• Title/Summary/Keyword: Dose Report

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Preliminary Report of Gamma Knife Radiosurgery for the Movement Disorders (운동성 장애에 대한 감마나이프 시술의 초기경험)

  • Hong, Joon Ki;Kim, Moo Seong;Lee, Sun Il;Jung, Yong Tae;Kim, Soo Chun;Sim, Jae Hong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1024-1029
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    • 2000
  • Objectives : With recent improvements in neuroimaging and the development of third and fourth-generation radiosurgical dose-planning soft ware, came a renewed interest in using radiosurgery for the treatment of movement disorders. Radiosurgery involves no opening of the cranium and no incisions, eliminating both the risk of hemorrhage from passing an electrode to the depths of meningitis from operative infection. It is for these reasons stereotactic radiosurgical treatment of movement disorders has value in a small subgroup of patients. The authors report four cases of Parkinson's disease and one case of dystonia that were treated by Gamma knife. Methods : Radiosurgical nucleus ventralis intermedius thalamotomy using the gamma knife unit was performed to make lesion in two Parkinson's disease patients. A radiation dose of 120Gy was delivered to nucleus using a single 4-mm collimator plug pattern following classic anatomical landmarks. Patients were followed for a median of 10.5 months(range 9-12 months). An independent neurological evaluation of tremor, based on the change in the United Parkinson's Disease Rating Scale tremor score(UPDRS), was correlated with a subjective evaluation. Gamma knife ventrolateral(V.O.P) thalamotomy was performed in one case of dystonia. A central dose of 150Gy was delivered and the patient was followed for 18 months. Gamma knife globus pallidus interna pallidotomy was performed in two Parkinson's disease patients. A radiation dose of 130Gy(range 120-140Gy) was delivered. Patients were followed for a median of 13 months(range 9-14 months). Result : Ventrolateral thalamotomy in dystonia produced regained left hand usage in order to be able to use the telephone. Ventralis intermedius thalamotomy produced an excellent improvement of the tremor in one case, mild improvement of the tremor in the other case of Parkinson's disease. A globus pallidus internalis(GPi) pallidotomy produced improvement of rigidity and dyskinesia : one other showed no change. There were no neurological complications. Conclusion : Gamma Knife thalamotomy considered a safe and effective technique for the treatment of tremor in Parkinson's disease. Although the results from Longer follow-up is not available yet, the short-term results seem to be encouraging.

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Nefazodone and Associated Perceptual Disturbance : A Report of Four Cases (Nefazodons투여 후 지각이상을 보인 환자 4례)

  • Kim, Ji-Yun;Song, Hyoung-Seok;Cho, Bang-Hyun;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.259-263
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    • 1999
  • Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes $5-HT_{2A}$ and ${\alpha}_1$ adrenergic receptors. Compared with SSRIs, nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. It is not certain what mechanisms mediated these side effects, but three mechanisms are possible. 1) Nefazodone, as a 5-HT2 antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. These case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.

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Effect of the Geijibokryunghwan Water Extracts on Stimulus-induced Superoxide Generation and Tyrosyl Phosphorylation in Human Neutrophils

  • Choi, Meung-Hee;Park, Won-Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.2
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    • pp.477-481
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    • 2006
  • A clinical report indicates that 'Geijibokryunghwan(GBH) is very effective in treating thrombosis in those patients who have difficulties with more conventional antithrombotic drugs. The isolation and identification of various compounds from this plant and the same genus have been reported by several groups. However, the pharmaceutical effect of the GBH on superoxide generation in human neutrophils has not been studied. In the present report, we investigated the possibility of using herbal medicine as an alternative therapy. In particular, we studied tremor in antiatheroscleosis. In this report, we shows the GBH extract can be used as a potential atherosclerosis preventive agent in human. The effect of GBH on stimulus-induced superoxide generation and phosphorylation of tyrosine residues of protein in human neutrophils was investigated. In a conclusion, GBH suppressed tyrosine phosphorylase in a dose-dependent manner, and may have pharmacoceutical applications. These data suggest that GBH extracts merits investigation as a potential anti-atherosclerogenic agent in humans.

