• Title/Summary/Keyword: 3D CT

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Efficacious Pleurodesis with OK-432 Plus Autoblood or OK-432 Against the Pneumothorax with Persistent Air Leak (지속성 기흉에서 OK-432와 자가혈액을 이용한 흉막 유착술의 효과)

  • Kim, Hyoung Soo;Choi, Goang Min
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.72-75
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    • 2006
  • Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.

Integrated Rotary Genetic Analysis Microsystem for Influenza A Virus Detection

  • Jung, Jae Hwan;Park, Byung Hyun;Choi, Seok Jin;Seo, Tae Seok
    • Proceedings of the Korean Vacuum Society Conference
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    • 2013.08a
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    • pp.88-89
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    • 2013
  • A variety of influenza A viruses from animal hosts are continuously prevalent throughout the world which cause human epidemics resulting millions of human infections and enormous industrial and economic damages. Thus, early diagnosis of such pathogen is of paramount importance for biomedical examination and public healthcare screening. To approach this issue, here we propose a fully integrated Rotary genetic analysis system, called Rotary Genetic Analyzer, for on-site detection of influenza A viruses with high speed. The Rotary Genetic Analyzer is made up of four parts including a disposable microchip, a servo motor for precise and high rate spinning of the chip, thermal blocks for temperature control, and a miniaturized optical fluorescence detector as shown Fig. 1. A thermal block made from duralumin is integrated with a film heater at the bottom and a resistance temperature detector (RTD) in the middle. For the efficient performance of RT-PCR, three thermal blocks are placed on the Rotary stage and the temperature of each block is corresponded to the thermal cycling, namely $95^{\circ}C$ (denature), $58^{\circ}C$ (annealing), and $72^{\circ}C$ (extension). Rotary RT-PCR was performed to amplify the target gene which was monitored by an optical fluorescent detector above the extension block. A disposable microdevice (10 cm diameter) consists of a solid-phase extraction based sample pretreatment unit, bead chamber, and 4 ${\mu}L$ of the PCR chamber as shown Fig. 2. The microchip is fabricated using a patterned polycarbonate (PC) sheet with 1 mm thickness and a PC film with 130 ${\mu}m$ thickness, which layers are thermally bonded at $138^{\circ}C$ using acetone vapour. Silicatreated microglass beads with 150~212 ${\mu}L$ diameter are introduced into the sample pretreatment chambers and held in place by weir structure for construction of solid-phase extraction system. Fig. 3 shows strobed images of sequential loading of three samples. Three samples were loaded into the reservoir simultaneously (Fig. 3A), then the influenza A H3N2 viral RNA sample was loaded at 5000 RPM for 10 sec (Fig. 3B). Washing buffer was followed at 5000 RPM for 5 min (Fig. 3C), and angular frequency was decreased to 100 RPM for siphon priming of PCR cocktail to the channel as shown in Figure 3D. Finally the PCR cocktail was loaded to the bead chamber at 2000 RPM for 10 sec, and then RPM was increased up to 5000 RPM for 1 min to obtain the as much as PCR cocktail containing the RNA template (Fig. 3E). In this system, the wastes from RNA samples and washing buffer were transported to the waste chamber, which is fully filled to the chamber with precise optimization. Then, the PCR cocktail was able to transport to the PCR chamber. Fig. 3F shows the final image of the sample pretreatment. PCR cocktail containing RNA template is successfully isolated from waste. To detect the influenza A H3N2 virus, the purified RNA with PCR cocktail in the PCR chamber was amplified by using performed the RNA capture on the proposed microdevice. The fluorescence images were described in Figure 4A at the 0, 40 cycles. The fluorescence signal (40 cycle) was drastically increased confirming the influenza A H3N2 virus. The real-time profiles were successfully obtained using the optical fluorescence detector as shown in Figure 4B. The Rotary PCR and off-chip PCR were compared with same amount of influenza A H3N2 virus. The Ct value of Rotary PCR was smaller than the off-chip PCR without contamination. The whole process of the sample pretreatment and RT-PCR could be accomplished in 30 min on the fully integrated Rotary Genetic Analyzer system. We have demonstrated a fully integrated and portable Rotary Genetic Analyzer for detection of the gene expression of influenza A virus, which has 'Sample-in-answer-out' capability including sample pretreatment, rotary amplification, and optical detection. Target gene amplification was real-time monitored using the integrated Rotary Genetic Analyzer system.

