• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.178-182
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• 2016

Purpose: Medium-dose (1 g/kg) intravenous immunoglobulin (IVIG) is effective in the majority of patients with Kawasaki disease (KD) but some patients who do not respond to medium-dose IVIG are at high risk for the development of coronary artery lesions (CALs). The purpose of this study was to identify the clinical predictors associated with unresponsiveness to medium-dose IVIG and the development of CALs. Methods: A retrospective study was performed in 91 children with KD who were treated with mediumdose IVIG at our institution from January 2004 to December 2013. We classified the patients into responders (group 1; n=68) and nonresponders (group 2; n=23). We compared demographic, laboratory, and echocardiographic data between the 2 groups. Results: Multivariate logistic regression analysis identified 6 variables as predictors for resistance to medium-dose IVIG. We generated a predictive scoring system assigning 1 point each for percentage of neutrophils ${\geq}65%$, C-reactive protein ${\geq}100mg/L$, aspartate aminotransferase ${\geq}100IU/L$, and alanine aminotransferase ${\geq}100IU/L$, as well as 2 points for less than 5 days of illness, and serum sodium level ${\leq}136mmol/L$. Using a cutoff point of ${\geq}4$ with this scoring system, we could predict nonresponsiveness to medium-dose IVIG with 74% sensitivity and 71% specificity. Conclusion: If a patient has a low-risk score in this system, medium-dose IVIG can be recommended as the initial treatment. Through this process, we can minimize the adverse effects of high-dose IVIG and incidence of CALs.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.25-28
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• 2012

Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.41-52
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• 1996

Purpose : This paper reports a dosimetric study of 88 patients treated with a combination of external radiotherapy and high dose rate ICR for FIGO stage IIB carcinoma of the cervix. The purpose is to investigate the correlation between the radiation doses to the rectum, external radiation dose to the whole pelvis, ICR reference volume, TDF BED and the incidence of late rectal complications, retrospectively. Materials and Methods : From November 1989 through December 1992, 88 patients with stage IIB cervical carcinoma received radical radiotherapy at Department of Radiation Oncology in Yonsei University Hospital. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam irradiation plus high dose rate intracavitary brachytherapy with 5 Gy per fraction twice a week to a total dose of 30 Gy on point A. The maximum dose to the rectum by contrast(r, R) and reference rectal dose by ICRU 38(dr, DR) were calculated. The ICR reference volume was calculated by Gamma Dot 3.11 HDR planning system, retrospectively The time-dose factor(TDF) and the biologically effective dose (BED) were calculated. Results : Twenty seven($30.7\%$) of the 88 patients developed late rectal complications:12 patients($13.6\%$) for grade 1, 12 patients($13.6\%$) for grade 2 and 3 patients($3.4\%$) for grade 3. We found a significant correlation between the external whole pelvis irradiation dose and grade 2, 3 rectal complication. The mean dose to the whole pelvis for the group of patients with grade 2, 3 complication was Higher, $4093.3\pm453.1$ cGy, than that for the patients without complication, $3873.8\pm415.6$ (0.05$7163.0\pm838.5$ cGy, than that for the Patients without rectal complication, $0772.7\pm884.0$ (p<0.05). There was no correlation of the rate of grade 2, 3 rectal complication with the iCR rectal doses(r, dr), ICR reference volume, TDF and BED. Conclusion : This investigation has revealed a significant correlation between the dose calculated at the rectal dose by ICRU 38(DR) or the most anterior rectal dose by contrast(R) dose to the whole pelvis and the incidence of grade 2, 3 late rectal complications in patients with stage IIB cervical cancer undergoing external beam radiotherapy and HOR ICR. Thus these rectal reference points doses and whole pelvis dose appear to be useful Prognostic indicators of late rectal complication in high dose rate ICR treatment in cervical carcinoma.

• Journal of the Korean Society of Radiology
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• v.11 no.2
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• pp.87-94
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• 2017

Monte Carlo simulations were used to assess dose enhancement effects for 60-, 90-, 120-, and 150-kV X-rays, and for 6- and 15-MV X-rays. The MCNPX code was used for a computer simulation of the ICRU slab phantom, and gold, gadolinium, and iron oxide (Fe2O3) were employed as dose enhancement agents. In consideration of the buildup region of the incident energy, agent concentrations of 5, 10, 15, and 20 mg/g were inserted on the surface of the phantom at a depth of 5 cm. Based on baseline values obtained in the absence of dose enhancement agents, a quantitative analysis was performed by evaluating depth-dependent changes in the absorbed energy and the dose enhancement factor (DEF). A higher concentration of dose enhancement agents led to a greater dose enhancement effect with iron oxide, gadolinium, and gold in descending order. For kilovoltage (kV) X-rays, as the incident energy was decreased and as the energy became closer to the ionization potential of the atoms in the enhancement agent, the dose enhancement effect increased. In the megavoltage (MV) X-ray range, dose enhancement was higher at 6 MV compared with 15 MV. However, the overall dose enhancements were significantly lower compared to the results obtained with kV X-rays.

