• 제목/요약/키워드: thyroid cancer

검색결과 699건 처리시간 0.028초

Robot-Assisted Free Flap in Head and Neck Reconstruction

  • Song, Han Gyeol;Yun, In Sik;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • 제40권4호
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    • pp.353-358
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    • 2013
  • Background Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction. Methods We investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated. Results Among five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes), and complications including flap necrosis, hematoma, and wound dehiscence did not occur. Conclusions This study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.

우리나라에서 방사성옥소입원치료 관리 최적화 (Optimization of Inpatient Management of Radioiodine Treatment in Korea)

  • 박민재;김중현;장정찬;김창호;정재민;이동수
    • Nuclear Medicine and Molecular Imaging
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    • 제42권4호
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    • pp.261-266
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    • 2008
  • We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after longterm retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer.

후두 스트로보스코프 검사의 신호 동기화를 위한 진동 검출기의 유용성 (Usefullness of the Vibration Pick-Up in Detection of Pitch for Synchronization of Laryngeal Stroboscopy)

  • 이진춘;이병주;왕수건;노정훈;권순복;조철우
    • 대한후두음성언어의학회지
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    • 제18권1호
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    • pp.26-32
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    • 2007
  • Objective and Background: Laryngeal stroboscope is an useful equipment in evaluation of vocal cord vibration and in early detection of mucosal lesion including invasive cancer of the vocal cord. Recently Lee et al. (2006) developed portable stroboscope using voice as synchronization signal. It has been frequently impaired ability to synchronize the flashes even in normal female. Authors tried to investigate various methods including vibration pick-up, microphone, laryngeal microphone, and contact microphone for development of simple and accurate method like electroglottograph signal. The purpose of this study was to estimate wheher the vibration pick-up is available and is consistent with the signal of EGG. Subjects and Methods: Authors compared the signals between EGG and noncontact method such as voice, contact methods including vibration pick-up, laryngeal microphone, and contact microphone in normal twenty adults (male 10 and female 10). The number of peak in one cycle was compared with the number of the peak in EGG, and the percent of phase difference in the peak was compared with EGG Also, authors tried to investigate which site of vibration pick-up was most effective for synchronization of stobo flashes. Three site including anterior neck below the cricoid cartilage, thyroid ala, and suprahyoid region were analysed. Results: Among various methods for synchronization of strobo flashes, vibration pick-up was most effective method in peak detection. And anterior neck below cricoid cartilage was the most available site of the vibration pick-up. Conclusion: Authors suggest that vibration pick-up is most available and effective method for synchronization of strobo flashes.

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몬테 칼로 전산코드 MCNPX를 이용한 I-123 생산량 예측 (Prediction of 123I production using the monte Carlo code MCNPX)

  • 유재준;김계홍;김병일;이동훈
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2014년도 춘계학술대회
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    • pp.816-818
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    • 2014
  • 갑상선암 진단 방사성의약품인 $^{123}I$ 생산을 목적으로 한 가스타겟챔버를 개발하고 MCNPX를 이용해 30MeV 빔에너지 가 가스타겟챔버에 어떻게 들어가는지와 들어갔을 경우의 $^{124}Xe$와 핵반응은 어떻게 발생하는지를 모델링하였다. 빔에너지 가 확산되어 가스타겟챔버 내경에 맞아 에너지 손실이 생긴다. 그것은 즉 손실된 에너지가 열로 바뀜으로 타겟챔버가 변형이 일어나기 않게 냉각수를 이용한다. 쿨링시스템도 타겟챔버를 효율적으로 냉각하기위해 냉각수라인을 나선형으로 설계하였다. KIRAMS에서 보유하고 있는 사이크로트론 C30을 이용하여 30MeV 에너지에 100A 빔을 조사해 $^{124}Xe(p,2n)$, $^{124}Xe(p,n)$, $^{124}Xe(p,pn)$ 각각의 핵반응이 일어나는걸 알 수 있었고 생산량을 예측 할 수 있었다.

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Comparative Study of the Effective Dose from Panoramic Radiography in Dentistry Measured Using a Radiophotoluminescent Glass Dosimeter and an Optically Stimulated Luminescence Detector

