• Title/Summary/Keyword: Cancer characteristics

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Evaluation of Beam-Matching Accuracy for 8 MV Photon Beam between the Same Model Linear Accelerator (동일 기종 선형가속기간 8 MV 광자선에 대한 빔 매칭 정확도 평가)

  • Kim, Yon-Lae;Chung, Jin-Beom;Kang, Seong-Hee
    • Journal of radiological science and technology
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    • v.43 no.2
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    • pp.105-114
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    • 2020
  • This study aimed to assess of beam-matching accuracy for an 8 MV beam between the same model linear accelerators(Linac) commissioned over two years. Two models were got the customer acceptance procedure(CAP) criteria. For commissioning data for beam-matched linacs, the percentage depth doses(PDDs), beam profiles, output factors, multi-leaf collimator(MLC) leaf transmission factors, and the dosimetric leaf gap(DLG) were compared. In addition, the accuracy of beam matching was verified at phantom and patient levels. At phantom level, the point doses specified in TG-53 and TG-119 were compared to evaluate the accuracy of beam modelling. At patient level, the dose volume histogram(DVH) parameters and the delivery accuracy are evaluated on volumetric modulated arc therapy(VMAT) plan for 40 patients that included 20 lung and 20 brain cases. Ionization depth curve and dose profiles obtained in CAP showed a good level for beam matching between both Linacs. The variations in commissioning beam data, such as PDDs, beam profiles, output factors, TF, and DLG were all less than 1%. For the treatment plans of brain tumor and lung cancer, the average and maximum differences in evaluated DVH parameters for the planning target volume(PTV) and the organs at risk(OARs) were within 0.30% and 1.30%. Furthermore, all gamma passing rates for both beam-matched Linacs were higher than 98% for the 2%/2 mm criteria and 99% for the 2%/3 mm criteria. The overall variations in the beam data, as well as tests at phantom and patient levels remains all within the tolerance (1% difference) of clinical acceptability between beam-matched Linacs. Thus, we found an excellent dosimetric agreement to 8 MV beam characteristics for the same model Linacs.

A Study of Digitalizing Analog Gamma Camera Using Gamma-PF Board (Gamma-PF 보드를 이용한 아날로그 감마카메라의 디지털화 연구)

  • Kim, Hui-Jung;So, Su-Gil;Bong, Jeong-Gyun;Kim, Han-Myeong;Kim, Jang-Hwi;Ju, Gwan-Sik;Lee, Jong-Du
    • Journal of Biomedical Engineering Research
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    • v.19 no.4
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    • pp.351-360
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    • 1998
  • Digital gamma camera has many advantages over analog gamma camera. These include convenient quality control, easy calibration and operation, and possible image quantitation which results in improving diagnostic accuracies. The digital data can also be utilized for telemedicine and picture archiving and communication system. However, many hospitals still operate analog cameras and have difficult situation to replace them with digital cameras. We have studied a feasibility of digitalizing an analog gamma camera into a digital camera using Gamma-PF interface board. The physical characteristics that we have measured are spatial resolution, sensitivity, uniformity, and image contrast. The patient's data obtained for both analog and digital camera showed very similar image quality. The results suggest that it may be feasible to upgrade an analog camera into a digital gamma camera in clinical environments.

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The Characteristics of the Appearance and Health Risks of Volatile Organic Compounds in Industrial (Pohang, Ulsan) and Non-Industrial (Gyeongju) Areas

  • Jung, Jong-Hyeon;Choi, Bong-Wook;Kim, Mi-Hyun;Baek, Sung-Ok;Lee, Gang-Woo;Shon, Byung-Hyun
    • Environmental Analysis Health and Toxicology
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    • v.27
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    • pp.12.1-12.8
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    • 2012
  • Objectives: The aim of this study was to identify the health and environmental risk factors of air contaminants that influence environmental and respiratory diseases in Gyeongju, Pohang and Ulsan in South Korea, with a focus on volatile organic compounds (VOCs). Methods: Samples were collected by instantaneous negative pressure by opening the injection valve in the canister at a fixed height of 1 to 1.5 m. The sample that was condensed in $-150^{\circ}C$ was heated to $180^{\circ}C$ in sample pre-concentration trap using a 6-port switching valve and it was injected to a gas chromatography column. The injection quantity of samples was precisely controlled using an electronic flow controller equipped in the gas chromatography-mass spectrometer. Results: The quantity of the VOC emissions in the industrial area was 1.5 to 2 times higher than that in the non-industrial area. With regards to the aromatic hydrocarbons, toluene was detected at the highest level of 22.01 ppb in Ulsan, and chloroform was the halogenated hydrocarbons with the highest level of 10.19 ppb in Pohang. The emission of toluene was shown to be very important, as it accounted for more than 30% of the total aromatic hydrocarbon concentration. Conclusions: It was considered that benzene in terms of the cancer-causing grade standard, toluene in terms of the emission quantity, and chloroform and styrene in terms of their grades and emission quantities should be selected for priority measurement substances.

