• Journal of Digital Convergence
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• v.17 no.7
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• pp.215-224
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• 2019

The objective of study was to identify perceived medication administration Competence of senior nursing students. A total of 128 students were recruited. The instruments for this study were self-efficacy for drug dosage calculation, anxiety for drug dosage calculation and perceived medication administration competence. The data were collected from November 2018 to January 2019, analyzed by descriptive analysis, chi-square, t-test, Scheffe test, correlation coefficients, and multiple regression using the SPSS 25.0 program. The main predictors of perceived medication administration competence were identified as confidence in drug dosage calculation (${\beta}=.463$, p<.001), Attitude of participation at clinical practice (${\beta}=.168$, p=.040). These two factors explained about 29% of variance in perceived medication administration competence (F=26.93, p<.001). It can contribute to improve their ability to administrate medication in practice, with the accuracy of prescription, recalculation of prescribed drug dose, and observation of adverse reactions in clinical practice and simulation with collaborative approach.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.156-163
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• 1998

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.1-9
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• 2001

Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.9-16
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• 2018

Purpose : Brain Stereotactic Radiosurgery can treat non-invasive diseases with high rates of complications due to surgical operations. However, brain stereotactic radiosurgery may be accompanied by radiation induced side effects such as fractionation radiation therapy because it uses radiation. The effects of Coplanar Volumetric Modulated Arc Therapy(C-VMAT) and Non-Coplanar Volumetric Modulated Arc Therapy(NC-VMAT) on surrounding normal tissues were analyzed in order to reduce the side effects caused fractionation radiation therapy such as head and neck. But, brain stereotactic radiosurgery these contents were not analyzed. In this study, we evaluated the usefulness of NC-VMAT by comparing and analyzing C-VMAT and NC-VMAT in patients who underwent brain stereotactic radiosurgery. Methods and materials : With C-VMAT and NC-VMAT, 13 treatment plans for brain stereotactic radiosurgery were established. The Planning Target Volume ranged from a minimum of 0.78 cc to a maximum of 12.26 cc, Prescription doses were prescribed between 15 and 24 Gy. Treatment machine was TrueBeam STx (Varian Medical Systems, USA). The energy used in the treatment plan was 6 MV Flattening Filter Free (6FFF) X-ray. The C-VMAT treatment plan used a half 2 arc or full 2 arc treatment plan, and the NC-VMAT treatment plan used 3 to 7 Arc 40 to 190 degrees. The angle of the couch was planned to be 3-7 angles. Results : The mean value of the maximum dose was $105.1{\pm}1.37%$ in C-VMAT and $105.8{\pm}1.71%$ in NC-VMAT. Conformity index of C-VMAT was $1.08{\pm}0.08$ and homogeneity index was $1.03{\pm}0.01$. Conformity index of NC-VMAT was $1.17{\pm}0.1$ and homogeneity index was $1.04{\pm}0.01$. $V_2$, $V_8$, $V_{12}$, $V_{18}$, $V_{24}$ of the brain were $176{\pm}149.36cc$, $31.50{\pm}25.03cc$, $16.53{\pm}12.63cc$, $8.60{\pm}6.87cc$ and $4.03{\pm}3.43cc$ in the C-VMAT and $135.55{\pm}115.93cc$, $24.34{\pm}17.68cc$, $14.74{\pm}10.97cc$, $8.55{\pm}6.79cc$, $4.23{\pm}3.48cc$. Conclusions : The maximum dose, conformity index, and homogeneity index showed no significant difference between C-VMAT and NC-VMAT. $V_2$ to $V_{18}$ of the brain showed a difference of at least 0.5 % to 48 %. $V_{19}$ to $V_{24}$ of the brain showed a difference of at least 0.4 % to 4.8 %. When we compare the mean value of $V_{12}$ that Radione-crosis begins to generate, NC-VMAT has about 12.2 % less amount than C-VMAT. These results suggest that if NC-VMAT is used, the volume of $V_2$ to $V_{18}$ can be reduced, which can reduce Radionecrosis.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.171-178
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• 2016

Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

• Journal of Hospice and Palliative Care
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• v.6 no.2
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• pp.144-151
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• 2003

