• 한국임상약학회지
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• 제32권1호
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• 대한방사선치료학회지
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• 제30권1_2호
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• pp.161-167
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• 2018

목 적 : 동일 선상축(co-axial image)의 다발성 뼈 전이암에 대한 하이브리드 세기변조(modified hybrid-VMAT) 계획의 유용성을 평가하고자 한다. 대상 및 방법 : 동일 선상축의 다발성 뼈 전이암환자 총 5명을 대상으로 치료계획시스템(Ray station, 5.0.2.35, Sweden)을 이용하여 치료계획을 수립하였다. 치료계획용적(planning target volume, PTV) 처방 선량은 30 Gy로 설정하여 총 3가지 치료계획: 용적변조회전치료계획(volumetric modulated arc therapy, VMAT); 배경방사선(background)을 고려하지 않은 하이브리드 용적변조회전치료계획(hybrid VMAT, VMAT(h)); 배경방사선을 고려한 하이브리드 용적변조회전치료계획(modified hybrid VMAT, VMAT(mh))을 비교하였다. 선량용적히스토그램(dose volume histogram, DVH)을 이용하여 PTV의 maximum dose($D_{max}$), mean dose($D_{mean}$), 처방선량지수(conformity index, CI), 선량균질지수(homogeneity Index, HI) 및 손상위험장기(organ at risk, OAR)의 선량을 분석하였다. 또한 monitor unit(MU)와 치료시간(beam on time)을 분석하였다. 결 과 : VMAT, VMAT(h)과 VMAT(mh)의 PTV $D_{max}$는 3188.33 cGy, 3526 cGy, 3285.67 cGy이고, $D_{mean}$은 3081 cGy, 3252 cGy, 3094 cGy이고, CI는 $1.35{\pm}0.19$, $1.43{\pm}0.12$, $1.30{\pm}0.06$이고, HI는 $1.06{\pm}0.01$, $1.14{\pm}0.06$, $1.09{\pm}0.02$로 평가되었다. VMAT(h)과 VMAT(mh)의 OAR은 3 % 증가와 18 % 감소하는 것으로 평가되었다. 추가적으로 평균 MU는 904.90, 911.73, 1202.13 그리고 평균 Beam on time은 $128.67{\pm}10.97$초, $167.33{\pm}7.57$초, $190.33{\pm}4.51$초 소요되었다. 결 론 : 다중표적 치료 시에는 modified Hybrid-VMAT를 적용하면 선량의 겹침이 보정되어 과선량(over dose) 조사되는 것을 방지하는 다중표적을 치료할 수 있다. 그리고 PTV의 선량포함을 만족하면서 주위의 정상장기를 더 효과적으로 보호할 수 있는 치료계획이 가능하다. 또한 modified Hybrid-VMAT의 임상적 효능을 확인하기 위해 많은 수의 환자를 대상으로 한 장기 추적 관찰이 필요하다.

• 한국방사선학회논문지
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• 제14권4호
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• pp.345-351
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• 2020

본 연구에서는 현재 건강검진에서 시행되고 있는 다중 CT 검사 시 개인선량계를 이용하여 갑상선, 유방, 생식선의 피폭선량에 대한 선량평가를 시행하였다. 선량평가는 CT 항목 중 Brain, Brain + C-S, Brain + Low lung, Brain + L-S CT 검사 시 갑상선, 유방, 생식선의 위치에 TLD와 EPD를 부착하여 측정하였다. 기기 발생선량인 CTDI_vol, DLP를 측정하였다. 연구결과 유효 선량은 일반인 연간 선량한도 1mSv보다 Brain + C-S CT 검사 시 갑상선 TLD 41.7%, EPD 156%, Brain + Low lung CT 검사 시 유방 EPD 10%, Brain + L-S CT 검사 시 생식선 TLD 124.4%, EPD 339.8% 높게 평가되었다. 전체 평균값에 대한 CTDI_vol, DLP 분석결과 진단참조수준 보다 C-S CTDI_vol 값은 0.6%, Low lung CTDI_vol 값은 5.7%, DLP 값은 11.8%, L-S CTDI_vol 값은 1.2%로 높게 평가되었다. 환자의 피폭선량 감소를 위해 무분별한 검사를 줄이고, 건강검진에서의 선량한도 설정이 필요하다.

• Radiation Oncology Journal
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• 제16권4호
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• pp.357-366
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• 1998

Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week. 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as. 78-86$\%$ for Stage 1, 68-85$\%$ for stage 11, and 38-56$\%$ for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.

• 대한핵의학회지
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• 제9권1호
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• pp.59-71
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• 1975

