• Title/Summary/Keyword: Prescribed dose

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TOXICITY STUDY ON CHINESE HERBAL DRUGS USING THE MICRONUCLEUS ASSAY IN MURINE BONE MARROW ERYTHROCYTES

  • Ian C. Guest;Yoo, Sang-Ou;Paik, Nam-Woo;Lee, Young-Wook;Oh, Ki-Bong;Yang, Heyong-Cheol;Suh, Nan-Joo;Chang, Il-Moo
    • Toxicological Research
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    • v.5 no.2
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    • pp.71-77
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    • 1989
  • A mouse whole animal bioassay was employed to screen for potential mutagenicity of ethanol/water extracts of 16 Chinese herbal drugs that are commonly prescribed in Korea. Specific cytogenetic toxicity was measrured by recording evidence of clastogenesis toxicity was measured by recording evidence of clastogenesis via the mouse bone marrow micronucleus test. Male ICR mice administered ethanol extract of Pinelliae tuber (Pinellia eternata Breitenbach, ARACEAE, 양복) and ddY female mice administered extract of Angelica Koreanae radix(Angelica Koreana Maximowicz, UMBELLIFERAE, ) (both by oral administration, at a dose of 600 mg/kg), in a short-term dosing schedule, demonstrated significant increase in micronucleated polychromatophilic erythrocytes, indicating the increase of clastogenicity.

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A Case Study of Gunggi-tang that induces Natural Expulsion in Missed Abortion (계류유산 환자의 자연배출을 돕는 궁귀탕가감(芎歸湯加減) 치험 1례)

  • Kim, Eun-Seop;Jang, Eun-Ha;Choi, Ho-Su
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.136-145
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    • 2017
  • Objectives: The aim of this study was to report a case of 43 year-old patient, diagnosed with missed abortion who previously failed to do spontaneous gestational sac expulsion in spite of 2 week-expectant-method, eventually succeeded with Traditional Korean Herb Medicine (TKHM) treatment only. Methods: In transabdominal sonography, gestational sac was not present at week 8. Due to the possibility of effect of medication on future pregnancy and post-surgery complications, D&C (Dilation & Curettage) as well as any other treatment was not done. Instead, she presented to our clinic. A combination of 2 main TKHMs was prescribed with 120-150 cc/dose (2 times per day for a week) : Gunggi-tang for helping expulsion of the dead fetus and placenta, and Wooseul-tang for treating retained placenta. Results: On day 6 of TKHM treatment, initiation of placenta expulsion was done. From day 8, hemorrhage started, lasting for 6 days. On day 10, placenta was expelled. On day 13, gestational sac and placenta were completely expelled. No infection, delayed bleeding, or pain was observed. After bleeding stopped, menorrhea started from week 7. Conclusions: This report implies a potential of TKHM as an optional and safe medication for the natural expulsion of conceptus in missed abortion.

Evaluation of Contralateral Breast Surface Dose in FIF (Field In Field) Tangential Irradiation Technique for Patients Undergone Breast Conservative Surgery (보존적 유방절제 환자의 방사선치료 시 종속조사면 병합방법에 따른 반대편 유방의 표면선량평가)

  • Park, Byung-Moon;Bang, Dong-Wan;Bae, Yong-Ki;Lee, Jeong-Woo;Kim, You-Hyun
    • Journal of radiological science and technology
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    • v.31 no.4
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    • pp.401-406
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    • 2008
  • The aim of this study is to evaluate contra-lateral breast (CLB) surface dose in Field-in-Field (FIF) technique for breast conserving surgery patients. For evaluation of surface dose in FIF technique, we have compared with other techniques, which were open fields (Open), metal wedge (MW), and enhanced dynamic wedge (EDW) techniques under same geometrical condition and prescribed dose. The three dimensional treatment planning system was used for dose optimization. For the verification of dose calculation, measurements using MOSFET detectors with Anderson Rando phantom were performed. The measured points for four different techniques were at the depth of 0cm (epidermis) and 0.5cm bolus (dermis), and spacing toward 2cm, 4cm, 6cm, 8cm, 10cm apart from the edge of tangential medial beam. The dose calculations were done in 0.25cm grid resolution by modified Batho method for inhomogeneity correction. In the planning results, the surface doses were differentiated in the range of $19.6{\sim}36.9%$, $33.2{\sim}138.2%$ for MW, $1.0{\sim}7.9%$, $1.6{\sim}37.4%$ for EDW, and for FIF at the depth of epidermis and dermis as compared to Open respectively. In the measurements, the surface doses were differentiated in the range of $11.1{\sim}71%$, $22.9{\sim}161%$ for MW, $4.1{\sim}15.5%$, $8.2{\sim}37.9%$ for EDW, and 4.9% for FIF at the depth of epidermis and dermis as compared to Open respectively. The surface doses were considered as underestimating in the planning calculation as compared to the measurement with MOSFET detectors. Was concluded as the lowest one among the techniques, even if it was compared with Open method. Our conclusion could be stated that the FIF technique could make the optimum dose distribution in Breast target, while effectively reduce the probability of secondary carcinogenesis due to undesirable scattered radiation to contra-lateral breast.

