• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.17-20
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• 2010

Purpose: The hepatobiliary scan is the examination which is the possibility of knowing the function of liver, gall bladder and closing of the biliary tract. Also, after subtotal gastrectomy, the increased gastric-bile reflux is known as the primary reason of reflux gastritis. In this study, according to changing the acquisition method, we tried to prove the reflux time and reflux index in patients who underwent subtotal gastrectomy. Materials and Methods: From Oct 2008 to Jan 2009, 72 patients with subtotal gastrectomy who took the hepatobiliary scan (man: 52, woman: 20, age range: 31-77, mean age: $60.5{\pm}7$) in our department. We used the radiopharmaceutical $^{99m}Tc$-mebrofenin 185 MBq/0.5 cc. After 5 minutes, we acquired 300,000 counts anterior image on supine, and then we acquired right lateral and $45^{\circ}$ LAO position by using the time setting method. We acquired 30 min, 60 min, 90 min, 120 min and fatty meal by the same method. We painted the ROI of liver, GB and CBD on 30 min anterior image and LAO image in patients had occurred the bile juice reflux. And then we painted the ROI of stomach on others image. We calculated the reflux index from those values. Results: According to this study, we found out 40 patients (55.6%) who had occurred the gastric-bile juice reflux (1 person from 30 min, 7 persons from 60 min, 4 persons from 90 min, 28 persons from after fatty meal). Hourly, the bile reflux highest level is 6 persons from 60 min, 2 persons from 90 min, 32 persons from fatty meal among those people. The reflux index of anterior is 0.85-23.36% (mean 6.53%). The reflux index of LAO is 1-29.13% (mean 8.89%). By visual assessment, we can distinguish that there were 26 of the 40 patients (65%) had occurred the reflux on LAO image more than anterior image. Conclusion: We find out that the patients with subtotal gastrectomy had occurred gastric-bile juice reflux more than 50% from hepatobiliary scan. And after eating fatty meal, we can know that it's the most possible to occur the gastric-bile juice reflux. When it happened, we have to change the acquisition method to reduce the overlap between colon and stomach. This study will be more valuable in diagnosis.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1063-1069
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• 1998

Background: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. Materials and methods: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. Results: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis(8 cases) or chest tube drainage(10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases(42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, α-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1∼4(mean 1.78±1.00). Operating time was relatively short, about 55∼140 mins(mean 102.8±30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3∼42 days(mean 11.4±11.5) and 6∼36 days(mean 12.9±8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3∼6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. Conclusions: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.

• The Korean Journal of Physiology
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• v.23 no.1
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• pp.79-87
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• 1989

Molecular property as well as biological activities of bombesin-like substance (BBS-LS) isolated from the skin of B. orientalis in Korea was compared with those of synthetic BBS-14. BBS-LS in the crude extract was applied on a Sephadex G-50, superfine column $(1.6{\times}112\;cm)$. On chromatogram, the first peak (3.5% of BBS-LS) was found ahead of synthetic GRP-27, and the second peak (rest) between synthetic GRP-27 and synthetic BBS-14. The main form of BBS-LS was successfully purified by using a column of alkaline alumina followed by sequential gel-filtrations on a column of Sephadex G-10, fine and a column of Sephadex G-50, superfine. Chromatographic analysis of the purified BBS-LS using a column of Sephadex G-50, superfine and reversed phase HPLC revealed that the main form of BBS-LS in the skin of B. orientalis could be distinctly different from either BBS-14 or GRP-27 in molecular size. The purified BBS-LS exerted biological activities quite identical to those of synthetic BBS-14. The results of the present investigation indicate that the skin of B. orientalis contains BBS-LS composed of two distinct forms. The main form of BBS-LS purified in the present study is heterogenous to both synthetic BBS-14 and GRP-27 in molecular size but identical to BBS in biological activities.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.35-43
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• 2003

Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.120-147
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• 1994

This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.565-571
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• 2009

Purpose: The aim of this study was to evaluate the clinical value of rectal gas distension F-18 FDG PET/CT imaging for the differentiation of the rectal focal uptake lesions. Materials and Methods: Twenty four patients (M:F=11:13, Age $62.8{\pm}12.4$ years) underwent rectal gas distension F-18 FDG PET/CT, prospectively: initial image at 50-60 min after the intravenous injection of F-18 FDG and rectal distension image after the infusion of air through the anus. Focally increased uptake lesions on initial images but disappeared on rectal distension images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on rectal distension images, colonoscopy and histopathologic examination were performed. Results: Among the 24 patients, 27 lesions of focal rectal uptake were detected on initial images of F-18 FDG PET/CT. Of these, 7 lesions were able to judge with physiological uptake because the focal increased uptake disappeared from rectal distension image. Remaining 3 lesions were non-rectal lesions (2 lesions: rectovesical space, 1 lesion: uterine myoma). Among 17 lesions which was showed persistent increased uptake in rectal distension image, 15 lesions were confirmed as the malignant tumor (SUVmax=$15.9{\pm}6.8$) and 2 lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Conclusion: The rectal distension F-18 FDG PET/CT imaging could be an important noninvasive method for the differentiation of malignant and benign focal rectal uptake lesions including physiologic uptake.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.90-93
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• 2011

