• Title/Summary/Keyword: lung/liver cancer

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Analysis of Radiotherapy Associated Factors in Stage IIb Carcinoma of Uterine Cervix (자궁 경부암 처지)

  • Moon, Chang-Woo;Jeung, Tae-Sig;Yum, Ha-Yong
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.241-253
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    • 1990
  • 331 patients of stage IIb uterine cervix cancer trated by radiation alone at Kosin Medical Center between June 1980 and Dec. 1985 were analysed to determine parameters of radiotherapy associated to disease states. Survival rate was highest among the reported ($82.8{\%}$ for crude and $82.4{\%}$ for disease free survival). Pelvic control rate in 6 weeks after the end of radiotherapy was $93.6{\%}$ in the patients treated with ICR following total pelvic radiation and $71.6{\%}$ with small field additional external irradiation. 5 year survival rate in those who achieved pelvic control was $98.9{\%}$ and $12.9{\%}$ in those who had pelvic failure and/or metastasis after radiation. The survival rate figured maximal $88.5{\%}$ with dosage of $7500{\~}8500$ cGy to point A with acceptable incidence of complications ($4.9{\%}$) but without increasing survival above it and minimal $74.1{\%}$ with dosage of less than 6500 cGy. The treatment failure was counted $18.7{\%}$ (62 of 331 patients): Local failure $72.6{\%}$ (45 of 62 patients), locoregional failure $3.2{\%}$ (2 of 62 patients) and distant failure $24{\%}$ (15 of 62 patients). Late complications were found in 50 patients ($15.1{\%}$) and $42{\%}$ of them was rectal bleeding and stenosis. The dose of 8500 cGy to point A was found to be critical for complication and $70{\%}$ of complications occurred above it and was more serious one such as fistula. Rectal complications were developed above rectal dose 6500 cGy and bladder complication above bladder dose 7500 cGy. Major cause of death was cachexia due to locoregional failure ($73.7{\%}$ of death), next was due to metastasis to lung, liver and bone, and only 3 patients died of complication of intestinal perforations and obstruction. In conclusion higher external radiation dose for a bulky uterine cervix and barrel shaped uterus was essential for local control.

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Evaluation of Difference between Skin Motion and Tumor Motion for Respiration Gated Radiotherapy (호흡조절방사선치료를 위한 피부움직임과 종양움직임 차이 평가)

  • Kwon, Kyung-Tae;Lim, Sang-Wook;Park, Sung-Ho;Kwon, Soo-Il;Shin, Sung-Soo;Lee, Sang-Wook;Ahn, Seung-Do;Kim, Jong-Hoon;Choi, Eun-Kyung
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.14-20
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    • 2008
  • Accounting for tumor motion in treatment planning and delivery is one of the most recent and significant challenges facing radiotherapy. The purpose of this study was to investigate the correlation and clarified the relationship between the motion of an external marker using the Real-Time Position Management (RPM) System and an internal organ motion signal obtained fluoroscope. We enrolled 10 patients with locally advanced lung cancer and liver cancer, retrospectively. The external marker was a plastic box, which is part of the RPM used to track the patient's respiration. We investigated the quantitatively correlation between the motions of an external marker with RPM and internal motion with fluoroscope. The internal fiducial motion is predominant in the caraniocaudal direction, with a range of $1.3{\sim}3.5cm$ with fluoroscopic unit. The external fiducial motion is predominant in the caraniocaudal direction, with a range of $0.43{\sim}2.19cm$ with RPM gating. The two measurements ratio is from 1.31 to 5.56. When the regularization guided standard deviation is from 0.08 to 0.87, mean 0.204 cm, except only for patients #3 separated by a mean 0.13 cm, maximum of 0.23 cm. This result is a good correlation between internal tumor motion imaged by fluoroscopic unit and external marker motion with RPM during expiration within 0.23 cm. We have demonstrated that gating may be best performed but special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct phase difference alone would not guarantee that the entire tumor volume is within the treatment field.

