• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.33-37
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• 2010

Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.188-198
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• 2002

Background: Reoperations on the aortic root or the ascending aorta are being performed with increasing frequency and remain a challenging problem. This study was performed to analyze the results of reoperations on the ascending aorta and aortic root. Material and Method: Between May 1995 and April 2001, 30 patients had reoperations on the ascending aorta and aortic root and were reviewed retrospectively. The mean interval between the previous repair and the actual reoperation was 56 months(range 3 to 142 months). Seven patients(23.3%) had two or more previous operations. The indications for reoperations were true aneurysm in 7 patients(23.3%), prosthetic valve endocarditis in 6(20%), false aneurysm in 5(16.7%), paravalvular leak associated with Behcet's disease in 4(13.3%), malfunction of prosthetic aortic valve in 4(13.3%), aortic dissection in 3(10%), and annuloaortic ectasia in 1(3.3%). The principal reoperations performed were aortic root replacement in 17 patients(56.7%), replacement of the ascending aorta in 8(26.7%), aortic and mitral valve replacement with reconstruction of fibrous trigone in 2(6.6%), patch aortoplasty in 2(6.6%), and aortic valve replacement after Bentall operation in 1 (3.3%). The cardiopulmonary bypass was started before sternotomy in 7 patients and the hypothermic circulatory arrest was used in 16(53.3%). The mean time of circulatory arrest, total bypass, and aortic crossclamp were 20$\pm$ 12 minutes, 228$\pm$56 minutes, and 143$\pm$62 minutes, respectively Result: There were three early deaths(10%). The postoperative complications were reoperation for bleeding in 7 patients(23.3%), cardiac complications in 5(16.7%), transient acute renal failure in 2(6.6%), transient focal seizure in 2(6.6%), and the others in 5. The mean follow-up was 22.8 $\pm$20.5 months. There were two late deaths(7.4%). The actuarial survival was 92.6$\pm$5.0% at 6 years. One patient required reoperation for complication of reoperation on the ascending aorta and aortic root(3.7%). The 1- and 6-year actuarial freedom from reoperation was 100% and 83.3$\pm$15.2%, respectively. One patient with Behcet's disease are waiting for reoperation due to false aneurysm, which developed after aortic root replacement with homograft. There were no thromboembolisms or anticoagulant related complications. Conclusions: This study suggests that reoperations on the ascending aorta and aortic root can be performed with acceptable early mortality and morbidity, and adequate surgical strategies according to the pathologi conditions are critical to the prevention of the reoperation.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.17-29
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• 2015

Purpose For nuclear medicine technologists, it is difficult to stay away from or to separate from radiation sources comparing with workers who are using radiation generating devices. Nuclear medicine technologists work is recognized as an optimized way when they are familiar with work practices. The aims of this study are to measure radiation exposure of technologists working in PET and to evaluate the occupational radiation dose after implementation of strategies to lower exposure. Materials and Methods We divided into four working types by QC for PET, injection, scan and etc. in PET scan procedure. In QC of PET, we compared the radiation exposure controlling next to $^{68}Ge$ cylinder phantom directly to controlling the table in console room remotely. In injection, we compared the radiation exposure guiding patient in waiting room before injection to after injection. In scan procedure of PET, we compared the radiation exposure moving the table using the control button located next to the patient to moving the table using the control button located in the far distance. PERSONAL ELECTRONIC DOSEMETER (PED), Tracerco$^{TM}$ was used for measuring exposed radiation doses. Results The average doses of exposed radiation were $0.27{\pm}0.04{\mu}Sv$ when controlling the table directly and $0.13{\pm}0.14{\mu}Sv$ when controlling the table remotely while performing QC. The average doses of exposed radiation were $0.97{\pm}0.36{\mu}Sv$ when guiding patient after injection and $0.62{\pm}0.17{\mu}Sv$ when guiding patient before injection. The average doses of exposed radiation were $1.33{\pm}0.54{\mu}Sv$ when using the control button located next to the patient and $0.94{\pm}0.50{\mu}Sv$ when using the control button located in far distance while acquiring image. As a result, there were statistically significant differences(P<0.05). Conclusion: From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine. Conclusion From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine.

• Journal of Intelligence and Information Systems
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• v.26 no.4
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• pp.87-109
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• 2020

Currently, thanks to the major stride made in developing wired and wireless communication technology, a variety of IT services are available on land. This trend is leading to an increasing demand for IT services to vessels on the water as well. And it is expected that the request for various IT services such as two-way digital data transmission, Web, APP, etc. is on the rise to the extent that they are available on land. However, while a high-speed information communication network is easily accessible on land because it is based upon a fixed infrastructure like an AP and a base station, it is not the case on the water. As a result, a radio communication network-based voice communication service is usually used at sea. To solve this problem, an additional frequency for digital data exchange was allocated, and a ship ad-hoc network (SANET) was proposed that can be utilized by using this frequency. Instead of satellite communication that costs a lot in installation and usage, SANET was developed to provide various IT services to ships based on IP in the sea. Connectivity between land base stations and ships is important in the SANET. To have this connection, a ship must be a member of the network with its IP address assigned. This paper proposes a SANET-CC protocol that allows ships to be assigned their own IP address. SANET-CC propagates several non-overlapping IP addresses through the entire network from land base stations to ships in the form of the tree. Ships allocate their own IP addresses through the exchange of simple requests and response messages with land base stations or M-ships that can allocate IP addresses. Therefore, SANET-CC can eliminate the IP collision prevention (Duplicate Address Detection) process and the process of network separation or integration caused by the movement of the ship. Various simulations were performed to verify the applicability of this protocol to SANET. The outcome of such simulations shows us the following. First, using SANET-CC, about 91% of the ships in the network were able to receive IP addresses under any circumstances. It is 6% higher than the existing studies. And it suggests that if variables are adjusted to each port's environment, it may show further improved results. Second, this work shows us that it takes all vessels an average of 10 seconds to receive IP addresses regardless of conditions. It represents a 50% decrease in time compared to the average of 20 seconds in the previous study. Also Besides, taking it into account that when existing studies were on 50 to 200 vessels, this study on 100 to 400 vessels, the efficiency can be much higher. Third, existing studies have not been able to derive optimal values according to variables. This is because it does not have a consistent pattern depending on the variable. This means that optimal variables values cannot be set for each port under diverse environments. This paper, however, shows us that the result values from the variables exhibit a consistent pattern. This is significant in that it can be applied to each port by adjusting the variable values. It was also confirmed that regardless of the number of ships, the IP allocation ratio was the most efficient at about 96 percent if the waiting time after the IP request was 75ms, and that the tree structure could maintain a stable network configuration when the number of IPs was over 30000. Fourth, this study can be used to design a network for supporting intelligent maritime control systems and services offshore, instead of satellite communication. And if LTE-M is set up, it is possible to use it for various intelligent services.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.3-8
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• 2010

Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.