• 핵의학기술
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• 제27권2호
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• pp.111-127
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• 2023

Purpose: Gallium-68 (⁶⁸Ga) is increasingly used in nuclear medicine imaging for various conditions such as lymphoma and neuroendocrine tumors by labeling tracers like Prostate Specific Membrane Antigen (PSMA) and DOTA-TOC. However, compared to Fluorine-18 (¹⁸F) used in conventional nuclear medicine imaging, ⁶⁸Ga has lower spatial resolution and relatively higher Signal to Background Ratio (SBR). Therefore, this study aimed to investigate the optimized parameters and reconstruction methods for PET/CT imaging using the ⁶⁸Ga radiotracer through model-based image evaluation. Materials and Methods: Based on clinical images of ⁶⁸Ga-PSMA PET/CT, a NEMA/IEC 2008 PET phantom model was prepared with a Hot vs Background (H/B) ratio of 10:1. Images were acquired for 9 minutes in list mode using DMIDR (GE, Milwaukee WI, USA). Subsequently, reconstructions were performed for 1 to 8 minutes using OS-EM (Ordered Subset Expectation Maximization) + TOF (Time of Flight) + Sharp IR (VPFX-S), and BSREM (Block Sequential Regularized Expectation Maximization) + TOF + Sharp IR (QCFX-S-400), followed by comparative evaluation. Based on the previous experimental results, images were reconstructed for BSREM + TOF + Sharp IR / 2 minutes (QCFX-S-2min) with varying β-strength values from 100 to 700. The image quality was evaluated using AMIDE (freeware, Ver.1.0.1) and Advanced Workstation (GE, USA). Results: Images reconstructed with QCFX-S-400 showed relatively higher values for SNR (Signal to Noise Ratio), CNR (Contrast to Noise Ratio), count, RC (Recovery Coefficient), and SUV (Standardized Uptake Value) compared to VPFX-S. SNR, CNR, and SUV exhibited the highest values at 2 minutes/bed acquisition time. RC showed the highest values for a 10 mm sphere at 2 minutes/bed acquisition time. For small spheres of 10 mm and 13 mm, an inverse relationship between β-strength increase and count was observed. SNR and CNR peaked at β-strength 400 and then decreased, while SUV and RC exhibited a normal distribution based on sphere size for β-strength values of 400 and above. Conclusion: Based on the experiments, PET/CT imaging using the ⁶⁸Ga radiotracer yielded the most favorable quantitative and qualitative results with a 2 minutes/bed acquisition time and BSREM reconstruction, particularly when applying β-strength 400. The application of BSREM can enhance accurate quantification and image quality in ⁶⁸Ga PET/CT imaging, and an optimization process tailored to each institution's imaging objectives appears necessary.

• Journal of Korean Medical Science
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• 제33권52호
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• pp.346.1-346.11
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• 2018

Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.552-558
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• 2015

Background The Klippel-Trenaunay syndrome (KTS) is characterized by three clinical features, namely cutaneous capillary malformations, venous malformations, and soft tissue and/or bony hypertrophy of the extremities. The varied manifestations are attributed to the unpredictable clinical nature and prognosis of the syndrome. To elucidate the clinical characteristics of this disease, we reviewed a relatively large number of KTS patients who presented to our vascular anomalies center. Methods We conducted a retrospective study with 19 patients who were diagnosed with KTS and treated in our vascular anomalies clinic between 2003 and 2014, and examined their demographic characteristics, their clinical features, and the treatments administered. Results The sex distribution was balanced, with 9 (47%) males and 10 (53%) females. The mean follow-up period was 4.1 years (range, 7 months-9 years). Most of the patients received conservative treatments such as medication or physiotherapy. Compression therapies such as wearing of elastic garments/bandages were also administered, and surgical interventions were considered only when the patients became excessively symptomatic. Other treatments included laser therapy and sclerotherapy, and all the treatments were adjusted according to each case, tailored to the conditions of the individual patients. Conclusions KTS is an extremely rare, multifactorial disorder that induces widely varied symptoms. Because of this unique feature, plastic surgeons, when not careful, tend to attach a one-sided importance to typical symptoms such as limb hypertrophy or capillary malformation and thus overlook other symptoms and clinical features. KTS can be suspected in all infants who show capillary malformations or limb hypertrophy and require a multi-disciplinary approach for comprehensive management.

