• 대한한의학회지
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• 제23권3호
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• pp.211-222
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• 2002

Currently convulsion is considered to be a chronic central nerve disease characterized by involuntary and severe muscle contraction or spasm. In many recent studies, convulsion's mechanism is due to unbalance between stimulation and suppression of the central nerve system, such as GABA and glutamic acid. Objectives : This study was performed to examine the anticonvulsant effects of Podam-hwan on brain GABA levels and glutamate content in picrotoxin-induced convulsions and to determine the inhibitory activity on GABA transaminase. Methods : Brain GABA levels and glutamate content in the brains of picrotoxin-induced mice using reverse phase HPLC method, anticonvulsant effect in vivo, and the inhibitory effect on GABA transaminase activity in vivo have been investigated. Results : Podam-hwan significantly lengthened the onset time of picrotoxin-induced convulsion at a concentration of 15mg/kg, but did not show a dose-dependent pattern. Also, Podam-hwan shortened the duration of convulsion by 52.2% at a dose of 30mg/kg in comparison with the control group. Podam-hwan inhibited dose-dependently GABA transaminase activity by 35.5% at 30mg/kg, comparing with the control gmup. Podam-hwan also increased the brain GABA level by 38.7% and 68.8% at doses 15mg/kg and 30mg/kg, respectively. In addition, Podam-hwan decreased the brain glutamate level by 9.6% and 17.8% at doses 15mg/kg and 30mg/kg, respectively. Conclusions : Podam-hwan can be prescribed for the treatment of convulsion by enhancement of brain GABA level and inhibition of GABA transaminase activity.

• 대한방사선기술학회지:방사선기술과학
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• 제30권1호
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• pp.33-38
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• 2007

이 연구는 플라토 치료계획시스템의 치료계획에서 Ir-192 선원에 대한 처방점의 처방선량과 선원 주위의 선량분포상의 선량점들의 선량이 정확하게 계산되는지를 확인하는데 그 목적이 있다. 선원의 중심축의 전후방향에서의 평면의 직교좌표계와 측면방향에서의 평면의 직교좌표계 및 선원을 A4 용지 위에 그려서 치료계획시스템에 입력하였다. 처방선량은 선원중심으로부터 극각 $90^{\circ}, $270^{\circ}의 방향으로 반경 1 cm인 두 지점에 400 cGy를 처방하였다. 처방점과 선량점들의 선량은 치료계획시스템에서 출력된 선량과 파울 킹 등이 유도한 기하학 함수식으로 계산된 선량을 분석하였다. 본 실험의 분석에서 처방 점의 선량은 오차 없이 정확하게 일치하였고, 선량 점들의 선량은 1.85% 이내의 오차를 얻었다. 그리고 플라토 치료계획시스템의 선량계산은 허용오차 ${\pm}2%$ 범위 이내의 정확성으로 분석되었다. 파울 킹 등이 유도한 기하학 함수식을 사용하여 손으로 계산한 선량은 높은 정확성의 품질보증과 편리성에 기인하여, 임상에서 사용하는데 유용할 것으로 생각된다.

• The Korean Journal of Pain
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• 제12권2호
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• pp.188-190
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• 1999

Background: The goal of this study was to evaluate the effects of gabapentin on postherpetic neuralgia. Gabapentin is a known anti-seizure medication, whose cellular mechanism of action is not well understood. Unlike other anticonvulsant, gabapentin has the advantage of a low toxicity and favorable side effect profile. If has been recently recommended for use in treatment of neuropathic pain. Methods: Twelve patients with a diagnosis of postherpetic neuralgia were prescribed gabapentin after failure of routine therapeutic regimens. The dose of gabapentin ranged 300~1800 mg per day, in three divided doses. If initial dose was ineffective and no side effects were noted, the dosages was increased by 300 mg a day in divided doses, to the maximum level for 2 weeks. Patients were evaluated for analgesia using visual analogue scale (VAS) pain score (0; no pain, 10; worst possible pain) and possible side effects. Results: A significant decrease in pain scores with gabapentin were noted. There were several mild side effects such as dizziness, somnolence, dry mouth, constipation and facial edema, without need of special treatment. Conclusions: Gabapentin may be a useful adjunct for treating intractable postherpetic neuralgia with a minimal side effects.

