• 제목/요약/키워드: Treatment schedule

검색결과 278건 처리시간 0.027초

비인강암의 3차원 입체조형치료에서 등가선량분포에 관한 연구 (3-Dimensional Conformal Radiation Therapy in Carcinoma of The Nasopharynx)

  • 금기창;김귀언;이상훈;장세경;임지훈;박원;서창옥
    • Radiation Oncology Journal
    • /
    • 제16권4호
    • /
    • pp.399-408
    • /
    • 1998
  • 목적 : 본 연구는 비인강암 환자의 방사선치료에서 기존의 2차원적 치료계획과 3차원 입체조형 치료계획을 비교 분석하여 3차원적 치료계획의 우월성을 입증하고자 하였다. 대상 및 방법 : 병기가 T4인 환자를 대상으로 하였으며, 두 치료계획 모두 기존의 2차원적 치료방법으로 50.4Gy가 조사된 후 추가조사하는 과정을 2차원적 치료계획과 3차원적 치료계획으로 구분하여 수립하였다. 치료계획의 비교는 선량통계, 선량체적히스토그람, 국소제어율, 그리고 정상조직손상확률을 이용하여 시행하였다. 결과 : 3차원적 치료계획에서 2차원적 치료계획과 비교하여 계획용표적체적의 선량균일성이 더욱 향상되었으며 평균선량도 15.2$\%$의 증가를 보였다. 또한 종양 주위의 정상 장기인 측두엽, 뇌간, 이하선 및 측두하악골관절에 조사되는 평균선량은 3차원적 치료계획에서 낮았다. 종양제어확률은 3차원적 치료계획에서 2차원적 치료계획에서보다도 6$\%$ 증가하였으나 정상조직손상확률은 측두엽, 뇌간, 이하선, 측두하악골관절, 그리고 시신경교차 등 대부분의 정상장기에서 낮았다. 결론 : 3차원 입체조형치료계획은 2차원적 치료계획에 비교하여 종양의 국소제어율을 증가시킬수 있는 우월한 치료법임이 증명되었으나 임상적으로도 같은 결과를 가져올 지는 향후 전향적인 임상 연구가 요구된다.

  • PDF

랫드에서 cis-Malonato[(4R,5R)-4,5-bis(aminomethyl)-2-isopropyl-1,3-dioxolane]platinum(II)(SKI 2053R)의 아급성독성시험에 관한 연구 (Subacute Toxicity of cis-Malonato[(4R,5R)-4,5-bis(aminomethyl)-2-isopropyl-1,3-dioxolane]platinum(II)(SKI 2053R) in rats)

  • 김형욱;강경선;신동진;조재진;김배환;서광원;남기환;이영순
    • Toxicological Research
    • /
    • 제8권2호
    • /
    • pp.217-233
    • /
    • 1992
  • This study was performed to determine the toxic effects of graded dose levels of SKI 2053R after repeated administration. Three groups of Sprague-Dawley rats(10M and 10F per group) were given a total of 25 i.v. injections of SKI 2053R (1.50,3.75,9.38mg/kg/day). In order to compare the toxic effects of SKI 2053R with those of cisplatin, one group of Sprague-Dawley rats (10M and 10F per group) were given a total of 25 i.v.injections of cisplatin (1.70mg/kg/day). The dosing schedule was divided into five courses of 5 consecutive days with 16-day dose-free intervals between each course. No drug-related toxicity occurred in low dose level group (1.50mg/kg/day) of SKI2053R. From the results of hematological examination, peripheral WBC counts, RBC counts and hemoglobin of high dose level group(9.38mg/kg/day)of SKI 2053R were significantly lower than those of no-treated group. Other toxicities including reduced final body weight, proteinuria and hematuria were observed in high dose level group of SKI 2053R. But, no change was detected in serum biochemical values of SKI 2053R treated groups. All of the rats in cisplatin treated group were died between 3 and 13 weeks, while rats treated with SKI2053R survived to the end except one rat of middle dose level group(3.75mg/kg/day). In histopathological examinations, rats that received cisplatin manifested severe tubular damage in kidney and hemosiderosis in spleen, but no critical pathological lesion was observed in rats of other groups. Considering the results of this study, it was concluded that non-toxic dose of SKI 2053R in this treatment schedule was estimated to be 3.75 mg/kg/day and the maximum tolerated dose was to be higher than 9.38mg/kg/day. The toxic profiles fo SKI 2053R were different from those of cisplatin, and its toxicity was considerably lower than that of cisplatin.

