• Progress in Medical Physics
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• v.10 no.2
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• pp.95-101
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• 1999

The aims of this report are to classify the incorrect data of patients and the errors of dose and dose distribution observed in QA activities on teleradiotherapy chart, and to analyze their frequency. In our department, radiation physicists check several sheets of patient chart to reduce numeric errors before starting radiation therapy and at least once a week, which include history, port diagram, MU calculation or treatment planning summary and daily treatment sheet. The observed errors are classified as followings. 1) Identity of patient, 2) Omitted or unrecorded history sheet even though not including the item related to dose, 3) Omission of port diagram, or omitted or erroneous data, 4) Erroneous calculation of MU and point dose, and important causes, 5) Loss of summary sheet of treatment planning, and erroneous data of patient in the sheet, 6) Erroneous record of radiation therapy, and errors of daily dose, port setup, MU and accumulated dose in the daily treatment sheet, 7) Errors leading inexact dose or dose distribution, errors not administerd even though its possibility, and simply recorded errors, 8) Omission of sign. Number of errors was counted rather than the number of patients. In radiotherapy chart QA from Jun 17, 1996 to Jul 31, 1999, no error of patient identity had been observed. 431 Errors in 399 patient charts had been observed and there were 405 physical errors, 9 cases of omitted or unrecorded history sheet, and 17 unsigned. There were 23 cases (5.7%) of omitted port diagram, 21 cases (5.2%) of omitted data and 73 cases (18.0 %) of erroneous data in port diagram, 13 cases (3.2 %) treated without MU calculation, 68 cases (16.3 %) of erroneous MU, 8 cases (2.0%) of erroneous point dose, 1 case (0.2 %) of omitted treatment planning summary, 11 cases (2.7%) of erroneous input of patient data, 13 cases (3.2%) of uncorrected record of treatment, 20 cases (4.9%) of discordant daily doses in MU calculation sheet and daily treatment sheet, 33 cases (8.1%) of erroneous setup, 52 cases (12.8%) of MU setting error, 61 cases (15.1%) of erroneous accumulated dose. Cases of error leading inexact dose or dose distribution were 239 (59.0 %), cases of error not administered even though its possibility were 142 (35.1 %), and cases of simply recorded error were 24 (5.9 %). The numeric errors observed in radiotherapy chart ranged over various items. Because errors observed can actually contribute to erroneous dose or dose distribution, or have the possibility to lead such errors, thorough QA activity in physical aspects of radiotherapy charts is required.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.127-135
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• 2001

Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.175-183
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• 2019

Cerebral nervous system intervention has been reported frequently due to radiation exposure such as blistering of the skin, hair loss, and erythema due to prolonged procedures. By applying ergonomically manufactured Bismuth (atomic number 83; Bi) shield to endovascular treatment of cerebral aneurysms, we aimed to minimize radiation exposure of scalp and lens from medical radiation exposure. The measurement site was the posterior part of the head, bilateral temporal part, bilateral quadriceps part, nose part, and the measuring part was attached to the optically stimulated Luminescence dosimeter (OSLD) Before and after the use, the entrance surface dose was compared and analyzed. The average entrance surface dose of group A (unshield) was 92.44 mGy, and group B was measured at 67.55 mGy. The average decrease in Group B was 26.92% compared to Group A. The entrance surface dose mean of the occipital region was measured at 146.08 mGy B group at 103.23 mGy and decreased by an average of 29.32% in group B compared to group A. The average entrance surface dose of the bilateral temporal part was measured in group A at 101.90 mGy group B at 72.69 mGy and decreased by an average of 28.67% in group B compared to group A. The average entrance surface dose for bilateral quadriceps part was measured at 27.51 mGy group B at 21.39 mGy and averaged 22.26% less in group B than group A. It is believed that the use of bismuth shields will be an alternative to reducing radiation disturbance due to temporary hair loss and other stochastic effects that may occur after the endovascular treatment of cerebral aneurysms procedure.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.183-188
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• 2012

Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

• Food Science and Biotechnology
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• v.16 no.3
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• pp.392-397
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• 2007

We investigated whether ethanol extracts of the safflower seeds containing phenolic compounds were responsible for the bone-protecting effects. Crude ethanol extract (CEE) of the safflower seeds was fed for 4 weeks at the level of 1% in diet to female Sprague-Dawley rats that had been subjected to bilateral ovariectomy (OVX). The CEE effects (OVX+CEE) were evaluated by comparing results obtained from OVX, Sham, and OVX injected with $17{\beta}$-estradiol ($OVX+E_2$) groups. OVX resulted in a dramatic reduction in the trabecular bone mass of the proximal tibia (approximately 40% of the Sham group) and an increase in fat deposition in bone marrow. In $OVX+E_2$ group, the bone loss was completely prevented as well as marrow adiposity. In OVX+CEE group, approximately 80% of the bone mass was maintained compared with Sham group and fat deposition in the bone marrow was prevented. Meanwhile, the partially purified ethanol extract containing the phenolic compounds stimulated proliferation of the ROS 17/2.8 osteoblast-like cells in a dose-dependent manner, as potently as positive controls of $E_2$ and genistein. The present data demonstrate that the ethanol extracts of safflower seeds reduced bone loss caused by estrogen deficiency. The bone-protecting effect of safflower seeds seems to be mediated, at least partly, by the stimulating effect of the phenolic compounds on the growth of osteoblasts.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.27-35
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• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.27-35
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• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Journal of Korean Medicine for Obesity Research
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• v.23 no.1
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• pp.28-41
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• 2023

