• Quality Improvement in Health Care
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• v.14 no.2
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• Herbal Formula Science
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• v.17 no.1
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• pp.29-43
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• 2009

This report carried out to study 59 prescriptions related to the use of Pueraria thunbergiana bentham in Dongueibogam This study is based on Dongueibogam which has been widely used for herbal clinic in Korea. And this study is investigated to make sure of the range of treatment, nature of disease, the pathology and the dosage of Pueraria thunbergiana bentham in Dongueibogam. The following conclusions were reached through investigations on the prescriptions that used in Dongueibogam as a various role. 1. The prescriptions that Pueraria thunbergiana bentham was taken as a 15 for monarchy, 15 for attendant, 11 for assistance and valet herb are utilized for therapeutic treatments such as cough, fever etc, mainly Sanghan syndromes in the chapter of Wind. 2. The Pueraria thunbergiana bentham was also utilized as a key ingradients in the chapter of Eye and Onyeok epidemic. 3. The most frequent mass of the Pueraria thunbergiana bentham when used as a monarchy herb is 2jeon, and the standard limited range of adding Pueraria thunbergiana bentham to medical prescription is 7pun$\sim$5jeon per dose. But, when used as a attendant herb, an typical and regular adding dose is the range of 3pun5ri$\sim$1yang2.5jeon,and 3pun$\sim$1.5jun in the case of assistant. 4. The phathogenic factors and phathology of Pueraria thunbergiana bentham in the prescription are based on the chapter of Cold when used as a monarchy herb and on the chapter of Wind in the case of attendant herb. 5. The Seungmagalgeontang is the most useful base prescription which use the Pueraria thunbergiana bentham as the main ingredient.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.1
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• pp.53-58
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• 2014

The object of this study was to evaluate the single dose toxicity of Choweseuncheng-tang (CWS), a polyherbal formula have been traditionally used as prevention or treatment agent for various diseases as Tae-eumin prescription on Korean medicinal theory, Sasang-euihak, in male and female mice. Aqueous extracts of CWS (yield = 11.00%) was administered to female and male mice as an oral dose of 2,000, 1,000 and 500 mg/kg (body weight) according to the recommendation of Korea Food and Drug Administration (KFDA) Guidelines. Animals were monitored for the mortality and changes in body weight, clinical signs and gross observation during 14 days after dosing, upon necropsy; organ weight and histopathology of 14 principle organs were also examined. As results, we could not find any CWS treatment related mortality and clinical signs, changes in the body and organ weights, gross findings and changes in histopathology of principle organs, except for some dose-independent accidental findings. The results obtained in this study suggest that the 50% lethal dose and approximate lethal dose of CWS aqueous extracts in both female and male mice were considered as over 2,000 mg/kg, the limited highest dosage recommended by KFDA Guidelines, and can be safety used in clinics.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.183-188
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• 2012

Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.801-809
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• 2019

Existing Gamma Knife Radiosurgery(GKRS) for large lesions is often conducted in stages with volume or dose partitions. Often in case of volume division the target used to be divided into sub-volumes which are irradiated under the determined prescription dose in multi-sessions separated by a day or two, 3~6 months. For the entire course of treatment, treatment informations of the previous stages needs to be reflected to subsequent sessions on the newly mounted stereotactic frame through coordinate transformation between sessions. However, it is practically difficult to implement the previous dose distributions with existing Gamma Knife system except in the same stereotactic space. The treatment area is expanding because it is possible to perform the multistage treatment using the latest Gamma Knife Platform(GKP). The purpose of this study is to introduce the image-coregistration based on the stereotactic spaces and the strategy of multistage GKRS such as the determination of prescription dose at each stage using new GKP. Usually in image-coregistration either surgically-embedded fiducials or internal anatomical landmarks are used to determine the transformation relationship. Author compared the accuracy of coordinate transformation between multi-sessions using four or six anatomical landmarks as an example using internal anatomical landmarks. Transformation matrix between two stereotactic spaces was determined using PseudoInverse or Singular Value Decomposition to minimize the discrepancy between measured and calculated coordinates. To evaluate the transformation accuracy, the difference between measured and transformed coordinates, i.e., ${\Delta}r$, was calculated using 10 landmarks. Four or six points among 10 landmarks were used to determine the coordinate transformation, and the rest were used to evaluate the approaching method. Each of the values of ${\Delta}r$ in two approaching methods ranged from 0.6 mm to 2.4 mm, from 0.17 mm to 0.57 mm. In addition, a method of determining the prescription dose to give the same effect as the treatment of the total lesion once in case of lesion splitting was suggested. The strategy of multistage treatment in the same stereotactic space is to design the treatment for the whole lesion first, and the whole treatment design shots are divided into shots of each stage treatment to construct shots of each stage and determine the appropriate prescription dose at each stage. In conclusion, author confirmed the accuracy of prescribing dose determination as a multistage treatment strategy and found that using as many internal landmarks as possible than using small landmarks to determine coordinate transformation between multi-sessions yielded better results. In the future, the proposed multistage treatment strategy will be a great contributor to the frameless fractionated treatment of several Gamma Knife Centers.

• The Journal of Korean Medical History
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• v.34 no.2
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• pp.117-126
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• 2021

Songjeol-tea is a prescription that mixes alcohol with some ingredients and Songjeol[松節], and appears only in the King-Yeongjo era throughout 『Seungjeongwon Ilgi』. King Yeongjo recognized that the Songjeol-tea was an excellent prescription for the treatment of leg diseases, and took it in various ways thanks to the title of "tea" by his officials and doctors. There were many internal conflicts as King Yeongjo taking a prescription in the form of alcohol in a situation where an official who violated it was punished after issuing prohibition of drinking alcohol, and recognized the Songjeol-tea as alcohol. The officials and doctors of King Yeongjo's reign rationalized the King's actions by creating a justification for taking the Songjeol-tea to treat the disease because the king's body was related to the safety of the state.