  • Lee, Kyeong Hee;Kim, Myeong Seong;Kweon, Dae Cheol;Choi, Jiwon
    • Journal of the Korean Physical Society
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    • 제73권9호
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    • pp.1377-1384
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    • 2018
  • Accurate measurement of the absorbed dose and the effective dose is required in dental panoramic radiography involving relatively low energy with a rotational X-ray tube system using long exposures. To determine the effectiveness of measuring the irradiation by using passive dosimetry, we compared the entrance skin doses by using a radiophotoluminescent glass dosimeter (RPL) and an optically stimulated luminescence detector (OSL) in a phantom model consisting of nine and 31 transverse sections. The parameters of the panoramic device were set to 80 kV, 4 mA, and 12 s in the standard program mode. The X-ray spectrum was applied in the same manner as the panoramic dose by using the SpekCalc Software. The results indicated a mass attenuation coefficient of $0.008226cm^2/g$, and an effective energy of 34 keV. The equivalent dose between the RPL and the OSL was calculated based on a product of the absorbed doses. The density of the aluminum attenuators was $2.699g/cm^3$. During the panoramic examination, tissue absorption doses with regard to the RPL were a surface dose of $75.33{\mu}Gy$ and a depth dose of $71.77{\mu}Gy$, those with regard to the OSL were surface dose of $9.2{\mu}Gy$ a depth dose of $70.39{\mu}Gy$ and a mean dose of $74.79{\mu}Gy$. The effective dose based on the International Commission on Radiological Protection Publication 103 tissue weighting factor for the RPL were $0.742{\mu}Sv$, $8.9{\mu}Sv$, $2.96{\mu}Sv$ and those for the OSL were $0.754{\mu}Sv$, $9.05{\mu}Sv$, and $3.018{\mu}Sv$ in the parotid and sublingual glands, orbit, and thyroid gland, respectively. The RPL was more effective than the OSL for measuring the absorbed radiation dose in low-energy systems with a rotational X-ray tube.

소아 구내촬영 시 방사선량 평가 및 최적화 방안에 대한 연구 (A Study of Radiation Dose Evaluation and Optimization Methods for Intra Oral Dental X-ray in Pediatric Patient)

  • 이현용;조용인
    • 대한방사선기술학회지:방사선기술과학
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    • 제44권3호
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    • pp.195-203
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    • 2021
  • Although intra oral dental x-ray is a lower dose than other radiological examinations, pediatric patients are known to have a higher risk of radiation damage than adults. For this reason, pediatric dental x-ray requires management of dose evaluation and imaging conditions during the examination. In this study, the dose calculation program ALARA-Dental(child/adult) was used to evaluate the organ dose and effective dose exposed to each examination site during intra oral imaging of children during dental radiographic examination, and dose analysis according to the imaging conditions was performed. As a result, the highest organ dose distribution was shown at 0.044 ~ 0.097 mGy in all are as of the mucous membrane of oral cavity except for the maxillary incisors and canines. Also, in the case of the thyroid gland, the maxillary canine and maxillary premolar examination showed 0.027 and 0.020 mGy, respectively, and the dose distribution was 15.4% to 70.0% higher than that of the mandibular examination. As for the effective dose calculated during intra oral imaging, the maxillary anterior and canine examinations showed the highest effective doses of 0.005 and 0.004 mSv, respectively, and the maxillary area examination showed a higher dose distribution on average than the mandible.

Involvement of adaptor protein, phosphotyrosine interacting with PH domain and leucine zipper 1 in diallyl trisulfide-induced cytotoxicity in hepatocellular carcinoma cells

  • Guan, Feng;Ding, Youming;He, Yikang;Li, Lu;Yang, Xinyu;Wang, Changhua;Hu, Mingbai
    • The Korean Journal of Physiology and Pharmacology
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    • 제26권6호
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    • pp.457-468
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    • 2022
  • It has been demonstrated that APPL1 (adaptor protein, phosphotyrosine interacting with PH domain and leucine zipper 1) is involved in the regulation of several growth-related signaling pathways and thus closely associated with the development and progression of some cancers. Diallyl trisulfide (DAT), a garlic-derived bioactive compound, exerts selective cytotoxicity to various human cancer cells through interfering with pro-survival signaling pathways. However, whether and how DAT affects survival of human hepatocellular carcinoma (HCC) cells remain unclear. Herein, we tested the hypothesis of the involvement of APPL1 in DAT-induced cytotoxicity in HCC HepG2 cells. We found that Lys 63 (K63)-linked polyubiquitination of APPL1 was significantly decreased whereas phosphorylation of APPL1 at serine residues remained unchanged in DAT-treated HepG2 cells. Compared with wild-type APPL1, overexpression of APPL1 K63R mutant dramatically increased cell apoptosis and mitigated cell survival, along with a reduction of phosphorylation of STAT3, Akt, and Erk1/2. In addition, DAT administration markedly reduced protein levels of intracellular TNF receptor-associated factor 6 (TRAF6). Genetic inhibition of TRAF6 decreased K63-linked polyubiquitination of APPL1. Moreover, the cytotoxicity impacts of DAT on HepG2 cells were greatly attenuated by overexpression of wild-type APPL1. Taken together, these results suggest that APPL1 polyubiquitination probably mediates the inhibitory effects of DAT on survival of HepG2 cells by modulating STAT3, Akt, and Erk1/2 pathways.

