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SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images (1.5T MR 기기를 이용한 확산강조영상에서 b Value의 증가에 따른 요추압박골절 환자의 신호대 잡음비와 현성 확산 계수의 변화)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.52-59
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    • 2010
  • To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.

The Utility of Immunological Markers and Pulmonary Function Test in the Early Diagnosis of Pulmonary Involvement in the Patients with Rheumatoid Arthritis (류마티스 관절염환자에서 폐침범의 진단에 있어서 면역학적 지표와 폐기능 검사의 유용성)

  • Lee, Dong-Suk;Lee, Chang-Beam;Koh, Hee-Kwan;Moon, Doo-Seop;Lee, Jae-Young;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Bae, Sang-Cheol;Shin, Dong-Ho;Kim, Seong-Yoon;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.878-887
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    • 1995
  • Background: It is reported that frequency of pulmonary involvement in the patients with rheumatoid arthritis reaches 10 to 50% and pulmonary involvement is a principal cause of death. As immunology and radiology has developed, interest for the early diagnosis of pulmonary involvement is increasing. Method: Among the patients at Hanyang University Hospital from March, 1990 to July, 1995, we compared the 29 patients having pulmonary involvement with the 18 patients controls in clinical and chest high resolution computed tomography(HRCT) findings by immunological markers and findings of pulmonary function test. We sought useful markers for early diagnosis of pulmonary involvement with noninvasive investigations. Results: The ratio of males to females was 14 : 15 in the group of pulmonary involvement, and all of the 18 patients were females in the control group. Smoking history was 31%(9/29) in the former group and none in the latter group. Rheumatoid factor(RF) was positive in 95.5%(28/29) of the pulmonary involvement group and in 100%(18/18) of the control group(p=0.12). Antiperinuclear factor(APF) showed a significant difference: 86.9%(20/23, average value: 2.0) was positive in the pulmonary involvement group and 50%(8/16, average value: 1.1) in the control group(p=0.04). Antinuclear antibody(ANA) was positive in 60.7%(17/28) of the pulmonary involvement group and in 72.2%(13/18) of the control group(p=0.33). Cryoglobulin also showed a significant difference: 72%(18/25) in the pulmonary involvement group was positive and 56.2%(9/16) in the control group was positive(p=0.02). Bony erosion was positive in 61.5%(16/26) of the pulmonary involvement group and in 77.7%(14/18) of the control group(p=0.8). On the pulmonary function test, the average value of alveolar volume corrected diffusion capacity and residual volume in the pulmonary involvement group and in the control group were 1.07mmol/rnin/KPa(predicted value: 64.2%), 1.32L(predicted value: 70%) and 1.44mmol/min/KPa, 3.75L(predicted value: 86.6%), respectively(p=0.003, p=0.004), showing a significant difference. Conclusion: APF or cryoglobulin on the serological test, the measurement of residual volume and alveolar volume corrected diffusion capacity may be used as effective markers in the diagnosis of pulmonary involvement of the patients with rheumatoid arthritis.

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The Determinations of Estrogen and Progesterone Receptor in Breast Cancer Cell by Radioimmunoabbay Method (방사선면역법(放射線免疫法)에 의(依)한 유방암세포내(乳房癌細胞內)의 Estrogen과 Progesterone 수용체(受容體)의 측정(測定))

  • Kim, Chi-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.2
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    • pp.53-57
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    • 1981
  • The estrogen and progesterone receptors which are bound to the cytoplasmic protein of cancer cells were measured in 20 patients with the early breast cancer by means of radioimmunoassay using charcoal. 1. The Patients with estrogen receptor positive were 13 (65%) of 20 cases and with progestrone receptor positive were 7 cases (35%) in the early breast cancer. 2. Coexistence of estrogen and progesterone receptor positive was noted in 7 cases (35%). The cases of estrogen receptor positive and progesterone receptor negative were 6 cases (33.3%), while there were no cases of estrogen receptor negative with progestrone receptor positive. 3. Coincidence of estrogen and progesterone negative was notied in 7 cases(35%). Conclusively, it is considered that the measurement of estrogen and progesterone receptors has relevance as predictive value, in the response to hormonal manipulations and chemotherapy for breast cancer patients.

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A Clinical Study of Gagamsipungtang(GGSP) - in view of treatment for fever in children- (가감시평탕(加減柴平湯) 효능(效能)에 대한 임상적(臨床的) 연구(硏究) - 소아(小兒)의 발열(發熱)에 대한 효과(效果)를 위주(爲主)로 -)

  • Chang Gyu-Tae;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.41-53
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    • 1998
  • The purpose of this study was on effect of Gagamsipungtang(GGSP) which removal of fever, side effect etc. During 4months between September and December 1998 , GGSP water extract administered to the patients coming to Dept. of Pediatrics, Dongguk university Pundang Oriental Hospital on account of the symptom of fever with common cold in acute stage, and this study was conducted for 97 children (male 55, female 42). GGSP was used in children both men and women. There were 13 kinds of complications including cough, nasal obstruction, headache, nausea, anorexia, chilling and sweat etc. The distributions of remedial value were improved(62.9%) and no improved(37.6%) patients. 'Improved' standed for no fever over 2 days after GGSP used to patients. GGSP was affected in remedial values by only used without antipyretics. Side effect were diarrhea, anorexia, vomiting and so on.

