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The Prognostic Role of B-type Natriuretic Peptide in Acute Pulmonary Thromboembolism (급성 폐혈전색전증 환자에서 예후 인자로서 혈중 BNP의 의의)

  • Lee, Su Jin;Lee, Jae Hyung;Park, Ji Young;Jo, Woo Sung;Kim, Ji Eun;Kim, Ki Uk;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.540-547
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    • 2006
  • Background : Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism. Methods : Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared. Results : The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively. Conclusion : This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

Efficient Culture Method for Early Passage hESCs after Thawing (초기 계대 인간 배아줄기세포의 해동 후 효율적인 배양 방법)

  • Baek, Jin-Ah;Kim, Hee-Sun;Seol, Hye-Won;Seo, Jin;Jung, Ju-Won;Yoon, Bo-Ae;Park, Yong-Bin;Oh, Sun-Kyung;Ku, Seung-Yup;Kim, Seok-Hyun;Choi, Young-Min;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.4
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    • pp.311-319
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    • 2009
  • Objective: Human embryonic stem cells (hESCs) have the capacity to differentiate into all of the cell types and therefore hold promise for cell therapeutic applications. In order to utilize this important potential of hESCs, enhancement of currently used technologies for handling and manipulating the cells is required. The cryopreservation of hESC colonies was successfully performed using the vitrification and slow freezing-rapid thawing method. However, most of the hESC colonies were showed extremely spontaneous differentiation after freezing and thawing. In this study, we were performed to rapidly collect of early passage hESCs, which was thawed and had high rate of spontaneously differentiation of SNUhES11 cell line. Methods: Four days after plating, partially spontaneously differentiated parts of hESC colony were cut off using finely drawn-out dissecting pipette, which is mechanical separation method. Results: After separating of spontaneously differentiated cells, we observed that removed parts were recovered by undifferentiated cells. Furthermore, mechanical separation method was more efficient for hESCs expansion after thawing when we repeated this method. The recovery rate after removing differentiated parts of hESC colonies were 55.0%, 74.5%, and 71.1% when we have applied this method to three passages. Conclusion: Mechanical separation method is highly effective for rapidly collecting and large volumes of undifferentiated cells after thawing of cryopreserved early passage hESCs.

A Study on the Traditional Costumes and Tattoo of the Maori (마오리族 傳統 服飾과 文身 考察)

