• Title/Summary/Keyword: Head and Neck

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A Case of Kimura's Disease Occurring During Remission of Steroid-responsive Nephrotic Syndrome (소아에서 스테로이드 반응성 신증후군의 관해기에 발병한 Kimura 병의 1례)

  • Bae Keun-Wook;Lee Min-Kyu;Lee Joo-Hoon;Huh Joo-Ryung;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.52-57
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    • 2006
  • Kimura's disease is a rare chronic inflammatory disease of unknown etiology which appears primarily in young Asian males as non-tender subcutaneous swellings in the head and neck region. Histologic characteristics are the presence of lymphoid follicles, vascular proliferation and infiltration of eosinophils. Peripheral eosinophilia and elevated serum IgE are frequently combined. Systemic steroid therapy with surgical excision is the mainstay of treatment, though recurrence after surgery or discontinued steroid treatment is common. It has been known that about 16% of the cases are associated with renal diseases, particularly nephrotic syndrome. We present an 8-year-old boy with a past history of steroid-responsive, infrequently relapsing nephrotic syndrome who developed right buccal swelling and peripheral eosinophilia during the remission state. He has been managed with surgical resection, steroid and cyclosporine due to multiple recurrences.

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Laboratory Management Status of Vestibular Function Test in Korea (국내 전정기능검사실의 운영 현황)

  • Kim, Tae Su;Kim, Mi Joo;Kim, Byung-Kun;Kim, Hyun Ah;Bae, Dae Woong;Bae, Miran;Bae, Seong-Cheon;Lee, Eeksung;Jeon, Eun-Ju
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.160-166
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    • 2018
  • Objectives: This study was conducted to assess the current management status of the vestibular function test laboratories in Korea. Methods: Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires. Results: Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.

A Comparison of PM10 Exposure Characteristics of Swine Farmers by Body Parts using Direct-reading Instrument (직독식 기기를 이용한 양돈작업자의 신체부위별 PM10 노출 특성 비교 연구)

  • Sin, Sojung;Kim, Hyocher;Kim, Kyung-ran;Seo, Mintae;Park, Sooin;Kim, Kyungmin;Kim, Kyungsu
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.2
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    • pp.159-166
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    • 2019
  • Objectives: The purpose of this study was to evaluate the personal exposure to $PM_{10}$ by body parts for the development of dust monitoring wearable device for swine farmers. Methods: Tasks were classified by using motion pictures taken by action cameras attached to swine farmers. Concentrations of $PM_{10}$ were measured by attaching direct-reading instruments at the head, neck and waist of worker. Differences of $PM_{10}$ exposure between body parts were analyzed with linear regression. Results: We identified three tasks(vaccination, moving pigs, and manure treatment). $PM_{10}$ concentration during vaccination was the highest among the tasks, and the body part showing the highest concentration of $PM_{10}$ was the waist regardless of task. In all tasks, the closer distance between the body parts, the higher were the R-squared values(vaccination 0.4221, moving pigs 0.6990, and manure treatment 0.2164). Conclusions: We presumed that $PM_{10}$ concentrations were affected by the parts of the body in which they were measured. In order to develop swine farmer's wearable device for monitoring dust concentration in air, the determination of the positions of monitoring sensor to ensure accurate measurement is essential. Considering the results of this study, wearable sensor should be positioned at the waist.

Granular Cell Tumor of the Axillary Accessory Breast: A Case Report (액와부 부유방에 발생한 과립 세포 종양: 증례 보고)

  • Youn Joo Jung;Kyung Jin Nam;Ki Seok Choo;Kyeyoung Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.275-279
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    • 2023
  • Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

Development of Supplemental Equipment to Reduce Movement During Fusion Image Acquisition (융합영상(Fusion image)에서 움직임을 줄이기 위한 보정기구의 개발)

