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Magnetic Resonance Imaging Factors Predicting Re-excision in Breast Cancer Patients Having Undergone Conserving Therapy (유방보존술을 시행받는 유방암환자에서 재절제 예측의 자기공명영상소견)

  • Jang, Mijung;Kim, Sun Mi;Yun, Bo La;Kim, Sung-Won;Kang, Eun Young;Park, So Yeon;Kim, Jee Hyun;Kim, Yeongmi;Ahn, Hye Shin
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.133-143
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    • 2014
  • Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using ${\chi}^2$ test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (${\geq}5cm$) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.

Nuclear DNA inheritance of intra-specific somatic hybrids by di-mono cross in Pleurotus ostreatus based on URP-PCR analysis (URP-PCR 분석에 의한 느타리 이핵-단핵 계통간 교잡주의 핵 DNA 유전)

  • Kim, Eun Jung;Shin, Pyung Gyun;Jang, Kab Yeul;Kong, Won Sik;Han, Young Sook;Yoo, Young Bok
    • Journal of Mushroom
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    • v.12 no.2
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    • pp.96-106
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    • 2014
  • The primary objective of the present study is the characterization of the somatic hybrids of dikaryon-monokaryon (di-mono) crosses in mushroom breeding. We employed this technique for developing superior strains from Pleurotus ostreatus strains with 48 intraspecific hybrids of 12 combinations between six P. ostreatus strains and one P. florida strain. The results on the experiments of hybridization rate, nuclear DNA patterns, and colors and morphology of fruit-bodies, are presented. In di-mono crosses, somatic hybrids among Pleurotus strains showed 100% of crossability as seen in those between P. ostreatus and P. florida strains indicating that the nuclei of a dikaryon is inferred to be migrated to a recipient. 87.5% of the somatic hybrids among Pleurotus strains were similar to the donor dikaryons, and 12.5% of the somatic hybrids presented DNA patterns of both parents. In 16.6% of di-mono crosses between P. ostreatus and P. florida, the nuclear DNA patterns of all hybrids showed the same or similar patterns compared to the donor dikaryons. 70.9% of the hybrids between P. ostreatus and P. ostreatus were similar to the donor dikaryons and 12.5% of them presented the DNA patterns of both parents. 79.2% of fruiting body morphology of the hybrids among Pleurotus strains were similar to the dikaryons and 20.8% of them were similar to both parents. Interestingly, the morphology of all dikaryons were dissimilar each other. All hybrid strains between dikaryon P. florida and monokaryon P. ostreatus showed the fruiting body of which colors were similar to those of the dikaryon, while the hybrids between dikaryon P. ostreatus and monokaryon P. florida were showed the combined colors of both parents. Therefore, the fruiting body color of P. florida tends to be generally dominant. In conclusion, the present study provides a way to find out and suggest superior hybrid strains using the nuclear DNA patterns of hybrids between Pleurotus strains as well as the characteristics of their fruiting bodies. The advantages of the di-mono crossing are needs to be fully utilized in mushroom breeding because it is an ideal way to develop the superior strains of Pleurotus.

Ictal Cerebral Perfusion Patterns in Partial Epilepsy: SPECT Subtraction (부분적 간질에서 SPECT Subtraction을 이용한 발작 중 뇌혈류 변화에 대한 연구)

  • Lee, Hyang-Woon;Hong, Seung-Bong;Tae, Woo-Suk;Kim, Sang-Eun;Seo, Dae-Won;Jeong, Seung-Cheol;Yi, Ji-Young;Hong, Seung-Chyul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.169-182
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    • 2000
  • Purpose: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Materials and Methods: Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. Results: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Conclusion: Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.