53 patients with hyperthyroidism have been analyzed with special reference to therapeutic response to radioactive iodine ($^{131}I$) treatment. Mean effective half-life, 24 hour uptake rate and radiation dose of $^{131}I$ in hyperthyroid patients included in this study were respectively. 1. Mean effective half-life of $^{131}I\;was\;4.7{\pm}1.5$ days in the tracer dose and $5.0{\pm}1.5$ days in the therapeutic dose. 2. Mean 24 hour uptake rate of $^{131}I\;was\;72.7{\pm}11.1%$ in the tracer dose and $73.4{\pm}12.3%$ in the theapeutic dose. 3. Mean radiation dose of $^{131}I\;was\;5,319{\pm}2,648$ RAD as predicted and $5,692{\pm}2,843$ RAD as actual. A single dose of radioactive iodine treatment was satisfactory in 34 patients (radioiodine sensitive) and multiple doses of radioactive iodine treatments were required in 19 patients (radioiodine resistant). A radioiodine resistant group of patients with hyperthyroidism was distinctively characteristic in the following aspects. 1. Mean thyroid weight calculated in the resistant group ($63.9{\pm}14.0gm$) was significantly (p<0.01) greater than that of the sensitive group ($46.6{\pm}13.3gm$). 2. Mean 24 hour uptake rate of the tracer dose in the resistant group ($67.3{\pm}10.7%$) was significantly (p<0.01) lower than that of the sensitive group ($75.7{\pm}10.5%$). 3. Mean 24 hour uptake rate of the therapeutic dose in the resistant group ($68.5{\pm}13.7%$) was significantly (p<0.05) lower than that of the sensitive group ($76.1{\pm}10.9%$). 4. Mean predicted radiation dose, of $^{131}I$ in the resistant group ($3,684{\pm}1,745$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,232{\pm}2,683$ RAD). 5. Mean actual radiation dose of $^{131}I$ in the resistant group ($4,100{\pm}1,691$ RAD) was significantly (p<0.01) lower than that of the sensitive group ($6,582{\pm}3,024$ RAD). 6. No significant difference was detected in terms of effective half-life of $^{131}I$ among the groups (p>0.05). 7. The average mean % difference of effective half-life, uptake rate and radiation dose measured following the tracer and therapeutic dose of $^{131}I$ were not statistically significant (p>0.05). Therefore effective half-life, uptake rate and radiation dose of the therapeutic dose of $^{131}I$ were readily predictable following the tracer dose of $^{131}I$. 8. It is concluded that the possibility of resistance to radioactive iodine treatment may be anticipated in patients with thyroid gland large in size and compromised $^{131}I$ uptake rate.

• Journal of Plant Biology
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• 제7권4호
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• pp.9-14
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• 1964

According to the results measured the respiratory quotient of Saccharomyces cerevisiae with neutron radiation by manometric direct method, the respiratory quotient of them was stimulated at the dose(7$\times$106N/$\textrm{cm}^2$/sec) of neutron radiation for 60 seconds, and was inhibited in each group irradiated at the high dose (7$\times$108N/$\textrm{cm}^2$/sec) of neutron. Its physiological effects influenced on neutron had relations with respiratory quotient, reproductive rate and fermentation in the curve of normal logarithmic phase. The multiple reactions which appeared in yeast, indicated that a great deal of physiological function were closely correlated with the irradiated dosage of neutron. The kinds of free amino acid in yeast irradiated with neutron were different from those of unirradiated yeast. The activityof dehydrogenase system accelerated the metabolic function of yeast irradiated at some low dose of neutron. By this results, it may demonstrate that the fact which the phenomena obtained in the stimulation of neutron possess its character for several generation, is dependent on the theory of mutation. Subsequently, it seemed reasonable certain dominant type of microorganisms.

• 대한방사선치료학회지
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• 제35권
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• pp.23-31
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• 2023

목 적: 다발성 전이암 환자의 방사선치료 시 저선량 영역을 줄이기 위해 Non-Treat Functionailty-Volumetric Modulated Arc Therapy(NTF-VMAT)과 Treat Functionality VMAT(TF-VMAT)치료계획을 수립하고 비교하여 유용성을 평가하고자 한다. 대상 및 방법: Arccheck phantom에서 X, Y, Z 축에 2 cm, 4 cm, 6 cm 간격으로 치료계획용적 위치를 쌍(Pair)으로 설정하였다. 이를 바탕으로 NTF-VMAT와 TF-VMAT의 저선량 체적을 측정하여 비교·분석하였다. 결 과: 처방선량의 10% ~ 70% 범위 내에서 NTF-VMAT와 TF-VMAT의 18개 전산화 치료계획을 분석한 결과, 각 축에서 저선량 영역의 체적 차이는 X축에서는 최대 -47.6%, 최소 -2.2%, Y축에서는 최대 -17.5%, 최소 -7.3%의 차이가 나타났다. Z축에서는 최대 -39.7%의 차이를 보였으며, 가장 적은 차이는 -6.8%로 나타났다. 결 론: 다발성 전이암 환자의 방사선치료 시 TF-VMAT 치료계획이 NTF-VMAT에 비해 저선량 영역을 10~40% 줄일 수 있었다. 이는 Island block technique이 적용된 Treat Functionaliy을 이용하여 선량 분포를 개선하고, 부작용을 최소화하여 다발성 전이암 환자의 치료에 유용할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제33권2호
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• pp.165-173
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• 2000

Objectives : To assess the availability of the glycophorin A (GPA) assay to detect the biological effect of ionizing radiation in workers exposed to low-doses of radiation. Methods : Information on confounding factors, such as age and cigarette smoking was obtained on 144 nuclear power plant workers and 32 hospital workers, by a self-administered questionnaire. Information on physical exposure levels was obtained from the registries of radiation exposure monitoring and control at each facility. The GPA mutant assay was performed using the BR6 method with modification by using a FACScan flow cytometer. Results : As confounders, age and cigarette smoking habits showed increasing trends with GPA variants, but these were of no statistical significance. Hospital workers showed a higher frequency of the GPA variant than nuclear power plant workers in terms of the NO variant. Significant dose-response relationships were obtained from in simple and multiple linear regression models. The slope of the regression equation for nuclear power plant workers was much smaller than that of hospital workers. These findings suggest that there may be apparent dose-rate effects. Conclusion : In population exposed to chronic low-dose radiation, the GPA assay has a potential to be used as an effective biologic marker for assessing the bone marrow cumulative exposure dose.

• 한국임상약학회지
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• 제32권2호
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• pp.125-132
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• 2022

Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2004년도 제47차 추계학술대회
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• pp.101.1-101.1
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• 2004