• Title/Summary/Keyword: peripheral

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A Study of Peripheral Doses for Physical Wedge and Dynamic Wedge (고정형쐐기(Physical Wedge)와 동적쐐기(Dynamic Wedge)의 조사야 주변 선량에 관한 연구)

  • Min, Je-Soon;Na, Kyung-Soo;Lee, Je-Hee;Park, Heung-Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.77-82
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    • 2007
  • Purpose: This study investigates peripheral dose from physical wedge and dynamic wedge system on a multileaf collimator (MLC) equipment linear accelerator. Materials and Methods: Measurments were performed using a 2D array ion chamber and solid water phantom for a 10$\times$10 cm, source-surface distance (SSD) 90 cm, 6 and 15 MV photon beam at depths of 0.5 cm, 5 cm through dmax. Measurments of peripheral dose at 0.5 cm and 5 cm depths were performed from 1 cm to 5 cm outside of fields for the dynamic wedge and physical wedge 15$^\circ$, 45$^\circ$. Dose profiles normalized to dose at the maximum depth. Results: At 6 MV photon beam, the average peripheral dose of dynamic wedge were lower by 1.4% and 0.1%. At 15 MV photon beam, the peripheral dose of dynamic wedge were lower by maximum 1.6%. Conclusion: This study showed that dynamic wedge can reduce scattered dose of clinical organ close to the field edge and reduced treatment time. The wedge systems produce significantly different peripheral dose that should be considered in properly choosing a wedge system for clinical use.

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Evaluation of Chemotherapy Induced Peripheral Neuropathy by Cisplatin, Carboplatin and Oxaliplatin (Cisplatin, Carboplatin, Oxaliplatin 투여로 인한 말초신경병증에 대한 평가)

  • Yoon, Wan Ki;Heo, Mi Jung;Lee, Ok Sang;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.356-366
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    • 2012
  • Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

The Clinical Research of the Effectiveness of "Danmuji Anchu Traction technique" on Acute Peripheral Facial Paralysis (초기 말초성 안면신경마비에 대한 단무지 안추 신전법 병행 치료 효능의 임상적 고찰)

  • Park, Jae-Heung;Lee, Chang-Hwan;Lee, Yoo-Hwan;Kwon, Gi-Sun;Yoon, Hyun-Min;Jeun, Dae-Seong;Han, Min-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.43-52
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    • 2011
  • Objectives : The aim of this study is to investigate the effectiveness of combining "Danmuji Anchu Traction technique" on acute peripheral facial paralysis. Methods : Clinical studies were done 36 patients who were treated acute peripheral facial paralysis to Dept. of Acupuncture and Moxibustion, of Oriental Medicine Hospital Dongeui University from July 10, 2009 to September 15, 2010. subjects were randomly divided into 2 groups. : Complex oriental medical treatment without "Danmuji Anchu Traction technique" treated group (Group A, n=18), Complex oriental medical treatment with "Danmuji Anchu Traction technique" treated group (Group B, n=18). All process of treatment were performed by double blinding method. To compare the effectiveness of treatment applied for two groups, we used Yanagihara's unweighed grading system at before treatment, after 1week and 2weeks of treatment. Results: The Yanagihara's Scores of Group B and Improvement Indexes of Group B were higher than those of Group A, and showed significant difference statistically. "Danmuji Anchu Traction technique" can be available for relieving symptoms related with Acute Peripheral Facial Paralysis. And there were significant differences statistically between Complex oriental medical treatment without "Danmuji Anchu Traction technique" and Complex oriental medical treatment with "Danmuji Anchu Traction technique" on Acute Peripheral Facial Paralysis. Conclusions: These results suggested that "Danmuji Anchu Traction technique" effected for Acute Peripheral Facial Paralysis.

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A Study of Peripheral Blood Stem Cell Collection and Bone Marrow Engraftment after Peripheral Blood Stem Cell Transplantation (말초혈액 조혈모세포 채혈 및 이식 후 생착에 관한 연구)