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Management of Dental Patients taking Warfarin (와파린(Warfarin) 투여 환자의 치과 치료)

  • Park, Kwan-Soo
    • The Journal of the Korean dental association
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    • v.57 no.10
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    • pp.623-628
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    • 2019
  • Warfarin is an anticoagulant involved in the production of vitamin K dependent blood clotting factors. Dentists should be familiar with the appropriate assessment methods and considerations for the treatment of patients taking warfarin. Dental surgery with the moderate risk of bleeding can be performed without stopping the drug through preoperative examination of the INR(international normalized ratio) value and evaluation. When performing a surgery with a high risk of bleeding, it is necessary to evaluate whether the drug can be discontinued, what the duration is, and the risk of discontinuation. Hemostasis can be obtained by local methods in most cases of postoperative bleeding in patients taking appropriately adjusted doses of warfarin.

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The Accuracy of Prediction Models in Burn Patients (화상환자에서 사망예측모델의 성능 평가에 관한 연구)

  • Woo, Jaeyeon;Kym, Dohern
    • Journal of the Korean Burn Society
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    • v.24 no.1
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    • pp.1-6
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    • 2021
  • Purpose: The purpose of this study was to evaluate the accuracy of four prediction models in adult burn patients. Methods: This retrospective study was conducted on 696 adult burn patients who were treated at burn intensive care unit (BICU) of Hallym University Hangang Sacred Heart Hospital from January 2017 to December 2019. The models are ABSI, APACHE IV, rBaux and Hangang score. Results: The discrimination of each prediction model was analyzed as AUC of ROC curve. AUC value was the highest with Hangang score of 0.931 (0.908~0.954), followed by rBaux 0.896 (0.867~0.924), ABSI 0.883 (0.853~0.913) and APACHE IV 0.851 (0.818~0.884). Conclusion: The results of evaluating the accuracy of the four models, Hangang score showed the highest prediction. But it is necessary to apply the appropriate prediction model according to characteristics of the burn center.

The Usefulness of $^{18}F$-FDG PET/CT for Predicting the Response of Locally Advanced Rectal Cancer to Neoadjuvant Chemoradiation Therapy (국소 진행된 직장암의 $^{18}F$-FDG PET/CT를 이용한 항암방사선치료의 반응성 예측)

  • Kang, Jin-Kyu;Kim, Mi-Sook;Choi, Chul-Won;Jeong, Su-Young;Yoo, Seong-Yul;Cho, Chul-Koo;Yang, Kwang-Mo;Yoo, Hyung-Jun;Cheon, Gi-Jeong;Shin, Young-Joo;Seo, Young-Seok
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.111-119
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    • 2009
  • Purpose: This study aimed at assessing the value of fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) for predicting the response of locally advanced rectal cancer to neoadjuvant CRT. Materials and Methods: Between August 2006 and January 2008, we prospectively enrolled 20 patients with locally advanced rectal cancer and who were treated with neoadjuvant CRT at the Korea Institute of Radiological and Medical Sciences. The treatment consisted of radiation therapy and chemotherapy, and this was followed by curative resection 6 weeks later. All the patients underwent $^{18}F$-FDG PET/CT both before CRT and 6 weeks after completing CRT. The measurements of the FDG uptake ($SUV_{max}$), the absolute difference (${\Delta}SUV_{max}$) and the percent $SUV_{max}$ difference (response index, $RI_{SUV}$) between the pre- and post-CRT $^{18}F$-FDG PET/CT scans were assessed. The measurements of the metabolic volume, the absolute difference (${\Delta}$metabolic volume) and the percent metabolic volume difference (response index, $RI_{metabolic\;volume}$) were also assessed. Results: Of the 20 patients who underwent surgery, 11 patients (55%) were classified as responders according to Dworak's classification. The post-CRT $SUV_{max}$ was significantly lower than the pre-CRT $SUV_{max}$. However, there were no significant differences in the $SUV_{max}$ and the metabolic volume reduction between the responders and non-responders. We used a minimum $SUV_{max}$ reduction of 67% as the cut-off value for defining a response, with a sensitivity of 45.5%, a specificity of 88.9%, a positive predictive value of 77% and a negative predictive value of 53.8%. Conclusion: Although there were no statistically significant results in this study, other studies have revealed that $^{18}F$-FDG PET/CT has the potential to assess the tumor response to neoadjuvant CRT in patients with locally advanced rectal cancer.

Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images (18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가)

  • Lee, Hyeon-Guck;Han, Man-Seok;Kim, Yong-Kyun;Seo, Sun-Youl;Jeon, Min-Cheol;Kim, Tae-Hyung;Hong, Seong-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2958-2965
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    • 2013
  • Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

A retrospective clinical study of isolated patent ductus arteriosus (동맥관 개존증의 임상적 고찰)

  • 곽영태
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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Accuracy of Spirometry at Predicting Restrictive Pulmonary Impairment (제한성 환기장애의 진단에서 폐활량검사의 정확성)

  • Ahn, Young Mee;Koh, Won-Jung;Kim, Cheol Hong;Lim, Seong Yong;An, Chang Hyeok;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.330-337
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    • 2003
  • Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.