• Korean Journal of Digital Imaging in Medicine
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• v.15 no.2
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• pp.39-44
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• 2013

Purpose : The purpose of this study is the magnification rates depending on the area of patient dose (DAP) and glass dosimeter see the change of the dose according to the dose characteristics of low-magnification aims to raise standards. Materials and Method : Direct DR equipment Sonialvision DAR-8000f, Shimadzu was used, the patient entrance dose measurements to the surface of the Rando Phantom of the neck and the abdomen was placed on the Xi unfors. glass dosimeter for measuring organ doses at the same time the Rando Phantom of the major organs in place by inserting a 9 ", 12", 15 ", 17" and 30 seconds for each magnification were measured according in fluoroscopy. DAP meter area of the patient dose was measured. Result : Esophagography at 17" 143% than 9"magnification the average area dose was increased. Organ dose of Esophagography at 17" was decreased 25.32% than 9" magnification. UGI at 17" was increased 129.73% DAP than 9" magnification. Organ dose of UGI at 17" was decreased 23.32% than 9" magnification. Where the major organs of magnification at 17" were decreased(lung -25.96%, stomach -33.09%, spleen -27.81%, liver -4.92%) than 9" magnification. Conclusion : Expected to get better quality image While using the proper magnification, and have recognition that difference Organ doses and DAP meter in fluoroscopy.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.335-335
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• 1994

Possibility whether lead ingestion can cause selective toxicity to central serotonergic nervous system in rats was tested. Three groups of wistar rats; 1)Control, 2) Low dose and 3) High dose groups, were prepared. In prenatally lead-exposed rats, until parturition from dams, rat pups were intoxicated via placenta of mother rats having received drinking water containing either 0%(control ), 0.05%(low dose) or 0.2%(high dose) of lead acetate respectively, In postnatally lead-exposed rats, right after parturition from dams rat pups received drinking water containing either 0％ (control), 0.05%(low dose) or 0.2％(high dose) of lead acetate. At 2, 4, 6 and 8 weeks of age, tryptophan hydroxylase (TPH) activity and Na$\^$+//K$\^$+/-ATPase activity were measured in 4 areas of rat brain; Telencephalon, Diencephalon, Midbrain and Pons/Medulla. TPH activities were assayed by modified method of Beevers et al. (1983) using L-(5-$^3$H)-tryptophan as substrate. TPH activity was determined as a criterion of lead poisoning to central serotonergic nervous system and Na$\^$+//K$\^$+/-ATPase activity as a criterion of non specific lead poisoning to any kinds of tissues. Selective toxicity of lead poisoning to central serotonergic nervous system was evaluated by the changes of TPH activities without concomitant changes of Na$\^$+//K$\^$+/-ATPase activities. In prenatally lead-exposed rats. this selectivity was found in Telencephalon (2 weeks of age), Diencephalon/Midbrain (2 weeks of age), Midbrain (4 and 6 weeks of age), Pons/Medulla (2, 4 and 6 weeks of age) In rats exposed to low dose of lead and Pons/Medulla (2 weeks of age) to high dose of lead. In postnatal Iy lead-exposed rats, this selectivity was found in Telencephalon (8 weeks of age), Diencephalon(8 weeks of age), Pons/Medulla (6 and 8 weeks of age) in rats exposed to low dose of lead and Pons/Medulla (8 weeks of age) to high dose of lead. These results suggest that lead poisoning may exhibit selective toxicity to central serotonergic nervous system.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.186-194
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• 2014

