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The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA) (관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가)

  • Jung, Kang-Kyo;Lee, Mi-Hwa;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.307-313
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    • 2014
  • The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about $4.8{\pm}0.3bpm$ (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

Therapeutic Results of Concurrent Chemoradiation in Locally Advanced Uterine Cervical Cancer (국소적으로 진행된 자궁경부암에서 방사선과 Cisplatin의 동시병합요법의 치료결과)

  • Kang, Seung-Hee;Suh, Hyun-Suk;Yang, Kwang-Mo;Lee, Eung-Soo;Park, Sung-Kwon
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.55-61
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    • 1995
  • Purpose : Despite a development of therapeutic machines and advance in modern radiation therapy techniques, locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate, Combination of chemotherapy and radiotherapy demonstrated benefit in improving local control and possibly the overall survival. Our study was performed to evaluate effect of concurrent chemoradiation on locally advanced uterine cervical cancer. Methods and Materials : Twenty six patients with locally advanced stage(FIGO stage IIB with ${\geq}5cm$ in diameter, III, IVA) were treated with combination of radiation therapy and concurrent cisplatinum between May of 1988 and September of 1993 at our hospital. Radiation therapy consisted of external irradiaton and 1-2 sessions of intracavitary irradiation. Cisplatinum was administered in bolus injection of 25mg/$m^2$ at weekly intervals during the course of external radiation therapy. Results : Of the 26 Patients, twenty-five patients were evaluable for estimation of response. Median follow-up period was 25 months with ranges from 3 to 73 months. Stage IIB, III, and IVA were 16, 5, 4 patients, respectively, Twenty patients were squamous cell carcinoma. Response was noted in all 25 patients: complete response(CR) in 17/25($68\%$), Partial response(PR) in 8/25($32\%$). Of the 24 patients except one who died of sepsis at 3 months follow-up, seventeen patients($70.8\%$) maintained local control in the pelvis: 16/17($94.1\%$) in CR, 1/17($14.3\%$) in PR. Fourteen of the 17 patients with CR are alive disease free on the completion of follow-up. Median survival is 28 months for CR and 15 months for PR. Analysis of 5-year survival by stage shows 11/16($59.8\%$) in IIB, 3/5($60.0\%$) in III, and 1/4($25.0\%$) in IVA. Overall 5-year survival rate was $55.2\%$. Ten patients recurred: 4 at locoregional, 3 in distant metastasis and 3 with locoregional and distant site. Toxicity by addition of cisplatinum was not excessive. Conclusion : Although the result of this study was obtained from small number of patients, it is rather encouraging in view of markedly improved response rate compared with the results of historical group.

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Pharmacokinetics and Excretion into Expired Air of Urea, a Potential Diagnosis Reagent of Helicobacter pylori Infection (헬리코박터 파이로리 균의 진단시약 개발을 위한 요소의 체내동태 및 호기 중 배설)

  • Park, Seung-Hyeok;Shin, Dae-Hwan;Cho, Han-Jun;Yim, Ju-Bin;Lim, Sung-Cil;Han, Kun;Chung, Youn-Bok
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.160-166
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    • 2012
  • Purpose: The purpose of the present study was to investigate the pharmacokinetics of urea, a new potential diagnosis reagent of Helicobacter pylori infection. Methods: Considering the mechanism of urea breath test, we determined the excretion of urea in expired air after its oral administration in rats and beagle dogs at the dose of 2 mg/kg (including 50 mCi/mmol $^{14}C$-urea 50 ${\mu}Ci/kg$ for rats and 13.5 ${\mu}Ci/kg$ for dogs). Results: Urea was rapidly disappeared from the blood circulation by 1 hr after its i.v. bolus injection, followed by a slow disappearance by 24 hr. The half-lives at the distributive phase ($t_{1/2{\alpha}}$) and post-distributive phase ($t_{1/2{\beta}}$) were 2 min and 6 hr, respectively. The bioavailability of urea was 64.3% after its oral administration. The values of the volume of distribution ($V_{dss}$) and the total body clearance ($CL_t$) after the oral administration were compatible with those after i.v. administration. The recovery of urea in the bile was about 0.1% of the dose by 24 hr after its oral administration. Urea was extensively eliminated in the urine by 48 hr. The recovery ratios of urea in the urine and expired air were about 86.8% and 2.99% of the dose by 48 hr, respectively. Moreover, urea was mostly distributed from the blood circulation to the kidney, followed by being eliminated in the urine without metabolism. The concentration of urea in the kidney was 4.0 times higher than that of plasma at 40 min after its oral administration. Conclusions: These findings indicated that oral route appears to be available for the administration of urea. Orally administered urea, thus, was considered to be useful for the diagnosis of Helicobacter pylori infection.