• 성인간호학회지
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• 제27권6호
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• pp.665-672
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• 2015

Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

• Radiation Oncology Journal
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• 제37권3호
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• pp.193-200
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• 2019

Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD₂). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD₂) were significantly associated with OS. The high dose group (≥52 Gy, EQD₂) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

• 한국임상약학회지
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• 제9권1호
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• pp.1-14
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• 1999

Vancomycin-resistant Enterococci (VRE) have recently emerged in Korean hospitals, as well as in those of other countries. VRE have been partially attributed to the overuse and misuse of vancomycin. The mecbanisms of VRE resistance are related to VanA, VanB, and VanC. Both VanA and VanB produce abnormal ligase enzymes to form D-ala-D-lactate termini in E. faecium and E. faecalis, instead of D-ala-D-ala termini. Meanwhile, Van C produces D-ser-D-ala termini in E. gallinarum and E. casseliflavus. These abnormal termini have a low affinity to vancomycin. As a result, VRE avoid the activity of vancomycin by these mechanisms. Unfortunately, there is no approved therapy for the treatment of VRE. Thus, available but uncommonly prescribed antibiotics (due to their toxicity or unproven efficacy) may become possible options. They include chloramphenicol, novobiocin, fosfomycin, and bacitracin. The combination therapy of available agents may also be the other options. They include high doses of a penicillin- or ampicillin-aminoglycoside combination, high doses of an ampicillin/sulbactam and aminoglyoosidcs combination, an ampicillin and vancomycin combination, and a ciprofloxacin, aminoglycosides, and rifampin combination. With respect to the near future, many types of investigational agents will most likely expand their treatment options for VRE. Teicoplanin, a glycopeptide, can be used for VanB- and VanC-related VRE. LY333328, a new generation of glycopeptide, is effective in treating VanA as well as VanB and VanC. RP59500 (quinupristin/dalfopristin), a streptogramin, is effective in treating vancomycin-resistant E. faecium. New generation quinolones (especially clinatloxacin) are potential options for the treatment of VRE, even though they cannot work as effectively against VRE as they can against Staphylococci. Both glycylcyclines (a new generation of tetracyclines) and ketolides (a new generation of macrolides) show good activity against Enterococci, regardless of vancomycin susceptibility. Oxazolidinones (i. e. eperezolid and 1inezolid) and everninomicins (i. e. SCH27899) are new groups of antibiotics, which also demonstrate good activity against VRE. It is imperative that clinical pharmacists take the responsibility of investigating new treatment options for VRE in order to combat this growing problem throughout the world.

• 대한본초학회지
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• 제28권2호
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• pp.61-65
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• 2013

Objectives : Samchulgeonbi-tang (shenzhujianpi-tang) has been prescribed as one of traditional herbal medicine for treatment of stomach diseases since ancient time in Korea. Samchulgeonbi-tang extract was fermented by Lactobacillus spp. for improving the effect. However, the toxicity and safety of fermented Samchulgeonbi-tang (FS) extract were not confirmed. Therefore, this study was performed to evaluate the acute toxicity and safety of FS extract. Methods : To evaluate the acute toxicity and safety of FS extract, several doses of FS extract, 0, 500, 1000 and 2000 mg/kg, were orally administered to 20 male and 20 female ICR mice, respectively. After treatment with FS extract, we observed mortality, general toxicity, behavior and change of body weight for the 14 days. After 14 days of oral administration, all mice were sacrificed and hematological parameters were analyzed from blood serum. Results : In present study, the toxic signs such as mortality or abnormal behaviors by FS extract were not observed. There are no significant differences between FS-treated group and control group in body weight, organ weights, and hematological parameters. Conclusions : The remarkable adverse effects by FS extract were not observed in ICR mice. Also, any death was not occurred at all treated FS doses, 500, 1000 and 2000 mg/kg. Therefore, the approximate lethal dose (ALD) of FS extract may be more than 2000 mg/kg.