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Cost-effectiveness of Myocardial Perfusion SPECT for Diagnosis of Coronary Artery Disease in Korea: Comparison with Exercise ECG and Coronary Angiography (우리 나라에서 관동맥질환을 진단하는 약물부하 심근관류 SPECT의 비용효과 성능: 운동부하심전도와 관동맥조영술과 비교)

  • Lee, Dong-Soo;Kang, Keon-Wook;Jang, Myung-Jin;Cheon, Gi-Jeong;Lee, Myoung-Mook;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.207-221
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    • 2000
  • Purpose: Cost-effectiveness of myocardial SPECT for the diagnosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Materials and Methods: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (${\Delta}QALY$) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases. $Cost/{\Delta}QALY$ was calculated and compared between four different tactics according to pre-test probability. Results: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective. Conclusion: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.

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Detection of Multidrug Resistance Using Molecular Nuclear Technique (분자핵의학 기법을 이용한 다약제내성 진단)

  • Lee, Jae-Tae;Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.180-189
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    • 2004
  • Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. $^{99m}Tc$-MIBI and other $^{99m}Tc$-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of PgP-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with $^{11}C$ have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and $N-[^{11}C]acetyl-leukotriene$ E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.

Automatic Interpretation of F-18-FDG Brain PET Using Artificial Neural Network: Discrimination of Medial and Lateral Temporal Lobe Epilepsy (인공신경회로망을 이용한 뇌 F-18-FDG PET 자동 해석: 내.외측 측두엽간질의 감별)

  • Lee, Jae-Sung;Lee, Dong-Soo;Kim, Seok-Ki;Park, Kwang-Suk;Lee, Sang-Kun;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.233-240
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    • 2004
  • Purpose: We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). Materials and Methods: We studied brain F-18-FDG PET images of 113 epilepsy patients sugically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptrons (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 51 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. Results: The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). Conclusion: We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

The Heterogeneity of Flow Distribution and Partition Coefficient in [15O-H2O] Myocardium Positron Emission Tomography ([15O-H2O] 심근 양전자 단층 촬영에서 혈류 분포의 비균일성과 분배계수)

  • Ahn, Ji Young;Lee, Dong Soo;Kim, Kyung Min;Jeong, Jae Min;Chung, June-Key;Shin, Seung-Ae;Lee, Myung Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.32-49
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    • 1998
  • For estimation of regional myocardial blood flow with O-15 water PET, a few modifications considering partial volume effect based on single compartment model have been proposed. In this study, we attempted to quantify the degree of heterogeneity and to show the effect of tissue flow heterogeneity on partition coefficient(${\lambda}$) and to find the relation between perfusable tissue index(PTI) and ${\lambda}$ by computer simulation using two modified models. We simulated tissue curves for the regions with homogeneous and heterogeneous blood flow over a various flow range(0.2-4.0ml/g/min). Simulated heterogeneous tissue composed of 4 subregions of the same or different size of block which have different homogeneous flow and different degree of slope of distribution of blood flow. We measured the index representing heterogeneity of distribution of blood flow for each heterogeneous tissue by the constitution heterogeneity(CH). For model I, we assumed that tissue recovery coefficient ($F_{MME}$) was the product of partial volume effect($F_{MMF}$) and PTI. Using model I, PTI, flow, and $F_{MM}$ were estimated. For model II, we assumed that partition coefficient was another variable which could represent tissue characteristics of heterogeneity of flow distribution. Using model II, PTI, flow and ${\lambda}$ were estimated. For the simulated tissue with homogeneous flow, both models gave exactly the same estimates, of three parameters. For the simulated tissue with heterogeneous flow distribution, in model I, flow and $F_{MM}$ were correctly estimated as CH was increased moderately. In model II, flow and ${\lambda}$ were decreased curvi-linearly as CH was increased. The degree of underestimation of ${\lambda}$ obtained using model II, was correlated with CH. The degree of underestimation of flow was dependent on the degree of underestimation of ${\lambda}$. PTI was somewhat overestimated and did not change according to CH. We conclude that estimated ${\lambda}$ reflect the degree of tissue heterogeneity of flow distribution. We could use the degree of underestimation of ${\lambda}$ to find the characteristic heterogeneity of tissue flow and use ${\lambda}$ to recover the underestimated flow.

