• Radiation Oncology Journal
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• v.26 no.4
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• pp.237-246
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• 2008

Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.77-80
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• 2013

메치실린 저항성 황색 포도상구균(MRSA)에 감염된 환자에게 단기간 연속적으로 반코마이신을 투여했을 때 비정상적으로 호중구의 수치가 감소한 약인성 부작용 사례를 보고하고자 한다. 해당 여성 환자는 61세로서 MRSA 감염증을 판정받고 반코마이신 투여와 더불어 점차 백혈구(WBC)와 절대호중구수치(ANC)가 감소하였고, 제10일째에 이르러 호중구 감소증이 발생하여 ANC가 최저 430 $cells/mm^3$까지 낮아졌으나, 반코마이신의 투여를 중단하자 곧 정상수준으로 회복되었다. 본 사례는 Naranjo Probability Scale과 Korean Algorithm Score(Ver. 2.0)로 각각 평가하였을 때 반코마이신의 투여와 호중구감소증의 발현 사이에 모두 '가능한(probable)' 정도의 인과관계를 가진 것으로 평가되었다. 이는 통상적으로 20일 이상 연속투여를 할 때 임상적으로 관측되던 반코마이신-유래 호중구감소증이 단지 10일 정도의 단기간 투여만으로도 발생할 수 있다는 임상적 약물부작용의 사례로서, 향후 MRSA환자에게 반코마이신을 선택할 때에는 이와 같은 부작용을 고려하여 환자의 WBC와 ANC를 면밀히 관찰하면서 투여할 필요성이 있음을 시사한다.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.2
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• pp.109-119
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• 2020

This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N₂O/O₂ in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables. The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects. It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.44-51
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• 2003

Objectives: Antidepressants are frequently associated with sexual dysfunction. Especially, there were few report of sexual dysfunction related with venlafaxine and mirtazapine in Korea. The purpose of this survey was to evaluate the frequency and nature of sexual dysfunction related with selective serotonin reuptake inhibitors(SSRIs), venlafaxine and mirtazapine by the use of specific questionaires. Methods: In one hundred twenty two patients, sexual dysfunction was investigated cross-sectionally by using The questionaires for sexual dysfunction, which includes questions about decreased libido, delayed orgasm or ejaculation, premature ejaculation or orgasm, absence of orgasm or ejaculation, erectile dysfunction in men/vaginal lubrication dysfunction in women, sexual pain and patient's tolerance of the sexual dysfunction. BDI was also measured. Sexual dysfunction was analyzed in association with the duration and the dose of medications and the severity of depression. Results: The incidence of sexual dysfunction during antidepressants use in our survey was 37.7%. There were no difference of incidence in sexes(p=.746). In comparison of paroxetine, venlafaxine and mirtazapine, there were no significant differences of the incidence(p=.065) and the severity of any type of sexual dysfunction. Conclusion: Although there were no significant differences of sexual dysfunction in our survey, sexual dysfunction may be closely associated with antidepressants. Further prospective study of sexual dysfunction should be needed.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.2
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• pp.179-185
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• 1997

$23{\sim}40$세 (평균 연령 31.6세)의 자궁내막증 환자35명 (1기 7명, 2기 7명, 3기 14명, 4기 7명)을 대상으로 gonadotropin-releasing hormone agonist (Goserelin) 3.6 mg을 한달 간격으로 6개월 복부의 피하에 이식한 후 자궁내막증에 대한 치료 효과와 부작용을 알아보기 위하여 매달 호르몬 검사와 증상에 대한 설문조사를 시행하였다. 투여 1개월 후 혈청 estradiol농도는 30 pg/mL이었고 이후 치료중 $10{\sim}20$ pg/mL를 유지하였으며 투여를 중간한 1개월 후 50 pg/mL로 증가하였다. 혈청 LH농도는 치료 중 유의하게 감소하였으며 투여를 중단한 후 증가하였다. FSH는 투여 1개월 후 감소하였으나 2개월후부터 계속 치료전과 같은 농도를 유지하였다. 혈청 CA-125치는 19명중 10명에서 치료전에 35 mIU/mL이상으로 증가되었으며 치료 2개월 후부터 모두 정상으로 감소되었다. 월경곤란증은 치료 3개월째 완전히 소실되었고 성교통은 치료가 끝날 때까지 20%의 환자에서 지속되었다. 백혈구수, 혈색소, 전해질, 단백질, 빌리루빈 및 간효소는 치료 중 모두 정상이었다. 혈압과 체중도 치료전, 치료중에 변화가 없었다. 투여후 86%의 환자가 안면홍조를 63%에서 질건조증을 20%가 두통, 우울을 호소하였다. 이와 같은 부작용은 투여를 중단한 1개월 후 모두 소실되었으며 부작용 때문에 투여를 중단한 예는 없었다. 이상의 결과로 GnRH-a는 난소의 estradiol생산을 완벽하게 중단시키고 골반증상을 완하시켜 자궁 내막증 치료에 효과적이라고 사료되며 안면홍조와 같은 부작용의 빈도가 높기 때문에 향후 호르몬 보충요법을 병행하는 것이 바람직 하다고 사료된다.

