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Jeju, South Korea

Chae S.-M.,Cheju Halla General Hospital | Lee G.W.,Cheju Halla General Hospital | Son S.H.,Catholic University of Korea
Radiation Oncology

Purpose: We aim to evaluate the effects of multileaf collimator (MLC) leaf width (5 mm vs. 2.5 mm) on the radiosurgery planning for the treatment of spine lesions according to the modulated techniques (intensity-modulated radiotherapy [IMRT] vs. volumetric-modulated arc therapy [VMAT]) and the complexity of the target shape. Methods: For this study, artificial spinal lesions were contoured and used for treatment plans. Three spinal levels (C5, T5, and L2 spines) were selected, and four types of target shapes reflecting the complexity of lesions were contoured. The treatment plans were performed using 2.5-mm and 5-mm MLCs, and also using both static IMRT and VMAT. In total, 48 treatment plans were established. The efficacy of each treatment plan was compared using target volume coverage (TVC), conformity index (CI), dose gradient index (GI), and V30%.Results: When the 5-mm MLC was replaced by the 2.5-mm MLC, TVC and GI improved significantly by 5.68% and 6.25%, respectively, while CI did not improve. With a smaller MLC leaf width, the improvement ratios of the TVC were larger in IMRT than VMAT (8.38% vs. 2.97%). In addition, the TVC was improved by 14.42-16.74% in target type 4 compared to the other target types. These improvements were larger in IMRT than in VMAT (27.99% vs. 6.34%). The V30% was not statistically different between IMRT and VMAT according to the MLC leaf widths and the types of target. Conclusion: The smaller MLC leaf width provided improved target coverage in both IMRT and VMAT, and its improvement was larger in IMRT than in VMAT. In addition, the smaller MLC leaf width was more effective for complex-shaped targets. © 2014 Chae et al.; licensee BioMed Central Ltd. Source

Moon M.S.,Cheju Halla General Hospital
Journal of orthopaedic surgery (Hong Kong)

PURPOSE. To report on 23 patients with giant cell tumour (GCT) of the femur or tibia treated with curettage, electrocautery, burring, phenol irrigation, and cementation. METHODS. Records of these 14 men and 9 women aged 22 to 38 (mean, 31) years were reviewed. The most common site involved was the distal femur (n=13), followed by proximal tibia (n=8), proximal femur (n=1), and distal tibia (n=1). The lesions were classified as grade I (n=3), grade II (n=18), and grade III (n=2). Based on histology, the tumour stage was classified as grade I (n=5) and grade II (n=18). Two of these patients had recurrences, which were initially treated with simple curettage and bone grafting of the distal femur and distal tibia. RESULTS. The mean follow-up period was 5.7 (range, 2.5-10.1) years. 14 of the 23 patients were followed up for over 10 years. No patient developed any local recurrence, remote metastasis, or complication related to surgery or adjuvant therapy. CONCLUSION. Combined treatment entailing curettage, electrocautery, burring, phenol irrigation, and cementation was effective in treating GCT of bone. Source

Cho K.B.,Keimyung University | Jeon W.J.,Cheju Halla General Hospital | Kim J.J.,Sungkyunkwan University
World Journal of Gastroenterology

The high incidence of gastric cancer has led to the initiation of cancer screening programs. As a result, the number of early gastric cancer cases has increased and consequentially, the cancer mortality rate has decreased. Moreover, the development of minimally invasive endoscopic treatment has been introduced for these early lesions. Endoscopic submucosal dissection (ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis. We review the results of ESD including experiences in Japan and Korea, as well as western countries. © 2011 Baishideng. Source

Moon M.S.,Cheju Halla General Hospital
Journal of orthopaedic surgery (Hong Kong)

To evaluate the morphologies of congenital C2-3 synostosis in 25 patients. Radiographs of 11 males and 14 females aged 5 to 74 years with congenital C2-3 synostosis were reviewed. All cases were found incidentally on radiographs when presenting with neck/shoulder discomfort/pain. 13 of the patients had spondylosis in 21 segments: C1-2 (n=1) and C3-4 (n=1), C4-5 (n=7), C5-6 (n=9), and C6-7 (n=3). Of whom 12 had normal sagittal alignment and one had kyphotic synostosis (who developed compensatory hyperlordosis of the caudal mobile segments and subsequent spondylosis at C3-4 and C5 retrolisthesis). The remaining 12 patients had no spondylosis and had normal sagittal alignment, but had other associated pathologies including disc herniation at C3-4, C1 ring hypoplasia, and calcification of the nuchal ligament. Normally aligned congenital synostosis of C2-3 is rarely associated with a junctional problem, whereas a kyphotic synostosis is associated with a caudal junctional problem. Spondylosis developing after age 40 years is not associated with C2-3 synostosis. Source

Cha B.H.,Cheju Halla General Hospital | Bae J.-M.,Jeju National University
Asian Pacific Journal of Cancer Prevention

Background: Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Materials and Methods: Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2008 and November 2011, were enrolled and divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Results: Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) were identified as IGBC and NIGBC, respectively. The proportions of patients with gallstone disease, gallbladder polyp, and cholecystectomy were significantly different between the two groups. Additionally, the median survival rate was significantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confidence interval, 5.6-13.7 vs 4.0, 95% confidence interval 3.03-5.96 months; p=0.01) during a median follow-up period of 5.7 months. Conclusions: Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo advanced work-up for chelecystectomy. Source

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