• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.12
• /
• pp.5075-5079
• /
• 2015

Background: Adverse effects of treatment prolongation beyond 8 weeks with radiotherapy for cervical cancer have been established. Clinical data also show that cisplatin increases the biologically effective dose of radiotherapy. However, there are no data on the effect of overall treatment time in patients with locally advanced cervical cancer treated with concomitant chemo-radiotherapy (CCRT) in an Indian population. The present study concerned the feasibility of concurrent chemotherapy and interspacing brachytherapy during the course of external radiotherapy to reduce the overall treatment time and compare the normal tissue toxicity and loco-regional control with a conventional schedule. Materials and Methods: Between January 2009 and March 2012 fifty patients registered in the Gynaecologic Oncology Clinic of Institute Rotary Cancer Hospital with locally advanced cervical cancer (FIGO stage IIB-IIIB) were enrolled. The patients were randomly allocated to treatment arms based on a computer generated random number. Arm I (n=25) treatment consisted of irradiation of the whole pelvis to a dose of 50 Gy in 27 fractions, and weekly cisplatin $40mg/m^2$. High dose rate intra-cavitary brachytherapy (HDR-ICBT) was performed after one week of completion of external beam radiotherapy (EBRT). The prescribed dose for each session was 7Gy to point A for three insertions at one week intervals. Arm II (n=25) treatment consisted of irradiation of the whole pelvis to a dose of 50 Gy in 27 fractions. Mention HDR-ICBT ICRT was performed after 40Gy and 7Gy was delivered to point A for three insertions (days 23, 30, 37) at one week intervals. Cisplatin $20mg/m^2/day$ was administered from D1-5 and D24-28. Overall treatment time was taken from first day of EBRT to last day of HDR brachytherapy. The overall loco-regional response rate (ORR) was determined at 3 and 6 months. Results: A total of 46 patients completed the planned treatment. The overall treatment times in arm I and arm II were $65{\pm}12$ and $48{\pm}4$ days, respectively (p=0.001). At three and six months of follow-up the ORR for arm I was 96% while that for arm II was 88%. No statistically significant difference was apparent between the two arms. The overall rate of grade ${\geq}3$ toxicity was numerically higher in arm I (n=7) than in arm II (n=4) though statistical significance was not reached. None of the predefined prognostic factors like age, performance status, baseline haemoglobin level, tumour size, lymph node involvement, stage or histopathological subtype showed any impact on outcome. Conclusions: In the setting of concurrent chemoradiotherapy a shorter treatment schedule of 48 days may be feasible by interspacing brachytherapy during external irradiation. The response rates and toxicities were comparable.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.1
• /
• pp.77-85
• /
• 1996

Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

• Journal of Radiation Protection and Research
• /
• v.41 no.2
• /
• pp.101-104
• /
• 2016

Background: To protect the public from natural radioactive materials, the 'Act on safety control of radioactive rays around living environment" was established in Korea. There is an annual effective dose limit of 1 mSv for products, but the activity concentration limit for products is not established yet. Materials and Methods: To suggest the activity concentration limits for consumer goods containing NORM, in this research, we assumed the "small room model" surrounding the ICRP reference phantom to simulate the consumer goods in contact with the human bodies. Using the Monte Carlo code MCNPX, we evaluate the effective dose rate for the ICRP reference phantom in a small room with dimension of phantom size and derived the activity concentration limit for consumer goods. Results and Discussion: The consumer goods have about 1600, 1200 and $19000Bq{\cdot}kg^{-1}$ for $^{226}Ra$, $^{232}Th$ and $^{40}K$, and the activity concentration limits are about six times comparing with the values of building materials. We applied the index to real samples, though we did not consider radioactivity of $^{40}K$, indexes of the some samples are more than 6. However, this index concept using small room model is very conservative, for the consumer goods over than index 6, it is necessary to reevaluate the absorbed dose considering real usage scenario and material characteristics. Conclusion: In this research, we derived activity concentration limits for consumer goods in contact with bodies and the results can be used as preliminary screening tool for consumer goods as index concept.