  • Cho, Yong Gwi;Pyo, Sung Jae;Kim, Bong Su;Shin, Chae Ho;Cho, Jin Woo;Kim, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.84-89
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    • 2013
  • Purpose: Patients' movement during long image acquisition time for the fusion image of PET-CT (Positron Emission Tomography-Computed Tomography) results in unconformity, and greatly affects the quality of the image and diagnosis. The arm support fixtures provided by medical device companies are not manufactured considering the convenience and safety of the patients; the arm and head movements (horizontal and vertical) during PET/CT scan cause defects in the brain fundus images and often require retaking. Therefore, this study aims to develop patient-compensation device that would minimize the head and arm movements during PET/CT scan, providing comfort and safety, and to reduce retaking. Materials and Methods: From June to July 2012, 20 patients who had no movement-related problems and another 20 patients who had difficulties in raising arms due to shoulder pain were recruited among the ones who visited nuclear medicine department for PET Torso scan. By using Patient Holding System (PHS), different range of motion (ROM) in the arm ($25^{\circ}$, $27^{\circ}$, $29^{\circ}$, $31^{\circ}$, $33^{\circ}$, $35^{\circ}$) was applied to find the most comfortable angle and posture. The manufacturing company was investigated for the permeability of the support material, and the comfort level of applying bands (velcro type) to fix the patient's head and arms was evaluated. To find out the retake frequency due to movements, the amount of retake cases pre/post patient-compensation were analyzed using the PET Torso scan data collected between January to December 2012. Results: Among the patients without movement disorder, 18 answered that PHS and $29^{\circ}$ arm ROM were the most comfortable, and 2 answered $27^{\circ}$ and $31^{\circ}$, respectively. Among the patients with shoulder pain, 15 picked $31^{\circ}$ as the most comfortable angle, 2 picked $33^{\circ}$, and 3 picked $35^{\circ}$. For this study, the handle was manufactured to be adjustable for vertical movements. The material permeability of the patient-compensation device has been verified, and PHS and the compensation device were band-fixed (velcro type) to prevent device movements. A furrow was cut for head fixation to minimize the head and neck movements, fixing bands were attached for the head, wrist, forearm, and upper arm to limit movements. The retake frequency of PET Torso scan due to patient movements was 11.06% (191 cases/1,808 patients) before using the movement control device, and 2.65% (48 cases/1,732 patients) after using the device; 8.41% of the frequency was reduced. Conclusion: Recent change and innovation in the medical environment are making expensive medical image scans, and providing differentiated services for the customers is essential. To secure patient comfort and safety during PET/CT scans, ergonomic patient-compensation devices need to be provided. Therefore, this study manufactured a patientcompensation device with vertically adjustable ergonomic ROM according to the patient's body shape and condition during PET Torso scan. The defects in the basal ganglia images due to arm movements were reduced, and retaking was decreased.

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Significance of Apoptotic Cell Death after $\gamma-Irradiation$ (방사선 조사에 의한 세포사에 있어서 세포고사의 의미)

  • Wu H.G.;Kim I.H.
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.252-258
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    • 2001
  • Purpose : The objectives of this study are to investigate the significance of apoptotic death compared to total cell death after $\gamma-ray$ irradiation in human H&N cancer cell lines and to find out correlation between apoptosis and radiation sensitivity. Materials and method : Head and neck cancer cell lines (PCI-1, PCI-13, and SNU-1066), leukemia cell line (CCRF-CEM), and fibroblast cell line (LM217) as a normal control were used for this study. Cells were irradiated using Cs-137 animal experiment irradiator. Total cell death was measured by clonogenic assay. Annexin-V staining was used to detect the fraction of apoptotic death. Results : Surviving fraction at 2 Gy (SF2) were 0.741, 0.544, 0.313, 0.302, and 0.100 for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217 cell lines, respectively. Apoptosis was detected in all cell lines. Apoptotic index reached peak value at 72 hours after irradiation in head and neck cancer cell lines, and that was at 24 hours in CCRF-CEM and LM217. Total cell death increased exponentially with increasing radiation dose from 0 Gy to 8 Gy, but the change was minimal in apoptotic index. Apoptotic fractions at 2 Gy were $46\%,\;48\%,\;46\%,\;24\%,\;and\;19\%$ and at 6 Gy were $20\%,\;33\%,\;35\%,\;17\%,\;and\;20\%$ for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217, respectively. The radioresistant cell lines showed more higher apoptotic fraction at 2 Gy, but there was not such correlation at 6 Gy. Conclusion : All cell lines used in this study showed apoptosis after irradiation, but time course of apoptosis was different from that of leukemia cell line and normal fibroblast cell line. Reproductive cell death was more important mode of cell death than apoptotic death in all cell lines used in this study. But there was correlation between apoptotic fraction and radiation sensitivity at 2 Gy.

