• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.2
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• pp.35-40
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• 2021

Purpose Glomerular filtration rate(GFR) is an important indicator for the diagnosis, treatment, and follow-up of kidney disease and is also used by healthy individuals for drug use and evaluating kidney function in donors. The gold standard method of the GFR test is to measure by continuously injecting the inulin which is extrinsic marker, but it takes a long time and the test method is complicated. so, the method of measuring the serum concentration of creatinine is used. Estimated glomerular filtration rate (eGFR) is used instead. However, creatinine is known to be affected by age, gender, muscle mass, etc. eGFR formulas that are currently used include the Cockroft-Gault formula, the modification of diet in renal disease (MDRD) formula, and the chronic kidney disease epidemilogy collaboration (CKD-EPI) formula for adults. For children, the Schwartz formula is used. Measurement of GFR using ⁵¹Cr-EDTA (diethylenetriamine tetraacetic acid), ^99mTc-DTPA (diethylenetriamine pentaacetic acid) can replace inulin and is currently in use. Therefore, We compared the GFR measured using ^99mTc-DTPA with the eGFR using CKD-EPI formula. Materials and Methods For 200 kidney transplant donors who visited Asan medical center.(96 males, 104 females, 47.3 years ± 12.7 years old) GFR was measured using plasma(Two-plasma-sample-method, TPSM) obtained by intravenous administration of ^99mTc-DTPA(0.5mCi, 18.5 MBq). eGFR was derived using CKD-EPI formula based on serum creatinine concentration. Results GFR average measured using ^99mTc-DTPA for 200 kidney transplant donors is 97.27±19.46(ml/min/1.73m²), and the eGFR average value using the CKD-EPI formula is 96.84±17.74(ml/min/1.73m²), The concentration of serum creatinine is 0.84±0.39(mg/dL). Regression formula of ^99mTc-DTPA GFR for serum creatinine-based eGFR was Y = 0.5073X + 48.186, and the correlation coefficient was 0.698 (P<0.01). Difference (%) was 1.52±18.28. Conclusion The correlation coefficient between the ^99mTc-DTPA and the eGFR derived on serum creatinine concentration was confirmed to be moderate. This is estimated that eGFR is affected by external factors such as age, gender, and muscle mass and use of formulas made for kidney disease patients. By using ^99mTc-DTPA, we can provide reliable GFR results, which is used for diagnosis, treatment and observation of kidney disease, and kidney evaluation of kidney transplant patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.2
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• pp.15-24
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• 2021

Purpose SPECT/CT was noted for its excellent correction method and qualitative functions based on fusion images in the early stages of dissemination, and interest in and utilization of quantitative functions has been increasing with the recent introduction of companion diagnostic therapy(Theranostics). Unlike PET/CT, various conditions like the type of collimator and detector rotation are a challenging factor for image acquisition and reconstruction methods at absolute quantification of SPECT/CT. Therefore, in this study, We want to find out the effect on the radioactivity concentration estimate by the increase or decrease of the total acquisition time according to the number of projections and the acquisition time per projection among SPECT/CT imaging conditions. Materials and Methods After filling the 9,293 ml cylindrical phantom with sterile water and diluting 99mTc 91.76 MBq, the standard image was taken with a total acquisition time of 600 sec (10 sec/frame × 120 frames, matrix size 128 × 128) and also volume sensitivity and the calibration factor was verified. Based on the standard image, the comparative images were obtained by increasing or decreasing the total acquisition time. namely 60 (-90%), 150 (-75%), 300 (-50%), 450 (-25%), 900 (+50%), and 1200 (+100%) sec. For each image detail, the acquisition time(sec/frame) per projection was set to 1.0, 2.5, 5.0, 7.5, 15.0 and 20.0 sec (fixed number of projections: 120 frame) and the number of projection images was set to 12, 30, 60, 90, 180 and 240 frames(fixed time per projection:10 sec). Based on the coefficients measured through the volume of interest in each acquired image, the percentage of variation about the contrast to noise ratio (CNR) was determined as a qualitative assessment, and the quantitative assessment was conducted through the percentage of variation of the radioactivity concentration estimate. At this time, the relationship between the radioactivity concentration estimate (cps/ml) and the actual radioactivity concentration (Bq/ml) was compared and analyzed using the recovery coefficient (RC_Recovery Coefficients) as an indicator. Results The results [CNR, radioactivity Concentration, RC] by the change in the number of projections for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results [CNR, radioactivity Concentration, RC] by the acquisition time change for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at - 90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Conclusion In SPECT/CT, the total coefficient obtained according to the increase or decrease of the total acquisition time and the resulting image quality (CNR) showed a pattern that changed proportionally. On the other hand, quantitative evaluations through absolute quantification showed a change of less than 5% (-3.55 to +3.90%) under all experimental conditions, maintaining quantitative accuracy (RC 0.96 to 1.04). Considering the reduction of the total acquisition time rather than the increasing of the image acquiring time, The reduction in total acquisition time is applicable to quantitative analysis without significant loss and is judged to be clinically effective. This study shows that when increasing or decreasing of total acquisition time, changes in acquisition time per projection have fewer fluctuations that occur in qualitative and quantitative condition changes than the change in the number of projections under the same scanning time conditions.