• Journal of Environmental Impact Assessment
• /
• v.22 no.1
• /
• pp.89-97
• /
• 2013

RADCONS Ver. 1.0 (RADiological CONSequence Assessment Program) was developed for radiological risk assessment in this study. A Gaussian plume model was used to analyze the fate and transport of radionuclides released into the air in case of accidents. Both single meterological data and time series meterological data can be used in RADCONS. To assess the radiological risk of the early phase after an accident, ED (Effective Dose) estimated by both deterministic and probabilistic approaches are presented. These EDs by deterministic and probabilistic will be helpful to efficient decision making for decision makers. External doses from deposited materials by time are presented for quantifying the effects of mid and late phases of an accident. A radiological risk assessment was conducted using RADCONS for an accident scenario of 1 Ci of Cs-137. The maximum of ED for radii of 1,000 meters from the accident point was 8.51E-4 mSv. After Monte-Carlo simulation, considering the uncertainty of the breathing rate and dispersion parameters, the average ED was 8.49E-4, and the 95 percentile was 1.10E-3. A data base of the dose coefficients and a sampling module of the meteorological data will be modified to improve the user's convenience in the next version.

• Journal of the Korean Society of Radiology
• /
• v.17 no.3
• /
• pp.367-373
• /
• 2023

Aircrews and passengers are exposed to radiation from cosmic rays and secondary scattered rays generated by reactions with air or aircraft. For aircrews, radiation safety management is based on the exposure dose calculated using a space-weather environment simulation. However, the exposure dose varies depending on solar activity, altitude, flight path, etc., so measuring by route is more suggestive than the calculation. In this study, we developed an instrument to measure the cosmic radiation dose using a general-purpose Si sensor and a multichannel analyzer. The dose calculation applied the algorithm of CRaTER (Cosmic Ray Telescope for the Effects of Radiation), a space radiation measuring device of NASA. Energy and dose calibration was performed with Cs-137 662 keV gamma rays at a standard calibration facility, and good dose rate dependence was confirmed in the experimental range. Using the instrument, the dose was directly measured on the international line between Dubai and Incheon in May 2023, and it was similar to the result calculated by KREAM (Korean Radiation Exposure Assessment Model for Aviation Route Dose) within 12%. It was confirmed that the dose increased as the altitude and latitude increased, consistent with the calculation results by KREAM. Some limitations require more verification experiments. However, we confirmed it has sufficient utilization potential as a cost-effective measuring instrument for monitoring exposure dose inside or on personal aircraft.

• Journal of Radiation Industry
• /
• v.6 no.2
• /
• pp.189-197
• /
• 2012

This study was carried out to develop the improved useful mutants for yield or composition of stevia plants using the gamma ray or chemical mutagens treatments. The seeds of stevia 'Suwon No. 11' were irradiated up to 400 Gy of gamma ray. Chemical mutagens were treated on the seeds of the 'Suwon No. 11' using 0.07% colchicine, 10 mM sodium azide, or 10 mM NMU for various durations. The germination rate, and shoot and root growth of seedling were estimated at 30 days after gamma ray irradiation or chemical mutagen treatment, and the plant height, the number of branches, and leaf length and width were examined at 3 months after mutagenesis treatments. In the case of gamma ray treatments, the germination rate and early-stage growth were decreased as the increase of radiation dose, and the 50% lethal dose was found to be 200 Gy. the plant height was decreased as the increase of radiation dose, while the number of branches per plant and leaf length were increased. Leaf shape was modified to the relatively longer one compared to the control, which was identified more apparently at the treatments of higher than 150 Gy. In the treatment of chemical mutagens, the rate of germination and survival were decreased as the increase of incubation time. The 50% lethal dose for germination rate were identified as the conditions of the 15 hours incubation in 0.07% colchicine, the 4 hrs in 10 mM sodium azide, and the 2 hrs in 10 mM NMU, in the three chemical mutagens treatments. Chemical mutagens had no influence on shoot growth, while root growth was increased, especially as the incubation time was extended. The highest root growth occurred in the NMU treatment at 6 hrs incubation time. The plant height was decreased as the increase of incubation time in the chemical mutagens treatments. Among the chemical mutagens, NMU was the most effective to induce the mutants with long-shaped or the least lobed leaves.

• Korean Journal of Biological Psychiatry
• /
• v.28 no.2
• /
• pp.50-57
• /
• 2021

Objectives Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%-70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRS-related conditions.

