• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2889-2894
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• 2015

Background: To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the length of lung draw on the selected transverse CT slice) on the volumetric dose to heart with whole breast irradiation (WBI) of left-sided breast cancer patients. Materials and Methods: Fifty-three patients with left-sided breast cancer undergoing adjuvant intensity-modulated radiotherapy (IMRT) were enrolled in the study. The primary breast size and shape, MHD and DCWH (chest wall hypotenuse) were contoured on radiotherapy (RT) planning CT slices. The dose data of hearts were obtained from the dose-volume histograms (DVHs). Data were analyzed by one-way analysis of variance (ANOVA), Student's t-test and linear regression analysis. Results: Breast size was independent of heart dose, whereas breast shape, MHD and DCWH were correlated with heart dose. The shapes of breasts were divided into four types, as the flap type, hemisphere type, cone type and pendulous type with heart mean dose being $491.8{\pm}234.6cGy$, $752.7{\pm}219.0cGy$, $620.2{\pm}275.7cGy$, and $666.1{\pm}238.0cGy$, respectively. The flap type of breasts shows a strong statistically reduction in heart dose, compared to others (p=0.008 for V30 of heart). DCWH and MHD were found to be the most important parameters correlating with heart dose in WBI. Conclusions: More attention should be paid to the heart dose of non-flap type patients. The MHD was found to be the most important parameter to correlate with heart dose in tangential WBI, closely followed by the DCWH, which could help radiation oncologists and physicsts evaluate heart dose and design RT plan in advance.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.252-257
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• 2010

Objective : Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with $Bispectral^{TM}$ index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. Methods : We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. Results : The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were $0.63{\pm}0.26$ in low dose group, and $1.31{\pm}0.48$ in high dose group. The treatment durations were $4.89{\pm}1.68$ days and $3.38{\pm}1.24$ days in low dose BCT and high dose BCT, respectively. Conclusion : It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.302-304
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• 2002

In linac-based stereotactic radiosurgery, assuring the quality of the planning and delivery of external photon beam requires accurate evaluation of beam parameters, usually including output factors, tissue-phantom ratio and off-axis ratios, and measurement of actual dose distributions from simulated treatment. We're going to test the use of calibrated radio chromic film (Gafchromic film; type MD-55, Nuclear associate) using a Lumiscan 75 digitizer to measure absolute dose and relative dose distributions for linac-based radiosurgery unit Relative dose distribution of a human-style spherical acryl phantom were measured using radiochromic film and calculated by treatment planning system. The absolute dose at the sphere center was measured by radiochromic film and micro chamber (Exradin A-14, 0.009cc). What we want to demonstrate in this work, the 'well selected' radiochromic films when external photon beam are used in linac-based stereotactic radiosurgery are very accurate detector for dosimetry.

• YAKHAK HOEJI
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• v.30 no.3
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• pp.149-156
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• 1986

Many experiments have showed that the sodium and potassium ion transporting system and the Na, $^+K^+$-ATPase activity of membrane fragments are inhibited by digitalis glycosides and that the pump may be associated with the pharmacological receptor for the drugs. The aim of our investigation is to elucidate the ouabain binding sites occupation in heart following infusion of ouabain to intact animals by the $^3H$-ouabain binding assay. Lethal dose and 26 percent of lethal dose of ouabain were infused to intact rabbit through ear vein. Microsomal fraction was fractionated from ouabain treated rabbit heart. $^3H$-ouabain binding to these fraction in vitro was studied by the Schwartz's method. $^3H$-ouabain binding to heart microsomal fraction was also studied following infusion of ginseng ethanol extract and caffeine to rabbits respectively. 1) The infusion of lethal dose ouabain (113$\mu\textrm{g}$/kg) inhibited the specific $^3H$-ouabain binding to rabbit heart microsomal fraction to the level of 60% (p<0.01) of control group and the infusion of 26% of lethal dose of ouabain led to the level of 79% (p<0.01) of the control group. 2) Time course of binding of 0.4$\mu{M}$ $^3H$-ouabain to microsomal fraction from rabbit heart following infusion of lethal and 26% of lethal dose of ouabain showed dose dependence at various incubation time. 3) Compared with control, only slight change of $K_d$ and $B_{max}$ was detected in in vitro $^3H$-ouabain binding after infusion of ginseng ethanol extract (300mg/kg) to rabbit. 4) In caffeine infusion group, $^3H$-ouabain binding yielded nearly the same results as control group.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.224-228
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• 2009

Background: Shoulder arthroscopic surgery is frequently associated with severe postoperative pain, which can be difficult to manage without the use of high-dose opioids. Although an interscalene brachial plexus block (ISBPB) can be used to provide anesthesia for shoulder arthroscopic surgery, its effect using low-dose mepivacaine on postoperative pain management has not been reported. We hypothesized that ISBPB using a low-dose mepivacaine can provide effective postoperative analgesia for shoulder arthroscopic surgery without the need for high-dose opioids and act as a significant motor or sensory block. Methods: This study examined a total of 40 patients, who underwent shoulder arthroscopic surgery, and received ISBPB with 10 ml of normal saline (group NS; n = 20) or 10 ml of 1% mepivacaine with epinephrine 1:200,000 (group MC; n = 20). The block was performed preoperatively. The postoperative pain score, opioid consumption, and side effect were recorded. Results: The visual analog scale scores were significantly lower in group MC than in group NS at 120 minutes after shoulder arthroscopic surgery ($1.9{\pm}1.0$ versus $4.0{\pm}1.4$). Group MC showed significantly lower fentanyl consumption after shoulder arthroscoic surgery than group NS ($27{\pm}32.6$ versus $79{\pm}18.9{\mu}g$). The degree of motor and sensory block after surgery was minimal. Conclusions: ISBPB using low-dose mepivacaine reduced the level of postoperative pain and fentanyl consumption without significant side effects. ISBPB using low-dose mepivacaine is a useful analgesic technique for shoulder arthroscopic surgery.