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Development and Utility Evaluation of Portable Respiration Training Device for Image-guided Stereotactic Body Radiation Therapy (SBRT) (영상유도 체부정위방사선 치료시 호흡동조를 위한 휴대형 호흡연습장치의 개발 및 유용성 평가)

  • Hwang, Seon Bung;Park, Mun Kyu;Park, Seung Woo;Cho, Yu Ra;Lee, Dong Han;Jung, Hai Jo;Ji, Young Hoon;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.264-270
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    • 2014
  • This study developed a portable respiratory training device to improve breathing stability, which is an important element in using the CyberKnife Synchrony respiratory tracking device, one of the typical Stereotactic Radiation Therapy (SRT) devices. It produced an interface for users to be able to select one of two displays, a graph type and a bar type, supported an auditory system that helps them expect next respiration by improving a sense of rhythm of their respiratory period, and provided comfortable respiratory inducement. By targeting 5 applicants and applying individual respiratory period detected through a self-developed program, it acquired signal data of 'guide respiration' that induces breathing through signal data gained from 'free respiration' and an auditory system, and evaluated the usability by comparing deviation average values of respiratory period and respiratory amplitude. It could be identified that respiratory period decreased $55.74{\pm}0.14%$ compared to free respiration, and respiratory amplitude decreased $28.12{\pm}0.10%$ compared to free respiration, which confirmed the consistency and stability of respiratory. SBRT, developed based on these results, using the portable respiratory training device, for liver cancer or lung cancer, is evaluated to be able to help reduce delayed treatment time due to respiratory instability and improve treatment accuracy, and if it could be applied to developing respiratory training applications targeting an android-based portable device in the future, even use convenience and economic efficiency are expected.

Antimutagenic and Cytotoxicity Effects of Agaricus blazei Murill Extracts (아가리쿠스버섯(Agaricus blazei Murill) 추출물의 항돌연변이원성 및 세포독성 효과)

  • Ji, Jeong-Hwan;Kim, Mi-Nam;Choi, Kun-Pyo;Chung, Cha-Kwon;Ham, Seung-Shi
    • Korean Journal of Food Science and Technology
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    • v.32 no.6
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    • pp.1371-1378
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    • 2000
  • This study was performed to determine the antimutagenic and cytotoxic effect of Agaricus blazei Murill methanol extract on Salmonella typhimurium TA98, TA100 and human cancer cell lines using Ames test and cytotoxicity assay, respectively. In Ames test, methanol extract from A. blazei Murill did not exhibit any mutagenicity and most of the samples showed high antimutagenic effects against mutation induced by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG), 4-nitroquinoline-1-oxide(4NQO), 3-amino-1,4-dimethyl-5H-pyrido [4,3-b] indol(Trp-P-1) and $benzo({\alpha})pyrene(B({\alpha})P)$. The methanol extracts of A. blazei Murill$(200\;{\mu}g/plate)$ showed approximately 92.4%, 81.9% and 83.4% inhibitory effect on the mutagenesis induced by 4NQO, Trp-P-1 and $B({\alpha})P$ against TA98 strain, whereas 87.3%, 94.7%. 92.3% and 89.9% inhibitions were observed on the mutagenesis induced by MNNG, 4NQO, Trp-P-1 and $B({\alpha})P$ against TA100 strain. The solvent fractions of methanol extracts from A. blazei Murill except water fraction showed high antimutagenic effects of $70{\sim}90%$ against mutation induced by MNNG, 4NQO. Trp-P-1 and $B({\alpha})P$. In anticancer effects of A. blazei Murill extract and fraction against cancer cell lines including human breast adenocarcinoma(MCF7), human lung carcinoma(A549), human fibrosarcoma(HT1080), human hepatocellular carcinoma(Hep3B), human epitheloid carcinoma(HeLa), human gastric carcinoma(KATO III) and human chronic myelogenous leukemia(K562) were investigated. The treatment of 1 mg/mL A. blazei Murill extracts had the highest cytotoxicity with 91.9% against HeLa, followed by KATO III(88.7%), A549(86.5%) and Hpe3B(84.3%). Whereas 1 mg/mL treatment of A. blazei Murill extracts had only $10{\sim}40%$ cytotoxicity on human normal liver cell (WRL68).