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Comparison and Evaluation of radiotherapy plans by multi leaf collimator types of Linear accelerator (선형가속기의 다엽콜리메이터 형태에 따른 치료계획 비교 평가)

  • Lim, Ji Hye;Chang, Nam Joon;Seok, Jin Yong;Jung, Yun Ju;Won, Hui Su;Jung, Hae Youn;Choi, Byeong Don
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.129-138
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    • 2018
  • Purpose : An aim of this study was to compare the effect of multi leaf collimator(MLC) types for high dimension radiotherapy in treatment sites used clinically. Material and Method : 70 patients with lung cancer, spine cancer, prostate cancer, whole pelvis, head and neck, breast cancer were included in this study. High definition(HD) MLC of TrueBeam STx (Varian Medical system, Palo Alto, CA) and millenium(M) MLC of VitalBeam (Varian Medical system, Palo Alto, CA) were used. Radiotherapy plans were performed for each patient under same treatment goals with Eclipse (Version 13.7, Varian Palo Alto USA, CA). To compare the indicators of the radiotherapy plans, planning target volume(PTV) coverage, conformity index(CI), homogeneity index(HI), and clinical indicators for each treatment sites in normal tissues were evaluated. To evaluate low dose distribution, $V_{30%}$ values were compared according to MLC types. Additionally, length and volume of targets for each treatment sites were investigated. Result : In stereotatictic body radiotherapy(SBRT) plan for lung, the average value of PTV coverage was reduced by 0.52 % with HD MLC. With SBRT plan using HD MLC for spine, the average value of PTV coverage decreased by 0.63 % and maximum dose decreased by 1.13 %. In the test of CI and HI, the values in SBRT plan with HD MLC for spine were 1.144, 1.079 and the values using M MLC were 1.160, 1.092 in SBRT plan for lung, The dose evaluation of critical organ was reduced by 1.48 % in the ipsilateral lung mean dose with HD MLC. In prostate cancer volumetric modulated arc therapy(VMAT) with HD MLC, the mean dose and the $V_{30}$ of bladder and the mean dose and the $V_{25}$ of rectum were reduced by 0.53 %, 1.42 %, 0.97 %, and 0.69 %, respectively (p<0.05). The average value of heart mean dose was reduced by 0.83 % in breast cancer VMAT with M MLC. Other assessment indices for treatment sites showed no significant difference between treatment plans with two types of MLC. Conclusion : Using HD MLC had a positive impact on the PTV coverage and normal tissue sparing in usually short or small targets such as lung and spine SBRT and prostate VMAT. But, there was no significant difference in targets with long and large such as lung, head and neck, and whole pelvis for VMAT.

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Radiosensitization of Cis-Platimum in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma (국소 진행된 두경부편평 상피암에 대한 CIS-PLATINUM과 방사선치료의 동시 병행요법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.27-34
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    • 1992
  • Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

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Postoperative Radiotherapy for Parotid Gland Malignancy (귀밑샘 악성 종양의 수술 후 방사선 치료)

  • Eom Keun-Yong;Wu Hong-Gyun;Kim Jae-Sung;Park Charn Il;Kim In-Ah;Kim Kwang Hyun;Lee Chae Seo
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.131-136
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    • 2005
  • Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

The Usability Analysis of 3D-CRT, IMRT, Tomotherpy Radiation Therapy on Nasopharyngeal Cancer (NPC의 방사선치료시 3D-CRT, IMRT, Tomotherapy의 유용성 분석)

  • Song, Jong-Nam;Kim, Young-Jae;Hong, Seung-Il
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.365-371
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    • 2012
  • The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.