  • Son, Gye-Sung;Kwon, Heung-Man;Kwon, Gye-Cheol
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.1
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    • pp.9-15
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    • 2006
  • Peripheral bood stem cell collection (PBSCC), including peripheral blood stem cell transplantation (PBSCT), has been utilized worldwide as a very beneficial treatment method instead of allogenic Bone Marrow Transplantation (BMT) because it has many advantages such as rapid bone marrow engraftment and hematopoietic recovery, easy and safe accessibility and lower risk of rejection compared with allogenic BMT. In order to identify most the observable parameter in PBSCC, we analyzed various hematological parameters before and after PBSCC, and evaluated the correlation between the time of bone marrow engraftment and the number of CD34+ cells. Thirteen patients, who underwent 54 PBSCCs from January, 2003 to August, 2004 at Chungnam National University Hospital due to various systemic neoplasms, were analyzed in aspects of various hematological parameters including CD34+ cells using by Flow Cytometry (FCM). PBSCC harvests are described below: Mononuclear cells (MNC) $2.3{\pm}1.4{\times}10^8/kg$ and CD34+ cells $0.63{\pm}0.35{\times}10^6/kg$ on average, respectively. There was a statistical significance in Hb and Hct before and after PBSCC, but not in WBC and platelet counts. The period to reach the hematological bone marrow engraftment was 13.4(10~21) days and 19.5(11~38) days according to the criteria of absolute neutrophile counts (ANC) ${\geq}500/uL$ and platelet counts ${\geq}50,000/{\mu}L$ in peripheral blood, respectively. There was a significant correlation between the numbers of CD34+ cell and ANC (p<0.05), and a borderline significance between MNC and ANC (p=0.051). We found that a group of patients, who were infused with CD34+ cells more than $3.5{\times}10^6/kg$, reached more rapidly the period of bone marrow engraftment in platelet counts (p=0.040). This present study suggested that Hb and Hct were the most useful parameters and should be closely monitored before and after PBSCC, that a PBSCT with the dosage of more than $3.5{\times}10^6/kg$ of CD34+ cells was needed to perform successful bone marrow engraftment, and additionally that platelet counts could be more useful in indicating bone marrow engraftment than ANC.

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Five Case Report of Peripheral Vertigo Diagnosed Dam Hun with Oriental Medical Treatment - Banhabaeckchulchunma-tang gagam - (담훈으로 변증된 말초성 현훈 환자 5례에 대한 임상보고 - 반하백출천마방 가감방을 중심으로 -)

  • An, So-Hyun;Choi, Jeong-Sik;Cho, Chung-Sik;Kim, Cheol-Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.263-268
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    • 2009
  • Pripheral vertigo occurs if there is a problem with the part of the inner ear that controls balance or with the vestibular nerve, which connects the inner ear to the brainstem. Peripheral vertigo is caused by benign paroxysmal positional vertigo(BPPV), Menieres disease, vestibular neuronitis, or labyrinthitis. We diagnosed five patients who have severe vertigo as peripheral vertigo and Dam Hun. We treated them with Banhabaeckchulchunma-tang gagam and acupuncture. After treatment, vertigo and other symptoms -nausea, vomiting, abdominal discomfort had improved. So I report these cases, but more clinical case reports are needed.

Oxaliplatin-Induced Peripheral Neuropathy and Quality of Life in Patients with Digestive System Cancer

  • Kim, Hye Young
    • Korean Journal of Adult Nursing
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    • v.28 no.3
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    • pp.343-353
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    • 2016
  • Purpose: This study aimed to identify the levels of oxaliplatin-induced peripheral neuropathy (OXLIPN) and the quality of life (QOL) related to OXLIPN in patients with digestive system cancer. Methods: A total of 83 patients with chemotherapy-induced peripheral neuropathy (CIPN)-related symptoms participated in this study. Data were collected through self-reported questionnaire which were constructed to include general and clinical characteristics, EORTC QLQ-C30, Patient Neurotoxicity Questionnaire (PNQ), and EORTC QLQ-CIPN20. Results: The average scores of OXLIPN upper and lower extremity scale were 30.01 and 29.16, respectively. The average scores of PNQ sensory and motor scale were 2.11 and 1.70, respectively. The mean score of the QLQ-C30 global health status was 54.85, and the range of mean score of the functional and symptom subdomains was 34.85~73.29 and 17.67~53.54, respectively. The CIPN-related symptoms positively correlated with the global health status scale and all subdomains of functional scale, respectively and negatively correlated with fatigue, pain, dyspnea, insomnia, and financial problem subdomains of the symptom scale, respectively. Conclusion: Oncology nurses should pay attention and provide remedies for CIPN symptoms reported by their patients. Nursing interventions should be developed for patients with digestive system cancer to alleviate CIPN and enhance their QOL.

Effects of Bogijetong-Tang on Diabetic-peripheral Neuropathy Induced by Streptozotocin in the Mouse (보기제통탕(補氣除痛湯)이 Streptozotocin으로 유발된 당뇨병성 말초신경병증 동물 모델에 미치는 영향)

