• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.231-238
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• 2005

Purpose: We investigated prospectively whether the interpretation considering the patterns of FDG uptake and the findings of unenhanced CT for attenuation correction can improve the diagnostic accuracy for assessing malignant lymph node (LN) and N stage in non-small cell lung cancor (NSCLC) using CT-corrected FDG-PET (PET/CT). Materials & Methods: Subjects were 91 NSCLC patients (M/F 62/29, age: $60{\pm}9$ yr) who underwent PET/CT before in dissection. We evaluated the maximum SUV (maxSUV), patterns of FDG uptake, short axis diameter, and calcification of LN showing abnormally increased FDG uptake. Then we investigated criteria improving the diagnostic accuracy and correlated results with postoperative pathology. In step 1, in was classified as benign or malignant based on maxSUV only. In step 2, LN was regarded as benign if it had lower maxSUV than the cut-off value of step 1 or it had calcification irrespective of its maxSUV. In step 3, LN regarded as malignant in step 2 was classified as benign if they had indiscrete margin of FDG uptake. Results: Among 432 LN groups surgically resected (28 malignant, 404 benign), 71 showed abnormally increased FDG uptake. We determined the cut-off as maxSUV=3.5 using ROC curve analysis. The sensitivity, specificity, and accuracy for assessing malignant LN were 64.3%, 86.9%, 85.4% in step 1, 64.3%, 95.0%, 93.1% in step 2, and 57.1%, 98.0%, 95.4% in step3, respectively. The accuracy for assessing N stage was 64.8% in step 1, 80.2% in step 2, and 85.7% in step 3. Conclusion: interpreting PET/CT, consideration of calcification and shape of the FDG uptake margin along with maxSUV can improve the diagnostic accuracy for assessing malignant involvement and N stage of hilar and mediastinal LNs in NSCLC.

• Geophysics and Geophysical Exploration
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• v.13 no.3
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• pp.268-276
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• 2010

Earthquake Hazard Mitigation Law was activated into force on March 2009. By the law, the obligation to monitor the effect of earthquake on the facilities was extended to many organizations such as gas company and local governments. Based on the estimation of National Emergency Management Agency (NEMA), the number of free-surface acceleration stations would be expanded to more than 400. The advent of internet protocol and the more simplified operation have allowed the quick and easy installation of seismic stations. In addition, the dynamic range of seismic instruments has been continuously improved enough to evaluate damage intensity and to alert alarm directly for earthquake hazard mitigation. For direct visualization of damage intensity and area, Real Time Intensity COlor Mapping (RTICOM) is explained in detail. RTICOM would be used to retrieve the essential information for damage evaluation, Peak Ground Acceleration (PGA). Destructive earthquake damage is usually due to surface waves which just follow S wave. The peak amplitude of surface wave would be pre-estimated from the amplitude and frequency content of first arrival P wave. Earthquake Early Warning (EEW) system is conventionally defined to estimate local magnitude from P wave. The status of EEW is reviewed and the application of EEW to Odesan earthquake is exampled with ShakeMap in order to make clear its appearance. In the sense of rapidity, the earthquake announcement of Korea Meteorological Agency (KMA) might be dramatically improved by the adaption of EEW. In order to realize hazard mitigation, EEW should be applied to the local crucial facilities such as nuclear power plants and fragile semi-conduct plant. The distributed EEW is introduced with the application example of Uljin earthquake. Not only Nation-wide but also locally distributed EEW applications, all relevant information is needed to be shared in real time. The plan of extension of Korea Integrated Seismic System (KISS) is briefly explained in order to future cooperation of data sharing and utilization.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.13-19
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• 2011

Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.18-24
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• 2013

Purpose: Myocardial perfusion SPECT using $^{201}Tl$ is an important method for viability of left ventricle and quantitative evaluation of cardiac function and now various reconstruction methods are used to improve the image quality. But in case of small sized heart, you should always be careful because of the Partial Volume Effect which may cause errors of quantitative indices at the reconstruction step. So, In this study, we compared those quantitative indices of left ventricle according to the reconstruction method of myocardial perfusion SPECT with the Echocardiography and verified the degree of the differences between them. Materials and Methods: Based on ESV 30 mL of Echocardiography, we divided 278 patients (male;98, female;188, Mean age;$65.5{\pm}11.1$) who visited the Asan medical center from February to September, 2012 into two categories; below the criteria to small sized heart, otherwise, normal or large sized heart. Filtered and output each case, we applied the method of FBP and OSEM to each of them, and calculated EDV, ESV and LVEF, and we conducted statistical processing through Repeated Measures ANOVA with indices that measured in Echocardiography. Results: In case of men and women, there were no significant difference in EDV between FBP and OSEM (p=0.053, p=0.098), but in case of Echocardiography, there were meaningful differences (p<0.001). The change of ESV especially women in small sized heard, significant differences has occurred among FBP, OSEM and Echocardiography. Also, in LVEF, there were no difference in men and women who have normal sized heart among FBP, OSEM and Echocardiography (p=0.375, p=0.969), but the women with small sized heart have showed significant differences (p<0.001). Conclusion: The change in quantitative indices of left ventricle between Nuclear cardiology image reconstruction, no difference has occurred in the patients with normal sized heart but based on ESV, under 30 mL of small sized heart, especially in female, there were significant differences in FBP, OSEM and Echocardiography. We found out that overestimated LVEF caused by PVE can be reduced in average by applying OSEM to all kinds of gamma camera, which are used in analyzing the differences.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.172-179
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• 2008

Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.92-98
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• 2011

Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.35-39
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• 2009

Purpose: Diagnostic and functional imaging softwares in Nuclear Medicine have been developed significantly. But, there are some limitations which like take a lot of time. In this article, we introduced that the basic concept of macro to help understanding macro and its application to Brain SPECT processing. We adopted macro software to SPM processing and PACS verify processing of Brain SPECT processing. Materials and Methods: In Brain SPECT, we choose SPM processing and two PACS works which have large portion of a work. SPM is the software package to analyze neuroimaging data. And purpose of SPM is quantitative analysis between groups. Results are made by complicated process such as realignment, normalization, smoothing and mapping. We made this process to be more simple by using macro program. After sending image to PACS, we directly input coordinates of mouse using simple macro program for processes of color mapping, adjustment of gray scale, copy, cut and match. So we compared time for making result by hand with making result by macro program. Finally, we got results by applying times to number of studies in 2007. Results: In 2007, the number of SPM studies were 115 and the number of PACS studies were 834 according to Diamox study. It was taken 10 to 15 minutes for SPM work by hand according to expertness and 5 minutes and a half was uniformly needed using Macro. After applying needed time to the number of studies, we calculated an average time per a year. When using SPM work by hand according to expertness, 1150 to 1725 minutes (19 to 29 hours) were needed and 632 seconds (11 hours) were needed for using Macro. When using PACS work by hand, 2 to 3 minutes were needed and for using Macro, 45 seconds were needed. After applying theses time to the number of studies, when working by hand, 1668 to 2502 minutes (28 to 42 hours) were needed and for using Macro, 625 minutes (10 hours) were needed. Following by these results, it was shown that 1043 to 1877 (17 to 31 hours were saved. Therefore, we could save 45 to 63% for SPM, 62 to 75% for PACS work and 55 to 70% for total brain SPECT processing in 2007. Conclusions: On the basis of the number of studies, there was significant time saved when we applied Macro to brain SPECT processing and also it was shown that even though work is taken a little time, there is a possibility to save lots of time according to the number of studies. It gives time on technologist's side which makes radiological technologist more concentrate for patients and reduce probability of mistake. Appling Macro to brain SPECT processing helps for both of radiological technologists and patients and contribute to improve quality of hospital service.

• The Korean Journal of Pharmacology
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• v.32 no.1
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• pp.13-21
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• 1996

Intracellular calcium concentration ($[Ca^{2+}]_i$) may play a crucial role in a variety of neuronal functions. Here we report that in primary culture of mouse cerebellar granule cells nicotinic acetylcholine receptors (nAChRs) are expressed in a specific developmental stage and involved in the regulation of intracellular calcium homeostasis. Nicotine-mediated calcium responses were measured using $^{45}Ca^{2+}$ or fluorometrically using the calcium-sensitive fluorescent dye fura-2. Maximal uptake of $^{45}Ca^{2+}$ evoked by nicotine in mouse cerebellar granule cells were revealed $8{\sim}12$ days in culture. In contrast, nicotine did not alter the basal $^{45}Ca^{2+}$ uptake in cultured glial cells. In cerebellar granule cells nicotine-evoked $^{45}Ca^{2+}$ uptake was largely blocked by the NMDA receptor antagonists. Glutamate pyruvate transaminase (GPT). which removes endogenous glutamate, also prevented nicotine effects, implying the indirect involvement of glutamate in nicotine-mediated calcium responses. Fluorometric studies using fura-2 showed two phases of nicotine-evoked $[Ca^{2+}]_i$ rises: the initial rising phase and the later plateau phase. Interestingly, the NMDA receptor antagonists and GPT appeared to inhibit only the later plateau phase of nicotine-evoked $[Ca^{2+}]_i$ rises. The present results imply that nicotine mediated $^{45}Ca^{2+}$ uptake and $[Ca^{2+}]_i$ rises are attributed to the calcium fluxes through both nAchRs and NMDA receptors in a time-dependent manner. Consequently, nAChRs may play an important role in neuronal development by being expressed in a specific developmental stage and regulating the intracellular calcium homeostasis.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.122-126
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• 2014

