• Title, Summary, Keyword: Prescription dose level

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Determining the Optimal Dose Prescription for the Planning Target Volume with Stereotactic Body Radiotherapy for Non-Small Cell Lung Cancer Patients

  • Liu, Xi-Jun;Lin, Xiu-Tong;Yin, Yong;Chen, Jin-Hu;Xing, Li-Gang;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2573-2577
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    • 2016
  • Objective: The aim of this study was to determine a method of dose prescription that minimizes normal tissue irradiation outside the planning target volume (PTV) during stereotactic body radiotherapy (SBRT) for patients with non-small cell lung cancer. Methods: Previous research and patients with typical T1 lung tumors with peripheral lesions in the lung were selected for analysis. A PTV and several organs at risk (OARs) were constructed for the dose calculated; six treatment plans employing intensity modulated radiotherapy (IMRT) were produced, in which the dose was prescribed to encompass the PTV, with the prescription isodose level (PIL) set at 50, 60, 70, 80, 90 or 95% of the isocenter dose. Additionally, four OARs around the PTV were constructed to evaluate the dose received in adjacent tissues. Results: The use of higher PILs for SBRT resulted in improved sparing of OARs, with the exception of the volume of lung treated with a lower dose. Conclusions: The use of lower PILs is likely to create significant inhomogeneity of the dose delivered to the target, which may be beneficial for the control of tumors with poor conformity indices.

Cyberknife Dosimetric Planning Using a Dose-Limiting Shell Method for Brain Metastases

  • Yoon, Kyoung Jun;Cho, Byungchul;Kwak, Jung Won;Lee, Doheui;Kwon, Do Hoon;Ahn, Seung Do;Lee, Sang-Wook;Kim, Chang Jin;Roh, Sung Woo;Cho, Young Hyun
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.753-760
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    • 2018
  • Objective : We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs). Methods : We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans ($CK_{original}$) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at low-isodose levels (10-30% of prescription dose) for dose spillage. In each case, a modified CK plan ($CK_{modified}$) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared. Results : There were no differences in the conformity indices among the $CK_{original}$, $CK_{modified}$, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the $CK_{modified}$ plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the $CK_{original}$ plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345). Conclusion : These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.

Combinational Treatment of Oral Chenggihaedok-san and Topical Solar salt on Atopic Dermatitis (아토피피부염에 대한 천일염(天日鹽)과 청기해독산(淸肌解毒散)의 병용 투여 효과)

  • An, Hwang-Yong;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1431-1443
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    • 2009
  • In order to investigate the therapeutic effect of SSC, NC/Nga animal model resembling the AD-like symptoms were used to measure the changes in cytokines and histology. SSC prescription group showed significant decrease in the atopic dermatitis clinical index by 40.2% compared to that of the control. The SSC prescription had significant effect on immune cells that are related to inducing AD symptoms. SSC prescription also increased the ratio of immune cells in DLN that were not directly involved in AD symptoms. SSC prescription group showed significant decrease in the level of cytokines within spleen cells and DLN. The prescription also decreased the level of immunoglobulin IgE levels in serum by 25.3%. The thickness of epidermis and dermis as well as the precipitation of erythrocytes were also observed. The results indicate the therapeutic effect of SSC in the treatment of atopic dermatitis through immune modulation. The study will provide a broader applications in the treatment of atopic dermatitis. Particularly, skin regeneration effect and supplemental use of topical application of SS in atopic dermatitis treatment had been reported previously, and further investigation on the dose dependent effect as well as skin irritation studies of SS should be followed.

High dose vitamin D injection induced severe hypercalcemia (비타민 D 고용량 주사로 인한 심한 고칼슘혈증 발생 1예)

  • Lee, Sang Ah;Moon, Jae Cheol
    • The Journal of Medicine and Life Science
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    • v.16 no.1
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    • pp.31-33
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    • 2019
  • Hypercalcemia is often seen in patients, but most of them showed mild to moderate hypercalcemia. The severe hypercalcemia with a blood calcium level of 14.0 mg/dL or more is known to be associated mainly with malignant tumors. Because this is emergency status, most clinicians tried to decrease serum calcium level to near normal range to improve symptoms related to hypercalcemia. A 71-year-old female patient visited the emergency room with dizziness and general weakness. Her serum calcium level was very high (15.6 mg/dL), but serum PTH, 25-OH vitamin D, and PTH related peptide were normal. We can exclude hyperparathyroidism, familial hypocalciuric hypercalcemia, other connective tissue diseases, and hypercalcemia due to malignant tumors as a cause of severe hypercalcemia. Conclusively, we diagnosed as severe hypercalcemia due to high-dose vitamin D injections treated one week ago. High dose vitamin D injections have recently been shown to increase the frequency of prescription as the various causes and the clinicians needed to carefully monitor the serum calcium levels in the patients after treating with high dose vitamin D.

