• Clinical and Experimental Reproductive Medicine
• /
• v.29 no.4
• /
• pp.259-267
• /
• 2002

Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.

• Journal of Pharmaceutical Investigation
• /
• v.39 no.2
• /
• pp.111-115
• /
• 2009

The pharmacokinetics of cyclosporin A (CsA) after single and multiple oral dosing of new CsA self-micro-emulsifying drug delivery system (SMEDDS) in dogs were estimated. A single dose study was performed following a two-way crossover design against six dogs with reference SMEDDS. For a multiple dose study, three dogs were allocated for each drug, and 100 mg of drug was administered daily for 6 days. Whole blood concentration of CsA was analyzed by radio-immunoassay. Both drug showed identical blood concentration profiles in both studies, and no statistical difference was detected in pharmacokinetic parameters. The relative bioavailabilities of test SMEDDS were 91.4% and 89.1%, respectively, in the single dose study and the last day of multiple dose study. Especially, multiple dose study proved the good relationship between C-0/C-2 and AUC for reference SMEDDS, which is an indispensable part of therapeutic drug monitoring. These results suggest newly formulated CsA SMEDDS possibly shows identical pharmacokinetics and pharmacodynamic behaviors in clinical trials.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.2
• /
• pp.102-107
• /
• 2013

Objective : The Leksell Gamma Knife$^{(R)}$ (LGK) is based on a single-fraction high dose treatment strategy. Therefore, independent verification of the Leksell GammaPlan$^{(R)}$ (LGP) is important for ensuring patient safety and minimizing the risk of treatment errors. Although several verification techniques have been previously developed and reported, no method has ever been tested statistically on multiple LGK target treatments. The purpose of this study was to perform and to evaluate the accuracy of a verification method (modified variable ellipsoid modeling technique, MVEMT) for multiple target treatments. Methods : A total of 500 locations in 10 consecutive patients with multiple brain tumor targets were included in this study. We compared the data from an LGP planning system and MVEMT in terms of dose at random points, maximal dose points, and target volumes. All data was analyzed by t-test and the Bland-Altman plot, which are statistical methods used to compare two different measurement techniques. Results : No statistical difference in dose at the 500 random points was observed between LGP and MVEMT. Differences in maximal dose ranged from -2.4% to 6.1%. An average distance of 1.6 mm between the maximal dose points was observed when comparing the two methods. Conclusion : Statistical analyses demonstrated that MVEMT was in excellent agreement with LGP when planning for radiosurgery involving multiple target treatments. MVEMT is a useful, independent tool for planning multiple target treatment that provides statistically identical data to that produced by LGP. Findings from the present study indicate that MVEMT can be used as a reference dose verification system for multiple tumors.

• Progress in Medical Physics
• /
• v.29 no.2
• /
• pp.53-58
• /
• 2018

This paper evaluates patient-specific quality assurance (PSQA) in the treatment of small and multiple tumors by the CyberKnife system with fixed collimators, using an ion chamber and EBT3 films. We selected 49 patients with single or multiple brain tumors, and the treatment plans include one to four targets with total volumes ranging from 0.12 cc to 3.74 cc. All PSQA deliveries were performed with a stereotactic dose verification phantom. The A16 microchamber (Standard Imaging, WI, USA) and Gafchromic EBT3 film (Ashland ISP Advanced Materials, NJ, USA) were inserted into the phantom to measure the point dose of the target and the dose distribution, respectively. The film was scanned 1 hr after irradiation by a film digitizer scanner and analyzed using RIT software (Radiological Imaging Technology, CO, USA). The acceptance criteria was <5% for the point dose measurement and >90% gamma passing rate using 3%/3 mm and relative dose difference, respectively. The point dose errors between the calculated and measured dose by the ion chamber were in the range of -17.5% to 8.03%. The mean point dose differences for 5 mm, 7.5 mm, and 10 mm fixed cone size was -11.1%, -4.1%, and -1.5%, respectively. The mean gamma passing rates for all cases was 96.1%. Although the maximum dose distribution of multiple targets was not shown in the film, gamma distribution showed that dose verification for multiple tumors can be performed. The use of the microchamber and EBT3 film made it possible to verify the dosimetric and mechanical accuracy of small and multiple targets. In particular, the correction factors should be applied to small fixed collimators less than 10 mm.

