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Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma (원발성 위암 환자의 치료 전 PET/CT 스캔에서 FDG 섭취 정도와 임상병리학적 및 면역조직화학적 지표들과의 비교)

  • Han, Eun-Ji;Choi, Woo-Hee;Chung, Yong-An;Kim, Ki-Jun;Maeng, Lee-So;Sohn, Kyung-Myung;Jung, Hyun-Suk;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.26-34
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    • 2009
  • Purpose: The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Materials and Methods: Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Results: Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors ($5.8{\pm}3.1$ vs. $3.7{\pm}2.1$, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) ($5.7{\pm}3.2$ vs. $3.7{\pm}2.0$, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types ($5.4{\pm}2.8$ vs. $3.7{\pm}1.3$, p=0.003). SUVmax between p53 positive group and negative group was significantly different ($6.0{\pm}2.8$ vs. $4.4{\pm}3.0$, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. Conclusion: T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.

The Clinical Analysis of Sulcus Vocalis (성대구증에 관한 임상적 고찰)

  • 김광문;서장수;오혜경;최홍식;김기령
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.11.2-12
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    • 1982
  • The major advancement in phonosurgery due to recent development of laryngomicrosurgery enabled more accurate diagnosis and treatment of patient with voice disorders. Among large proportion of voice disordered patients, prominent linear furrow running parallel along the free edge of vocal cord extending from the vocal process to anterior commissure can be seen as well as incomplete closure during phonation. These cases were illustrated and coined as sulcus vocalis by Salvi in 1901, since then other similar paper was reported in Europe and Japan, but has not been reported in Korea. The exact etiology and therapeutic methods of sulcus vocalis has not been elaborated. At Department of Otolaryngology of Yonsei University College of Medicine a series of voice analysis were performed among those 35 patients with sulcus vocalis visited to Vocal Dynamics Laboratory from May, 1981 to March, 1982. Following is the result of clinical statistical investgation and therapeutic modality. 1) The incidance of sulcus vocalis among 290 patients with voice disorder visited to Vocal Dynamics Laboratory was approximately 12%(35 cases). 2) Onset of this voice disorder was most frequent among patient under 10 year-old groups; 19 cases (54%) followed by second decade, third decade groups in decreasing frequency respectably. 3) The etiology of sulcus vocalis was mostly unknown. The sequelae after measle (4 cases) and severe upper respiratory infection (3 cases) and congenital deformity (2 cases) were the possible causes of sulcus vocalis. 4) These patients were involved bilaterally in 25 cases (71%), left side only in 8 cases (23%) and right side only in 2 cases (6%). 5) Almost all patients complained hoarseness and 7 patients were suffering from chronic laryngitis. 6) In aerodynamic analysis, Maximal Phonation Time was decreased in 20 cases (57%), Phonation Quotient was increased in 22 cases (63%) and Mean Air Flow Rate was increased in 23 cases (66%). 7) Among them, 33 cases were analyzed with stroboscopy. The findings were as follows; incomplete glottic closure during phonation in 31 cases (93%), regular vocal cord movement in whole cases, asymmetric cord movement in 4 cases (12%), decreased amplitude in 5 cases (21%) and small mucosal wave in 24 cases (73%). 8) Intracordal Teflon injection in 5 cases and Sulcusectomy in 1 cases were performed as therapeutic management, however, the therapeutic results were not effective except one case with Teflon injection.

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A Study on the Permeability Reduction Methods of the Riverbed Ground during Urban Railway Tunnel construction (도시철도터널공사 시 하저통과구간의 지반투수저하 공법에 대한 연구)

  • Kim, Joon-Jeong;Cho, Kook-Hwan;Lee, Jun-Seok
    • Proceedings of the KSR Conference
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    • 2007.11a
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    • pp.551-557
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    • 2007
  • This paper describes a study on the permeability reduction of the riverbed ground during urban railway tunnel construction. The research is mainly concentrated on the study of the grouting or injection methods among permeability reduction methods which can be adapted in the riverbed ground. Firstly, the various grouting methods are theoretically reviewed and compared based on the previous research papers and case study results. It is also evaluated the grouting methods in view of a safe construction of the river crossing railway tunnel. Baced on the literature review and previous construction data, the design technology of grouting methods considering the long term hydro-geological behaviour in the riverbed, is suggested. Two injection methods namely, Natural Durable Stabilizer(N.D.S) and Space-Multi Injaction Grouting(S.M.I) methods, are introduced as new approach methods which can be adopted to modify the riverbed ground. In order to evaluate the ground that grouted and modified by the N.D.S and S.M.I method, the pilot test programmes including the field and laboratory permeability tests, are carried out in the river crossing tunnel construction sites. The results obtained from pilot test programme, are also reviewed. In conclusion, the grouting efficiency of the S.M.I method using the non-alcalimeter silica sol is better than that of NDS method using cement. In addition, it hopes that the research results are contributed to develop the grouting design technology.

