• Title/Summary/Keyword: Dose management

검색결과 869건 처리시간 0.027초

Image Viewer System의 개발 및 적용에 관한 고찰 (Study on the Development and Application of Image Viewer System)

  • 양오남;서인기;홍동기;권경태
    • 대한방사선치료학회지
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    • 제18권2호
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    • pp.67-73
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    • 2006
  • 목 적: 암 환자의 증가와 함께 방사선 치료기술도 날로 발전하고 있으며 이로인해 치료를 위해 사용되는 영상 및 데이터의 양들도 대폭 증가하는 결과를 가져오게 되어 이들을 저장, 보관, 관리하는데 많은 어려움이 있었다. 이러한 문제점 해결을 위해 과에서 발생되는 모든 영상 및 data의 PACS (picture archiving and communication system)화를 목적으로 의료정보팀의 협조 하에 본 System을 개발, 적용하게 되었다. 대상 및 방법: 본과 방사선치료 관리 시스템(RO-radiation oncology)에서 PACS에 접근할 수 있는 code를 부여한 후 영상은 R&V (Record and Verify: Varis vision, Varian, USA) 시스템 및 planning system에서 export 한다. 이때 DICOM (digital image and communication system) head에 있는 많은 정보들 중에서 필요한 정보를 이용하여 프로그램화 하였다. 결 과: 방사선종양학과에서 발생되는 모든 영상 및 자료 즉, 모의치료, CT, L-gram 영상, structure (normal organ & target volume), DRR (Digital Reconstruction Radiography), 선량 분포도, DVH (dose volume histogram) 등을 PACS에 구현 하였으며 과내 어느 컴퓨터에서도 선명히 영상을 볼 수 있고 출력할 수 있도록 하였다. 결 론: 본 시스템의 개발로 film less화가 가능하게 되어 현상 처리에 관련한 암실 공간과 유지비용이 소멸되었고 film 저장공간 및 film을 찾는데 소요되는 인력과 시간을 포함한 유, 무형의 경제적 비용뿐만 아니라 영상 저장을 위한 별도의 저장장치의 구입도 불필요하게 되었다. 아울러 방사선 치료를 위해 복잡하게 행해졌던 일련의 과정들이 본 시스템을 통해서 현재는 전산 상에서 쉽게 처리할 수 있게 되어 업무에 많은 도움이 될 것으로 사료된다.

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말티즈 개에서 인슐린종의 장기간 관리 증례 (A Case of Long-Term Management of Insulinoma in a Maltese Dog)

  • 박소영;강병택;강지훈;장동우;양만표
    • 한국임상수의학회지
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    • 제30권5호
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    • pp.363-365
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    • 2013
  • 15살, 중성화 암컷 2.80 kg의 말티즈 개가 불명의 경련 및 허탈로 내원하였다. 내원시, 혈청화학적검사에서 심한 저혈당이 나타났으나 전해질검사, 전혈구검사, 뇨분석 및 방사선과 복부초음파에서는 특이적인 소견이 관찰되지 않았다. 인슐린 수치는 정상이었으며, 프락토스아민은 정상범위보다 약간 낮았다. 저혈당의 교정을 위해 프레드니솔론이 처방되었고, 임상증상은 개선되었다. 처음 내원한지 45주 후에, 저혈당성 경련의 재발로 다시 내원하였고, 이때 낮은 혈당치와 매우 높은 인슐린농도가 측정되었다. 복부 초음파 상에서, 췌장은 실질이 전반적으로 증가된 균질하지 않은 에코를 보였으며, 실질 내에 저에코성의 병변이 관찰되었다. 이러한 소견을 근거로, 이 개는 인슐린종으로 임상적 진단되었다. 더 높은 용량의 프레드니솔론을 하루에 2회씩 투여하였고, 경련 등의 임상증상은 개선되었다. 처음 내원한지 688일 후, 환자는 인슐린종으로 인한 저혈당성 경련의 재발 없이 아직 생존해있다. 이 사례는 말티즈 개에서 인슐린종의 진단과 프레드니솔론 단독으로 인슐린종의 장기간 관리에 대한 좋은 예를 보여준다.

