• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.110-114
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• 2007

Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.539-563
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• 1998

39-year-old female had been treated for the exophytic mass on buccal aspect of the left, maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical. radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical. radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of /sup 99m/Tc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sunray appearace, and coincided with benign characters as follows; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.

• The Korean Journal of Nuclear Medicine
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• v.13 no.1_2
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• pp.45-53
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• 1979

Bone scans with $^{99m}Tc$-MDP (methylene diphosphonate) was analysed in 112 patients with various type of biopsy proven malignant tumor who visited Seoul National University Hospital from March 1979 to August 1979. The results were as follows; 1. Of the 112 cases, bone scans were positive in 61 cases (54.1%), while only 27 cases (24.1%) were positive in roentgenogram. 2. Of the 61 cases with positive bone scan, bone metastases were found in 25 cases by roentgenogram. Of the 51 cases with negative bone scan, bone metastasis was found in only 1 case by roentgenogram. 3. In comparison of bone scan and roentgenogram by number of regions, 137 regions were positive in bone scan or roentgenogram. Of these, 46 regions (33.5%) were both bone scan and roentgenogram positive, 89 regions (65.0%) were bone scan positive roentgenogram negative, and 2 regions were bone scan negative roentgenogram positive. 4. Bone scan and roentgenographic findings had significant correlation with the presence of bone pain but no significant correlation with the elevated level of serum alkaline phosphatase, acid phosphatase, Ca, and P. From above result, we found that bone scan was more sensitive than roentgenogram in early detection of bone metastasis in malignant tumors.

• The Korean Journal of Nuclear Medicine
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• v.29 no.4
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• pp.511-517
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• 1995

Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement(13 unilaterally affected, 8 bilaterally affected), 25 patients with TMJ arthritis(23 unilateral, 3 bilateral), and 39 volunteers with no signs, symtoms, or history of TMJ disease. TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99mTc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were $1.673{\pm}0.606$ in TMJs affected with arthritis, $1350{\pm}0.351$ in TMJs affected with disc displacement, and $1.084{\pm}0.172$ in TMJs of controls. Significant differences were demonstrated among them(p<0.01) Difference of bith TMJ SUR was highest in patients with unilateral TMJ arthritis($0.608{\pm}$0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ dist displacement patients($0.062{\pm}0.063$ vs $0.122{\pm}0.100$). TMJ SUR of Joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(696% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan nay help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.428-436
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• 2003

Purpose: Increased periarticular uptake could be associated with peripheral bone marrow expansion in cancer patients with axial bone marrow metastasis. We compared bone scan and bone marrow scan to investigate whether the increased whole body count in patients with increased periarticular uptake on bone scan is useful in the diagnosis of axial marrow metastasis, and evaluate the role of additional bone marrow scan in these cases. Materials and methods: Twelve patients with malignant diseases who showed increased periarticular uptake on bone scan were included. Whole body count was measured on bone scan and it is considered to be increased when the count is more than twice of other patients. Bone marrow scan was taken within 3-7 days. Results: Five hematologic malignancy, 3 stomach cancer, 2 breast cancer, 1 prostate cancer and 1 lung cacner were included. All three patients with increased whole body count on bone scan showed axial marrow suppression and peripheral marrow expansion. Eight of 9 patients without increased whole body count showed axial marrow suppression and peripheral marrow expansion. One turned out to be blastic crisis of chronic myelogeneous leukemia, and seven showed normal axial marrow with peripheral marrow expansion in chronic anemia of malignancy. The last one without increased whole body count showed normal bone marrow scan finding. Conclusion: Increased whole body count on bone scan could be a clue to axial bone marrow metastasis in cancer patients with increased periarticular uptake, and bone marrow scan is a valuable method for differential diagnosis in these cases.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.387-391
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• 2015

Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.219-226
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• 1991

