• Title/Summary/Keyword: Skin dose

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Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer (조기유방암환자의 이차원치료계획과 삼차원치료계획의 방사선조사범위의 차이)

  • Jo, Sun-Mi;Chun, Mi-Son;Kim, Mi-Hwa;Oh, Young-Taek;Kang, Seung-Hee;Noh, O-Kyu
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.177-183
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    • 2010
  • Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

Study on the Antioxidant and Human Neutrophil Elastase Inhibitory Activities of Mushroom Ramaria formosa Extracts (붉은싸리버섯 추출물의 항산화 및 Human Neutrophil Elastase 저해활성)

  • Kim, Kwan-Chul;Kwon, Yong-Beom;Jang, Hae-Dong;Kim, Jae Wha;Jeong, Jae Cheol;Lee, Ik-Soo;Ha, Byung-Jo;Yoo, Ick-Dong
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.3
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    • pp.269-278
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    • 2016
  • In searching for novel agents for skin anti-aging from natural resources, we found that the extract of the fruiting bodies of Ramaria formosa (R. formosa) had significant antioxidant and human neutrophil elastase (HNE) inhibitory activities. R. formosa extract exhibited a considerable DPPH radical scavenging activity with an antioxidant content of 117.0mg/mL (ascorbic acid equivalents) at the concentration of $500{\mu}g/mL$. The capacity of R. formosa extract to scavenge peroxy radicals measured by ORAC assay also showed dose-dependent antioxidant effect with $ORAC_{Roo}$ (trolox equivalents, $1{\mu}M$) values of 0.8, 5.2, and 7.8 at the concentrations of 1, 10, and $20{\mu}g/mL$. The cellular antioxidant capacity of R. formosa extract was investigated by assaying the cellular fluorescence intensity using dichlorodihydrofluorescein (DCF). The cellular oxidative stress induced by AAPH, $Cu^{2+}$ or $H_2O_2$ in HepG2 cells was significantly attenuated by more than 30% at $20{\mu}g/mL$ of R. formosa extract. HNE activity was reduced by treatment with R. formosa extract in a dose-dependent manner, and the $ED_{50}$ value for the ethanol extract of R. formosa was $42.9{\mu}g/mL$. R. formosa extract did not exhibited antimicrobial activity against four microorganisms including Bacillus subtilis (B. subtilis), Escherichia coli (E. coli), Candida albicans (C. albicans), Aspergillus oryzae (A. oryzae). Furthermore, the extract did not affect the inflammatory cytokine production of interleukin-10 and interferon-${\gamma}$ in NK92 cells. From the above results, we found that R. formosa extract has considerable antioxidant and elastase inhibitory effects, and does not stimulate immune cells. These findings suggest that R. formosa extract may be used as a bioactive component in cosmetic composition.

Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences (중환자실 간호사의 기초간호과학 지식의 필요성 분석)

  • Byeon, Young-Soon;Choe, Myoung-Ae;Kim, Hee-Seung;Park, Mi-Jung;Seo, Wha-Sook;Lee, Kyung-Sook;Choi, S-Mi;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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The Effect of levamisole in Steroid-Dependent Nephrotic Syndrome in Children (소아 스테로이드 의존형 신증후군에서 Levamisole의 치료 효과)

  • Han Jae-Hyuk;Lee Kyoung-Jae;Lee Young-Mock;Kim Il-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.109-116
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    • 2001
  • Purpose Long- term use of steroid, cyclophosphamide and cyclosporin, which are frequently used in the therapy of SDNS, might cause severe side effects. Recently, the immune-modulator levamisole has been tried as a substitute therapy and it has been reported as a method with less side effects and more effectiveness. We started this research in order to observe the effects of levamisole and compare it to other therapy results. Patients and Methods : We chose 16 steroid dependent nephrotic syndrome children, those who had shown frequent relapse during the immunocompromised therapy period. Mean age was $9.1{\pm}1.4$ years in children and the male to female ratio was 15:1. All of subjects were diagonized with MCNS and had received cyclophosphamide or cyclosporin before receiving levamisole. Levamisole at a dose of 2.5mg/kg was used every other day for 1 year and the relapse rate was observed. Results : On average of 14 days after treatment, complete remission was visible in all of the children, and the relapse percentage was $50\%$, which represents 8 children, while remaining 8 children representing $50\%$ of the cases showed no relapse during treatment. During the levamisole therapy period, tile average relapse rate was reduced significantly from $2.18{\pm}0.9/year\;to\;0.77{\pm}0.9/year$(P=0.027). Also the average relapse rate after the therapy was reduced to $1.34{\pm}1.1/year$, which was a significant level compared to the level before treatment(P=0.003). There was no significant difference in terms of duration of remission maintenance. Duration of remission maintenance showed an average of $12.2{\pm}9.1$ months before the use of levamisole, but it was also $10.1{\pm}6.9$ month after therapy. No other side effects such as leukopenia, skin disease and other clinically significant symptoms appeared at all during therapy. Conclusion : The long-term medication of levamisole for the therapy of SDNS children is thought to be able to maintain stable remission by reducing the relapse frequency without causing severe side effects. Further study with a broader range of subjects is required to eluccidate the long-term effects of this treatment. (J. Korean Soc Pediatr Nephrol 2001;5 : 109-16)

