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Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Concurrent Cisplatin-Radiation Therapy in Locally Advanced Head & Neck Cancers - Preliminary Report - (국소진행된 두경부종양의 Cisplatin-방사선 동시병용치료 - 예비적 임상결과보고 -)

  • Kim In Ah;Choi Ihl Bhong;Cho Seung Ho;Hong Young Seon;Choi Byung Ok;Kang Young Nam
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.205-210
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    • 2001
  • Purpose : This study tried to evaluate the effectiveness of combined treatment using radiation therapy and concurrent cisplatin as a radiosensitizer in the management of locally advanced head and neck cancer. Materials and methods : From January 1995 to August 1998, 29 evaluable patients with locally advanced head & neck cancels (AJCC stage $II\~IV$) were received curative radiation therapy $(total\;70\~75.6\;Gy/35\~42\;fractions,\;1.8\~2\;Gy/fraction)$ and concurrent cisplatin chemotherapy ($100\;mg/m^2$, D1, D22, D43). The neck dissections were peformed for residual lymphadenopathy. Follow-up ranged from 5 to 55 months (median 24 months). Results : Twenty-one $(72.4\%)$ patients achieved clinical complete responses. The partial response and minimal response rates were $17.2\%\;and\;10.4\%$, respectively. Locoregional failure rate was $27.6\%$, and included 6 patients with local failures, 4 patients with regional failures, and 2 patients with combined local and regional failures. Four of 29 patients $(13.8\%)$ developed distant metastasis. The disease free survival rate at 3 years was $60\%$. Nasopharyngeal primary tumors or complete responders showed significantly higher disease free survival rate. The grade 3 mucositis and nausea/vomiting was noted in $34.5\%$, respectively. Major prolongation of radiation therapy duration was inevitable in three patients. Twenty-one patients $(72.4\%)$ completed 3 courses of cisplatin and 5 patients received 2 courses of cisplatin. Three patients received only one course of cisplatin due to nephrotoxicity and neurotoxicity, and then changed to 5-FU regimen. Conclusions : Concurrent cisplatin-radiation therapy in locally advanced head and neck cancer showed high response rate, reasonable locoregional control, and survival rate. As expected, acute toxicities were increased, but compliance to treatment was acceptable. Assessment of the effect of the combination in this setting requires further accrual and follow-up.

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Understanding the Response Characteristics of X-ray Verification Film (X-선 Verification 필름의 반응 특성에 관한 연구)

  • Yeo Inhwan;Seong Jinsil;Chu Sung Sil;Kim Gwi Eon;Suh Chang Ok;Burch Sandra E.;Wang Chris K.
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.505-515
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    • 1998
  • Purpose : This study is intended to understand the sensitometric characteristics and the emulsion properties of the commercially available CEA TVS film in comparison with the Kodak X-Omat V film. Materials and Methods : For this purpose, we have formulated an analytic expression of the characteristic curves for x-ray film exposed to mixed radiation of electrons, photons, and visible light. This mathematical expression was developed based on reaction-rate and target-hit theories. Unlike previous expressions. it relates optical density to emulsion properties such as grain size and silver bromide content We have also developed a quantity which characterizes the film response to visible light relative to that to photons and electrons. This quantity could be expressed as a function of grain area. Thus, we have developed mathematical expressions and quantities with which the emulsion properties of the films can be revealed based on the sensitometric characteristics. Demonstrating the use of this analytical study, we exposed CEA and Kodak verification films to the mixed radiation of electrons, photons, and visible light, and interpreted the experimental results accordingly. Results : We have demonstrated that: (1) the saturation density increases as the silver bromide content increases, (2) the time required to reach the threshold dose (to which the film begins to respond) when films are exposed to visible light decreases as the grain size increases, and (3) the CEA film contains more silver bromide. whereas the Kodak film contains larger grains. These findings were supported by the data provided by the manufacturers afterward. Conclusion : This study presented an analytical and experimental basis for understanding the response of X-ray film with respect to the emulsion properties.

