• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.43-45
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• 2013

Background: The aim of this epidemiological study was to establish the laterality of breast cancer (BC) and its association with size, receptor status of the primary tumor and bone metastasis (BM) in a local population. Materials and Methods: This retrospective study included cases of BC from Jan-2009 to Dec-2011 who were referred for metastatic work up or follow up survey with Technetium-99m MDP bone scan (BS) to the Nuclear Medicine Department of Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). A total of 384 patients out of 521 were included and all reviewed for age, primary tumor size (PTS), laterality, receptor status like estrogen receptor (ER) progesterone receptor (PR) and Her-2-Neu receptor, presence or absence of BM with sites of involvement and time interval between diagnosis of BC and appearance of BM. Results: The left to right sided BC proportion was significantly higher than unity (59%:41%; p<0.001). The right sided BC was observed in younger age group (46:52 years; p<0.0001) and with a smaller PTS than the left sided (3.43:4.15 cm; p<0.0001). The patients with BM had relatively higher negative receptor status with a significant predominance of right sided BC. The overall incidence of BM on BS was 28% and relatively higher in right than left breast (33%:24% p=0.068). The average number of BM sites was also significantly greater for the right side (6:4, P<0.0001). The % cumulative risk of BM in right breast was noted at significantly smaller PTS than left side with log rank value of 5.579; p<0.05. The Kaplan Meier survival plot for event free survival of BM in left sided BC was significantly higher than for the right side (log rank value=4.155, p<0.05), with an earlier appearance of BM in right BC. Conclusions: 1) A left sided predominance of BC was seen in local population; 2) right sided BC had a more aggressive behavior with extensive and earlier appearance of BM at relatively younger age, smaller PTS and receptor (s) negativity.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.256-265
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• 1997

Objectives：The purpose of this study was to investigate the characteristics and differences of brain function in pervasive developmental disorder and developmental language disorder. Method：The subjects were composed of 14 cases of pervasive developmental disorder and 13 cases developmental language disorder. They were investigated by technitium-99m-EDC SPECT. All SPECT were visually assessed by two nuclear medicine specialists, and then quantified by region of interest including temporal, parietal cortex, thalamus, basal ganglia and cerebellum. Result：In both groups, cerebral blood flow was decreased in the temporal, parietal cortex, basal ganglia, thalamus, cerebellum by visual assessment. There was no significant difference between the 2 groups by quantitative and qualitative assessment. Conclusion：These results suggest that pervasive developmental disorder and developmental language disorder are caused by defects in the interneural connection and that both disorders are spectrum disorders.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.131-136
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• 2008

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.200-205
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• 2003

Purpose: To report our experiences of clinical features, treatment method and results of giant cell tumor of 5 patients in proximal fibula. Materials and Methods: Five patients managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon followed up between January 1997 and July 2001. Preoperative plain radiograph and MRI and bone scan were checked. The recurrence of the tumor was judged by plain radiograph and clinical signs. Lateral instability of knee joint was checked during the outpatient follow-up. Results: The mean age of the patients at the time of operation was twenty- three (21-29). There were one male and four female patients. Dull pain was main symptom and palpable mass was seen in two patients. Peroneal nerve palsy and local recurrence were not observed except one case of temporary peroneal nerve palsy. During the outpatient follow up, one among 5 patients showed slight lateral instability and the other 4 patients showed no instabililty. Conclusion: Giant cell tumor in proximal fibula managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon showed favorable results.

• Journal of Magnetics
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• v.19 no.3
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• pp.248-254
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• 2014

The purpose of this study is to figure out how uptake counts of technetium ($^{99m}Tc$) among radioisotopes in the human body are affected if computed tomography (CT), magnetic resonance imaging (MRI) and isotope examination are performed consecutively. $^{99m}Tc$ isotope material, iodinated contrast media for CT and paramagnetic contrast media for magnetic resonance (MR) were used as experimental materials. First, $^{99m}Tc$ was added to 4 cc normal saline in a test tube. Then, 2 cc of CT contrast media such as $Iopamidol^{(R)}$ and $Dotarem^{(R)}$ were diluted with 2 cc normal saline, and 2cc of MRI contrast media such as $Primovist^{(R)}$ and $Gadovist^{(R)}$ were diluted with 2 cc normal saline. Each distributed contrast media was a total of 4 cc and included 10m Ci of $^{99m}Tc$. A gamma camera, a LEHR (Low energy high resolution) collimator and a pin-hole collimator were used for image acquisition. Image acquisition was repeated a total of 6 times and 120 frames were obtained and uptake counts of $^{99m}Tc$ were measured (from this procedure). In this study, as a result of measuring the uptake counts of $^{99m}Tc$ using the LEHR collimator, the uptake counts were less measured in all contrast media than normal saline as a reference. In particular, the lowest uptake counts were measured when $Gadovist^{(R)}$, contrast media for MRI, was used. However, the result of measuring the uptake counts of $^{99m}Tc$ using the pin-hole collimator showed higher uptake counts in all contrast media, except for $Iopamidol^{(R)}$, than normal saline as a reference. The highest uptake counts were measured particularly when $Primovist^{(R)}$, contrast media for MRI, was used. In performing the gamma camera examination using contrast media and $^{99m}Tc$, it is considered significant to check the changes in the uptake counts to improve various diagnosis values.