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The Three Dimensional Analysis on Nasal Airway Morphology in Class III Malocclusion (골격성 III급 부정교합자의 Nasal Airway 형태에 관한 3차원적 분석 연구)

  • Kim, Moon-Hwan;Lee, Jin-Woo;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.389-403
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    • 2008
  • In Angle's Class III malocclusion, which has higher incidence in Korean than Western, depressed midfacial profile with protruded lower lips and mandible may give rise to many functional, esthetic, psychological, social problems. Due to the different malocclusion incidence according to racial differences, many previous studies focused on the relationship between Class II malocclusion and nasal airway obstruction. Previous studies used lateral cephalography which has limitations of 2 dimensional image with projection error and identification error. Therefore, the purpose of this study was to analyze morphologic differences in the nasal airway between normal occlusion and Angle's Class III malocclusion patients using 3-dimensional facial computed tomography. Thirteen normal occlusion(7 men and 6 women) and sixteen skeletal Class III(7 men and 9 women) patients were selected and 3-dimensional facial computed tomography taking was performed. Comparison between two group in volume and sectional area of nasal airway were carried out. The results were followed. 1. In the comparison of absolute nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 2. In the comparison of relative nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 3. In the oropharyngeal space width on frontal and lateral view, the similar tendency was revealed between two groups. 4. In the lateral curvature of nasal airway, the similar tendency was revealed between two groups.

A Study on Prospective Plan Comparison using DVH-index in Tomotherapy Planning (토모 테라피 치료 시 선량 체적 히스토그램 표지자를 이용한 치료계획 비교에 관한 연구)

  • Kim, Joo-Ho;Cho, Jeong-Hee;Lee, Sang-Kyoo;Jeon, Byeong-Chul;Yoon, Jong-Won;Kim, Dong-Wook
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.113-122
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    • 2007
  • Purpose: We proposed the method using dose-volume Histogram index to compare prospective plan trials in tomotherapy planning optimization. Materials and Methods: For 3 patients in cranial region, thorax and abdominal region, we acquired computed tomography images with PQ 5000 in each case. Then we delineated target structure and normal organ contour with pinnacle Ver 7.6c, after transferred each data to tomotherapy planning system (hi-art system Ver 2.0), we optimized 3 plan trials in each case that used differ from beam width, pitch, importance. We analyzed 3 plan trials in each region with isodose distribution, dose-volume histogram and dose statistics. Also we verified 3 plan trials with specialized DVH-indexes that is dose homogeneity index in target organ, conformity index around target structure and dose gradient index in non-target structures. Results: We compared with the similarity of results that the one is decide the best plan trial using isodose distribution, dose volume histogram and dose statistics, and the another is using DVH-indexes. They all decided the same plan trial to better result in each case. Conclusion: In some of case, it was appeared a little difference of results that used to DVH-index for comparison of plan trial in tomotherapy by special goal in it. But because DVH-index represented both dose distribution in target structure and high dose risk about normal tissue, it will be reasonable method for comparison of many plan trials before the tomotherapy treatments.

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Accuracy Evaluation of Tumor Therapy during Respiratory Gated Radiation Therapy (호흡동조방사선 치료 시 종양 치료의 정확도 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chol-Soo;Kang, Se-Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.113-122
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    • 2010
  • Purpose: To evaluate the accuracy of a target position at static and dynamic state by using Dynamic phantom for the difference between tumor's actual movement during respiratory gated radiation therapy and skin movement measured by RPM (Real-time Position Management). Materials and Methods: It self-produced Dynamic phantom that moves two-dimensionally to measure a tumor moved by breath. After putting marker block on dynamic phantom, it analyzed the amplitude and status change depending on respiratory time setup in advance by using RPM. It places marker block on dynamic phantom based on this result, inserts Gafchromic EBT film into the target, and investigates 5 Gy respectively at static and dynamic state. And it scanned investigated Gafchromic EBT film and analyzed dose distribution by using automatic calculation. Results: As a result of an analysis of Gafchromic EBT film's radiation amount at static and dynamic state, it could be known that dose distribution involving 90% is distributed within margin of error of 3 mm. Conclusion: As a result of an analysis of dose distribution's change depending on patient's respiratory cycle during respiratory gated radiation therapy, it is expected that the treatment would be possible within recommended margin of error at ICRP 60.

