유방 종괴의 감별진단을 위한 탈륨 스캔의 유용성

염하용(Ha Yong Yum),배상균(Sang Kyun Bae),이충한(Chung Han Lee),최경현(Kyung Hyun Choi) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.2

N/A The purpose of this study is to evaluat.e thallium scanning as a potential test in differentiating malignant from benign lesions of breast. Thirty-one female pat,ients underwent thallium scan of the breast. After intravenous injection of 74-111 MBq(2-3 mCi)of thallium-201, anterior and lat,eral images were obtained. We cornpared thallium scans with pathological results. Of 11 patiens with breat cancers, 10 cases(90.9%) were detected using thallium scan. Thallium scan obtained in one pat,ient who had breast cancer but received several cycles of chemotherapy did not show thallium uptake. The smallest detect,able cancer was 1.5cm in diameter. ln contrast, there is no thallium accumulation in breasts of 17 of 20 patients with benign dis ease(85%), Three cases of 13 fibrocystic disease show thallium uptake in their breast. In conclusion, thallium scan is an effective test in differentiating benign from malignant lesion.

골수전이의 평가

염하용 ( Ha Yong Yum ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

CAPD 중에 생긴 흉막삼출 2예

염하용(Ha Yong Yum),배상균(Sang Kyun Bae),임학(Hark Rim) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

Massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) is relatively rare. A 67-year-old male and a 23-year-old female patients during CAPD presented massive pleural effusion, They have been performing peritoneal dialysis due to end-stage renal disease for 8 months and 2 weeks respectively. We injected 99mTc-labelled radiopharmaceutical (phytate and MAA, respec- tively) into peritoneal cavity witb the dialysate. The anterior, posterior and right lateral images were obtained. The studies reveal visible radioactivity in the right chest indicating the communication between the peritoneal and the pleural space. After sclerotherapy with tetracycline, the same studies reveal no radioactivity in the right chest suggesting successful therapy. We think nuclear imaging is a simple and noninvasive method for the differential diagnosis of pteural effusion in patients during CAPD and the evaluation of therapy.

전자선 에너지 및 조사야에 따른 유효선원 피부 간 거리 변화

양칠용,염하용,정태식,Yang, Chil-Yong,Yum, Ha-Yong,Jung, Tae-Sik 대한방사선종양학회 1987 Radiation Oncology Journal Vol.5 No.2

It is known that fixed source to skin distance (SSD) cannot be used when the treatment field is sloped or larger than the size of second collimator in electron beam irradiation and inverse square law using effective ssd should be adopted. Effective SSDs were measured in different field sizes in each 6, 9, 12, 15 and 18MeV electron energy by suing NELAC 1018D linear accelerator of Kosin Medical Center. We found important parmeters of effective SSD. 1. Minimum effective SSD was 58.8cm in small field size of $6\pm6cm$ and maximum effective SSD was 94.9cm in large field size of $25\pm25cm$, with 6MeV energy. It's difference was 36.1cm. The dose rate at measuring point was quite different even with a small difference of SSD in small field $(6\times6cm)$ and low energy (6 MeV). 2. Effective SSD increased with field size in same electron energy. 3. Effective SSDs gradually increased with the electron energies and reached maximum at 12 or 15 MeV electron energy and decreased again at 18MeV electron energy in each identical field size. And so the effective SSD should be measured in each energy and field size for practical radiotherapy.

비호지킨 림프종의 진단에서 갈륨 SPECT의 유용성 : 평면영상과 SPECT 영상의 비교

왕정,배상균,염하용 ( Jing Wang,Sang Kyun Bae,Ha Yong Yum ) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1

병기 III 자궁경부암의 방사선치료 결과

문창우,신병철,염하용,정태식,유명진,Moon, Chang-Woo,Shin, Byung-Chul,Yum, Ha-Yong,Jeung, Tae-Sig,Yoo, Myung-Jin 대한방사선종양학회 1995 Radiation Oncology Journal Vol.13 No.3