• Herbal Formula Science
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• v.18 no.2
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• pp.183-199
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• 2010

Rheumatoid arthritis is characterized by the focal loss of cartilage due to an up-regulation of inflammatory pathways, which produce inflammatory mediators, such as interleukin-1beta(IL-$1{\beta}$), IL-6, tumour necrosis factor alpha(TNF-$\alpha$), prostaglandin, and nitric oxide(NO). We investigated the anti-arthritic effects of water extract from FLOS LONICERAE(FLWE) in vitro and in vivo. Extract inhibited the production of inflammatory mediators(NO, IL-$1{\beta}$, TNF-$\alpha$, and prostaglandin $E_2$) and the expression of inducible NO synthase(iNOS) and cyclooxygenase-2(COX-2) in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages in a dose-dependent manner. FLWE also inhibited TNF-$\alpha$, IL-$1{\beta}$, IL-6, and $PGE_2$ production as well as COX activity in collagen-induced mouse arthritis. Moreover, FLWE significantly suppressed collagen-induced mouse arthritis. These results suggest that FLOS LONICERAE may be useful for therapy against inflammatory immune diseases and rheumatoid arthritis, probably by suppressing the production of inflammatory mediators.

• Herbal Formula Science
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• v.20 no.2
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• pp.55-63
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• 2012

Objectives : This study was conducted to investigate the safety of Bangpungtongsung-san in rats. Methods : The safety of this prescription on acute toxicity was evaluated by single dose toxicity study. Rats were orally administrated in a single dose of 0 and 2,000 mg/kg(limited dose) Bangpungtongsung-san. There were 7 rats in each groups. All animals were sacrificed after 14 days of treatment. After single administration, mortality, clinical signs, and body weight changes were observed for 14 days. Three parameters(autopsy finding, clinical chemistry, and hematology) were tested on the last day. Results : In this study with rats, Bangpungtongsung-san treatment did not show any acute toxicity. No mortality was noted for 14 days of treatment. There were no adverse effects on clinical signs, body weight changes, and autopsy finding at all treatment groups. The clinical chemistry parameters attesting to liver and kidney functions as well as the hematological parameters were within the normal ranges. Conclusions : It is considered that $LD_{50}$ of Bangpungtongsung-san is over 2,000 mg/kg in oral administration by rats. This finding of the safety of Bangpungtongsung-san is expected to strengthen the position of this prescription as nontoxic medicine.

• Progress in Medical Physics
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• v.25 no.4
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• pp.288-297
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• 2014

Dynamic conformal arc therapy (DCAT) and flattening-filter-free (FFF) beams are commonly adopted for efficient conformal dose delivery in stereotactic body radiation therapy (SBRT). Off-axis geometry (OAG) may be necessary to obtain full gantry rotation without collision, which has been shown to be beneficial for peripheral targets using flattened beams. In this study dose distributions in OAG using FFF were evaluated and the effect of mechanical rotation induced uncertainty was investigated. For the lateral target, OAG evaluation, sphere targets (2, 4, and 6 cm diameter) were placed at three locations (central axis, 3 cm off-axis, and 6 cm off-axis) in a representative patient CT set. For each target, DCAT plans under the same objective were obtained for 6X, 6FFF, 10X, and 10FFF. The parameters used to evaluate the quality of the plans were homogeneity index (HI), conformality indices (CI), and beam on time (BOT). Next, the mechanical rotation induced uncertainty was evaluated using five SBRT patient plans that were randomly selected from a group of patients with laterally located tumors. For each of the five cases, a plan was generated using OAG and CAG with the same prescription and coverage. Each was replanned to account for one degree collimator/couch rotation errors during delivery. Prescription isodose coverage, CI, and lung dose were evaluated. HI and CI values for the lateral target, OAG evaluation were similar for flattened and unflattened beams; however, 6FFF provided slightly better values than 10FFF in OAG. For all plans the HI and CI were acceptable with the maximum difference between flattened and unflattend beams being 0.1. FFF beams showed better conformality than flattened beams for low doses and small targets. Variation due to rotational error for isodose coverage, CI, and lung dose was generally smaller for CAG compared to OAG, with some of these comparisons reaching statistical significance. However, the variations in dose distributions for either treatment technique were small and may not be clinically significant. FFF beams showed acceptable dose distributions in OAG. Although 10FFF provides more dramatic BOT reduction, it generally provides less favorable dosimetric indices compared to 6FFF in OAG. Mechanical uncertainty in collimator and couch rotation had an increased effect for OAG compared to CAG; however, the variations in dose distributions for either treatment technique were minimal.

• Radiation Oncology Journal
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• v.7 no.1
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• pp.81-83
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• 1989

This study, involving thirty-two patients with carcinoma of uterine cervix treated by high dose rate intracavitary irradiation using a remotely controlled afterloading system, compares the doss at point A and 8 with the Curie-minutes prescription. A linear least-square regression analysis was used to compare the two sets of date. Correlation coefficients between doses at points A and B and the Ci-min prescription are 0.92 (p<0.001) and 0.90 (p<0.001), respectively, and linear relationship is observed between these two system. The limitation and significance of the comparison of the two approaches to intracavitary dosimetry is discussed.