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Accuracy of FDG-PET/CT for Detection of Incidental Pre-Malignant and Malignant Colonic Lesions - Correlation with Colonoscopic and Histopathologic Findings

  • Kunawudhi, Anchisa;Wong, Alexandra K;Alkasab, Tarik K;Mahmood, Umar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4143-4147
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    • 2016
  • Purpose: We evaluated all PET/CTs acquired for patients without a primary diagnosis of colorectal cancer, and compared results for those who had subsequent colonoscopy within 6 months, to assess the accuracy of FDG PET/CT for detection of incidental pre-malignant polyps and malignant colon cancers. Materials and Methods: Medical records of 9,545 patients who underwent F-18 FDG PET/CT studies over 3.5 years were retrospectively reviewed. Due to pre-existing diagnosis of colorectal cancer, 818 patients were excluded. Of the remainder, 157 patients had colonoscopy within 6 months (79 males; mean age 61). We divided the colon into 4 regions and compared PET/CT results for each region with colonoscopy and histopathologic findings. True positive lesions included colorectal cancer, villous adenoma, tubulovillous adenoma, tubular adenoma and serrated hyperplastic polyp/hyperplastic polyposis. Results: Of 157 patients, 44 had incidental colonic uptake on PET/CT (28%). Of those, 25 had true positive (TP) uptake, yielding a 48% positive predictive value (PPV); 9% (4/44) were adenocarcinoma. There were 23 false positive (FP) lesions of which 4 were hyperplastic polyp, one was juvenile polyp and 7 were explained by diverticulitis. Fifty eight patients had false negative PET scans but colonoscopy revealed true pre-malignant and malignant pathology, yielding 23% sensitivity. The specificity, negiative predictive value (NPV) and accuracy were 96%, 90% and 87%, respectively. The average SUVmax values of TP, FP and FN lesions were 7.25, 6.11 and 2.76, respectively. There were no significant difference between SUVmax of TP lesions and FP lesions (p>0.95) but significantly higher than in FN lesions (p<0.001). The average size (by histopathology and colonoscopy) of TP lesions was 18.1 mm, statistically different from that of FN lesions which was 5.9 mm (p<0.001). Fifty-one percent of FN lesions were smaller than 5 mm (29/57) and 88% smaller than 10 mm (50/57). Conclusions: The high positive predictive value of incidental focal colonic FDG uptake of 48% for colonic neoplasia suggests that colonoscopy follow-up is warranted with this finding. We observed a low sensitivity of standardly acquired FDG-PET/CT for detecting small polyps, especially those less than 5 mm. Clinician and radiologists should be aware of the high PPV of focal colonic uptake reflecting pre-malignant and malignant lesions, and the need for appropriate follow up.

A Study on Reliability Based Design Criteria for Reinforced Concrete Bridge Superstructures (철근(鐵筋)콘크리트 도로교(道路橋) 상부구조(上部構造) 신뢰성(信賴性) 설계규준(設計規準)에 관한 연구(研究))

  • Cho, Hyo Nam
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.2 no.3
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    • pp.87-99
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    • 1982
  • This study proposes a reliability based design criteria for the R.C. superstructures of highway bridges. Uncertainties associated with the resistance of T or rectangular sections are investigated, and a set of appropriate uncertainties associated with the bridge dead and traffic live loads are proposed by reflecting our level of practice. Major 2nd moment reliability analysis and design theories including both Cornell's MFOSM(Mean First Order 2nd Moment) Methods and Lind-Hasofer's AFOSM(Advanced First Order 2nd Moment) Methods are summarized and compared, and it has been found that Ellingwood's algorithm and an approximate log-normal type reliability formula are well suited for the proposed reliability study. A target reliability index (${\beta}_0=3.5$) is selected as an optimal value considering our practice based on the calibration with the current R.C. bridge design safety provisions. A set of load and resistance factors is derived by the proposed uncertainties and the methods corresponding to the target reliability. Furthermore, a set of nominal safety factors and allowable stresses are proposed for the current W.S.D. design provisions. It may be asserted that the proposed L.R.F.D. reliability based design criteria for the R.C. highway bridges may have to be incorporated into the current R.C. bridge design codes as a design provision corresponding to the U.S.D. provisions of the current R.C. design code.

