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Clinical Characteristics and Prognosis of Gastrointestinal Stromal Tumors of Stomach (위의 위장관 간질 종양의 임상적 특징 및 예후)

  • Kim, Min-Hyung;Hur, Hoon;Kim, Sin-Sun;Kim, Sung-Keun;Jeon, Kyung-Hwa;Song, Kyo-Young;Kim, Jin-Jo;Jin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.146-153
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    • 2006
  • Purpose: Gastrointestinal stromal tumorsm (GISTs) are the most common mesenchymal tumors that arise anywhere in the tubular GI tract. The prognosis for GSTIs is important because f GISTs may metastasiwx in the liver or the abdominal cavity in an early stage. For the reason we examined the tumor size, the mitotic number, ki 67, p53, and c-kit mutation as independent prognostic factor for GISTs. Materials and Methods: A retrospective study was conducted in 76 patients who had been re-evaluated for confirmation of diagnosis between Jan 1998 and Dec. 2001. at Catholic University of medicine. Results: There were significant difference between the turner size, mitotic indices, ki 67, c-kit mutations and the 5-years survival rates. Tumor size (${\geq}5\;cm$) and mitotic index (${\geq}5/50\;HPF$) were statistically related to a significantly poor prognosis (P=0.017 and P=0.042, respectively). c-kit mutations in exon 11 were found in 7 cases c-kit mutation was observed more frequently in high risk patients, and there was a significant difference between c-kit mutation and survival (P=0.037). Elevated ki 67 was noted in 34 out of the 76 cases. High risk patients showed elevated ki67 index more frequently and there was significant relation with the survival rate (P=0.0417). Conclusion: We think that tumor size, mitotic index, Ki 67 and c-kit mutation are as independent prognostic factors for GISTs, but more research is needed.

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INDIVIDUALIZED RECONSTRUCTION OF THE LOWER OCCLUSAL PLANE ACCORDING TO SKELETAL PATTERN (안면 골격 형태에 따른 하악 교합평면의 재구성)

  • Hyun, Seong-Wook
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.465-485
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    • 1995
  • The purpose of this study is to locate the proper position of the lower occlusal plane according to individual skeletal pattern. Cephalometric films of 234 subjects of the control group, 358 of the pretreatment group and 358 of the treated group were analyzed to study proper relationships between vertical dimension ratio(VDR) and lower occlusomandibular plane angle(LOM). The control group was divided into two subgroups by the age. The first subgroup consisted of 113 subjects of the age 14 years and under and with the mean age of 10.82 years. The other subgroup consisted of 113 subjects of the age 18 years and above with the mean age of 23.76 years. The pretreatment group was divided into three subgroups by the age. The first subgroup consisted of 274 subjects of the age 14 years and under with the mean age of 11.36 years. The second subgroup consisted of 54 subjects of the age 14 through 18 years with the mean age of 15.4 years. The last subgroup consisted of 30 subjects of the age 18 years and above with the mean age of 21.35 years. The treated group was also divided into three subgroups by the age. The first subgroup consisted of 145 subjects of the age 14 years and under with the mean age of 12.91 years. The second subgroup consisted of 166 subjects of the age 14 through 18 years with the mean age of 15.64 years. The last subgroup consisted of 47 subjects of the age 18 years and above with the mean age of 21.61 years. Cephalometric films of the sample were traced. Measurements were made to a hundredth using a program specifically prepared for this study, and the results were entered into a 486DX PC. Means and Standard deviations of all the veriables were calculated for each group. Correlation coefficients between pertinent variables were calculated. Significance tests on those coefficients, one-way ANOVA and t-tests between variables or groups were performed. On the basis of the results studied above, certain subjects were selected from the control and the treated groups to locate the proper position of the occlusal plane, and designated as the optimal occluaion group. The subjects of this optimal occlusion group had 1-3 mm overbite, 1-3 mm of overjet and less than 1.75 mm of curve of Spee. A total subjects of 187 in this group consisted 104 treated subjects and 83 control group. Regression analysis was carried out between VDR and LOM, and regression equations were tabulated for this optimal occlusion group. The results were as follows : 1. Highly significant correlations were observed between various variables useful for identifying vertical component of skeletal frame, but any one particular variable did not accurately indicate the magnitude of anterior vertical overbite. 2. Of the variables useful identifying vertical component of skeletal frame, The VDR showed the highest correlation to the LOM. 3. Of the total sample, 80 percent had overbite within the normal range, irrespective of VDR. 4. The optimal occlusion group was divided into 9 subgroups by the age and the anteroposterior skeletal pattern, and correlation coefficient and determination coefficient between VDR and LOM of each group were calculated. Correlation coefficients and determination coefficients were found to be significantly high in all groups. 5. Regression equation was induced for each of the optimal occlusion group to find proper LOM according to the VDR. 6. It was found that the mean value of the cant of occlusal plane itself is not enough for a diagnosis and a treatment plan. Rather, It is very important to locate the proper occlusal plane for an Individual skeletal pattern.

