• Title/Summary/Keyword: Deterioration diagnostic

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The Diagnostic Role of HRCT in Simple Pneumoconiosis (단순진폐증에 대한 흉부 고해상 전산화 단층촬영의 진단적 의의)

  • Kim, Kyoung-Ah;Kim, Hi-Hong;Chang, Hwang-Sin;Ahn, Hyeong-Sook;Lim, Young;Yun, Im-Goung
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.471-482
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    • 1996
  • Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending eve, two o, more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiogrphy in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in $FEV_1,\;FEV_1/FVC$, PEFR, $FEF_{25},\;FEF_{50},\;and\;FEF_{75}$ and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.

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Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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The Diagnosis and Treatment of Osteoporosis (골다공증의 진단과 치료)

  • Moon, Jun-Sung;Won, Kyu-Chang
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.19-30
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    • 2008
  • Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.

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Exclusive correlation analysis for algae and environmental factors in weirs of four major rivers in South Korea (4대강 주요지점에서의 조류 발생인자의 배타적 상관성분석에 대한 연구)

  • Lee, Eun Hyung;Kim, Yeonhwa;Kim, Kyunghyun;Kim, Sanghyun
    • Journal of Korea Water Resources Association
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    • v.49 no.2
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    • pp.155-164
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    • 2016
  • Algal blooms not only destroy fish habitats but also diminish biological diversity of ecosystem which results into water quality deterioration of 4 major rivers in South Korea. The relationship between algal bloom and environmental factors had been analyzed through the cross-correlation function between concentration of chlorophyll a and other environmental factors. However, time series of cross-correlations can be affected by the stochastic structure such auto-correlated feature of other controllers. In order to remove external effect in the correlation analysis, the pre-whitening procedure was implemented into the cross correlation analysis. The modeling process is consisted of a series of procedure (e.g., model identification, parameter estimation, and diagnostic checking of selected models). This study provides the exclusive correlation relationship between algae concentration and other environmental factors. The difference between the conventional correlation using raw data and that of pre-whitened series was discussed. The process implemented in this paper is useful not only to identify exclusive environmental variables to model Chl-a concentration but also in further extensive application to configure causality in the environment.

The Evaluation of Dose Reduction and Quality of Images According to 80 kVp of Scan Mode Change in Pediatric Chest CT (소아 흉부 CT 검사에서 관전압 80 kVp 조건으로 스캔 모드별 방사선량 감소와 화질 평가)

  • Kim, Gu;Kim, Gyeong-Rip;Lee, Eun-Sook;Cho, Hee-Jung;Sung, Soon-Ki;Moon, Seul-ji-a;Kwak, Jong-Hyeok
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.284-292
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    • 2019
  • To evaluate the usefulness of pediatric chest CT scans by comparing the dose, examination time, and image quality by applying Helical mode, High-pitch mode, and Volume Axial mode to minimize the radiation exposure and obtain high diagnostic value. Revolution (GE Healthcare, Wisconsin USA) was used to divide PBU-70 phantom into Helical mode, High-pitch mode, and Volume Axial mode. After acquiring images, ROI is set for each image, heart, bone, lung, and back-ground air, and the average value is obtained by measuring CT number (HU) and noise (SD). SNR and CNR were measured and compared with DLP values provided directly by the equipment. Determining statistical significance Statistical analysis was performed using ONE-WAY-ANAOVA using SPSS 21.0. In this experiment, it was possible to inspect at a short time without deterioration of image quality with the lowest dose when using volume axial mode. Although the detector coverage of 16 cm is limited to all pediatric chest CT scans, it is recommended to be actively used in pediatric patients, and further study is needed to apply other test sites in volume axial mode.

Elderly Sarcopenia and Vitamin B Deficiency: A Relationship? (비타민 B 결핍에 의한 노인성 근감소증)

  • Kisang Kwon;Hye-Jeong Jang;Sun-Nyoung Yu;Soon-Cheol Ahn;O-Yu Kwon
    • Journal of Life Science
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    • v.33 no.7
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    • pp.574-585
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    • 2023
  • Sarcopenia is a leading cause of increased medical and nursing care costs among the elderly. In Korea, preventive measures for sarcopenia are mostly targeted toward the general elderly population without specific diseases. However, it is also necessary to implement measures for elderly individuals living in nursing homes and hospitals, where the prevalence of sarcopenia is high. Currently, computed tomography and/or magnetic resonance imaging are considered standard diagnostic tools. However, their complexity and time-consuming nature make them unsuitable for clinical use. The exact pathophysiological mechanisms of sarcopenia are unclear, as they involve various molecular biological pathways, including decreased exercise, protein and nutrient intake, changes in testosterone and growth hormone, and inflammation. Sarcopenia symptoms can lead to several diseases, such as osteoporosis, fractures, dementia, diabetes, and cardiovascular disease. Vitamin B deficiency is a significant factor in sarcopenia induction, with B vitamins being directly involved in energy and protein metabolism and nerve function. Vitamin B deficiency can lead to neuromuscular and neurogenic disorders, which often overlap with sarcopenia. Suboptimal intake of B vitamins, malabsorption, and anorexia are common among the elderly. This study aims to provide information on the role of water-soluble B vitamins in preventing and controlling muscle mass loss and deterioration among the elderly with sarcopenia. In addition, we discuss the potential of myokines from the B vitamin family in modulating sarcopenia.

