• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.211-219
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• 2012

Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the treatment of extensive diseases related to various symptoms; inflammation, pain and fever. NSAIDs work by blocking prostaglandin synthesis, but adverse drug events (ADEs) have been increasing dramatically such as gastrointestinal bleeding, perforation and stenosis, a kind of serious ADEs. Therefore, NSAID-related ulcer complication guidelines have been announced containing various risk factors and symptoms. Thus, this study aims to evaluate of NSAID usage and appropriateness for prevention of NSAID-related ulcer complication based on American journal of gastroenterology (AJG) guideline 2009. Further, the study suggests Korean guideline for prevention of NSAID-related ulcer compared to AJG guideline. For this study, data was collected through electronic medical record (EMR) at Seoul national university of Bundang hospital. The primary end point was a composite of NSAID-related ulcer risk factor, types of NSAIDs, co-prescribed NSAID ulcer prevention drugs and NSAID-related ulcer after taking NSAID. The risk factors include over 65 years, high dose NSAID, previous ulcer history and taking drugs (e.g. aspirin, anticoagulant and steroid) causing ulcer. If a patient has 3 or 4 factors, that patient was classified high risk group. And if 1 or 2 factors that patient was classified moderate risk group. The patient who has no risk factor was in low risk group. I studied 8,120 patients who received NSAID from 1 January 2009 to 31 December 2009. High risk group was 16(0.2%), moderate risk group was 4,364(53.7%), and low risk group was 3,740(46.1%). The results show that high risk group should be prescribed COX-2 inhibitors with ulcer prevention drugs, and moderate or low risk group need traditional NSAIDs with ulcer prevention drugs. This may be different with 2009 AJG guideline because AJG guideline suggested taking COX-2 inhibitor alone in moderate group or taking traditional NSAID alone in low risk group could get higher ulcer complication. The results indicated that choosing preventive drug is important in case that how many risk factors the patients have. The proper drugs would be helpful for safe and effective NSAID usage in each patient group.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.341-351
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• 2018

Objectives: Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements. Methods: Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified. Results: Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin $B_{12}$ (45.8%), vitamin C (38.6%), and vitamin $B_6$ (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes. Conclusions: Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.

• Journal of Radiation Protection and Research
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• v.28 no.3
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• pp.199-206
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• 2003

Because the MIRD phantom, the representative mathematical phantom was developed for the calculation of internal radiation dose, and simulated by the simplified mathematical equations for rapid computation, the appropriateness of application to external dose calculation and the closeness to real human body should be justified. This study was intended to modify the MIRD phantom according to the comparison of the organ absorbed doses in the two phantoms exposed to monoenergetic broad parallel photon beams of the energy between 0.05 MeV and 10 MeV. The organ absorbed doses of the MIRD phantom and the Zubal yokel phantom were calculated for AP and PA geometries by MCNP4C, general-purpose Monte Carlo code. The MIRD phantom received higher doses than the Zubal phantom for both AP and PA geometries. Effective dose in PA geometry for 0.05 MeV photon beams showed the difference up to 50%. Anatomical axial views of the two phantoms revealed the thinner trunk thickness of the MIRD phantom than that of the Zubal phantom. To find out the optimal thickness of trunk, the difference of effective doses for 0.5 MeV photon beams for various trunk thickness of the MIRD phantom from 20 cm to 36 cm were compared. The optimal thunk thickness, 24 cm and 28 cm for AP and PA geometries, respectively, showed the minimum difference of effective doses between the two phantoms. The trunk model of the MIRD phantom was modified and the organ doses were recalculated using the modified MIRD phantom. The differences of effective dose for AP and PA geometries reduced to 7.3% and the overestimation of organ doses decreased, too. Because MIRD-type phantoms are easier to be adopted in Monte Carlo calculations and to standardize, the modifications of the MIRD phantom allow us to hold the advantage of MIRD-type phantoms over a voxel phantom and alleviate the anatomical difference and consequent disagreement in dose calculation.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.83-88
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• 2015

Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

• Advances in concrete construction
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• v.2 no.4
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• pp.249-259
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• 2014

