• Korean Journal of Head & Neck Oncology
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• v.30 no.1
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• pp.1-4
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• 2014

배경 및 목적 타액선 선양낭성암종은 느린 성장 속도와 늦은 원격 전이를 특징으로 하는 드문 상피성종양이다. 본 연구는 다양한 임상 병리학적 변수를 통해 선양낭성암종의 원격 전이에 영향을 주는 인자를 조사하고자 하였다. 대상 및 방법 1999년 10월부터 2011년 12월까지 본원 이비인후과에서 타액선 선양낭성암종으로 진단되어 치료 받은 44명(남자 19명, 여자 25명)을 대상으로 원격전이를 유발하는 위험 인자를 조사하였다. 8명의 환자는 배제 기준에 따라 제외하였다. 환자의 평균 연령은 54세였다. 환자의 병리 보고서, 종양의 크기, T 병기, 수술 절제연의 종양 존재 유무, 신경 조직 침습, 림프절 전이가 조사되었다. 결 과 15명의 환자가 원격전이가 있었으며 21명은 원격 전이가 없었다. 원격 전이를 유발할 수 있는 여러 인자들을 비교하였을 때, 원격 전이는 수술 절제연의 종양 세포 잔존(p=0.014), 종양의 크기(p=0.038), 진행된 T 병기(p=0.024)가 통계적으로 유의하게 연관성이 있었다. 림프절 전이와 신경 조직 침습은 원격 전이와 연관이 없었다. 결 론 종양의 크기, 진행된 T 병기, 수술 후 절제연의 종양 세포 잔존은 원격 전이의 예측 인자로 생각된다. 따라서 이에 해당하는 환자의 경우 더욱 철저한 관리 및 경과 관찰을 요한다.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.9-15
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• 2003

Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.572-576
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• 2009

Purpose: Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. Materials and Methods: One hundred ninety nine patients (M:F=33:166, age $46.7{\pm}12.3$ years) who had HD-RIT (dose $159.1{\pm}25.9\;mCi$, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive (${\geq}50\;dpm$) or negative (<50 dpm), and analyzed its values. Results: Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were $62{\pm}66.1\;dpm$ in increased one of follow-up UBT, and $153.3{\pm}157.1\;dpm$ in decreased one of follow-up UBT. Conclusion: We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection.

• Journal of Radiation Protection and Research
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• v.40 no.2
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• pp.118-123
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• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.40-46
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• 2009

Purpose: A whole body scan using a radioactive iodine (I-131) for the patients with differentiated thyroid cancer is generally an useful method to detect the remnant thyroid tissue, recurred lesion or metastasis lesion after a surgery. The high dose treatment using the radioactive iodine recently tends to increase, and a hospitalization wait for the treatment has been delayed for several months. In this hospital, the treatable patients per week were increased in number through expanding a water-purifier tank and the examination time also increased as the I-131 whole body scan patients increased. Improvement for this problem, this research reduce the existing examination time and classifying the lesion's exact position intended to by fabricating and utilizing the transmission scan tool and an excellent resolution for whole body imaging. Materials and Methods: After conducting the whole body scan for patients who visited the department from February to July 2008 and received the I-131 whole body scan using the ORBITER Gamma Camera. A rail was installed in the examination table for the transmission scan for show a contour of surface area and then the transmission image was obtained and fused to the whole body scan through fabricating the tool to put a flood phantom of diluted 2 mCi $^{99m}Tc$-pertechnetate. Results: Fused image of I-131 whole body scan and the transmission scan had the excellent resolution to discriminate an oral cavity or salivary gland region, neck region's lesion, and metastasis region's position through a simple marking, and could reduce the examination time of 8~28 minutes because without the additional local image. Conclusions: In I-131 whole body scan, the transmission scan can accurately show a contour of surface area through the attenuation of radioactivity, and is useful to indicate the remnant thyroid tissue or metastasis lesion's position by improving the resolution through the fusion image with alreadyexecuted I-131 whole body scan. Also, because the additional local image is not necessary, it can reduce the time required for the examination. It will extensively apply to other clinical examinations to be helpful for identifying an anatomical position because it shows the contour of surface area.