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Clinical Study on Fluvoxamine Combined with Oxycodone Prolonged-Release Tablets in Treating Patients with Moderate to Severe Cancer Pain

  • Xiao, Yang;Liu, Jun;Huang, Xin-En;Ca, Li-Hua;Ma, Yi-Min;Wei, Wei;Zhang, Rong-Xia;Huang, Xiao-Hong;Chang, Juan;Wu, Yi-Jia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10445-10449
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    • 2015
  • Objective: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. Methods: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. Results: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P>0.05). Baseline pain score of patients with moderate pain in treatment and control group was $4.9{\pm}0.8$ and $5.1{\pm}0.8$, respectively; and decreased to $1.8{\pm}1.1$ and $1.2{\pm}1.1$ after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P=0.028). Average daily consumption of oxycodone prolonged-release tablets was ($54.0{\pm}19.6$) mg and ($44.7{\pm}18.7$) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were $8.3{\pm}1.1$ and $8.3{\pm}1.1$, respectively; and pain intensity after treatment decreased to $2.9{\pm}1.0$ and $2.3{\pm}1.0$. Pain intensity was significantly reduced in the treatment group, with statistical significance (P=0.026). Average daily consumption of oxycodone prolonged-release tablets was ($132.0{\pm}42.2$) mg and ($110.7{\pm}33.9$) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). Conclusion: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

A Study on the Effectiveness of the Manufacture of Compensator and Setup Position for Total Body Irradiation Using Computed Tomography-simulator's Images (전산화 단층 모의치료기(Computed Tomography Simulator)의 영상을 이용한 TBI(Total Body Irradiation) 자세 잡이 및 보상체 제작의 유용성에 관한 고찰)

  • Lee Woo-Suk;Park Seong-Ho;Yun In-Ha;Back Geum-Mun;Kim Jeong-Man;Kim Dae-Sup
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.147-153
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    • 2005
  • Purpose : We should use a computed tomography-simulator for the body measure and compensator manufacture process was practiced with TBI's positioning in process and to estimate the availability.,Materials and Methods : Patient took position that lied down. and got picture through computed tomography-simulator. This picture transmitted to Somavision and measured about body measure point on the picture. Measurement was done with skin, and used the image to use measure the image about lungs. We decided thickness of compensator through value that was measured by the image. Also, We decided and confirmed position of compensator through image. Finally, We measured dosage with TLD in the treatment department.,Results : About thickness at body measure point. we could find difference of $1{\sim}2$ cm relationship general measure and image measure. General measure and image measure of body length was seen difference of $3{\sim}4$ cm. Also, we could paint first drawing of compensator through the image. The value of dose measurement used TLD on head, neck, axilla, chest(lungs inclusion), knee region were measured by $92{\sim}98%$ and abdomen, pelvis, inquinal region, feet region were measured by $102{\sim}109%$.,Conclusion : It was useful for TBI's positioning to use an image of computed tomography-simulator in the process. There was not that is difference of body thickness measure point, but measure about length was achieved definitely. Like this, manufacture of various compensator that consider body density if use image is available. Positioning of compensator could be done exactly. and produce easily without shape of compensator is courted Positioning in the treatment department could shortened overall $15\{sim}20$ minute time. and reduce compensator manufacture time about 15 minutes.

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New Whitening Agent From Pimpinella brachycarpa (참나물추출물의 멜라닌 생성저해 효과)

  • Kim, Jin-Hwa;Sim, Gwan-Sub;Lee, Dong-Hwan;Lee, Geun-Soo;Lee, Bum-Chun;Pyo, Hyeong-Bae
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.33 no.3
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    • pp.203-208
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    • 2007
  • To develop a new whitening agent for cosmetics from natural products, Pimpinella brachcarpa was selected for its inhibitory effect on melanogenesis in B16 melanoma cells. Crude ethanolic extract of P. brachycarpa and its four fractions-hexane, ethyl acetate(EtOAc), butanol and aqueous were evaluated for antioxidative effects and tyrosinase inhibitory activity. To elucidate the mechanism of active compounds of P. brachycarpa, we investigated the changes in protein level of tyrosinase, TRP-1 and TRP-2 using Western blotting and the changes in mRNA level of tyrosinase using RT-PCR technique. Following UV irradiation, expression of ET-1 in HaCaT keratinocytes was measured by quantitative enzyme immunoassay(EIA) using human ET-1 antibody. Crude ethanolic extract of P. brachycarpa and its four fractions-hexane, EtOAc, butanol and aqueous had free radical scavenging effect by 87.2, 2.5, 97.2, 80.5, 49.8% at 100 ${\mu}g/mL$ and tyrosinase inhibitory effect by 18.3, 15.1, 55.4, 13.1, 0 % at 100 ${\mu}g/mL$. P. brachycarpa EtOAc fraction significantly inhibited melanin production in B16 melanoma cells. Treatment with P. brachycarpa extract for 72 h suppressed the biosynthesis of melanin up to 58 % at 100 ${\mu}g/mL$. Especially, the EtOAc fraction of P. brachycarpa reduced the tyrosinase activity and tyrosinase expression in B16 melanoma cells in a dose-dependent manner. mRNA levels of tyrosinase and TRP-1 were markedly reduced by the EtOAc fraction of P. brachycarpa. Moreover, at the concentrations of $12.5{\sim}50{\mu}g/mL$ of the fraction, the production of UV-induced ET-1 in HaCaT keratinocytes(24 h after 8 $mJ/cm^2$ UVB irradiation) was reduced about 40%(p<0.05). P. brachycarpa could be used as a new natural skin-whitening agent due to the inhibitory effect of on melanin biosynthesis and endothelin-1 expression.