Purpose : The purpose of this study was to identify the current status of symptom and pain control in cancer patients treated with chemotherapy. Methods : The study population consisted of 66 cancer patients treated with chemotherapy and the data was collected by chart audit and using questionnaire from 19 clinicians in an university hospital during the period of August 7 to 24, 2001. The degree of symptom, analgesics type, dose, administration route, and pain control method of cancer patients treated with chemotherapy was investigated. The collected data were analyzed by frequency, percent, mean, and SD using SPSS $PC^+$ program. Results : The number of cancer patients treated with chemotherapy was 66, male 35 (53.0%), female was 31 (47.0%). The largest of age group was $61{\sim}69$(34.8%) years old. Most frequent cancer site was stomach 19 case (28.8%), cole-rectal 17 case (25.8%), urinary 11 case (16.7%) in the respective order. The most common stage of cancer was stage 3, 14 case (29.2%). The most frequent duration of diagnosis was under 3 month, 25 (37.9%). The frequent symptom of cancer patients treated with chemotherapy was marasmus ($2.4193{\pm}1.2220$), pain ($1.9333{\pm}1.2194$), sleep disorders ($1.7142{\pm}1.0384$), personality change ($1.5806{\pm}0.8971$) in the respective order. 3) The analgesics used for pai control were narcotic analgesics 66.2% and nonnarcotic analgesics 33.8%. Pain control method were regular basis+as needed 47.4%, as needed 31.6%, regular basis 21.0% in order. Administration route were oral 50.7%, injection 41.8%, patch 7.5% in order. Conclusion : The most frequent symptom of cancer patients treated with chemotherapy were marasmus and pain. The frequent analgesics was narcotic analgesics but 21% of the clinician regularly prescribed analgesics for pain control. Thus this prescription was insufficient for pain control. Administration route that were used more oral or injection than patch. Based on this evidence, it seemed that more active practice and education about evaluation and pain control of cancer patients treated with chemotherapy are needed.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.3
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• pp.1-17
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• 2013

Objectives: In this research, the effect of samul-tanggahyangbuja on depression and learning in ovariectomized rats subjected to repetitive stress were assessed. Samul-tanggahyangbuja is the prescription consisting of Samul-tang and Cyperi Rhizoma. Methods: Ovariectomized rats were repeatedly stressed over a 2-week period. After being orally medicated with samul-tanggahyangbuja (100 or 400 mg/kg), rats performed the Morris water maze test and forced swimming test, and social exploration was assessed in a behavior test. As well, sucrose intake was measured and measurements of blood serum corticosterone and the change of interleukin-$1{\beta}$ (IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in blood samples were made. Results: 1. In the Morris water maze test, rats medicated with 100 mg samul-tanggahyangbuja mastered the maze in a shorter time on the 4th day in comparison with the control group, while rats medicated with 400 mg samul-tanggahyangbuja mastered the maze more quickly (p<0.05 on the 3rd day ; p<0.01 on the 4th day, as compared to control). 2. Immobility time in the forced swimming test was significantly decreased in rats receiving 400 mg samul-tanggahyangbuja compared with the control group (p<0.05). 3. Sucrose intake and active social behavior of rats receiving 400 mg samul-tanggahyangbuja were markedly increased in comparison with the control group (p<0.01). 4. Blood serum corticosterone measurements revealed decreased blood serum corticosterone level after medicating with samul-tanggahyangbuja. But it was not statistically significant. 5. Treatment with either dose of samul-tanggahyangbuja significantly reduced IL-$1{\beta}$ and TNF-${\alpha}$ (p<0.05). Conclusions: These results suggest that samul-tanggahyangbuja possesses the anti-depressant and cognitive-enhancing activities related to menopause.

• Journal of Radiation Protection and Research
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• v.33 no.2
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• pp.61-65
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• 2008

Objective: To reduce urinary side effects in prostate cancer patients receiving radiation, patients were asked to drink certain amount of water to maintain bladder volume constant and the bladder volumes were measured weekly using ultrasound scanner. Materials and Methods: Twenty-six patients with prostate cancer who received radiation between December 2002 and August 2007 were enrolled in this study. Thirteen patients were enrolled in experimental group. These patients were asked to drink 450 cc of water, one hour prior to simulation, CT scan, and treatment. The other thirteen patients were given no information about bladder filing. Bladder, prostate, and rectum were contoured on CT and volumes were calculated. 3D conformal treatment planning was performed and effective volumes of bladder were calculated when a prescription dose of 70.2 Gy was delivered. For the patients in experimental group, bladder volumes were measured weekly using ultrasound scanner for 6-8 weeks and the bladder volume variations were analyzed. Results: Average bladder volumes and standard deviations obtained at CT scanning were $283.5{\pm}114.0\;cc$ (40%) and $181.2{\pm}120.1\;cc$ (66%) in experimental and control groups, respectively. Although it was not statistically significant, there was correlation between the bladder volumes measured from CT and ultrasound. The volumes measured using ultrasound scanner were 62% lower than the volumes using CT images on average. There was significant variations in volumes measured weekly for 6-8 weeks. It ranged between 33 - 75 %. Conclusion: Our results showed that it is possible to obtain larger bladder volume if they are asked to drink certain amount of water prior to CT scan. However, patients were unable to maintain constant bladder volumes over the 6-8 weeks of treatment period although they were asked to drink constant amount of water.