Effect of Ohjeoksan-Decoction on Brain Metal Level in Rats (오적산을 투여한 흰쥐의 뇌중 금속농도변화에 관한 연구)

  • Min Dae Ki;Han Seong Nim;Ko Seong Gyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.967-975
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    • 2002
  • This study was to investigate the metal accumulation from Ohjeoksan-Decoction to rat brain(Sprague Dawley). 1. In Control group, each metal concentration was within 26.65mg/kg, and in each experimental groups, was within 28.39mg/kg. And, there were no significant metal concentration between control and experimental groups. Exceptionally, Cr and Ni level of control group was lower than experimental groups significantly. (p<0.05) and Cr and Ni level of experimental I group was lower than other experimental groups too.(p<0.05). But, Pb level of control group was higher than experimental groups significantly.(p<0.05) Pb level of experimental I group was higher than other experimental groups(p<0.01). 2. In non-hazardous, hazardous and total metal concentration, there was no increase tendency in brain according to the high dose of OD(Ohjeoksan-Decoction) intake. Reversely, in experimental groups, hazardous metal concentration was decrease by high OD intake.(p<0.05). 3. Correlation among each metal in brain was various in each groups. Briefly under the intake of Ohjeoksan-Decoction, that is very busy herb prescription, this study was defined within safety in brain metal level by P.O. during 10 days. But, there should be a more research about Pb increase by high dose OD intake

Antidiabetic effect and mechanisms of SPH-1 in db/db mice

  • Kang, Kwi-Man;Cho, Hee-Jae;Chung, Sung-Hyun
    • Proceedings of the PSK Conference
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    • pp.263.2-264
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    • 2002
  • SPH-l is a herbal medicine composing oriental prescription. We have studied the antidiabetic effect and mechanism of SPH-l in insulin-resistant diabetic db/db mice. Mice were grouped and treated for 3 weeks as follows: control group was administrated with tap water orally: treated group was administrated with SPH-l orally at dose of 500 mg/kg. SPH-l lowered plasma glucose level by 67% as compared to the diabetic control (omitted)

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Antidiabetic effect and mechanisms of SPH-2 in db/db mice

  • Kang, Kwi-Man;Cho, Hee-Jae;Chung, Sung-Hyun
    • Proceedings of the PSK Conference
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    • pp.260.2-260
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    • 2002
  • SPH-2 is a herbal medicine composing oriental prescription. We have studied the antidiabetic effect and mechanism of SPH-2 in insulin-resistant diabetic db/db mice. Mice were grouped and treated for 3 weeks as follows: control group was administrated with tap water orally: treated group was administrated with SPH-2 orally at dose of 500 mg/kg. SPH-2 lowered plasma glucose level by 43% as compared to the diabetic control. Total cholesterol. triglyceride and free fatty acid were all reduced in SPH-2 treated group. (omitted)

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Changes in Perception of Consumers for Non-prescription Drug Policy since Sales Begins at the Outside of Pharmacy (일반의약품 약국 외 판매 이후의 일반의약품 정책에 대한 소비자의 인식 변화)

  • Kim, Eun Hee;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.3
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    • pp.183-192
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    • 2014
  • Purpose: This study was aimed to identify the status of utilization of healthcare services and self-care behaviors, knowledge level and influencing choice factors of non-prescription drugs (OTCs) on consumers since sales of OTCs at the outside of pharmacy in Korea, and to confirm the changes in perception of consumers for OTCs policy through check of perception level for current OTCs policy. Methods: Data was collected from April 2014 to May 2014 from questionnaires by 418 adults who are in university located in Seoul or live in Seoul Metropolitan area but not health science major and healthcare providers. Results: The female gender was 56.6% and University students were 73.9%. The ratio by age was as follows: below 25 (60.9%), 26-30 (18.2%), 30-40s (14.9%) and 50-60s (6.0%). The knowledge level of OTCs for use of medicine, dose and side effects was generally low and especially they knew little how to deal with side effects after taking OTCs on sale at the outside of pharmacy, even though over one year has passed since the policy. The proportion of those who thought the current OTCs policy has problems regarding safety issues since the policy was very high and it was also high that the study group thought there are problems with the current way to sale OTCs and educate employees. Conclusion: After selling OTCs at the outside of pharmacy, the consumers still lacked knowledge of OTCs and did not get correct information properly. Especially, they had little information about the way to deal with side effects after taking OTCs. Public policy should be based on the health of the people and the public health is a national health priority. When all these things are taken into consideration, the government has to strengthen the OTCs policy and provide a safer environment with the accurate drug information for people than developing OTCs policy in the future.

Brain Metal Level in Ohjeoksan-Treated Rats (오적산(五積散)을 투여한 흰쥐의 뇌중 금속농도변화에 관한 연구)

  • Min Dae-Ki;Goh Seong-Kyu;Lee Sun-Dong;Wen Yong
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.242-257
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    • 2000
  • This study was to investigate the metal accumulation from Ohjeoksan-Decoction to rat brain(Sprague Dawley). 1. In Control group, each metal concentration was within 26.65mg/kg. and in each experimental groups, was within 28.39mg/kg. And there were no significant metal concentration between control and experimental groups. Exceptionally, Cr and Ni level of control group was lower than experimental groups significantly. (p<0.05) and Cr and Ni level of experimental I group was lower than other experimental groups too. (p<0.05). But, Pb level of control group was higher than experimental groups significantly (p<0.05) Pb level of experimental I group was higher than other experimental groups(p<0.01) 2. In non-hazardous, hazardous and total metal concentration, there was no increase tendency in brain according to the high dose of OD(Ohjeoksan-Decoction) intake. Reversely, in experimental groups, hazardous metal concentration was decrease by high OD intake. (P<0.05) 3. Correlation among each metal in brain was various in each groups Briefly under the intake of Ohjeoksan-Decoction, that if very busy herb prescription , this study was defined within safety in brain metal level by P.O. during 10 days. But, there should be a more research about Pb increase by high dose OD intake

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Analysis of factors affecting antibiotic use at hospitals and clinics based on the defined daily dose (병원 및 의원급 일일사용량 기준 항생제 사용량에 영향을 미치는 요인)

  • Lee, Eun Jee;Lee, GeunWoo;Park, Juhee;Kim, Dong-Sook;Ahn, Hyeong Sik
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.687-698
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    • 2018
  • Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.