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Usefulness of Low Dose Oral Contrast Media in $^{18}F-FDG$ PET/CT ($^{18}F-FDG$ PET/CT에서 저용량 경구용 조영제의 유용성)

  • An Young-Sil;Yoon Joon-Kee;Hong Seon Pyo;Joh Chul-Woo;Yoon Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.257-262
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    • 2006
  • Purpose: The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in $^{18}F-FDG$ PET/CT. Materials and Methods: We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oval contrast agent (barium sulfate) was administered immediately before injection of $^{18}F-FDG$. The FDG uptake of intestines was analyzed by visual and semi- quantitative method on transaxial, coronal and saggital planes. Results: Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (15%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n=27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. Conclusion: We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image.

Spatial Distribution and Dynamics of Vegetation on a Gravel Bar: Case Study in the Bangtae Stream (자갈 하중주에서 식생의 공간 분포 및 동태: 방태천의 사례)

  • Pee, Jung-Hun;Kim, Hye-Soo;Kim, Gyung-Soon;Oh, Woo-Seok;Koo, Bon-Yoel;Lee, Chang-Seok
    • Korean Journal of Ecology and Environment
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    • v.46 no.2
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    • pp.215-224
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    • 2013
  • We clarified the background for establishment of vegetation by comparing the spatial distribution maps of vegetation and substrate on a gravel bar in the Bangtae stream located on Inje-gun of Gangwon-do, the central eastern Korea. The total vegetation coverage was higher in the interior and lower in the marginal parts of the gravel bar. Spatial distribution of vegetation on the longitudinal section of the gravel bar tended to be arranged in the order of shrub, subtree, and tree dominated vegetation types from the front (upstream) toward the rear (downstream) parts. Coverage of the herbaceous plants was higher in the central and rear parts and lower in the front and right parts of the gravel bar. Vegetation height was higher in the rear part and became lowered as move toward the front part. Substrate was distributed in the order of boulder, gravel, sand, and boulder from the front toward the rear parts. Ordination of stands based on vegetation data was arranged in the order of annual plant, perennial herb, shrub, and tree dominated vegetation as move from the right to the left parts on the axis I. Species richness was higher in the order of Pinus densiflora community, Phragmites japonica community, Salix gracilistyla community, Fraxinus rhynchophylla community, annual plant dominated vegetation, and Prunus padus for. padus community based on the species rank-abundance curve. The order based on the Shannon's index was some different; diversity of Phragmites japonica community and Salix gracilistyla community, which showed higher dominance degree, were low differently from species richness. In conclusion, it was evaluated that the gravel bar newly established toward the upstream and vegetation dynamics of the gravel bar seemed to follow ecosystem mechanisms of succession. As were shown in the above results, the Bangtae stream corresponded to the upstream and thereby particle size of substrate was big. Therefore, they move by rolling and are accumulated for the upstream. Vegetation types were arranged in the order of woodland, shrub-land and grassland from the rear toward the front parts of the gravel bar and thereby reflected the formation process of the bar. However, the gravel bar is disturbed frequently by not only the running water but also the suspended sand as the dynamic space. Such disturbances cause habitat diversity and consequently led to high biodiversity.

Lahar flow simulation using Laharz_py program: Application for the Mt. Halla volcano, Jeju, Korea (Laharz_py 프로그램을 이용한 라하르 수치모의: 한라산 화산체에 적용)

