• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.88-95
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• 2004

Purpose: Current treatment for osteoid osteomas is usually surgical excision of the nidus. Various minimal invasive techniques have been reported to overcome the invasiveness of the surgical excision. We treated 22 patients with osteoid osteoma by percutaneous thermoablation of the nidus under computed-tomography guidance. Materials and Methods: Twenty two consecutive patients underwent CT-guided percutaneous radio-frequency thermoablation between April 1999 and May 2004. The mean age was 26.5(7~55) years. In three cases, the diagnosis was confirmed pathologically before the prodedure while the others clinically and radiologically. Computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 80 or 90 degrees C for 6(3~8) minutes. Clinical success was assessed at a mean of 30(4~62) months after the procedure at out patient clinic or by telephone interview. Results: The procedure was technically successful in all cases except a complication. Patients were discharged on 1.9 days after the procedure and resumed normal activities immediately. All patients but three (86%) remained pain free during follow-up (range 4~62 months). A second thermoablation treatment relieved the recurrent symptoms in 2 patients and the remained had persistent pain without a second prodedure. Conclusion: Percutaneous thermoablation appears to be safe and effective for osteoid osteomas, and is a minimally invasive procedure alternative to surgical resection.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.12
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• pp.1560-1567
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• 2008

This study was designed to evaluate the effect of green tea products (GTP) on bone metabolism marker in ovariectomized (OVX) rats fed high cholesterol diet. Forty Sprague-Dawley female rats, 10 weeks of age ($279{\pm}2g$), were divided into 4 groups and fed on the experimental diets for 6 weeks: sham operated control (Sham-C) and OVX-control (OVX-C) groups treated high cholesterol diet. OVX-GTP 5% (OVX-G5) and OVX-GTP 20% (OVX-G20) groups were treated with high cholesterol diet containing 5% GTP and 20% GTP, respectively. Food efficient ratio was significantly (p<0.05) lower in OVX-G20 than in the other OVX groups. Bone mineral density of femur was not significantly different among the experimental groups in the order of Sham-C>OVX-G5 and OVX-G20>OVX-C. Alkaline phosphatase activities on serum was lower in the GTP supplement groups than in the OVX-C. Estradiol levels of serum were higher in the GTP supplement groups than in the OVX-C. Osteocalcin levels of serum was the lowest in the OVX-G20. Deoxypyridinoline crosslink values of urine, indicator of bone absorption, was the lowest in the OVX-G20 group. The GTP supplemented groups had a lower bone resorption ratio than in the OVX-C group. From the above results, these findings suggest the possibility of using GTP as a functional food materials related to bone metabolism in menopause.

• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.66-72
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• 1999

Purpose : To evaluate the usefulness of Dual Echo in Steady State(DESS) image in the diagnosis of chondromalacia of the knee compared with turbo spin-echo MR images Materials and Methods : We included 26 patients with chondromalacia of the knee. MR imaging was obtained with a 1.5T imager. Sagittal and coronal double echo T2 weighted images(TR/TE 3000-4200/16-96msec, FOV $140-160{\times}140-160mm$, matrix size $180{\times}256$, slice thickness 4.0mm, interslice gap 0.5mm), and sagittal DESS image(TR/TE 25.4/9.0msec, flip angle $35-45^{\circ}$, FOV $150-160{\times}150-160mm,{\;}matrix{\;}size{\;}192{\times}256$, effective slice thickness 1.5mm) were obtained. Cartilage lesions were staged according to a modified scheme proposed by Outerbirdge: grade 0, normal; grade 1, softening or/and swelling; grade 2, mild surface fibrillation or/and less than 50% of cartilage thickness; grade 3, severe surface fibrillation or/and loss of more than 50% of cartilage thickness but without exposure of subchondral bone; and grade 4, complete loss of cartilage with subchondral bone exposure. Gradings were determined by two readers with consensus, and patellofemoral, medial and lateral tibiofemoral compartments were evaluated. Results : Arthroscopic findings revealed grade 1 in seven cases, grade 2 in 21 cases, grade 3 in six cases, and grade 4 in 18 cases. Sensitivity of turbo spin-echo MR image was as follows; 0%, 14%, 0%, 61% in each grade, and sensitivity of DESS image was as follows; 0%, 33%, 50%, 67%, in each grade(p=0.001). In the detection of chondromalacic lesions regardless of gradings, sensitivity, specificity and accuracy of conventional MR image were 59.6% 88.6% 78.8%, and of DESS image, 73.1% 88.4%, 82.2%(p=0.007). Conclusion : For chondromalacia of knee joints, DESS images showed higher sensitivity than turbo spin-echo MR images. Therefore, DESS images will be helpful for diagnosis of chondromalacia of knee joints.

