• Clinical and Experimental Reproductive Medicine
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• 제43권1호
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• pp.15-25
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• 2016

Objective: In the present study, we aimed to evaluate the effects of high doses of dexamethasone (DEX) in early pregnancy on pregnancy outcomes. Methods: Pregnant BALB/c mice were treated with high-dose DEX in the experimental group or saline in the control group on gestational days (GDs) 0.5 to 4.5. Pregnant mice were sacrificed on GDs 7.5, 13.5, or 18.5 and their peripheral blood, placentas, fetuses, and uterine tissue were collected. Decidual and placenta cell supernatants were examined to evaluate the effect of DEX on the proliferation of mononuclear cells, the quantity of uterine macrophages and uterine natural killer (uNK) cells, and levels of progesterone and $17{\beta}-estradiol$, as determined by an 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. We also were measured fetal and placental growth parameters on GD 18.5. Results: We found that high doses of DEX were associated with an increased abortion rate, enhancement of the immunosuppressive effect of the decidua, alterations in placental growth parameters, decreased progesterone and $17{\beta}-estradiol$ levels, and a reduced frequency of macrophages and uNK cells. Conclusion: Our data suggest that the high-dose administration of DEX during early pregnancy negatively affected pregnancy outcomes.

• 약학회지
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• 제42권5호
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• pp.473-479
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• 1998

Lovastatin (LOVA), a fungal metabolite isolated from cultures of Aspergillus terreus, is a competitive HMG-CoA reductase inhibitor used for the treatment of primary hyper cholesterolemia, and has also been shown to suppress growth in a variety of non-glioma tumor cell lines. A sensitive reversed-phase high-perfonnance liquid chromatographic method with ultraviolet (UV) absorbance detection has been developed to quantitate LOVA in human plasma and urine samples using liquid-liquid extraction procedure. Baseline separation of LOVA and internal standard, simvastatin was achieved on a Novapak $C_{18}$ analytical column with a mobile phase containing 0.025M $NaH_2PO_4$: CAN (35:65, v/v%), adjusted pH to 4.5. The flow rate was set at 1.5ml/min, and the column effluent was monitored by a UV detection at 238nm. The limit of quantification was determined to be 0.5${\mu}$g/ml while extraction efficiency of LOVA ranged from 73.4-82.9% at LOVA concentrations of 0.5 to 10${\mu}$g/ml. Good linearity with correlation coefficients greater than 0.999 was obtained in the range of LOVA concentrations from 0.5 to 10${\mu}$g/ml. The accuracy and the precision were proven excellent with relative standard deviation (RSD, %) and relative error (RE, %) of less than 4.2 and 4.0, respectively. Intraday precision, evaluated at five LOVA concentrations (0.5, 1, 2, 5, 10${\mu}$g/ml) and expressed as RSD ranged from 0-1.82% while the interday precision at the same concentrations ranged from 0.7-10.5%. The analytical method described was then successfully employed for the determination of LOVA concentrations in plasma samples obtained during a phase II clinical trial using high doses of LOVA (30-40mg/kg/day). This method could be further utilized for the ongoing pharmacolkinetic studies and therapeutic drug monitoring of the high-dose LOVA therapy in adenocarcinoma patients.

• 한국의학물리학회지:의학물리
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• 제21권3호
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• pp.253-260
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• 2010

