fractions (range, 3 to 5 fractions), and 16 Gy (range, 12 to 20 Gy), respectively. At a median follow-up of 46 months (range, 9 to 122 months), local recurrence was observed in 2 patients, and distant metastasis was present in 7 patients. All patients with local recurrence subsequently developed distant metastases. The 5-year local control, disease-free survival, and overall survival rates were 89.1%, 65.9%, and 62.9%, respectively. Of the 21 patients, 7 patients (33.3%) reported grade 2 acute toxicity; however, there were no grade 3 or higher acute adverse events. Grade 1-2 late toxicities were observed in 8 patients. Late grade 3 urinary toxicity was reported in 1 patient. Conclusions: Adjuvant EBRT and VB showed excellent local control and low toxicity in cervical cancer patients with positive VRM. Although limited by its retrospective nature, the findings from our study provide evidence supporting the use of additional VB in pathologically involved VRM.

The Differences of the Normalized Jerk According to Shoes, Velocity and Slope During Walking (보행시 신발, 속도, 그리고 경사도에 따른 정규 저크의 차이)

  • Han, Young-Min;Choi, Jin-Seung;Kim, Hyung-Sik;Lim, Young-Tae;Yi, Jeong-Han;Tack, Gye-Rae;Yi, Kyung-Ok;Park, Seung-Bum
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.1-8
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    • 2006
  • The purpose of this study was to evaluate normalized jerk according to shoes, slope, and velocity during walking. Eleven different test subjects used three different types of shoes (running shoes, mountain climbing boots, and elevated forefoot walking shoes) at various walking speeds(1.19, 1.25, 1.33, 1.56, 1.78, 1.9, 2, 2.11, 2.33m/sec) and gradients(0, 3, 6, 10 degrees) on a treadmill. Since there were concerns about using the elevated forefoot shoes on an incline, these shoes were not used on a gradient. Motion Analysis (Motion Analysis Corp. Santa Rosa, CA USA) was conducted with four Falcon high speed digital motion capture cameras. Utilizing the maximum smoothness theory, it was hypothesized that there would be differences in jerk according to shoe type, velocity, and slope. Furthermore, it was assumed that running shoes would have the lowest values for normalized jerk because subjects were most accustomed to wearing these shoes. The results demonstrated that elevated forefoot walking shoes had lowest value for normalized jerk at heel. In contrast, elevated forefoot walking shoes had greater normalized jerk at the center of mass at most walking speeds. For most gradients and walking speeds, hiking boots had smaller medio-lateral directional normalized jerk at ankle than running shoes. These results alluded to an inverse ratio for jerk at the heel and at the COM for all types of shoes. Furthermore, as velocity increased, medio-lateral jerk was reduced for all gradients in both hiking boots and running shoes. Due to the fragility of the ankle joint, elevated forefoot walking shoes could be recommended for walking on flat surfaces because they minimize instability at the heel. Although the elevated forefoot walking shoes have the highest levels of jerk at the COM, the structure of the pelvis and spine allows for greater compensatory movement than the ankle. This movement at the COM might even have a beneficial effect of activating the muscles in the back and abdomen more than other shoes. On inclines hiking boots would be recommended over running shoes because hiking boots demonstrated more medio-lateral stability on a gradient than running shoes. These results also demonstrate the usefulness of normalized jerk theory in analyzing the relationship between the body and shoes, walking velocity, and movement up a slope.

Analysis of change of internal organ in the Inter-and Intrafraction using MVCT (MVCT를 이용한 치료 간(Interfraction) 그리고 치료 중(Intrafraction) 내부 장기 변화 분석)

  • Jung, Won Seok;Kim, Ju Ho;Kim, Young Jae;Shin, Ryung Mi;Oh, Jeong Hun;Jeong, Geon A;Jo, Jun Young;Kim, Gi Chul;Choi, Tae Kyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.115-126
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    • 2014
  • Purpose : Depending on a variety of therapeutic areas using MVCT(Megavoltage computed tomography) intra-and interfraction is to evaluate changes in patient position. Materials and Methods : In this study, head and neck, thorax, liver, and prostate tumor patients, 48 people with a full course of treatment for patients with various MVCT scan was performed. Average 60 per patient MVCT images were acquired and analyzed. Results : Interfraction error thorax and abdomen, and pelvis in the longitudinal difference was more than 3 mm. Intrafraction to see a change after the end of treatment MVCT taken, and the results confirmed Intrafraction 2 mm in motion around the longitudinal difference. In addition, due to changes in the movement before and after treatment, Inter-and Intrafraction difference was found. Conclusion : In the present study, the Head and Neck, Thorax, liver, prostate cancer in patients with inter-and intrafraction changes and target the appropriate fixtures to complete the outline of the margin would be helpful is considered.