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A Study on the Meaning of Plant Material in the 2016 Korea Garden Show Designer's Garden (2016년 코리아가든쇼 작가정원의 식물 의미에 관한 연구)

  • Lee, Chung-Hee;Jin, Hye-Young;Lee, You-Mi;Song, Yu-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.3
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    • pp.41-53
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    • 2017
  • This study was performed to determine what the plant material were selected to reflect in the 2016 Korea Garden Show designer's garden. It was analyzed that plant material was used to display the theme of the garden and to create a specific space. Under the given theme of 'K-Garden, Shinhallyu Garden(new style garden culture) with the most Korean taste', the plants were used to highlight the theme in two types: 'representation' and 'expression'. There were two 'representation' gardens that imitate a particular space of Korean taste and four 'expression' gardens that showcase the designer's thoughts with abstract concepts and concrete objects. Three gardens included both types of garden. The way of revealing the subject with plants was used more for 'expression' than for 'representation'. There were eleven spaces for 'representation' of the Korean taste, a vegetable garden, faucet, pond, field, nature, a Hanok court garden, groves of bamboo, tile roof, stone wall, rock and backyard of a Hanok connected to the mountain. The planting material was used in two ways: reflecting only the ecological characteristics of the plant, and considering the ecological and visual characteristics together. Vegetation plantings reflecting the ecological characteristics were observed in all eleven spaces. Nine of the spaces reflected the growth environment of the plants, but the other two did not reflect the ecological characteristics of the plants, unlike the designer's intention. In the case of the four spaces that considered the ecological and visual characteristics together, color and size were considered visual characteristics. The plants in the seven spaces that included 'expression' as the theme were selected to reflect the visual characteristics in the order of color, shape, texture, and size, rather than reflecting ecological characteristics. A group planting method was applied. When the plants were used as materials for creating space, Norman(1989) analyzed three enclosure factors(overhead, vertical, ground plane). Only two deciduous trees were used in the overhead plane while five species of evergreen shrubs and thirty species of various deciduous plants were used in the vertical plane. There were forty-five species (nine trees and thirty-six herbaceous plants) forming the ground plane, and various herbaceous plants were utilized without duplication in each garden. The designer's garden of the Garden Show played a role in introducing new groundcover plants to the public. Three of the nine gardens did not include ornamental plants, and the use of decorative plants in other gardens was few compared to the number of plantings. In the Korea Garden Show designer's garden, most of the plants were being used with the intention of exposing the theme or architectural uses. In the 2016 Korea Garden Show designer's garden, many species of plants were used as materials for showcasing themes rather than for creating spaces. Also, the method of 'expression' was used more than the method of 'representation' in order to highlight the theme. This indicates that the planting materials reflect visual characteristics such as color, shape, texture, size rather than ecological characteristics.

