Three-dimensional dose calculations based on CT images are fundamental to stereotactic radiosurgery for small intracranial tumor. In our stereotactic radiosurgery program, irradiations have been performed using the 6 MV photon beam of linear accelerator after stereotactic CT investigations of the target center through the beam's-eye view and the coordinates of BRW frame converted to that of radiosurgery. Also we can describe the tumor diameter and the shape in three dimensional configuration. Non-coplanar irradiation technique was developed that it consists of a combination of a moving field with a gantry angle of 140degree, and a horizontal couch angle of 200degreearound the isocenter In this radiosurgery technique, we provide the patient head setup in the base-ring holder and rotate around body axis. The total gantry moving range shows angle of 2520 degrees via two different types of gantry movement in a plane perpendicular to the axis of patient. The 3-D isodose cuties overlapped to the tumor contours in screen and analytic dose profiles in calculation area were provided to calculate the thickness of 80% of tumor center dose to 20% of that. Furtheremore we provided the 3-D dose profiles in entire calculation plane. In this experiments, measured isodose cuties in phantom irradiation have shown very similar to that of computer generations.
Axis, Cervical Vertebra ; Family Characteristics ; Head ; Humans ; Particle Accelerators* ; Radiosurgery*

Fibrofolliculoma is a benign follicular neoplasm which usually occurs in multiple and rarely solitarily. We have found only seven cases of previous reports of solitary fibrofolliculomas worldwide and only two in Korean literature. Herein we report on a 40-year-old female patient with a solitary flesh-colored bean sized mass on the scalp which histopathologically proved to be a fibrofolliculoma.
Adult ; Female ; Humans ; Scalp

From the Department of Dermatology, College of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505, Banpo-Dong, Seocho-Gu, 137-040, Seoul, Korea, Gastrointestinal stromal tumors are usually late manifestations of neurofibromatosis (von Recklinghausen's disease) and most become clinically apparent in middle-aged patients as multiple benign tumors. To our review of the literature, solitary malignant stromal tumor of gastrointestinal tract is exceptionally rare in von Recklinghausen's disease. We herein present a case of solitary jejunal stromal tumor in a 50-year-old woman with NF1, which histopathologically showed a malignant change and combined smooth muscle-neural type.
Dermatology ; Female ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Korea ; Middle Aged ; Neurofibromatoses* ; Neurofibromatosis 1* ; Seoul

No abstract available.
Child* ; Humans ; Pheochromocytoma*

No abstract available.
Cytomegalovirus Infections*

PURPOSE: This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. MATERIALS AND METHODS: Seventy-six patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system, there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage IIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months. RESULTS: Complete response (CR) rate were 86.1% in radiation alone group and 80% in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was 67.3%. According to stage, overall five-year survival rates were 74% in stage IIb, 66.7% in stage IIIa, 49.8% in stage IIb, 50% in stage IVa. According to treatment modality overall five year survival rates were 74.1% in radiation alone and 61.4% in chemoradiation group (P=0.4). Five year local failure free survival rates were 71.5% in radiation alone group and 60% in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were 80.7% in radiation alone group and 89.9% in chemoradiation group (P=0.42). Bone marrow suppression (more than grade II) was noted in 4 patients (11.1%) of radiation alone and 9 patients (22.5%) of chemoradiation group. Grade II vesical complication was noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients in chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. CONCLUSION: There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.
Bone Marrow ; Cisplatin ; Drug Therapy* ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Metastasis ; Radiation Oncology ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with glassy cell carcinoma of cervix. MATERIALS AND METHODS: We reviewed all cases of glassy cell carcinima of the uterine cervix confirmed and treated at the Dongsan Medical Center, Keimyung University, between January 1993 and December 2005. There were 7 cases with histopathologically confirmed gassy cell carcinoma. A tumor was diagnosed as glassy cell carcinoma if over 50% of the tumor cell type displayed glassy cell features. Six patients with stage IB had radical hysterectomy and bilateral pelvic node dissection, and 2 of them received adjuvant external pelvic irradiation with concurrent chemotherapy. Remaining one patient with stage IIA had curative concurrent chemoradiotherapy with external pelvic irradiation and brachytherapy. RESULTS: There were 7 patients diagnosed as glassy cell carcinoma among the 3,745 (0.2%) patients of carcinoma of uterine cervix. The mean age of 7 patients was 44 years with range of 35 to 53 years of age. The most frequent symptom was vaginal bleeding (86%). By the punch biopsy undertaken before treatment of 7 cases, 2 only cases could diagnose as glassy cell carcinoma of uterine cervix, but remaining of them confirmed by surgical pathological examination. The mean follow up duration was 73 months with range of 13 to 150 months. All 7 patients were alive without disease after treatment. CONCLUSION: Glassy cell carcinoma of the uterine cervix is a distinct clinicopathologic entity that demonstrates an aggressive biologic behavior. However for early-stage disease, we may have more favorable clinical outcome with radical surgery followed by chemoradiothery.
Biopsy ; Brachytherapy ; Cervix Uteri* ; Chemoradiotherapy ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Uterine Hemorrhage