Diphyllobothrium nihonkaiense Infections in a Family

  • Go, Young Bin;Lee, Eun Hye;Cho, Jaeeun;Choi, Seoyun;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.53 no.1
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    • pp.109-112
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    • 2015
  • Diphyllobothrium latum and Diphyllobothrium nihonkaiense are morphologically similar to each other, and only genetic method can differentiate clearly between the 2 species. A strobila of diphyllobothriid tapeworm discharged from a 7-year-old boy was analyzed to identify the species by mitochondrial cytochrome c oxidase subunit 1 (cox1) gene sequencing. He and his family (total 4 persons) ate slices of 3 kinds of raw fish 16 days before visiting our outpatient clinic. All family members complained of abdominal pain and watery diarrhea. They all expelled tapeworm strobilae in their stools. They were treated with a single oral dose of praziquantel and then complained of no more symptoms. The cox1 gene sequencing of the strobila from the boy revealed 99.9% (687/688 bp) similarity with D. nihonkaiense and only 93.2% (641/688 bp) similarity with D. latum. Thus, we assigned this tapeworm as D. nihonkaiense. This is the first report of D. nihonkaiense infection in a family in Korea, and this report includes the 8th pediatric case in Korea. The current report is meaningful because D. nihonkaiense infection within a family is rare.

Atypical Hemolytic Uremic Syndrome in a 13-year-old Lao Girl: A Case Report

  • Kedsatha, Philavanh;Cheong, Hae Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.43-47
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    • 2019
  • Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (antiCFH-aHUS) primarily affects children aged 9-13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.

Survival after Cardiac Arrest due to Acute Methamphetamine Poisoning: A Case Report (메스암페타민(필로폰) 급성 중독으로 유발된 심정지 후 생존한 1례)

  • Mun, You Ho;Kim, Jung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.176-180
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    • 2018
  • Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

Investigation of Radiation Effects on the Signal and Noise Characteristics in Digital Radiography (디지털 래디오그라피의 신호 및 잡음 특성에 대한 방사선 영향에 관한 연구)

  • Kim, Ho-Kyung;Cho, Min-Kook;Graeve, Thorsten
    • Journal of Biomedical Engineering Research
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    • v.28 no.6
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    • pp.756-767
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    • 2007
  • For the combination of phosphor screens having various thicknesses and a photodiode array manufactured by complementary metal-oxide-semiconductor (CMOS) process, we report the observation of image-quality degradation under the irradiation of 45-kVp spectrum x rays. The image quality was assessed in terms of dark pixel signal, dynamic range, modulation-transfer function (MTF), noise-power spectrum (NPS), and detective quantum efficiency (DQE). For the accumulation of the absorbed dose, the radiation-induced increase both in dark signal and noise resulted in the gradual reduction in dynamic range. While the MTF was only slightly affected by the total ionizing dose, the noise power in the case of $Min-R^{TM}$ screen, which is the thinnest one among the considered screens in this study, became larger as the total dose was increased. This is caused by incomplete correction of the dark current fixed-pattern noise. In addition, the increase tendency in NPS was independent of the spatial frequency. For the cascaded model analysis, the additional noise source is from direct absorption of x-ray photons. The change in NPS with respect to the total dose degrades the DQE. However, with carefully updated and applied correction, we can overcome the detrimental effects of increased dark current on NPS and DQE. This study gives an initial motivation that the periodic monitoring of the image-quality degradation is an important issue for the long-term and healthy use of digital x-ray imaging detectors.