• Journal of Korean Biological Nursing Science
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• 제14권2호
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• pp.112-121
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• 2012

Purpose: The purpose of this study was to investigate the level of self management behavior of patients with type 2 diabetes and to compare the factors influencing self management behavior between the elderly and adults. Methods: The participants consisted of 105 adults and 100 elderly who visited the outpatient department of a hospital from August to December 2011. Data was collected by questionnaires and analyzed using the SPSS/WIN 18.0. Results: The elderly showed higher mean scores of subcategory of self management behavior than adults. In stepwise multiple regression analysis, a total of 42% (adults), 52% (elderly) respectively of variance in self management behavior were accounted for by self-efficacy, perceived barriers, perceived benefits, yes or no smoking and regular exercise in adults and readiness, self efficacy, perceived benefits in the elderly. Conclusion: Therefore, a diabetics intervention program should be designed and provided as a tailored one for adults and elderly separately in Korea. In the strategy for adults with type 2 diabetes in the promotion of self efficacy, perceived benefits and reduction of perceived barriers, and correction of life habits such as smoking and exercise are needed, whereas in the elderly promotion of readiness, self efficacy, perceived benefits are required.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.477-483
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• 2013

Objective : Although surgical techniques for clipping paraclinoid aneurysms have evolved significantly in recent times, direct microsurgical clipping of large and giant paraclinoid aneurysms remains a formidable surgical challenge. We review here our surgical experiences in direct surgical clipping of large and giant paraclinoid aneurysms, especially in dealing with anterior clinoidectomy, distal dural ring resection, optic canal unroofing, clipping techniques, and surgical complications. Methods : Between September 2001 and February 2012, we directly obliterated ten large and giant paraclinoid aneurysms. In all cases, tailored orbito-zygomatic craniotomies with extradural and/or intradural clinoidectomy were performed. The efficacy of surgical clipping was evaluated with postoperative digital subtraction angiography and computed tomographic angiography. Results : Of the ten cases reported, five each were of ruptured and unruptured aneurysms. Five aneurysms occurred in the carotid cave, two in the superior hypophyseal artery, two in the intracavernous, and one in the posterior wall. The mean diameter of the aneurysms sac was 18.8 mm in the greatest dimension. All large and giant paraclinoid aneurysms were obliterated with direct neck clipping without bypass. With the exception of the one intracavenous aneurysm, all large and giant paraclinoid aneurysms were occluded completely. Conclusion : The key features of successful surgical clipping of large and giant paraclinoid aneurysms include enhancing exposure of proximal neck of aneurysms, establishing proximal control, and completely obliterating aneurysms with minimal manipulation of the optic nerve. Our results suggest that internal carotid artery reconstruction using multiple fenestrated clips without bypass may potentially achieve complete occlusion of large paraclinoid aneurysms.

• Clinical and Experimental Pediatrics
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• 제63권7호
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• pp.278-283
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• 2020

Background: Major questions remain regarding the agestratified trends of allergic diseases and asthma in Korea. Purpose: To identify the estimated recent prevalence and 10-year trends in asthma, allergic rhinitis, and atopic dermatitis among the Korean population from 2008 to 2017. Methods: This nationwide cross-sectional survey (Korean National Health and Nutrition Examination Survey) over 10 years (2008-2017) examined representative samples of the Korean population (n=85,006) including 2,131 infants, 4,352 preschool children, 12,919 school-age children, 44,200 adults, and 21,404 elderly adults. Results: In the 2016 to 2017 population, the estimated prevalence of asthma was 0.9% in infants, 2.3% in preschool children, 4.1% in school-age children, 2.3% in adults, and 4.1% in the elderly. The estimated prevalence of allergic rhinitis was 9.0%, 20.2%, 27.6%, 17.1%, and 6.9%, respectively. The estimated prevalence of atopic dermatitis was 5.9%, 11.3%, 14.6%, 3.9%, and 1.6%, respectively. Ten-year trends revealed a significant decrease in asthma prevalence in infants, preschool children, and the elderly. and in atopic dermatitis prevalence in infants and preschool children (P<0.05 for all trends). Furthermore, 10-year trends demonstrated a significant increase in allergic rhinitis prevalence in school-age children, adults, and the elderly, and in atopic dermatitis prevalence in school-age children and the elderly (P<0.05 for all trends). Conclusion: These results improve our understanding of the age-stratified epidemiology of allergic diseases in Korea and suggest the need for the development of tailored and precise strategies to prevent allergic diseases in different age groups.