• Journal of Practical Agriculture & Fisheries Research
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• v.24 no.3
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• pp.15-24
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• 2022

In 2000, a total of 23,794ha of forest was lost due to the East Coast forest fire, and about 70% of the damaged area was concentrated in Samcheok. In 2001, artificial restoration and natural restoration were implemented in the damaged area. This study was conducted to understand the current vegetation structure 21 years after the restoration of forest fire damage in the Samcheok, Gumbong Mountain area. As a result of classifying the vegetation community, it was divided into three communities: Quercus variabilis-Pinus densiflora community, Pinus densiflora-Quercus mongolica community, and Pinus thunbergii community. Quercus variabilis, Pinus densiflora, and Pinus thunbergii planted in the artificial restoration site were found to continue to grow as dominant species in the local vegetation after restoration. As for the species diversity index of the community, the Quercus variabilis-Pinus densiflora community dominated by deciduous broad-leaf trees showed the highest, and the coniferous forest Pinus thunbergii community showed the lowest. Vegetation in areas affected by forest fires is greatly affected by reforestation tree species, and 21 years later, it has shown a tendency to recover to the forest type before forest fire. In order to establish DataBase for effective restoration and to prepare monitoring data, it is necessary to construct data through continuous vegetation survey on the areas affected by forest fires.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.21-30
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• 2022

Purpose: The purpose of this study is to evaluate the effectiveness of oral positioning stent, the BinkieRT^TM in radiation treatment for head and neck cancer patients in terms of tongue positions reproducibility, tongue doses and material properties. Materials and Methods: 24 cases using BinkieRT^TM during radiation treatments were enrolled. The tongue was contoured on planning CT and CBCT images taken every 3 days during treatment, and then the DSC and center of tongue shift values were analyzed to evaluate the reproducibility of the tongue. The tongue dose was compared in terms of dose distribution when using BinkieRT^TM and different type of oral stents (mouthpiece, paraffin wax). Randomly selected respective 10 patients were measured tongue doses of initial treatment plan for nasal cavity and unilateral parotid cancer. Finally, In terms of material evaluation, HU and relative electron density were identified in RTPS. Results: As a result of DSC analysis, it was 0.8 ± 0.07, skewness -0.8, kurtosis 0.61, and 95% CI was 0.79~0.82. To analyze the deviation of the central tongue shift during the treatment period, a 95% confidence interval for shift in the LR, SI, and AP directions were indicated, and a one-sample t-test for 0, which is an ideal value in the deviation(n=144). As a result of the t-test, the mean and SD in the LR and SI directions were 0.01 ± 0.14 cm (p→.05), 0.03 ± 0.25 cm (p→.05), and -0.08 ± 0.25 cm (p ←.05) in the AP direction. In the case of unilateral parotid cancer patients, the Dmean to the tongue of patients using BinkieRT^TM was 16.92% ± 3.58% compared to the prescribed dose, and 23.99% ± 10.86% of patients with Paraffin Wax, indicating that the tongue dose was relatively lower when using BinkieRT^TM (p←.05). On the other hand, among nasal cavity cancer patients, the Dmean of tongue dose for patients who used BinkieRT^TM was 4.4% ± 5.6%, and for those who used mouthpiece, 5.9% ± 6.8%, but it was not statistically significant (p→.05). The relative electron density of Paraffin Wax, BinkieRT^TM and Putty is 0.94, 0.99, 1.26 and the mass density is 0.95, 0.99 and 1.32 (g/cc), Transmission Factor is 0.99, 0.98, 0.96 respectively. Conclusion: The result of the tongue DSC analysis over the treatment period was about 0.8 and Deviation of the center of tongue shifts were within 0.2 cm, the reproducibility was more likely excellent. In the case of unilateral head and neck cancer patients, it was found that the use of BinkieRT^TM rather than Paraffin Wax or Putty can reduce the unnecessary dose irradiated to the tongue. This study might be useful to understand of BinkieRT^TM's properties and advantages. And also it could be another considered option as oral stent to keep the reproducibility of tongue and reducing dose during head and neck radiation treatments.

