• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.519-526
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• 1999

Purpose: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. Materials and Methods: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. Results: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide funker studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. Conclusion: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.17-21
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• 2001

Purpose : To analyze changes of the anterior translation, MRI findings and associated injuries at scarring of the torn ACL in the chronic ACL rupture. Materials & Method : From Dec. 1996 to May 2000, 19 patients who were diagnosed as the chronic ACL rupture were studied. We analyzed KT-2000 side to side difference of maximal manual anterior displacement(MMAD), MRI findings and associated injuries. Results : There was statistically significant difference in the average MMAD between the 7 cases$(37\%)$ with scar formation$(2.78{\pm}2.41mm)$ and the 12 cases without scarring$(5.75{\pm}2.52mm)$. The chronic ACL rupture without scarring had more meniscal injuries$(67\%)$ than with scarring$(28\%)$. MRI showed that relatively straight bands toward expected insertion site with single large fragment(5 cases) and continuous band with focal angulation(2 cases). Conclusion : If relatively straight bands toward expected insertion site with single large fragment or continuous band with focal angulation on MR imaging is showed in the patient without significant anterior translation at arthrometer, the possibility of the scar formation of the torn ACL should be considered. We think that the chronic ACL rupture with scarring had less meniscal injuries than without scarring will give additional information on the natural history of ACL injuries.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1225-1231
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• 2005

Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.

• Childhood Kidney Diseases
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• v.6 no.1
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• pp.61-67
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• 2002

Purpose: The urinary mass screening program in school aged population has been performed since 1981, but the consensus on the follow-up schedule and the management of isolated proteinuria has not been reached yet. The aim of this study was to investigate the cause of isolated proteinuria and to propose a guideline for the treatment and follow-up afterwards Methods: The medical records of 114 cases of isolated proteinuria detected through the analysis of urinary mass screening and evaluated at the pediatric outpatient clinic of Asan Medical Center from January 1990 to July 2001 have been reviewed. Results: The classification of isolated proteinuria was as follows. Transient proteinuria $32\%$, orthostatic proteinuria $65\%$, persistent proteinuria $3\%$, In orthostatic proteinuria group, daytime and nighttime proteinuria were $319.2{\pm}189.1\;mg/dL$ and $56.5{\pm}56.1\;mg/dL$. In persistent proteinuria group, daytime and nighttime proteinuria were $1140{\pm}540.5\;mg/dL$ and $289{\pm}58\;mg/dL$. After 30 month follow-up, 2 cases of persistent proteinuria were needed renal biopsy and 1 case revealed focal segmental glomerular sclerosis. In all cases, serum creatinine, albumin and complements levels were normal. In the orthostatic proteinuria group, no significant renal diseases were detected. Conclusion: Since most of the isolated proteinuria detected through the school urinary mass screening were orthostatic proteinuria or transient proteinuria, initially aggressive diagnostic method such as renal biopsy is not needed and regular follow- up with quantitation of proteinuria is warranted.(J Korean Soc Pediatr Nephrol 2002 ; 6 61-7)

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.125-135
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• 2001

Purpose : Efforts to predict long-term outcome of focal segmental glomerulosclerosis(FSCS) have been made but have yielded conflicting results. Reports are rare especially in Pediatric patients. In this study, we reviewed the predictable prognostic factors in patients of FSGS Method : Fifty children who diagnosed as biopsy-proven FSGS at department of pediatrics at Yonsei university were studied retrospectively. Based on medical records, response to treatment and pathologic slides, we compared normal renal function group and decreased renal function group, assessed the factors affecting renal survival and progression to renal failure. Results : The mean age at onset was 8 1/12 years, sex ratio was 2.3 : 1, and the mean duration of follow-up was 7 1/12 years. The overall renal survival rate was $34\%$ at 5 years, $8\%$ at 10 years Five-year survival rate was $74\%$ in normal renal function group and $27\%$ in decreased renal function group. Between the two groups, there were no significant differences in age at onset, sex ratio, amount of proteinuria, incidence of hematuria and hypertension, mesangial hypercellularity. Decreased renal function group showed higher serum creatinine level, poor response to treatment, higher percent of glomeruli with sclerosis, moderate to severe tubulointerstitial change and vascular change(P<0.05). The prognostic factors of renal survival rate were same as above and incidence of hypertension also affected renal survival( P<0.05). The progression rate to renal failure did not show statistically significant factor. Conclusion : We reviewed the factors affecting long-term outcome of FSGS. Serum creatinine level, steroid responsiveness, and the degree of glomerulosclerosis were significant prognostic factors. (J Korean Soc Pediatr Nephrol 2001 ;5 : 125-35)

• Journal of Life Science
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• v.20 no.10
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• pp.1556-1562
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• 2010