• The Korean Journal of Nuclear Medicine
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• v.35 no.5
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• pp.324-333
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• 2001

Purpose: $^{123}I$-labeled fatty acids have been used in the evaluation of regional myocardial energy metabolism. This study aimed to evaluate the usefulness of $^{123}I$-BMIPP as a liposarcoma-imaging agent. Materials and Methods: We compared in vitro uptakes between liposarcoma(SW872) and glioma(9L) cell lines, and examined biodistribution and in vivo images of $^{123}I$-BMIPP in liposarcoma-bearing nude mice. Cold-BMIPP was labeled with $^{123}I\;using\;Cu^{2+}$ as catalyst. After purification by Sep-pak, radiochemical purity was determined by TLC. We compared cellular uptake between glioma and liposarcoma after incubation of 5, 10, 15, 30, 60, 120, and 180 mins with culture medium containing $^{123}I$-BMIPP. The difference in biodistribution was determined between non-feeding (water only) group for 18 hr and feeding group in normal mice (n=6/group) at 0.5, 2, and 24 hr. In liposarcoma-hearing nude mice model, liposarcoma, SW872, ceil lines were injected subcutaneously into the felt thigh of nude mice. The biodistribution of $^{123}I$-BMIPP was evaluated at 0.5, 2, and 24 hr (n:5 / group) and in vivo Image of $^{123}I$-BMIPP was obtained with gamma camera at 2 and 24 hr in liposarcoma-hearing nude mice. Results: Radiolabeling yield and radiochemical purity were 95% and above 99%, respectively. SW872 cell line showed more increased uptake than 9L with 1.5 times at 180 mins. The clearance of $^{123}I$-BMIPP in various tissues was more delayed in the non-feeding group than in the feeding group, especially at delayed time (24 hr) in normal mice, and the major excreting organ was the gastrointestinal tract. In liposarcoma-bearing nude mice, tumor/blood ratio of $^{123}I$-BMIPP was 0.94, 0.75, and 1.38 and tumor/muscle ratio was 0.66, 1.53, and 1.11 at 0.5, 2, and 24hr, respectively. $^{123}I$-BMIPP was selectively localized in liposarcoma at 24 hr image. Conclusions: These results suggest that $^{123}I$-BMIPP can be used as a liposarcoma-imaging agent.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.145-149
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• 2010