Radiation Therapy for Primary Eyelid Cancers in Tunisia

  • Belaid, A;Nasr, C;Benna, M;Cherif, A;Jmour, O;Bouguila, H;Benna, F
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3643-3646
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    • 2016
  • Management of eyelid cancers is based on surgery and/or radiotherapy (RT). The treatment objective is to control tumors with acceptable functional and esthetic outcomes. The aim of this study was to evaluate the results of radiation therapy in management of epithelial eyelid cancers, reviewing retrospectively the clinical records of patients treated in our institution from January 1989 to December 2013. We focused on clinical and histological features, treatment characteristics, tolerance and disease control. One hundred and eight patients (62 men and 46 women) were enrolled, with a mean age of 61 years [ranges 15-87]. The most frequent tumor location was the inner canthus (42.6%). Median tumor size was 21 mm [ranges 4-70]. Histological type was basal cell carcinoma in 88 cases (81.5%), squamous cell carcinoma in 16 (14.8%) and sebaceous carcinoma in 4 (3.7%). Radiation therapy was exclusive in 67 cases (62%) and post-operative for positive or close margins in the remaining cases. Kilovoltage external beam radiotherapy (KVRT) was used in 63 patients (58.3%) and low-dose-rate interstitial brachytherapy in 37 (34.3%). Eight (7.4%) were treated with cobalt or with a combination of KVRT-cobalt, KVRT-electron beams, KVRT-brachytherapy or cobalt-electron beams. The total delivered radiation doses were 70 Gy (2 Gy/fraction) in 62 patients (57.4%), 66 Gy (2 Gy/fraction) in 37 (34.3%) and 61.2 Gy (3.4Gy/fraction) in 9 (8.3%). After a median follow-up of 64 months, we noted 10 cases of local recurrences(9.2%): 7 after exclusive and 3 after post-operative RT. No local recurrence occurred in patients treated with brachytherapy. Actuarial 5-year local recurrence-free rate, disease-free survival and overall survival were respectively 90%, 90% and 97%. T-stage was found to be a significant factor for recurrence (p=0.047). All acute radiation-related reactions were scored grade I or II. Delayed effects were eye watering in 24 cases (22.2%), eye dryness in 19 (17.6%), unilateral cataract in 7 (6.4%) and ectropion in 4 (3.7%). Radiation therapy and especially brachytherapy is an efficient treatment of eyelid cancers, allowing eye conservation and functional preservation with good local control rates and acceptable toxicity.

음용수 중 유해 화학 물질에 대한 위해성 평가에 관한 연구 - I. 발암성 화학 물질을 중심으로 - (Study on Health Risk Assessment of Carcinogenic Chemicals in Drinking Water)

  • 정용;신동천;김종만;박성은;양지연;이자경;황만식;박연신
    • Environmental Analysis Health and Toxicology
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    • 제10권1_2호
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    • pp.1-14
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    • 1995
  • The purpose of this research is to assess the health risk of pollutants in drinking water and recommend the guidelines and management plans for maintaining good quality of drinking water. This study has been funded as a national project for three years from 1992 to 1995. This study(the second year, 1993-1994) was conducted to monitor 32 species of carcinogenic chemicals such as volatile organic compounds(VOCs), polynuclear aromatic hydrocarbons(PAHs), pesticides and heavy metals of drinking water at some area in six cities of Korea, and evaluate health risk due to these chemicals through four main steps of risk assessment in drinking water. In hazard identification, 32 species of carcinogenic chemicals were identified by the US EPA classification system. In the step of exposure assessment, sampling of raw, treated and tap water from the public water supply system had been conducted from 1993 to 1994, and 32 chemicals were analyzed. In dose-response assessment, cancer potencies, unit risk estimates and virtually safe doses of carcinogens were obtained by TOX-RISK (Version 3.1). In risk characterization of detected chemicals, health risk due to carcinogens such as vinyl chloride, carbon tetrachloride, dichloromethane, 1, 2-dichloromethane, chloroform, benzene and arsenic of tap water in several cities exceeded 10$^{-5}$ level. We suggest that non-regulated chemicals which exceed 10$^{-5}$ excess cancer risk level, such as vinyl chloride, carbon tetrachloride and 1, 2-dichloroethane, should be monitored periodically and be regulated by the Drinking Water Management Act, and database for exposure parameter of our own situation should be established.