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Effects of Interpersonal Relationship, Self Differentiation on College Adjustment in Nursing Students (간호대학생의 대인관계능력, 자아분화가 대학생활적응에 미치는 영향)

  • Lim, Mi-Hye
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.225-233
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    • 2018
  • The purpose of this study was to investigate the level of interpersonal relationship, self differentiation and adjustment to college life as well as to identify the factors influencing the adjustment to college life in nursing students. The study was conducted on 185 nursing students in D and S Province and from November 15th to December 5th 2016. The data was analyzed using t-test, one-way ANOVA, Pearson's correlation and Multiple regression. The mean score of the adjustment to college life was $3.30({\pm}0.49)$ and the interpersonal relationship was $3.73({\pm}0.41)$ and self differentiation was $3.07({\pm}0.32)$. There were positive correlations between adjustment to college life and interpersonal relationship(r=.614, p<.001) and self differentiation((r=.264, p<.001). Significant factors influencing adjustment to college life were interpersonal relationship, self differentiation which explained 39% of adjustment to college life. Based on these findings, programs that develop interpersonal relationship and self differentiation are necessary for college nursing students in order to promote college adjustment.

INFLUENCE OF THE ENAMEL TREATMENT WITH ER:YAG LASER ON THE MICROLEAKAGE OF PIT AND FISSURE SEALANT (Er:YAG 레이저를 이용한 법랑질 표면처리가 치면열구전색제의 미세누출에 미치는 영향)

  • Lee, Ji-Hyun;Kim, Jae-Moon;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.192-200
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    • 2006
  • The aim of this study was to assess the microleakage underneath a pit and fissure sealant bonded to occlusal surfaces treated by Er:YAG laser To determine the most effective energy density of laser, fourteen specimens were irradiated from 50mJ to 300mJ at 3Hz. After irradiation, the lased specimens were observed under the scanning electron microscope. Thirty six non-carious extracted premolars were randomly assigned to four groups of nine teeth: group 1, no treatment on the occlusal surface; group 2, acid etching for 15 seconds; group 3, Er:YAG laser irradiation; group 4, acid etching followed by Er:YAG laser irradiation. The pits and fissures were sealed with unfilled sealant(Helioseal F) and the specimen teeth were thermo-cycled, immersed in 2% Rhodamine B solution, longitudinally sectioned and analyzed for microleakage with fluorescent microscope. The results were as follows: 1. Er:YAG lased surfaces with 50mJ, 3Hz showed a similar pattern of irregularity with acid etched enamel surfaces 2. The mean microleakage score increased in the order of group 2, 4, 3 and 1. There was no significant difference among group 1, 3 and 4(p>0.05), however group 2 showed significantly less microleakage compared with group 1 and 3. Conclusively, the laser irradiation seemed not enough to replace the acid etching for proper retention of pit and fissure sealants.

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Perception on Hospice and Attitude to Death for University Students (대학생의 호스피스 인식과 죽음 태도)

  • Kim, Myosung
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.115-121
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    • 2019
  • The purpose of this study was to examine relation between perception on hospice and attitude toward death to provide baseline data for the development of programs for hospice or death-related education for university students. The survey was performed on 150 students in four universities in B metropolitan city. The data was collected from July 30 to August 13, 2019. Data were analyzed using descriptive analysis, t-test, ANOVA Pearson's correlation coefficient with the SPSS/WIN 26.0 program. The mean of perception on hospice score was 3.06 out of 4, of the attitude toward death, 'neutral acceptance', 'fear of death', 'death avoidance', 'approach acceptance', and 'escape acceptance' had average scores of 5.31, 3.77, 3.56, 3.15, and 3.06, respectively. There were significant differences in perception on hospice according to gender, major, and experience of hospice-related education and in attitude toward death according to gender, major, religion, subjective health status, experience of hospice-related education. The relationship between perception on hospice and neutral acceptance showed a significant positive correlation, and fear of death and death avoidance showed a significant negative correlation. Therefore, we need consider these variables to develop a hospice or death-related education program to enhance university students' attitudes to death and their perception of hospice.