Effects of Rice Straw and Rice Hull Supplement on Rumination and Chewing Behavior in Hanwoo Steers (볏짚 및 가공처리 왕겨의 급여가 한우의 사료섭취 및 반추행동에 미치는 영향)

  • Lee, W.S.;Lee, B.S.;Lee, S.C.;Lee, Sang-S;Lee, S.Y.;Lee, D.Y.;Ha, J.K.
    • Journal of Animal Science and Technology
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    • v.46 no.1
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    • pp.49-54
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    • 2004
  • Effects of low quality roughage sources on duration and frequencies of rumination and chewing in Hanwoo steers were determined, Animals were fed three diets; concentrate+rice straw(SO:SO), concentrate+ rice straw + popped rice hull(SO:3S: IS) and concentrate+ rice straw+ground rice hull(SO:3S: IS) to compare both rice straw alone and combination with rice hull. Eating and ruminating time of steers fed concentrate+ rice straw(SO:50), concentrate+ rice straw + popped rice hull(50:35:15) and concentrate + rice straw + ground rice hull(50:3S:15) were 78.8 and 338.4minlday; 98.0 and 362.5minlday, and 160 and 519.2min/day, respectively. When steers were fed popped rice hull and ground rice hull, time spent for both eating and ruminating was significantly increased(p <0.05). When steers fed popped and ground rice hull, number of ruminating chews and number of chews per rumination time were significantly decreased(p<0.05). The number of rumination boli and boli per rumination time had significantly decreased(p<0.05), but chewing time per boli, number of chew'S per bolus were significantly increased(p

Acute Toxicity of DW-166HC (Hlolmium-165-chitosan) in Mice (마우스에서의 DW-166HC (Ho1mium-165-chitosan)에 대한 급성독성)

  • Lee, Won-Yong;Lee, Jin;Moon, Eun-Yi;Nam, Soon-Chul;Lee, Dug-Keun;Yoon, Sung-June
    • Biomolecules & Therapeutics
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    • v.5 no.1
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    • pp.100-105
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    • 1997
  • DW-166HC ($^{166}$Holmium-chitosan) is a complex of $^{166}$Ho, $\beta$- and $\gamma$-ray emitter, and chitosan, a polymer of glucosamine, with radiotherapeutic potential. The current study was performed to determine the acute toxicities of $^{165}$Ho-chitosan in mice by two different routes of administration. The both sex mice were given a single intravenous bolus injection of $^{165}$Ho-chitosan complex at doses of 12, 10, 6, 5 and 4 mg/kg or subcutaneous administration at doses of 600, 500, 400 and 300 mg/kg. Chitosan was dosed to control animals as 16 and 800 mg/kg, intravenously and subcutaneously, respectively. The doses of $_{165}$Ho-chitosan complex were expressed as $_{165}$holmium nitrate pentahydrate and the ratio of $^{165}$Ho$(NO_3)_3$).$5H_2O$ to chitosan was 3/4 Severe convulsion and respiratory failure were followed by death within 10 min after intravenous dosing. Transient unilateral hindlimb hypokinesias were found in two mice of 5 mg/kg dosing group during the study period. No abnormalities were observed during the necropsy of survived animals in intravenous dosing group. Only one male animal was found dead in 500 mg/kg subcutaneously dosed group. Alopecia with or without cutaneous ulcer were found in most mice including control animals. During necropsy, omental adhesion was observed in all dose ranges and enlarged spleen was found in several animals including control group. It is suggested that the acute intravenous >).$LD_{50}s$ for male and female mice were 4.90 and 6.03 mg/kg, respectively. The lowest lethal dose in male was 500 mg/kg by subcutaneous administration.