• Radiation Oncology Journal
• /
• v.12 no.1
• /
• pp.109-115
• /
• 1994

The purpose of this paper is to develop an efficient method for the quick determination of multiple isocenters plans to provide optimal dose distribution in sterotactic radiosurgery. A Spherical dose model was developed through the use of fit to the exact dose data calculated in a 18cm diameter of spherical head phantom. It computes dose quickly for each spherical part and is useful to estimate dose distribution for multiple isocenters. An automatic computer search algorithm was developed using the relationship between the isocenter move and the change of dose shape, and adapted with a spherical dose model to determine isocenter separation and cellimator sizes quickly and automatically. A spheric81 dose model shows a comparable isodose distribution with exact dose data and permits rapid calculations of 3-D isodoses. the computer search can provide reasonable isocenter settings more quickly than trial and error types of plans, while producing steep dose gradient around target boundary. A spherical dose model can be used for the quick determination of the multiple isocenter plans with 3 computer automatic search. Our guideline is useful to determine the initial multiple isocenter plans.

• Nuclear Engineering and Technology
• /
• v.53 no.12
• /
• pp.4189-4200
• /
• 2021

In this study, the relationship between the environmental radiation dose rate and meteorological variables was investigated with multiple regression analysis and big data of those variables. The environmental radiation dose rate and 36 different meteorological variables were measured on Ulleung Island, Republic of Korea, from 2011 to 2015. Not all meteorological variables were used in the regression analysis because the different meteorological variables significantly affect the environmental radiation dose rate during different periods, and the degree of influence changes with time. By applying the Pearson correlation analysis and stepwise selection methods to the big dataset, the major meteorological variables influencing the environmental radiation dose rate were identified, which were then used as the independent variables for the regression model. Subsequently, multiple regression models for the monthly datasets and dataset of the entire period were developed.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.25 no.1
• /
• pp.27-38
• /
• 1995

The organ or tissue doses were determined with head and neck phantom measurement for multiple axial scans (36 slices), multiple coronal scans (13 slices), 3 types of single axial scans(orbit, maxillary sinus and mandibular canal) and single coronal scan (maxillary sinus). For each scan sequence 30 TLDs were placed in selected sites(16 internal sites and 14 external sites) in a tissue-equivalent phantom. The exposure was made at 120kVp, 500mAs with 5 mm slice width. The results were as follows : 1. In multiple axial scans, the greatest effective dose recorded was that delivered to the thyroid glands(2.77 mSv) and the least was that received by the skin(0.05 mSv). From these data, stochastic effects were 202.2x10/sup -6/ and 3.7×10/sup -6/, respectively. 2. In multiple coronal scans, the greatest effective dose recorded was that delivered to the salivary glands(0.58 mSv) and the least was that received by the skin(0.01 mSv). From these data, stochastic effects were 42.2×10/sup -6/ and 0.7×10/sup -6/, repectively. 3. Among single axial scans, the greatest effective dose recorded was that delivered to the salivary gland(0.38 mSv) in maxillary sinus scan. From this data, stochastic effect was 27.7×10/sup -6/. 4. In single coronal scan, the greatest effective dose recorded was that delivered to the salivary gland(0.01 mSv). From this data, stochastic effect was 1.0×10/sup -6/. 5. The equivalent dose measured that delivered to the lens of the eyes was 69.64 mSv in multiple axial scan, 39.32 mSv in multiple coronal scan and 36.77 mSv in single axial scan(orbit).