• The Korean Journal of Pain
• /
• v.7 no.2
• /
• pp.188-192
• /
• 1994

Recently, epidural morphine has been administrated to decrease patients' systemic stress responses such as: suffers, endocrine responses and impairment of pulmonary function, etc. Epidural morphine provided excellent analgesic effect, but incomplete sensory blockade as compared to epidural local anesthetics, which has sympathetic blockade effect and tachyphylaxis. Therefore, the authors surmised that low dose bupivacaine on low dose epidural morphine improved postoperative pain with greater sensory analgesia than epidural morphine alone. The effect of low dose bupivacaine on epidural morphine analgesia for postoperative pain was evaluated in seventy patients. They were physical status I-III by ASA classification. Patients were randomly divided into 2 groups and they were administrated morphine 2.5 mg only (group I), morphine 2.5 mg plus 0.125% bupivacaine (group II) through epidural catheter 1 hour before the end of the operation. During postoperative second days, their analgesic effects were evaluated by visual analogue scale (0-10). Side effects were also evaluated. The results were as follows, 1) On the day of the operation, VAS score showed significant differences between two groups (morphine group $3.20{\pm}0.16$, morphine plus bupivacaine group $2.77{\pm}0.08$; p < 0.05). 2) On the postoperative and second day, there were no statistical differences between the groups according to VAS score. 3) The incidence of pruritus, nausea, and vomiting were no differences in both groups. 4) None of the patients showed objective sedation or a low respiratory rate (< 10 bpm). We concluded that epidural administration of low dose bupivacaine on the epidural morphine analgesia was an effective method to decrease postoperative pain with little change in frequencies of side effects compared to epidural morphine alone.

• Proceedings of the Korean Radioactive Waste Society Conference
• /
• 2003.11a
• /
• pp.584-589
• /
• 2003

The hot cell facility which is designed to permit safe handling of source materials with radioactivity levels up to 1,385 TBq, is planned to be built. To meet this goal, the facility is designed to keep gamma and neutron radiation lower than the recommended dose-rate in normally occupied areas. The calculations performed with QAD-CGGP and MCNP-4C are used to evaluate the proposed engineering design concepts that would provide acceptable dose-rates during a normal operation in hot cell facility. The maximum effective gamma dose-rates on the surfaces of the facility at operation area and at service area calculated by QAD-CGGP are estimated to be $2.10{\times}10^{-3}$, $2.97{\times}10^{-2}$ and $1.01{\times}10^{-1}$ mSv/h, respectively. And those calculated by MCNP-4C are $1.60{\times}10^{-3}$, $2.99{\times}10^{-3}$ and $7.88{\times}10^{-2}$ mSv/h, respectively The dose-rates contributed by neutrons are one order of magnitude less than that of gamma sources, and penetration and toboggan will be partly reinforced by lead shield.

• Journal of Oral Medicine and Pain
• /
• v.42 no.3
• /
• pp.72-80
• /
• 2017

Purpose: Pilocarpine as a salivation stimulant in pill form has mostly been used to relieve oral dryness for xerostomic patients but its use may often be limited due to variable side effects from systemic absorption. Therefore, the purpose of this study was to investigate the effects of pilocarpine mouthwash on salivation according to the variable concentration and duration for healthy volunteers. Related adverse effects and subjective assessment on its effects on salivation were also examined. Methods: This study was performed as placebo-controlled, double-blind, randomized clinical trial. Thirty healthy volunteers (male=23, mean age=22.2 years) were randomly allocated to 6 groups with the different concentration of pilocarpine mouthwash (placebo, 0.1%, 0.5%, 1.0%, 1.5%, and 2.0%). The whole experiment consisted of 3 sessions according to the duration of mouthwash, i.e., 1, 3, and 5 minutes with the mean wash-out period ${\geq}2$ days between the sessions. Unstimulated whole saliva was collected before and after gargling with a mouthwash. Results: Salivation of the higher concentration groups ${\geq}1%$ significantly increased than those of lower concentration group. The application period of mouthwash did not cause any changes of salivary flow rate at the higher concentrations ${\geq}1.0%$. The lower concentrations of 0.5% and 0.1% had no effects on salivation even after 5-minute mouthwash. There was no significant difference between blood pressure and pulse rate before and after use of mouthwash. Conclusions: From the results of the current study, pilocarpine mouthwash with at least 1.0% concentration more than a minute might be clinically effective in salivation without any serious side effects. Dose of mouthwash rather than duration seems to be a critical factor to salivation.