  • Yun, Sung-Hyo;Chang, Cheolwoo
    • The Journal of the Petrological Society of Korea
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    • v.25 no.4
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    • pp.361-372
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    • 2016
  • Lahar, one of catastrophic events, has the potential to cause the loss of life and damage to infrastructure over inhabited areas. This study using Laharz_py program, was performed schematic prediction on the impact area of lahar hazards at the Mt. Halla volcano, Jeju island. In order to comprehensively address the impact of lahar for the Mt. Halla, two distinct parameters, H/L ratio and lahar volume, were selected to influence variable for Laharz_py simulation. It was carried out on the basis of numerical simulation by estimating a possible lahar volumes of 30,000, 50,000, 70,000, 100,000, 300,000, $500,000m^3$ according to H/L ratios (0.20, 0.22 and 0.25) was applied. Based on the numerical simulations, the area of the proximal hazard zone boundary is gradually decreased with increasing H/L ratio. The number of streams which affected by lahar tended to decrease with increasing H/L ratio. In the case of H/L ratio 0.20, three streams (Gwangryeong stream, Dogeun stream, Han stream) in the Jeju-si area and six streams (Gungsan stream, Hogeun stream, Seohong stream, Donghong stream, Bomok stream, Yeong stream-Hyodon stream) in the Seogwipo-si area are affected. In the case of H/L ratio 0.22, two streams (Gwangryeong stream and Han stream) in the Jeju-si area and five streams (Gungsan stream, Seohong stream, Donghong stream, Bomok stream, Yeong stream-Hyodon stream) in the Seogwipo-si area are affected. And in the case of H/L ratio 0.25, two streams (Gwangryeong stream and Han stream) in the Jeju-si area and one stream (Yeong stream-Hyodon stream) in the Seogwipo-si area are affected. The results of this study will be used as basic data to create a risk map for the direct damage that can be caused due to volcanic hazards arising from Mt. Halla.

A Study on the Medical Costs on Last Admission in Terminal Cancer Inpatients for Hospice Care (호스피스 케어를 위해 입원한 말기 암 환자의 사망직전 의료비용 실태 조사)

  • Yoo, Sang-Yeon;Lee, Hye-Ree;Lee, Yong-Je;Ahn, Mi-Hong;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.146-154
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    • 2002
  • Purpose : Death due to cancer has been continuously increasing, therefore cancer is the first in the cause of death now. A national policy for the elevation of medical costs in cancer patients is necessary, therefore, we searched for the medical costs and its related factors in terminal cancer patients for the effective reduction of the medical costs. Methods : We reviewed the medical records of 259 hospitalized terminal cancer patients who had died during the period of July 1, 2000 to June 30, 2002. History of cancer included type of cancer, type of past treatment, existence of metastasis. Clinical manifestation was examined and medical costs on last admission was categorized based on the account of charges of the department of patient affair on the last hospitalization. For analysis of factors related with medical costs, ANOVA was used. Results : Of the 259 patients, the number of male was 135 cases (52.1%), and the female, 124 cases (47.9%). The most frequent type of cancer was stomach (21.9%) cancer. Of the clinical manifestation, anorexia (87.6%) was the most frequent manifestation. Total medical costs was 740,628,045won, the mean costs was $285,968{\pm}3,070,272won$. The frequent category of medical costs was injection (32.0%), medical accommodation (27.9%), examination (14.0%), in order. The only factor related with mean medical costs was pain (P<0.05). Conclusion : If unnecessary injection of opioid analgesics is reduced, hospice care at home is activated and excessive examination is reduced In terminal cancer inpatients, it will be possible to reduce the medical costs in terminal cancer patients more effectively.

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Study of Kidney Toxicity of Azadirachta Indica Extract for Oral Administration in Rats (님추출물의 경구투여에 따른 랫드의 신장독성 연구)

  • Yoon, Hyunjoo;Choe, Miseon;Cho, Hyeon-Jo;Han, Beom Seok;Park, Kyung-Hun;Oh, Jin-Ah;Cho, Namjun;Paik, Min-Kyoung
    • Korean Journal of Environmental Agriculture
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    • v.33 no.2
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    • pp.103-110
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    • 2014
  • BACKGROUND: Azadirachta indica has been widely used as environment-friendly organic materials because of its insecticidal properties. This study was carried out to investigate the acute toxicity and the subacute toxicity of Azadirachta indica extract(AIE) in rats. METHODS AND RESULTS: For the oral acute toxicity test, Sprague-Dawley rats were gavaged with 2.0 g/Kg bw of AIE. The $LD_{50}$ value was greater than 2.0 g/Kg bw for both male and female rats. For the subacute toxicity study, rats were treated with AIE at doses of 0.5, 1.0, 2.0 mg/Kg bw once a day for 4 weeks(n=10 animals per each group). There were no significant changes in body weight, food intake and water consumption observed during the experimental duration. In addition, no difference of relative kidney weight was observed among all treated groups. Serum creatinine level in the AIE 2.0 g/Kg group increased significantly compared with that of control group in male rats, but serum blood urea nitrogen was significantly decreased in a dose-dependent manner (p<0.05). Significant increase of serum cholesterol levels were observed in all AIE groups, compared with the control group, in the female rats (p<0.05). However, histopathological examination of the kidney did not reveal any significant lesions in all groups. CONCLUSION: On the basis of results, it could be concluded that oral administration AIE didn't cause any toxic response in kidney, except the increased serum cholesterol.