Objectives: This study was aimed to evaluate the hemodynamic feasibility using pulse parameters as a way to establish safe dose guidelines for herbal prescription containing Ephedra herb (Ephedra intermedia Schrenk & C.A.Mey) on weight loss, and to provide a foundation for developing evidence-based guidelines for clinical use. Methods: Forty-two volunteers were recruited to participate in a study examining the changes in pulse wave characteristics following the ingestion of Gambi-hwan, a herbal prescription containing ephedra, over a period of 4 weeks, and pulse wave measurements were taken before and after the administration. Pulse wave parameters were measured in this study using a 3-dimensional radial pulse tonometry device (DMP-Lifeplus). In addition, questionnaire, blood pressure, temperature, and body composition were also measured as secondary measures. Results: Fifteen minutes after administration of Gambi-hwan, the non-adverse event group (non-AE) exhibited a statistically significant increase in several power and pressure-related parameters, including h1, h5, systolic area, pulse area, and pulse width, while the AE group showed a trend of decreasing stroke volume and increasing Radial Augmentation Index (RAI), w, and w/t. After 4 weeks of administration, both groups exhibited significant changes in pulse rate, w/t, RAI, t3/t, stroke volume (SV), and stroke volume Index (SVI). Notably, there are significant differences between AE group and non-AE group in w/t, SV, and SVI. Conclusions: These findings suggest that pulse parameters may be a useful way to establish safe dosing guidelines for weight loss herbal prescription containing ephedra. Further research is needed to confirm these results and to develop evidence-based guidelines for clinical use.

• Journal of Korean Society of Environmental Engineers
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• v.38 no.9
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• pp.482-496
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• 2016

Algal blooms of cyanobacteria (blue-green Algae) due to the eutrophication of rivers and lakes can cause not only the damage by its biological toxins but also the economic loss in drinking water treatment. The natural algae coagulant, a commercial product known as W.H. containing the algicidal and allelopathic material derived from oak, can control algal problems proactively through the coagulation flotation process. However, because there have been no applications of the process for pre-treatment in drinking water plants, we could find no report on the optimum injection dose of W.H.. In this study, we have conducted several sets of jar-tests while changing W.H. dose and concentration of chl-a for (1) Han-river samples and (2) subcultured cyanobacteria samples, and monitored the removal mechanisms of algae intensively. Based on these jar-test results, two linear equations with variables of chl-a and turbidity have been deduced to predict the optimal W.H. dose after the multiple regression analysis using IBM-SPSS. Also, prototypes of automatic control logic have been suggested to inject the optimal W.H. dose promptly in response to the variation of water quality.

• Toxicological Research
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• v.23 no.4
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• pp.353-362
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• 2007

Deoxynivalenol (DON) is a common food borne mycotoxin and occurs predominantly in grains such as wheat, barley, oats, etc. DON induces systemic health problems such as loss of appetite, emesis and diarrhea in both human and farm animals. Reliable diagnostic parameters for DON intoxication are needed to prevent deep health impact. In order to establish useful diagnostic parameters, we investigated clinical signs, hematological values, serum biochemical values, gross-, histo- and toxico-pathological findings in B6C3F1 male mice after oral administration of DON (0.83, 2.5 and 7.5 mg/kg) for 8 days. Body weight gain was significantly decreased at the highest dose of DON. Anorexia, ataxia, for crudness and lack of vigor were observed at the highest dose DON group. In hematological values, the numbers of WBC and platelets and hemoglobin content were reduced with decreased neutrophil and monocytes by 7.5 mg/kg DON. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were prolonged in a dose-dependent manner and the content of fibrinogen was elevated at high dose of DON. Of serum biochemical values, total protein, globulin, BUN, cholesterol and test-osterone were reduced but total bilirubin and albumin/globulin ratio increased. The enzyme activity of alkaline phosphatase was decreased while that of alanine aminotransferase was elevated. Relative organ weights of thymus, seminal vesicle/prostate and testes were dose-dependently reduced but those of liver and left adrenal gland increased with dose dependency. As for pathological findings, atrophy of thymus, seminal vesicle/prostate and testes and submucosal edema and ulceration in stomach and depletion of lymphocytes in thymus cortex were observed. In conclusion, these clinical, hematological, blood biochemical and patholgical parameters obtained in the present studies can be used for diagnosis of DON-mycotoxicosis, especially, low WBC, platelets, protein, BUN and testosterone and delayed prothrombin time can be available as for reliable diagnostic parameters.