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The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

  • Kim, Hee Jin;Chun, Byung Chul;Kwon, AmyM;Lee, Gyeong-Ho;Ryu, Sungweon;Oh, Soo Yeon;Lee, Jin Beom;Yoo, Se Hwa;Kim, Eui Sook;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.349-355
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    • 2015
  • Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.

Effects of Whey Protein-rich Meal Substitute in 4-Week Diet Trial on Body Weight, Body Fat, and Body Composition of Overweight or Obese Females (유청단백 함유 체중조절용 식사대체제를 이용한 4주 다이어트 프로그램이 과체중 및 비만 여성의 체중, 체지방 및 체성분에 미치는 영향)

  • Xi, Mei-Zhu;Zhang, Yi-Lin;Choi, Young-Bin;Jeong, Gi-Hee;Kim, Gun-Woo;Park, Yong-Woo;Lee, Bog-Hieu
    • Journal of the East Asian Society of Dietary Life
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    • v.26 no.1
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    • pp.25-33
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    • 2016
  • The study was performed to investigate the effects of whey protein-rich meal substitute added with vitamins, minerals, and lactobacillus powder probiotics on weight loss, body fat, and body composition in 24 female volunteers for 4 weeks. Whey protein-rich meal substitute was consumed with low-fat, high calcium milk (1% fat, 260 mg/200 mL) twice a day. Subjects submitted 3-day diet records and a life-style questionnaire before the study. During the study, subjects were required to turn in a diet record every day and consume the meal substitute formula in the metabolic ward at C university for 4 weeks. Anthropometric measurements were carried out weekly by Inbody 7.0. The dietary intake and anthropometric data were analyzed to compare changes before and after the study by paired t-test with SPSS version 23.0. The subjects were mostly early 20's and either overweight or obese and highly motivated to lose weight. Most of the subjects consumed three meals per day regularly and spent mostly 10~15 minutes for a meal. Their caloric intake was relatively low and decreased from 1,360 kcal at week 0 to 1,100 kcal after 4 weeks. However, total protein intake increased while carbohydrate and fat intakes decreased (p<0.05) after the trial. Nine vitamin intakes after the study improved compared to those before the study (p<0.05). After the study, subjects showed lower body weight (-1.8 kg), body fat (-0.94 kg), percent body fat (-0.86%), as well as waist circumference (-4.52 cm), hip circumference (-0.44 cm), waist hip ratio (-0.05), and triceps skinfold thickness (-2.39 mm) compared to those at week 0 (p<0.05). Muscle mass tended to be less compared to week 0, although there was no significant differences between weeks 0 and 4. In conclusion, diet trial with whey protein-rich meal substitute induced weight loss and positively changed body fat parameters and body composition.

Conclusions and Suggestions on Low-Dose and Low-Dose Rate Radiation Risk Estimation Methodology

  • Sakai, Kazuo;Yamada, Yutaka;Yoshida, Kazuo;Yoshinaga, Shinji;Sato, Kaoru;Ogata, Hiromitsu;Iwasaki, Toshiyasu;Kudo, Shin'ichi;Asada, Yasuki;Kawaguchi, Isao;Haeno, Hiroshi;Sasaki, Michiya
    • Journal of Radiation Protection and Research
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    • v.46 no.1
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    • pp.14-23
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    • 2021
  • Background: For radiological protection and control, the International Commission on Radiological Protection (ICRP) provides the nominal risk coefficients related to radiation exposure, which can be extrapolated using the excess relative risk and excess absolute risk obtained from the Life Span Study of atomic bomb survivors in Hiroshima and Nagasaki with the dose and dose-rate effectiveness factor (DDREF). Materials and Methods: Since it is impossible to directly estimate the radiation risk at doses less than approximately 100 mSv only from epidemiological knowledge and data, support from radiation biology is absolutely imperative, and thus, several national and international bodies have advocated the importance of bridging knowledge between biology and epidemiology. Because of the accident at the Tokyo Electric Power Company (TEPCO)'s Fukushima Daiichi Nuclear Power Station in 2011, the exposure of the public to radiation has become a major concern and it was considered that the estimation of radiation risk should be more realistic to cope with the prevailing radiation exposure situation. Results and Discussion: To discuss the issues from wide aspects related to radiological protection, and to realize bridging knowledge between biology and epidemiology, we have established a research group to develop low-dose and low-dose-rate radiation risk estimation methodology, with the permission of the Japan Health Physics Society. Conclusion: The aim of the research group was to clarify the current situation and issues related to the risk estimation of low-dose and low-dose-rate radiation exposure from the viewpoints of different research fields, such as epidemiology, biology, modeling, and dosimetry, to identify a future strategy and roadmap to elucidate a more realistic estimation of risk against low-dose and low-dose-rate radiation exposure.

Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT

  • Xi Hu;Xinwei Tao;Yueqiao Zhang;Zhongfeng Niu;Yong Zhang;Thomas Allmendinger;Yu Kuang;Bin Chen
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1777-1785
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    • 2021
  • Objective: To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. Materials and Methods: This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. Results: No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. Conclusion: The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

Image Comparative Evaluation by PET/CT Equipment Using Phantom (팬텀을 활용한 PET/CT 장비 별 영상 비교 평가)

  • Moo-Jin Jeong;Jun-Chul Ham;Yong-Hoon Choi;Young-Kag Bahn;Han-Sang Lim;Jae-Sam Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.28 no.1
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    • pp.71-79
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    • 2024
  • Purpose: This study aims to identify SUV, SNR, spatial resolution, and axial uniformity under the same reconstruction conditions and to find out the differences between equipment models. Materials and Methods: The equipment was GE's Discovery 600, 710, IQ, MI(GE Healthcare, USA), and the Phantom used ACR(American College of Radiology) Flangeless Esser Phantom and PET/SPECT Performance Phantom. The PET/SPECT Performance Phantom injected 18F-FDG at a concentration of 3.8 kBq/mL, and the ACR Flangeless Esser Phantom made the conditions for Hot Spot and Background activity for 4 : 1. Image evaluation was compared and evaluated for SUV, SNR, spatial resolution, and axial uniformity with the same reconstruction that added SharpIR of VPHD. Results: The SUVmax showed a difference up to 4.6% with an average of 2.71, 2.35, 1.89, and 1.43 from Hot Spot 1 to 4, and the SUVmean showed a difference up to 4.7% with 2.06, 1.75, 1.49, and 1.27. There was a difference up to 5% between equipment, and there was no significant difference between both SUVmax and SUVmean. SNR showed a difference up to 0.04 with an average of 0.37, 0.26, 0.18, and 0.11. FWHM showed a difference up to 0.27. Lastly, COV of axial uniformity was up to 0.018. Conclusion: SUV showed differences within 5% between equipment and showed no significant difference. This is considered to be used as basic data that can be used for the development and replacement of equipment because it has the advantage of being able to observe with a large number of equipment.

Impact of Photon-Counting Detector Computed Tomography on Image Quality and Radiation Dose in Patients With Multiple Myeloma

  • Alexander Rau;Jakob Neubauer;Laetitia Taleb;Thomas Stein;Till Schuermann;Stephan Rau;Sebastian Faby;Sina Wenger;Monika Engelhardt;Fabian Bamberg;Jakob Weiss
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.1006-1016
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    • 2023
  • Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

Correlation between Reactogenicity and Immunogenicity after the ChAdOx1 nCoV-19 and BNT162b2 mRNA Vaccination

  • So Yun Lim;Ji Yeun Kim;Soonju Park;Ji-Soo Kwon;Ji Young Park;Hye Hee Cha;Mi Hyun Suh;Hyun Jung Lee;Joon Seo Lim;Seongman Bae;Jiwon Jung;Nakyung Lee;Kideok Kim;David Shum;Youngmee Jee;Sung-Han Kim
    • IMMUNE NETWORK
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    • v.21 no.6
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    • pp.41.1-41.13
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    • 2021
  • Correlation between vaccine reactogenicity and immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Thus, we investigated to determine whether the reactogenicity after coronavirus disease 2019 vaccination is associated with antibody (Ab) titers and T cell responses. This study was prospective cohort study done with 131 healthcare workers at tertiary center in Seoul, South Korea. The degrees of the local reactions after the 1st and 2nd doses of ChAdOx1 nCov-19 (ChAdOx1) vaccination were significantly associated with the S1-specific IgG Ab titers (p=0.003 and 0.01, respectively) and neutralizing Ab (p=0.04 and 0.10, respectively) in age- and sex-adjusted multivariate analysis, whereas those after the BNT162b2 vaccination did not show significant associations. T cell responses did not show significant associations with the degree of reactogenicity after the ChAdOx1 vaccination or the BNT162b2 vaccination. Thus, high degree of local reactogenicity after the ChAdOx1 vaccine may be used as an indicator of strong humoral immune responses against SARS-CoV-2.

Added Value of 3D Cardiac SPECT/CTA Fusion Imaging in Patients with Reversible Perfusion Defect on Myocardial Perfusion SPECT (심근관류 SPECT에서 가역적인 병변을 보인 환자의 3차원 심장 SPECT/CTA 퓨전영상의 유용성)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Kang, Won-Jun;Kim, Seong-Min;Won, Kyoung-Sook;Lim, Seok-Tae;Hwang, Kyung-Hoon;Lee, Byeong-Il;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.513-518
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    • 2009
  • Purpose: Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. Materials and Methods: Forty-eight patients (M:F=26:22, Age: $63.3{\pm}10.4$ years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. Results: Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. Conclusion: Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.