  • 황춘섭;정현주
    • The Research Journal of the Costume Culture
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    • v.3 no.2
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    • pp.241-260
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    • 1995
  • The Maori's traditional clothing materials, basic forms of dress, and the pattern and technique of tatoo were examined in the present study in order to deepen the appreciation of the cultural heritage of the Maori. The research method employed was the analysis of written materials. And a fild-trip was also made for the study. The study was limitted to the traditional culture of body adornment of the Maori including the clothing which is preserved and practicing by them at the present day, and the origin and the process of the historical development of those are not included in the scope of the present study. Followings are the results of the study: (1) By far the most widely used fiber for Maori clothing is abtained from what is commonly called New Zealand Flax. The fiber of kiekie(Freycinetia baueriana) and cabbage trees(Cordyline spp.) may also be used. The strong, long-lasting fiber of toi(cordyline indivisa) is used for a prestige warrior's cloak. Flat strips of ti kauka(Cordyline australi) are also used as thatch on rain cloaks. (2) Regardless of technique used, Maori weaving is always worked horizontally from left to right. Traditionally the work was suspended between two upright turuturu or weaving sticks. As the work progressed a second pair of uprights was used to keep the work off the ground. These uprights were moved forward as required. Because the weaver sat on the ground, the working edge was kept at a height that was comfortable to reach. No weaving tools are used, the wefts(aho) being manipulated by the fingers. The two main Maori weaving techniques are whatu aho patahi(single-pair twining) and whatu aho rua(double-pair twining). (3) The Maori wore two basic garments - a waist met and a cloak. The cloth of commoners were of plain manufacture, while those of people of rank were superior, sometimes being decorated with feather or dyed tags and decorated borders. Children ran more-or-less naked until puberty, being dressed only for special events. Some working dress consisted of nothing more than belts with leaves thrust under them. Chiefs and commoners usually went barefoot, using rough sandals on journeys over rough country (4) The adornment of men and women of rank was an important matter of tribal concern as it was in chiefly persons that prestige of the group was centred, The durable items of Maori persons adornment were either worn or carried. Ornaments of various kinds were draped about the neck or suspended from pierced earlobes. Combs decorated the head. Personal decorations not only enhanced the appearance of men and women, but many had protective magical function. The most evident personal ornament was the hei-tiki made of jade or other material. Maori weapons were treasured by their owners. They served on bottle and were also personal regalia. A man of rank was not fully dressed without a weapon in hand. Also weapons were essential to effective oratory. (5) No man or woman of rank went without some tattoo adornment except in extremely rare instances when a person was too sacred to have any blood shed. The untattooed were marked as beeing commoners of no social standing. This indelible mark of rank was begun, with appropriate rite and ritual, at puberty. And tattoo marked the person as being of a marriageable age. Maori tattoo was unlike most traditional tattoo in that its main line were 'engraved' on the face with deep cuts made by miniature bone chisels. The fill-in areas were not tattooed with cuts but with the multiple pricks of small bone 'combs' that only lightly penetrated the skin surface. The instrument of tattoo consisted of small pots of pumice or wood into which was placed a wetted black pigment made from burnt kauri gum, burnt vegetable caterpillars or other sooty materials. A bird bone chisel or comb set at right angles on a short wooden handle was dipped into the gigment, that a rod or stick was used to tap head of this miniature adze, causing penetration of the skin surface. Black pigment lodged under the skin took on a bluish tinge. A full made facial tattoo consisted of major spirals with smaller spirals on each side of the nose and sweeping curved lines radiating out from between the brows over the forehead and from the nose to the chin. The major patterns were cut deep, while the secondary koru patterns were lightly pricked into the skin.

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Evaluation of the Solitary Pulmonary Nodule by Spiral Computed Topography with Contrast Enhancement (고립성 폐결절의 감별에 있어서 나선형 흉부 전산화 단층촬영시 조영증강의 의의)

  • Song, Kwang Seon;Shin, Kye Chul;Yong, Suk Joong;Ryu, Jeong Seon;Kang, Sin Goo;Kim, Chong Ju;Sung, Ki Joon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.519-526
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    • 1996
  • Background : Clinical and Radiographic studies to differentiate benign from malignant pulmonary nodules have previously focused on clinical status and the morphologic and the computed tomographic attenuation characteristics of the lung nodules. Distinctive differences in the vascularity and pathophysiology of malignant versus benign pulmonary nodules were identified. We evaluated the diagnostic method for differentiating malignant from benign solitary pulmonary nodule by contrast enhancement on the spiral CT. Method : Sixteen patients with solitary pulmonary nodule were examined(Tuberculoma 8, primary lung cancer 8). Serial thin section on the spiral CT was performed before and after(45second, 2min, 5min) the onset of the injection of 100mL of nonionic contrast material(2mL/sec). Results : There was no difference in size of nodule and pre-contrast CT number (Hounsfield unit) between benign and malignant nodules. At forty-five second after the onset of the injection, malignant neoplasms($19.6{\pm}7.9$ HU) enhanced significantly more than tuberculomas($4.9{\pm}9.4$ HU, p=0.008). At 2minute and 5 minute after, malignant neoplasms($34.0{\pm}19.2$HU, $34.0{\pm}15.4$HU) enhanced significantly more than tuberculomas ($6.7{\pm}9.7$HU, p=0.007 and $7.7{\pm}11.5$HU, p=0.011). On cut-off value 20HU(contrast enhancement) 2minute after the injection of contrast media, sensitivity was 87% and specificity was 87%. No correlation between the contrast enhancement and size of the nodules was observed. Conclusion : Studies with the use of an intravenously administered noniodinated contrast medium in examining the enhancement properties of lung nodules was performed. The contrast enhancement was useful in differential diagnosis of solitary pulmonary nodules.

