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Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis (전두엽 간질에서 F-18-FDG PET의 간질병소 국소화 성능: 육안 판독과 SPM에 의한 분석)

  • Kim, Yu-Kyeong;Lee, Dong-Soo;Lee, Sang-Kun;Chung, Chun-Kee;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.131-141
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    • 2001
  • Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

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Estimation of the Possible Age for Using Various Types of Inhaler by In-Check Inspiratory Flow Meter(TM) (In-Check Inspiratory Flow Meter(TM)를 사용하여 추정한 다양한 흡입기구의 사용 가능한 연령)

  • Jung, Kyung Hyun;Kim, Sun Ye;Lee, Jun Ho;Kim, Kye Sung;Jang, Yook;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.192-198
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    • 2002
  • Purpose : It is important to select and use kinds of Inhaler appropriate to the age of the patient and severity of symptoms. Several kinds of Inhaler have been developed and recommended according to each inhaler's resistance and usage method. We evaluated the usable age of 4 inhalers (turbulent flow inhalers, multi unit dose inhalers, breath actuated MDI, and autohalers) by measuring peak inspiratory flow(PIF) using $In-Check^{(TM)}$ Inspiratory Flow Meter. Methods : Ninety three patients aged from 3 to 7 years(mean $57{\pm}12.9$ mo.) who had admitted to CHA hospital from July 2000 to April 2001 were enrolled. Study patients were divided into 4 groups according to age : 3-4 years of age(group A, n=31), 4-5 years of age(group B, n=32), 5-6 years of age(group C, n=18), and 6-7 years of age(group D, n=12). Results : Out of total 93 patients, 23(71%), 27(84%), 17(94%) patients of each group A, B, C and all 12 patients of group D could use the 4 types of inhaler through adequated education. In all four groups, height, body weight and age were significantly correlated(P<0.05). Usable age, height and weight of children who can use turbulent flow inhaler(TFI) were each 8 year 7 month old, 144 cm, 32.0 kg, and those of multi unit dose inhaler(MUD) were 2 year 10 month old, 92 cm, 12.0 kg. Also that of breath-actuated MDI were 1 yr 8 months, 83 cm, 8.5 kg and that of autohaler were 2 yr 8 months, 91 cm, 11.0 kg Conclusion : We concluded that the ability to use inhalers correlated with height, weight and age of the patients. Multi unit dose inhalers, Breath actuated MDI and Autohaler are useful after 3 years of age through adequate education.

The Adjuvant Effect of Subcutaneous Interferon-gamma in the Treatment of Refractory Multidrug-resistant Pulmonary Tuberculosis (난치성 다제내성 폐결핵에서 피하주사 Interferon-gamma 치료의 효과: 예비연구)

  • Kim, Eun Kyung;Shim, Tae Sun;Lee, Jung Yeon;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Dong Soon;Kim, Won Dong;Kim, Woo Sung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.226-233
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    • 2004
  • Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.

Clinical Significance of Myocardial Uptake on F-18 FDG PET/CT Performed in Oncologic Patients (종양 환자의 F-18 FDG PET/CT에서 관찰된 심근 섭취의 임상적 의미)

  • Cho, Ho-Jin;Cho, Arthur;Lee, Jong-Doo;Kang, Won-Jun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.519-525
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    • 2009
  • Purpose: F-18 fluorodeoxyglucose (FDG) uptake of myocardium is influenced by various factors. Increased glycolysis, and subsequent increased F-18 FDG uptake has been reported in ischemic cardiomyopathy. However, clinical significance of incidentally found myocardial F-18 FDG uptake has not been clarified. We retrospectively reviewed the degree and pattern of myocardial uptake in patients without history of ischemic heart disease who underwent torso F-18 FDG PET/CT for evaluation of neoplastic disease. Materials and Methods: From January 2005 to June 2009, 77 patients who underwent F-18 FDG PET/CT and Tc-99m sestamibi stress/rest SPECT within 3 months were enrolled. Results: Of 77 patients, 55 (71.4%) showed increased F-18 FDG uptake in the myocardium. In this population, 40 showed uniform uptake pattern, while 15 showed focal uptake. In patients with uniform uptake, 17 showed decreased uptake in the septum without perfusion defect on myocardial SPECT. Remaining 23 patients showed uniform uptake, with 1 reversible perfusion defect and 1 fixed perfusion defect. In 15 patients with focal uptake, 9 showed increased F-18 FDG uptake in the base, and only 1 of them showed reversible perfusion defect on myocardial SPECT. In the remaining 6 focal uptake group, 4 had reversible perfusion defect in the corresponding wall, and 1 had apical hypertrophy. Conclusion: We demonstrated that septal defect pattern and basal uptake pattern in the myocardium may represent normal variants. Focal myocardial uptake other than normal variants on oncologic torso F-18 FDG PET/CT with routine fasting protocol may suggest ischemic heart disease, thus further evaluation is warranted.

