Myelography is widely used fo radiological diagnosis of herniated lumbar disc. But the diagnositc accuracy isonly about 84% with range of 67 to 100% with many cases of false negative and equivocal cases. In cases of extremelateral disc herniation and short cul de sac or wide epidural space, even quite a large disc herniation cannot bedetected to myelography. But with epidural venography these defects of myelography can easily be over come. 52cases of epidural venography were performed in department of Radiology of Capital Armed Forces General Hospitalduring the 20 months from May 1979 to Dec. 1980. And the findings were compared with those of myelography andoperative results. The results are as follows; 1. Of 52 cases, satisfactory opacification was obtained in 48 cases(92.3%). 2. Single vein injection was adequate for satisfactory opacification in 40 cases (76.9%). 3. There were 2cases of retroperitoneal extravasation of contrast media, but the patient recovered without difficulty. 4. Of 24cases operated, the venographic finding was confirmed in 21 casesa (87.5%) and of the 48 cases adequatelyopacified, there were only 3 cases of confirmed diagnostic error and so the error rate is only 6.25%. 5. Abnormalfindings of myelography were exactly reproduced on epidural venography and many cases with equivocal or normalmyelographic findings were accurately diagnosed with epidural venography. 6. In cases of total block, epiduralvenography was very useful for evalutaion of the caudal portion. So lumbar epidural venography is very useful notonly as an adjunctive method to myelography, but also as the first diagnostic procedure for herniated disc, forthe procedure is simple and the diagnostic accuracy is very high.
Arm ; Diagnosis ; Diagnostic Errors ; Epidural Space ; Extravasation of Diagnostic and Therapeutic Materials ; Humans ; Intervertebral Disc Displacement ; Methods ; Myelography ; Phlebography ; Veins

No abstract available.
Fever* ; Microwaves*

PURPOSE: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. MATERIALS AND METHODS: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. RESULTS: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The V20 Gy of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. CONCLUSION: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.
Head ; Humans ; Neutrons ; Organs at Risk ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

The funding acknowledgment in this article was omitted as published.

A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography(IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, 10.7%(49/456) and 5/3%(24/452) showed abnormality, respectively, but only 0.7% (3/413) did on signoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six (5.1%) out of 510 patients were upstaged from the stage determned by the findings of physical examination alone. The proportions of upataging in each stage were as follows none in stage IB(35), IIA (89) and IIIA(8), 7.9%(20/252) in stage IIB(14 patients to FIGO Stage IIIB, 6 patients to FIGO stage IVA), and 4.8% (6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in 25.2% (85/337) and paraaortic LN enlargement in 7.4% (25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in 65.6%(442/674). When compared with endoscopic studeies, CT had much lower positive predicitive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-ups may be increased without compromising the appropriate FIGO staging and treatment.
Cervix Uteri* ; Cystoscopy ; Female ; Humans ; Lymph Nodes ; Physical Examination ; Sigmoidoscopy ; Uterine Cervical Neoplasms

No abstract available.
Fever* ; Thermometry* ; Ultrasonography*

No abstract available.
Cyclophosphamide*

Whole brain irradiation is one mode in the treatment of brain cancer and brain metastasis, but it might cause brain injury such as brain necrosis. It has been studied whether the dose distribution could be a cause of brain injury. The dose distribution in whole brain irradiated by Co-0 beam has been measured by means of calibrated TLD chips inserted in the brain of Humanoid phantom. The following results were obtained. 1. Dose distribution on each transverse section of the brain was uniform. 2. On the midsagital plane of the brain, the dose was highest in upper portion and lowest in lower portion, varying 8 from 104% to 90%. 3. When the radiation field includes free space of 2cm or more width out of the head, the dose distribution in the whole brain is almost independent of the field width. 4. It is important to determine adequate shielding area and to set shielding block exactly in repetition of treatment.
Brain Injuries ; Brain Neoplasms ; Brain* ; Head ; Necrosis ; Neoplasm Metastasis ; Radiotherapy*

PURPOSE: This study was done to evaluate the efficacy of low-dose radiation in reduction of thoracic vertebral metastases in patients with breast cancer. MATERIALS AND METHODS: 109 patients who were treated for bone metastasis from breast cancer from June, 1988 to June, 1998 in the Department of Therapeutic Radiology, Seoul National University were included. Of the 109 patients, 40 patients had been previously treated by postoperative radiotherapy and 69 had not. Postoperative radiotherapy had been given using Co-60 teletherapy device in 30 patients or 6 MV linear accelerator in 10. Thoracic spines from 1 to 10 were usually irradiated except in 1 patient and cervical vertebrae 6 and/or 7 were partially included in 38 patients. A total of 50.4 Gy was given with 1.8 Gy fraction. Metastatic bone diseases were scored in 11 regions, i. e., skull, cervical spine, thoracic spine from 1 to 4, from 5 to 8, 9 and 10, 11 and 12, lumbar spine, pelvis, femur, ribs and others. RESULTS: In no postoperative parasternal irradiation group, lumbar vertebrae were the most common metastatic sites (55.1%) followed by pelvis (44.9%), ribs (40.6%), thoracic vertebrae 11 and 12 (37.7%), thoracic vertebrae between 5 and 8 (36.2%), thoracic vertebrae 9 and 10 (34.8%), and thoracic vertebrae between 1 and 4 (26.1%). In postoperative parasternal irradiation group, lumbar vertebrae and pelvis were also the most common sites of metastases (55.0% both) followed by ribs (37.5%), and thoracic vertebrae 11 and 12 (32.5%). But significant less metastases were seen at thoracic vertebrae from 1 to 10. CONCLUSION: We can find that there were significantly less bony metastases at thoracic vertebrae which had been previously irradiated postoperatively.
Bone Diseases ; Breast Neoplasms* ; Breast* ; Cervical Vertebrae ; Female ; Femur ; Humans ; Lumbar Vertebrae ; Neoplasm Metastasis* ; Particle Accelerators ; Pelvis ; Radiation Oncology ; Radiotherapy* ; Ribs ; Seoul ; Skull ; Spine ; Thoracic Vertebrae

From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stageIIA. In stage IB, five year locoregional control, five year disease A, five year locoregional control, five disease free survival, and five year overall survival were 78.0%, 66.8%, and 72.1%, respectively. To identify prognostic factor, pretreatment including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physical examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overal survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant pronostic factor on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregional control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivarate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.
Cervix Uteri* ; Classification ; Diabetes Mellitus ; Disease-Free Survival ; Female ; Humans ; Hypertension ; Multivariate Analysis ; Physical Examination ; Pregnancy ; Radiotherapy ; Retrospective Studies ; Uterine Cervical Neoplasms