• Nutrition Research and Practice
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• 제9권2호
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• pp.180-185
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• 2015

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (${\pm}SD$) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was $150.7({\pm}9.5)$/$84.149({\pm}5.6)$. Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to $135.5({\pm}13.0)$/$82.5({\pm}12.8)$ (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still ${\leq}140mmHg$. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.

• 지역사회간호학회지
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• 제21권1호
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• pp.31-42
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• 2010

Purpose: The aims of this study were to identify successful strategies and propose a community-based participatory global health project model for primary health care capacity development. Methods: The study used case study methodology. A The unit of analysis was an international cooperation health project entitled "Community-based Primary Health Care Improvement in San Lorenzo, Ecuador" using community-based participatory research conducted in 2007~2008. Data were collected through windshield surveys, focus group discussion, key informant interviews, and provider surveys. Results: Identified successful strategies for the international cooperation health project were reciprocal partnership between researchers and community, partners' capacity building, south-to-south cooperation, and continuous monitoring and feedback. Community participation was found to be an essential tenet to guarantee the improvement of primary health care in the underserved rural community. Evidence from the activities of community health practitioners in Korea was applicable to the development of training programs for primary health care providers in Ecuador. Conclusion: Strategies for strengthening primary health capacity may be tailored depending on socio-cultural, political, and economical situations of each country. The model, however, would be applicable to the entire process of community-based global health projects in underserved rural communities of other countries.

• 한국보건간호학회지
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• 제31권2호
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• pp.327-340
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• 2017

Purpose: The aim of this study was to identify the barriers to promoting physical activity among obese children from low-income families using community child care (CCC) centers. Methods: This study employed an exploratory-descriptive qualitative research using focus group interviews. The participants were recruited from CCC centers, and 4 focus group interviews were conducted with 10 overweight and obese children and 14 primary caregivers. All interviews were recorded and transcribed verbatim. The data were analyzed using content analysis. Results: The barriers to promoting physical activity were classified into three areas: 1) individual, a lack of will for physical activity; 2) interpersonal, a change in communicative mean with the peer group, absence of parental monitoring due to work-family balance, and an absence of consistent rules; and 3) organizational, lack of physical activity programs and human resources, and confined space for physical activity. Conclusion: The physical activity of children in low-income families is influenced by a range of ecological barriers. These findings can be used to develop tailored intervention to prevent and manage childhood obesity in low-income children.

• 한국식품영양학회지
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• 제24권3호
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• pp.386-395
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• 2011

The purpose of this research was to study food behaviors and nutrient intakes according to body mass index(BMI) and body image recognition in 211 female university students in Incheon. The majority of the surveyed subjects were in the normal range for BMI. Most of these female university students preferred a thin body type and were not satisfied with their body shapes. Most also controlled their body weight for appearance by exercising and limiting food intake. The obese group often ate processed foods(p<0.01) and ate out(p<0.05). The underweight group and normal-weight group took vitamins and supplements more frequently(p<0.001). Those students who recognized their body image as a 'fat shape' had good appetites(p<0.05) and those who recognized themselves as 'normal shape' considered food formulations ate every meal (p<0.05) and consumed vitamins and other supplements frequently(p<0.01). The mean calorie intake of all students was about 80% of the recommend amount, so there was a risk of lack of various nutrients. The 'fat' students by body image recognition had lower calorie intakes in order to reduce body weight. In all the groups, there was a lack of vitamins $B_1$ and $B_2$, as well as the minerals Ca and Fe. Therefore, education on correct body image recognition and training on proper weight control are deemed necessary. In addition, education and counseling on nutrition that are tailored to individual status are needed.