• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.55-59
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• 2010

Purpose: Renal excretion is the main route of FDG clearance in FDG PET/CT scan. Applying optimal method of renal excretion is very important for enhancing image quality and diagnostic accuracy. We evaluated several methods of renal excretion in FDG PET/CT scan. Materials and Methods: Thirty patients with normal renal function were prospectively included. Patients were divided into three group and undergone early and delayed FDG PET/CT scans. (1) Delay group; at 1 hour later of early scan, delayed scan was performed without additional hydration, (2) Hydration group; at 1 hour later of early scan, delayed scan was performed with additional oral hydration (700 mL of water), (3) Lasix group; lasix was administered at the end of early scan and dealyed scan was performed 30 min later. Early and delayed scans were compared to evaluate efficiency of renal excretion. Visual and quantitative analyses were performed by experienced physician and technologist of nuclear medicine. Results: On the visual analysis, renal excretion was the most evident in Lasix group followed by Hydration group. Delay group showed poor renal excretion. On the quantitative analysis, washout rates were $9.2{\pm}20.7%$, $28.1{\pm}22.8%$ and $29.5{\pm}23.1%$ for Delay, Hydration and Lasix groups, respectively. Conclusion: Administration of lasix was the best method for enhancing renal excretion. Delayed scan with hydration was also efficient method, but delayed scan without hydration was not adequate method.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.542-549
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• 2002

Purpose : The purpose of our study was to assess the usefulness of the Tl-201 SPECT for the detection of the postoperative tumor recurrence on chest wall. Methods: 28 patients including 14 with suspected recurrence of tumor in the chest wall on postoperative chest cr scan, 10 with postoperative pleural effusion which proved benign on radiologic, cytologic and laboratory findings, and 4 with chronic tuberculous empyema as control group were included. All patients underwent SPECT 30 minutes and 4 hours after intravenous injection of 111MBq of Tl-201. Tumor uptake was visually graded by two interpreters and scored as follows : no uptake:0, similar to contralateral lung: 1, higher than contralateral lung but less than heart:2 and similar to heart:3. Results : Markedly increased (grade 3 or 2) Tl-201 uptake was noted in patients with suspected recurrence of tumor in the chest wall (13/14) whereas no (8/10) or minimal (2/10) uptake along the collapsed lung in patients with postoperative benign pleural effusion. In two patients, Tl-201 SPECT revealed additional recurrent tumor mass lesions that were barely perceptible on chest cr scan. Patients with chronic tuberculous empyema showed relatively smoothly marginated increased uptake along the chest wall 4/4), but lesser in degree (grade 1 or 2), when compared to recurrent tumor uptake. Conclusion : Tl-201 lung SPECT seems to be useful to detect postoperative tumor recurrence on chest wall and to differentiate malignant from benign pleural effusion and may provide additional information to the morphologic data obtained by CT.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.81-85
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• 2009

Purpose: The examination of nuclear medicine observes the change in accordance with the time elapsed in the same region purposed and there are many examinations to acquire the image during the same term. At this time, the same parameter should be applied. The hepatobiliary scan, lung scan etc, are the acquired examination in the divided time with a regular term. Pre-set time that is applied in continued next image is set in order to acquire the fixed counts. The same scan time should be applied for each image. This study will look for the rational plan and analyze the change of scan time in accordance with the time of the decision of scan time at examination that pre-set time is applied. Methods: The hapatobiliary scan that use the radio pharmaceutical $^{99m}Tc$-mebrofenin is choosed as compensation from Jan. 2009 to Mar. 2009 in the department of nuclear medicine in ASAN MEDICAL CENTER. Scan is started after 5 minutes from when 222 MBq (6 mCi) is injected to patient. We let patient stand up between both detectors, and possibly close to the front of detector. When scan time reach 10%, 25%, 50%, 75% of total scan time, we measured the expected total scan time. After finishing all of scan, we compared the total scan time and the expected total scan time, while image is acquiring. and we observed the change of scan time in accordance with radio activity by using phantom. Results: After starting scan, a difference of when scan time reach 10%, 25%, 50%, 75% of total scan time is that the biggest difference is 5 seconds on 10%. There statistically is difference between 25% (t:2.88, p<0.01) and 50% (t:2.05, p<0.01). Conclusions: When the same the scan time is applied in the examination that acquire the many frame, concluding the same scan time has a important effect on a quantitative analysis. Although method that decide the scan time after finish all of the examinations, there is a few problem to apply practical affairs. This may cause an inaccurate result on the examination that need a quantitative analysis. We think that operator should try to improve it. At least, after reach 50% of total scan time, deciding the total scan time mean that you can minimize error of a quantitative analysis caused by unmatched scan time from a gap of image.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.46-52
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• 2009