두부 CT 검사 시 테이블 높이에 따른 선량과 화질에 관한 연구 (A Study on Radiation Dose and Image Quality according to CT Table Height in Brain CT)

  • 김기원;오주영;민정환;이상선;이영봉;임경환;이윤
    • 대한방사선기술학회지:방사선기술과학
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    • 제46권2호
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    • pp.99-106
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    • 2023
  • The height of the table should be considered important during computed tomography (CT) examination, but according to previous studies, not all radiology technologists set the table at the patient's center at the examination, which affects the exposure dose and image quality received by the patient. Therefore, this study intends to study the image quality exposure dose according to the height of the table to realize the optimal image quality and dose during the brain CT scan. The head phantom images were acquired using Philips Brilliance iCT 256. When the image was acquired, the table height was adjusted to 815, 865, 915, 965, 1015, and 1030 mm, respectively, and each scan was performed 3 times for each height. For the exposure dose measurement, optically stimulated luminescence dosimeter (OSLD) was attached to the front, side, eye, and thyroid gland of the head phantom. In the signal to noise ratio (SNR) measurement result, The SNR values for each table height were all lower than 915 mm. As a result of exposure dose, the exposure dose on each area increased as the table height decreased. The height of the table has a close relationship with the patient's radiation exposure dose in the CT scan.

생쥐골수세포 미소핵검사에 의한 치료용량 방사성옥소($^{131}I$)의 유전독성 평가 (Genotoxicity of Therapeutic Dose of $^{131}I$ Analyzed by Micronuclei Test in the Mouse Bone Marrow)

  • 범희승;김지열
    • 대한핵의학회지
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    • 제27권1호
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    • pp.112-117
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    • 1993
  • 연구배경 :핵사고시 가장 중요한 유출방사성핵종의 하나이며, 갑상선암 및 갑상선 기능항진증 치료에 없어서는 안되는 치료제인 방사성옥소($^{131}I$)는 과량 투여시 백혈병 또는 유전이상을 나타낼 것으로 추측되고 있으나, 이에 대해서는 아직 논란의 여지가 있다. 방법 : 실험군은 방사성옥소를 투여하지 않고 위장수술만을 시행한 대조군과, 갑상선 기능항진증의 치료용량인 10mCi/60Kg(0.17mCi/Kg)을 투여하는 군, 갑상선암의 치료용량인 100 mCi/60 Kg (1.67 mCi/Kg)을 투여하는군, 그리고 골수억제 등의 부작용 때문에 치료를 중단하게 되는 1000 mCi/60 Kg(16.67 mCi/Kg)를 투여하는 군으로 나누어 실험을 시행하였다. 각 군은 생후 6주(30g)전후의 생쥐 10마리로 구성되었으며, 방사성옥소는 복강에 투여하였다. 투여 1일 및 3일 후 생쥐를 희생시켜 골수를 채취하고, 이를 대상으로 미소핵검사를 시행하였다. 미소핵은 골수세포 중핵이 없는 정염성 및 다염성적헐구에서 관찰하며, 1000개의 세포 중 미소핵이 나타난 세포수를 %로 표시하였다. 결과 : 다염성 적혈구 (괄호안은 정염성 적혈구)에서의 미소핵 발현은 대조군의 경우 1일째 $0.25{\pm}0.07$ ($0.23{\pm}0.07$)%, 3일째 $0.24{\pm}0.07$ ($0.21{\pm}0.07$)%, 치료용량의 방사성옥소를 투여한 군 중 0.17 mCi/Kg을 투여한 군에서는 1일째 $0.27{\pm}0.1$ ($0.23{\pm}0.09$)%, 3일째 $0.28{\pm}0.07$ ($0.25{\pm}0.06$)%, 1.67 mCi/Kg을 투여한 군에서는 1일째 $0.29{\pm}0.08$ ($0.26{\pm}0.09$)%, 3일째 $0.31{\pm}0.05$ ($0.29{\pm}0.06$)%, 16.67mCi/Kg를 투여하는 군에서는 1일째 $0.32{\pm}0.06$ ($0.25{\pm}0.09$)%, 3일째 $0.33{\pm}0.08$ ($0.3{\pm}0.06$)%를 보였다. 투여한 방사성옥소의 양이 많을수록 미소핵 빈도수가 증가하는 경향을 보였으나, 각 군간에 통계학적으로 유의한 차이는 없었다(p>0.05). 결론 : 임상적으로 치료를 중단하게 되는 1000mCi/60 Kg(16.67 mCi/Kg)를 투여한 군에서도 생쥐 골수내 미소핵이 발현되지 않는 것으로 보아, 방사성옥소는 비교적 안심하고 치료에 사용할 수 있는 제제로 사료되었다.

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간호사고와 관련판례에 대한 임상간호사의 지각 (Perception of the Nurse on the Nursing Malpractice and Its Case)

  • 정지연;이명하
    • 간호행정학회지
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    • 제5권3호
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    • pp.445-462
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    • 1999
  • The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

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