Hormesis as a Confounding Factor in Epidemiological Studies of Radiation Carcinogenesis

  • Sanders Charles L.
    • Journal of Radiation Protection and Research
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    • v.31 no.2
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    • pp.69-89
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    • 2006
  • Biological mechanisms for ionizing radiation effects are different at low doses than at high doses. Radiation hormesis involves low-dose-induced protection and high-dose-induced harm. The protective component is associated with a reduction in the incidence of cancer below the spontaneous frequency, brought about by activation of defensive and repair processes. The Linear No-Threshold (LNT) hypothesis advocated by the International Commission on Radiological Protection (ICRP) and the Biological Effects of ionizing Radiation (BEIR) Report VII for cancer risk estimations Ignores hormesis and the presence of a threshold. Cancer incidences significantly less than expected have been found in a large number of epidemiological studies including, airline flight personnel, inhabitants of high radiation backgrounds, shipyard workers, nuclear site workers in scores of locations throughout the world, nuclear power utility workers, plutonium workers, military nuclear test site Participants, Japanese A-bomb survivors, residents contaminated by major nuclear accidents, residents of Taiwan living in $^{60}Co$ contaminated buildings, fluoroscopy and mammography patients, radium dial painters, and those exposed to indoor radon. Significantly increased cancer was not found at doses <200 $mSv^*$. Evidence for radiation hormesis was seen in both sexes for acute or chronic exposures, low or high LET radiations, external whole- or partial body exposures, and for internal radionuclides. The ubiquitous nature of the Healthy Worker Effect (HWE)-like responses in cellular, animal and epidemiological studies negates the HWE as an explanation for radiation hormesis. The LNT hypothesis is wrong and does not represent the true nature of the dose-response relationship, since low doses or dose-rates commonly result in thresholds and reduce cancer incidences below the spontaneous rate. Radiation protection organizations should seriously consider the cost and health implications of radiation hormesis.

Subchronic Oral Dose Toxicity Study of Enterococcus Faecalis 2001 (EF 2001) in Mice

  • Gu, Yeun-Hwa;Yamasita, Takenori;Kang, Ki-Mun
    • Toxicological Research
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    • v.34 no.1
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    • pp.55-63
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    • 2018
  • As a part of general toxicity studies of Enterococcus Faecalis 2001 (EF 2001) prepared using heat-treatment bacillus mort body EF 2001 in mice, this study examined the toxicity of EF 2001 in single and repeated administrations following the previous report in order to apply this product to preventive medicine. The safety of oral ingestion of EF 2001 was examined in 6-week-old male and female ICR mice with 1,000 mg/kg, 3,000 mg/kg and 5,000 mg/kg body weight/day administrated by gavage of the maximum acceptable dose of EF 2001. The study was conducted using distilled water as a control following the methods for general toxicity studies described in the "Guidelines for Non-clinical Studies of Pharmaceutical Products 2002". As a control, 1) observation of general conditions, 2) measurement of body weight, 3) determination of food consumption, 4) determination of water consumption, 5) blood test and urinalysis and 6) pathological examination were performed for the administration of EF 2001. Mice received EF 2001 for 13 weeks and results were compared with those of the control group that received distilled water. The results of the above examinations revealed no significant differences between control and EF 2001 groups for both males and females. Thus, no notable toxicity was confirmed with single and repeated oral administrations of EF 2001. Oral administration in the above doses did not result in abnormal symptoms or death during the observation period. No abnormalities in blood cell count or organ weights were seen. Without any evidence of toxicity to cells and organs, EF 2001 is speculated to not adversely affect living organisms. The 50% lethal dose of EF 2001 with oral administration in mice is estimated to be greater than 5,000 mg/kg body weight/day for both male and female mice. Therefore, $LD_{50}$ value for animals was 5,000 mg/kg or more.

Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease (베체트병 환자에서 저용량 스테로이드 사용과 관련하여 발생한 중심성장액맥락망막병증)

  • Cha, Sungwook;Kim, Kyung Jin;Kweon, Seongmin;Lee, Sinae;Min, Byungchul;Kim, Eunsung;Lee, Jungwook
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.111-114
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    • 2017
  • Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.