A study has been made on the skin response of mouse hind limb to radiation to evaluate the difference of skin response to superfractionation and conventional fractionation schedules, and to optimize the time interval betweenfractions and the dose per fraction in the superfractionated irradiation. 96 mouse hind limbs were dvided into 12groups and were irradiated with 10 consecutive fractions by intervals of 6, 12 or 24 hours and dose per fractionsof 400, 500, 600 or 700 rads. The skin changes of the irradiated hind limb were observed for 30 days and the skin response were analyzed. The results are as follows; 1. There was no significant difference of early skin response along the time interval, from 6 to 24 hours, up to 600 rads per fraction. 2. Mean duration to maximum skin reaction in superfractionation (15.48±2.80 days) is shorter than in conventional fractionation (18.05±3.20 days)by 2.57 days. (p<0.05). 3. Optimum time interval betwen fractions in superfractionation may be 6 hours or less. 4. Optimum dose per fraction in superfractionation may be 500 rads or less.
Animals ; Appointments and Schedules ; Extremities ; Mice ; Skin

A total of 47 patients with a diagnosis of nasopharyngeal carcinoma was treated in Department of Therapeutic Radiology, Seoul National University Hospital during last 4 years. Of the 47 patients, 23(49%) had undifferentiated carcinoma, 20(43%) had squamous cell carcinoma, while 4(8%) had lymphoepithelioma. Most of the patients(71%) has Stage IV disease, cervical lymph node metastases were found in 36(77%) and distant metastasis was found in 1 at the time of diagnosis. Complete response rate after radiotherapy for 47 patients of nasopharyngeal carcinoma was 85.1%. The overall actuarial 3 year survival rates was 0.718 and the disease free actuarial 3 year survival rates was 0.468. Nodal involvement and symptom duration were statistically significiant influencing factors for actuarial survival rate. Treatment failures were found in 20 patients (42.6%), local recurrence only in 6(30%), local and neck recurrence in 3(15%), local recurrence with metastasis in 4(20%) and distant metastasis only in 7(35%). Local failures were more frequent in the patients with cranial nerve symptoms (P=0.032). Distant metastases were more frequent with T4 lesions (P=0.047), and with nodal involvement (P<0.01). Retreatment after the tumor recurrence was chemotherapy and/or radiotherapy, two patients refreated for local recurrence were alive without evidence of disease for more than 19 and 44 months after retreatment.
Carcinoma ; Carcinoma, Squamous Cell ; Cranial Nerves ; Diagnosis ; Drug Therapy ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retreatment ; Seoul ; Survival Rate ; Treatment Failure

CT scans obtained on 15 patients of head and neck malignant tumors were evaluated for their utility in ratiotherapy treatment planning. To evaluate the advantage of incorporating CT scans in radiotherapy treatment planning of head and neck malignant tumors, the dose distributions of treatment plan with and without CT scan were compared in 15 patients. And then the dose distributions of the first and second treatment plan were compared. 1. Tumor extend and localization were clearly delineated on CT scan in 12 of 15 cases (80%), suggestive in 2 (13.3%), and not seen in only one (6.7%) which had been in the postoperative state. 2. Tumor coverage after CT scan was adequate in 14 of 15 cases (93.3%) and not in only one. In one case of inadequate tumor coverage the target volume lay inside the field but reached within 0.5cm of the field margin (marginal miss). 3. The volume of normal tissue irradiated was reduced after CT scan in 12 of 15 cases (80%), increased in 1 (6.7%) and not changed in 2 (13.3%). 4. We could maximize the local control of disease and minimize unnecessary morbidity by delineating the location and extent of tumor and normal tissue with CT for treatment plannings.
Head* ; Humans ; Neck* ; Radiotherapy* ; Tomography, X-Ray Computed

