• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.134-139
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• 2021

Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion: Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

• 생물정신의학
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• 제13권3호
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• pp.152-161
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• 2006

Objective : The relationship between the total daily dose of clozapine given and the plasma concentrations of clozapine and its metabolites(N-desmethylclozapine and clozapine N-oxide) and the effect of Glu158Lys (wild-type : Glu, 'H' ; variant : Lys, 'h') and Glu308Gly(wild-type : Glu, 'D' ; variant : Lys, 'd') variation in FMO3 gene on plasma concentrations of clozapine and its metabolites was studied in schizophrenic patients. Methods : Trough plasma concentrations of clozapine and its metabolites were measured in 34 schizophrenic patients receiving clozapine. The genetic variation of 'h' and 'd' in FMO3 were analyzed in 21 among 34 patients. Results : A linear relationship between the total daily dose of clozapine given(mg/kg body weight per day) and the plasma concentrations(nM) of clozapine was revealed by regression analysis(p<0.001) in the 23 patients receiving a constant daily dose of clozapine for 8 days. The plasma molar concentration ratios of clozapine N-oxide/clozapine in 8 subjects with 'hh' or 'Hh' alleles were not different from those in 6 subjects with 'HH' alleles and the plasma molar concentration ratios in 6 subjects with 'dd' or 'Dd' alleles were not different from those in 8 subjects with 'DD' alleles. Conclusion : The effect of Glu158Lys and Glu308Gly variation in FMO3 gene on clozapine metabolism could not be shown.

• 한국임상약학회지
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• 제17권1호
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• pp.19-32
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• 2007

Objectives : It is necessary to monitor consumption of drugs in order to enhance promote appropriate use of drugs. Defined Daily Dose(DDD) of World Health Organization(WHO) has been used for evaluating the amount of medicine use. However, DDD of some drugs must be determined for drugs in Korea which are not listed by WHO. Our formulary follows ourself classification and DDD of some drugs must be determined since they exist only in Korea. This study was aimed to determine DDD value using RAND Appropriateness Methods and evaluate the amount of antibiotics use using DDD value. Methods : J01 antibiotics of WHO anatomical therapeutic chemical(ATC) classification were extracted from drug formulary. Antibiotics list without DDD was identified to determine their DDD with comprehensive review of references and recommendation of experts. defined. Review of reference was executed. of Expert panels were comprised of clinical pharmacist and clinical doctors. Modified Delphi Method was applied by survey and consensus meeting. Amount of antibiotic use was calculated by DDD/1000 inhabitants/day in the national level using health insurance claim data. Results : The result of 1 round, DDD values of 28 ingredients were determined from the first round of consensus meeting. With 2nd round meeting, 3 ingredients were deleted and DDD of 17 ingredients were decided. Analysis of antibiotic use in health insurance claim data showed 22.97 DDD/1000 inhabitants/day in 2003 year. Conclusion : This study can contribute to the establishment of DDD assignment and thus quantifying drug uses.

• Asian-Australasian Journal of Animal Sciences
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• 제15권10호
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• pp.1469-1474
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• 2002

This study was designed to evaluate the influence of a single or double dose of Fe dextran with organic trace mineral supplementation on the performance of piglets from dams fed diets with either inorganic (ITM) or organic trace minerals (OTM). It also determined the effect of the source of the trace minerals on the reproductive performance of sows. The trace mineral premixes were prepared using metal proteinates and the corresponding inorganic salts for the OTM and the ITM, respectively. Each mineral premix provided 100 ppm Fe/175 ppm Fe, 35 ppm Cu/170 ppm Cu, 90 ppm Zn/120 ppm Zn, and 40 ppm Mn/35 ppm Mn when added at 0.20% in sows /weaned pigs' diets, respectively. The first dose of Fe dextran was administered to piglets at 3 d and the second dose at 10 d after birth. One dose of Fe dextran supplied 100 mg of Fe. A total of 16 gestating sows (Landrace${\times}$Yorkshire) in parities 2 to 4 were randomly allocated to four treatments: 1) diet with ITM/one dose of Fe dextran to piglets, 2) diet with ITM/two doses of Fe dextran to piglets, 3) diet with OTM/one dose of Fe dextran to piglets, and 4) diet with OTM/two doses of Fe dextran to piglets. The total born alive, weaned, body weight at birth and at weaning were not affected by the sow's dietary treatment. Although organic trace mineral supplementation tended to increase the milk Fe content (p<0.10) at 7 d postpartum, piglets in all treatments performed equally from birth to weaning. The double doses of Fe dextran neither improved the average daily gain (ADG) nor influenced the survival of piglets from birth to weaning (21 d). Results suggest that a single dose of Fe dextran given to suckling pigs is adequate to sustain their needs for growth throughout the lactation period (21 d). Furthermore, there was a 21% improvement in both the ADG and the average daily feed intake (ADFI) (p<0.05) in weaned pigs fed diets with OTM. Cu and Fe in the liver (p<0.01), and Zn in both the bone (p<0.01) and the serum (p<0.01) were higher in piglets fed OTM than in those fed ITM. It would be concluded that single dose of Fe dextran administration with organic trace mineral supplementation show similar growth performance compared to 2 dose Fe dextran administration with inorganic mineral supplementation in young pigs.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.241-247
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• 2016

Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting ${\beta}2$-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.

• Journal of Pharmaceutical Investigation
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• 제39권2호
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• pp.111-115
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• 2009

The pharmacokinetics of cyclosporin A (CsA) after single and multiple oral dosing of new CsA self-micro-emulsifying drug delivery system (SMEDDS) in dogs were estimated. A single dose study was performed following a two-way crossover design against six dogs with reference SMEDDS. For a multiple dose study, three dogs were allocated for each drug, and 100 mg of drug was administered daily for 6 days. Whole blood concentration of CsA was analyzed by radio-immunoassay. Both drug showed identical blood concentration profiles in both studies, and no statistical difference was detected in pharmacokinetic parameters. The relative bioavailabilities of test SMEDDS were 91.4% and 89.1%, respectively, in the single dose study and the last day of multiple dose study. Especially, multiple dose study proved the good relationship between C-0/C-2 and AUC for reference SMEDDS, which is an indispensable part of therapeutic drug monitoring. These results suggest newly formulated CsA SMEDDS possibly shows identical pharmacokinetics and pharmacodynamic behaviors in clinical trials.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.259-279
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• 2009

Radioiodine ablation therapy has been considered to be a standard treatment for patient with differentiated thyroid cancer after total thyroidectomy. Patients may need to be hospitalized to reduce radiation exposure of other people and relatives from radioactive patients receiving radioiodine therapy. Medical staffs, nursing staffs and technologists sometimes hesitate to contact patients in radioiodine therapy ward. The purpose of this paper is to introduce radiation dosimetry, estimate radiation dose from patients and emphasize the safety of radiation exposure from patients treated with high dose radioiodine in therapy ward. The major component of radiation dose from patient is external exposure. However external radiation dose from these patients treated with typical therapeutic dose of 4 to 8 GBq have a very low risk of cancer induction compared with other various risks occurring in daily life. The typical annual radiation dose without shielding received by patient is estimated to be 5 to 10 mSv, which is comparable with 100 to 200 times effective dose received by chest PA examination. Therefore, when we should keep in mind the general principle of radiation protection, the risks of radiation exposure from patients are low and the medical personnel are considered to be safe from radiation exposure.

• Biomolecules & Therapeutics
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• 제2권2호
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• pp.161-172
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• 1994

This study was conducted to examine DA-3002, a biosynthetic human growth hormone, for its acute and subacute toxicities in mice and rats. The drug was administered subcutaneously and orally at a dose level of 1.0, 3.0, 8.9, 26.7 or 80.0 lU/kg once for single dose toxicity and given subcutaneously at a dose level of 0.34, 1.7 or 8.4 lU/kg daily for 13 weeks to investigate repeated dose toxicity. In the acute toxicity study, doses up to 80 lU/kg had no adverse effect on the behavior or body weight gain. Pathological examinations revealed no abnormal changes which could be attributed to toxic effect of DA-3002. In the subacute toxicity study, the growth hormone was tolerated well in broth mice and rats. No drug related deaths occurred and all animals appeared to be normal throughout the dosing period. Increases in body weight gain, food utilisation and absolute organ weights were observed in the rats in the high dose group. Mild changes in the blood chemical parameters were also seen in the treated groups. Histopathologically, however, no abnormal changes were observed in any organ. The changes noted during the treatment periods presumably represent exaggerated pharmacological effects of the growth hormone, and no observed adverse effect level (NOAEL) was considered to be more than 8.4 lu/kg/day.