Detection of Brain Metastatses Using Limited Brain MR Imaging : Usefulness of Limited Contrast-Enhanced MR Imaging in Brain Metastasis (뇌전이암 진단을 위한 제한적 뇌 자기공명영상의 유용성에 관한 연구)

  • Kwon, Sun Jung;Lee, Yun Sun;An, Jin Yong;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Jin Hwan;Song, Chang Joon;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.499-505
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    • 2003
  • Background : The brain is a common site of a metastasis in lung cancer patients. If left untreated, the patients succumb to progressive neurological deterioration with a lower survival rate than with other metastases sites. Contrast-enhanced MR imaging in the absence of symptoms or clinical signs is not recommended for identifying a cerebral metastasis in lung cancer patients because of management effectiveness. This pilot study was performed to estimate whether or not limited brain MR imaging, which has a lower cost, could be used to replace conventional brain MR imaging. Method : Between April 1999 and March 2001, 43 patients with a primary lung cancer and the others (breast cancer, stomach cancer, colon cancer, malignant melanoma etc), who had neurological symptoms and signs, were examined using conventional brain MR imaging to examine brain metastases. The control group involved four patients who had no evidence of brain metastases the sensitivity, specificity and correlation of limited brain MR imaging were compared with conventional brain MR imaging. Results : All the 43 patients who were examined with conventional brain MR imaging showed evidence of brain metastases, whereas limited brain MR imaging indicated that 42 patients had brain metastases(sensitivity=97.67%). One patient in whom limited brain MR imaging showed no brain metastasis had a metastasis in the cerebellum, as shown by the contrast-enhanced T1 weighted axial view using conventional brain MR imaging. The conventional brain MR imaging and the limited brain MI imaging of the 4 control patients both indicated no brain metastases (specificity=100 %). The Pearson Correlation of the two groups was 0.884(Confidence Interval : 99%) observed. Conclusion : Limited brain MR imaging can detect a brain metastasis with the same accuracy. In addition, it is cost-effective (229,000 won, 180$) compared to conventional brain MR imaging(529,000 won, 480$) when patients had neurological symptoms and signs or staging.

Reduction of Injection Dose in 18F-FDG Fusion PET (PET-CT 검사에서 18F-FDG 투여량 감소에 대한 고찰)

  • Kim, Jong-Pil;Kim, Jae-Il;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.17-21
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    • 2014
  • Purpose With the recent rise of social issue regarding radiation exposure, attention to medical radiation use has been placed under a great spotlight. During PET-CT examination, generally about 40% more of $^{18}F$-FDG is used than EANM recommendation. While maintaining the diagnostic test result, we hope to find optimal injection dose to minimize the $^{18}F$-FDG in patients by utilizing the latest PET-CT scanner which is equiped with the newest technology. Materials and Methods During this experiment, the Biograph Truepoint 40 (siemens, USA) installed in 2007 and mCT 64 (siemens, USA) installed in 2011 were used and evaluated NECR (noise-equivalent counting rate) by using a scatter phantom. For the image quality evaluation of each scanner, we injected 3.7, 4.44 and 5.18 MBq/kg of $^{18}F$-FDG in NEMA IEC Body Phantom and also evaluated SNR between two scanners by using the data acquired at 60, 70, 80, 90, 100, 110 and 120 sec per bed. For the clinical evaluation, actual data of patients who were injected $^{18}F$-FDG 3.7, 4.44, 5.18 MBq/kg were used to compare SNR and draw a final result. Results As a result, mCT 64 peak NECR value was 1.65e+005, which is 10% higher than Turepoint 40. SNR values using the IEC body phantom was 17.9%, 17.4% and 17.1% higher in $^{18}F$-FDG 3.7 MBq/kg, 4.44 MBq/kg and 5.18 MBq/kg. In clinical patients, SNR values of the image mCT 64 was 16.5, which is 25% higher than Turepoint 40 scanner. Conclusion To draw a conclusion from the test result of this experiment, the same quality of SNR could be attained even with 10% reduced injection dose, if when the duration is extended by 10 sec/bed. This optimal result was possible due to enhanced equipment. The NECR (one of the equipment's performance assessment criteria for the scanner) increased by 10% and the SNR (one of the image quality assessment criteria) also increased by 17.5%. Therefore, we can expect to reduce the injection dose without deterioration of image quality. In consequence, it will also help to decrease the patient's anxiety of the radiation exposure.

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The Role of T1-201 Brain SPECT in the Differentiating Recurrent Tumor from Radiation Necrosis (뇌종양의 재발과 방사선 괴사의 감별을 위한 탈륨 SPECT의 역할)

  • Won, Kyoung-Sook;Ryu, Jin-Sook;Moon, Dae-Hyuk;Yang, Seoung-Oh;Lee, Hee-Kyung;Lee, Jung-Kyo;Kwun, Byung-Duk
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.476-483
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    • 1996
  • Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging rrere calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.

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