• Title/Summary/Keyword: 전뇌 조사

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Evaluation of the reduced scalp dose at Volumetric Modulated Arc Therapy(VMAT) (전뇌조사의 체적변조회전치료 시 두피선량 감소에 관한 평가)

  • Kim, Jeong-Ho;Bae, Seok-Hwan;Kim, Ki-Jin;Yoo, Se-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.10
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    • pp.6187-6192
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    • 2014
  • The use of WBRT(whole brain radiation therapy) has increased due to the increase in the incidence of metastatic brain tumors. The development of radiation therapy techniques is expected to improve the quality of life. The VMAT (Volumetric Modulated Arc Therapy) is an excellent treatment technique that can distinguish the dose in each volume. Therefore, this study compared conventional WBRT and VMAT for hair loss according to the scalp dose using a head phantom. The CI (Conformity Index), HI (Homogeneity Index) and QOC (Quality of Coverage) were measured brain tissue. A 20 percent and 50 percent dose was measured at the scalp, eyeball, lens, and c-spine. Conventional WBRT is excellent at 10 percent of brain tissue. VMAT is far superior at 1000 percent at the other organs. VMAT at the prescribed dose can be used as radiation therapy of metastatic brain tumors with less hair loss.

Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases (4개 이상의 다발성 전이성 뇌종양의 정위적 방사선수술과 전뇌 방사선조사의 비교)

  • Kim, Cheol-Jin;Baek, Mi-Young;Park, Sung-Kwang;Ahn, Ki-Jung;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.163-168
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    • 2009
  • Purpose: This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with $\geq$4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10~20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival and intracranial progression-free survival were compared in each group. Results: The median follow-up period was 5 months (range, 2~19 months) in the SRS group and 6 months (range, 4~23 months) in the WBRT group. The mean number of metastatic lesions in the SRS and WBRT groups was 6 and 5, respectively. The intracranial progression-free survival and overall survival in the SRS group was 5.1 and 5.6 months, respectively, in comparison to 6.1 and 7.2 months, respectively, in the WBRT group. Conclusion: SRS was less effective than WBRT in the treatment of patients with >4 metastases to the brain.

The CNS Relapse of the Acute Lymphoblastic Leukemia: Radiotherapy Results (급성 림프모구성 백혈병의 중추신경계 재발의 방사선치료)

  • Kim Yong-Ho;Kim Il-Han
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.385-390
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    • 1995
  • Purpose : To assess the efficacy of craniospinal radiotherapy in patients with acute lymphoblastic leukemia (ALL) experiencing the CNS relapse. Materials and Methods: Thirty ALL patients with relapse in the central nervous system (CNS) were treated with radiotherapy and intrathecal chemotherapy. Age ranged 2 to 46. The number of males and females were all 15. Twenty-two cases were previously treated with presymptomatic radiotherapy to the whole brain. The extent of radiotherapy was the whole brain (18-24 Gy) and the whole spine (12 Gy) in 21 cases but the whole brain only in the 9 cases with poor performance. Results : The complete remission rate in the CNS was $100{\%}$. Among the 12 cases ($40{\%}$) who had secondary relapse, 9 cases had the bone marrow relapse alone, 2 cases had the CNS and bone marrow relapse, 1 cases had the CNS relapse alone. Higher CNS remission rate was observed when the initial remission duration was longer than 24 months or radiation was delivered to the whole brain and the whole spine. Survival rate at 2 year was $31.6{\%}$. Remission duration in the 10 living patients ragned from 9 to 87 months (median; 58 months).

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Radiotherapy of Supratentorial Primitive Neuroectodermal Tumor (천막상부 원시신경외배엽 종양의 방사선요법)

  • Kim Il Han;Yoo Hyung Jun;Cho Young Kan;Kim Dae Yong
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.11-18
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    • 1997
  • Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

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Comparison of the Dose of the Normal Tissues among Various Conventional Techniques for Whole Brain Radiotherapy (여러 통상적인 전뇌방사선치료 기법에서의 정상조직의 조사선량 비교)