• Nuclear Engineering and Technology
• /
• v.38 no.3
• /
• pp.231-238
• /
• 2006

Whole-body exposure to high-dose radiation causes injury involving multiple organs that depends on their sensitivity to radiation. This acute radiation syndrome (ARS) is caused by a brief exposure of a major part of the body to radiation at a relatively high dose rate. ARS is characterized by an initial prodromal stage, a latent symptom-free period, a critical or manifestation phase that usually takes one of four forms (three forms): hematologic, gastrointestinal, or cardiovascular and neurological (neurovascular), depending upon the exposure dose, and a recovery phase or death. One of the most important factors in treating victims exposed to radiation is the estimation of the exposure dose. When high-dose exposure is considered, initial dose estimation must be performed in order to make strategy decisions for treatment as soon as possible. Dose estimation can be based on onset and severity of prodromal symptoms, decline in absolute lymphocyte count post exposure, and chromosomal analysis of peripheral blood lymphocytes. Moreover, dose assessment on the basis of calculation from reconstruction of the radiation event may be required. Experience of a criticality accident occurring in 1999 at Tokai-mura, Japan, showed that ARS led to multiple organ failure (MOF). This article will review ARS and discuss the possible mechanisms of MOF developing from ARS.

• Radiation Oncology Journal
• /
• v.9 no.2
• /
• pp.351-359
• /
• 1991

The current LINAC technique for radiosurgery utilizes a single isocenter approach with multiple noncoplanar arcs. This approach results in spherical dose distributions in the target. Many arteriovenous malformations and tumors suitable for radiosurgical treatment have non-spherical or irregular shapes. The basic approach presented in this paper is to use two or multiple isocenters with standard arcs to shape irregular target volumes through the use of multiple spherical targets. Selection of reasonable irradiation parameters in the first stage is critical to the success of real-time optimization. A useful guideline for optimum isocenter separation and collimator size is developed to shape the target margin uniformly with an desired isodose surface for an elongated target. The implementation of multiple isocenters with three dimensional dose model and application of multiple isocenters approach to several cases are discussed.

• Journal of Acupuncture Research
• /
• v.20 no.3
• /
• pp.1-14
• /
• 2003

Objective : The aim of the study was to investigate the preventive effect of Acanthopanax senticosus(AS) aqua-acupuncture into Sinsu(BL23) of the multiple low-does strepozotocin(STZ)-induced diabetic rats. Methods : The experimental animals were divided into 4 groups : normal group of rats, control group of multiple low-does STZ-induced diabetic rats, NSAA group with 0.4ml normal saline(NS) aqua-acupunctured subcutaneously into Sinsu in multiple low-does STZ-induced diabetic rats, and ASAA group with 0.4ml of 20% AS aqua-acupunctured subcutaneously into Sinsu in multiple low-does STZ-induced diabetic rats. Each of AS and NS aqua-acupuncture was done subcutaneously into both loci of Sinsu taking turns everyday for 3 weeks. Thereafter the levels of serum glucose, body weight, index of kidney hypertrophy, urine glucose, urinary albumin excretion, creatinine clearance, mesangial cell and TGF-${\beta}1$ expression in glomeruli and tubular cells were measured on the determined day. Conclusions : 1. Both ASAA and NSAA groups decreased the serum glucose levels in multiple low-dose STZ-induced diabetic rats as compared to the cintrol group, and ASAA group showed more significant decreases than NSAA group. 2. Both ASAA and NSAA groups prevented the development of diabetes in multiple low-dose STZ-induced diabetic rats as compared to the control group, and ASAA group prevented more markedly the development of diabetes than NSAA group. 3. Both ASAA and NSAA groups prevented the reduction of body weight in multiple low-dose STZ-induced diabetic rats as compared to the control group, and ASAA group showed the same as the normal group. 4. Both ASAA and NSAA groups did not show any changes of the creatinine clearance in multiple low-does STZ-induced diabetic rats. 5. Both ASAA and NSAA groups prevented the excretion of urinary glucose and albumin in multiple low-dose STZ-induced diabetic rats as compared to the cintrol group, and ASAA group showed more significant prevention than NSAA group. 6. Both ASAA and NSAA groups prevented the expansion of glomerular cells and the protein expression of transforming growth factor-${\beta}1$ in multiple low-dose STZ-induced diabetic rats as compared to the cintrol group, and ASAA group prevented more significantly than NSAA group.