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Early Onset Renal Failure in Congenital Nephrotic Syndrome associated with Congenital Diaphragmatic Hernia by WT1 Gene Mutation (WT1 유전자 돌연변이에 의해 선천성 가로막 탈장이 동반되고 조기 신부전이 초래된 선천성 신증후군 1례)

  • Park, Yong-Jun;Oh, Jin-Won;Choi, Kyong-Min;Kim, Pyung-Kil;Lee, Jong-In;Song, Ji-Sun
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.84-91
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    • 2009
  • We experienced a female neonate with congenital nephrotic syndrome (CNS) associated with congenital diaphragmatic hernia (CDH). Because of the rare combination of two conditions, we report this case with literature review. CDH was found immediately after birth and emergency operation was done for hernia repair. But on the next day, generalized edema and oliguria(0.59 mL/kg/hour) was found and her blood chemistry showed hypoalbuminemia (1.6 g/dL), increased BUN (27.7 mg/dL) and serum creatinine( 1.8 mg/dL) along with heavy proteinuria (4+). We started albumin infusion with a bolus of intravenous furosemide. We suspected the neonate had congenital nephrotic syndrome and her 24hr urine protein was 1,816 mg/day. In spite of immunosuppressive therapy, the nephrotic syndrome and renal failure progressed. We started peritoneal dialysis on the day of life 22 but it was not satisfactory. She was complicated by intracranial hemorrhage and multi-organ failure and expired at 34 days of age. Kidney necropsy was performed which showed diffuse mesangial sclerosis (DMS). Her chromosome study revealed 46, XX and her gene study revealed a heterozygous missense mutation, Arg366His, in Wilms tumor suppressor gene (WT1). This case deserves attention on account of the 4th case of CNS with CDH revealing the Arg366His mutation in the WT1 gene and G the 1st case of early onset renal failure without male pseudohermaphroditism and Wilms tumor with CNS, CDH and the Arg366His mutation in the WT1 gene. So, this report gives support to the hypothesis that Arg366His mutation in the WT1 gene can result in CNS and CDH.

Clinical Experience of Continuous Epidural Analgesia Using Baxter $Infusor^{(R)}$ (Baxter $Infusor^{(R)}$를 이용한 경막외 진통제 지속 주입)

  • Bae, Sang-Chull;Lee, Jang-Won;Kim, Ill-Ho;Song, Hoo-Bin;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.127-132
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    • 1991
  • Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

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The Effect of Epidural Low Dose Ketamine Plus Morphine on the Postoperative Pain Control (Morphine과 병용한 경막외 Low-dose Ketamine의 술후 통증에 대한 효과)

  • Kim, Myoung-Oak;Joo, Koung-Hwa;Kim, Woon-Young;Shin, Hye-Weon;Lee, Bong-Jae;Suh, Kuy-Suk
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.205-210
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    • 1999
  • Background: Epidural morphine for postoperative pain control has a serious risk of respiratory depression and other side effects such as pruritus, nausea and urinary retention. In recent years, it is known that epidural administration of ketamine potentiates the effect of epidural morphine, and so decrease the side effects of epidural morphine. This study was performed to evaluate the analgesic efficacy of epidurally administered ketamine and whether this epidural administration can decrease the amount of epidural morphine. Methods: Sixty patients scheduled for the elective cesarean section were randomly selected. All patients were given subarachnoid injection of tetracaine 9 mg. Group I received epidural bolus injection of 0.15% bupivacaine 10 ml with morphine 2 mg followed by a continuous infusion of 0.125% bupivacaine 100 ml containing morphine 4 mg after peritoneum closure, and group II received the same method as group I except for the addition of epidural ketamine 30 mg. Analgesic effects were assessed using Numeric Rating Score (NRS) and Prince Henry Score (PHS). Also, the degree of satisfaction and the incidence of the side effects were observed. Results: Analgesic effects were significant in both groups after drug administration. But NRS and PHS were not significantly different between two groups at all times. The incidence of nausea and vomiting was 11 out of 30 in group I and 9 out of 30 in group II and the incidence of itching was 11 out of 30 in group I and 8 out of 30 in group II. Number of patients using additional analgesics were 2 and 1 in group I and II, respectively. Conclusions: Epidural ketamine did not potentiate the analgesic effect of epidural morphine and could not decrease the side effect of epidural morphine.