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Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images

  • Paek, Seung Jae;Yoo, Ji Yong;Lee, Jang Won;Park, Won-Jong;Chee, Young Deok;Choi, Moon Gi;Choi, Eun Joo;Kwon, Kyung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.38.1-38.10
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    • 2016
  • Background: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. Methods: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program $Ondemand^{TM}$. Paired and independent t tests were performed for statistical analysis. Results: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-$ChLt^{\circ}$) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-$ChLt^{\circ}$) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm ($^{\circ}$) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li ($^{\circ}$) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. Conclusions: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.55-62
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    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images (사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Park, Hee-Chul;Ahn, Jong-Ho;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jin-Sung;Han, Young-Yih;Lim, Do-Hoon;Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.155-165
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    • 2010
  • Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

FEM Analysis of the Effects of Mouth guard material properties on the Head and Brain under Mandibular Impact (구강보호장치의 재료적인 특성이 하악골 충격 시악골 및 두부에 미치는 영향에 관한 유한요소분석)

  • Kang, Nam-Hyun;Kim, Hyung-Sub;Woo, Yi-Hyung;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.325-334
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    • 2008
  • Statement of problem & Purpose: The purpose of this study was to investigate the effect of a mouth guard material properties on the skull and brain when they were under impact loads on mandible. Material and methods: Two customized mouth protectors having different material propeerst ieach other were made for a female Korean who had no history of brain trauma, no cerebral diseases, nomal occlusion and natural dentition. The 3D finite element model of human skull and brain scanned by means of computed tomography was constructed. The FEM model of head was composed of 407,825 elements and 82,138 nodes, including skull, brain, maxilla, mandible, articular disc, teeth and mouth guard. The stress concentrations on maxillary teeth, maxilla and skull with two mouth guards were evaluated under oblique impact load of 800N onto mandibular 3 loading points for 0.1sec. And the brain relative displacement was compared in two different mouth guard materials under same condition. Result and Conclusion: The results were as follows; 1. In comparison of von Mises stress on maxillary teeth, a soft mouth guard material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 2. In comparison of von Mises stress on maxilla and skull, A soft mouth protector material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 3. For impact loads on mandible, there were more stress concentrated area on maxilla and skull with hard mouth guard than soft with mouth protector. 4. For impact loads on mandible, brain relative displacement had little relation with mouth guard material properties. In results of this study, soft mouth guard materials were superior to hard mouth guard materials for mandible impact loads for prevention of sports injuries. Although the results of this study were not enough to figure out the roles of needed mouth guard material properties for a human head, we got some knowledge of the pattern about stress concentration and distribution on maxilla and skull for impact loads with soft or hard mouth protector. More studies are needed to substantiate the relationship between the mouth guard materials and sports injuries.

A Novel in Vitro Method for the Metabolism Studies of Radiotracers Using Mouse Liver S9 Fraction (생쥐 간 S9 분획을 이용한 방사성추적자 대사물질의 새로운 체외 측정방법)

  • Ryu, Eun-Kyoung;Choe, Yearn-Seong;Kim, Dong-Hyun;Lee, Sang-Yoon;Choi, Yong;Lee, Kyung-Han;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.325-329
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    • 2004
  • Purpose: Usefulness of mouse liver S9 fraction was evaluated for the measurement of the metabolites in the in vitro metabolism study of $^{18}F$-labeled radiotracers. Materials and Methods: Mouse liver S9 fraction was isolated at au early step in the course of microsome preparation. The in vitro metabolism studies were tarried out by incubating a mixture containing the radiotracer, S9 fraction and NADPH at $37^{\ciirc}C$, and an aliquot of the mixture was analyzed at the indicated time points by radio-TLC. Metabolic defluorination was further confirmed by the incubation with calcium phosphate, a bone mimic. Results: The radiotracer $[^{18}F]1$ underwent metabolic defluorination within 15 min, which was consistent with the results of the in vivo method and the in vitro method using microsome. Radiotracer $[^{18}F]2$ was metabolized to three metabolites including $4-[^{18}F]fluorobenzoic$ acid within 60 min. It is likely that the one of these metabolites at the origin of radio-TLC was identical with the one that obtained from the in vivo and in vitro (microsome) method. Compared with the in vitro method using microsome, the method using S9 fraction gave a similar pattern of the metabolites but with a different ratio, which can be explained by the presence of cytosol in the S9 fraction. Conclusion: These results suggest that the findings of the in vitro metabolism studies using S9 fraction can reflect the in vivo metabolism of novel radiotracers in the liver. Moreover, this method can be used as a tool to determine metabolic defluorination along with calcium phosphate absorption method.