PURPOSE: To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. MATERIAL AND METHODS: From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage Ia, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was performed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was 2,100~5,400 cGy and the range of the total radiation dose was 3,780~8,550 cGy. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. RESULTS: Fourteen of eighteen patients (78%) had local control just after reirradiation. The two year disease free survival (2YDFS) rate was 53.6%. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS 28.5% in uterine cervix, 71.4% in vagina, ( p=0.03)) and the total dose (2YDFS 71.8% in >6,000 cGy , 25% in < OR = 6,000 cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, 39%). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. CONCLUSION: In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.
Aged ; Cervix Uteri ; Cystitis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hematuria ; Hemorrhage ; Humans ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Recurrence ; Uterine Cervical Neoplasms* ; Uterus ; Vagina

BACKGROUND: Recently, laparoscopic cholecystectomy becomes more favorite method than traditional open cholecystectomy. But postoperative pain control is still remaining problem. METHOD: Patients scheduled for elective laparoscopic cholecystectomy were assigned to two groups by simple randomization (15 patients per group). Group C (control) had no specific treatment and group B (bupivacaine) received 20 ml of 0.5% bupivacaine with epinephrine 1:200,000 before surgery. Immediately after the creation of a pneumoperitoneum, the surgeon sprayed the bupivacaine near and above the operation field. Operation was started 10 minutes after then. We attempted to investigate that the degree of postoperative pain which was assessed using the visual analogue scale (VAS) and the verbal rating scale (VRS) in the recovery room at postoperative 1 h., as well as the analgesic requirements during the first 24 h. postoperatively. RESULT: VRS of group B was significantly lower than group C (p<0.05), but VAS was not significantly different. Six patients in group B and only one in group C requested no analgesics. Group C had statistically more frequent request for analgesics than group B (p<0.05). CONCLUSION: The topical intraperitoneal anesthesia of 20 ml of 0.5% bupivacaine with epinephrine 1 : 200,000 before laparoscopic cholecystectomy is effective on the postoperative pain control. So, we recommmend that this simple and effective management is routinely treated in patients undergoing laparoscopic cholecystectomy.
Analgesics ; Anesthesia* ; Bupivacaine* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Epinephrine ; Humans ; Pain, Postoperative* ; Pneumoperitoneum ; Random Allocation ; Recovery Room

The quasi-conformation therapy was performed to get a homogeneous dose distributions for irregeular shaped tumor lesion by using the arc moving beam and beam modifying filer which was made by cerrobend alloy (p=9.4g/cc) metal. In our dose calcuation programme, it was fundmentally based on Clarkson's method to calcuate the irregular multi-step block field in rotation therapy. In this study, the expected relative depth doses under multipartial attenuator agree well with measured data at same plane. The results of comparison the dose computation with that of TLD measurement are very closed within +/-5% uncertainties in the irradiation to phantom with quasi-comformation method. And it has shown that irregular typed multi-step filter can be applied to quasi-conformation therapy in high energy radiation plannings.
Alloys ; Radiotherapy*