Evaluation of the efficiency of the Vac-lock type belly board in Pelvic cancer Radiation Treatment (골반부 방사선치료 시 자체 제작한 Vac-lock type belly board에 대한 유용성 평가)

  • Kim, YoungYeun;Bang, Seungjae;Jung, Ilsun;Kim, Jungsu;Kim, YoungKon
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.37-42
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    • 2014
  • Purpose : At the time of the pelvis cancer radiation treatment using the belly board, set-up error is large because of a prone position. In order to improve the reproducibility, we made Vac-lock type belly board. In this study, we attempt to validate its utility. Materials and Methods : We compared belly board and Vac-lock type belly board through the OBI. OBI was performed three times with entire course of treatment and the setup errors in the direction of X axis, Y axis, Z axis were recorded and calculated the distance from the isocenter. Results : X axis, Y axis, Z axis setup errors with existing belly board were 0.32 cm, 0.41 cm, 0.29 cm. The setup errors with the vac-lock type belly board were 0.12 cm, 0.19 cm, 0.17 cm. Further, errors of 0~0.29 cm were increased from 48% to 83% when using VLT belly board. Error of 0.5 cm or more was reduced from 21% to 2%. Conclusion : Vac-lock type belly board is able to maintain the efficacy of existing and create to match the characteristics of the patient. Therefore We think that vac-lock type belly board is very useful in pelvic cancer patients.

Efficacy of Ilizarov External Fixation and Autologous Bone Grafting for Performing Arthrodesis on the Ankle Arthropathy with Risk Factors (불유합의 위험 인자를 가진 족관절 병변에 시행한 족관절 유합술로서 Ilizarov 외고정 기구 장착술 및 자가골 이식술의 유용성)

  • Lee, Yong-Sik;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yeong-Hyeon;Lee, Hee-Hyung;Hwang, Sung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.189-195
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    • 2019
  • Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

Pulmonary Endometriosis (폐 자궁내막 증식증 1예)

  • Kim, Ki-Joong;Cho, Yoon-Hyung;Choi, Byeong-Kee;Choi, Eui-Young;Chang, Yoon-Su;Kim, Hyung-Jung;Ahn, Chul-Min;Cho, Sang-Ho;Rhu, Jin-A.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.389-393
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    • 1999
  • Endometriosis is defined as an extrauterine growth of endometrial tissue and it is primarily limited in the pelvis but it can also occur in the pleural cavity as well as pulmonary parenchyme. The diagnosis of pulmonary endometriosis is usually based on the clinical history of recurrent hemoptysis in association with menstrual cycle and by histopathologic confirmation of endometrial tissue in the lung parenchyme. Pulmonary endometriosis was first reported by Lattes in 1956. and dozens of cases have been reported so far. We experienced a case of 25 year old single woman with a history of hemoptysis in association with her menstruation. The bleeding focus was localized with chest CT scan and repeated fibrooptic bronchoscopy and basal segmentectomy of the right lower lobe was performed. The resected specimen shows endometrial stroma and glands of early proliferative phase with respiratory epithelium on the laterobasal bronchus. Her postoperative course was uneventful with no recurrence of hemoptysis during 6 months of follow-up in the outpatient clinic.

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Survey of CT Practice and Collective Effective Dose Estimation (CT검사건수 및 CT검사에 의한 집단 실효선량의 추정)

  • Lee, Man-Koo;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.231-237
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    • 2010
  • Computed tomography (CT) has been established as an important diagnostic tool in clinical medicine and has become a major source of medical exposure. A nationwide survey regarding CT examinations was carried out in 2007. Thanks to the appeasement policy regulating the import of CT scanners, there are 1,825 CT scanners across the country as of the end of March 2010, which means that we have 36.8 CT scanners per one million people. The annual number of examinations was 3.29 million, the number of examinations per 1000 population was 68. The most part of examinations was abdomen and pelvis. and the collective effective dose was in these parts. The effective dose per one population was evaluated as 0.952 mSv.