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Optimization of Estrus Synchronization Protocol for Target Breeding to Decrease Voluntary Waiting Period in Lactating Cows

  • Kabir, Md. Parvez;Islam, Md. Rashedul;Maruf, Abdulla Al;Shamsuddin, Mohammed;Bari, Farida Yeasmin;Juyena, Nasrin Sultana;Rahman, Md Saidur
    • Reproductive and Developmental Biology
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    • 제41권2호
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    • pp.25-31
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    • 2017
  • Effective estrus detection and artificial insemination (AI) are necessary for profitable management of dairy herd. In current study, 45 crossbred lactating cows have been selected with the complaint of unobserved oestrus for more than sixty days postpartum. All cows had functional corpus luteum as examined by transrectal ultrasonography. Cows were treated with $PGF_2{\alpha}$ analogue and AI was performed with observed oestrus and then single dose of GnRH was administered. Similar synchronization protocol has been repeated after 14 days in cows that did not repose to first treatment. Remaining cows received additional $PGF_2{\alpha}$ after 14 days of second treatment and timed AI was performed following GnRH administration. Among 45 cows, 28.89% showed estrus after first treatment and 78.79% responded to second hormonal intervention. A higher conception rate (88.89% vs 26.66 and 72.72%) was observed in cows after triple administration of $PGF_2{\alpha}$ and timed AI. We noticed a significant differences in body condition score (BCS, 1~5 scale), postpartum period, and daily milk production between cows that either responded of non-responded following first and second hormonal treatment. In addition, there was a significant positive correlation between daily milk production and BCS, age and postpartum days, milk production and estrus/BCS, and milk production/BCS/estrus and conception rate. Depending upon the findings we conclude that hormonal intervention with $PGF_2{\alpha}$ and GnRH enhances postpartum ovarian cyclicity and help decreasing the days open of dairy herd. Therefore, this finding might provide an excellent guideline for target breeding system for profitable dairy herd management.

Kinetic models에 의한 딸기 중 농약의 생물학적 반감기 비교와 생산단계잔류허용기준 설정 (Field tolerance of pesticides in the strawberry and comparison of biological half-lives estimated from kinetic models)

  • 박동식;성기용;최규일;허장현
    • 농약과학회지
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    • 제9권3호
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    • pp.231-236
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    • 2005
  • 본 연구는 생산단계의 딸기에 4가지 살균제(tolclofos-m, folpet, procymidone, triflumizole)를 수확 10일전 안전사용 기준량으로 처리한 후 잔류량을 파악하였고, 이것을 근거로 6 가지 kinetic models(first order, zero order, second order, power function model, elovich model, parabolic model)에 따른 반감기를 비교하였다. 최적의 모델로 판명된 first order kinetic model로부터 구한 반감기를 이용하여 생산단계잔류허용기준(field tolerance)을 설정, 제시하였다. 잔류분석법의 적합성 판단을 위한 회수율 실험에서는 $85.1{\sim}105.0%$ 범위를 보였으며, 4 가지 약제 모두 약제 처리 5일 후 평균 73% 이상 소실되었다. 잔류량과 시간과의 상관관계는 first order kinetic model에서 가장 높은 결정계수값을 보였으며, 이를 이용하여 산출한 반감기로 생산단계 잔류허용기준(안)을 설정하였다. 이와 같은 결과는 최적의 kinetic model로 반감기를 산출해야 한다는 이론적 근거를 제시하는 것이며, 수확 후 또는 유통 중의 잔류허용기준뿐만 아니라 생산단계에서도 허용기준을 마련하여 부적합 품목을 사전에 차단할 수 있는 기준설정의 예로서 안전 농산물 공급과 농가소득에 크게 기여할 수 있는 기초자료가 될 것이라 사료된다.