• Journal of Veterinary Clinics
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• v.22 no.1
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• pp.21-25
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• 2005

This study was performed to assess therapeutic effect of the tibial plateau leveling osteotomy (TPLO) in dogs with experimentally transected cranial cruciate ligaments (CrCL). Nine healthy adult Beagle dogs were transected left CrCL under general anesthesia. The dogs were assigned to TPLO and non-TPLO control groups. The TPLO procedures for correcting the CrCL rupture in the left stifle of dogs were performed under sterile conditions. Before TPLO procedures, all dogs were screened by orthopedic and radiographic examinations. Dogs were lameness free for the previous three months, and when examined at the walk and trot on a hard surface, in a straight line and on a circle. Lateral and craniocaudal radiographs were done to confirm the soundness of the both knee joint in dogs and not detectable lesions were diagnosed. The dogs were intravenously injected with a 10 mci/kg of 99mTechnetium-methylene diphosphonate (99mTc-MDP) under general anesthesia. Scintigraphs were obtained using a large field of view gamma camera equipped a parallel-hole, low-energy about 3 hours after intravenous injection of 99mTc-MDP. Before CrCL transection and 4, 8, and 12 weeks after the procedures, scintigraphy were conducted. Bone uptake of the left stifle joint increased after the procedures in all dogs. When the bone uptake from the TPLO procedure was compared with that of the control, there was a significant difference (p < 0.05). At 12 weeks after the TPLO procedure, the dogs showed normal anatomical posture and gait. It is concluded that TPLO procedure was effective in reconstruct of the stifle joint in dogs with CrCL rupture.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.219-223
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• 1989

Inflammation scan using radiolabelled leukocytes has high sensitivity and specificity. Several methods for labelling leukocytes have been evaluated using P-32 diisopropyl fluorophosphate (DFP-32), H-3 thymidine, Cr-51 chromate, Ga-67 citrate and Tc-99m-sulfur colloid. In-111-oxine has proved so far to be the most reliable agent for labelling leukocytes. In-111-oxine is, however, expensive, not easily available when needed, and its radiation dose to leukocytes is relatively high. Moreover, resolution of the resultant image is relatively poor. Tc-99m is still the agent of choice because of, as compared with the indium, its favorable physical characteristics, lower cost and availability. Now the technique for labelling the leukocytes with technetium is successfully obtained using the lipophilic HAPAO with higher efficiency for granulocytes than for other cells. With this technique it is possible to label leukocytes in plasma to improve the viability of the leukocytes. Inflammation scan using Tc-99m-HMPAO has been evaluated in several laboratories, and difference in methods for separation and labelling accounts for difference in efficiency, viability and biodistribution of the labelled leukocytes. We performed inflammation scan using leukocytes labelled with Tc-99m-HMPAO in three dogs 24 hours after inoculation of live E. Coli and A. Aureus in their right abdominal wall. We separated mixed leukocytes by simple sedimentation using 6% hetastarch (HES) and labelled the leukocytes with Tc-99m-HMPAO in 20% cell free plama diluted with phosphate buffer solution(Fig. 1). Uptake was high in the liver and spleen but is was minimal in the lungs on whole body scan. Kidneys and intestine showed minimal activity although it was high in the urinary bladder(Fig. 2). Uptake of labelled leukocytes in the inflammation site was do(mite on 2 hour-postinjection scan and abscess was clearly delineated on 24 hour-delayed scan with high target-to-nontarget ratio(Fig. 3, 4). Inflammation scan using mixed leukocytes labelled with Tc-99m-HMPAO is very sensitive and specific in early detection of inflammation.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.30-35
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• 1997

It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age $57{\pm}9$ years) and 120 patients (79 males, 41 females, mean age $59{\pm}10$ years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively. All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by ${\geq} 50%$. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35% and 68%, respectively. Those of rest-stress protocol were 96%, 47% and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using $^{99m}Tc$ agents were comparable and were very sensitive tests in detecting coronary artery diseases.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.71-80
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• 1993

In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.