• Journal of Yeungnam Medical Science
• /
• v.25 no.1
• /
• pp.19-30
• /
• 2008

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.

• Journal of Yeungnam Medical Science
• /
• v.18 no.1
• /
• pp.30-38
• /
• 2001

Background: The purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging for monitoring the response to radiation therapy in metastatic bone marrow of the spines. Materials and Methods: Twenty-one patients with metastatic bone marrow of the spines were examined with MRI. Diffusion-weighted and spin-echo MRI were performed in 10 patients before and after radiation therapy with or without systemic chemotherapy, and performed in 11 patients after radiation therapy alone. Follow up spin-echo and diffusion-weighted MRI were obtained at 1 to 6 months after radiation therapy according to patients' condition. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the metastatic bone marrows before and after radiation therapy on conventional spin-echo sequence MRI and diffusion-weighted MRI were evaluated. Bone marrow contrast ratios and signal-to-noise ratios before and after radiation therapy of diffusion- weighted MRI were analyzed. Results: All metastatic bone marrow of the spinal bodies were hyperintense to normal bone marrow of the spinal bodies on pretreatment diffusion-weighted MRI and positive bone marrow contrast ratios(p<0.001), and hypointense to normal spinal bodies on posttreatment diffusion-weighted MRI and negative bone marrow contrast ratios(p<0.001). The signal to noise ratios after treatment decreased comparing with those of pretreatment. Decreased signal intensity of the metastatic bone marrows on diffusion-weighted MRI began to be observed at average more than one month after the initiation of the radiation therapy. Conclusion: These results suggest that diffusion-weighted MRI would be an excellent method for monitoring the response to therapy of metastatic bone marrow of the spinal bodies, however, must be investigated in a larger series of patients with longer follow up period.

• Journal of Yeungnam Medical Science
• /
• v.22 no.2
• /
• pp.191-198
• /
• 2005

Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP.1) Materials and methods: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.

• The Journal of Korean Society for Radiation Therapy
• /
• v.21 no.2
• /
• pp.67-74
• /
• 2009

Purpose: To evaluate the results of absorbed and effective doses using two different modes, standard mode (A-mode) and low-dose mode (B-mode) settings for prostate cancer IGRT from CBCT. Materials and Methods: This experimental study was obtained using Clinac iX integrated with On Board Imager (OBI) System and CBCT. CT images were obtained using a GE Light Speed scanner. Absorbed dose to organs from ICRP recommendations and effective doses to body was performed using A-mode and B-mode CBCT. Measurements were performed using a Anderson rando phantom with TLD-100 (Thermoluminescent dosimeters). TLD-100 were widely used to estimate absorbed dose and effective dose from CBCT with TLD System 4000 HAWSHAW. TLD-100 were calibrated to know sensitivity values using photon beam. The measurements were repeated three times for prostate center. Then, Evaluations of effective dose and absorbed dose were performed among the A-mode and B-mode CBCT. Results: The prostate absorbed dose from A-mode and B mode CBCT were 5.5 cGy 1.1 cGy per scan. Respectively Effective doses to body from A mode and B-mode CBCT were 19.1 mSv, 4.4 mSv per scan. Effective dose from A-mode CBCT were approximately 4 times lower than B-mode CBCT. Conclusion: We have shown that it is possible to reduce the effective dose considerably by low dose mode(B-mode) or lower mAs CBCT settings for prostate cancer IGRT. Therefore, we should try to select B-mode or low condition setting to decrease extra patient dose during the IGRT for prostate cancer as possible.

• Journal of Yeungnam Medical Science
• /
• v.16 no.2
• /
• pp.237-243
• /
• 1999

We conducted this study to find the optimal correction factor(${\alpha}$) of Lassen's linearization algorithm which has been applied for correction of flow-limited uptake at a high flow range in $^{99m}Tc$ d,l-hexamethylpropy leneamine oxime(HMPAO) and $^{99m}Tc$ ethyl cysteinate dimer(ECD). Ten patients with chronic cerebral infarction were involved in this study. We obtained the corrected $^{99m}Tc$ HMPAO and $^{99m}Tc$-ECD brain SPECT(single photon emission computed tomography) using the algorithm with ${\alpha}$ values that varied from 0.1 to 10 and compared the results with regional cerebral blood flow determined by positron emission tomography (PET-rCBF). The multi-modal volume registration by maximization of mutual information was used for matching between PET-rCBF and SPECT images. The highest correlation coefficient between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain uptake and PET-rCBF was revealed at ${\alpha}$ 1.4 and 2.1, respectively. We concluded that the ${\alpha}$ values of Lassen's linearization algorithm for $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain SPECT images were 1.4 and 2.1, respectively to indicate cerebral blood flow with comparison of PET-rCBF.

• Journal of Yeungnam Medical Science
• /
• v.19 no.1
• /
• pp.28-38
• /
• 2002

Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusions: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

• Journal of Yeungnam Medical Science
• /
• v.2 no.1
• /
• pp.103-111
• /
• 1985

Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

• Journal of Biomedical Engineering Research
• /
• v.21 no.3 s.61
• /
• pp.321-331
• /
• 2000