• 대한방사선치료학회지
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• 제24권2호
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• pp.61-66
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• 2012

목 적: 본 연구에서는 자궁강 내 근접치료 시 ABS (American Brachytherapy Society)에서 권고한 H점(point H)을 이용한 치료계획을 수립해 보았고, 이를 A점(point A)에 처방한 치료계획과 비교하고자 한다. 대상 및 방법: 2010년 3월부터 2012년 1월까지 본원에 내원한 자궁경부암 환자 중 탄뎀(tandem)과 난형체(ovoid)를 이용해 고선량률 강내 근접치료(high dose rate intracavitary brachytherapy)를 시행한 103명을 대상으로 하였다. 치료계획은 Manchester System에 따라 A점, 방광 기준점, 직장 기준점을 지정하였고, ABS의 권고에 따라 H점을 지정하였다. 또한 임의로 S자 결장기준점과 질 기준점을 설정하였다. A점과 H점의 위치가 얼마나 차이가 나는지 살펴보았으며, H점에 100%의 선량을 처방하였을 때 A점에 들어가는 선량을 계산하였다. 그리고 A점과 H점에 각각 선량을 처방하였을 때 직장, 방광, S자 결장, 질 기준점에 들어가는 선량을 비교 분석하였다. 결 과: H점이 A점보다 미측에 있는 경우 A점의 상대선량은 기존의 A점이 아닌 H점에 처방하였을 때 더 적어지는 경향을 보였다. 방광 기준점과 직장 기준점, S자결장 기준점, 질 기준점에서의 상대선량은 H점이 두측에 있는 경우 H점에 처방하였을때의 선량이 A점에 처방하였을 때보다 크며, 미측에 있는 경우 더 적어지는 양상을 보였다. 결 론: H점이 A점보다 두측에 위치할수록 주변 장기의 흡수선량이 커지고, 미측에 위치할수록 주변 장기의 흡수선량이 적어지는 경향을 보였다. 그 선량 차이가 치료에 큰 영향을 미칠 정도는 아니지만, 두 치료계획에서의 선량 분포 및 주변 장기 흡수선량 차이가 크다면 두 점의 치료계획은 비교 또는 참고할 만한 가치가 있는 것으로 생각된다.

• 대한본초학회지
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• 제22권2호
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• pp.13-16
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• 2007

Objectives : Palmul-tang(Bawu-tang) has been traditionally prescribed a medicine as a restorative. Methods : In this study, we investigated the acute toxicity about water-extracted PalMul-tang(Bawu-tang). Twenty-five mice completed 14 days of oral Palmul-tang(Bawu-tang) at the respective doses of 0(control group), 2560, 3200, 4000 and 5000mg/kg. Results : We observed survival rates, general toxicity, change of body weight, and autopsy. Conclusions : To be confirmed the data for the toxicity and safety problems of oriental medicine prescription. Compared with the control group, we could not find any toxic alteration in all treated groups (2560, 3200, 4000 and 5000mg/kg). In conclusion, LD50 of Palmul-tang(Bawu-tang) was over 5000mg/kg and it is very safe to ICR mice.

• 대한한방내과학회지
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• 제32권3호
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• pp.334-344
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• 2011

Objectives : Sipjeondaebo-tang is a medicine traditionally prescribed as a restorative. The aim of this study was to investigate the single oral dose toxicity and safety of extract of fermented Sipjeondaebo-tang in ICR mice. Methods : In single oral dose toxicity study, non-fermented or fermented Sipjeondaebo-tang were administered by oral gavage to ICR mice (5 males, 5 females) at single doses of varying concentrations: 1250, 2500 and 5000 mg/kg. Changes of body weight, general behavior, adverse effects and mortality were determined throughout the experimental period. Hematological parameters, organ weights and necropsy findings were evaluated at the end of the experiment. Results : There were no mortality or signs of toxicity in single oral dose toxicity studies. There were also no significant differences in body weight, organ weight, or hematological parameters between the treatment and control groups. Conclusions : Fermented Sipjeondaebo-tang did not cause remarkable adverse effects in ICR mice. The oral lethal dose of fermented Sipjeondaebo-tang is more than 5000 mg/kg and no-observed-adverse-effect level (NOAEL) of the extract for both male and female mice is 5000 mg/kg.