  • PDF

측두하악장애 의료행위분류에 관한 연구 (The Development of Classification System of Dental Services for Temporomandibular Joint Disorders)

  • 송윤헌;김미은;김기석
    • Journal of Oral Medicine and Pain
    • /
    • 제30권2호
    • /
    • pp.257-268
    • /
    • 2005
  • 우리나라 건강보험제도는 보수지불방식에서 전체적으로 보면 행위별수가제(fee for service)를 유지하고 있다. 이 제도에서는 진료수가의 설계에서 각 의료서비스의 단위를 설정하기 위해서는 현재 임상에서 이루어지고 있는 모든 의료행위에 대한 목록이 필요하게 된다. 따라서 본 연구에서는 측두하악장애 의료의 수가구조와 수가항목에 대해 재분류를 통한 체계화과정을 통해서 향후 투입자원에 기초한 상대가치를 산정하여 수가수준을 결정할 수 있는 준거를 제시하고자 하였다. 현행 행위별 수가제도의 범위내에서 측두하악장애 진료행위에 대한 델파이법을 이용하여 의료행위에 대한 재분류하여 항목화 작업을 거치면서 자원기준 상대가치 산출모델의 선행연구를 시행하였다. 이를 통해 의료행위분류에서는 총 151개의 의료 행위를 규명하였다. 이를 건강보험 수가항목이 되도록 하기 위해서는 지속적인 정련화 과정이 필요하게 되므로 용어의 정리 및 통일, 명확한 진료범위의 설명, 체계적인 분류구조 등이 고려되어야 한다. 이상의 연구결과는 향후 치과의료의 구조적 문제점과 현안과제를 해결하는 기초자료로 활용하고, 앞으로 치과의료의 수가 수준을 결정하는 후속연구의 방향설정과 참고자료로 활용하며, 의료수가체계의 표준화를 유도하여 의료이용의 편의성을 도모하고 의료정책에 대한 국민적 신뢰를 회복하여 측두하악관절장애 진료의 건강보험 확대적용 및 향후 민간 사보험 도입시 기초자료로 활용될 것으로 사료된다.

Effects of a Stair-step Growth Pattern on Improvements in Meat Quality and Growth in Hanwoo Steers

  • Li, Z.H.;Lee, H.G.;Xu, C.X.;Hong, Z.S.;Jin, Y.C.;Yin, J.L.;Zhang, Q.K.;Piao, D.C.;Yang, U.M.;Choi, Y.J.
    • Asian-Australasian Journal of Animal Sciences
    • /
    • 제23권11호
    • /
    • pp.1427-1435
    • /
    • 2010
  • The present study was conducted to examine the effect of a stair-stepped feed intake pattern on growth, feed efficiency, and meat quality of Hanwoo steers. Twenty-seven 11-month-old Hanwoo steers were randomly divided into three groups. The control group was fed according to the Korean steer feeding program, and the other two groups were fed according to an alternated feeding schedule of 3-2-4-2 months. During the first three months of the experiment, treatment group 1 (T1) and treatment group 2 (T2) were fed 20% and 30% less than the control group, respectively. For the following two months, the T1 group was fed 20% more than the control group while the T2 group was fed 20% less than the control group. In the third step, T1 and T2 groups were fed 20% and 10% less, respectively, than the control group for four months. In the last two months, T1 and T2 groups were fed 20% more than the control group. After the stair-step feeding trial, steers were fed concentrated feed ad libitum for five months. The altered feed intake pattern did not affect daily body weight gain. However, daily feed intake tended to decrease and growth efficiency tended to increase in the two treatment groups compared to the control group. Altered feed intake also affected blood metabolite levels. The serum glucose and BUN level of the T1 group increased in the first re-fed period compared to the T2 and control groups. The serum cholesterol level of the T2 group decreased in the first restricted-re-fed growth period compared to the T1 and control groups. The serum NEFA levels of the two treatment groups increased from the first restricted period compared to the controls. The serum insulin level of the T2 group increased in the last period compared to the T1 and control groups. Regarding meat yield index, the control group was significantly higher than the T2 group (p<0.05). Regarding meat yield grade, the carcass back fat thickness of the T2 group was significantly higher than the control group (p<0.05). In marbling score, the T1 group was the highest (4.9), followed by the control group (4.1) and the T2 group (4.0). These results indicate that using a stair-stepped growth pattern (T1) can contribute to improvements in growth efficiency and muscle marbling.