Risk Factors of Tissue-Expander Infection in Breast Reconstruction (유방재건술에서 조직확장기 감염의 위험인자)

  • Han, Sung-Bum;Lee, Dong-Won;Lew, Dae-Hyun
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.621-626
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    • 2011
  • Purpose: Implant-based breast reconstruction has multiple advantages such as decreased morbidity, shorter operative time and faster recovery. However, postoperative infection with tissue expander increases medical cost and causes a delay in concurrent antineoplastic treatment. To reduce tissue expander infection, it is important to identify related risk factors and minimize them when possible. Methods: A retrospective review of patient records in a single breast cancer center was performed. Eighty-six tissue expanders were placed in 80 women for postmastectomy breast reconstruction. Variables including patients'age, body mass index (BMI), preoperative breast volume, operation time, drain indwelling time, postoperative seroma/hematoma formation, chemotherapy, and radiation therapy were evaluated. Infection was defined as the status that shows any symptom of local inflammation and identification of pathogens. Representative values were compared through Student's t-test and univariate and multivariate analyses. Results: We examined 86 postmastectomy tissueexpanders which were placed between June 2004 and April 2010. Seven cases of tissue expander infection (8.1%) were identified. The infected tissue expander was removed in three of the cases. The relationship between BMI, and preoperative breast volume and that between infection and non-infection groups were significant ($p$ <0.05). Univariate analysis showed significant association between BMI ($p$=0.023) and preoperative breast volume ($p$=0.037). Multivariate analysis revealed that BMI and preoperative breast volume were independent variables regarding tissue expander infection. Conclusion: Certain characteristics of implant-based breast reconstruction patients increase infection rate of tissue expander. These risk factors should be monitored and evaluated before surgeries for more successful outcome.

Differences of Cold-heat Patterns between Healthy and Disease Group (건강군과 질환군의 한열지표 차이에 관한 고찰)

  • Kim Ji-Eun;Lee Seung-Gi;Ryu Hwa-Seung;Park Kyung-Mo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.1
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    • pp.224-228
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    • 2006
  • The pattern identification of exterior-interior syndrome and cold-heat syndrome is one of the diagnostic methods using most frequently in Oriental medicine. There was no systematic studies analyzing the characteristics of the 'exterior-interior and cold-heat' between healthy and disease group. In this study, cold-heat pattern, blood pressure, pulse rate, height and weight are recorded from 100 healthy subjects and 196 disease subjects with age ranging from 30 to 59 years. To analyze the differences between healthy and disease group, we used the descriptive statistics. And linear regression function, linear support vector machine and bayesian classifier were used for distinguishing healthy group from disease group. The score of both exterior-heat and interior-cold in healthy group is higher than the score in disease group. This means that if one belongs to the disease group, his(or her) exterior gets cold and his interior gets hot. And also, these result have no relevance to age. But, the attempt to classify healthy group from disease group with a exterior-interior and cold-heat and other vital signs did not have good performance. It mean that even though they have a different trend each other, only these kinds of information couldn't classify healthy group and disease group.

What Cases Are Worth Publishing in the Korean Medical Case Report? (한의학증례보고에서 가치 있는 증례는 무엇일까?)

  • Han, Gajin;Kim, Song-Yi
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.159-171
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    • 2020
  • Objectives : This study aimed to understand the characteristics of the cases covered in the case studies on traditional Korean medicine (TKM) and furthermore, to provide basic information that can lead the discussion on 'what cases are worth reporting' in future case reports. Methods : Case reports on TKM were searched using the OASIS. The searched researches were analyzed according to the type of case, including information on disease/symptoms and intervention. Results : A total of 940 researches were searched. The most frequently reported type of case study was the report on the effectiveness of intervention. Case reports, which were only two cases in the 1970s, increased rapidly in the 2000s, and in particular, 314 cases within the last five years accounted for about 33% of the total literature. As for the number of studies by disease, the cases dealing with musculoskeletal diseases such as spine, shoulder and knee joint disorders were the most prevalent. Besides, there were many case reports related to cardiovascular, gynecological, cancer, psychiatric, and dermatological diseases. In a total of 51.9% of the included case reports, a combination of two or more Korean medical treatments such as acupuncture and herbal medicine was used at once, and western treatment was used with Korean medical treatment in 28.2% of the studies. The types of Korean medical treatments were varied, such as acupuncture, moxibustion, pharmacopuncture, electroacupuncture, Chuna, acupotomy, herbal medicine, external preparation, and psychotherapy. The main purpose of the publication of the included case reports was analyzed as a report of TKM treatment for rare diseases, or the application of TKM treatment to diseases or symptoms that are "uncommon in TKM treatment" even if it is not a rare disease. Conclusions : Case reports have the strength of generating new scientific hypotheses by detecting the basic needs and novelty of medicine. The current case studies of TKM do not seem to be sufficient to highlight these strengths. It is necessary to discuss which cases are reported as cases of patients worth publishing, and based on this, it is necessary to activate case studies of TKM by utilizing diagnostic tools and science technology.