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Characteristics of the Maximum Glow Intensity According to the Thermoluminescent Phosphors used in the Absorbed Dose Measurement of the Radiation Therapy (방사선치료 선량 측정에 사용되는 열형광체에 따른 최대 형광 강도 특성)

  • Kang, Suman;Im, Inchul;Park, Cheolwoo;Lee, Mihyeon;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.4
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    • pp.181-187
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    • 2014
  • The purpose of this study were to analyze the characteristic of the glow curves in order to the glow temperature of the thermoluminescent dosimeters (TLDs) for the absorbed dose measurement of the radiation therapy. In this study, we was used the TLDs of the LiF:Mg${\cdot}$Ti, LiF:Mg${\cdot}$Cu${\cdot}$P, $CaF_2$:Dy, $CaF_2$:Mn (Thermo Fisher Scientific Inc., USA). The source-to-solid dry phantom (RW3 slab, IBA Dosmetry, Germany) surface distance was set at 100 cm, and the exposure dose of 100 MU (monitor unit) was used 6- and 15-MV X-rays, and 6- and 12-MeV electron beams in the reference depth, respectively. After the radiations exposure, we were to analyze the glow curves by using the TL reader (Hashaw 3500, Thermo Fisher Scientific Inc., USA) at the fixed heating rate of $15^{\circ}C/sec$ from $50^{\circ}C$ to $260^{\circ}C$. The glow peaks, the trapping level in the captured electrons and holes combined with the emitted light, were discovered the two or three peak. When the definite increasing the temperature of the TLDs, the maximum glow peak representing the glow temperature was follow as; $LiF:Mg{\cdot}Ti$: $185.5{\pm}1.3^{\circ}C$, $LiF:Mg{\cdot}Ti$: $135.0{\pm}5.1^{\circ}C$, $CaF_2$:Dy: $144.0{\pm}1.6^{\circ}C$, $CaF_2$:Mn: $294.3{\pm}3.8^{\circ}C$, respectively. Because the glow emission probability of the captured electrons depend on the heating temperature after the exposure radiation, TLDs by applying the fixed heating rate, the accuracy of measurement will be able to improve within the absorbed dose measurement of the radiation therapy.

Factors for Delayed Diagnosis of Acute Appendicitis in Children (소아 급성 충수돌기염 진단에 지연을 일으키는 요인에 관한 연구)

  • Han, Myung-Ki;Kim, Kyoung-Soo;Park, Yu-In;Kim, Jeong-Ho;Lee, Jung-Joo;Kim, Bong-Seong;Kang, Hye-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.158-165
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    • 2002
  • Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

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Role of Whole Body FDG-PET in the Diagnosis of Hidden Distant Metastasis before Liver Transplantation in Patients with Primary Liver Cancer (고식적 검사로 간외 전이를 진단하지 못한 원발성 간암 환자에서 간이식 전에 시행한 전신 FDG-PET의 역할)

  • Lee, Won-Woo;Ryu, Jin-Sook;Yang, You-Jung;Kim, Jae-Seung;Yeo, Jeong-Seok;Moon, Dae-Hyuk;Lee, Sung-Gyu
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.6
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    • pp.368-380
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    • 2002
  • Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.

Radiation Absorbed Dose Measurement after I-131 Metaiodobenzylguanidine Treatment in a patient with Pheochromycytoma (갈색세포종 환자에서 Medical Internal Radiation Dose법을 이용한 I-131 Metaiodobenzylguanidine 치료 후 흡수선량 평가)

  • Yang, Weon-Il;Kim, Byeung-Il;Lee, Jae-Sung;Lee, Jung-Rim;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.422-429
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    • 1999
  • Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

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Some Characteristics of Teflon-Thermoluminescent Dosimeters (테프론 열형광선량계(熱螢光線量計)의 특성(特性))

  • Lee, Soo-Yong
    • Journal of Radiation Protection and Research
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    • v.7 no.1
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    • pp.23-33
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    • 1982
  • The characteristic thermoluminescence responses of Teflon thermoluminescent dosimeters to radiations have been studied by the variation of radiation qualities as well as the high dose radiations. The change in the sensitivity of TLDs for different radiation qualities were studied through not only the photon energy dependence but also the change of supralinearity on the photon energy dependence, by exposing $^{60}Co$ gamma rays, the effective X-rays of 44keV, 69keV, 108keV, and thermal neutron of 0.04 eV. The results were as the following: The TL response of $T-CaSO_4$: Dy as a function of absorbed dose was linear up to about 5 Gy, and the response beyond 5Gy was supralinear for $^{60}Co$ gamma rays. The supralinearity of T-LiF-7 became noticeably apparent more than that of $T-CaSO_4$:Dy and also the lower the LET of radiation became the higher the supralinear effects were. No supralinearity appeared for the thermal neutron irradiations equivalent to 10Gy of $^{60}Co$ gamma rays. The relative sensitivities (Rs), which depended on the doses of $^{60}Co$ gamma rays to the TLDs of T-LiF-7 and T-$CaSO_4$:Dy could be, respectively, approximated to the following empirical formula fitted by the least square method: $$R_{LiF}=1.021-0.04581\;logD+0.402(logD)^2-0.405(logD)^3,\;\;5{\times}10^3{\geq}D{\geq}1(Gy)$$ $$R_{CaSO_4}=0.976-0.3241\;logD+0.262(logD)^2-0.298(logD)^3,\;5{\times}10^3{\geq}D{\geq}1(Gy)$$.