Purpose : The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. Materials and Methods : From January 1980 through December 1985, 227 patients with stage III uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients($317{\%}$) were stage IIIa, and 155 patients($68.3{\%}$) were stage IIIb according to FIGO classification. Age distribution was 32-71 years (median: 62 years). Sixty nine patients($95.8{\%}$) in stage IIIa and 150 patient ($96.8{\%}$) in stage IIIb were squamous cell carcinoma. pelvic lymph node metastasis at initial diagnosis was 8 patients($11.1{\%}$) in stage IIIa and 29 patients($18.7{\%}$) in stage IIIb, Among 72 patients with stage IIIa, 36 patients ($50{\%}$) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr.) and 36 patients($50{\%}$) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with $Cs^{137}$ sources, and among 155 patients with stage IIIb, 80 patients ($51.6{\%}$) were treated with external radiation therapy alone and 75 patients ($48.4{\%}$) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median: 78.5 Gy) and 65-125.5 Gy (median 83.5 Gy). Survival rate was calculated by life-table method. Results : Complete response rates were $58.3{\%}$(42 patients) in stage IIIa and $56.1{\%}$(87 patients) in stage IIIb. Overall 5 year survival rates were $57{\%}$ in stage IIIa and $40{\%}$ in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were $64{\%},\;40{\%}$ in the group treated in combination of external radiation and ICR, and $50\%,\;40\%$ in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were $90\%,\;66\%$ in responder group and $10\%,\;7\%$ in non-responder group (P<0.001) There were statistically no significant differences of 5 year survival rate by total radiation doses and external radiation doses(40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatment failures rates were $40.3\%$(29 patients) in stage IIla and $57.4\%$(89 patients) in stage IIIb. 17 patients ($23.6\%$) in stage IIIa and 46 patients ($29.7\%$) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa($50\%$) and IIIb($50\%$). Serious complication rates were higher in group received external radiation doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Serious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of death was cachexia due to locoregional failure in both stage IIIa($34.7\%$) and IIIb($43.9\%$). Conclusion : From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy to whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.

6MV 선형가속기의 비대칭 조사야의 변화에 따른 선량분포

윤주호,이철수,염하용,Yoon, Joo-Ho,Lee, Chul-Soo,Yum, Ha-Yong 대한방사선치료학회 2000 大韓放射線治療技術學會誌 Vol.12 No.1

Recently linear accelerator in radiation therapy in asymmetric field has been easily used since the improvement and capability of asymmetrical field adjustment attached to the machine. It has been thought there have been some significant errors in dose calculation when asymmetrical radiation fields have been utilized in practice of radiation treatments if the fundamental data for dose calculation have been measured in symmetrical standard fields. This study investigated how much the measured data of dose distributions and their isodose curves are different between in asymmetrical and symmetrical standard fields, and how much there difference affect the error in dose calculation in conventional method measured in symmetrical standard field. The distributions of radiation dose were measured by photon diode detector in the water phantom (RFA-300P, Scanditronix, Sweden) as tissue equivalent material on utilization of 6 MV linear accelerator with source surface distance (SSD) 1000 mm. The photon diode detector has the velocity of 1 mm per second from water surface to 250 mm depth in the field size of $40mm{\times}40mm\;to\;250mm{\times}250mm\;symmetric\;field\;and\;40mm{\times}20mm\;to\;250mm{\times}125mm$ asymmetrical fields. The measurements of percent depth dose (PDD) and subsequent plotting of their isodose curves were performed from water surface to 250mm dmm from Y-center axis in $100mm{\times}50mm$ field in order to absence the variability of depth dose according to increasing field sizes and their affects to plotted isodose curves. The difference of PDD between symmetric and asymmetric field was maximum $4.1\%\;decrease\;in\;40mm{\times}20mm\;field,\;maximum\;6.6\%\;decrease\;in\;100mm{\times}50mm\;and\;maximum\;10.2\%\;decrease\;200mm{\times}100mm$, the larger decrease difference of PDD as the greater field size and as greater the depth, The difference of PDD between asymmetrical field and equivalent square field showed maximum $2.4\%\;decrease\;in\;60mm{\times}30mm\;field,\;maximum\;4.8\%\;decrease\;in\;150mm{\times}75mm\;and\;maximum\;6.1\%\;decrease\;in\;250mm{\times}125mm$, and the larger decreased differenced PDD as the greater field size and as greater the depth, these differences of PDD were out of $5\%$ of dose calculation as defined by international Commission on radiation unit and Measurements(ICRU). In the dose distribution of asymmetrical field (half beam) the plotted isodose curves were observed to have deviations by decreased PDD as greater as the blocking of the beam moved closer to the central axis, and as the asymmetrical field increased by moving the block 10 mm keeping away from the central axis, the PDD increased and plotted isodose curves were gradually more flattened, due to reduced amount of the primary beam and the fraction of low energy soft radiations by passing thougepth in asymmetrical field by moving independent jaw each 10 h beam flattening filter. As asymmetrical radiation field as half beam radiation technique is used, the radiation dosimetry calculated in utilizing the fundamental data which measured in standard symmetrical field should be converted on bases of nearly measured data in asymmetrical field, measured beam data flies of various asymmetrical field in various energy and be necessary in each institution.