골 신티 그라피는 섬유성 골 이형성증의 초기 병소와 다골성 형 섬유성 골 이형성증의 진단에 예민한 검사 방법이나, 양성 또는 악성 골 병변과의 감별진단에 어려움이 있었다. 이에 저자들은 조직학적으로 확진된 섬유성 골 이형성증 환자 17명에서 (단골성 형 12명, 다골성 형 : 5명) $^{99m}Tc-MDP$ (20 mCi 또는 7,400 MBq) 주사후 $2\sim4$시간에 전면, 후면 전신상과 부분상을 얻은 30부위 병소를 X선 사진과 비교분석 하였으며 CT, MRI 영상과 병리조직 소견을 얻었다. 병소 침습 부위별로는 대퇴골-10예, 경골-4, 요골-2, 늑골-2, 척추골-2, 후두골-2, 장골-2, 두정골-1, 하악골-1, 접형골-1, 견갑골-1, 쇄골-1, 척골-1예 였으며 5명의 다골성 형에서는 :우 대퇴골과 우 비골 : 양측 말단 대퇴골 :좌 경골과 좌 대퇴골 :우 요골과 우 장골 양측 대퇴골, 양측 경골, 접형골, 두정골, 척추골, 늑골과 장골이었다. 골 신티 그라피 소견상 30예중 28예에서(28/30, 93.3%) 방사능 섭취 증가를 보였으며 2예에서(2/30, 6.7%)는 정상 방사능 섭취 소견을 보였으나 각각은 X선상 불투명 유리상과 골흡수 병변을 보였다. 하악골의 골 3상 스캔상 병소에 현저한 혈류 증가가 관찰되었다. X선 소견상 30예중 11예에서 (l1/30, 36.7%) 불투명 유리상의 병변을, 골 변형을 동반한 1예를 포함한 18예에서는 (18/30, 60.0%) 골흡수 병변을 보였으며, 1예의 늑골 병변은 정상소견을 보였다(1/30, 3.3%). 이상에서 골 신티 그라피 만으로 섬유성 골 이형성증을 진단하는데는 주의를 요하나 골 대사의 동적 측면인 혈류와 골 재형성 양상 특히, 초기 병변과 단골성 형 침습에서 다골성 형을 진단하는데 필수적이며 결론적으로 골 신티 그라피와 X선 촬영등은 섬유성 골 이형성증 진단에 상호보완적인 검사 방법으로 사료된다.

• Journal of Veterinary Clinics
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• v.23 no.4
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• pp.400-404
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• 2006

This study demonstrates the anti-arthritic effect of topical application of ketoprofen gel containing N-methyl-2-pyrrolidone (NMP) in adjuvant arthritis therapy. Adjuvant arthritis was induced by a single injection of Freund's complete adjuvant (FCA). Mature female Sprague-Dawley rats were designated to 3 groups such as control group, K10 group (ketoprofen 10 mg/rat), and NK10 group (ketoprofen 10 mg/rat containing NMP). The anti-arthritic activity of ketoprofen containing NMP was tested not only as to its capability to suppress the inflammatory edema, but also bone damage (X-ray score and regional bone uptake) of the hind paw in arthritis-induced rats. These results showed a higher efficacy of ketoprofen containing NMP than ketoprofen treatment in the adjuvant-induced arthritis. Ketoprofen containing NMP has good intrinsic characteristics for formulation in an efficacious anti-inflammatory topical application.

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.332-337
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• 1996

Purpose : It has been known that the activity of extracellular matrix degradative enzymes such as collagenase correlate well with the metastatic potential of various tumor cells in experimental study. This study was aimed at comparing the activities of type IV collagenase with bone scan findings in patients with breast cancer. Materials and Methods : We retrospectively correlated bone scan findings with the results of immunohistochemical staining for 92kDa, 72kDa type IV collagenase in 28, and 30 patients with metastatic breast cancer, respectively, as well as 23, and 27 patients with primary breast cancer, respectively. The immunohistochemical staining was performed with tissue specimens obtained from primary or metastatic breast tumor lesions. The amounts of the enzyme were graded from 0 to 4 and scored by multiplication with the percentage of tumor cells. The confidence of bone scan interpretation for metastasis was also scored from 1 to 5 with increasing probability. Results : There was a significant difference in enzyme scores between patients with and without metastasis. In patients with primary breast cancer group, the frequency of patients with enzyme score of less than 170 were 96%(26/27) and 100%(26/26) with 92kDa and 72kDa collagenase, respectively. In contrast, in patients with metastatic breast cancer group, the frequency of patients with enzyme score of more than 200 were 93%(28/30) and 87%(26/30) with 92kDa and 72kDa collagenase, respectively. All patients with each enzyme score of less than 170 show no active bony metastasis, however, there were variable bone scan findings in patients with each enzyme score of more than 200. Conclusion : Bone scan is useful to confirm, localize or follow up of bony metastasis in patients with each enzyme scores of more than 200. Acitve metastatic lesions were hardly seen on the bone scintigraphy in patients with collagenase scores of less than 170.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.206-213
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• 1994

We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.