A study of quantitative correlation between step animation and emotional expressions (스텝 애니메이션과 감성 표현 사이의 정량적 상호관계에 관한 연구)

  • Lee, Ji-Sung;Jeong, Jae-Wook
    • Archives of design research
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    • v.17 no.4
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    • pp.141-148
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    • 2004
  • The purpose of this study is to define the emotion that expressed in step animation and to quantify the intuitional expression of emotion that related step for using extract, measure, analysis the stimulate element about step. The survey of relation with 27 word of emotional expressions and 36 moving pictures of step sample is used for method of this test. The emotional mental structure is transferred to 2 dimensional planes as applying the results of analysis of integrated data using Quantification Method 3, which the integrated data is composed two axial - confidential axial and stabling axial. Analysis of distribution of 2 dimensional diagram shows that the second of the plane and the third of the plane have much data. However, the first of the plane and the forth of the plane have a little data. Through this kind of analysis of graph, it is difficult to express a different emotion between unstable the timidity mind and stable feel the timidity mind using only step analysis. Six difference types about physical elements affecting to emotion are selected and analyzed such as the paces of step, the rate of step, the movement angle of pelvis, the swing range of arm, angle of backbone and the lean angle of body. The result is that the rate of stop and the lean angle of body are the major element that effects to emotional stimulate of stop. This thesis argues about methods transforming subjective expression to objective and quantitative expression with the state of delicate emotion of character apply to step animation naturally. Those data to apply to multi-contents in future are the main target in this study.

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Application of Modified Mupit for the Recurrent Vulva Cancer in Brachytherapy

  • Kim, Jong-Sik;Jung, Chun-Young;Oh, Dong-Gyoon;Song, Ki-Won;Park, Young-Hwan
    • 대한방사선치료학회:학술대회논문집
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    • 2005.06a
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    • pp.23-26
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    • 2005
  • Introduction: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Methods and Materials: Modified MUPIT applicator basically consists of an acrylic cylinder with flexible brain applicator , an acrylic template with a predrilled array of holes that serve as guides for interstitial needles and interstitial needles. CT scan was performed to determine tumor volume and the position of interstitial needles. Modified MUPIT applicator was applied to patient in operation room and the accuracy for position of interstitial needles in tumor volume was confirmed by CTscan. Brachytherapy was delivered using modified MUPIT applicator and RALS (192-Ir HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3000cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Result: The application of modified MUPIT applicator improved dramatically dose distributions in tumor volume and follow-up of 3 month for this patient was clinically partial response without normal tissue complication, Rectal dose was measured 34.1cGy, 57.1cGy, 103.8cGy, 162.7cGy, 165.7cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1cGy, 57.1cGy Conclusion: Patients with locally recurrent tumor in uterine cervix cancer treated with modified MIUPIT applicator can expect reasonable rates of local control. The advantages of the system are the fixed geometry Provided by the template and cylinders, and improved dose distributions in irregular tumor volume without rectal complication

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Differences in Male and Female Spinopelvic Alignments in Middle School and High Schools Students of Gyeongnam Areas in Korea : a Three Dimensional Analysis Using Rasterstereography (경남 일부지역 중-고교생의 성별에 따른 시상면상 척추-골반 정렬의 특성 비교 연구 : Rasterstereography를 이용한 3차원 영상 분석)

  • Kim, Seong-Yeol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.2
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    • pp.962-969
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    • 2014
  • This study investigated the patterns and correlations of spinopelvic alignments in in middle school and high schools students of Gyeongnam areas in Korea using rasterstereography. Sixty-one subjects were recruited from May to October 2013, the average age of subjects was $16.40{\pm}2.20$ years. In the present results, PSIS ratio was statistically different between the sexes(male $21.15{\pm}2.40$%, female $23.41{\pm}3.28$%)(p<.01) and lordotic angle was statistically different between the sexes(male $33.44{\pm}8.46^{\circ}$, female $38.96{\pm}8.11^{\circ}$)(p<.001), but other parameters were not statistically different between the sexes. However, we verified that lordotic angle was significant correlation separately with pelvic tilt(r=.348), kyphotic angle(r=.609). Surface rotation was significant correlation separately with kyphotic angle(r=-.278), lordotic angle(r=-.256), trunk inclination(r=.493). These finding could be used as basic data research to confirm normal pattern of spinopelvic alignment and balance in health adolescents, and might help understand adolescents with structure problem in spine and pelvis.