• The Korean Journal of Pain
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• v.27 no.1
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• pp.35-42
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• 2014

Background: Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods: Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results: More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions: Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.6 no.1
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• pp.10-19
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• 2020

Boron Neutron Capture Therapy (BNCT) has the advantage of selectively removing cancer cells ingesting boron compounds. In this study, the benefits for treatment time and boron compound injection dose were compared between current neutron sources and a high current neutron sources to be developed in near future. The time-activity curve (TAC) of GBM (Glioblastoma) for one bolus injection was obtained by applying modified 3 compartment model. The treatment time was determined for an accelerator-based neutron sources at the present time and a high current accelerator based neutron source to be developed in the near future. In the case of the double amount of IAEA-recommended neutron flux, the treatment time was shortened to 15 minutes. In the case of high current accelerators, which are five times the amount of IAEA-recommended neutron flux, the irradiation time is within 5 minutes. The use of a high current accelerator based neutron source in BNCT is advantageous in terms of treatment time. In addition, it can increase the efficiency of use of neutrons and reduce the boron compound injection dose to patients, thus reducing pharmacological toxicity.

• The Journal of the Society of Stroke on Korean Medicine
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• v.21 no.1
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• pp.11-20
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• 2020

■ Objectives The purpose of this study is to report on a case that showed improvement in type 2 diabetic patients by using herbal medicine, Yeoldahansotang-gami. ■ Methods Yeoldahansotang-gami was given to patients with type 2 diabetes for 71days. To evaluate the effect, blood glucose was measured 4 times a day. As measured blood sugar, the frequency of hyperglycemia, changes in fasting blood sugar, changes in postprandial blood sugar, and changes in glucose variability were analyzed. The patient's insulin injection dose change was observed, and HbA1c and glycated albumin were measured. Follow-up was performed for 7 months to observe whether the treatment effect was maintained. ■ Results During treatment, the patient's blood sugar control, glucose variability, and HbA1c were improved, and insulin injection dose was gradually reduced and stopped. HbA1c and glycated albumin levels maintained improvement without insulin injection during the follow-up period. ■ Conclusion This study showed the effect of yeoldahansotang-gami on type 2 diabetes patient.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.181-189
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• 2019

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.67-75
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• 2018

Purpose The purpose of this study is to investigate and analyze the external dose rates of $^{18}F-FDG$ Whole Body PET/CT patients by distance, and to identify the main factors that contribute to the reduction of radiation dose by checking the cumulative doses of nuclear medicine technologist(NMT). Materials and Methods After completion of the $^{18}F-FDG$ Whole Body PET/CT scan($75.4{\pm}3.3min$), the external dose rates of 106 patients were measured at a distance of 0, 10, 30, 50, and 100 cm from the chest. Gender, age, BMI(Body Mass Index), fasting time, diabetes mellitus, radiopharmaceutical injection information, creatine value were collected to analyze individual factors that could affect external dose rates from a patient's perspective. From the perspective of NMT, personal pocket dosimeters were worn on the chest to record accumulated dose of NMT who performed the injection task($T_1$, $T_2$ and $T_3$) and scan task($T_4$, $T_5$ and $T_6$). In addition, patient contact time with NMT was measured and analyzed. Results External dose rates from the patient for each distance were calculated as $246.9{\pm}37.6$, $129.9{\pm}16.7$, $61.2{\pm}9.1$, $34.4{\pm}5.9$, and $13.1{\pm}2.4{\mu}Sv/hr$ respectively. On the patient's aspect, there was a significant difference in the proximity of gender, BMI, Injection dose and creatine value, but the difference decreased as the distance increased. In case of dialysis patient, external dose rates for each distance were exceptionally higher than other patients. On the NMT aspect, the doses received from patients were 0.70, 1.09, $0.55{\mu}Sv/person$ for performing the injection task($T_1$, $T_2$, and $T_3$), and were 1.25, 0.82, $1.23{\mu}Sv/person$ for performing the scan task($T_4$, $T_5$, $T_6$). Conclusion we found that maintaining proper distance with patient and reducing contact time with patient had a significant effect on accumulated doses. Considering those points, efforts such as sufficient water intake and encourage of urination, maintaining the proper distance between the NMT and the patient(at least 100 cm), and reducing the contact time should be done for reducing dose rates not only patient but also NMT.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.579-589
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• 2020

Objective : No optimum genetic rat Huntington model both neuropathological using an adeno-associated virus (AAV-2) vector vector has been reported to date. We investigated whether direct infection of an AAV2 encoding a fragment of mutant huntingtin (AV2-82Q) into the rat striatum was useful for optimizing the Huntington rat model. Methods : We prepared ten unilateral models by injecting AAV2-82Q into the right striatum, as well as ten bilateral models. In each group, five rats were assigned to either the 2×10¹² genome copies (GC)/mL of AAV2-82Q (×1, low dose) or 2×10¹³ GC/mL of AAV2-82Q (×10, high dose) injection model. Ten unilateral and ten bilateral models injected with AAV-empty were also prepared as control groups. We performed cylinder and stepping tests 2, 4, 6, and 8 weeks after injection, tested EM48 positive mutant huntingtin aggregates. Results : The high dose of unilateral and bilateral AAV2-82Q model showed a greater decrease in performance on the stepping and cylinder tests. We also observed more prominent EM48-positive mutant huntingtin aggregates in the medium spiny neurons of the high dose of AAV2-82Q injected group. Conclusion : Based on the results from the present study, high dose of AAV2-82Q is the optimum titer for establishing a Huntington rat model. Delivery of high dose of human AAV2-82Q resulted in the manifestation of Huntington behaviors and optimum expression of the huntingtin protein in vivo.