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Neutrophil Chemotactic Activity in Bronchoalveolar Lavage Fluid of the Rats Exposed to Hyperoxia (고농도의 산소에 노출시킨 쥐의 기관지폐포세척액내 호중구 화학주성활성화도)

  • Song, Jeong Sup;Lee, Sook Young;Moon, Wha Sik;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.547-557
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    • 1996
  • Background : An excessive accumulation of neutrophils in lung tissue has been known to play an important role in mediating the tissue injury among the adult respiratory distress syndrome, idiopathic pulmonary fibrosis and cystic fibrosis by releasing toxic oxygen radicals and proteolytic enzymes. Therefore, it is important to understand a possible mechanism of neutrophil accumulation in lung tissue. In many species, exposure to hyperoxic stimuli can cause changes of lung tissues very similar to human adult respiratory distress syndrome and neutrophils are also functioning as the main effector cells in hyperoxic lung injury. The purpose of the present study was to examine whether neutrophils function as a key effector cell and to study the nature of possible neutrophil chemotactic factors found in bronchoalveolar lavage fluid from the hyperoxia exposed rats. Methods : We exposed the rats to the more than 95% oxygen for 24, 48, 60 arid 72 hours and bronchoalveolar lavage(BAL) was performed. Neutrophil chemotactic activity was measured from the BAT- fluid of each experimental groups. We also evaluated the molecular weight of neutrophil chemotactic tractors using fast performance liquid chromatography and characterized the substances by dialyzer membrane and heat treatment. Results : 1) The neutrophil proportions in bronchoalveolar lavage fluid began to rise from 48 hours after oxygen exposure, and continued to be significantly increased with exposure times. 2) chemotactic index for neutrophils in lung lavages from rats exposed to hyperoxia was significantly higher in 48 hours group than in control group, and was significantly increased with exposure time. 3) No deaths occured until after 48 hours of exposure. However, mortality rates were increased to 33.3 % in 60 hours group and 81.3 % in 72 fours group. 4) Gel filtration using fast performance liquid chromatography disclosed two peaks of neutrophil chemotactic activity in molecular weight of 104,000 and 12,000 daltons. 5) Chemotactic indices of bronchoalveolar lavage fluid were significantly deceased when bronchoalveolar lavage fluid was treated with heat ($56^{\circ}C$ for 30 min or $100^{\circ}C$ for 10 min) or dialyzed (dialyzer membrane molecular weight cut off : 12,000 daltons). Conclusion : These results suggested that the generation of neutrophil chemotactic factor and subsequent neutrophil influx into the lungs are playing an important roles in hyperoxia-induced acute lung injury. Neutrophil chemotactic factor in the lung lavage fluids consisted of several distinct components having different molecular weight and different physical characteristics.

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Changes of Physicochemical Properties during Fermentation of Peach Wine and Quality Improvement by Ultrafiltration (복숭아주 발효시 이화학적 특성변화와 한외여과에 의한 품질 향상)

  • 정재호;목철균;임상빈;박영서
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.4
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    • pp.506-512
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    • 2003
  • Peach wine was fermented at $25^{\circ}C$ for 2 weeks using Saccharomyces cerevisiae KCCM 12224, aged at 15$^{\circ}C$ for 14 weeks, and its physicochemical and microbiological changes were investigated. The viable bacterial cell numbers, 1.4$\times$10$^3$ CFU/mL at the beginning of fermentation, increased to 2.8$\times$10$^{6}$ CFU/mL after 2 weeks, but decreased to 7.0$\times$10$^3$ CFU/mL after 14 weeks. The viable yeast cell numbers were changed from 3.4$\times$10$^2$ CFU/mL to 2.4$\times$10$^{7}$ CFU/mL during fermentation, and decreased to 4.0$\times$10$^4$ CFU/mL after aging. Turbidity total sugar content, reducing sugar content, solid content and b value of peach wine decreased during fermentation but acidity, alcohol content, L and a value increased. Most physicochemical properties except alcohol content and reducing sugar content were not changed significantly during aging. When peach wine was filtered through 0.45 ${\mu}{\textrm}{m}$ nitrocellulose membrane followed by various ultrafiltration membranes with different molecular weight cut-off values, Biomax 100K membrane, with 79 liter/$m^2$/h (LMH) of initial flux, was suitable for ultrafiltration process of peach wine. These membrane filtration treatments resulted in complete removal of microorganisms and decrease in turbidity and alcohol content without changes in other chemical properties. The physicochemical properties of peach wine were not changed and any microorganisms were not found during the storage at 3$0^{\circ}C$ for 12 Weeks.