  • Kang, Min-Kyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.99-105
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    • 2010
  • Purpose: To compare radiation dose of the brain and lens among various conventional whole brain radiotherapy (WBRT) techniques. Materials and Methods: Treatment plans for WBRT were generated with planning computed tomography scans of 11 patients. A traditional plan with an isocenter located at the field center and a parallel anterior margin at the lateral bony canthus was generated (P1). Blocks were automatically generated with a 1 cm margin on the brain (5 mm for the lens). Subsequently, the isocenter was moved to the lateral bony canthus (P2), and the blocks were replaced into the multileaf collimator (MLC) with a 5 mm leaf width in the craniocaudal direction (P3). For each patient plan, 30 Gy was prescribed at the isocenter of P1. Dose volume histogram (DVH) parameters of the brain and lens were compared by way of a paired t-test. Results: Mean values of $D_{max}$ and $V_{105}$ of the brain in P1 were 111.9% and 23.6%, respectively. In P2 and P3, $D_{max}$ and $V_{105}$ of the brain were significantly reduced to 107.2% and 4.5~4.6%, respectively (p<0.001). The mean value of $D_{mean}$ of the lens was 3.1 Gy in P1 and 2.4~2.9 Gy in P2 and P3 (p<0.001). Conclusion: WBRT treatment plans with an isocenter located at the lateral bony canthus have dosimetric advantages for both the brain and lens without any complex method changes.

Radiation Therapy of Suprasellar Germ Cell Tumors (뇌하수체상부 배아세포종의 방사선치료 성적)

  • Park Woo Yoon;Choi Doo Ho;Choi Eun Kyung;Kim Il Han;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.169-176
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    • 1988
  • A retrospective study was performed on 15 patients with suprasellar germ cell tumors treated by megavoltage external beam irradiation between Feb. 1979 and Dec. 1985. Follow-up period of survivors was 30 to 91 months. Histologic diagnosis was obtained before radiation therapy in 10patients (9 germinomas and 1 mixed). Five patients were treated without histologic verification. In 9 patients with biopsy-proven germinomas radiation therapy was delivered to the craniospinal axis in 6, to the whole brain in 3. In 5 patients with mixed germ cell tumor or elevated tumor marker, irradiation was delievered to the craniospinal axis in 2, to the whole brain in 2, and to the primary site only in 1. Total doses ranged from 5,000 to 5,500 cGy to the primary site, 3,000 to 4,400 cGy to the whole brain, and 1,300 to 3,000 cGy to the spine. In these 14, local tumor was controlled and primary or spinal failure was not observed. One patient without elevated tumor marker was treated to the whole brain. The tumor was not controlled and he had spinal recurrence. Overall survival and disease-free survival rates were $86\%$ at 5 year. It is proven that radiation therapy is an effective treatment for suprasellar germ cell tumors. The neuroendocrinologic presentation, tumor marker status, early response to radiation measured on CT seem to be useful means for selecting patients for radiation therapy when tissue diagnosis is not available.

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Immunohistochemical Study on the Nerve Growth Factor receptors in the Basal forebrain Nuclei of the Postnatal and the adult Rats (출생후 발생단계와 성체의 흰쥐 전뇌 기저부 여러 핵들에서 신경성장인자수용체에 대한 면엮조직화학적 연구)

  • 정영화;홍영고고연영
    • The Korean Journal of Zoology
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    • v.37 no.3
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    • pp.385-408
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    • 1994
  • 출생후 0일. 7일. 14일 및 21일 그리고 성체의 흰쥐 전뇌 기저부의 내측중격핵, 수직 및 수평 대각 Broca대 거대세포 시삭전핵 그리고 복부담창구에서 신경성장인자수용체 (nerv-growth 배ctor receptor, NGFr)에 면역반응을 보이는 신경조직과 세포의 분화를 면역조직화학적 및 전자현미경적 방법을 이용하여 조사하였다. 출생후 초기와 성체에서 신경세포 원형질막 뿐만 아니라 세포질에서 NGFr 면역반응이 확인되었다. 그러나 성체에서 신경세포 원형질 막에서의 면역반응은 관찰되지 않았다. 특히 NGFr 면역반응은 골지 부위에서 보였고, 점상의 면역반응물들이 세포체의 세포질과 수상돌기에 소수 분산 분포하였다. 뇌 기저부의 NGFr 면역반응 신경세포들은 뇌 크기의 증대와 뇌 조직의 분화에 따라 점차 수적 증가를 보였다. 이 NGFr 면역반응 신경세포들은 세포의 모양과 세포체의 장 .단축의 비에 따라 6가지 형. 즉 1) 원형. 2) 타원형. 3) 세장형, 4) 방추형, 5) 삼각형, 6) 다각형으로 분류되었다. 전뇌 기저 핵에서 원형과 난형신경세포들의 출현율은 출생후 0일에서 높았으나 성체로 되면서 감소된 반면, 세장형. 방추형, 삼각형 그리고 다각형신경세포들의 출현율은 출생후 0일에서는 낮았으나 성체로 되면서 증가하였다. 모든 핵들에서 NGFr 면역반응 신경세포체의 부피는 출생후 0일에 759-1,640 Um3로 제일 작았으며, 수직 대각 Broca대와 복부담창구에서는 출생후 14일에 각각 5 107 7.385 Um3 그리고 내측중격핵, 수평 대각 Broca대, 거대세포 시삭전핵에서는 출생후 21일에 각각 4,705, 6,061, 6,412 Um3로 최대치를 보였다. 그후 성체로 되면서 모든 핵에서 1,893-3,464 $\mu$m3로 다시 감소하였다. 전자현미경적 관찰에서 출생후 21일된 흰쥐 수평 대각 Broca대에서 NGFr 면역반응은 세포체와 수상돌기의 원형질막 그리고 세포체내에서는 골지체, 다소포성소체 및 조면소포체에서 관찰되었다. 이 결과들로 미루어 NGFr은 출생후 발생단계와 성체의 횐쥐 전뇌 기저부에서 신경세포의 분화와 분포에 관계되는 것으로 생각된다.