• Radiation Oncology Journal
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• 제35권4호
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• pp.380-384
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• 2017

Massive chylous leakage is a rare postoperative complication that can prolong hospital stay and cause secondary morbidities. Conservative management strategies are the treatment of choice; however, radiation therapy (RT) can be used as an alternative for cases that are refractory to conservative treatment. Herein, we report a 69-year-old female patient who suffered from massive chylous leakage after subtotal gastrectomy. Due to persistent massive chylous leakage, she was scheduled to undergo low-dose RT. Radiation was delivered with a daily dose of 1 Gy, using an anterior-posterior and posterior-anterior beam arrangement. The clinical target volume encompassed the entire lymph node area of the D2 dissection. RT was completed at the total dose of 8 Gy because the amount of chylous leakage declined rapidly. Percutaneous drainage tube was removed after 3 days of RT. The patient did not complain of any symptoms related to massive chylous leakage 2 years after the completion of RT.

• 대한방사선치료학회지
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• 제26권1호
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• pp.83-89
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• 2014

목 적 : 토모테라피(Tomotherapy)와 선형가속기(Linac)를 이용한 세기조절방사선치료(IMRT) 시 환자의 정확한 위치잡이를 위해 매일 시행되는 MVCT와 CBCT의 imaging dose를 비교 평가해보고자 한다. 대상 및 방법 : 인체 모형 팬텀(Anderson rando Phantom, USA)을 Head, Thorax, pelvis의 3부위로 분류하여 촬영 부위의 중심에 $0.5{\times}0.5cm2$. 크기로 자른 GafChromic EBT3 film을 팬텀의 표면의 상, 하, 좌, 우와 팬텀의 표면에서 2cm깊이의 상, 하, 좌, 우, 중심에 위치시킨 뒤 토모테라피(Hi Art)와 Novalis Tx의 OBI를 이용하여 surface dose와 inner dose를 각각 3회씩 반복 측정한다. 측정 된 film은 RIP version6.0을 이용하여 값을 산출한 뒤 일원분산분석법을 이용하여 선량의 평균값을 산출한다. 결 과 : 인체모형팬텀을 이용하여 MVCT와 CBCT를 시행한 결과 MVCT inner dose의 측정값은 head에서 $15.43cGy{\pm}6.05$, thorax에서 $16.62cGy{\pm}3.08$, pelvis에서 $16.81cGy{\pm}5.24$로 나타났으며, CBCT inner dose는 head에서 $13.28{\pm}3.68$, thorax에서 $13.66{\pm}4.04$, pelvis에서 $15.52{\pm}3.52$의 값을 나타냈다. Surface dose의 측정 값은 MVCT 시행 시 head에서 $11.64{\pm}4.05$, thorax에서 $12.16{\pm}4.38$, pelvis에서 $12.05{\pm}2.71$로 나타났으며, CBCT의 경우 head에서 $14.59{\pm}3.51$, thorax에서 $15.82{\pm}2.89$, pelvis에서 $17.48{\pm}2.80$을 나타내었다. 결 론 : Inner dose의 경우 kV energy를 사용하는 CBCT보다 MV energy를 사용하는 MVCT에서 head에서 1.16배, thorax에서 1.22배, pelvis에 서 1.08배 높게 나타났으며, Surface dose의 경우 MVCT보다는 CBCT의 head에서 1.25배, thorax에서 1.30배, pelvis에서 1.45배 높게 측정되었다. Imaging dose는 치료 선량에 비해 작은 양이지만 daily로 시행되는 만큼 정상조직에 일정부분 영향을 미칠 것으로 생각된다. 하지만 IMRT치료를 위해서는 영상유도를 통한 IGRT가 반드시 병행되어 치료계획과 실제치료간 오차를 최소화하여야 한다. 따라서 환자가 받는 imaging dose를 최소화하기 위해서는 치료계획 시 Imaging dose를 고려하여 치료계획을 수립하거나 MVCT 촬영 시 Scan 범위를 최소화하여 시행해야 될 것으로 사료된다.