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Robust Planning of Intensity-modulated Proton Therapy for Prostate Cancer (전립선암 치료를 위한 세기조절 양성자 로버스트 치료계획)

  • Park, Su Yeon;Kim, Jong Sik;Park, Ju Young;Park, Won;Ju, Sang Gyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.25-31
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    • 2013
  • Purpose: The aim of this study is to evaluate the dosimetric properties of robust planning strategy for plain intensity-modulated proton therapy (IMPT) taking into account of the uncertainties of effective proton range and set up error as compared to photon intensity-modulated radiation therapy (photon-IMRT) in prostate cancer treatment. Materials and Methods: The photon-IMRT (7 beams, step & shoot), plain-IMPT (2, 4, and 7 portals), and robust- IMPT plans, which was recalculated the plain-IMPT based on the uncertainties of range error (${\pm}5%$) and set up error (0.5 cm), were evaluated for five prostate cancer patients prescribed by 70 Gy/35 fractions. To quantitatively evaluate the dose distributions, several parameters such as maximum dose, minimum dose, mean dose, conformity index (CI), and homogeneity index (HI) for PTV as well as dose-volume index of VxGy for OARs were calculated from dose-volume histograms. Results: Robust-IMPT showed superior dose distributios in the PTV and OARs as compared to plain-IMPT and photon-IMRT. Like plain-IMPT, robust-IMPT were resulted in dose fluctuation around OARs, while better homogeneity and conformity in PTVs and lower mean dose in OARs as compared to photon-IMRT. Conclusion: In consideration with the effective range correction and set up movement using robustness in IMPT plan, the dosimetric uncertainties from plain-IMPT could substantially reduce and suggest more effective solutions than photon-IMRT in prostate cancer treatment.

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Improved Breast Irradiation Techniques Using Multistatic Fields or Three Dimensional Universal Compensators (Multistatic Field또는 3차원 공용보상체를 사용한 유방의 방사선 조사법의 평가)

  • Han Youngyih;Cho Jae Ho;Park Hee Chul;Chu Sung Sil;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.24-33
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    • 2002
  • Purpose : In order to improve dose homogeneity and to reduce acute toxicity in tangential whole breast radiotherapy, we evaluated two treatment techniques using multiple static fields or universal compensators. Materials and Methods : 1) Multistatic field technique : Using a three dimensional radiation treatment planning system, Adac Pinnacle 4.0, we accomplished a conventional wedged tangential plan. Examining the isodose distributions, a third field which blocked overdose regions was designed and an opposing field was created by using an automatic function of RTPS. Weighting of the beams was tuned until an ideal dose distribution was obtained. Another pair of beams were added when the dose homogeneity was not satisfactory. 2) Universal compensator technique : The breast shapes and sizes were obtained from the CT images of 20 patients who received whole breast radiation therapy at our institution. The data obtained were averaged and a pair of universal physical compensators were designed for the averaged data. DII (Dose Inhomogeneity Index : percentage volume of PTV outside $95\~105\%$ of the prescribed dose) $D_{max}$ (the maximum point dose in the PTV) and isodose distributions for each technique were compared. Results : The multistatic field technique was found to be superior to the conventional technique, reducing the mean value of DII by $14.6\%$ (p value<0.000) and the $D_{max}$ by $4.7\%$ (p value<0.000). The universal compensator was not significantly superior to the conventional technique since it decreased $D_{max}$ by $0.3\%$ (p value=0.867) and reduced DII by $3.7\%$ (p value=0.260). However, it decreased the value of DII by maximum $18\%$ when patients' breast shapes fitted in with the compensator geometry. Conclusion : The multistatic field technique is effective for improving dose homogeneity for whole breast radiation therapy and is applicable to all patients, whereas the use of universal compensators is effective only in patients whose breast shapes fit inwith the universal compensator geometry, and thus has limited applicability.

Dose Planning of Forward Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer using Compensating Filters (보상여과판을 이용한 비인강암의 전방위 강도변조 방사선치료계획)

  • Chu Sung Sil;Lee Sang-wook;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.53-65
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    • 2001
  • Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

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Personnel Dosimetry Performance Test (개인방사선 피폭선량판독 성능시험)

  • Na, Seong-Ho;Han, Seung-Jae;Lee, Dew-Hey;Cho, Dae-Hyung
    • Journal of Radiation Protection and Research
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    • v.21 no.2
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    • pp.131-138
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    • 1996
  • This paper describes the methods and results of the personnel dosimetry performance tests which were been implemented for the first time in Korea in 1995. Seven categories, except the neutron category prescribed in the ANSI N13.11-1993, were adopted in the test. Fifteen types of dosimeters were participated by fourteen dosimeter processing institutes. A total of 129 dosimeters were selected to test-each type - 15 dosimeters for each of the seven categories and 24 for the controls. A total of 144 radiation categories were employed in the test and a total of 2560 (including 400 controls)dosimeters were submitted-7 categories for each type of the fifteen types dosimeters and 39 categories for the retest. The performance index in each category. sum of the absolute value of the bias and the standard deviation value of the performance quotient. was estimated by the use of delivered and processed dose equivalents according to the standard procedure. The performance in a given category was assessed as acceptable, for the deep and shallow dose equivalents (or the absorbed dose), if the performance index was less than 0.5. The test results showed 54% of the processors passed in the first test, 33% in the retest and 13% in the second retest.