The Effect of Dexamethasone on Airway Goblet Cell Hyperplasia and Inflammation in $TiO_2$-Treated Sprague-Dawley Rats ($TiO_2$로 처치된 백서에서 기도내 배상세포 증식과 염증에 대한 Dexamethasone의 효과)

  • Lim, Gune-Il;Kim, Do-Jin;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.37-48
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    • 2000
  • Backgrounds : The pathophysiology of chronic airflow obstruction, such as bronchial asthma, is characterized by mucus hypersecretion, goblet cell hyperplasia(GCH), smooth muscle hypertrophy, and inflammatory cells infiltration. In fatal asthma patients, one distinct findings is mucus hypersecretion due to GCH. However, the mechanisms of GCH in these hypersecretory diseases remain still unknown. In this study, a rat model was rapidly induced with GCH by instillation of $TiO_2$, intratracheally. We intend to confirm GCH and association of concomitant inflammatory cells infiltration and to observe the effect of potent antiinflammatory agent, that is dexamethasone, on GCH with inflammatory cells. Methods : Twenty-one 8-weeks-old male Sprague-Dawley rats were divided into three groups. Endotoxinfree water was instilled intratracheally in group 1(control) ; $TiO_2$, was instilled in the group 2 ; and dexamethasone was injected intraperitoneally to group 3 before $TiO_2$ instillation. After 120 hours, all rats were sacrificed, and trachea, bronchi, and lungs were resected respectively. These tissues were made as paraffin blocks and stained as PAS for goblet cells and Luna stain for eosinophils. We calculated the ratio of goblet cell to respiratory epithelium and number of infiltrated eosinophils from each tissue. Results : (1) Fraction of goblet cells was significantly increased in group 2 than in group 1 in the trachea and in the main bronchus. (10.19$\pm$11.33% vs 4.09$\pm$8.28%, p<0.01 and 34.09$\pm$23.91% vs 3.61$\pm$4.84%, p<0.01, respectively). (2) Eosinophils were significantly increased in the airway of group 2 than that of group 1. (5.43$\pm$3.84% vs 0.17$\pm$0.47 in trachea and 47.71$\pm$16.91 vs 2.71$\pm$1.96 in main bronchi). (3) There was a positive correlation between goblet cells and eosinophils(r=0.719, p=0.001). (4) There was significant difference in the decrease of goblet cells after dexamethasone injection between group 2 and group 3 (p<0.01). Also, infiltration of eosinophils was suppressed by dexamethasone. Conclusion : We made an animal model of $TiO_2$-induced goblet cell hyperplasia. GCH was observed mainly in the main bronchi with concomitant eosinophilic infiltration. Both goblet cell hyperplasia and eosinophilic infiltration were suppressed by dexamethasone. This animal model may serve as a useful tool in understanding of the mechanism of GCH in chronic airway diseases.

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The Role of Poly(ADP-ribose) Polymerase-1 in Ventilator-Induced Lung Injury (기계환기로 인한 급성 폐손상에서 poly(ADP-ribose) polymerase-1의 역할)

  • Kim, Je-Hyeong;Yoon, Dae Wui;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.4
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    • pp.451-463
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    • 2006
  • Background : Reactive oxygen species (ROS) take center stage as executers in ventilator-induced lung injury (VILI). The protein with DNA-damage scanning activity, poly (ADP-ribose) polymerase-1 (PARP1), signals DNA rupture and participates in base-excision repair. Paradoxically,overactivation of PARP1 in response to massive genotoxic injury such as ROS can induce cell death through ${\beta}$ -nicotinamide adenine dinucleotide ($NAD^+$) depletion, resulting in inflammation. The purpose of this study is to investigate the role of PARP1 and the effect of its inhibitor in VILI. Methods : Forty-eight male C57BL/6 mice were divided into sham, lung protective ventilation(LPV), VILI, and PARP1 inhibitor (PJ34)+VILI (PJ34+VILI) groups. Mechanical ventilator setting for the LPV group was $PIP\;15cmH_2O$ + $PEEP\;3cmH_2O$ + RR 90/min + 2 hours. The VILI and PJ34+VILI groups were ventilated on a setting of $PIP\;40cmH_2O$ + $PEEP\;0cmH_2O$ + RR 90/min + 2 hours. As a PARP1 inhibitor for the PJ34+VILI group, 20 mg/Kg of PJ34 was treated intraperitoneally 2 hours before mechanical ventilation. Wet-to-dry weight ratio and acute lung injury (ALI) score were measured to determine the degree of VILI. PARP1 activity was evaluated by using an immunohistochemical method utilizing biotinylated NAD. Myeloperoxidase (MPO) activity and the concentration of inflammatory cytokines such as tumor necrosis factor $(TNF)-{\alpha}$, interleukin $(IL)-1{\beta}$, and IL-6 were measured in bronchoalveolar lavage fluid (BALF). Results : In the PJ34+VILI group, PJ34 pretreatment significantly reduced the degree of lung injury, compared with the VILI group (p<0.05). The number of cells expressing PARP1 activity was significantly increased in the VILI group, but significantly decreased in the PJ34+VILI group (p=0.001). In BALF, MPO activity, $TNF-{\alpha}$, $IL-1{\beta}$, and IL-6 were also significantly lower in the PJ34+VILI group (all, p<0.05). Conclusion : PARP1 overactivation plays a major role in the mechanism of VILI. PARP1 inhibitor prevents VILI, and decreases MPO activity and inflammatory cytokines.