Purpose: A Pixelated BSGI gamma camera has features to enhance resolution and sensitivity and minimize the distance between detector and organs by narrow FOV. Therefore, it is known as useful device to examine small organs such as thyroid, parathyroid and gall bladder. In general, when we would like to enlarge the size of images and obtain high resolution images by gamma camera in nuclear medicine study, we use pinhole collimator. The purpose of this study is to evaluate the usefulness of Pixelated BSGI gamma camera and to compare to it using pinhole collimator in thyroid scan which is a study of typical small organs. Materials and methods: (1) The evaluation of sensitivity and spatial resolution: We measured sensitivity and spatial resolution of Pixelated BSGI with LEHR collimator and Infinia gamma camera with pinhole collimator. The sensitivity was measured by point source sensitivity test recommended by IAEA. We acquired images considering dead time in BSGI gamma camera for 100 seconds and used $^{99m}TcO4-\;400{\mu}Ci$ line source. (2) The evaluation of thyroid phantom: The thyroid phantom was filled with $^{99m}TcO4-$. After set 300 sec or 100 kcts stop conditions, we acquired images from both pixelated BSGI gamma camera and Infinia gamma camera with LEHR collimator. And we performed all thyroid studies in the same way as current AMC's procedure. Results: (1) the result of sensitivity: As a result, the sensitivity and spatial resolution of pixelated BSGI gamma camera were better than Infinia's. The sensitivities of pixelated BSGI and Infinia gamma camera were $290cps/{\mu}Ci$ and $350cps/{\mu}Ci$ respectively. So, the sensitivity of pixelated BSGI was 1.2 times higher than Infinia's (2) the result of thyroid phantom: Consequently, we confirmed that images of Pixelated BSGI gamma camera were more distinguishable between hot and cold spot compared with Infinia gamma camera. Conclusion: A pixelated BSGI gamma camera is able to shorten the acquisition time. Furthermore, the patients are exposed to radiation less than before by reducing amount of radiopharmaceutical doses. Shortening scan time makes images better by minimizing patient's breath and motion. And also, the distance between organ and detector is minimized because detector of pixelated BSGI gamma camera is small and possible to rotate. When patient cannot move at all, it is useful since device is feasible to move itself. However, although a pixelated BSGI gamma camera has these advantages, the effect of dead time occurs over 2000 cts/s since it was produced only for breast scan. So, there were low concentrations in organ. Therefore, we should consider that it needs to take tests to adjust acquisition time and amount of radiopharmaceutical doses in thyroid scan case with a pixelated BSGI gamma camera.

• Korean Journal of Food Science and Technology
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• v.5 no.3
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• pp.169-173
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• 1973

Secondary amines and nitrites in various daily foods have been known as the precursors of potent carcinogenic nitroso compound produced in the human stomach when they were ingested simultaneouly in high concentration. In this report, the amounts and distribution of secondary amines and nitrites in Korean daily foods, kim-chi, fishes, fish eggs, sausages, canned fish foods and fish sauces (salted fish) were studied.Nitrite contents were low in most subjected foods except in sausages. Secondary amines showed low contents in kim-chi, fishes, but high in fish sauces, fish eggs and canned fish foods. The result of this study suggested that the possible formation of carcinogenic nitrosamines during manufacturing, storage and cooking of all Korean foods should be studied.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.232-237
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• 2004

Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

• Journal of Life Science
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• v.16 no.6
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• pp.1060-1065
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• 2006

Non-invasive evaluation of liver function in animal models remains a challenge. Hepatoscintigraphy provides information about changes in liver size and shape, and enables to understand general liver function. Futhermore it is readily used to diagnosis complications of liver transplantation like hepatitis, rejections and biliary complications. In this study, we investigated the usefulness of evaluating the liver function in miniature pigs with $^{99m}Tc-Tin$ colloid and $^{99m}Tc-DISIDA$ which are the most commonly used radiopharmaceuticals in human medicine. In result, $^{99m}Tc-Tin$ colloid was uptaked in lung, liver, gastric wall and kidney in miniature pigs. And $^{99m}Tc-DISIDA$ showed continuous uptake images of heart, lung, liver, gallbladder and duodenum, and it was similar to human's. Therefore we could conclude $^{99m}Tc-Tin$ colloid would not be suitable for evaluating hepatic function because of it's nonspecific affinity, however $^{99m}Tc-DISIDA$ scintigraphy would be an effective method for detecting hepatobiliary function in miniature pigs.