This study examined the histopathologic and electron microscopic findings of aborted fetuses from pregnant dairy cows naturally infected with Neospora caninum (N. caninum) at four farms in Gongju city and Yeonki gun of Choongnam province. Systemic subcutaneous edema was observed in the aborted fetuses. The necropsy revealed considerable serosanguinous fluid in the body cavity of the aborted fetuses. Light microscopy showed the infiltration of many inflammatory cells consisting of macrophages, lymphocytes and mononuclear cells, accompanied by congestion, hemorrhage and necrosis of myocardiac cells and hepatocytes in the liver and heart of the aborted fetuses. In the liver, clusters of tachyzoites were formed in the cytoplasm of hepatocytes and the interstitial tissue. In the brain, many tissue cysts of various sizes were observed in the nerve cells and their adjacent areas. Tissue cysts had a round shape and contained a large amount of bradyzoite. In addition, there was diffuse gliosis accompanied by congestion and hemorrhage and focal necrosis in the brain. Infiltration of microglial cells were observed at the periphery of the focal necrosis and perivascular area in the brain. Electron microscopy showed that the tissue cyst wall had a thickness of approximately 1 ${\mu}m$ with an irregular shape. On the interior side, more than 100 bradyzoites with lengths of 2-5 ${\mu}m$ and widths of 1-2 ${\mu}m$ were observed. The nucleus of in the bradyzoites was located approximately 1-1.5 ${\mu}m$ anterior to the posterior tip of the zoite. In the cytoplasm between the nucleus and the posterior tip, there were many amylopectin granules, electron-dense small-sized and electron-thin large-sized round granules, homogeneously electron-dense rhoptries and micronemes oriented perpendicularly to the zoite pellicle. To summarize, tissue cysts were identified on electron microscopy from the aborted fetus from N. caninum seropositive pregnant cow by the ELISA. This led to the confirmed presence of N. caninum.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.70-85
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• 2006

A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.

• 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.

• Korean Journal of Veterinary Research
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• v.34 no.4
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• pp.745-757
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• 1994

Superovulatory treatment with exogenous gonadotropins adversely affects the uterus through the disruption of the delicate balance of ovarian steroids (estrogens, progestins, androgens). To examine the uterine effects of this treatment, 189 rats were given 4IU, 20IU or 40IU pregnant mare',s serum gonadotropin(PMSG) at 28 days of age and sacrificed every 24h until day 10(D10) post injection. Long term uterine effects were examined in 12 rats treated with 4IU or 40IU PMSG and killed on D30. Adult rat uteri were examined to provide a reference for comparisons. Morphological and histological changes of control (4IU) uteri mimicked those of the adult on a comparable time-course form D2 to D5. Administration of superovulatory doses(20IU, 40IU) of PMSG produced stromal hypertrophy by D2 and focal papillary hyperplasia of the luminal epithelia by D3. Levels of $17{\beta}$-estradiol following 20IU and 40IU PMSG treatment were significantly(p<0.05, p<0.005) elevated above those of controls after D1. Androgen levels of both groups(20IU, 40IU) significantly p<0.05, p<005 increased from baseline on D1 and were maximum between D2 and D3. In the 20IU PMSG group, the hyperplasia gradually regressed after D3 and was absent by D10. The hyperplasia in the 40IU PMSG group, however, had become extensive by D6. It is suspected that preceding elevated levels of estrogen may be responsible for this progressive change. On D 4, the levels of $17{\beta}$-estradiol reached a maximum, which was significantly(p<0.001) greater than both the controls and 20IU PMSG-treated rats. Between D6 and D10, the hyperplasia in 40IU PMSG-treated rats partially regressed. Examination of uteri from D30 revealed no evidence of the hyperplasia. It is suggested that previous exposure to high levels of estrogen and androgens, secondary to superovulation, is possible cause for the observed hyperplasia.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.486-491
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• 2007

Background: This study examined the relationship between the pleural adenosine deaminase (ADA) level and the patterns of pleural enhancement in patients with a tuberculous pleural effusion (TPE) shown on a CT scan. Methods: The charts and CT findings of 44 patients with TPE from February 2002 to October 2006 were reviesed retrospectively. A diagnosis of TPE was made by the pleural ADA level with a follow-up (24/44), sputum smear or culture of sputum (16/44), pleural fluid culture (3/44) or pleural biopsy (1/44). The patients were divided into two groups according to the ADA level(Group I [n=12]: 40-70, Group II [n=32]: >70 U/L). The presence or absence, maximal thickness and patterns of pleural enhancement were analyzed. The pattern of pleural enhancement was classified into diffuse or focal, smooth or irregular and interrupted or continuous. The difference in CT findings between groups I and group II were analyzed using an unpaired T test, Chi-square test and Z test. Results: All 44 patients showed diffuse pleural enhancement on the CT scans. The maximal pleural thickness of groups I and II was $1.83{\pm}1.03mm$ (1-4 mm) and $3.63{\pm}1.78mm$ (1-8 mm), respectively (p =0.0002). Pleural thickening ${\geq}5mm$ was only demonstrated in 31.3% of patients in group II (10/32). Diffuse interrupted pleural thickening was noted in 91.7% (11/12) of patients in group I and 62.5% (20/32) in group II, respectively. Diffuse continuous pleural thickening was observed in 8.3% (1/12) of patients in group I and 37.5% (12/32) in group II, respectively (p=0.0748). Conclusion: Pleural thickening ${\geq}5mm$ on the contrast enhanced CT is rare in patients with lymphocyte-dominant TPE in whom the pleural ADA level is between 40-70 U/L.