The object of this study was to obtain acute toxicity information (single-dose oral toxicity) of Woohwangchungshim-won (WHCSW), a pill type herbal medicine used in Korean Medicine (KM) for treating stroke. In order to obtain the 50% lethal dose (LD50), approximate lethal dosage (ALD) and target organs, WHCSW powders were once orally administered to female and male ICR mice at dose levels of 2,000, 1,000, 500 and 0 (control) mg/kg (body weight.) according to the recommendation of Korea Food and Drug Administration (KFDA) Guidelines (Notification No. 2009-116). The mortality and changes in the body weight, clinical signs and gross observation were monitored for 14 days after single-dose oral administration of WHCSW according to KFDA Guidelines with organ weights and histopathological changes were observed in 12 principle organs. After single-dose oral administration of WHCSW, we could not find any mortality and toxicological evidences up to 2,000 mg/kg-administered group, except for some accidental findings and dose-independent increases of body weight gains in female 1,000 and 500 mg/kg-administered female mice. The results obtained in this study suggest that the LD50 and ALD of WHCSW in both female and male mice after single-dose oral administration were considered as over 2,000 mg/kg because no mortalities were detected up to 2,000 mg/kg that was the highest dose recommended by KFDA and Organization for Economic Co-Operation and Development (OECD), and can be safely used in clinics.

• Korean Journal of Digital Imaging in Medicine
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• v.9 no.2
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• pp.23-30
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• 2007

This study attempts to propose an appropriate method of using digital medical imaging equipments, by studying the effects of automatic exposure control(AEC), grid ratio and the change of radiography distance on the patient dose and detertor acquisition dose during the procedure of acquiring image through a digital medical imaging detector. The change of dose following the change of grid ratio's exposure and radiography distance was measured, by using an abdominal phantom organized with tissue equivalent materials in an amorphous silicon thin film transistor detecter installed with AWC. The case to use grid ratio 12 : 1, focal distance 180cm to radiography distance 110cm in AEC, the patient dose increased rather when we used grid ration 10 : 1, focal distance 110cm. When AEC was not used,the dose necessary for image acquisition decreased as the grid ratio became higher and the distance became further. but detector acquisition dose was not reduced when in applied AEC. When purchasing digiral medical imaging equipments, optional items such as AEC and grid shall be accurately selected to satisfy the use of the equipments. Radiography error made by radiation technologist and unnenessary patient dose can be reduced by selecting equipments with a radiography distance marker equipment when it did not apply AEC. These equipments can also be helpful in maintaining high imaging quality, one of the merits of digital detectors.

• Radiation Oncology Journal
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• v.2 no.2
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• pp.271-280
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• 1984

The peripheral dose, defined as the dose outside therapeutic photon fields, which is responsible for the functional damage of the critical organs, fetus, and radiation. induced carcinogenesis, has been investigated for $^{60}Co\;\gamma$ ray and 10 MV Xray. It was measured by silicon diode controlled by semiautomated water phantom without any shielding or with lead plate of HVL thickness put horizontally or vertically to shield stray radiations. Authors could obtain following results. 1. The peripheral dose was larger than $0.7\%$ of central axis maximum dose even at 20cm distance from field margin. That is clinically significant, so it should be reduced. 2. Even for square fields of 10 MV Xray, radial peripheral dose distribution did not coincide with transverse distribution, because of the position of collimator jaws. 3. Between surface and $d_m$, the peripheral dose distributions show a pattern of the dose distribution of electron beams and the maximum doss was approximately proportional to the length of a side of square field. 4. The peripheral doses depended on radiation quality, field size, distance from field margin and depth in water. Distance from field margin was the most important factor. 5. Except for near surface, the peripheral dose from phantom was approximately equal to that from therapy unit. 6. To reduce the surface dose outside fields, therapist should shield stray radiations from therapy unit by lead plate of at least one HVL for 10 MV X-ray and by bolus equivalent to tissue of 0.5cm thickness for $^{60}Co$. 7. To reduce the dose at depth deeper than $d_m$, it is desirable to shield stray radiations from therapy unit by lead.

• Journal of the Korea Convergence Society
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• v.6 no.5
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• pp.287-294
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• 2015

The purpose of this study, was Let's examine the exposure dose at the time of cerebral blood flow CT scan of acute ischemic stroke patients. In particular, long-term high doses of radiation sensitive organs and we Measured using phantom and a glass dosimeter. Apply the existing protocol suggested by the manufacturer (fixed time delay technique) and the proposed new convergence protocol (bolus tracking technique), reporting to measure the dose, dose reduction was to prepare the way. Results up to 39.8% as compared to the existing protocols in a new suggested convergence protocol, a minimum of 5.8% was long-term dose is reduced. Test dose of $CDTI_{vol}$ and DLP values decreased 25%, respectively, were measured at less than recommended dose. Try checking the protocol set out in the existing based on the analysis result of the above, by applying the proposed new convergence protocol by reducing the dose would have to contribute to improved public health. It is believed to be research continues to find the optimum protocol in the other tests.