Recent Status of Commercial PET Cyclotron and KOTRON-13 (KOTRON-13과 상용 PET 사이클로트론의 최근 기술 동향)

  • Chai, Jong-Seo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.1-8
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    • 2005
  • This paper is described on the development of KOTRON-13 and recent status of PET cyclotron by commercial cyclotron companies. KIRAMS has developed medical cyclotron which is KIRAMS-13. Samyoung Unitech produces KOTRON-13 with transfered technology by KIRAMS. As a part of Regional Cyclotron Installation Protect, KOTRON-13 cyclotrons and $[18F]FDG$ production modules are being installed at regional cyclotron centers in Korea. The medical concern with radiation technology has been growing for the last several years. Early cancer diagnosis through the cyclotron and PET-CT have been brought to public attention by commercial cyclotron models in the world. The new commercial cyclotron models are introduced compact low energy cyclotrons developed by CTI, GE, Sumitomo in recent. It produces different short-lived radioisotopes, such as $[^{18}F],\;[^{11}C],\;[^{13}N]\;and\;[^{15}O]$. For the better reliability acceleration particle is proton only. The characteristics of new model cyclotrons are changed to lower energy corresponding to less 13 MeV. New models have self-shielding and low power consumption. Design criteria for the different types of commercial cyclotrons are described with reference to hospital demands.

Radiopharmaceuticals for the Therapy of Metastatic Bone Pain (뼈전이의 방사성동위원소 통증치료)

  • Ahn, Byeong-Cheol
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.82-89
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    • 2006
  • Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

Objective photographic assessments and comparisons of immediate bilateral breast reconstruction using deep inferior epigastric perforator flaps and implants

  • Han, Hyun Ho;Choi, Jin Mi;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.473-482
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    • 2021
  • Background The increasing number of bilateral breast cancer patients has been accompanied by a growing need for bilateral mastectomy with immediate reconstruction. However, little research has investigated the complications and aesthetic outcomes related to bilateral reconstruction. Therefore, we analyzed retrospective data comparing the outcomes of bilateral reconstruction using deep inferior epigastric perforator (DIEP) flaps or implants. Methods This study included 52 patients (24 DIEP group and 28 implant group) who underwent bilateral mastectomy with immediate reconstruction between 2010 and 2020. Patient demographics, surgical characteristics, and complications were recorded. The difference between the left and right position of the nipple-areolar complex with respect to the sternal notch point at the clavicle was measured, and breast symmetry was evaluated. Results The average weight of breasts reconstructed with DIEP flaps (417.43±152.50 g) was higher than that of breasts with implants. The hospitalization period and operation time were significantly longer in the DIEP group. Early complications were significantly more common in the implant group (36.53%) than in the DIEP group. The angles between the nipples and the horizontal line were 1.09°±0.71° and 1.75°±1.45° in the DIEP and implant groups, respectively. Conclusions Although the surgical burden is lower, breast reconstruction using implants requires greater attention with respect to implant positioning, asymmetry, and complications than DIEP flap reconstruction. DIEP flap reconstruction has a prolonged operation time and a high risk of flap failure, but yields excellent cosmetic results and does not require intensive follow-up. Patients should be consulted to determine the most suitable option for them.

Effectiveness and Complication Rate of Percutaneous Endoscopic Gastrostomy Placement in Pediatric Oncology Patients

  • Kidder, Molly;Phen, Claudia;Brown, Jerry;Kimsey, Kathryn;Oshrine, Benjamin;Ghazarian, Sharon;Mateus, Jazmine;Amankwah, Ernest;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.546-554
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    • 2021
  • Purpose: Malnutrition is a significant issue for pediatric patients with cancer. We sought to evaluate the effectiveness and complication rate of percutaneous endoscopic gastrostomy (PEG) placement in pediatric oncology patients. Methods: A retrospective chart review was performed on 49 pediatric oncology patients undergoing PEG placement at Johns Hopkins All Children's Hospital between 2000 and 2016. Demographic and clinical characteristics, complications, absolute neutrophil count at time of PEG placement and at time of complications, length of stay, and mortality were identified. Weight-for-age Z-scores were evaluated at time of- and six months post-PEG placement. Results: The overall mean weight-for-age Z-score improved by 0.73 (p<0.0001) from pre- (-1.11) to post- (-0.38) PEG placement. Improvement in Z-score was seen in patients who were malnourished at time of PEG placement (1.14, p<0.0001), but not in those who were not malnourished (0.32, p=0.197). Site infections were seen in 12 (24%), buried bumper syndrome in five (10%), and tube dislodgement in one (2%) patient. One patient (2%) with fever was treated for possible peritonitis. There were no cases of other major complications, including gastric perforation, gastrocolic fistula, clinically significant bleeding, or PEG-related death documented. Conclusion: Consistent with previous studies, our data suggests a relationship between site complications (superficial wound infection, buried bumper syndrome) and neutropenia. Additionally, PEG placement appears to be an effective modality for improving nutritional status in malnourished pediatric oncology patients. However, larger prospective studies with appropriate controls and adjustment for potential confounders are warranted to confirm these findings.