Background: Vascular injuries to the extremities are potentially devastating and they can lead to limb loss and mortality if they are not appropriately managed. The vascular trauma caused by traffic and industrial accidents has recently increased according to the developing industry and transport system in Korea. Early recognition and treatment of these injuries are mandatory to achieve satisfactory outcomes. Material and Method: We retrospective reviewed 43 patients with vascular injuries that were due to blunt and penetrating trauma and they underwent emergency operations from January of 1998 to December of 2006. Result: There were 38 men and 5 women patients with a mean age of $42.0{\pm}16.8$ years (range: 17~77). The cause of vascular injuries were 28 traffic accidents (65%), 6 industrial accidents (14%), 6 glass injuries (14%) and 3 knife injuries (7%). The average time from admission to the operating room was $319.0{\pm}482.2$ minutes (range: 27~2,400 minutes). The average time from admission to discharge was $53.1{\pm}56.0$ days (range: 2~265 days). The anatomic injuries included the femoral artery in 16 cases (37%), the popliteal artery in 8 cases (19%), the brachial artery in 8 cases (19%), and the subclavian and axillary arteries in 7 cases (16%). The associated injuries were 23 bone fractures (53%), 18 muscle injuries (42%) 5 nerve injuries (12%) and 11 vein injuries (26%). The operation methods were 20 end to end anastomoses (46%), 16 interposition grafts (36%), 2 repairs with using patches (5%) and 5 others (12%). The number of amputations and cases of mortality were 3 cases (7%) and 4 cases (9%), respectively. Conclusion: Minimizing ischemia is an important factor for maximizing salvage of extremities. Prompt diagnosis and treatment can reduce the amputation and mortality rates.

• The Korean Journal of Pharmacology
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• v.32 no.3
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• pp.357-371
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• 1996

Lithium (Li) is known to be used not only during acute manic psychosis but also acute depressive phase in manic-depression. In the present study, it was attempted to investigate the effect of lithium on catecholamine (CA) secretion from the isolated perfused rat adrenal gland and to clarify the mechanism of its action. Replacement of $Na^+$ (118.4 mM) by lithium in the normal Krebs-bicarbonate solution used to perfuse the gland produced gradually an increased response in the spontaneous catecholamine release, which was peaked at $30{\sim}60$ min after its perfusion. Li-Krebs solution was perfused into an adrenal vein for 2 hours in every experiments. Li-Krebs-evoked CA secretory responses were depressed significantly under loading with $Ca^{++}-free$ medium. This CA secretion evoked by lithium loading was also reduced markedly by the pretreatment with nicardipine ($10^{-6}$ M), TMB-8 ($10^{-5}$ M) and chlorisondamine ($10^{-6}$ M) for 20 min, respectively, while was not affected by preloading with a pirenzepine ($2{\times}10^{-6}$ M)-containing Krebs. $Na^+$ pump inhibition by pretreatment with ouabain ($10^{-4}$ M) for 20 min did make the marked depression in Li-evoked CA secretory responses. Moreover, Li-evoked CA release was also diminished markedly by preloading with tetrodotoxin ($5{\times}10^{-7}$ M)-contaming Krebs for 20 min. All these experimental results taken together suggest that lithium enhances CA secretion in a $Ca^{++}$-dependent fashion by its accumulation in the adrenomedullary chromaffin cells of the rat, and that this secretory effect may be meidated by a dual mechanism: (i) chromaffin cell depolarization and subsequent opening of voltage-sensitive $Ca^{++}$ channels and (ii) activation of a $[Li]_i-[Ca]_0$ counter-transport system.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.876-882
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• 2003

Purpose : To find out the myocardial protective effect of cardioxane for the myocardial damage by doxorubicin. Methods : Using Eighteen rabbits(2.0-3.2 kg), doxorubicin($30mg/m^2$) was injected intravenously once a week in group I(12 rabbits) and cardioxane($600mg/m^2$) was injected at 20-30 minutes before doxorubicin administration in group II(6 rabbits). After this, we operated on the rabbits when the total cumulative dose of doxorubicin was reached at 210, 240, 270 and $300mg/m^2$ and observed the degree of myocardial damage with light and electronic microscope. Results : In group I, rabbits with less than $210mg/m^2$ of total cumulative dose of doxorubicin, there was no definite myocardial damage but with $240mg/m^2$, focal degenerative change was observed and with $300mg/m^2$, severe degenerative change was detected with light microscopic examination. With electronic microscope, rabbits with less than $180mg/m^2$ of total cumulative dose of doxorubicin in group I, there was no evidence of myocardial damage. In $210mg/m^2$, focal degenerative change was detected. With $240mg/m^2$, degenerative change was much more advanced and with $300mg/m^2$, severe degenerative change was detected. In group II, no definite myocardial damage was observed even though the total cumulative dose of doxorubicin reached $300mg/m^2$, but with $360mg/m^2$, there was a focal area where myocardial fibers were somewhat decreased, but it's difficult to say whether these decrement were due to adriamycin in the electronic microscopic examination. Conclusion : Cardioxane have a good protective effect for the doxorubicin induced cardiomyopathy and it will be used safely in pediatric cancer patients.

• The Korean Journal of Pharmacology
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• v.23 no.1
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• pp.1-7
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• 1987

The renal handling and tissue distribution of pyrazinamide were studied after administration of single dose intravenous injection for 15 min or constant infusion in New Zealand White rabbits. Peak pyrazinamide serum concentration ranged from 57.3 to $105.0{\mu}g/ml$ ($mean{\pm}SD;83.0{\pm}17.8$). The mean half-life of the a phase was $0.143{\pm}0.047$ hr while the ${\beta}$ phase ranged from 1.66 to 3.25 hr($mean{\pm}SD;2.38{\pm}0.57$). The mean steady-state volume of distribution in non-compartmental model was $0.935{\pm}0.362\;L/kg$ Excretion ratio of pyrazinamide was dramatically reduced from 1.02 to 0.30 when unbound serum pyrazinamide concentration was increased from 6.04 to $60.9\;{\mu}g/ml$. The urine flow dependency of renal clearance of pyrazinamide was demonstrated in steady-state serum concentration. The tissue/serum concentration ratio of pyrazinamide was highest in kidney and lowest in skeletal muscle among the tissues examined. The results suggested that a large fraction of pyrazinamide filtered by glomerulus and secreted by renal tubule was reabsorbed and this tubular reabsorption of pyrazinamide might be greatly influenced by urine flow.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.525-531
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• 1999

Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.4
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• pp.723-729
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• 2004

To develop foods using dried persimmon, hot-water extracts of dried persimmons were added into strong wheat flour in the ratio of 10, 20, 30, and 40% and the quality characteristics of baked products were investigated. The proximate compositions of dried persimmons hot-water extracts were 70.37% of moisture, 1.72% of crude protein, 0.18% of crude lipids, 1.99% of crude ash and 4.37% of crude fiber, respectively. With increasing the addition of dried persimmons hot-water extracts, moisture content of the added breads was increased to 47.20% from 41.12% of non-added bread and water activity to 0.576 from 0.495. Water binding capacity of the added dried persimmons hot-water extracts rasied weight of the bread but decreased specific volume. In the hunter's color values the more dried persimmons hot-water extracts was added, the lower L vaules we, and the higher a and b values we. In the texture property, the addition of dried persimmons hot-water extracts increased hardness, gumminess and chewiness, while decreased adhesiveness and fracturability. Judging from texture, taste and overall acceptability of the product, recommended substitution level for hot-water extracts of dried persimmons in bread was 30% or less.