An Approach for Enhancing Current Korean e-Grocery Business Focusing on Delivery Service Alternatives (한국의 e-Grocery 배송서비스 대안에 관한 연구)

  • Koo, Jong-Soon;Lee, Jung-Sun;Jeon, Dong-Hwa
    • International Commerce and Information Review
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    • v.13 no.3
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    • pp.169-201
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    • 2011
  • There was a new wave in grocery business with development of information and technology, thus a movement from traditional stores to online stores, In order to expand the scale of traditional supermarket and to satisfy the customers' needs, they provide offline and online services simultaneously. This paper is based on the previous studies which had been researched in developed countries from late 1990s to early 2000s and the purpose of this study is to introduce the idea and operation system of e-Grocery business. Moreover, we suggest the alternatives on delivery service methods in order to satisfy the customers' needs through analyzing the current condition of e-Grocers in Korea. According to the result of this study, Korean e-Grocers offer only attended home delivery services. In our opinion, Korean supermarkets have to take hybrid model which Tesco.com is using. There are some alternatives to increase the profits of Korean e-Grocers and to provide better services to their customers as follows: As an alternatives for delivery services, picking service is the easiest and cheapest way to apply for supermarkets. This is very useful for working women and also it is possible to order by smartphone recently. They can order the goods to the closest local supermarkets from working place, and then they pick them up on the way home from working off. In order to improve the quality of delivery services, to use the reception box will be the way to provide better services to the customers. The reception box is a way to protect the quality of goods such as fresh-cut product, which require the freshness through the temperature adjustment, and also to keep the safety of ordered goods through locking system Through this system, supermarkets are able to use attended or unattended services under the customers' satisfaction. However, using the reception box is expensive, so shared reception box will be an alternative. As an alternative for development of e-Grocery business, the advertisement for e-Grocery business has to be supported in order to attract potential customers in e-Grocery business. Furthermore, the main concerns of e-Grocery business such as the sanitation and safety of goods, and convenience must be guaranteed in order to keep the loyal customers and to attract new customers.

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Discussion on the Strategic Priorities and Navy's Coping in the Interwar Period Britain, 1919?1939 (「전간기 영국의 전략 우선순위 논의와 영국해군의 대응, 1919-1939」)