The Efficacy of ZD1839 ($Iressa^{TM}$) in Patients with Advanced Non-small Cell Lung Cancer which has Progressed After Previous Chemotherapy (표준 항암화학요법에 실패한 진행성 비소세포폐암에서 ZD1839 ($Iressa^{TM}$)의 효과)

  • Lee, Seung Whan;Kim, Duck Ryung;Lee, Sang Dae;Lee, Jong Sin;Park, Yeon Hee;Ryoo, Baek-Yeol;Kim, Heung Tae;Park, Sunhoo;Kim, Bong Seog;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.160-168
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    • 2004
  • Background : The role of second-line chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) is known to be limited. Recently, ZD1839, the small molecule epidermal growth factor receptor-tyrosine kinase inhibitor, has been developed and has shown anti-tumor activity in patients with solid malignant tumors including lung cancer. We evaluated the response rate and toxicities of ZD1839 in patients with advanced NSCLC which has progressed after previous chemotherapy. Patients and Methods : We examined 83 patients with advanced NSCLC treated with ZD1839 for more than 1 month in Korea Cancer Center Hospital during the period from January 2002 to September 2003. All the patients were enrolled in the international expanded access program (EAP) with ZD1839 by AstraZeneca. The administered dose of ZD1839 was 250 mg once daily. Chest radiography and laboratory tests were followed-up. We evaluated the response rate, median survival, and toxicity after treatment. Results : Median age of the patients was 59 years (range 33-76). The most predominant cell type was adenocarcinoma and the most stage of the patients was IV. ECOG performance status was as follows; grade 0-1 in 10, grade 2 in 42, and grade 3 in 31 patients. Partial response was achieved in 12 patients (14.5%). Median overall survival was 9.2 (range 1.3-21.6+) months and median time to progression was 3.1 (range 1-21.2+) months. The most common adverse effect of ZD1839 was skin eruption which developed in 25 patients (25.8%). Significantly higher response rate and survival was found in patients with adenocarcinoma or good performance status. Conclusion : ZD1839 showed modest activity and tolerable toxicity in the treatment for patients with NSCLC which has progressed after previous chemotherapy.

Effect of Steviol β-Glucopyranosyl Ester on The Production of Nitric Oxide and Inflammatory Cytokines in RAW 264.7 Cells (Steviol β-Glucopyranosyl Ester가 RAW 264.7 세포의 산화질소 및 염증성 사이토카인 생성에 미치는 영향)

  • Jung, Heehoon;Cho, Uk Min;Hwang, Hyung Seo;Cho, Kun;Lee, Sang Rin;Kim, Moo Sung
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.44 no.3
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    • pp.239-247
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    • 2018
  • Chronic inflammation is known to have effects on various diseases such as gout, cancer, dementia, atopic disease, and obesity. In addition, since some signal cascades involved in the development of inflammation are known to affect the damage and aging of the skin tissue, studies are being conducted actively to control the inflammation mechanism. In order to mitigate or prevent inflammatory response, a number of researches have been made to develop anti-inflammatory materials from some plants. In particular, Stevia rebaudiana produces steviol glycosides (SG), a natural sweetener with a distinctive flavor. Studies on some of SG have been shown to have anti-inflammatory activity. Researchers of this study expected that more SG also possess anti-inflammatory activity, besides stevioside, rebaudioside A, and steviol. In order to confirm this possibility, the researchers screened inhibition activity of various steviol glucosides for NO production in RAW 264.7 cell lines. As a result, steviol ${\beta}-glucopyranosyl$ ester (SGE) showed the highest inhibitory activity among steviol derivatives treated at the same molar concentration. In addition, we found that mRNA expression level of $interleukin-1{\alpha}$ ($IL-1{\alpha}$), $interleukin-1{\beta}$ ($IL-1{\beta}$), cyclooxygenase-2 (COX-2), nuclear factor kappa-light chain-enhancer of activated B cells ($NF-{\kappa}B$) and inducible nitric oxide synthase (iNOS) was also decreased in a dose-dependent manner. These results show that SGE inhibits anti-inflammatory activity and NO production in mouse macrophage RAW 264.7 cells. It was confirmed that SGE has potential to be applied as an anti-inflammatory material.