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Effects of Electrolyzed Alkaline Reduced Water on Echinostoma hortense Infection and Immune Response in C57BL/6 Mice (C57BL/6 생쥐에서 전해알칼리환원수가 호르텐스극구흡충 감염과 면역에 미치는 영향)

  • Kim, Dong-Heui;Deung, Young-Kun;Jin, Dan;Huang, Xue Zhu;Qi, Xu Feng;Kim, Kwang-Yong;Lee, Kyu-Jae
    • Applied Microscopy
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    • v.38 no.1
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    • pp.11-19
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    • 2008
  • To examine the effect of the electrolyzed alkaline reduced water (ERW) on animal immunity, by employing Echinostoma hortense that is a parasite in the small intestine, the immune response of C57BL/6 was examined. To C57BL/6 mice, Echinostoma hortense metacercaria 15 per animal was in oculate dorsally, the worm was collected after 2 weeks, and the change of goblet cells and mast cells in the mucosa of small intestine was examined, and by using a protein chip, the change of cytokines in the serum was compared and observed. As a result, average 8.3 worms were collected from the C57BL/6 mice infected with E. hortense, and in the group fed with the ERW, average 10 worms were collected. In regard to the examination of the change of goblet cells, in the experimental group infected with E. hortense and fed with the ERW, average 4.3 worms per villus were detected, hence, it was found that the expression of goblet cells was low (p<0.001). Regarding the examination of the change of mast cells, similarly, in the group infected with E. hortense and fed with the ERW, average 11 worms per villus were detected, and it appears to be less than control group (p<0.001). Regarding the expression of cytokines in mouse serum, in comparison of the experiment group infected with E. hortense and control group, in the expression of the Th1 cytokines IL-6, IL-$1{\beta}$, IFN-${\gamma}$, TNF-${\alpha}$, and IL-2, and the Th2 cytokines IL-4, IL-5, IL-10, and IL-13, a significant difference was not detected. In our study, it was found that in the infection of E. hortense, the ERW mediates its effect on the number of goblet cells and mast cells in the intestinal mucosa, and simultaneously, the worm expulsion was delayed, and thus the conclusion that the ERW mediated its effect on the intestinal immunity of mice was obtained.

Clinical Features of Eosinophilic Colitis Developed in Early Infancy (영아 초기에 발생한 호산구성 대장염의 임상적 고찰)

  • Kwak, Jeong Won;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.122-129
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    • 2005
  • Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

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Helicobacter pylori Infection and Gastroduodenal Pathology in Children with Upper Gastrointestinal Symptoms (상부 위장관 증세가 있는 소아의 위십이지장병변 및 Helicobacter pylori 감염)

  • Yoon, Young-Ran;Kim, Mi-Ryeung;Lim, Jae-Young;Choi, Myoung-Bum;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Ko, Gyung-Hyuck;Kang, Hyung-Lyun;Baik, Seung-Chul;Lee, Woo-Kon;Cho, Myung-Je;Rhee, Kwang-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.103-111
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    • 2003
  • Purpose: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. Methods: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. Results: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. Conclusion: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

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Causes of Childhood Injuries Observed at the Emergency Rooms of Five Hospitals in Taegu (대구시내 종합병원 응급실에 찾아온 소아사고 환아의 사고원인)

  • Park, Jung-Han;Bae, Yeong-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.224-237
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    • 1988
  • To determine the causes of and related factors to childhood injuries, the emergency room records and inpatient medical records were reviewed for 4,849 injured children out of 15,790 pediatric patients(<15 years old) who visited the emergency rooms of 3 university hospitals and 2 general hospitals in Taegu from 1 January to 31 December 1987. Out of total injured children, 54.675 were 3-8 years old and the male to female ratio of the total injured children was about 2:1. The leading causes of injury were falls and slips (29.1%) and traffic accident(28.2%). The frequency of injury was higher in May-October than the rest of months and 51.6% of the injuries occurred between 15 and 20 o'clock. Falls and slips took place most frequently at the stairway(25.7%). The most common interpersonal violence was inflicted injuries(85.6%) and there were 11 child rapes. Dog bites accounted for 67.6% of all biting injuries and it occured 2.9 times more in male than in female. CO intoxication was the most common cause of poisoning (45.3%) and scalding accounted for 85.2% of all burns. Common places of drownings were river (32.2%), swimming pool (22.6%) and construction site(19.3%). To prevent childhood injuries, it is recommended to eliminate the hazardous environmental factors, to provide safe playgrounds, to educate the children for safety from kindergarten and the general public through mass communication, to establish a strict safety standard for houses, public buildings and facilities, and playgrounds.