방사성옥소 섭취를 보이지 않은 갑상선 유두암에서 Retinoic acid 치료

배상균(Sang Kyun Bae),염하용(Ha Yong Yum) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.6

N/A

하인두암의 방사선치료

신병철(Byung Chul Shin),염하용(Ha Yong Yum),문창우(Chang Woo Moon),정태식(Tae Sik Jeong) 대한방사선종양학회 2002 Radiation Oncology Journal Vol.20 No.3

목적 : 하인두암 환자에서 방사선단독치료와 항암화학요법 병용치료시의 반응과 생존율, 그리고 합병증에 영향을 미치는 요소를 알아보고자 하였다. 대상 및 방법 : 1984년 1월부터 1999년 12월까지 고신대학교 복음병원 치료방사선과에서 치료를 받았던 환자 중 근치적 목적으로 방사선치료 단독 또는 항암화학요법과 병용치료를 받았던 56명을 대상으로 후향적 조사를 하였다. 방사선 단독치료(Group I)가 24명(42.9%), 항암화학방사선치료(Group II)가 32명(57.1%)이었다. 방사선치료는 정규분할 조사법으로 9명(16.4%), 과분할조사로 분할선량이 1.15~1.2 Gy인 경우가 26명(47.2%), 1.35 Gy인 경우가 18명(32.7%), 가속과분할조사로 2명(3.6%)이 치료받았으며 총 방사선량은 40.5~83.5 Gy (평균선량 68.3 Gy)이었다. 항암화학요법은 cisplatin 100 mg/㎡을 day 1에, 5-FU 1,000 mg/㎡를 day 2~6에 방사선치료에 선행해서 사용하였으며 3주 간격으로 시행하였고 환자에 따라 1회에서 3회까지 시행하였다(평균 2.3회). 추적관찰기간은 1개월에서 195개월 이었고 중앙값은 28개월이었다. 결과 : 전체 대상 환자들의 3년 및 5년 생존율은 40.6%, 27.6%였고, Group I은 50.0%, 30.0%, II는 36.4%, 26.3%였다. 국소제어율은 Group I에서 완전관해율이 70.0%, Group II에서는 완전관해율이 67.7%였다. 생존율에 영향을 미치는 예후인자로는 방사선치료에 대한 반응과 림프절 병기로 나타났다. 항암화학요법을 병용한 군에서 합병증 발생율이 높았으나 다분할 조사군에서는 정규분할조사군보다 적게 나타났다. 결론 : 하인두암의 방사선치료 결과는 방사선치료에 대한 반응과 경부 림프절 병기에 따라 좌우되었다. Cisplatin, 5-FU를 방사선치료 전 선행하여 1~3회 사용하는 것은 하인두암의 국소제어율과 생존율에 가치가 없는 것으로 증명되었으며 오히려 합병증을 높이는 것으로 판명되었다. 다분할 방사선치료는 후기 합병증을 저하시키는 것으로 판명되었다. Purpose : The aim of this study was to assess the effectiveness, survival rate and complications of radiation therapy and chemoradiation treatment in hypopharyngeal cancer. Methods and Materials : From January 1984 to December 1999, 56 patients who had hypopharyngeal carcinoma treated with curative radiation therapy were retrospectively studied. Twenty four patients (42.9%) were treated with radiation therapy alone (Group I) and 32 (57.1%) treated with a combination of chemotherapy and radiation (Group II). Total radiation dose ranged from 40.5 to 83. 5 Gy (median 67.9 Gy). Radiotherapy was given with conventional technique in 9 patients (16.4%), with hyperfractionation I (1.15~1.2 Gy/fr., BID) in 26 (47.2%), hyperfractionation II (1.35 Gy/fr., BID) in 18 (32.7%), and accelerated fractionation (1.6 Gy/fr., BID) in 2 (3.6%). In chemotherapy, 5-FU (1,000 mg/㎡ daily for 5 consecutive days) and cisplatin (100 mg/㎡ on day 1) were administered in a cycle of 3 weeks interval, and a total of 1 to 3 cycles (average 2..3 cycles) were given prior to radiation therapy. Follow up duration was 1~195 months (median 28 months). Results : Overall 2 and 5 year survival rates were 40.6% and 27.6% 50.0% and 30.0% in Group I, and 36.4% and 26.3% in Group II, respectively. Complete local control rates in Group I and II were 70.0% and 67.7%, respectively. The response to radiotherapy and nodal stage were statistically significant prognostic factors. The complication rate was increased in Group II and was decreased in hyperfractionation. Conclusion : The response to radiotherapy and nodal stage were valid factors to indicate the degree of control over the hypopharyngeal cancer. The induction cisplatin, 5-Fu chemotherapy was not valid in terms of local control rate and survival rate, but did contribute to an increased complication rate. The use of hyperfractionation was valid to reduce the late radiation complications.