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Consideration of the Accuracy by Variation of Respiration in Real-time Position Management Respiratory Gating System (호흡동조 방사선치료에 사용되고 있는 RPM (Real-time Position Management) Respiratory Gating System의 호흡변화에 따른 정확성에 대한 고찰)

  • Na, Jun Young;Kang, Tae Young;Baek, Geum Mun;Kwon, Gyeong Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.49-55
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    • 2013
  • Purpose: Respiratory Gated Radiation Therapy (RGRT) has been carried out using RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, varian, USA) in Asan Medical Center. This study was to analyze and evaluate the accuracy of Respiratory Gated Radiation Therapy (RGRT) according to variation of respiration. Materials and Methods: Making variation of respiration using Motion Phantom:QUASAR Programmable Respiratory Motion Phantom (Moudus Medical Device Inc. CANADA) able to adjust respiration pattern randomly was varying period, amplitude and baseline by analyze 50 patient's respiration of lung and liver cancer. One of the variations of respiration is baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. The other variation of respiration is baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm. Experiments were performed in the same way that is used RPM Respiratory Gating System (phase gating, usually 30~70% gating) in Asan Medical Center. Results: It was all exposed radiation under one of the conditions of baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. Under the other condition of baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm equally radiation was exposed. Conclusion: The variations of baseline shifts didn't accurately reflect on phase gating in RPM Respiratory Gating System. This inexactitude makes serious uncertainty in Respiratory Gated Radiation Therapy. So, Must be stabilized breathing of patient before conducting Respiratory Gated Radiation Therapy. also must be monitored breathing of patient in the middle of treatment. If you observe considerable changes of breathing when conducting Respiratory Gated Radiation Therapy. Stopping treatment immediately and then must be need to recheck treatment site using fluoroscopy. If patient's respiration rechecked using fluoroscopy restabilize, it is possible to restart Respiratory Gated Radiation Therapy.

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Review on Usefulness of EPID (Electronic Portal Imaging Device) (EPID (Electronic Portal Imaging Device)의 유용성에 관한 고찰)

  • Lee, Choong Won;Park, Do Keun;Choi, A Hyun;Ahn, Jong Ho;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.57-67
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    • 2013
  • Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

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Radiation Therapy of Nasopharyngeal Carcinoma (비인두강 종양의 방사선치료성적)

  • Nho Young Ju;Cho Jeong Gill;Ahn Seung Do;Choi Eun Kyung;Kim Jong Hoon;Kang One Chul;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.305-313
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    • 1997
  • Purpose : This is a retrospective study to evaluate the results of radiation therapy and prognostic factors influencing the results in nasopharyngeal carcinoma. Materials and Methods: From October 1989 to May 1996. 56 Patients were treated for nasopharyngeal carcinoma at Department of Radiation On-cology. According to stage, patients were distributed as follows : stage I (2), II (13). II (11), IV (30). Twenty-eight patients were treated with radiation therapy only, 7 patients were treated with neoadiuvant chemotherapy followed by radiation therapy. Twenty-one Patients were treated with radiation therapy and weekly CDDP. After external beam radiotherapy of 60Gy, 46Patients received boost dose with intracavitary radiation and 9 Patients with 3D conformal therapy. One patient received boost dose with 2 dimensional Photon beam therapy. The tumor dose ranged from 69.4Gy to 86.2Gy with median dose of 74.4Gy. The follow-up Period ranged from 5 months to 92 months with a median of 34 months. Results : Forty-seven patients achieved complete response and 8 Patients showed partial response. One Patient showed minimal response. Patterns of failure were as follows : locoregional recurrence (8) and distant metastasis (18). Among these patients, 2 patients failed locoregionally and distantly. The sites of distant metastasis were bone (8), lung (8) and liver (4). Five years survival rate was $67.2\%$ and 5 years disease-free survival rate was $53.6\%$. KPS (P=0.005) and response ol radiation therapy (P=0.0001) were significant prognostic factors for overall survival. KPS (P= 0.02) and response of radiation therapy (P=0.005) were significant Prognostic factors for disease-free survival. Conclusion : This retrospective study showed that distant metastasis was the Predominant pattern of relapse in nasopharyngeal cancer Neoadiuvant chemotherapy or weekly CDOP did not influence the distant metastasis-free survival. For advanced T stage, 3D conformal therapy Provided an improved dose coverage compared to ICR But further follow-up was needed in Patients with 3D conformal therapy to assess the efficacy of this therapy. Development of techniques of radiation therapy to improve locoregional control and of more effective systemic chemotherapy regimen are needed.