The thickness of the part being irradiated is finite. Percent depth dose tables being used routinely are generally obtained from dosimetry in a phantom much thickner than usual patient. At or close to exit surface, the dose should be less than that obtained from the percent depth dose tables, because of insufficient volume for backscattering. To know the difference between the true absorbed dose and the dose obtained from percent depth dose table, the doses at or close to the exit surface were measured with plate type ionization chamber with volume of 0.5ml. The results are as follows; 1. In the case of 60Co, percent depth dose at a given depth increases with underlying phantom thickness up to the 5cm. 2. In the case of 60Co, the dose correction factor at exit surface which is less than 1, increases with part thickness and decreases with field size. 3. Exposure time may not be corrected when the part above 10cm in thickness is treated by 60Co. 4. In the case of 10MV x-ay, the dose correction factor is nearly 1 and constant for the underlying phantom thickness and field size, so the correction of monitor unit is not necessary for part thickness.
Axis, Cervical Vertebra* ; Fibrinogen ; Humans

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 x 82degrees / K2 = 45.88 x 172degrees, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 microm and the other was 150 microm and both were placed at 70degrees. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 x 60degrees) and the keratometric reading (K1 = 50.05 x 93degrees / K2 = 48.83 x 3degrees) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.
Cataract/*complications/diagnosis ; Corneal Stroma/pathology/*surgery ; Corneal Topography ; Follow-Up Studies ; Humans ; Keratoconus/complications/diagnosis/*surgery ; Lens Implantation, Intraocular/*methods ; Male ; Middle Aged ; Phacoemulsification/*methods ; Severity of Illness Index

This is a case report of pernicious anemia with neurologic deficits. The patient is a 69 years old male with generalized tingling sense. On examination, slight pale conjunctiva and beefy red tongue are noted. Laboratory stud show megaloblastic anemia with low serum vitamin B12 level, positive Schilling test, gastric achlorhydria and mild gastric atrophy. Neurologic examination reveals cerebral, spinal and peripheral involovement and EEG and EMG study support those things. On parenteral vitamin B12, the hematologic and neurological abnormalities are improved dramatically.
Achlorhydria ; Aged ; Anemia, Megaloblastic ; Anemia, Pernicious* ; Atrophy ; Conjunctiva ; Electroencephalography ; Humans ; Male ; Neurologic Examination ; Neurologic Manifestations ; Schilling Test ; Tongue ; Vitamin B 12

The natural course of lateral epicondylitis is widely regarded to be self-limiting within 1 year of symptom duration in 90% of all patients. The spectrum of treatments include simple ‘wait and see', bracing, physical therapy, corticosteroid injection, and recently some biologic injection such as autologous blood and platelet rich plasma. However, recalcitrant lateral epicondylitis which are not responding to conservative treatments can be treated with surgical treatment although much remains unclear regarding the ideal treatment. Debates surrounding open procedures are the management for the defect after resection of pathologic tissue, necessity of decortication, selective denervation procedure, etc. Since the trend is changing to minimal invasive surgery and arthroscopic release of extensor carpi radialis brevis tendon are becoming more popular these days, surgical tips and pitfall to obtain good results and avoid complications have been reported recently. Bipolar radiofrequency (RF)-based microtenotomy or percutaneous tendon release is another surgical procedures reported to be effective in lateral epicondylitis. However, there are some patients who present with persistent pain after surgical treatment. Thus, selection of ideal candidates for surgery, thorough evaluation of all pathologies prior to surgery, and adequate surgical procedures would be essential in the surgical treatment of lateral epicondylitis.
Braces ; Denervation ; Humans ; Pathology ; Platelet-Rich Plasma ; Tendons ; Tennis Elbow ; Tenotomy