• Neonatal Medicine
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• v.18 no.1
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• pp.130-136
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• 2011

Purpose: Chloral hydrate is a common drug frequently used for procedural sedation. But data on chloral hydrate use in the newborns are limited. This study examined the frequency of adverse effects of chloral hydrate and factors related to the adverse effects. We also examined if there were additional adverse effects when an additional sedative was used. Methods: The medical records of 104 patients admitted to neonatal intensive care unit of Seoul St. Mary's Hospital from March 2010 to February 2011 who used chloral hydrate for procedural sedation were retrospectively reviewed. Results: Adverse effects after administration of chloral hydrate were noted in 41.3% of the 104 patients. The adverse events included oxygen desaturation (18.8%), increase in apneic episodes (17.5%), increase in bradycardia (10%), and feeding intolerance (3.8%). Using oxygen at the time of chloral hydrate administration was independently associated with adverse effects (odds ratio [OR], 10.911: 95% confidence interval [CI], 2.082-57.178) and with the necessity for an additional sedative after administration of chloral hydrate (OR, 4.151: 95% CI, 1.455-11.840). Using one additional sedative agent after chloral hydrate showed no difference in adverse effects except feeding intolerance. Conclusion: Patients dependent on oxygen at the time of chloral hydrate administration may were found to be at higher risk for adverse effect of chloral hydrate and for an additional sedative. When an additional sedative is needed, it could be used with monitoring feeding intolerance after chloral hydrate administration.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.248-254
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• 2006

$\underline{Purpose}$: To evaluate acute toxicities in cervix cancer patients receiving intensity modulated whole pelvic radiation therapy (IM-WPRT). $\underline{Materials\;and\;Methods}$: Between August 2004 and April 2006, 17 patients who underwent IM-WPRT were analysed. An intravenous contrast agent was used for radiotherapy planning computed tomography (CT). The central clinical target volume (CTV) included the primary tumor, uterus, vagina, and parametrium. The nodal CTV was defined as the lymph nodes larger than 1 cm seen on CT and the contrased-enhanced pelvic vessels. The planning target volume (PTV) was the 1-cm expanded volume around the central CTV, except for a 5-mm expansion from the posterior vagina, and the nodal PTV was defined as the nodal CTV plus a 1.5 cm margin. IM-WPRT was prescribed to deliver a dose of 50 Gy to more than 95% of the PTV. Acute toxicity was assessed with common toxicity criteria up to 60 days after radiotherapy. $\underline{Results}$: Grade 1 nausea developed in 10 (58.9%) patients, and grade 1 and 2 diarrhea developed in 11 (64.7%) and 1 (5.9%) patients, respectively. No grade 3 or higher gastrointestinal toxicity was seen. Leukopenia, anemia, and thrombocytopenia occurred in 15 (88.2%). 7 (41.2%), and 2 (11.8%) patients, respectively, as hematologic toxicities. Grade 3 leukopenia developed in 2 patients who were treated with concurrent chemoradiotherapy. $\underline{Conclusion}$: IM-WPRT can be a useful treatment for cervix cancer patients with decreased severe acute toxicities and a resultant improved compliance to whole pelvic irradiation.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.39-46
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• 2007

The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group in Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information(24%), prevention of adverse reactions to contrast media(19%), pre-cognitive effect of adverse reactions to contrast media(39%) and information degree of adverse reactions to contrast media(19%). This CP program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings.

• Agrochemical news magazine
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• v.16 no.4 s.127
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• pp.10-15
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• 1995

• Journal of Haehwa Medicine
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• v.4 no.2
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• pp.255-272
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• 1996