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Effect of MRI Media Contrast on PET/MRI (PET/MRI에 있어 MRI 조영제가 PET에 미치는 영향)

  • Kim, Jae Il;Kim, In Soo;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.19-25
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    • 2014
  • Purpose: Integrated PET/MRI has been developed recently has become a lot of help to the point oncologic, neological, cardiological nuclear medicine. By using this PET/MRI, a ${\mu}-map$ is created some special MRI sequence which may be divided parts of the body for attenuation correction. However, because an MRI contrast agent is necessary in order to obtain an more MRI information, we will evaluate to see an effect of SUV on PET image that corrected attenuation by MRI with contrast agent. Materials and Methods: As PET/MRI machine, Biograph mMR (Siemens, Germany) was used. For phantom test, 1mCi $^{18}F-FDG$ was injected in cylinderical uniformity phantom, and then acquire PET data about 10 minutes with VIBE-DIXON, UTE MRI sequence image for attenuation correction. T1 weighted contrast media, 4 cc DOTAREM (GUERBET, FRANCE) was injected in a same phatnom, and then PET data, MRI data were acquired by same methodes. Using this PET, non-contrast MRI and contrast MRI, it was reconstructed attenuation correction PET image, in which we evanuated the difference of SUVs. Additionally, for let a high desity of contrast media, 500 cc 2 plastic bottles were used. We injected $^{18}F-FDG$ with 5 cc DOTAREM in first bottle. At second bottle, only $^{18}F-FDG$ was injected. and then we evaluated a SUVs reconstructed by same methods. For clinical patient study, rectal caner-pancreas cancer patients were selected. we evaluated SUVs of PET image corrected attenuastion by contrast weighted MRI and non-contrast MRI. Results: For a phantom study, although VIBE DIXON MRI signal with contrast media is 433% higher than non-contrast media MRI, the signals intensity of ${\mu}-map$, attenuation corrected PET are same together. In case of high contrast media density, image distortion is appeared on ${\mu}-map$ and PET images. For clinical a patient study, VIBE DIXON MRI signal on lesion portion is increased in 495% by using DOTAREM. But there are no significant differences at ${\mu}-map$, non AC PET, AC-PET image whether using contrast media or not. In case of whole body PET/MRI study, %diff between contras and non contrast MRAC at lung, liver, renal cortex, femoral head, myocardium, bladder, muscle are -4.32%, -2.48%, -8.05%, -3.14%, 2.30%, 1.53%, 6.49% at each other. Conclusion: In integrated PET/MRI, a segmentation ${\mu}-map$ method is used for correcting attenuation of PET signal. although MRI signal for attenuation correciton change by using contrast media, ${\mu}-map$ will not change, and then MRAC PET signal will not change too. Therefore, MRI contrast media dose not affect for attenuation correction PET. As well, not only When we make a flow of PET/MRI protocol, order of PET and MRI sequence dose not matter, but It's possible to compare PET images before and after contrast agent injection.