Mortar is a masonry product which is matrix of concrete. It consists of binder and fine aggregate and moreover, it is an essential associate in any reinforced structural construction. The strength of mortar is a special concern to the engineer because mortar is responsible to give protection in the outer part of the structure as well as at a brick joint in masonry wall system. The purpose of this research is to investigate the compressive strength and tensile strength of mortar, which are important mechanical properties, by replacing the cement and sand by stone dust. Moreover, to minimize the increasing demand of cement and sand, checking of appropriateness of stone dust as a construction material is necessary to ensure both solid waste minimization and recovery by exchanging stone dust with cement and sand. Stone dust passing by No. 200 sieve, is used as cement replacing material and retained by No. 100 sieve is used for sand replacement. Sand was replaced by stone dust of 15%, 20%, 25%, 30%, 35%, 40%, 45% and 50% by weight of sand while cement was replaced by stone dust of 3%, 5%, and 7% by weight of cement. Test result indicates that, compressive strength of specimen mix with 35% of sand replacing stone dust and 3% of cement replacing stone dust increases 21.33% and 22.76% respectively than the normal mortar specimen at 7 and 28 days while for tensile it increases up to 13.47%. At the end, optimum dose was selected and crack analysis as well as discussion also included.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.332-338
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• 2011

This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.123-135
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• 2012

Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.442-448
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• 2016

This study was conducted to determine the appropriateness of systemic radiation exposure control for students in clinical practice by comparing radiation exposure in radiography employees at different stations of a hospital with that of students conducting clinical practice using identical stations. Overall, 121 students who conducted clinical practice in the department of radiology area of C university hospital from July 2014 to August 2014 and 62 workers working in the same medical facility (47 in the department of radiology, 8 in the department of radiation oncology, 7 in the department of nuclear medicine) were investigated. The radiation exposure experienced by students was measured for 8 weeks, which is the duration of the clinical practice. Additionally, radiation exposure of workers were classified into 4 groups, department of radiology, department of radiation oncology, and department of nuclear medicine was compared. Dose was measured with OSLD and differences among groups were identified by ANOVA followed by Duncan's multiple range test. Among employees, those in the department of radiology, oncology and nuclear medicine were exposed depth doses of $0.127{\pm}0.331mSv$, $0.01{\pm}0.003mSv$, and $0.431{\pm}0.205mSv$, respectively, while students were exposed to $0.143{\pm}0.136mSv$. Additionally, workers in the department of radiology, oncology and nuclear medicine were exposed to surface doses of $0.131{\pm}0.331mSv$, $0.009{\pm}0.003mSv$, and $0.445{\pm}0.198mSv$, respectively, while students were exposed to $0.151{\pm}0.14mSv$, which was significantly different in both doses (p < 0.01). The average dose that students received is higher than that of the other groups (except for nuclear medicine workers), indicating that further improvements must be made in systemic controls for individual radiation exposure by including the students as subjects of management for protection from radiation.

• Journal of Marine Life Science
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• v.9 no.1
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• pp.9-21
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• 2024

Paralytic shellfish poisoning (PSP) including Saxitoxin (STX) is caused by harmful algae, and poisoning occurs when the contaminated seafood is consumed. The mouse bioassay (MBA), a standard test method for detecting PSP, is being sanctioned in many countries due to its low detection limit and the animal concerns. An alternative to the MBA is the Neuro-2a cell-based assay. This study aimed to establish various test conditions for Neuro-2a assay, including cell density, culture conditions, and STX treatment conditions, to suit the domestic laboratory environment. As a result, the initial cell density was set to 40,000 cells/well and the incubation time to 24 hours. Additionally, the concentration of Ouabain and Veratridine (O/V) was set to 500/50 μM, at which most cells died. In this study, we identified eight concentrations of STX, ranging from 368 to 47,056 fg/μl, which produced an S-shaped dose-response curve when treated with O/V. Through inter-laboratory variability comparison of the Neuro-2a assay, we established five Quality Control Criteria to verify the appropriateness of the experiments and six Data Criteria (Top and Bottom OD, EC₅₀, EC₂₀, Hill slop, and R² of graph) to determine the reliability of the experimental data. The Neuro-2a assay conducted under the established conditions showed an EC₅₀ value of approximately 1,800~3,500 fg/μl. The intra- & inter-lab variability comparison results showed that the coefficients of variation (CVs) for the Quality Control and Data values ranged from 1.98% to 29.15%, confirming the reproducibility of the experiments. This study presented Quality Control Criteria and Data Criteria to assess the appropriateness of the experiments and confirmed the excellent repeatability and reproducibility of the Neuro-2a assay. To apply the Neuro-2a assay as an alternative method for detecting PSP in domestic seafood, it is essential to establish a toxin extraction method from seafood and toxin quantification methods, and perform correlation analysis with MBA and instrumental analysis methods.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.165-176
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• 2004

Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.