고혈압 환자 마취시 Transdermal Clonidine (St 155 BS)의 임상적 유용성 (Clinical Efficacy of Transdermal Clonidine (St 155 BS) for Anesthetic Management in Hypertensive Patients)

  • 이현화;김동옥;김건식;최영규;신옥영;권무일;이두익
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.231-236
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    • 1993
  • Clonidine, a centrally-acting antihypertensive agent known to reduce central sympathetic outflow and modulate presynaptic transmitter's release, has shown to suppress central noradrenergic hyperactivity induced by immobilization stress in animals, by decreasing the MAC of halothane and the dose of narcotics required to prevent reflex cardiovascular response to noxious stimuli, and to have potent analgesic properties in humans. These characteristics suggest that clonidine might be a useful adjunct to the anesthetic management of patients with preexisting hypertension. Accordingly, we determined the clinical efficacy and safety on analgesia, sedation and hemodynamic stability in the perioperative period. Thirty patients(ASA physical status II-III) with a history of arterial hypertension, scheduled for elective orthopedic surgery were randomly assigned to two groups. We applied CPA-clonidine patch($6.9\;mg/cm^2$, 0.2 mg delivered daily) or placebo patch to each groups, 48 hours prior to induction of anesthesia. Antihypertensive medication was continued until the morning of the scheduled surgery. All patients received premedication of atropine and lorazepam, and induced anesthesia with thiopental and succinylcholine, and maintained with enflurane and 50% nitrous oxide, while sustaining the BP and pulse rate at acceptable range. For the relief of pain postoperatively, diclofenac and fentanyl were administered intramuscularly on demand. The results were as follows: 1) The change of hemodynamic responses in clonidine group was less compared to the placebo group. 2) Intraoperative anesthetic requirement for enflurane in clonidine group were significantly lower than placebo group. 3) Postoperative analgetic requirement in clonidine group were significantly lower than placebo group. In clonidine group, 5 cases out of 15 cases were required no analgetics, and the incidence of administration of additional fentanyl was decreased to 5 cases, comparing with 10 cases in placebo group.

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Lung Cancer의 Stereotactic Radiosurgery시 Respiratory Gating system의 유용성에 대한 연구 (Effectiveness of the Respiratory Gating System for Stereotectic Radiosurgery of Lung Cancer)

  • 송흥권;김민수;양오남;박철수;권경태;김정만
    • 대한방사선치료학회:학술대회논문집
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    • 대한방사선치료학회 2005년도 춘계학술대회 초록집
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    • pp.13-17
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    • 2005
  • Lung cancer 환자 중 호흡에 의한 종양의 움직임이 큰 lung lower lobe에서 stetreotactic radiosurgery(SRS)시 호흡 주기 중 종양의 움직임이 적은 호흡 주기에서만 방사선을 조사하기 위해 respiratory gating system을 사용함으로써 그 유용성에 대하여 알아보고자 한다. lung lower lobe의 SRS 환자 2명을 대강으로 하였으며, 환자의 복부에 maker block(sensor)을 부착하고 tracking camera와 real time position management(RPM)를 이용하여 호흡 주기를 측정하면서 1회 호흡주기에서 10 phases의 4D-CT를 촬영 하였다. 종양의 위치 변화가 급격하지 않은 percent($\%$)의 phases를 치료 phases로 결정하였고, 치료 phases의 CT image를 maximum intensity projection(MIP) 기법으로 재구성 후 volume contouring을 하였다. set up 의 재현성 및 GTV의 위치 변화를 확인하기 위해 치료 전과 치료 중 2회의 4D-CT 촬영을 하였다. GTV의 움직임이 가장 큰 Y(longitudinal)축에서 A환자 full($0\%\~90\%$) phases의 9.4mm가 치료 ($30\%\~60\%$) phases 에서는 2.6mm로, B환자 full($0\%\~90\%$) phases의 11.7mm가 치료($30\%\~70\%$) phases 에서는 2.3mm로 줄었다. 2회의 4D-CT 비교 결과 Set up의 X, Y, Z축 오차는 모두 3mm 이내였다. 호흡에 의한 종양의 움직임이 큰 lung lower lobe에서 SRS 시행 시 respiratory gating system의 사용은 종양의 움직임을 5mm 이내로 감소시킬 수 있어 유용하였다.