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Antimutagenic and Cytotoxic Effects of Extracts of Kalopanax pictus NAKAI Endodermis (음나무 내피 추출물의 항돌연변이원성 및 세포독성 효과)

  • Kim, Myong-Jo;Kim, Ju-Sung;Kang, Won-Hee;Yeon, Kyu-Dong
    • Korean Journal of Medicinal Crop Science
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    • v.10 no.2
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    • pp.132-138
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    • 2002
  • This study was performed to determine the antimutagenic and cytotoxic effect of ,Kalopanacis cortex endothelium. Methanol extract was used on Salmonella typhimurium TA98, TA100 and three cancer cell lines. In the Ames test, methanol extract of Kalopanacis cortex endothelium alone did not exhibit any mutagenicity but showed substantial inhibitory effects against mutation induced by 4-nitroquinoline-l-oxide(4NQO), N'-methyl- N'-nitro-N-nitrosoguanidine(MNNG) and benzo(a)pyrene(B(a)P). The methanol extract of Kalopanacis cortex endothelium showed approximately 79.29% and 75.38% inhibitory effect on the mutagenesis induced by 4NQO and B(a)P, respectively, against TA98 strain. Whereas 79.49%, 89.3% and 68.85% inhibitions were observed on the mutagenesis induced by 4NQO, MNNG and B(a)P against TA100 strain. Methanol extracts from Kalopanacis cortex endothelium showed high antimutagenic effects against 4NQO, MNNG and B(a)P. The anticancer effects of methanol extract from Kalopanacis cortex endothelium against human lung carcinoma(A549), human breast adenocarcinoma (MCF-7) and human hepatocellular carcinoma(Hep3B) were investigated. The treatment of 0.5mg/ml Kalopanacis cortex endothelium methanol extracts had the highest cytotoxicity against A549(81.54%), followed by MCF-7(81.92%) and Hep3B (78.57%). In contrast 0.5mg/ml treatment of methanol extracts from Kalopanacis cortex endothelium had only $4{\sim}25%$ cytotoxicity on normal human liver cell(293).

Evaluation of Macrophage Activity and Repeated Oral Dose Toxicity in Sprague-Dawley Rats on Multivitamin (종합비타민의 랫드에서 반복투여독성 시험과 대식세포 기능 활성 평가)

  • Kim, Hye-Ri;Jang, Hye-Yeon;Lee, Hae-Nim;Park, Young-Seok;Park, Byung-Kwon;Kim, Byeong-Soo;Kim, Sang-Ki;Cho, Sung-Dae;Nam, Jeong-Seok;Choi, Chang-Sun;Chang, Soon-Hyuk;Jung, Ji-Youn
    • Journal of Food Hygiene and Safety
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    • v.28 no.4
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    • pp.360-366
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    • 2013
  • The objective of this study is to investigate the effect of multivitamin on macrophage activity in Raw 264.7 cell and repeated oral dose toxicity in Sprague-Dawely rat of multivitamin. Raw 264.7 cells were treated with 50 and $100{\mu}g/mL$ multivitamin for 24 h. To measure the activity of macrophages, NO and TNF-${\alpha}$ assays were performed in Raw 264.7 cells. Treatment with 50 and $100{\mu}g/mL$ multivitamin for 24 h significantly increased production of NO and TNF-${\alpha}$ compared with control groups, indicating activation of macrophages. The female rats were treated with multivitamin of control group, low group (0.24 g/kg), medium group (1 g/kg) and high group (2 g/kg) intragastrically for 4 weeks, respectively. We examined the body weight, the feed intake, the clinical signs and serum biochemical analysis. We also observed the histopathological changes of liver, ovary, brain, adrenal gland, spleen, kidney, heart and lung in rats. No significant differences in body weights, feed intake, biochemical analysis and histopathological observations between control and multivitamin treatment group were found. In conclusion, multivitamin is physiologically safe and improve macrophage activity.