Efficacy and Tolerability of Weekly Docetaxel, Cisplatin, and 5-Fluorouracil for Locally Advanced or Metastatic Gastric Cancer Patients with ECOG Performance Scores of 1 and 2

  • Turkeli, Mehmet;Aldemir, Mehmet Naci;Cayir, Kerim;Simsek, Melih;Bilici, Mehmet;Tekin, Salim Basol;Yildirim, Nilgun;Bilen, Nurhan;Makas, Ibrahim
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권3호
    • /
    • pp.985-989
    • /
    • 2015
  • Background: Docetaxel, cisplatin, 5-fluorouracil (DCF) given every three weeks is an effective, but palliative regimen and significantly toxic especially in patients who have a low performance score. Here, we aimed to evaluate the efficacy and tolerability of a weekly formulation of DCF in locally advanced and metastatic gastric cancer patients. Materials and Methods: 64 gastric cancer patients (13 locally advanced and 51 metastatic) whose ECOG (Eastern Cooperative Oncology Group) performance status (PS) was 1-2 and who were treated with at least two cycles of weekly DCF protocol as first-line treatment were included retrospectively. The weekly DCF protocol included $25mg/m^2$ docetaxel, $25mg/m^2$ cisplatin, and 24 hours infusion of $750mg/m^2$ 5-fluorouracil, repeated every week. Disease and patient characteristics, prognostic factors, treatment response, grade 3-4 toxicity related to treatment, progression free survival (PFS) and overall survival (OS) were evaluated. Results: Of the patients, 41 were male and 23 were female; the median age was 63 (29-82) years. Forty-one patients were ECOG-1 and 23 were ECOG-2. Of the total, 81.2% received at least three cycles of chemotherapy. Partial response was observed in 28.1% and stabilization in 29.7%. Overall, the disease was controlled in 57.8% whereas progression was noted in 42.2%. The median time to progression was 4 months (95%CI, 2.8-5.2 months) and median overall survival was 12 months (95%CI, 9.2-14.8 months). The evaluation of patients for grade 3-4 toxicity revealed that 10.9% had anemia, 7.8% had thrombocytopenia and 10.9% had neutropenia. Non-hematologic toxicity included renal toxicity (7.8%) and thrombosis (1.6%). Conclusions: In patients with locally advanced or metastatic gastric cancer who were not candidates for DCF administered every-3-weeks, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients.

삼기활력약침이 불면, 피로에 미치는 효과 (The Clinical Review of Samgi-Halleak Pharmacopuncture Effects for Insomnia & Fatigue)

  • 이유환;권기순;이승훤;이은솔;김철홍;장경전;송춘호;김영균;김원일;윤현민
    • Journal of Acupuncture Research
    • /
    • 제29권3호
    • /
    • pp.101-113
    • /
    • 2012
  • Objectives : The purpose of this study is to investigate the effects of Samgi-Halleak pharmacopuncture treatment on insomnia and fatigue. Methods : This study was done with 47 nurses under shiftwork schedule. Subjects were divided into two groups ; Samgi-Halleak pharmacopuncture treated group(experimental group, N=24), normal saline treated group(control group, N=23). The procedures had been conducted to the subjects injecting 0.1~0.2mL total 1mL, 0.5~1cm deep on each acupoint 2 times per week. The acupoints were Pungji($GB_{20}$), Gyeonjeong($GB_{21}$), Sinsu($BL_{23}$). Both of groups were treated total 8 times, but control group was treated additional pharmacopuncture the same way as experimental group after 8 times normal saline treatment. The collected data were analyzed with insomnia and fatigue at baseline and post pharmacopuncture using independent samples t-test, Paired t-test, ${\chi}^2$-test by SPSS 18.0 Windows program. Results : After 8 times treatment, the scores of both groups showed significant improvement in insomnia and fatigue. Comparing the experimental and control group, there were more significant improvement in experimental group than control group in the scores of insomnia and fatigue. Conclusions : Samgi-Halleak pharmacopuncture can be used for effective treatment in patients with insomnia and fatigue.

항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교 (Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment)

