• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.285-291
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• 2008

Purpose: Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. Materials and Methods: In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F = 28:27) of low-likelihood for coronary artery disease were enrolled and $^{201}TI$ rest/$^{99m}Tc$-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. $^{201}TI$ rest/$^{99m}Tc$-MIBI stress / $^{201}TI$ 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, $Q_{delay}$ (perfusion measurement), ${\Delta}_{delay}$ ($Q_{delay}$ - m) and $Z_{delay}$ (($Q_{delay}$ - m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Results: Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was $51.8{\pm}6.5$ and the highest segmental perfusion was $87.0{\pm}5.9$, and they are $58.7{\pm}8.1$ and $87.3{\pm}6.0$, respectively in women. In the viability assessment $Q_{delay}$ showed AUC of 0.633, while those for ${\Delta}_{delay}$ and $Z_{delay}$ were 0.735 and 0.716, respectively. The AUCs of ${\Delta}_{delay}$ and $Z_{delay}$ were significantly higher than that of $Q_{delay}$ (p = 0.001 and 0.018, respectively). The diagnostic performance of ${\Delta}_{delay}$, which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. Conclusion: On automatic quantification of myocardial perfusion SPECT, the normal variation of perfusion measurements were considerable among segments. In the viability assessment, the parameters considering normal variation showed better diagnostic performance than the direct perfusion measurement. This study suggests that consideration of normal variation is important in the analysis of measurements on quantitative myocardial perfusion SPECT.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.611-621
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• 2001

Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

• Journal of the Korean Society of Radiology
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• v.5 no.2
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• pp.93-96
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• 2011

Currently, the development of direct conversion radiation detector using photoconductor materials is progressing in widely. Among of theses photoconductor materials, mercuric iodide compound than amorphous selenium has excellent absorption and sensitivity of high energy radiation. Also, the detection efficiency of signal generated in photoconductor film varies by electric filed and geometric distribution according to top-bottom electrode size. Therefore, in this work, the x-ray detection characteristics are investigated about the size of top electrode in $HgI_2$ photoconductor film. For sample fabrication, to solve the problem that is difficult to make a large area film, we used the spatial paste screen-print method. And the sample thickness is $150{\mu}m$ and an film area size is $3cm{\times}3cm$ on ITO-coated glass substrate. ITO(Indium-Tin-Oxide) electrode was used as top electrode using a magnetron sputtering system and each area is $3cm{\times}3cm$, $2cm{\times}2cm$ and $1cm{\times}1cm$. From experimental measurement, the dark current, sensitivity and SNR of the $HgI_2$ film are obtained from I-V test. From the experimental results, it shows that the sensitivity increases in accordance with the area of the electrode but the SNR is decreased because of the high dark current. Therefore, the optimized size of electrode is importance for the development of photoconductor based x-ray imaging detector.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.548-559
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• 1996

A series of performance measurements of positron emission tomography (PET) were performed following the recommendations of the Computer and Instrumentation Council of the Society of Nuclear Medicine and the National Electrical Manufacturers Association. We investigated the performance of the General Electric $Advance^{TM}$ PET. The measurements include the basic intrinsic tests of spatial resolution, scatter fraction, sensitivity, and count rate losses and randoms. They also include the tests of the accuracy of corrections: count rate linearity correction, uniformity correction, scatter correction and attenuation correction. GE $Advance^{TM}$ PET has bismuth germanate oxide crystals (4.0mm transaxial ${\times}$ 8.1mm axial ${\times}$ 30.0mm radial) in 18 rings, which form 35 imaging planes spaced by 4.25mm. The system has retractable tungsten septa 1mm thick and 12cm long. Transaxial resolution was 4.92mm FWHM in 2D and 5.14mm FWHM in 3D at the center. Average axial resolution in 2D decreased from 3.91mm FWHM at the center to 6.49mm FWHM at R=20cm. Average scatter fraction of direct and cross slices was 9.57%. Dead-time losses of 50% corresponded to a radioactivity concentration of $4.86{\mu}Ci/cc$ and a true count rate of 519 kcps in 2D. The accuracy of count rate linearity correction was 1.84% at the activity of $4.50{\mu}Ci/cc$. Non-uniformity was 2.06% in 2D and 2.93% in 3D. Remnant errors after scatter correction were 0.55% in 2D and 4.12% in 3D. The errors of attenuation correction were 6.21% (air), 0.20% (water), -6.32% (teflon) in 2D and 5.00% (air), 6.94% (water), 3.01% (teflon) in 3D. The results indicate the performance of GE $Advance^{TM}$ PET scanner to be well suited for clinical and research applications.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.337-343
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• 2009