• IMMUNE NETWORK
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• v.3 no.3
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• pp.211-218
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• 2003

Background: Vitamin C is an essential nutrient, taken as a daily supplement by many people. Recently, high-dose vitamin C is considered as a therapeutic regimen in some clinical situations. Until now, few studies have been done with the effects of high-dose vitamin C on the immune response. Methods: In this experiment, the effects of high-dose vitamin C on cell-mediated immune response in immunologically competent mice were evaluated. After intraperitoneal injection of 2.5, 5, or 10 mg/day of vitamin C for 10 days, delayed type hypersensitivity (DTH) was provoked against DNFB in the pinnae as a model for cell-mediated immune response. Severity of DTH reaction was evaluated as the thickness of pinnae, and the vitamin C levels were measured in the serum, liver, kidney, lung, pinnae, and splenocytes. Results: After challenge, the thickness increased at its peak on the $2^{nd}$ day in all groups. On the first day, the pinnae were thicker in the injected groups than in the control. On the contrary, the increment of the pinnae thickness was attenuated and the number of cells infiltrated in the site of DTH decreased proportionately to the amount of vitamin C administered from the second day on. With vitamin C exogenously given, the serum level peaked at 30 min after injection, and returned abruptly to its basal level without accumulation. However, it accumulated in the liver, kidney, and especially in the pinnae inflamed and splenopcytes, proportionately to the amount administered. Conclusion: Based on these results, it is suggested that, in one hand, exogenously administered high-dose vitamin C accumulated in the splenocytes and presumably changed the function of them resulting in the augmented cell-mediated immune response, as was revealed in the first day of DTH reaction. On the other hand, it seems likely that the vitamin C also showed anti-inflammatory effects.

• YAKHAK HOEJI
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• v.40 no.2
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• pp.202-211
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• 1996

Experiments were performed on male Sprague-Dawley rats to investigate the immunobiological effects on route of administration of amygdalin(AM). Rats were administered orally at 12.5, 25, or 50mg/kg/day of AM or injected wtih 25,50, or 100mg/kg/day of AM intravenously for 2 weeks. Rats were immunized and challenged with sheep red blood cells(SRBC). The results of this study were summarized as follows;(1) In oral administration of AM, body weight gains were significantly increased by 50mg/kg AM as compared with controls, the relative weights of liver and thymus also were significantly increased by 12.5 and 25mg/kg AM. However, 2-mercaptoethanol-resistant hemagglutination titier (2-MER HA), Plaque forming cells (PFC) and rosette forming cells (RFC) were non-dose dependently decreased. Phagocytic activity and delayed-type hypersensitivity (DTH) reaction also were significantly decreased by 50mg/kg AM. (2) In intravenous injection of AM, body weight gains, hemagglutination titer (HA), 2MER-HA, DTH reaction, PFC, RFC and circulating leukocytes were not influenced by AM. However, the relative weights of liver, spleen and thymus were significantly enhanced 100mg/kg AM. These results indicated that oral administration of AM non-dose dependently suppresses humoral and cell-mediated immunity in SD rats, and that intravenous injection of AM is unaffected humoral and cell-mediated immunity, however, the high dose of it significantly enhances phagocytic activity.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.61-71
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• 1986

An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.22-32
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• 2006

Background: This study was conducted to investigate the roles of the spinal and peripheral ${\gamma}$-aminobutyric acid (GABA)- ergic systems for the mechanical hypersensitivity produced by chronic compression of the dorsal root ganglion (CCD). Methods: CCD was performed at the left 5th lumbar dorsal root ganglion. The paw withdrawal threshold (PWT) to von Frey stimuli was measured. The mechanical responsiveness of the lumbar dorsal horn neurons was examined. GABAergic drugs were delivered with intrathecal (i.t.) or intraplantar (i.pl.) injection or by topical application onto the spinal cord. Results: CCD produced mechanical hypersensitivity, which was evidenced by the decrease of the PWT, and it lasting for 10 weeks. For the rats showing mechanical hypersensitivity, the mechanical responsiveness of the lumbar dorsal horn neurons was enhanced. A similar increase was observed with the normal lumbar dorsal horn neurons when the GABA-A receptor antagonist bicuculline was topically applied. An i.t. injection of GABA-A or GABA-B receptor agonist, muscimol or baclofen, alleviated the CCD-induced hypersensitivity. Topical application of same drugs attenuated the CCD-induced enhanced mechanical responsiveness of the lumbar dorsal horn neurons. CCD-induced hypersensitivity was also improved by low-dose muscimol applied (i.pl.) into the affected hind paw, whereas no effects could be observed with high-dose muscimol or baclofen. Conclusions: The results suggest that the neuropathic pain associated with compression of the dorsal root ganglion is caused by hyperexcitability of the dorsal horn neurons due to a loss of spinal GABAergic inhibition. Peripheral application of low-dose GABA-A receptor agonist can be useful to treat this pain.