  • Lee, Jong Bin;Kim, Chul Jung;Cho, Chung Sik
    • The Journal of Korean Medicine
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    • v.34 no.3
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    • pp.126-142
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    • 2013
  • Objectives: Previous reports have shown that Bogijetong-Tang (BJT) is effective in peripheral neuropathy induced by taxol and crush injury. In this study, we researched the effects of BJT on diabetic neuropathy induced by STZ in the mouse. Methods: We performed both in vitro and in vivo experiments to verify the effects of BJT on diabetic neuropathy induced by STZ in mice. Changes in axonal recovery were observed with immunofluorescence staining using NF-200, Hoechst33258, $S100{\beta}$, caspase 3 and anti-cdc2. Proliferation and degeneration of Schwann cells were investigated by immunofluorescence staining and western blot analyses. Results: BJT showed considerable effects on neurite outgrowth and axonal regeneration in diabetic neuropathy. BJT contributed to the creation of NF-200, GAP-43, Cdc2, phospho-vimentin, ${\beta}1$, active ${\beta}1$, ${\beta}3$ integrin, phospho-Erk1/2 protein. Conclusions: Through this study, we found that BJT is effective for enhanced axonal regeneration via dynamic regulation of regeneration-associated proteins. Therefore, BJT had a pharmaceutical property enhancing recovery of peripheral nerves induced by diabetic neuropathy and could be a candidate for drug development after more research.

Exchange Transfusion Treatment for Dapsone-induced Methemoglobinemia

  • Yi, Hwa-Yoen;Lee, Jang-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.37-41
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    • 2008
  • Methemoglobinemia can be caused by dapsone toxicity. We report a case dapsone induced methemoglobinemia unresponsive to methylene blue successfully treated by exchange transfusion. A 52-year-old male ingested a handful of dapsone. He presented with severe peripheral cyanosis in lips and fingertips and his methemoglobin level was found to be 21.9%. After admission, methylene blue (1%) at 1 mg/kg was injected each time peripheral cyanosis and rising serum methemoglobin occurred. Despite methylene blue therapy, the patient‘s methemoglobin level continued to fluctuate. Five days after the injections of methylene blue, many Heinz bodies were visualized in the peripheral blood, suggestive of hemolytic anemia occurrence. By hospital day 6, serum methemoglobine levels were elevated and not measurable (> 50%) and the patient was constantly in a semi-comatose mental state. An exchange transfusion carried out by utilizing 6 units of packed red blood cells and 4 units of fresh frozen plasma was performed. The patient's methemoglobin levels were subsequently kept up below 20% and his peripheral cyanosis receded. Physicians should recognize the important role of exchange transfusion in refractory dapsoneinduced methemoglobinemia.

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The influence of complex traditional Korean medical treatment on the Peripheral Facial Paralysis induced stress (한방복합치료(韓方複合治療)가 STRESS로 유발된 말초성안면신경마비(末梢性顔面神經麻痺)에 미치는 영향)

  • Kim, Kyung-tae;Song, Ho-sueb
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.53-64
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    • 2004
  • Objective: This study was to evaluate the influence of stress on Peripheral Facial Paralysis during the complex traditional korean medical treatment. Methods: We investigated 41 cases of patients with Peripheral Facial Paralysis who were given the complex traditional korean medical treatment. one group had stress as main factor, the other group didn't it. we evaluated the treatment effect of each group by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System. Results : 1. In age, sex, lesion, duration of disease, frequency of treatment, duration of treatment, we found that two groups have no significant differences. 2. Pain back of the ear showed the highest frequency in symptoms at onset. 3. Boyangwhanotang showed the highest frequency in oriental herb medicine treatment. 4. As a result of evaluation by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System, treatment score after 2weeks was marked more higher than score before treatment and treatment score after final treatment was more higher than treatment score after 2weeks on each groups. 5. After final treatment, Non-stress group had signficant result on Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System compared with stress group. Conclusion : These results suggested that patient with Non-stress group should be get better than stress group.

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The clinical research of the efficacy of bee venom aqua-acupuncture on peripheral facial paralysis (봉독(蜂毒) 약침(藥鍼)이 구안와사에 미치는 영향에 대한 임상적 고찰)

  • Kim, Min-soo;Kim, Hyun-joong;Park, Young-jae;Kim, Ee-hwa;Lee, Eun-yong
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.251-262
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    • 2004
  • Objective: Ths research was to investigate the efficacy of bee venom theraphy on peripheral facial paralysis. Methods: Thirty patients were deyided into two groups with fifteen patients each. Group A and B were both treated with basic oriental medicine treatment, and also group A was treated with bee venom aqua-acupunture additionaly. The groups were evaluated by Yanagihara's unweighted grading system before treatment, and at every one week till four weeks after treatment. Results: The Yanagihara's scores of group B were higher than those of group A before treatment, after one week and two weeks, but not statistically significant. After three and four weeks, the Yanagihara's scores of group A were higher than those of group B, but not statistically significant. The improvement indexes of group A were higher than those of group B from the first week and statistically significant after three and four weeks. Conclusion: Combinding bee venom aqua-acupunture theraphy on peripheral facial paralysis was more efficacious than the only use of basic oriental medicine treatment.

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