The Effect of Active Senior's Career Orientation and Educational Entrepreneurship Satisfaction on Entrepreneurship Intention and Entrepreneurship Preparation Behavior (액티브 시니어의 경력지향성과 창업교육 만족이 창업의지와 창업준비행동에 미치는 영향)

  • Park, Joungbum;Yang, Youngseok;Kim, Myungseuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.1
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    • pp.285-301
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    • 2020
  • Looking at the problem of aging in the nation from a demographic perspective, it is not a problem of the overall population, but of the structure of the population. It is the baby boomer and post-baby boomers, the largest population in the country. Baby boomers were born between 1955 and 1963, and currently have a population of 7001,333, which is 13.6 percent (as of 2015). The Post-Baby Boomer generation was born between 1964 and 1974, with a total population of 9,567,171, accounting for 18.8 percent of the total population. In particular, baby boomers and post-baby boomers (32.4% of the total population) have begun to retire or will retire soon. The average life expectancy continues to increase due to the development of medical technology, and the falling birth rate of newborns and the declining population of the production population are darkening the domestic economy. In a policy proposal aimed at easing the nation's falling economic growth rate, women's participation rate is as high as Sweden and men's efforts to increase it as high as Japan's, while the elderly rate is desirable to maintain Korea's high level. This is because the expansion of the elderly generation's participation in economic activities could ease a sharp drop in economic growth and reduce the burden of supporting the elderly population. The study, based on this social problem awareness and problem solving plan, looks at the relationship between career orientation and satisfaction in start-up education based on the diverse career base of active seniors, and also suggests the importance of customized start-up education on the diversity of active seniors by clarifying the relationship between them, and suggests the desirable direction of senior start-up policy design, funding, and start-up education. Based on the theoretical background, the concept of five factors was defined: active senior, career-oriented, satisfaction level of start-up education, willingness to start a business, and the concept definition of an active senior, which is particularly key to the baby boomers in their 50s and 60s, is generally regarded as a source of consumption or welfare benefits, but in this study, the concept of active start-up is reflected in the domestic start-up market by young people in their 40s, 50s and 60s. As a result of a hypothesis test. Hypothesis 1 and Hypothesis 5: Career orientation has been verified to affect the willingness to start a business and the behavior of preparation for a start-up. Hypothesis 3: The willingness to start a business has been verified as having an effect between startup preparation actions. Hypothesis 4: The satisfaction level of start-up education has been verified to affect start-up preparation behavior. However, hypothesis 2: The satisfaction level of education for start-ups does not affect the willingness to start a business. Such results can be inferred that satisfaction in start-up education does not have a direct effect on the will to start a business and increases the will to start a business through the influence of personal career orientation.

GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Recent Research for the Seismic Activities and Crustal Velocity Structure (국내 지진활동 및 지각구조 연구동향)

  • Kim, Sung-Kyun;Jun, Myung-Soon;Jeon, Jeong-Soo
    • Economic and Environmental Geology
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    • v.39 no.4 s.179
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    • pp.369-384
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    • 2006
  • Korean Peninsula, located on the southeastern part of Eurasian plate, belongs to the intraplate region. The characteristics of intraplate earthquake show the low and rare seismicity and the sparse and irregular distribution of epicenters comparing to interplate earthquake. To evaluate the exact seismic activity in intraplate region, long-term seismic data including historical earthquake data should be archived. Fortunately the long-term historical earthquake records about 2,000 years are available in Korea Peninsula. By the analysis of this historical and instrumental earthquake data, seismic activity was very high in 16-18 centuries and is more active at the Yellow sea area than East sea area. Comparing to the high seismic activity of the north-eastern China in 16-18 centuries, it is inferred that seismic activity in two regions shows close relationship. Also general trend of epicenter distribution shows the SE-NW direction. In Korea Peninsula, the first seismic station was installed at Incheon in 1905 and 5 additional seismic stations were installed till 1943. There was no seismic station from 1945 to 1962, but a World Wide Standardized Seismograph was installed at Seoul in 1963. In 1990, Korean Meteorological Adminstration(KMA) had established centralized modem seismic network in real-time, consisted of 12 stations. After that time, many institutes tried to expand their own seismic networks in Korea Peninsula. Now KMA operates 35 velocity-type seismic stations and 75 accelerometers and Korea Institute of Geoscience and Mineral Resources operates 32 and 16 stations, respectively. Korea Institute of Nuclear Safety and Korea Electric Power Research Institute operate 4 and 13 stations, consisted of velocity-type and accelerometer. In and around the Korean Peninsula, 27 intraplate earthquake mechanisms since 1936 were analyzed to understand the regional stress orientation and tectonics. These earthquakes are largest ones in this century and may represent the characteristics of earthquake in this region. Focal mechanism of these earthquakes show predominant strike-slip faulting with small amount of thrust components. The average P-axis is almost horizontal ENE-WSW. In north-eastern China, strike-slip faulting is dominant and nearly horizontal average P-axis in ENE-WSW is very similar with the Korean Peninsula. On the other hand, in the eastern part of East Sea, thrust faulting is dominant and average P-axis is horizontal with ESE-WNW. This indicate that not only the subducting Pacific Plate in east but also the indenting Indian Plate controls earthquake mechanism in the far east of the Eurasian Plate. Crustal velocity model is very important to determine the hypocenters of the local earthquakes. But the crust model in and around Korean Peninsula is not clear till now, because the sufficient seismic data could not accumulated. To solve this problem, reflection and refraction seismic survey and seismic wave analysis method were simultaneously applied to two long cross-section traversing the southern Korean Peninsula since 2002. This survey should be continuously conducted.

On the vibration influence to the running power plant facilities when the foundation excavated of the cautious blasting works. (노천굴착에서 발파진동의 크기를 감량 시키기 위한 정밀파실험식)

  • Huh Ginn
    • Explosives and Blasting
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    • v.9 no.1
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    • pp.3-13
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    • 1991
  • The cautious blasting works had been used with emulsion explosion electric M/S delay caps. Drill depth was from 3m to 6m with Crawler Drill ${\phi}70mm$ on the calcalious sand stone (soft -modelate -semi hard Rock). The total numbers of test blast were 88. Scale distance were induced 15.52-60.32. It was applied to propagation Law in blasting vibration as follows. Propagtion Law in Blasting Vibration $V=K(\frac{D}{W^b})^n$ were V : Peak partical velocity(cm/sec) D : Distance between explosion and recording sites(m) W : Maximum charge per delay-period of eight milliseconds or more (kg) K : Ground transmission constant, empirically determind on the Rocks, Explosive and drilling pattern ets. b : Charge exponents n : Reduced exponents where the quantity $\frac{D}{W^b}$ is known as the scale distance. Above equation is worked by the U.S Bureau of Mines to determine peak particle velocity. The propagation Law can be catagorized in three groups. Cubic root Scaling charge per delay Square root Scaling of charge per delay Site-specific Scaling of charge Per delay Plots of peak particle velocity versus distoance were made on log-log coordinates. The data are grouped by test and P.P.V. The linear grouping of the data permits their representation by an equation of the form ; $V=K(\frac{D}{W^{\frac{1}{3}})^{-n}$ The value of K(41 or 124) and n(1.41 or 1.66) were determined for each set of data by the method of least squores. Statistical tests showed that a common slope, n, could be used for all data of a given components. Charge and reduction exponents carried out by multiple regressional analysis. It's divided into under loom over loom distance because the frequency is verified by the distance from blast site. Empirical equation of cautious blasting vibration is as follows. Over 30m ------- under l00m ${\cdots\cdots\cdots}{\;}41(D/sqrt[2]{W})^{-1.41}{\;}{\cdots\cdots\cdots\cdots\cdots}{\;}A$ Over 100m ${\cdots\cdots\cdots\cdots\cdots}{\;}121(D/sqrt[3]{W})^{-1.66}{\;}{\cdots\cdots\cdots\cdots\cdots}{\;}B$ where ; V is peak particle velocity In cm / sec D is distance in m and W, maximLlm charge weight per day in kg K value on the above equation has to be more specified for further understaring about the effect of explosives, Rock strength. And Drilling pattern on the vibration levels, it is necessary to carry out more tests.