• Progress in Medical Physics
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• v.24 no.4
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• pp.278-283
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• 2013

Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.313-319
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• 2018

In radiation treatment, it is unavoidable to block the influence of scattered ray on a skin and prevent internal normal organs from being exposed to radiation. It is fair to say that radiation therapy aims to reduce an absorbed dose of normal tissues. In particular, in radiation therapy of left-sided breast cancer, the internal neighboring organs are normal breast tissues, the heart, and the lung. The side effects on the heart include cardioplegy and myocardial infarction. This study tried to observe changes in the volume and dose of the heart in general radiation therapy plan and respiratory control based radiation therapy plan for patients with left-sided breast cancer, and to find the heart's volume and dose generated by respiration. According to the 4D computer tomography (CT), a volume of the heart had $12.8{\pm}8.7cc$ on average, and its dose had $17.3{\pm}12.1cGy$ on average. The differences in the volume and dose may cause side effects in radiation treatment. Therefore, it is necessary to apply respiratory control technique to establish the radiation treatment plan based on an accurate position of the heart.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1107-1117
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• 1990

The regulatory role of the post \ulcorner1-and \ulcorner2-adrenoceptors on cardiac function, particularly in coronary flow rate, was investigated in the isolated rat heart treated with 10-6 M propranolol. When introduced into the left atrium of the heart, phenylephrine[10-7-10-2 M] decreased coronary flow rate and increased mean coronary resistance in a dose related fashion, but did not affect heart rate. Methoxamine also elicited the increment of coronary resistance and the decrement of coronary flow rate, though the effects of methoxamine were weaker than those by phenylephrine. The effect of phenylephrine was inhibited by 1\ulcornerM prazosin and shifting the dose-response curve to the right. The effects of clonidine, a selective \ulcorner2-adrenoceptor agonist, were studied in the heart taken from reserpinized rats. Clonidine increased coronary resistance, decreased heart rate and coronary flow rate with a dose-dependent manner. These effects were abolished by 10-6 M yohimbine, a selective \ulcorner2-antagonist, and were not affected by 10-6M prazosin. Clonidine also decreased coronary flow and increased mean coronary resistance in electric paced heart. These effects were inhibited by rawoulscine, a selective ca-antagonist. These results indicate that the stimulation of both post \ulcorner1-and \ulcorner2-adrenoceptor causes coronary vasoconstiction. And it is inferred that this model of sympathomimetics-induced coronary vasospasm may provide a useful tool for investigating spasmolytic agents which are of benefit in the treatment of variant angina.

• The Journal of Korean Medicine
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• v.24 no.1
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• pp.41-53
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• 2003

The effect of Banhasasim-tang extracts on the hepatic, splenic and cardiac toxicity induced by doxorubicin administration (three injection protocol) were monitored using male ICR mice. Changes of body weight, clinical signs, necropsy findings and organ weights of liver, spleen and heart were observed with blood GOT and GPT levels. The results were as follows: 1. Decrease of body weight after doxorubicin treatment was dose-dependently inhibited by Banhasasim-tang extracts. 2. The degrees of anorexia, ataxia and dehydration that were observed in doxombicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. 3. Increase of absolute and relative liver weight observed in the doxorubicin treatment group were dose-dependently inhibited by Banhasasim-tang extracts. In addition, the degrees of liver congestion and necrotic spot were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of the doxorubicin-only treatment group. It is also demonstrated that elevated serum GOT and GPT levels in the doxorubicin treatment group were significantly decreased in the Banhasasim-rang extracts dosing group. 4. Decrease of absolute and relative spleen weight observed in doxorubicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. In addition, the degrees of splenic atrophy were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of doxorubicin-only treatment group. 5. Increase of absolute and relative heart weight observed in doxorubicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. In addition, the degrees of heart congestion and enlargement were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of the doxorubicin-only treatment group. In conclusion, the toxicity of doxorubicin treatment (decrease of body weight, clinical signs such as anorexia, ataxia and dehydration, changes of organ weights of liver, spleen and heart, elevation of serum GOT and GPT levels) was inhibited and/or prevented by Banhasasim-rang extracts. According to these results, it is considered that Banhasasim-rang has some preventive effect against the toxicity induced by doxorubicin.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.106-108
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• 2002

Recent advances in radiation transport algorithms, computer hardware performance, and parallel computing make the clinical use of Monte Carlo based dose calculations possible. Monte Carlo treatment planning requires accurate beam information as input to generate accurate dose distributions. The procedures to obtain this accurate beam information are called "commissioning", which includes accelerator head modeling. In this study, we would like to investigate how much accurately Monte Carlo based dose calculations can predict the measured beam data in various conditions. The Siemens 6MV photon beam and the BEAM Monte Carlo code were used. The comparisons including the percentage depth doses and off-axis profiles of open fields and wedges, output factors will be presented.