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Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction (급성 심근경색 환자의 Tc-99m Tetrofosmin 심근 관류 지연영상에서 관찰되는 역재분포 현상의 임상적 의의)

  • Park, Soon-Ah;Kim, Dae-Weung;Kim, Chang-Guhn;Jeong, Jin-Won;Kim, Nam-Ho;Yun, Kyeong-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.112-119
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    • 2009
  • Purpose: This study was performed to investigate the clinical significance of reverse redistribution(RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography(SPEG) in patients with acute myocardial infarction after revascularization. Materials and Methods: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography(CAG) were performed 9 months later. Results: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments(31%) and in 43 patients(64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR(p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR(p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. Conclusions: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.

Optimal Imaging Time for Diagnostic I-123 Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Cancer: Comparison between 6- and 24-Hour Images of the Same Subjects (분화 갑상선 암의 추적 관찰에서 진단적 I-123 전신 스캔의 최적 영상 시점: 동일 환자에서 6시간과 24시간 영상의 비교)

  • Lee, Hong-Je;Lee, Sang-Woo;Song, Bong-Il;Kang, Sung-Min;Seo, Ji-Hyoung;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.129-136
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    • 2009
  • Purpose: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer(DTC), we compared the image quality of 6- and 24-hour images of the same subjects. Materials and Methods: Four hundred ninety-eight patients(M:F = 55:443, Age $47.6{\pm}12.9$ years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq(5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. Results: In 440 patients(88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients(11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue(4 patients) and cervical lymph node metastasis(3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. Conclusion: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.

Effects of Dietary Probiotics on Feed Intakes, Nutrient Digestibility and Nitrogen Retention in Korean Black Goats Fed Two Diets Differing in Forage to Concentrate Ratios (사료 내 조농비율에 따른 생균제의 첨가가 흑염소의 사료섭취량, 영양소 소화율 및 질소축적에 미치는 영향)

  • HwangBo, Soon;Jo, Ik-Hwan;Song, Ki-Jun;Lee, Sung-Hoon
    • Korean Journal of Organic Agriculture
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    • v.15 no.2
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    • pp.195-205
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    • 2007
  • This study was conducted to determine effects of probiotics on performance, nutrient digestibility and nitrogen retention in Korean black goats fed two diets differing in forage to concentrate (F:C) ratio (30:70 and 70:30), for the establishment of their more efficient feeding management system. The probiotics employed in this trial were mixtures of different microbial species, which consisted of Lactobacillus casei, Bacillus subtilis, Saccharomyces cerevisiae, Aspergillus oryzae and Streptomyces griseus. Additional levels of probiotics to each F:C ratio (70:30 or 30:70) were 0 and 0.2%, respectively. Thus, twelve Korean black male goats were allotted to treatments in four groups of three goats per treatment and then they were housed in individual metabolism cages with a randomized complete block design for 21 days. Dry matter (DM) intakes were not affected by dietary F:C ratio and probiotics. Digestible DM amounts were significantly (p<0.05) decreased with increasing levels of dietary forage, but they were not affected by probiotics addition. Dry matter intakes per metabolic body weight and their ratio per body weight had a similar trend to DM intakes with no significant difference by F:C ratio and probiotics addition. The nutrient digestibility was significantly (p<0.05) increased with decreasing levels of forage in the diet, but it was not affected by probiotics addition. Urinary nitrogen loss was significantly (p<0.05) decreased with decreasing levels of dietary forage, but there was no significant difference between probiotics-supplemented and unsupplemented groups within the same F:C ratio. On the contrary, nitrogen retention was decreased with increasing levels of dietary forage, and probiotics supplementation to two diets differing in F:C ratio showed slightly increasing trends in the nitrogen retention. From the above results, probiotics supplementation to two diets differing in F:C ratio did not have the significant influence on feed intakes, nutrient digestibility and nitrogen retention. Consequently, these parameters of Korean black goats were dominated rather by F:C ratio than by dietary probiotics.

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