Radiotherapy of Carcinoma of Maxillary Antrum

문창우(Chang woo Moon),정태식(Tae Sig Jeung),염하용(Ha Yong Yum) 대한방사선종양학회 1994 Radiation Oncology Journal Vol.12 No.1

1980년 6월부터 1986년 12월까지 고신의료원 치료방사선과에서 방사선 치료를 받았던 상악동 암환자 79예에서 생존율과 치료실패에 대해 후향적으로 비교 분석하였다. 43예에서는 방사선 단독 치료를 하였고, 36예에서는 수술과 방사선 치료를 병용 하였다. 전체 환자들의 5년 생존율은 32% 엿으며 방사선 단독 치료만을 받았던 환자들의 5년 생존율은 23% 였으며 수술과 방사선 치료를 병용한 환자들의 5년 생존율은 42%였다. 전체 환자 79예중 54예(68.3%)였고 국소치료 실채 및 원격전이가 동시에 나타난 경우가 16예(29.6%)였으며 원격전이 단독으로 인한 경우가 1예였다. 상기와 같은 치료결과에서 상악동 암의 국소치료율을 높이고 생존율을 증가시키기 위해서는 방사선 단독 치료보다는 수술과 방사선 치료의 병용 요법이 필요할 것으로 사료된다. Seventy-nine patients with carcinoma of maxillary antrum treated at the department of therapeutic radiology, Kosin Medical Center, between June 1980 and December 1986 were analyzed retrospectively for survival rate and treatment failure. Forty-three patients were treated with radiotherapy alone and thirty-six patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32%, patients that were treated with radiotherapy alone had a 5-year survival rate of 23%, and patients who were treated with combination of surgery and radiotherapy had a 5-year survival rate of 42%. 54 patients(68.4%) failed to be cured. Among these 54 patients, 37 patients (68.5%) had only locoregional failure. 16 patients(29.6%) had locoreginonal failure and distant metastases and 1patients had only distant metastasis. From above study combination of surgery and radiotherapy might be a better treatment modality for carcinoma of the maxillary antrum.