The Comorbidity of Periodic Limb Movements Disorder in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자에서의 수면중 주기성 사지운동장애의 동반이환율)

  • Yang, Chang-Kook;Son, Choon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1039-1046
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    • 1998
  • Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

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Efficacy of Pamidronate in Nephropathic Children with Ongoing Long Term Corticosteroid Therapy (장기 스테로이드 치료요법 중인 신질환 환자에서 Pamidronate의 효과)

  • Hong Hyun-Kee;Kim Eun-Seong;Kim Sung-Do;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.43-50
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    • 2004
  • Background : Steroid-induced osteoporosis(SIO) is one of the serious complications of long-term steroid therapy, especially in growing children. Recently bisphosphonates have been used to treat or prevent SIO in adult, which is rare in children with glomerular diseases. We studied the effect of pamidronate on SIO using dual energy X-ray absorptiometry and biochemical markers of bone turnover. Methods : Forty four children receiving moderate-to-high doses of steroids were enrolled. They had no history of bone, liver, or endocrine disease. Patients were stratified by their baseline bone mineral density(BMD) findings. All patients received corticosteroids for 3 month and oral calcium supplementation(500 mg/day) daily. Among them, 28 patients were treated with placebo and 16 were treated with pamidronate(125 mg) for 3 months. Blood chemistry and bone mineral density(BMD) were measured at baseline, and 3months. In addition, parathyroid hormone(PTH), serum osteocalcin, and urinary dipyridinoline levels were evaluated. Results : In overall population, the mean lumbar spine BMD decreased from $0.754{\pm}0.211(g/cm^2)$ to $0.728{\pm}0.208(g/cm^2)$ in the placebo group(P<0.05) and increased from $0.652{\pm}0.194(g/cm^2)$ to $0.658{\pm}0.226(g/cm^2)$ in the pamidronate group(P>0.05). Conclusion : Pamidronate appears to be effective in preventing SIO in children with glomerular diseases requiring long-term steroids therapy. Further careful observation and follow-up might be needed for children receiving bisphosphonates such as pamidronate.

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Etiologic Survey on the Acute Diarrhea of Puppies in Seoul (서울지역에서 문제되고 있는 강아지의 급성설사증에 관한 병인학적 연구)