Purpose: ((R)-1-(2-chlorophenyl)-N-1-[$^{11}$C]methyl-N(1-propyl)-3-isoquinoline carboxamide ((R)-PK11195) is a specific ligand for the peripheral type benzodiazepine receptor and a marker of activated microglia, used to measure inflammation in neurologic disorders. We report here that a direct and simple radiosynthesis of [$^{11}$C](R)-PK11195 in mild condition using NaH suspension in DMF and one-step loop method. Materials and Methods: (R)-N-Desmethyl-PK11195 (1 mg) in DMSO (0.1 mL) and NaH suspension in DMF (0.1 mL) were injected into a semi-prep HPLC loop. [$^{11}$C]methyl iodide was passed through HPLC loop at room temperature. Purification was performed using semi-preparative HPLC. Aliquots eluted at 11.3 min were collected and analyzed by analytical HPLC and mass spectrometer. Results: The labeling efficiency of [$^{11}$C](R)-PK11195 was 71.8$\pm$8.5%. The specific activity was 11.8:$\pm$6.4 GBq/$\mu$mol and radiochemical purity was higher than 99.2%. The mass spectrum of the product eluted at 11.3 min showed m/z peaks at 353.1 (M+1), indicating the mass and structure of (R)-PK11195. Conclusion: By the one-step loop method with the [$^{11}$C]CH3l automated synthesis module, [$^{11}C$](R)-PK11195 could be easily prepared in high radiochemical yield using NaH suspension in DMF.

• Progress in Medical Physics
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• v.14 no.2
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• pp.131-140
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• 2003

As the importance of accuracy in measurings of 3-D anatomical structures continues to be stressed, an objective and quantitative of assessing image quality and accuracy of 3-D volume-rendered images is required. The purpose of this study was to evaluate the quantitative accuracy of 3-D rendered images obtained with MDCT, scanned at various scanning parameters (scan modes, slice thicknesses and reconstruction slice thickness). Twelve clinically significant points that play an important role for the craniofacial bone in plastic surgery and dentistry were marked on the surface of a dry human skull. The direct distances between the reference points were defined as gold standards to assess the measuring errors of 3-D images. Then, we scanned the specimen with acquisition parameters of 300 mA, In kVp, and 1.0 sec scan time in axial and helical scan modes (pitch 3:1 and 6:1) at 1,25 mm, 2.50 mm, 3.75 mm and 5.00 mm slice thicknesses. We performed 3-D visualizations and distance measurements with volumetric analysis software and statistically evaluated the quantitative accuracy of distance measurements. The accuracy of distance measurements on the 3-D images acquired with 1.25, 2.50, 3,75 and 5.00 mm slice thickness were 48%, 33%, 23%, 14%, respectively, and those of the reconstructed 1.25 mm were 53%, 41%, 43%, 36% respectively. Meanwhile, there were insignificant statistical differences (P-value<0.05) in the accuracy of the distance measurements of 3-D images reconstructed with 1.25 mm thickness. In conclusion, slice thickness, rather than scan mode, influenced the quantitative accuracy of distance measurements in 3-D rendered images with MDCT. The quantitative analysis of distance measurements may be a useful tool for evaluating the accuracy of 3-D rendered images used in diagnosis, surgical planning, and radiotherapeutic treatment.

• Journal of East-West Nursing Research
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• v.8 no.1
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• pp.113-125
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• 2003

This study is a descriptive investigation into the image of nurses, and attempted to help to advance the profession of nursing and to provide basic data for developing strategies to improve the image of nurses. The Subject of this study was a group of 380 persons from a K Medical Centre in Seoul, including the hospital patients and their guardians, as well as the doctors, assistants and hospital administrative staff. The data have been collected from the 10th to the 30th of May, 2003. We have developed a research tool of 40 questions divided into three categories using a tool developed by Kim, H.J and KIm, H.O.(2001) verifying its construct validity. The reliability of the tool was Cronbache's ${\alpha}=.97$, and by categories, Cronbach's ${\alpha}=.86$ for service image, Cronbach's ${\alpha}=.96$ for professional image and Cronbache's ${\alpha}=.90$ for social image. The collected data have been analysed according to the purpose of this study using SPSS WIN 11.0 for real number, percentage, factors analysis, multiple regression analysis, ANOVA and $x^2$-test, and the results are as follows: 1) There was a significant difference in the image of nurses by job series of the subjects; from patients and guardians for 4.01 to doctors 3.62, assistants 3.54 and staff members 3.41 (F=36.14, p=.000). As well, there was a significant difference in service, professional and social image categories according to the position of the subjects ($F=20.36{\sim}42.35$, p=.000). 2) The main factors that affect on formation the nurse's imaging came by direct experiences with nurses at hospitals for 81.3%, by looking at the every life of the nurses that the subjects personally know for 15.5%, by mass media for 1.6% and by the accounts from the others for 1.6%. 3) 78.4% of the subjects considered that the image of nurses on mass media is described better than for real, 8.2% believed that the image is described worse than for real, and only 13.2% of the subjects perceived that the image of nurses on mass media corresponds the image of nurses in actual life. 4) 74.5% of the subjects said that they got a better image of nurses after their hospitalization while 2% got a worse one and 23.5% said to have had no changes, and the period of hospitalization had no relevance to the image of nurses (X2=5.04, P=.489). However, while 16.8% of the subjects who spent less than one week in hospital said that they got a better image of nurses, 27.5% of those who spent longer than four weeks got a better image of nurses. 5) There was a significant difference in the total image points of nurses by the patients and their guardians according to the period of hospitalization; 4.14 for 1 to 2 weeks, 4.07 for 2 to 4 weeks, 4.02 for 4 weeks and longer and 3.80 for less than a week (F=3.40, P=.019). Upon the results stated above, I should like to propose as below: 1) An investigative enquiry is needed to improve the image of nurses as though being a nurse is very hard and difficult. 2) A continuous monitoring in mass media is needed to create a positive image of nurses.