대다수의 근접치료용 방사선치료계획장치는 AAPM TG-43의 계산식에 기반을 둔 선량계산 알고리듬을 적용하고 있으나 이는 조직의 비균질성을 적절히 고려하지 못한다. 본 연구에서는 몬테칼로 방법을 이용하여 강내고선량근접치료계획을 검증하는 체계를 구축하고자 하였으며, 특히 환자의 CT 영상을 이용하여 물질정보로 변환한 후 직접 몬테칼로 계산을 수행하는 방법의 타당성에 초점을 맞추었다. 판형 팬텀 및 자궁경부암 환자의 CT 영상을 Plato (Nucletron, Netherlands) 치료계획장치를 이용하여 근접치료계획을 수행한 후 여기서 얻어진 인자들을 이용하여 EGSnrc 기반의 DOSXYZnrc 코드로 몬테칼로 계산을 수행하였으며, EBT 필름측정 결과와 비교하였다. DOSXYZnrc 코드의 선원 모델링 특성 상 후장전 장치의 $^{192}Ir$ 선원들을 직육면체 형태로 근사화하여 모델링하였으며 계산 시 체적소의 크기는 $2{\times}2{\times}2\;mm^3$로 하였다. 균질 매질 내에서는 TG-43 기반의 선량계산 결과와 몬테칼로 선량계산 결과가 잘 일치함을 확인할 수 있었으나 고밀도 물질이 포함된 비균질 매질 내에서는 오차가 커졌다. 환자의 경우 A점 및 B점의 오차는 3% 이내, 평균선량 오차는 5% 정도였다. 그러나 기존 선량계산 알고리듬의 경우 고밀도 물질의 영향을 적절히 고려하지 못하여 표적의 선량을 과대평가하여 실제로는 더 적은 선량이 들어갈 우려가 있다. 본 연구에서 제안된 선량계산 검증체계는 타당하며 선량 계산 결과도 실제와 잘 일치함을 확인할 수 있었다. 또한 기존의 선량계산 알고리듬으로 계산된 치료계획결과를 확인할 경우에는 주의가 필요하며, 몬테칼로 방법과 같은 독립적인 검증 시스템이 유용할 것이다.

• 한국전기전자재료학회논문지
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• 제24권1호
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• pp.36-41
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• 2011

Medical X-ray has been brought many changes according to the rapid development of high technology. Especially, for high-voltage generator which is the most important in X-ray generation the traditional way is to use high-voltage electric transformers primarily. However, since it is large and heavy and the ripple rate of DC high-voltage applied to X-ray tube is too big, it has a disadvantage of low X-ray production efficiency. To solve these problems, the studies about high-voltage power supply are now proceeding. At present, the high-voltage generator that generates high-voltage by making high frequency using inverter control circuit consisting of semiconductor device is mainly used. High-voltage generator using inverter has advantages in the diagnosis using X-ray including high performance with short-term use, miniaturization of power supply and ripple reduction. In this study, the X-ray high-voltage device with inverter type using pulse width modulation scheme to the control of tube voltage and tube current was designed and produced. For performance evaluation of produced device, the control signal analysis, irradiation dose change and beam quality depending on the load variation of tube voltage and tube current were evaluated.

• Pediatric Infection and Vaccine
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• 제27권1호
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• pp.45-52
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• 2020

목적: Carbapenem-resistant Acinetobacter baumannii (CRAB)에 의한 인공호흡기연관 폐렴(ventilator-associated pneumonia, VAP)의 치료에 있어 고용량 ampicillin-sulbactam과 colistin의 병합요법 치료효과를 살펴보기 위한 예비 연구이다. 방법: 2017년도 6월부터 2018년도 8월까지 17명의 CRAB VAP 환자를 후향적으로 분석하였다. 10명(58.8%)의 환자는 고용량 ampicillin-sulbactam과 colistin 병합요법(병합치료군)으로 치료받았으며, 나머지 7명은 colistin 단독치료를 하였거나 colistin을 포함 또는 미포함하는 다양한 항균제의 병합치료(기타치료군)를 하였다. 본 연구는 두 그룹간의 임상 및 세균학적 결과를 비교하였다. 결과: 병합치료군에서 항균제 사용 후 발열기간은 1.30±1.70일이었고, 기타치료군에서는 1.71±1.49일이었다. 기관내관 흡인물 검체에서 균이 음전 될 때까지의 평균 기간은 병합치료군에서 3.40±1.71일 기타치료군에서 11.80±8.86일이었다(P=0.030). 항균제 치료 30일 이내 사망률은 병합치료균에서 1/10 (10%)이고 기타치료군에서 3/7 (42.9%)이었다. 결론: 소아의 CRAB에 의한 인공호흡기연관 폐렴 환자에서 고용량 ampicillin-sulbactam과 colistin의 병합요법이 임상적 예후를 개선시킬 수 있을 것으로 기대된다.