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인체 방광암 T24 세포에서 Glycyrrhizae radix 열수추출물에 의한 apoptosis 유도 (Induction of apoptosis by water extract Glycyrrhizae radix in human bladder T24 cancer cells)

  • 엄정혜;황병수;정용태;김민진;신수영;김철환;이승영;최경민;조표연;정진우;오영택
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2019년도 춘계학술대회
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    • pp.111-111
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    • 2019
  • Glycyrrhizae radix is one of the most frequently prescribed ingredients in Oriental medicine, and G. radix extract has been shown to exert anti-cancer effects. However, the cellular and molecular mechanisms of apoptosis by G. radix are poorly defined. In the present study, it was examined the biochemical mechanisms of apoptosis by water extract of G. radix (WEGR) in human bladder T24 cancer cells. It was found that WEGR could inhibit the cell growth of T24 cells in a dose-dependent manner, which was associated with the induction of apoptotic cell death, as evidenced by the formation of apoptotic bodies, DNA fragmentation and increased populations of annexin-V positive cells. The induction of apoptotic cell death by WEGR was connected with an up-regulation of pro-apoptotic Bax protein expression and down-regulation of anti-apoptotic Bcl-2 and Bcl-xL proteins, and inhibition of apoptosis family proteins (XIAP, cIAP-1 and cIAP-2). In addition, apoptosis-inducing concentrations of WEGR induced the activation of caspase-9, an initiator caspase of the mitochondrial-mediated intrinsic pathway, and caspase-3, accompanied by proteolytic degradation of poly (ADP-ribose)-polymerase. WEGR also induced apoptosis via a death receptor-mediated extrinsic pathway by caspase-8 activation, resulting in the down-regulation of total Bid and suggesting the existence of cross-talk between the extrinsic and intrinsic pathways. Taken together, the present results suggest that WEGR may be a potential chemotherapeutic agent for the control of human bladder cancer cells.

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넙치에서 lincomycin 근육투여에 따른 휴약기간 도출 및 병원성 그람음성 세균에 대한 약효 평가 (Withdrawal time study of lincomycin administered intramuscularly to olive flounder Paralichthys olivaceus, and in vitro efficacy evaluation against Gram-negative bacterial pathogens)

  • 정은하;김근택;신동훈;배준성;이강욱;이채원;양찬영;김아름;이지훈;박수진;박관하
    • 한국어병학회지
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    • 제35권2호
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    • pp.195-203
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    • 2022
  • 본 연구는 lincomycin (LM)의 근육투여에 따른 저수온(13℃)에서의 잔류 특성 및 넙치에서 병원성 세균으로 발견되는 그람음성 세균에서의 시험관 내 in vitro 약효를 평가하기 위하여 수행하였다. LM을 10, 20 및 40 mg/kg의 용량으로 단회 투여하였을 때, 근육내 농도가 잔류허용기준인 0.1 mg/kg 이하로 감소하는 기간은 각각 32일, 33일 및 55일로 평가되었다. 또한, 현장 분리 균주 그람음성 세균인 Edwardsiella piscida 및 Vibrio harveyi에 대하여 LM의 minimal inhibitory concentration (MIC)로 평가된 in vitro 약효는 각각 >256 ㎍/mL 및 32 ㎍/mL을 나타냈다. 연구 결과, 넙치 양식장에서 사용되는 LM의 임상용량인 10 mg/kg을 고려하였을 때의 휴약기간을 30일 이상으로 설정하면 합리적일 것으로 판단된다. 또한 LM이 넙치 연쇄상구균증 치료 목적으로 투여될 때 그 동시에 감염된 그람음성 세균에는 약효가 발휘되지 않을 것으로 추정한다.