• Journal of radiological science and technology
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• v.27 no.3
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• pp.31-41
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• 2004

Attention deficit hyperactivity disorder(ADHD)is one of the most common psychiatric disorders in childhood, especially school age children and persisting into adult. ADHD is affected 7.6% in our children, Korea. and persisting into $15{\sim}20%$ in adult. And it is characterized by hyperactivity, inattention and impulsivity. Brain imaging is one of way to diagnosis for ADHD. Brain imaging studies may be provide information two types - structural and functional imaging. Structural and functional images of the brain play an important role in management of neurologic and psyciatric disorders. Brain SPECT, with perfusion imaging radiopharmaceuticals is one of the appropriate test to diagnosis of neurologic and psychiatric diseases. Ther are a few studies about separated analysis between boys and girls ADHD SPECT brain images. Selection of Probability level(P-value) is very important to determind the abnormalities when analysis a data by SPM. SPM is a statistical method used for image analysis and determine statistical different between two groups-normal and ADHD. Commonly used P-value is P<0.05 in statistical analysis. The purpose of this study is to evaluation of blood flow clusters distribution, between boys and girls ADHD. The number of normal boys are 8(6-7y, average : $9.6{\pm}3.9y$) and 51(4-11y, average : $9.0{\pm}2.4$) ADHD patients, and normal girls are 4(6-12y, average : $9{\pm}2.4y$) and 13(2-13y, average $10{\pm}3.5y$) ADHD patiens. Blood flow tracer $^{99m}Tc-ethylcysteinate$ dimer(ECD) injected as rCBF agent and take blood flow images after 30 min. during sleeping by SPECT camera. The anatomical region of hyperperfusion of rCBF in boys ADHD group is posterior cingulate gyrus and hyperperfusion rate is 15.39-15.77% according to p-value. And girls ADHD group appears at posterior cerebellum, Lt. cerbral limbic lobe and Lt. Rt. cerebral temporal lobe. These areas hyperperfusion rate are 24.68-31.25%. Hypoperfusion areas in boys ADHD,s brain are Lt. cerebral insular gyrus, Lt. Rt. frontal lobe and mid-prefrontal lobe, these areas decresed blood flow as 15.21-15.64%. Girls ADHD decreased blood flow regions are Lt. cerebral insular gyrus, Lt. cerebral frontal and temporal lobe, Lt. Rt. lentiform nucleus and Lt. parietal lobe. And hypoperfusion rate is 30.57-30.85% in girls ADHD. The girls ADHD group's perfusion rate is more variable than boys. The studies about rCBF in ADHD, should be separate with boys and girls.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.33-39
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• 2017

Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

• Progress in Medical Physics
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• v.25 no.3
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• pp.176-184
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• 2014

In this study, we compared dose distributions from simultaneously integrated boost (SIB) method versus the RTOG 0631 protocol for spine radiosurgery. Spine radiosurgery plans were performed in five patients with localized spinal metastases from hepatocellular carcinoma. The computed tomography (CT) and T1- and T2-weighted magnetic resonance imaging (MRI) were fused for delineating of GTV and spinal cord. In SIB plan, the clinical target volume (CTV1) was included the whole compartments of the involved spine, while RTOG 0631 protocol defines the CTV2 as the involved vertebral body and both left and right pedicles. The CTV2 includes transverse process and posterior element according to the extent of GTV. The doses were prescribed 18 Gy to GTV and 10 Gy to CTV1 in SIB plan, while the prescription of RTOG 0631 protocol was applied 18 Gy to CTV2. The results of dose-volume histogram (DVH) showed that there were competitive in target coverage, while the doses of spinal cord and other normal organs were lower in SIB method than in RTOG 0631 protocol. The 85% irradiated volume of VB in RTOG 0631 protocol was similar to that in the SIB plan. However, the dose to normal organs in RTOG 0631 had a tendency to higher than that in SIB plan. The SIB plan might be an alternative method in case of predictive serious complications of surrounded normal organs. In conclusion, although both approaches of SIB or RTOG 0631 showed competitive planning results, tumor control probability (TCP) and normal tissue complication probability (NTCP) through diverse clinical researches should be analyzed in the future.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.1-10
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• 2000

Purpose : Although using the high energy Photon beam with conventional Parallel-opposed beams radiotherapy for nasopharyngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-D CRT) in an effort to prevent the radiation-induced xerostomia. Materials and Methods : We peformed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54 Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator; shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was peformed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, DO5, V95, VOS, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. Results : For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69$\%$ for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96$\~$100$\%$, 79$\~$99$\%$, 51$\~$72$\%$ for each plan-A, B and C). Conclusion : We conclude that the new technique employing 3-D conformal radiotherapy at the beginning of radiotherapy and cone down using non-coplanar beams with early spinal cord block is highly recommended to spare parotid glands for node-negative nasopharygeal cancer patients.