• Radiation Oncology Journal
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• 제2권2호
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• pp.203-211
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• 1984

From 1979 to 1982, 80 patients with unresectable non-small-cell lung cancer without metastasis were treated with high-dose radiotherapy to the primary and to regional lymph nodes with or without supraclavicular lymphatics in the Department of Therapeutic Radiology, Seoul National University Hospital. Of these, 56 patients$(70\%)$ were completely evaluable, and 59 patients$(74\%)$ had squamous cell carcinoma, 13a large cell undifferentiated carcinoma and 831 adenocarcinoma. 21 patients$(26\%)$ had Stage II and 59 patients$(74\%)$ had Stage III. The complete and partial response rate in the high-dose$(\approx\;6,000\;rad)$ radiotherapy was $70\%\;with\;19\%$ complete response. 69 patients$(86\%)$ failed in the treatment, by the failure pattern, $64\%$ had local failure alone, $35\%$ had local failure and distant metastasis and $1\%$ had distant metastasis alone. The failure rate in the thorax were $76\%$ in squamous cell carcinoma, $40\%$in adenocarcinoma and $20\%$ in large cell undifferentiated carcinoma Preliminary result shows that actuarial survival at 1, 2 and 3 years were $56\%,\;26\%\;and\;20\%$ in overall patients and $64\%,\;37\%\;and\;21\%\;in\;Stage\;II\;and\;54\%1,\;21\%\;and\;18\%$ in Stage III, respectively. Overall median survival was 14 months; 17 months in Stage II and 13 months in Stage m. 8 patients$(10\%)$ have lived a minimum of 2 years with no evidence of disease. There was no fatal complication confirmed to be induced by radiotherapy, so definitive high-dose radiotherapy was tolerated well without major problems and resulted in good local control and survival.

• The Korean Journal of Pain
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• 제4권2호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3949-3953
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• 2013

Aim: To investigate the effectiveness and adverse effects of gemcitabine by fixed-dose rate infusion plus oxaliplatin (GEMOX regimen) as second-line therapy for advanced ovarian cancer. Methods: 64 patients with advanced ovarian cancer were divided into an experimental group (44 cases) and a control group (20 cases). The experimental group was treated with continuous intravenous infusion of gemcitabine at 1000 $mg/m^2$ with a fixed-dose rate of 10 $mg/m^2/min$, on days 1 and 8 and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, repeated every 3 weeks. The control group was treated with intravenous infusion of gemcitabine at 1000 $mg/m^2$ within 30 min on days 1 and and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, again repeated every 3 weeks. CT scans or MRI were used for review every 1-2 cycles. Results: The effective rate in the experimental group was significantly high than control group (43.2% vs 35.0%; P < 0.05), with no obvious difference of hematologic or non-hematologic toxicity between the two groups (P > 0.05). Conclusion: GEMOX regimen is very effective to treat advanced ovarian cancer, with low toxicity, good tolerance and improved life quality in patients.

• Radiation Oncology Journal
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• 제12권3호
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• pp.369-376
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• 1994

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

• 대한한방내과학회지
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• 제41권6호
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• pp.1119-1140
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• 2020

Objective: The purpose of this study was to review Chinese clinical studies of the treatment of gastroesophageal reflux disease (GERD) with herbal medicine including Pinellia ternata. Methods: We searched the China National Knowledge Infrastructure (CNKI) database for clinical studies on herbal treatments including Pinellia ternata for GERD, from January 1st, 2015 to September 30th, 2019. We evaluated the risk of bias using Cochrane's risk of bias to confirm the quality of the 37 selected documents. Results: The 37 papers included high-dose and middle-dose Pinellia ternata groups. The outcome measures included treatment effectiveness rate, symptom comparisons, and endoscopy effectiveness rates or scores. In both groups, most studies showed significant improvement in the treatment group compared with the control group. The meta-analysis revealed a higher treatment effectiveness rate and a lower recurrence rate in the treatment group than in the control group. Conclusions: Comparing the treatment effect between the two groups was difficult due to the low quality of most studies. However, the results suggest that herbal remedies including Pinellia ternata showed statistically significant improvement in GERD compared to control groups.