  • 지의규;하성환;박재갑;방영주;허대석;김노경
    • Radiation Oncology Journal
    • /
    • 제20권1호
    • /
    • pp.62-67
    • /
    • 2002
  • 목적 : 항문암의 치료에 있어 고전적으로는 복회음부절제술이 주된 치료였으나 현재는 화학방사선병용요법이 주된 치료방법으로 정립되었다. 저자들은 서울대학교병원에서 항문암으로 치료 받은 환자의 임상적 특성을 조사하고, 치료방법에 따른 치료성적과 예후인자를 분석하고자 하였다. 대상 및 방법 : 1979년 8월부터 1990년 7월까지 서울대학교병원 치료방사선과에서 근치적 또는 수술 후 방사선 치료를 받은 42명의 환자를 대상으로 후향적으로 분석하였다. 표피양암종이 38명으로 방사선치료가 4명에서, 복회음부절제술 및 수술 후 방사선치료${\pm}$화학요법이 19명에서, 화학방사선요법이 15명에서 시행되었다. 화학방사선요법은 복합화학요법$(5-FU\;1,000\;mg/m^2\;D1\~5,\;cisplatin\;60\;mg/m^2\;D1)$을 3회 시행 후 원발병소 및 영역림프절에 50.4 Gy를 조사하였고, 양측 서혜림프절에도 동일양을 조사하였다. 잔존암이 있는 경우 복합화학요법을 3회 추가 실시하였다. 중앙추적기간은 85개월이었다. 결과 : 전체 항문암 환자의 5년 생존율은 $80.3\%$이었다. 치료방법에 따른 5년 생존율은 복회음부절제술 및 수술 후 방사선치료${\pm}$화학요법군, 화학방사선요법군에서 각각 $88.9\%,\;79.4\%$이었으며 두군간의 생존율의 차이의 통계적인 의미는 없었다(p=0.495). 화학방사선요법을 시행 받은 환자군에서의 항문보존율은 $86.7\%$였다. 예후인자 중 단변량분석에서는 연령(p=0.0164)과 수행능력(p=0.0007)이 유의성을 보였으며, 다변량분석에서는 연령(p=0.0426)과 수행능력(p=0.0068) 및 서혜림프절 전이여부(p=0.0093)가 통계학적으로 유의하였다. 결론 : 항문암의 치료에 있어서 화학방사선요법을 시행할 경우 기존에 알려진 바와 같이 복회음부절제술과 유사한 생존율을 보이며, 항문기능을 보존할 수 있는 치료 방법임을 확인할 수 있었다. 나아가 병행화학요법이 아닌 선행화학요법을 시행하여 수반되는 합병증을 줄일 수 있는 가능성을 확인하였다.

마리화나 남용환자의 역동적인 발달요인과 문제해결 (Dynamic Developmental Factors and their Problem Solving of Patients that Abuse Marihuana)

  • 원정숙
    • 대한간호학회지
    • /
    • 제4권3호
    • /
    • pp.105-116
    • /
    • 1974
  • This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

  • PDF

질소와 인산의 시비량이 새로 조성된 Kentucky Bluegrass에 성장에 미치는 영향 (Phosphorus and Nitrogen Rate Effects to a Newly Seeded Kentucky Bluegrass)

  • 이상국
    • 아시안잔디학회지
    • /
    • 제25권2호
    • /
    • pp.217-222
    • /
    • 2011
  • 최근 잔디관리를 위한 시비프로그램에서 인산의 사용량을 줄이기 위한 연구가 많이 진행 되고 있다. 토양의 인산함량이 식물성장을 위해서 충분히 존재하더라도 시비프로그램은 질소의 양을 기준으로 이루어져 있기 때문에 인산이 불필요 하더라도 질소와 같이 시비되는 것이 일반적이다. 많은 선행연구에서 이미 조성된 잔디에서는 토양내 인산함량의 조건에 상관없이 인산의 영향이 발견되지 않았다. 이것은 뗏장으로 조성된 켄터키블루그래스의 대취층에 많은 인산의 함량이 발견되었기 때문이다. 본 연구에서는 대취층을 최소화 하기위하여 파종하여 새로 조성된 켄터키블루그래스의 성장에 질소와 인산의 영향을 측정하기 위해서 수행되었다. 질소의 시비량은 소량, 중량, 다량으로 각각 20, 30 and $40g\;m^{-2}\;yr^{-1}$로 되었으며 시비 횟수를 각각 2, 4, 6회로 구성되었다. 인산의 시비량은 0, 10 and $20g\;m^{-2}\;yr^{-1}$로 되었으며 인산은 질소시비와 함께 이루어 졌다. 소량의 질소시비는 실험기간 동안 최소수용 품질을 유지 하였으며 가장 적은 예지물을 생산하였다. 다량의 질소시비는 가장 좋은 잔디 품질을 나타내었다. 그러나 실험기간 동안 켄터키블루그래스의 성장에 대한 인산의 일관적인 영향은 발견되지 않았다. 두꺼운 대취층에 조성된 켄터키블루그래스의 성장에 인산의 영향이 없는 것과 동일하게 새로 조성된 켄터키블루그래스의 성장에도 인산의 영향은 일년 동안 발견되지 않았다.

Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study

  • Kang, Hye Jin;Kay, Chul-Seung;Son, Seok Hyun;Kim, Myungsoo;Jo, In Young;Lee, So Jung;Lee, Dong Hwan;Suh, Hong Jin;Choi, Yong Sun
    • Radiation Oncology Journal
    • /
    • 제34권1호
    • /
    • pp.45-51
    • /
    • 2016
  • Purpose: The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer. Materials and Methods: Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the ${\alpha}/{\beta}$ ratio is 1.5 Gy. Results: The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ${\geq}3$ acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed. Conclusion: Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.