소적백출산(消積白朮散)은 ${\ll}$화제국방(和劑局方)${\gg}$에 삼령백출산(蔘笭白朮散)에 정열해독약(淸熱解毒藥)인 와송(瓦松) 금은화(金銀花) 포공영(蒲公英)을 가미(加味)한 처방(處方)으로, 본방(本方)인 삼령백출산(蔘笭白朮散)은 비위허약(脾胃虛弱), 음식부진(飮食不振), 다곤소력(多困少力) 중만비대(中滿痺臺), 심정기천(心柾氣喘), 구토(嘔吐), 설사(泄瀉), 상한해수(傷寒咳嗽)를 치료목적(治療目的)으로 쓰여 온 이래(以來) 임상에서는 대편부실(大便不實), 구설(久泄), 옹달궤후(癰疸潰後) 불사식자(不思食者)를 치료(治療)하는데 다용(多用)되어 왔다. 종양(腫瘍)(Neoplasia)은 새로운 성장(成長)(New+ Glowth) 이라는 세포학적(細胞學的)으로 비정상세포(非正常細胞)의 과다증식(過多增殖)으로 인해 실질장기(實質臟器), 유강장기(有腔腸器), 및 골격(骨格), 피부조직(皮膚組織)에 비정상조직(非正常組織)을 형성(形成)하는 질환(疾患)이다. 현대적(現代的) 종양(腫瘍)과 유사(類似)한 한의학적(韓醫學的)인 병증(病症)은 ${\ll}$소문(素問)${\gg}$에서는 "궐산(厥疝), 복량(伏梁), 식적(息積)"으로 ${\ll}$영추(靈樞)${\gg}$에서는 "장담(腸覃), 석가"로 표시(表示)된 이후(以後)로 소원방(巢元方)은 징가, 식일, 석옹(石癰), 완저(緩疽), 석저(石疽) 등으로 표현(表現)하였다. 원인(原因)에 대(對)해서는 ${\ll}$내경(內經)${\gg}$에서는 허(虛)와 한기(寒氣), 한(寒) 열(熱)로 보았고, 그 외(外)의 학자(學者)들은 내허(內虛)와 기혈불순(氣血不順), 화(火), 한(寒), 기울(氣鬱), 음양불화(陰陽不和)등으로 보았다. 치료(治療)는 ${\ll}$내경(內經) 자법론(刺法論)${\gg}$에서 "정기재내(正氣在內) 사불가우(邪不可于)" 이라 하여 생명활동(生命活動)의 원동력(原動力)인 정기(正氣)의 역할(役割)을 강조(强調)하였고, ${\ll}$육원정기대론(六元正氣大論)${\gg}$에서는 "대적대취(大積大聚) 불가범야(不可犯也) 쇠기태반이지(衰其太半而止)"라 하여 공벌약(攻伐藥)을 과용(過用)하여 정기(正氣)를 손상(損傷)시켜서는 안된다고 하는 등 부정위주(扶正爲主), 거사위주(祛邪爲主) 혹은 부정거사(扶正祛邪) 겸용(兼用)의 방법(方法)이 혼용(混用)되고 있다. 현대(現代) 서양의학(西洋醫學)의 항암제(抗癌劑)는 치료효과(治療效果)는 우수(優秀)하지만 악심(惡心), 구토(嘔吐)를 비롯하여 골수억제효과(骨髓抑制效果)와 간(肝), 심(心), 신(腎), 폐(肺)의 손상(損傷)을 초래(招來)하는 등(等)의 부작용(副作用)을 나타내며, 빈번(頻繁)한 화학요법제(化學療法劑)의 투여(投與)로 인(因)한 암세포(癌細胞)의 약제저항성(藥劑抵抗性) 출현(出現)등이 항암제(抗癌劑)의 문제점(問題點)으로 제시(提示)되고 있다. 이에 저자(著者)는 비위기능(脾胃機能)을 강화(强化)시켜 정기형성(正氣形成)에 깊이 관여(關與)하는 삼령백출산(蔘笭白朮散)에 청열해독(淸熱解毒), 소종산결지제(消腫散結之劑)인 금은화(金銀花), 포공영(浦公英), 와송(瓦松)을 가미(加味)하여 암발생(癌發生) 백서(白鼠)에 투약(投藥)한 후(後) sarcoma 180암세포(癌細胞)에 대(對)한 생명연장효과(生命延長效果)와 항암제(劑)의 일종(一種)인 cis-platin을 이용(利用)하여 양방항암제(洋方抗癌劑)의 부작용(副作用)에 대(對)한 본(本) 방(方)의 효과(效果)를 실험(實驗)하여 관찰(觀察)하였던 바 다음과 같은 결론(結論)을 얻었다. 1. 소적백출산(消積白朮散)은 sarcoma 180 암세포(癌細胞) 이식종양(移植腫瘍)에 대(對)해 생명연장효과(生命延長效果)가 인정(認定)되었다. 2. 소적백출산(消積白朮散)은 치암제(治癌劑)인 cis-platin 치사독성(致死毒性)에 대(對)해 생존연장효과(生存延長效果)가 인정(認定)되었다. 3. 소적백출산(消積白朮散)은 cis-platin 현독성(腎毒性) 생쥐 및 흰쥐에 있어서 유의성(有意性) 있는 체중감소억제효과(體重減少抑制效果) 및 serum BUN 상승억제효과(上昇抑制效果)가 인정(認定)되었다. 4. 소적백출산(消積白朮散)은 cis-platin 현독성(賢毒性) 흰쥐에 대(對)해 유의성(有意性) 있는 serum creatinine 상승억제효과(上昇抑制效果)가 나타났으며, cis-platin의 혈액학적(血液學的) 부작용(副作用)인 RBC, WBC 감소(減少)에 대(對)해 감소억제효과(減少抑制效果)가 인정(認定)되었다. 5. 소적백출산(消積白朮散)은 cis-platin 현독성(腎毒性) 흰쥐에 대(對)해 뇨량감소억제(尿量減少抑制) 효과(效果) 및 ureanitrogen과 creatinine 배수감소억제효과가 관찰(觀察)되었다. 이상(以上)의 결과(結果)로부터 소적백출산(消積白朮散)은 악성종양치료(惡性腫瘍治療) 및 항암제(劑)의 부작용(副作用)을 경감(輕減)시키는 데 응용(應用)할 수 있을 것으로 사료(思料)된다.