• Progress in Medical Physics
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• v.23 no.4
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• pp.279-284
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• 2012

The X ray has been widely used in both diagnosis and treatment. Recently, a miniature X ray tube has been developed for radiotherapy. The miniature X ray tube is directly inserted into the body irradiated, so that X rays can be guided to a target at various incident angles according to collimator geometry and, thus, minimize patient dose. If such features of the miniature X ray tube can be applied to development of X ray imaging as well as radiation treatment, it is expected to open a new chapter in the field of diagnostic X ray. However, the miniature X ray tube requires an added filter and a collimator for diagnostic purpose because it was designed for radiotherapy. Therefore, a collimator and an added filter were manufactured for the miniature X ray tube, and mounted on. In this study, we evaluated beam characteristics of the miniature X ray tube for diagnostic X ray system and accuracy of measuring the HVL. We used the Si PIN Photodiode type Piranha detector (Piranha, RTI, Sweden) and estimated the HVL of the miniature X ray tube with added filter and without added filter. Through an another measurement using Al filter, we evaluated the accuracy of the HVL obtained from a direct measurement using the automatic HVL calculation function provided by the Piranha detector. As a result, the HVL of the miniature X ray tube was increased around 1.9 times with the added filter mounted on. So we demonstrated that the HVL was suitable for diagnostic X ray system. In the case that the added filter was not mounted on, the HVL obtained from use of the automatic HVL calculation function provided by Piranha detector was 50% higher than the HVL estimated using Al filter. Therefore, the HVL automatic measurement from the Piranha detector cannot be used for the HVL calculation. However, when the added filter was mounted on, the HVL automatic measurement value using the Piranha detector was approximately 15% lower than the estimated value using Al filter. It implies that the HVL automatic measurement can be used to estimate the HVL of the miniature X ray tube with the added filter mounted on without a more complicated measurement method using Al filter. It is expected that the automatic HVL measurement provided by the Piranha detector enables to make kV-X ray characterization easier.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.813-822
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• 1995

Background: Bronchial hyperresponsiveness and abnormal response such as a loss of distensibility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. Method: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in $FEV_1$) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. Results: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter <2 mm; area < $3.14mm^2$) was 48.7%(8.3; SEM, n=43), being more prominant than that of large airways(average diameter >2 mm; area > $3.14mm^2$), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). Conclusions: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.72-79
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• 2007

Purpose : Glycogen storage disease type III (GSD-III) is a rare autosomal recessive disorder of glycogen metabolism. The affected enzyme, amylo-1,6-glucosidase, 4-alpha-glucanotransferase (AGL, glycogen debranching enzyme), is responsible for the debranching of the glycogen molecule during catabolism. The disease shows clinical and biochemical heterogeneity, reflecting genotype-phenotype heterogeneity among different patients. In this study, we aim at analyzing mutations of the AGL gene in three unrelated Korean GSD-III patients, and characterizing their clinical and laboratory findings. Methods : We characterized the clinical features of three unrelated Korean GSD-III patients by biochemical, histological and imaging studies. The 35 exons and part of exon-intron boundaries of AGL were analyzed by direct sequencing using genomic DNA extracted from the peripheral leukocytes of patients. Results : Diverse clinical features were observed in these patients including hepatomegaly (all patients), seizures (patient 2), grow th failure (patients 1 and 2), hyperlipidemia (patients 1 and 3), raised transaminase and creatine kinase concentrations (all patients), and mild cardiomyopathy (patient 2). Liver transplantation w as performed in patient 2 due to progressive hepatic fibrosis. A dministration of uncooked corn starch maintained normoglycemia and improved biochemical and growth profiles. DNA sequence analysis revealed mutations in 5 out of 6 alleles. Patient 1 was a compound heterozygote of c.1282 G>A (p.R428K) and c.1306delA (p.S603PfsX6), patient 2 had c.1510_1511insT (p.Y 504L fsX 10), and patient 3 had c.3416 T >C (p.L 1139P) and c.1735+1 G>T (p.Y 538_R578delfsX 4) mutations. A part from the p.R428K mutation, the 4 other substitutions identified w ere nov el. Conclusion : GSD-III patients display variable phenotypic characteristics resembling those of GSD-Ia. Molecular defects in the AGL gene of Korean GSD-III patients are genetically heterogeneous.