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The Precision Test Based on States of Bone Mineral Density (골밀도 상태에 따른 검사자의 재현성 평가)

  • Yoo, Jae-Sook;Kim, Eun-Hye;Kim, Ho-Seong;Shin, Sang-Ki;Cho, Si-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.67-72
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    • 2009
  • Purpose: ISCD (International Society for Clinical Densitometry) requests that users perform mandatory Precision test to raise their quality even though there is no recommendation about patient selection for the test. Thus, we investigated the effect on precision test by measuring reproducibility of 3 bone density groups (normal, osteopenia, osteoporosis). Materials and Methods: 4 users performed precision test with 420 patients (age: $57.8{\pm}9.02$) for BMD in Asan Medical Center (JAN-2008 ~ JUN-2008). In first group (A), 4 users selected 30 patient respectively regardless of bone density condition and measured 2 part (L-spine, femur) in twice. In second group (B), 4 users measured bone density of 10 patients respectively in the same manner of first group (A) users but dividing patient into 3 stages (normal, osteopenia, osteoporosis). In third group (C), 2 users measured 30 patients respectively in the same manner of first group (A) users considering bone density condition. We used GE Lunar Prodigy Advance (Encore. V11.4) and analyzed the result by comparing %CV to LSC using precision tool from ISCD. Check back was done using SPSS. Results: In group A, the %CV calculated by 4 users (a, b, c, d) were 1.16, 1.01, 1.19, 0.65 g/$cm^2$ in L-spine and 0.69, 0.58, 0.97, 0.47 g/$cm^2$ in femur. In group B, the %CV calculated by 4 users (a, b, c, d) were 1.01, 1.19, 0.83, 1.37 g/$cm^2$ in L-spine and 1.03, 0.54, 0.69, 0.58 g/$cm^2$ in femur. When comparing results (group A, B), we found no considerable differences. In group C, the user_1's %CV of normal, osteopenia and osteoporosis were 1.26, 0.94, 0.94 g/$cm^2$ in L-spine and 0.94, 0.79, 1.01 g/$cm^2$ in femur. And the user_2's %CV were 0.97, 0.83, 0.72 g/$cm^2$ L-spine and 0.65, 0.65, 1.05 g/$cm^2$ in femur. When analyzing the result, we figured out that the difference of reproducibility was almost not found but the differences of two users' several result values have effect on total reproducibility. Conclusions: Precision test is a important factor of bone density follow up. When Machine and user's reproducibility is getting better, it’s useful in clinics because of low range of deviation. Users have to check machine's reproducibility before the test and keep the same mind doing BMD test for patient. In precision test, the difference of measured value is usually found for ROI change caused by patient position. In case of osteoporosis patient, there is difficult to make initial ROI accurately more than normal and osteopenia patient due to lack of bone recognition even though ROI is made automatically by computer software. However, initial ROI is very important and users have to make coherent ROI because we use ROI Copy function in a follow up. In this study, we performed precision test considering bone density condition and found LSC value was stayed within 3%. There was no considerable difference. Thus, patient selection could be done regardless of bone density condition.

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