  • Han Hong-Ryul;Park Hee-Myung;Lee Jin-Hee;Oh Tae-Ho;Jeong Soon-Wuk;Youn Sin-Keun;Park Cheol-Man
    • Journal of Veterinary Clinics
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    • v.10 no.2
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    • pp.171-184
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    • 1993
  • In Seoul area, there are so many kennel clubs, veterinary hospital, pet establishment and breeding confers that various problems have occurred. They are crowed pet houses, poor sanitation, stress to puppies, sudden environmental changes to puppies and unvaccination against parvovirus, canine distemper virus, parainfluenza virus, infectious hepatitis caused by Adenovirus type I and Leptospira. Several studies were made to survey the infectious agents involved in acute diarrhea of poppies in Seoul are, such as history taking, physical examination, complete blood count and serum chemistry, histopathological finding, bacterial isolation and identification, and hemagglutination test in feces and hemagglutination inhibition test in serum against parvovirus, respectively. The results obtained are summarized as followed. 1. The percent of PCV (30.5$\pm$5.6) and concentration of Total protein(5.0$\pm$0.8) resulted from statistical analysis are significantly lower than normal values (p<0.05), respectively. In addition, fibrinogen (505$\pm$326) was significantly higher an normal value (p<0.001), Band neutrophil (22.9$\pm$12.7) showed signifiant difference (P<0.01). decreased monocyte (3.2$\pm$2.1) and eosinophil (0.7$\pm$0.8) values appeared statistically significant (p<0.001), lymphocyte (16.7$\pm$9), as well. 2. The concentrations of calcium .(8.0$\pm$2.8), glucose (40.1$\pm$31.4), and albumin (2.0$\pm$0.39) were lower than normal values (p<0.01, p<0.01, p<0.001), respectively. Also Inorganic phosphate (7.1$\pm$2.4), pH (p<7.9f:0.2), and Blood Urea Nitrogen (40.41=37.1) were significantly higher than normal values (p<0.001, p(0.001, p<0.05), respectively. 3. Simple and mixed infections occupied 18% and 82% in the distribution of causes in puppies with acute diarrhea, respectively. 4. As puppies got older, incidence of acute diarrhea caused by Staphylococcus aureus was decreased to 13% and infection of canine distemper virus was increased to 53%, but E coli and canine parvovirus always showed high frequency of outbreak in the body weight ranged from 35g to 7.8Kg. 5. As showed in table 5, infections of E coli and Canine Parvovirus showed high outbreak regardless of the age which is classified into three stages, 35~50 day, 60 day and 75~day to 1 year, canine distemper virus appeared increased, but in case of Staphylococcus aureus, visa versa. 6. In comparison wi methods for the laboratory diagnosis diagnosis parvovirus, Hemagglutination test showed positive reaction in 25% and mean serum antibody titer measured by Hemagglutination inhibition test showed 2779 (n=20). In addition, positive reaction was 90% (18/20). 7. In histopathological studies, enteritic and pneumonic lesions were indicated in 53.7% and 39.5% of samples, respectively. 8. Etiologic diagnosis based on the history taking, clinical signs and histopathological findings in puppies with acute diarrhea and vomiting indicated that 50% of puppies were infected by canine parvovirus and distemper virus. 9. In the parasitological examination made by simple flotation with saturated zinc sulfate tour parasites found were Isospora canis, Toxocara canis, Ancylostoma spp and Toxocara spp. Isospora canis and Toxocara canis were more frequently found among those parasites of diarrhoeic causes in puppies ranged from 35 days to 1 year. Their infestation rates were 15% and 13% respectively.

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Analysis of Occlusal Contacts Using Add-picture Method (Add-picture 방법을 이용한 교합접촉점 분석)

  • Park, Ko-Woon;Cho, Lee-Ra;Kim, Dae-Gon;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.1
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    • pp.45-58
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    • 2013
  • The purpose of this study was to analyze the area of occlusal contact points using visual method. One subject was selected who had Angle Class I, normal dentition, without dental caries, periodontal disease and temporomandibular disorders. Forty times PVS impressions were taken and 10 pairs casts were fabricated using dental super hard stone. After mounting the casts with customized loading apparatus, 78.9kg/f force was loaded as a maximum biting force. In T-Scan method, occlusal contact points measurement was repeated twice. Then, using Photoshop program (Adobe photoshop CS3, Adobe. San Jose, USA), the pixels which indicated occlusal contact points by color was recognized, and the distribution of recognized pixels were calculated to area. In Add picture method, polyether bite material applied to the occlusal surface of the casts. Then, the image of the translucent areas was recorded and classified $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$, $0{\sim}60{\mu}m$ area by the amount of transmitted light. To acquire occlusal surface, the numbers of pixels from the photograph of the contact area indicated cast converted to $mm^2$. The mean occlusal contact area by two methods was statistically analyzed (paired t-test). Part of the red and pink area in T-Scan image were almost equivalent to the $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$, $0{\sim}60{\mu}m$ area in Add picture image. The distribution of occlusal contact points were similar, but the average area of occlusal contact points was wider in T-scan image (P<.05). Pink and red area in T-scan image was wider than $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$ area in Add picture image (P<.05), but similar to $0{\sim}60{\mu}m$area in Add picture image (P>.05). Occlusal contact points in T-scan image did not indicate real occlusal contact points. Occlusal contact areas in T-scan method were enlarged results comparing with those in Add picture method.

Histomorphological Comparison of the Coronary Artery and Available Graft Conduits (관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교)

  • Kim, Yong-Ho;Lee, Seok-Ki;Yu, Jeong-Hwan;Kim, Si-Wook;Kang, Shin-Kwang;Lim, Seung-Pyung;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.563-567
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    • 2008
  • Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.