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A study of calculate a time to peak enhancement of contrast level by using blood flow (혈류에 의한 조영제 peak time의 산출에 관한 연구)

  • Choi, Kwan-Woo;Son, Soon-Yong;Lee, Ho-Beom
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2315-2321
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    • 2013
  • This study attempt to develope and suggest a new, minimize side effects process for calculate a time to peak enhancement of contrast level by using blood flow instead of current mathematical process. We conducted a studies 127 patients who performed the CE MRA by using test-contrast inject way. We used measurements of a contrast inflow time and time to peak enhancement of contrast level of each cerebrovascular branch for similarity of witch cerebrovascular branch calculate a time to peak enhancement of contrast level by using blood flow in image compared with calculation a time to peak enhancement of contrast level by using current mathematical process after contrast enhancement. In this study, confidence interval were used if the variable is continuous variable; there is differences between 4 groups exist but in group 1, there is no difference with time in peak enhancement of contrast level by using mathematical method to inflow time in sinus sigmoideus. it was significant statistically, in addition there was significant low heterogeneity in Bland Altman plot. Thus, apply a new calculate a time to peak enhancement of contrast level by using blood flow method will minimize damage caused by side effect, maintain quality of image, easy and fast access. It should provide a space for the exchange of current calculate a time to peak enhancement of contrast level by using mathematical process.

Symptoms and Prescriptions Based on the Theory for Properties and Tastes of Korean Oriental Herbal Medicines with Regard to the Year When Taeyang is Affecting the Earth Energy and the Cold Energy is partially Over-abundant ("태양좌천(太陽左泉) 한음소승(寒淫所勝)의 병증(病證)과 기미(氣味)배합 분석")

  • Yang Yoo-In;Seo Bu-Il;Shin Soon-Shik
    • Herbal Formula Science
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    • v.12 no.2
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    • pp.19-30
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    • 2004
  • This thesis aims to provide an analytical basis for existing or new prescriptions based on the theory for properties and tastes of Korean oriental herbal medicines. To this end, prescriptions presented in the Various Changes in the Dominations of the Six Energies and their Relations with the Diseases of Plain Questions were analyzed based on the theory for properties and tastes of Korean oriental herbal medicines in Yellow Emperor's Canon of Internal Medicine. This thesis focused on symptoms and prescriptions based on the theory for properties and tastes of Korean oriental herbal medicines, which were described in the Various Changes in the Dominations of the Six Energies and their Relations with the Diseases of Plain Questions with regard to the year when Taeyang is affecting the earth energy and the cold energy is partially over-abundant. Those symptoms and prescriptions originate from the theory of the five elements and six climates. The symptoms were analyzed from the perspective of physiology. The prescriptions were first analyzed based on the theory for properties and tastes of Korean oriental herbal medicines in Yellow Emperor's Canon of Internal Medicine. Then, a mix formula of oriental medicines pursuant to those prescriptions was studied. Lastly, established prescriptions, which were in conformity with the above prescriptions, were selected. From the physiological point of view, symptoms with regard to the year when Taeyang is affecting the earth energy and the cold energy is partially over-abundant can be, based on the theory of the five elements and six climates, diagnosed as the symptoms from impaired heart due to excessive cold energy. Established prescriptions pursuant to prescriptions based on the theory for properties and tastes of Korean oriental herbal medicines can be broken down into the following: Cassia Twig, White Peony and Anemarrhena Decoction (Gyejijakyakjimotang); Rhemannia Bolus with Eight Herbs (Palmijihoanghoan); Back to the Left Pill (Joaguihoan); Bone-Strengthening Pill (Hojamhoan); Major Eum-Replenishing Pill (Daeboeumhoan). Therefore, symptoms of six kinds of weather presented in the Various Changes in the Dominations of the Six Energies and their Relations with the Diseases of Plain Questions can be analyzed from the physiological point of view. As a result, in addition to the methodology that analyzes existing prescriptions within the boundary of the theory for properties and tastes of Korean oriental herbal medicines in Yellow Emperor's Canon of Internal Medicine, it is expected that a theoretical basis for new prescriptions can be provided by analyzing established prescriptions based on prescriptions from the theory for properties and tastes of Korean oriental herbal medicines.

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