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Sediment Provenance using Clay Mineral in the Continental Shelf and Rise of the Eastern Bellingshausen Sea, Antarctica (벨링스하우젠 해의 동쪽 대륙붕과 대륙대의 코어의 점토광물을 이용한 기원지 연구)

  • Park, Young Kyu;Jung, Jaewoo;Lee, Kee-Hwan;Lee, Minkyung;Kim, Sunghan;Yoo, Kyu-Cheul;Lee, Jaeil;Kim, Jinwook
    • Journal of the Mineralogical Society of Korea
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    • v.32 no.3
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    • pp.173-184
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    • 2019
  • Variations in grain size distribution and clay mineral assemblage are closely related to the sedimentary facies that reflect depositional conditions during the glacial and interglacial periods. Gravity cores BS17-GC15 and BS17-GC04 were collected from the continental shelf and rise in the eastern Bellingshausen Sea during a cruise of the ANA07D Cruise Expedition by the Korea Polar Research Institute in 2017. Core sediments in BS17-GC15 consisted of subglacial diamicton, gravelly muddy sand, and bioturbated diatom-bearing mud from the bottom to the top sediments. Core sediments in BS17-GC04 comprised silty mud with turbidites, brownish structureless mud, laminated mud, and brownish silty bioturbated diatom-bearing mud from the bottom to the top sediments. The clay mineral assemblages in the two core sediments mainly consisted of smectite, chlorite, illite, and kaolinite. The clay mineral contents in core GC15 showed a variation in illite from 28.4 % to 44.5 % in down-core changes. Smectite contents varied from 31.1 % in the glacial period to 20 % in the deglacial period and 25.1 % in the interglacial period. Chlorite and kaolinite contents decreased from 40.5 % in the glacial period to 30.3 % in the interglacial period. The high contents of illite and chlorite indicated a terrigenous detritus supply from the bedrocks of the Antarctic Peninsula. Core GC04 from the continental rise showed a decrease in the average smectite content from 47.2 % in the glacial period to 20.6 % in the interglacial period, while the illite contents increased from the 21.3 % to 43.2 % from the glacial to the interglacial period. The high smectite contents in core GC04 during the glacial period may be supplied from Peter I Island, which has a known smectite-rich sediment contributed by Antarctic Circumpolar Currents. Conversely, the decrease in smectite and increase in chlorite and illite contents during the interglacial period was likely caused by a higher supply of chlorite- and illite-enriched sediment from the eastern Bellingshausen Sea shelf by the southwestward flowing contour current.

Production and characterization of rice starch from stale rice using improved enzymatic digestion method (개선된 효소소화법에 의한 고미로부터 쌀전분의 생산 및 특성)

  • Kim, Reejae;Lim, SongI;Kim, Hyun-Seok
    • Korean Journal of Food Science and Technology
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    • v.53 no.6
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    • pp.749-755
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    • 2021
  • The objective of this study was to investigate the physicochemical properties of rice starch extracted from stale rice using alkaline steeping (AKL) and improved enzymatic digestion (iENZ) methods. The crude protein content (0.5-0.7%) of stale rice starch (SRS) was less than 1% by iENZ, but not so when measured by the existing ENZ methods. SRS is an intermediate amylose rice starch. AKL-SRS and iENZ-SRS exhibited typical A-type crystal packing arrangements with similar relative crystallinities. iENZ-SRS showed higher gelatinization onset and peak temperatures with a narrower gelatinization temperature range, compared to those of AKL-SRS, indicating that iENZ annealed SRS. Thus, iENZ-SRS exhibited lower swelling power and solubility, and higher pasting viscosities with delayed viscosity development. Overall, the use of stale rice as a rice starch source could make economical production of rice starch possible, and iENZ may diversify rice starch characteristics, which expands the utilization of rice starch in food and non-food industries.