• Title/Summary/Keyword: Dose management

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Useful evaluation of 3D target location correction by using Xsight spine tracking system in CyberKnife (사이버나이프에서 Xsight spine tracking system을 이용한 3D 표적위치보정의 유용성 평가)

  • Jeong, Young-Joon;Kim, Sang-Hyun
    • Journal of Digital Convergence
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    • v.13 no.1
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    • pp.331-339
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    • 2015
  • The purpose of this study is to evaluate utility of rotating adjustment using Xsight spine tracking system in 3D DOF location adjusting method, to minimize error between 6D DOF and 3D DOF in fiducial tracking system. In this study, the result of 6D DOF target location error is $0.124{\pm}0.058mm$, using fiducial inside tumor 3D DOF $0.673{\pm}0.142mm$, outside tumor $1.126{\pm}0.253mm$, apply with Xsight spine tracking system 3D DOF $0.542{\pm}0.103mm$. As the experiment shows, it was demonstrated that rotating adjustment through Xsight spine tracking system is valuable in case of treatment in 3D DOF location error that makes increasing accuracy and dose distribution each approximately 48% and 3%. In accordance with result of this study is useful rotation.

Effects of the Cynanchum wilfordii Ethanol Extract on the Serum Lipid Profile in Hypercholesterolemic Rats

  • Lee, Hye-Sung;Choi, Jun-Hyeok;Kim, Young-Eon;Kim, In-Ho;Kim, Byoung-Mok;Lee, Chang-Ho
    • Preventive Nutrition and Food Science
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    • v.18 no.3
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    • pp.157-162
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    • 2013
  • The purpose of this study was to investigate the effects of the ethanol extract of Cynanchum wilfordii (ECW) on the blood lipid profile of hypercholesterolemic rats. Thirty 7-week-old male Sprague-Dawley rats were allowed free access to either a normal diet (AIN-93 diet), or 1% high-cholesterol diet with or without 0.5% or 1% ECW for 5 weeks. After sacrifice, the rat serum lipid profile was analyzed. The diets containing ECW decreased body weight gains compared to the normal diet. Serum HDL-cholesterol levels of ECW-fed groups were significantly increased in the hypercholesterolemic groups and normal groups (P<0.05). When 1% ECW was fed to the normal group, total cholesterol level was increased. Moreover, treatment of ECW in hypercholesterolemic groups yielded a dose-dependent and highly significant decrease in the atherogenic index as compared to the control. These results suggest that intake of Cynanchum wilfordii may help reduce the risks of hypercholesterolemia by increasing blood HDL-cholesterol and lowering the atherogenic index.

A Comparison of Patient-Controlled Analgesia and Conventional Intramuscular Opioid Regimen in Relation to their Post-Operative Pain Control and Side Effects (수술후 통증 관리의 Patient-Controlled Analgesia와 마약류의 전통적인 근육내 주사와의 비교)

  • Lee, Sang-Hun;Lee, Jin-Kyung;Lee, Kyn-Chang;Woo, Nam-Sik;Lee, Ye-Chul
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.55-59
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    • 1993
  • Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

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Perioperative duloxetine as part of a multimodal analgesia regime reduces postoperative pain in lumbar canal stenosis surgery: a randomized, triple blind, and placebo-controlled trial

  • Govil, Nishith;Parag, Kumar;Arora, Pankaj;Khandelwal, Hariom;Singh, Ashutosh;Ruchi, Ruchi
    • The Korean Journal of Pain
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    • v.33 no.1
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    • pp.40-47
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    • 2020
  • Background: Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. Methods: In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. Results: Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. Conclusions: Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.

Lymphoproliferative Disease After Lung Transplantation in Transplanted Lung (폐이식후 발생한 이식폐의 임파종 1예)

  • 이교준;김도형;함석진;김해균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.956-959
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    • 2001
  • The Iymphoproliferative disease after the organ transplantation is more commonly seen with the increase according to the increasing number of the organ transplantations and it occurs more frequently in the cases of heart and lung transplantations that needs more aggressive immunosuppression. It demands urgent evaluation and management because of poor prognosis. We transplanted left lung of a man to the woman who suffered from severe dyspnea due to terminal pulmonary emphysema in discrepancy of ABO blood type. Postoperatively, We used triple regimen immunotherapy(cyclosporin, azathioprine, prednisolone) and followed up in the out patient clinic. During the follow up, we found abnormal mass lesion on the transplanted lung and performed gun biopsy. We confirmed malignant lymphoma on the pathollgic examination and two cycled chemotherapy was given after reducing dose of immunosupression. The patient died of sudden onset of pulmonary edema of the transplanted lung.