A Comparative Analysis According to a Presence or Absence of Metal Artifacts when a Dose Change and QAC Technique are Applied in PET/CT Tests (PET/CT 검사에서 선량변화와 QAC기법 적용 시 Metal Artifact 유무에 따른 SUV 비교분석)

  • Yun, Sun-Hee;Kim, Yang-Jung;Kang, Young-Jik;Park, Su-Young;Kim, Ho-Sin;Ryu, Hyoung-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.51-56
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    • 2015
  • Purpose As medical radiation exposures on patients are being social issues an interest in a relief of radiation exposures on patients is increasing. Further, there are many cases where some patients among who are getting PET/CT tests choose to get implanted with metal artifacts in their bodies. This study is to find out effects of presence or absence of metal artifacts when dose change or CT attenuation correction for the relief of radiation exposures are applied using phantoms through changes in standard uptake value (SUV). Materials and Methods GE company's Discovery 710 machine was used for PET/CT test equipments. We used NEMA IEC body phantoms. We also used screw and mesh cage made of titanium which are used in real clinical processes for the metal artifacts. Two experiments were conducted: One is to test and measure repeatedly about SUV about differences in CT attenuation corrections according to dose changes and another is to do the same procedure for SUV about the presence and absence of the metal artifacts. We injected $^{18}F-FDG$ into NEMA IEC body phantoms with a TBR ratio of 4:1 and then put the metal material into the transformation phantoms. Once a scanning for the metal artifacts was done we eliminated the metal artifacts and went on non-metal artifacts. For the each two experiments, we scanned repeatedly with CT kVp (140, 120, 100, 80) and mA (120, 80, 40, 20, 10) for an experimental condition. For PET, we reconstructed each with standard AC (STD) technique and quantitation achieved cnsistently QAC) technique among CT attenuation correction methods. We conducted a comparative analysis on measured average values and variations which were measured through repeated measure of SUV of region 1, 2, 3 spheres for each conditions of non-metal /metal scan. Results For each kVp, 120, 80, 40 (mA) of non/metal (screw, mesh cage) showed low frequency of fluctuation rates of above 2%. In 20, 10 mA above 2% of fluctuation rates appeared in high frequency. Also, when we compared the fluctuation rates of STD and QAC techniques in non/metal (screw, mesh cage) tests QAC technique showed about 1-10% of differences for each conditions compared to STD technique. In addition, metal types did not have significant effects on fluctuation rates. Conclusion We confirmed that SUV fluctuation rates for both STD and QAC techniques increase as dosage is lower. We also found that the SUV of PET data was maintained steadily in a low dosage for QAC technique when compared with STD technique. Hence, when the low dosage is used for the relief of radiation exposures on patients QAC technique may be exploited helpfully and this could be applied in the same way for patients with metal artifacts implanted in their bodies.

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Effect of Astragali Radix and Opuntia humifusa on Quality of Red Ginseng Drink (황기 및 천년초 첨가가 홍삼음료의 품질에 미치는 영향)

  • You, SangGuan;Kim, Sung-Won;Jung, Kyung-Hwan;Moon, Sung-Kwon;Yu, Kwang-Won;Choi, Won-Seok
    • Food Engineering Progress
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    • v.14 no.4
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    • pp.299-306
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    • 2010
  • This study was performed to develop new functional red ginseng drinks with Astragali Radix and Opuntia humifusa. Optimum extraction conditions such as solvent property and temperature for Astragali Radix were determined by distilled water vs. ethanol (95%) ratio (0:100, 25:75, 50:50, 75:25) and 60 vs. $80^{\circ}C$. Water-soluble extracts at $80^{\circ}C$ showed higher antioxidant activities than fat-soluble extracts at $60^{\circ}C$. Viscosities of 1-2% (w/v) of Opuntia humifusa solution were similar to that of the 0.1% guar gum solution. Addtion of Astragali Radix (3% and 5%, w/v) and Opuntia humifusa (1.2%, w/v), especially, had effect on the changes of pH of the red ginseng solution(5%, w/v) during storage for 7 days. A significant difference during the storage was shown in total plate counts by addition of Opuntia humifusa (1.2%, w/v) and microorganisms were reduced by six log cycles. Significant antiproliferation effects of red ginseng (5%, w/v) solution with Astragali Radix (3% & 5%, w/v) and Opuntia humifusa (1.2%, w/v) on Colon26m-3.1 carcinoma (colorectal carcinoma) cell and U87-MG neuronale glioblastoma (brain carcinoma) cell were not observed.