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Protective Effects of 5-Androstendiol (5-AED) on Radiation-induced Intestinal Injury (방사선에 의한 장점막 손상에 대한 5-Androstenediol의 보호효과)

  • Kim, Joong-Sun;Lee, Seung-Sook;Jang, Won-Suk;Lee, Sun-Joo;Park, Sun-Hoo;Cho, Soo-Youn;Moon, Chang-Jong;Kim, Sung-Ho;Kim, Mi-Sook
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.141-146
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    • 2010
  • Purpose: We examined the radioprotective effects of 5-androstendiol (5-AED), a natural hormone produced in the reticularis of the adrenal cortex, as a result of intestinal damage in gamma-irradiated C3H/HeN mice. Materials and Methods: Thirty mice (C3H/HeN) were divided into three groups; 1) non-irradiated control group, 2) irradiated group, and 3) 5-AED-treated group prior to irradiation. Next, 5-AED (50 mg/kg per body weight) was subcutaneously injected 24 hours before irradiation. The mice were whole-body irradiated with 10 Gy for the histological examination of jejunal crypt survival and the determination of the villus morphology including crypt depth, crypt size, number of villi, villus height, and length of basal lamina, as well as 5 Gy for the detection of apoptosis. Results: The 5-AED pre-treated group significantly increased the survival of the jejunal crypt, compared to irradiation controls (p<0.05 vs. irradiation controls at 3.5 days after 10 Gy). The evaluation of morphological changes revealed that the administration of 5-AED reduced the radiation-induced intestinal damages such as villus shortening and increased length of the basal lamina of enterocytes (p<0.05 vs irradiation controls on 3.5 day after 10 Gy, respectively). The administration of 5-AED decreased the radiation-induced apoptosis in the intestinal crypt, with no significant difference between the vehicle and 5-AED at 12 hours after 5 Gy. Conclusion: The results of this study suggest that the administration of 5-AED has a protective effect on intestinal damage induced by $\gamma$-irradiation. In turn, these results suggest that 5-AED could be a useful candidate for radioprotection against intestinal mucosal injury following irradiation.

Gastrointestinal Complications after Lung Transplantation (폐이식 후 발생한 소화기계 합병증)

  • Haam, Seok-Jin;Paik, Hyo-Chae;Kim, Ji-Hyun;Lee, Doo-Yun;Kim, Chang-Wan;Kim, Jung-Hwan
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.280-284
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    • 2010
  • Background: The postoperative management following lung transplantation has dramatically improved in the recent decade. However, some complications still remain as troublesome problems. We retrospectively reviewed the gastrointestinal complications and their management after lung transplantation. Material and Method: We performed a retrospective review of the medical records of 25 cases in 23 patients who underwent lung and heart-lung transplantations from July 1996 to March 2009. The definition of gastrointestinal complication was the gastrointestinal tract-related disease that occurred after lung transplantation. There were eight postoperative deaths (within postoperative 30 days) that were excluded from the analysis. Result: Twenty three gastrointestinal complications occurred in 11 (64.7%) of the 17 cases. The median follow-up period was 6.9 months (range: 2 months to 111 months), and chronic gastritis (23.5%, 4 of 17 cases) was the most common complication. Severe, prolonged (more than 2 weeks) diarrhea occurred in 3 cases. Three patients had gastric ulcer with one case requiring gastric primary closure for gastric ulcer perforation. This patient had gastric bleeding due to recurrent gastric ulcer 2 months after laparotomy. Cytomegalovirus gastritis and esophagitis occurred in 2 cases and 1 case, respectively, and esophageal ulcer occurred in 2 cases. There were esophageal strictures in 2 patients who underwent esophageal stent insertion. Other complications were one case each of ileus, early gastric cancer requiring endoscopic mucosal resection, gall bladder stone accompanied with jaundice, and pseudomembranous colitis. Conclusion: The incidence of gastrointestinal complication is relatively high in patients after they undergo lung transplantation. Since gastrointestinal complications can induce malnutrition, which might be related to considerable morbidity and mortality, close follow-up is necessary for the early detection and proper management of gastrointestinal complications.

Direct Intratumoral Injection of Ethanol in the Patients with Obstruction of Major Bronchus (주기관지 폐색환자에서 종양내 ETHANOL 주입치료 효과)

  • Lee, Bong-Chun;Yum, Ho-Kee;Choi, Soo-Jeon;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.495-500
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    • 1993
  • Background: For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients. Method: All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5-1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lumen opens. Usually after 2-3 trials of ethanol injection, the lumen opened up. Results: The immediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. $FEV_{1.0}$ and FVC were improved and $PaO_2$ was increased from $68.1{\pm}9.2$ mmHg to $83.9{\pm}8.1$ mmHg, $SaO_2$: from $94{\pm}8.5%$ to $96.6{\pm}1.1%$, and $AaDO_2$ was reduced from $26.5{\pm}8.5$ mmHg to $10.9{\pm}9.1$ mmHg. Conclusion: Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.

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