Purpose: The new reconstruction algorithms (NRA) provided by vendor aim to shorten the acquisition scan time. Whereas depending on the installed version AutoQuant program used for myocardial SPECT quantitative analysis did not contain the normal data that NRA is applied. Thus, the purpose of this paper is to compare the results according to AutoQuant versions in myocardial SPECT applied NRA and half-time scan (HT). Materials and Methods: Rest Tl and stress MIBI data of total 80 (40 men, 40 women) patients were gathered. Data were applied HT acquisition and ASTONISH (Philips) software which is NRA. Modified autoquant of SNUH and old version of AutoQuant (full-time scan) provided by company were compared. Comparison groups were classified as coronary artery disease (CAD), 24 hrs delay and almost normal patients who have a simple pain patient. Perfusion distribution aspect, summed stress score (SSS), summed rest score (SRS), extent and total perfusion deficit (TPD) of each 25 patient who have above diseases were compared and evaluated. Results: The case of CAD, when using re-edited AutoQuant (HT) SSS and SRS showed about 30% reduction (P<0.0001), Extent showed about 38% reduction and TPD showed about 30% reduction in the tendency (P<0.0001). In the score of the perfusion, especially on the part of infero-medium, infero-apical, lateral-medium and lateral-apical regions were the biggest change. The case of the 24 hrs delay patient SRS (P=0.042), Extent (P=0.018) and TPD (P=0.0024) showed about 13-18% reduction. And the case of simple pain patient, comparison of 4 results showed about 5-7% reduction. Conclusion: This study was started based on expectation that results could be affected by normal patient data. Normal patient data is possible to change by race and gender. It was proved that combination of new reconstruction algorithm for reducing scan time and analysis program according to scan protocol with NRA could also be affected to results. Clinical usefulness of gated myocardial SPECT is possibly increased if each hospital properly collects normal patient data for their scan acquisition protocol.

• Radiation Oncology Journal
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• v.22 no.1
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• pp.55-63
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• 2004

Purpose : To evaluate the reflection of tumor motion according to the planning CT scan time. Material and Methods : A model of N-shape, which moved aiong the longitudinal axis during the ventilation caused by a mechanical ventilator, was produced. The model was scanned by planning CT, while setting the relative CT scan time (T: CT scan time/ventilatory period) to 0.33, 0.50, 0.67, 0.75, 1.00, 1.337, and 1.537. In addition, three patients with non-small cell lung cancer who received stereotactic radiosurgery In the Department of Radiation Oncology, Asan Medical Center from 03/19/2002 to 05/21/2002 were scanned. Slow (10 Premier, Picker, scan time 2.0 seconds per slice) and fast CT scans (Lightspeed, GE Medical Systems, with a scan time of 0.8 second per slice) were peformed for each patient. The magnitude of reflected movement of the N-shaped model was evaluated by measuring the transverse length, which reflected the movement of the declined bar of the model at each slice. For patients' scans, all CT data sets were registered using a stereotactic body frame scale with the gross tumor volumes delineated in one CT image set. The volume and three-dimensional diameter of the gross tumor volume were measured and analyzed between the slow and fast CT scans. Results : The reflection degree of longitudinal movement of the model increased in proportion to the relative CT scan times below 1.00 7, but remained constant above 1.00 T Assuming the mean value of scanned transverse lengths with CT scan time 1.00 T to be $100\%$, CT scans with scan times of 0.33, 0.50, 0.57, and 0.75 T missed the tumor motion by 30, 27, 20, and $7.0\%$ respectively, Slow (scan time 2.0 sec) and Fast (scan time 0.8 sec) CT scans of three patients with longitudinal movement of 3, 5, and 10 mm measured by fluoroscopy revealed the increases in the diameter along the longitudinal axis Increased by 6.3, 17, and $23\%$ in the slow CT scans. Conculsion : As the relative CT scan time increased, the reflection of the respiratory tumor movement on planning CT also Increased, but remained constant with relative CT scan times above 1.00 T When setting the planning CT scan time above one respiration period (>1.00 T), only the set-up margin is needed to delineate the planning target volume. Therefore, therapeutic ratio can be increased by reducing the radiation dose delivered to normal lung tissue.