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Malignant Melanoma of the Vagina: A Report of 2 Cases (질의 원발성 악성 흑색종: 증례보고)

  • Kim, Ok-Bae;Kim, Jin-Hee;Jung, Young-Yeon;Cho, Chi-Heum;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.111-115
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    • 2005
  • Primary malignant melanoma of the vagina is an extremely rare genital neoplasm occurring mainly on postmenopausal women. It has a worse prognosis than cutaneous melanomas, because of the high rate of loco-regional recurrences and rapid systemic dissemination. In the past, radical surgical extirpation as the primary management had been recommended to improve loco-regional control, and possibly overall survival. However, the prognosis was poor In spite of such a radical approache. Recently, more conservative treatment such as wide local excision combined with adjuvant high-dose fraction radiotherapy seems to have premising results. Primary radiation therapy could be served as an alternative to surgery for patients with lesion less than 3 cm in diameter. We report 2 cases of primary vaginal malignant melanoma treated with radiotherapy.

Assessment of Clinical Outcome in Dogs with Naturally Infected with Dirofilaria immitis after American Heartworm Society Protocol vs Slow Kill Method

  • Choi, Miru;Yoon, Won-Kyoung;Suh, Sang-IL;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.1-6
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    • 2017
  • Heartworm disease (HWD) in dogs is a life-threatening mosquito-borne disease resulting in right-sided congestive heart failure and inflammatory pulmonary disease. Due to complications from adulticidal therapy with melarsomine, slow kill protocol either with preventive dose of ivermectin or combined with doxycycline has been proposed for an alternative adultcidal therapy in dogs with HWD. Therefore, this study evaluated the clinical outcome of adultcidal therapy in dogs with class II stage of HWD after treating either American Heartworm Society (AHS) or slow kill protocol for 10 months. Clinical outcome after therapy was evaluated by clinical, radiographic and echocardiographic examination along with hematology before (D0) and after therapy (D300). Although clinical signs associated with HWD were all resolved after therapy in both groups, the infection was not cleared out 67% of dogs treated by slow kill protocol at the end of therapy. Furthermore, pulmonary arterial flow of acceleration time to ejection time ratio (AT/ET) and the right pulmonary artery distensibility index (RPADI) have been firstly used for detecting pulmonary hypertension in this study group. The pulmonary hypertension was more common in dogs with mild clinical signs, although tricuspid and pulmonary regurgitation were not detectable in most dogs in this study. Our study findings suggested that the slow kill protocol might not be efficacious enough to clear out HWD in dogs and more attention on the presence of pulmonary hypertension might be necessary for effective management of HWD in dogs.

Evaluation of the Application of worker-DNELs under REACH Guidance as Provisional Occupational Exposure Limits in the Workplace (작업자 무영향도출수준(worker-DNEL)의 사업장 적용을 위한 평가 연구)

  • Yoon, Young Hee;Lee, Seok Won;Jung, Hyun Hee;Kim, Kwan Sick
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.23 no.1
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    • pp.27-34
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    • 2013
  • Objectives: The purpose of this study is to calculate the worker-DNEL (Derived No Effect Level) values using the REACH guidance and compare the calculated DNELs with existing Korea occupational exposure limits (KOELs) for evaluation of the applicability of the worker-DNELs as provisional occupational exposure limits for chemicals that are not established KOELs in the workplace. Methods: The worker-DNELs for 46 chemicals among 113 hazardous substance requiring management were calculated using the REACH guidance, and a paired t-test was performed to see if there is any statistical difference between two lists (worker-DNELs vs KOELs). The ratios of KOELs over worker-DNELs were also calculated to compare the overall levels of two lists using the geometric means method. Results: The calculated worker-DNELs for 46 chemicals ranged from 0.001 to $329mg/m^3$ (GM= 6.9, GSD = 10.8), and appeared to be a significant difference between the worker-DNELs and the KOELs (p < 0.01). In addition, the ratios of KOELs over worker-DNELs ranged from 0.3 to 394 times (GM = 10.2, GSD = 3.9), indicating that the worker-DNELs were, on average, 27 times lower than the KOELs. Conclusions: Therefore, the study results show that the calculated worker-DNELs can be applied and used as provisional occupational exposure limits in the workplace in order to reduce worker exposures to chemicals and health risks, and manage potential worker exposures based on the precautionary principle through comprehensive chemical risk assessment.

Radiopharmaceuticals for the Therapy of Metastatic Bone Pain (뼈전이의 방사성동위원소 통증치료)

  • Ahn, Byeong-Cheol
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.82-89
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    • 2006
  • Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

Optimization of Inpatient Management of Radioiodine Treatment in Korea (우리나라에서 방사성옥소입원치료 관리 최적화)

  • Park, Min-Jae;Kim, Jung-Hyun;Jang, Jung-Chan;Kim, Chang-Ho;Jeong, Jae-Min;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.261-266
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    • 2008
  • We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after longterm retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer.