• Journal of the Korean Society of Radiology
• /
• v.82 no.3
• /
• pp.670-681
• /
• 2021

Purpose This study aimed to investigate the optimal threshold value in Hounsfield units (HU) on CT to detect the solid components of pulmonary subsolid nodules using pathologic invasive foci as reference. Materials and Methods Thin-section non-enhanced chest CT scans of 25 patients with pathologically confirmed minimally invasive adenocarcinoma were retrospectively reviewed. On CT images, the solid portion was defined as the area with higher attenuation than various HU thresholds ranging from -600 to -100 HU in 50-HU intervals. The solid portion was measured as the largest diameter on axial images and as the maximum diameter on multiplanar reconstruction images. A linear mixed model was used to evaluate bias in each threshold by using the pathological size of invasive foci as reference. Results At a threshold of -400 HU, the biases were lowest between the largest/maximum diameter of the solid portion of subsolid nodule and the size of invasive foci of the pathological specimen, with 0.388 and -0.0176, respectively. They showed insignificant difference (p = 0.2682, p = 0.963, respectively) at a threshold of -400 HU. Conclusion For quantitative analysis, -400 HU may be the optimal threshold to define the solid portion of subsolid nodules as a surrogate marker of invasive foci.

• Journal of the Korean Society of Radiology
• /
• v.85 no.3
• /
• pp.566-578
• /
• 2024

Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

• The Korean Journal of Nuclear Medicine
• /
• v.39 no.4
• /
• pp.239-245
• /
• 2005

Purpose: Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the iung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or injection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. Material and Methods: F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. light patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia werr included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. Results: F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Conclusions: Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.1
• /
• pp.21-30
• /
• 2005

Purpose: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. Methods: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (${\geq}60per$ 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. Results: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was $11.5{\pm}5.1$ (5~24) weeks, and mean age at diagnosis was $17.8{\pm}9.5$ (8~56) weeks. Duration from symptom onset to diagnosis was $6.3{\pm}6.7$ (0~36) weeks. Mean peripheral blood eosinophil count was $478{\pm}320$ (40~1,790)/$mm^3$ and eosinophilia (> $250/mm^3$) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at $29.4{\pm}8.7$ (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at $37.5{\pm}9.7$ (12~56) weeks of age. Conclusion: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.6
• /
• pp.916-924
• /
• 1996

Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.

• Journal of Fisheries and Marine Sciences Education
• /
• v.4 no.1
• /
• pp.30-46
• /
• 1992

Korea's first exploratory tuna fishing was done with a used longliner in 1957. Then the commercial fishing has been made steady headway since the 1960's and grown up to one of major tuna fishing countries in 1970's. The tuna fishing aimed primarily at acquiring foreign currency, then tuna was exported directly from the overseas fishing base. Tuna, however, has been gradually favored by Koreans as high-proteined foods according to the growth of GNP since the 1970's. In 1980, the canned tuna began to be produced and sold at home. And so the demand of raw tuna for cannaries has steeply increased not only for home but also for abroad, and stimulated the development of tuna purse seine fishery. The author carried out a study on the development of tuna purse seine fishery in Korea and countries concerned-the United States and Japan-because it is recognized to be significant for the further development of this fishery. Just as purse seining was originated in the United States, so tuna purse seining was also pioneered by Californian fishermen in the west coastal waters of the United States (Eastern Pacific Ocean). They started to produce the canned tuna in the early 1900's, and the demand for raw tuna began to be increased rapidly. In those days, tuna was mostly caught by pole-and-line, but the catch amount was far away from the demand. To satisfy this demand, they began to try out fishing tuna by the use of purse seine which had been born in the eastern waters in the 1820's and applied to catch white fishes in the western waters of the United States in those days. Even though their trial was technically successful through severe trial and error, a new problem was raised on the management of tuna resource and the preservation of porpoise which was occassionally caught with tuna. Then the Inter-American Tropical Tuna Commission (IATTC) was established by countries neighboring to the United States in 1950 and they set up the Commission's Yellowfin Regulatory Area (CYRA) and regulated the annual quota for yellowfin. Then, American owners tried to send their seiners to the Western African waters to expand the fishing ground in 1967 and to the Centeral-Western Pacfic in 1974, and the fishing ground was widely expanded. The number of the United States' purse seiners amounted to about 150 in 1980, but the enthusiasm was gradually cooled thereafter and the number of seiner was decreased to 67 in 1986. The landing of tuna by purse seiners in the United States after 1980 maintains 200 thousands M/T or so with a little increase despite the decreasing of domestic seiners. This shows that the landing by foreign seiners are increasing, compared with the landing by domestic seiners are decreasing. In Japan, even though purse seining was introduced in 1880, they had fished tuna by longline and pole-and -line until the tuna purse seining was introduced from the United States again. In the 1960's, Japanese tuna seiners made the exploratory fishing in the South-western Pacific and West African waters with a limited success. In 1971, the government-funded research center "JARMRAC" conducted the exploratory fishing which extended to the Central American waters, the Asia-Pacific Region and the South-western Pacific. It had also much difficulties, till they improved the fishing gear adaptable to the new fishing condition in the South-western Pacific. Japanese government has begun to licence 32 single seiners and 7 group seiners since 1980 and their standard has lasted up to now. The catch in the Pacific Islands Region amounted to 160 thousands M/T in 1986. Korea's tuna purse seine fishery was originated in 1971 by Jedong Industrial Co., Ltd. with three used tuna purse seiners purchased from the United States, and they began to fish in the Eastern Pacific, but failed owing to the superannuation of vessel and the infancy of fishing technique. The second challenge was done by Dongwon Industrial Co., Ltd. in 1979, with one used seiner purchased from the United States, and started to fish in the Eastern Pacific. Even though the first trial was almost unsuccessful but they could obtain the noticeable success by removing the vessel to the South-western Pacific in 1980. This success stimulated the Korean entherprisers to take part in this fishery, and the number of Korean tuna purse seiners has been increased rapidly in accordance with the increased demand for raw tuna. The number of vessels actually at work amounted to 36 in 1990 and they operate in the South-western Pacific. The annual catch of tuna by purse seiners amounted to 170 thousands M/T in 1990 and ranked to one of the major tuna purse seining countries in the world.