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Immunohistochemical study of the Cholinergic Nerve Cells in the Medial Septal Nucelus and Diagonal Band of Broca of the Postnatal and Adult Rats (흰쥐 출생후 발생단계에 따른 전뇌 기저부의 내측중격핵과 대각 Broca대에서 콜린성 신경세포에 대한 면역조직화학적 연구)

  • 고찬영;정영화홍영호
    • The Korean Journal of Zoology
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    • v.38 no.2
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    • pp.248-268
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    • 1995
  • 출생 후 0일, 7일, 14일, 21일 그리고 성체의 흰쥐 전뇌 기저부의 내측중격핵과 수직 및 수평대각 Broca대에서 choline acetyltransferase(ChAT)에 면역반응을 보이는 신경조직과 세포의 분화를 면역조직화학적 및 전자현미경적 방법을 이용하여 조사하였다. 출생 후 초기와 성체에서 신경세포의 세포질과 수상돌기에서 고루 ChAT 면역반응이 확인되었다. 뇌 기저부의 ChAT 면역반응 신경세포들은 발생에 따른 뇌 크기의 증대와 뇌 조직의 분화에 따라 점차 수적 증가를 보였다. 이 ChAT 면역반응 신경세포들은 세포의 모양과 세포제의 장 · 단축의 비에 따라 6가지 형 즉 1) 월형 2) 난형, 3) 세장형, 4) 방추형. 5) 삼각형, 6) 다각형으로 분류되었다 전뇌 기저 핵에서 원형과 난형 신경세포들의 출현율은 출생 후 0일에서 높았으나 성체로 되면서 감소된 반면, 세장형. 방추형. 삼각형 그리고 다각형 신경세포들의 출현율은 출생 후 0일에서는 낮았으나 성체로 되면서 증가하였다. 모든 핵들에서 ChAT 면역반응 신경세포체의 부피는 출생 후 0일에 996-1,252 Um3로 제일 작았으며, 내측중격핵과 수직대각 Broca대 그리고 수평대각 Broca대에서는 출생 후 21일에 각각 5,061, 5.701, 5,820 um3로 최대치를 보였다. 그후 성체로 되면서 모든 핵에서1,897-2,704 roms로 다시 감소하였다. 전자현미경적 관찰에서 출생 후 21일된 흰쥐 수평대각 Broca대에서 ChAT 면역반응은 핵의 핵질 일부와 핵막 그리고 미토콘드리아와 조면소포체에서 관찰되었다. 이 결과들로 미루어 출생 후 초기 발생단계에서 흰쥐 전뇌 기저부의 내측중격핵과 수직 및 수평대각 Broca대에서 ChAT 면역반응 신경세포들은 축삭과 수상돌기의 형성에 따라 세포의 형과 그 출현율 및 세포제의 크기에서 현저한 변화가 이루어지는 것으로 생각된다.