Multiple 15-hue tests were designed and implemented on a PC in the study so as to quickly and quantitatively evaluate color vision acuity. Difficulty of the test was control)ed by the value of CDBACC (color difference between adjacent color chips) calculated using a CIELAB formula. The multiple 15-hue tests consist of eight of the hue tests (test 3-10) and three of the basic color (red, green, blue) tests (test 11-13). The 15 colors used for the hue tests were specified by the 15 color coordinates that were located at a constant distance (d = 2. 3. 5. 7, 10, 20, 30. 40) from white reference in the CIE chromaticity coordinate system and were separated by a constant color difference (CDBACC = 0.75, 1.1, 1.8. 2.5. 3.5. 7.5. 11, 14) from the adjacent chips. The color coordinates for the 15 chips for the basic color tests were the same as those of the 15 points spaced equally by a constant color difference (6.87 for the green color test. 7.27 for the red color test, 7.86 for the blue color test) from the white reference along the axis of red, green and blue. Thirty normal subjects who were not color blind were taken to undergo the multiple 15-hue tests. It was observed that most of the subjects correctly arranged color chips for the tests with CDBACC greater than 5, whereas no one correctly answered for those with CDBACC less than 2. Rapid changes in the number of the subjects correctly arranged took place when CDBACC of the tests was between 2 and 4.5. In the basic color tests, unlike the hue tests having similar values of CDBACC, it was seen that the subjects arranged color chips even less correctly. It was found that JNCD (just noticeable color difference) - a measure of color vision acuity was about 3 in average for the subjects. The JNCD was chosen as the value of the CDBACC of the test for which about $50\%$ of the subjects failed to successfully arrange color chips. ERCCA (error rate of color chips arrangement) for the test with CDBACC the same as the JNCD was shown to be about $20\%$. It is expected that the multi 15-hue tests implemented on a PC in the study will be an economical tool to quickly and quantitatively evaluate color vision acuity and, accordingly, the tests can be used for early diagnosis to massive potential patients suffering from diseases (ex. diabetes, glaucoma) which may induce changes in color vision acuity.

• Journal of Yeungnam Medical Science
• /
• v.12 no.2
• /
• pp.226-236
• /
• 1995

We studied to evaluate CT characteristics of bronchogenic cysts. We retrospectively evaluated CT of 11 patients with pathologically proved bronchogenic cyst. Precontrast and postcontrast CT scan was performed in all. We analyzed CT with viewpoints of location, size, attenuation on pre- and postcontrast scan, and calcification. Three of 11 bronchogenic cysts were intrapulmonary in location and eight were located in the mediastinum. Two of 3 intrapulmonary bronchogenic cysts were located in the right lower lobe, and the remaining one was left lower lobe. Intrapulmonary bronchogenic cysts ranged from 6cm to 12cm in diameter (average, 9.7 cm). On CT, intrapulmonary bronchogenic cysts appeared as thin-wall air cyst, homogenous water attenuation and soft tissue attenuation with air bubble respectively. Mediastinal bronchogenic cysts were located in posterior mediastinum(n=5), superior mediastinum(n=2), middle mediastinum(n=1) respectively. These cysts ranged in size from 3cm to 8cm in diameter (average, 5.0 cm). On CT, five showed homogenous water attenuation, two soft tissue attenuation similar to that of muscle, one air-fluid level. Calcification or contrast enhancement was not detected in any cases. On operative findings, all of intrapulmonary bronchogenic cysts contained dirty pus-like material and all of mediastinal bronchogenic cysts contained whitish or yellowish mucus material. Bronchogenic cysts showed homogenous water density in many cases, homogenous soft tissue density, air-fluid level and air-filled cyst. The constellation of CT findings may be helpful in the diagnosis and differentiation of bronchogenic cyst.

• Journal of Radiation Protection and Research
• /
• v.23 no.4
• /
• pp.259-266
• /
• 1998

There are three different types of gynecological applicator sets available in microSelectron-high dose-rate(HDR) System by Nucletron; standard applicator set(SAS), standard shielded applicator set(SSAS), and Fletcher-Williamson applicator set(FWAS). Shielding effect of a SAS without shielding material was compared with that of a SSAS with shielding material made of stainless steel(density ${\varrho}=8,000kg/m^3$) at the top and bottom of each ovoid, and of a FWAS with shielding material made of tungsten alloy(density ${\varrho}=14,000kg/m^3$ at the top and bottom of each ovoid. The shielding effects to the rectum and bladder of these two shielded applicator sets were to be measured at reference points with an ion chamber and specially designed supporting system for applicator ovoids inside of the computerized 3-dimensional water phantom. To determine the middle point of two ovoids the measurement was performed with the reference tip of ion chamber placed at the same level and at the middle point from the two ovoids, while scanning the dose with the ion chamber on each side of ovoids. The doses to the reference points of rectum were measured at 20(Rl), 25(R2), 30(R3), 40(R4), 50(R5), and 60(R6) mm located posteriorly on the vertical line drawn from M5(the middle dwell position of ovoid), and the doses to the bladder were measured at 20(Bl), 30(B2), 40(B3), 50(B4), and 60(B5) mm located anteriorly on the vertical line drawn from M5. The same technique was employed to measure the doses on each reference point of both SSAS and FWAS. The differences of measured rectal doses at 25 mm(R2) and 30 mm(R3) between SAS and SSAS were 8.0 % and 6.0 %: 25.0% and 23.0 % between SAS and FWAS. The differences of measured bladder doses at 20 mm(Bl) and 30 mm(B2) between SAS and SSAS were 8.0 % and 3.0 %: 23.0 % and 17.0 % between SAS and FWAS. The maximum shielding effects to the rectum and bladder of SSAS were 8.0 % and 8.0 %, whereas those of FWAS were 26.0 % and 23.0 %, respectively. These results led to the conclusion that FWAS has much better shielding effect than SSAS does, and when SSAS and FWAS were used for gynecological intracavitary brachytherapy in microSelectron-HDR system, the dose to the rectum and bladder was significantly reduced to optimize the treatment outcome and to lower the complication rates in the rectum and bladder.