  • Jeon, Yoon-Jae
    • Strategy21
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    • s.32
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    • pp.123-159
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    • 2013
  • The purpose of this research paper is to re-valuate the factors that affected the Royal Navy's rearmament and preparation for war by conducting analysis on the discussion held in the Britain on the strategic priorities and Navy's coping measures adopted during the interwar period. After the end of the WWI, each of the military arms of the Britain faced significant difficulty in securing budget and increasing their military power all throughout the interwar period, and the Navy was not an exception. The WWII that got started on September 1939 was the turning point in which this difficulty led to full-fledged crisis. Immensely many criticisms followed after the war and problems were identified when it comes to the Royal Navy's performance during the war. This type of effort to identify problem led to the attempt to analyze whether Royal Navy's preparation for war and rearmament policy during interwar period were adequate, and to identify the root causes of failure. Existing studies sought to find the root cause of failed rearmament from external factors such as the deterioration of the Britain itself or pressure from the Treasury Department to cut the budget for national defense, or sought to detect problems from the development of wrong strategies by the Navy. However, Royal Navy's failed preparation for the war during interwar period is not the result of one or two separate factors. Instead, it resulted due to the diverse factors and situations that the Britain was facing at the time, and due to intricate and complex interaction of these factors. Meanwhile, this research paper focused on the context characterized by 'strategic selection and setting up of priorities' among the various factors to conduct analysis on the Navy's rearmament by linking it with the discussion held at the time on setting up strategic priorities, and sought to demonstrate that the Navy Department's inadequate counter-measures developed during this process waned Royal Navy's position. After the end of WWI, each of the military arms continued to compete for the limited resources and budget all throughout the interwar period, and this type of competition amidst the situation in which the economic situation of Britain was still unstable, made prioritization when it comes to the allocation of resources and setting up of the priorities when it comes to the military power build-up, inevitable. Amidst this situation, the RAF was able to secure resources first and foremost, encouraged by the conviction of some politicians who were affected by the 'theory of aerial threat' and who believed that curtailing potential attack with the Air Force would be means to secure national security at comparatively lower cost. In response, Navy successfully defended the need for the existence of Navy despite the advancement of the aerial power, by emphasizing that the Britain's livelihood depends on trade and on the maintenance of maritime traffic. Despite this counter-measuring logic, however, Navy's role was still limited to the defense of overseas territory and to the fleet run-off instead of sea traffic route production when it comes to the specific power build-up plan, and did not understand the situation in which financial and economic factors gained greater importance when it comes to the setting up of strategic priorities. As a result, Navy's plan to build its powers was met with continual resistance of the Treasury Department, and lost the opportunity to re-gain the status of 'senior service' that it had enjoyed in the past during the competition for strategic prioritization. Given that the strategic and economic situation that Korea faces today is not very different from that of the Britain during the interwar period, our Navy too should leverage the lessons learned from the Royal Navy to make the effort to secure viable position when it comes to the setting of priorities in case of national defense strategy by presenting the basis on why maritime coping should be prioritized among the numerous other threats, and by developing the measures for securing the powers needed effectively amidst the limited resources.

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Tibial Torsion in Children of the Jeju Area (제주지역 소아의 경골 염전)

  • Song, Dong Ho;Eun, Baik-Lin;Park, Sang Hee;Lee, Joon Young;Tockgo, Young Chang
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.75-80
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    • 2005
  • Purpose : Internal tibial torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Internal tibial torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The purpose of this study is to measure the tibial torsion in children of the Jeju area. Methods : Tibial torsion was measured in 1,042 lower extremities of 521 children from one to 12 years of age. The values of transmalleolar angles were analyzed for each age group divided by 6 months. Quadratic and linear regression models were used to fit patterns of changes in mean values of transmalleolar angles. The age at seven, which provides the highest coefficient of determination for quadratic regression analysis, was used as a cut-off point to fit different statistical models. Results : The mean transmalleolar angle was $0.10{\pm}5.79^{\circ}$ in all children,$ 0.90{\pm}5.49^{\circ}$ in males, and $-0.80{\pm}5.97^{\circ}$ in females. The value was $4.25{\pm}4.04$ in 1 year of age, gradually decreased to the lowest level of $-1.98^{\circ}$ in four years and seven months of age, increased again with age until it reached $0.67{\pm}1.10^{\circ}$ at seven years of age, and stayed at that level thereafter. Conclusion : Internal tibial torsion in infancy is known to correct spontaneously in the normal developing process. But in this study, the mean transmalleolar angle in children of Jeju area annually decreased after one year of age; to the lowest angle at four years and seven months of age; increased again gradually to the age of seven; and persisted in that level, about $10^{\circ}$ less than western children, not correcting further thereafter. These findings suggest tibial torsion might be caused by lifestyle, especially sitting on feet. To prevent abnormalities of joints and gaits, early diagnosis of tibial torsion in childhood and posture correction or early treatment when needed, seems to be necessary.

Differentiation of Recurrent Rectal Cancer and Postoperative Fibrosis: Preliminary Report by Proton MR Spectroscopy (재발성 직장암과 수술 후 섬유화의 감별 진단: 수소 MRS에 의한 예비보고)

  • Jeon Yong Sun;Cho Soon Gu;Choi Sun Keun;Kim Won Hong;Kim Mi Young;Suh Chang Hae
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.24-31
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    • 2004
  • Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

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