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Immunocytochemical Study of the Nerve Growth Factor Receptor in the Nucleus Basalis of Meynert of the Growth Receptorn in the Nucleus Basalis of Meynert of the Postnatal Rat BASAL Forebrain (출생후 발생에 따른 흰쥐 전뇌 기저부 Meynert 긴저칙에서의 신경성장인자 수용체에 대한 면역세포화학적 연구)

  • Jeong, Yeong-Hwa;Hong, Yeong-Ho;Sin, Bo-Cheol
    • The Korean Journal of Zoology
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    • v.36 no.4
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    • pp.562-579
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    • 1993
  • 출생후 발생에 따른 흰쥐 전뇌 기저부의 Mevnert 기저핵(nucleus basalis of Mevnert)에서 신경성장인자 수용체(nerve growth factor receptor, NGFr)를 함유하는 신경세포의 면역반응성 및 분포, 세포형의 분류, 각 형별 출현율 및 세포 크기 그리고 세포소기관과 NGFr 면역반응과의 관계를 조사하였다. NGFr 면역반응 신경세포들은 출생후 초기 발생에서 세포질 뿐만 아니라 원형질 막에서도 면역반응을 보였으나, 성체에서는 세포질에서만이 면역반응을 보였다. NGFr 면역반응 신경세포는 형태학적 특징인 세포체의 모양과 장·단축의 비를 기준으로 5가지 형, 즉 1) 원형, 2) 난형, 3) 세장형. 4) 방추형, 5) 삼각형(또는 다각형)세포로 구분되었다 원형과 난형 세포는 출생후 0일에서 각각 15.4%. 50.7%의 높은 출현율을 보였으나, 발생이 진행되면서 점차 감소하여 성체에서 각각 7.8%, 28.6%의 출현율을 보였다 반면, 세장형, 방추형 및 삼각형세포는 출생후 0일에서 각각 22%, 2.6% 9.2%의 낮은 출현율을 보였으나, 발생이 진행되면서 지속적으로 증가하여 성체에서는 각각 29 9%, 5.2%, 28.5%의 높은 출현율을 보였다. 출생후 0일에서 신경세포체의 부피는 매우 작았으나(1,642mm3), 발생에 따라 점차 증가하여 14일, 21일에서는 성체에서보다 매우 컸다(각각 6.745, 6,755mm3) 원형 및 난형세포체의 부피는 21일에서(각각 7 955. 7.020mm3), 세장형 방추형 그리고 삼각형세포체의 부피는 14일에서 제일 컸다(각각 7,067, 6,237, 7,748 mm3) 대체적으로 삼각형세포체의 부피가 제일 컸으며, 방추형세포체의 부피가 제일 작았다. 출생후 순일에서의 전자현미경적 관찰에서 세포소기관중 조면소포체, Golgi체, multivesicular body 그리고 세포표면 원형질막이 강한 NGFr 면역반응을 보였다. 위의 결과들로 미루어 MGFr은 출생후 흰쥐 전뇌 기저부 Meynert 기저핵 신경세포의 분화 및 분포와 밀접한 관계를 갖는 것으로 생각된다.

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Studies on the phosphotyrsine-proteins in the rat cerbellar PSD fraction (흰쥐 소뇌 연접후치밀질내 phosphotryrosine 함유 단백질에 대한 연구)

  • 전일수;함소희;고복현
    • Journal of Life Science
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    • v.7 no.3
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    • pp.198-204
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    • 1997
  • The signal transduction through tyrosine kinases play important roles in neuronal development and synaptic regulation. We carried out immunoblot analyses to study tyrosine=phosphorylated proteins in the rat cerebellar postsynaptic density (PSD), a protein-rich cytoskeletal specialization underlying beneath the postsynaptic membrane. The overall protein composition of cerebellar PSD fractions was similar to that of the forebrain’s and only a few bands were different in Coomassie stain. Immunoblot analyses with phosphtyrosine-specific antiboy (4G10) showed that there are many more tyrosine-phosphorylated proteins in the cerebellar PSD than in the forebrain PSD. Interestiingly, a major phosphotyrosine signals in cerebellar PSD fractions was associated with a 50 kD molecular size, named as PSD-50. Migration of PSD-50 coincided with that of $\alpha$CaMKII and remained in the pellet fraction after N-octylglucoside extraction. These results indicate that tyrosine phosphorylation is important in cerebellar synaptic regulation and that the PSD-50 may be same as $\alpha$CaMKIIor a new protein which is a major substrate of tyrosine kinase.

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