PURPOSE: To determine the reproducibility of morphoscopic contrast sensitivity test values in the patients with primary open angle glaucoma using the Visual Capacity Analyzer (ACV) designed for assessing full visual performance including contrast sensitivity. METHODS: Morphoscopic contrast sensitivity was measured in each five glaucomatous eyes. The measurement was repeated 5 times under two different luminance level of screen (maximum and 3 cd/m2). RESULTS: Under maximum luminance background, the coefficients of variation (CV) and the reliability coefficients (RC) for the spatial frequencies examined in this study ranged from 2.1% to 29.3%, from 92.1% to 100.0%, respectively. Under 3cd/m2 luminance level of screen, the CV ranged from 2.7% to 32.0%, and the RC ranged from 90.7% to 99.9%. CONCLUSIONS: The results indicates that for the spatial frequencies examined, the morphoscopic contrast sensitivity test using ACV shows good reproducibility in glaucomatous patients.
Contrast Sensitivity* ; Glaucoma* ; Glaucoma, Open-Angle ; Humans

To investigate the relationship between Radiosensitivity and postirradiation recovery in human cancer cells, a study was performed using human cancer cell lines-A549, CaSki, SNU-C5 and PCI-13. for the study of radiosensitivity, single doses of 2, 4, 6, 8, 10, 12, and 14 Gy were given and for postirradiation recovery, two fractions of 4 Gy were separated with a time interval of 0, 0.5, 1,1.5, 2, 2.5, 3, 4, 5, or 6 hours. Surviving fraction was estimated using colony forming ability. Surviving fractions at 2 Gy (SF2) were 0.496 (0.570-0.412) for A549, 0.496 (0.660-0.332) for CaSki, 0.386 (0.576-0.216) for SNU-C5, and 0.185(0.247-0.123) for PCI-13. By statistical analysis the SF2 of PCI-13 was lower significantly than those of others (p<0.05). this difference was also observed at 4,6 and 8 Gy dose levels. At 6 and 8 Gy the surviving fractions of SMU-C5 were also lower significantly than A549 and CaSki(p<0.05). By the analysis with linear quadratic model, the value of alpha for A549, CaSki, SNU-C5 and PCI-13 were 0.3016, 0.3212, 0.4327 and 0.8423, respectively, and those of betawere 0.024929, 0.02009, 0.03349 and 0.00059, respectively. So, the value of alpha showed increasing tendency with decreasing SF2.By the multitarget single hit model the values of Do for A549, CaSki, SUN-C5 and PCI-13 were 1.97, 1.97,1.46 and 0.81, respectively, and those of n were 1.53, 1.50, 1.56 and 2.28, respectively. So, the value of Do decreased with decreasing SF2. Post-irradiation recovery reached plateau at around 2 hours. Recovery ratio at plateau phase ranged from 1.2 to 4.2; the value were 1.2 for PCI-13, 3.2 for CaSki, 3.3 for SNU-C5, and 4.2 for A549. Recovery rate well correlated with SF2, and increased with increasing Do and decreasing alpha. According to above results, the intrinsic radiosensitivity was quite different among the tested cell ilnes; PCI-13 was the most sensitive and A549 and CaSki was similar. This difference of radiosensitivity is thought to be partly due to the difference in amount of postirradiation recovery. By linear quadratic model the difference of alpha values was very high, and by multitarget single hit model the difference of Do value was significantly high among four cell lines.
Cell Line* ; Humans* ; Radiation Tolerance*

For evaluation of biological effect of p+(50.5 MeV) Be neutron beam produced by Korea Cancer Center Hospital(KCCH) cyclotron the RBE had been measured in experimental tumor Walker 256 carcinosarcoma as well as normal tissue, mouse intestine and bone marrow, in single and fractionated irradiation. As pilot study, the RBE had been measured for the mouse jejunal crypt cells in single whole body irradiation of which the result was 2.8. The obtained RBE values of TCD 50 of Walker 256 tumor, bone marrow and intestine in single irraiation were 1.9, 1.9 and 1.5 respectively. In fractionated irradiation, the RBE value of tumor Walker 256 was decreased as increasing of fraction number and increased as increaing of fraction size.
Animals ; Bone Marrow ; Carcinosarcoma* ; Cyclotrons ; Fast Neutrons* ; Intestines ; Korea ; Mice ; Neutrons ; Pilot Projects ; Whole-Body Irradiation