Purpose: Recently, $^{18}F$-FDG Fusion PET which has a high sensitivity for diagnosing cancer is being used for purpose of health examination. This study is to demonstrate that $^{18}F$-FDG fusion PET study is useful for diagnosing an early stage cancer. Materials and Methods: This research has been conducted with 2790 patients visited Seoul National University Hospital Healthcare System (SNUHHS) for $^{18}F$-FDG fusion PET study for a health examination from February, 2004 to December 2008. PET/CT images were acquired from skull base to femur after 1 hour from injecting $^{18}F$-FDG 0.14 mCi/kg to the patients. GEMINI GS (Philips, Netherlands) was used for scanning. Results: From February 2004 to December 2008, $^{18}F$-FDG Fusion PET study was performed for 99,009 patients among all patients who visited SNUHHS and 2,790 patients was performed. Diagnostic rate for malignant cancer was 0.95% for the patients who were not examined by $^{18}F$-FDG Fusion PET study. 1.94% was for the patients who were. The rate of malignant tumor was showed 10% and benign tumor was 90% among 542 patients who showed abnormality in the PET/CT images. Types and rates of malignant tumor showed thyroid cancer: 31.5%, lung cancer: 14.8%, stomach cancer: 9.3%, rectum cancer: 3.7%, breast cancer: 3.7%, metastasis cancer: 16.7%. Nonspecific lymph node in the mediastinum, physiologic uptake in the colon, diffuse mild hypermetabolism in bilateral thyroid gland were shown as a benign tumor. Conclusion: The diagnostic rate of malignant tumor with $^{18}F$-FDG Fusion PET for a purpose of health examination was relatively higher than general medical examination. Consequently, it is superior and useful for applying $^{18}F$-FDG Fusion PET study for health examination.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.149-156
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• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• Korean Journal of Veterinary Research
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• v.41 no.3
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• pp.437-445
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• 2001

This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis and to evaluate the embolized kidney using B-mode ultrasonography and selective angiography. Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. Ultrasonographic findings revealed that size of the kidney was significantly increased at 9 days and 17 days and the length of renal cortex was significantly decreased at 17 days after ligation of the unilateral ureter and it was in accordance with dilation of ipsilateral renal pelvis. No significant change of BUN, creatinine, ALT, calcium, and phosphorus was found immediately after unilateral experimental hydronephrosis. Therefore, it was concluded that unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and respiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. Average ethanol dose for renal artery embolization was $1.94{\pm}1.24ml/kg$. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. Ultrasonographically, the mean longitudinal length of the embolized kidney decreased significantly at 2 and 3 months after TAE-RA compared to that of contralateral normal kidney. In summary, marked shrinkage of the embolized kidney was observed in dogs with unilateral experimental hydronephrosis treated by TAE-RA with iohexol-ethanol and no adverse effects were observed throughout the observation period. It is concluded that TAE-RA with iohexol-ethanol solution is a viable alternative to nephrectomy in dogs with unilateral hydronephrosis.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.422-427
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• 1999

Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.331-336
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• 2009

Background: Open surgical repair of abdominal aortic aneurysms was initiated by Dubost in 1952. Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized for curative intent. We retrospectively analyzed surgical outcome, complications, and mortality-related factors for patients with abdominal aortic aneurysms over a 6 year period. Material and Method: We analyzed 18 patients who underwent surgery for abdominal aortic aneurysms between March 2002 and March 2008. The indications for surgery were rupture, a maximal aortic diameter >60 mm, medically intractable hypertension, or pain. Result: The mean age was $66.6{\pm}9.3$ years (range, $49\sim81$ years). Twelve patients (66.7%) were males a 6 patients were females. Extension of the aneurysm superior to the renal artery existed in 6 patients (33.3%), and extension to the iliac artery existed in 13 patients (72.2%). Five patients (27.8%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $72.2{\pm}12.9$ mm (range, $58\sim109$ mm). Surgery was performed by a midline laparotomy, and 6 patients underwent emergency surgery. The mean total ischemic time from aorta clamping to revascularization was $82{\pm}42$ minutes (range, $35\sim180$ minutes). The mortality rate was 16.7%; the mortality rate for patients with ruptured aneurysms was 60%, and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included one each of renal failure, femoral artery and vein occlusion, and wound infection. The patients who were discharged had a long-term survival of $34{\pm}26$ months (range, $4\sim90$ months). Rupture and emergency surgery had a statistically significant mortality-related factor (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have a high mortality, but unruptured cases are repaired with relative safety. Successfully operated patients had long-term survival. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, aggressive application should be determined with care. Experience and systemic support of each center is important in the treatment plan.