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Repeat Stereotactic Radiosurgery for Recurred Metastatic Brain Tumors

  • Kim, In-Young;Jung, Shin;Jung, Tae-Young;Moon, Kyung-Sub;Jang, Woo-Youl;Park, Jae-Young;Song, Tae-Wook;Lim, Sa-Hoe
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.633-639
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    • 2018
  • Objective : We investigated the outcomes of repeat stereotactic radiosurgery (SRS) for metastatic brain tumors that locally recurred despite previous SRS, focusing on the tumor control. Methods : A total of 114 patients with 176 locally recurring metastatic brain tumors underwent repeat SRS after previous SRS. The mean age was 59.4 years (range, 33 to 85), and there were 68 male and 46 female patients. The primary cancer types were non-small cell lung cancer (n=67), small cell lung cancer (n=12), gastrointestinal tract cancer (n=15), breast cancer (n=10), and others (n=10). The number of patients with a single recurring metastasis was 95 (79.8%), and another 19 had multiple recurrences. At the time of the repeat SRS, the mean volume of the locally recurring tumors was 5.94 mL (range, 0.42 to 29.94). We prescribed a mean margin dose of 17.04 Gy (range, 12 to 24) to the isodose line at the tumor border primarily using a 50% isodose line. Results : After the repeat SRS, we obtained clinical and magnetic resonance imaging follow-up data for 84 patients (73.7%) with a total of 108 tumors. The tumor control rate was 53.5% (58 of the 108), and the median and mean progression-free survival (PFS) periods were 246 and 383 days, respectively. The prognostic factors that were significantly related to better tumor control were prescription radiation dose of 16 Gy (p=0.000) and tumor volume less than both 4 mL (p=0.001) and 10 mL at the repeat SRS (p=0.008). The overall survival (OS) periods for all 114 patients after repeat SRS varied from 1 to 56 months, and median and mean OS periods were 229 and 404 days after the repeat SRS, respectively. The main cause of death was systemic problems including pulmonary dysfunction (n=58, 51%), and the identified direct or suspected brain-related death rate was around 20%. Conclusion : The tumor control following repeat SRS for locally recurring metastatic brain tumors after a previous SRS is relatively lower than that for primary SRS. However, both low tumor volume and high prescription radiation dose were significantly related to the tumor control following repeat SRS for these tumors after previous SRS, which is a general understanding of primary SRS for metastatic brain tumors.

Evaluation of Chemotherapy Induced Peripheral Neuropathy by Cisplatin, Carboplatin and Oxaliplatin (Cisplatin, Carboplatin, Oxaliplatin 투여로 인한 말초신경병증에 대한 평가)

  • Yoon, Wan Ki;Heo, Mi Jung;Lee, Ok Sang;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.356-366
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    • 2012
  • Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

Residues of sulfadimethoxine in blood and liver of cultured olive flounder Paralichthys olivaceus by oral administration (Sulfadimethoxine의 경구 투여에 따른 넙치, Paralichthys olivaceus 혈액 및 간에서의 잔류량 변화)

  • Jun, Sung-Hee;Kim, Jin-Woo;Seo, Jung-Soo;Jee, Bo-Young;Park, Myoung-Ae
    • Journal of fish pathology
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    • v.25 no.2
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    • pp.95-101
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    • 2012
  • The residue levels of sulfadimethoxine (SDM) was studied after oral administration to cultured olive flounder, Paralichthys olivaceus at $20{\pm}1.0^{\circ}C$. The concentrations of SDM in the plasma and liver were determined by HPLC-UV detector after a single dosage of 400 mg/kg body weight. The average recoveries of SDM in spiked samples between 2~50 ppm were 92.24~93.62% for plasma and 88.34~91.90% for liver. Limit of detection for SDM was 0.05 ppm by using this method. Samples were taken at 1 h, 6 h, 12 h, 24 h, 48 h, 72 h, 168 h, 240 h, 336 h and 480 h post-dose. The peak plasma and liver concentrations of SDM, which attained at 1 h post-dose, was $402.64{\pm}59.66{\mu}g/ml$ and $238.18{\pm}54{\mu}g/g$, respectively. Thereafter, it's elimination from both tissues was considerably faster following process of time. Their concentrations of SDM were not measurable at 480 h post-dose. Based on this results, dosage and withdrawal times for SDM could be used when it is prescribed with SDM in olive flounder.