Hemophagocytic Syndrome Presenting as Severe Acute Hepatitis (중증 급성 간염으로 발현한 혈구탐식증후군에 관한 연구)

  • Ryu, Jeong Min;Chang, Soo Hee;Kim, Joon Sung;Lee, Joo Hoon;Lee, Mi Jeong;Park, Kie Young;Kim, Kyung Mo;Seo, Jong Jin;Moon, Hyung Nam;Ghim, Thad;Chi, Hyun Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.213-221
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    • 2005
  • Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.

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Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center (2005-2008년 단일 기관의 소아 혈액 종양 환자에서의 균혈증 양상: 소아 혈액 종양 환자에서의 균혈증)

  • Kim, Ji Hye;Kim, Hyung Jin;Lim, Yeon Jung;Lee, Young Ho;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.36-48
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    • 2010
  • Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

Orbital and Periorbital Cellulitis in Children: A Recent 7-Year Clinical Review (소아에서 안와와 안와주위 봉와직염에 관한 최근 7년간의 임상적 고찰)

  • Choi, Jeong Ho;Hon, Sun Yeong;Park, Sung Sin;Cha, Sung Ho;Kim, Eun Jin;Lee, Jin;Chang, Jin Keun
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.36-44
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    • 2008
  • Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

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An Epidemiological Study on the Accidental Mortality in Various Industries in Busan Area (부산지역 산업인구의 사고사에 관한 역학적인 조사연구)

  • Chung, Young-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.10 no.1
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    • pp.166-175
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    • 1977
  • The author have performed an epidemiological study on the accidental deaths at industry from 1970 to 1975, in order to seek for the preventive measures of industrial accident with the under-standing of its cause and characteristics of the accidental deaths. The obtained results were as follows; 1. Total number of deaths for 6 years were 361 (350 males, 11 females). and the mean death rate was 33.8 per 100,000 industrial workers during 6 years. By the highest as 52.9 was in 1974 and the lowest as 13.7 in 1970. By the industry group, the death rate of Electricity, Gas and Water was 149.3, Construction 83.9 and the lowest was Manufacturing as 18.3. 2. Standardized mortality rate of the cases by the age group showed that 20-29 years old group was 43.0, 40-49 years old group 38.1, 30-39 years old group 32.0, and the lowest as 17.9 was under 19 years old group. 3. The cumulative percentage of the cases by years of service showed that under 6 months was 60.4%, under 1 year 72.9%, under 2 years 83.1%. 4. By the month of occurrence, the highest was 15.8% which occurred in August and the lowest was 5.8% in February. The highest as 19.1% was on Friday and the lowest as 11.9% on Monday by the day of a week. 5. By the causes of accident, car accidents was 28.3%, fall accidents 19.1%, accidents by a crash 9.1% in that order. By the location of injury, head was 44.6%, multiple injuries 33.0%, chest 10.5%, and back was the lowest as 1.9%. The distribution of the cases by nature of injury shelved that cerebral contusion and hemorrhage was 39.4%, fracture and dislocation 33.2%, asphyxia 8.0% in that order. 6. The cumulative percentage of the cases by the duration from injury to death showed that the injuried day was 74.2%, within 3 days after injury 88.5%, within 7 days 96.1%. Therefore most of the cases were occurred within 7 days after injury. 7. Byythe daily mean wages, most of the cases as 91.7% were under 2,000 won, and more 4,000 won was 1.6% merely.

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Valve Replacement in Children (소아심장판막치환술)

  • 김재현;이광숙;윤경찬;유영선;박창권;최세영
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.341-346
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    • 1999
  • Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

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