Effects of Aqueous Chlorine Dioxide against Escherichia coli O157:H7 and Listeria monocytogenes on Broccoli Served in Foodservice Institutions (급식소에서 제공되는 브로콜리에 있어 이산화염소 처리가 Escherichia coli O157:H7과 Listeria monocytogenes의 균수에 미치는 영향)

  • Ryu, Si-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.12
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    • pp.1622-1627
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    • 2007
  • This study was undertaken to evaluate the effects of chlorine dioxide on reducing E. coli O157:H7 and L. monocytogenes on broccoli served in foodservice institutions. Broccoli samples inoculated with $10^6$ CFU/mL of E. coli O157:H7 and L. monocytogenes were treated with chlorine dioxide. Treatments with 5, 10, and 20 ppm for 1, 5, and 10 min were not sufficient in controlling E. coli O157:H7 on broccoli. L. monocytogenes were effectively reduced by $2.19{\sim}2.48log\;CFU/g\;and\;3.31{\sim}3.87log\;CFU/g$ with 10 and 20 ppm chlorine dioxide for 1, 5, and 10 min treatment, respectively, compared with the control. E. coli O157:H7 and L. monocytogenes population were significantly negatively correlated with concentration and treatment time of chlorine dioxide. These results show that the use of chlorine dioxide was effective in sanitizing L. monocytogenes on broccoli and the level of concentration was more associated with populations of E. coli O157:H7 and L. monocytogenes than treatment time of chlorine dioxide on broccoli.

Nocturnal Arterial Oxygen Saturation Monitoring in Patients with Respiratory Disease (호흡기 질환 환자들에서 야간 동맥혈 산소포화도 감시 성적)

  • Choi, In-Seon;Yang, Jae-Beom;Kim, Young-Chul;Chung, Ik-Joo;Kang, Yu-Ho;Koh, Yeoung-Il;Park, Sang-Seon;Lee, Min-Su;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.103-110
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    • 1994
  • To find out the predictors of nocturnal arterial oxygen desaturation in patients with respiratory diseases, transcutaneous oxygen saturation($StcO_2$) monitoring studies using a pulse oximeter were performed during sleep in 20 patients. $StcO_2$ was decreased more than 4% from the baseline value in 18 patients(90%) and more than 10%("Desaturator") in 8(40%). Five of the seven patients(71.4%) with awake $PaO_2$<60mmHg and three of the thirteen patients(23.1%) with awake $PaO_2{\geq}60mmHg$ were "desaturators". The awake $PaO_2/FIO_2$ and $PaO_2/PAO_2$ could distinguish "desaturator" from "nondesaturator", and $PaO_2,\;SaO_2$ or $StcO_2$ could not. These results suggest that the nocturnal oxygen desaturation depends on the severity of the underlying disease rather than the baseline $PaO_2$. Anthropomorphic and lung function factors could not separate between "desaturator" and "non-desaturator", and about a quater of patients with a wake $PaO_2{\geq}60mmHg$ developed significant desaturation. Therefore, it is necessary to monitor the nocturnal arterial oxygen saturation in patients with respiratory diseases regardless of their severity of airflow obstruction or awake $PaO_2$.

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