• Journal of Life Science
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• v.34 no.2
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• pp.113-121
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• 2024

Endoplasmic reticulum (ER) stress responses are markedly induced during toxic responses caused by various chemical substances, including difenoconazole, but no research has been conducted on 1,2,3-trichloropropane (TCP), a chemical that is generally used in agriculture and industry, which induces hepatotoxicity. Therefore, in this study, the changes in indicators for hepatotoxicity, apoptosis, and ER stress were analyzed in TCP-treated Sprague Dawley (SD) rats to study the regulatory mechanism of ER stress during the hepatotoxicity. The TCP-treated group decreased in body weight and dietary intake compared to the vehicle-treated group, and necrosis and vacuolation increased significantly in liver histology. In addition, the expression of apoptosis-related factors, including Bax/Bcl-2 and cleaved caspase (Cas)-3/Cas-3 increased significantly in the TCP-treated group compared to the vehicle-treated group. In the analysis of ER stress response indicators, the expression of C/EBP homologous protein (CHOP), phospho-eukaryotic translation initiation factor 2 alpha subunit (eIF2α), and phospho-inositol-requiring enzyme 1α (IRE1α) increased only in the TCP100-treated group and decreased in the TCP200-treated group. However, the transcriptions of growth arrest and DNA damage-34 (GADD34) increased in the TCP200-treated group, while Spliced X-box binding protein-1 (XBP1s) and unspliced XBP1(XBP1u) decreased in the same group. These results suggest that the ER stress response is successfully triggered during the hepatotoxicity induced by TCP treatment through the alternative regulation of the unfolded-protein response (UPR) pathway.

• Sim-seong Yeon-gu
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• v.26 no.1
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• pp.36-66
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• 2011

The goal of this article is to examine the connection between creativity of unconscious and religion. Jung criticized how Freud's approach in studying the unconscious as a scientific inquiry focuses on the unconscious as reflecting only those which is repressed by the ego. Jung conceived of the unconscious as encompassing not only the repressed but also the variety of other psychic materials that have not reached the threshold of the consciousness in its range. Moreover, since human psyche is as individualistic as is a collective phenomenon, the collective psyche is thought to be pervasive at the bottom of the psychic functioning and the conscious and the personal unconscious comprising the upper level of the psychic functioning. Through clinical and personal experience, Jung had come to a realization that the unconscious has the self-regulatory function. The unconscious can make "demands" and also can retract its demands. Jung saw this as the autonomous function of the unconscious. And this autonomous unconscious creates, through dreams and fantasies, images that include an abundance of ideas and feelings. These creative images the unconscious produces assist and lead the "individuation process" which leads to the discovery of the Self. Because this unconscious process compensates the conscious ego, it has the necessary ingredients for self-regulation and can function in a creative and autonomous fashion. Jung saw religion as a special attitude of human psyche, which can be explained by careful and diligent observation about a dynamic being or action, which Rudolph Otto called the Numinosum. This kind of being or action does not get elicited by artificial or willful action. On the contrary, it takes a hold and dominates the human subject. Jung distinguished between religion and religious sector or denomination. He explained religious sector as reflecting the contents of sanctified and indoctrinated religious experiences. It is fixated in the complex organization of ritualized thoughts. And this ritualization gives rise to a system that is fixated. There is a clear goal in the religious sector to replace intellectual experiences with firmly established dogma and rituals. Religion as Jung experienced is the attitude of contemplation about Numinosum, which is formed by the images of the collective unconscious that is propelled by the creativity and autonomy of the unconscious. Religious sector is a religious community that is formed by these images that are ritualized. Jung saw religion as the relationship with the best or the uttermost value. And this relationship has a duality of being involuntary and reflecting free will. Therefore people can be influenced by one value, overcome with the unconscious being charged with psychic energy, or could accept it on a conscious level. Jung saw God as the dominating psychic element among humans or that psychic reality itself. Although Jung grew up in the atmosphere of the traditional Swiss reformed church, it does not seem that he considered himself to be a devoted Christian. To Jung, Christianity is a habitual, ritualized institution, which lacked vitality because it did not have the intellectual honesty or spiritual energy. However, Jung's encounter with the dramatic religious experience at age 12 through hallucination led him to perceive the existence of living god in his unconscious. This is why the theological questions and religious problems in everyday life became Jung's life-long interest. To this author, the reason why Jung delved into problems with religion has to do with his personal interest and love for the revival of the Christian church which had lost its spiritual vitality and depth and had become heavily ritualized.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.115-121
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• 2013

Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.351-360
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• 1995

Background: Pressure support(PS) is becomimg a widely accepted method of mechanical ventilation either for total unloading or for partial unloading of respiratory muscle. The aim of the study was to find out if PS exert different effects on respiratory mechanics in synchronized intermittent mandatory ventilation(SIMV) and continuous positive airway pressure (CPAP) modes. Methods: 5, 10 and 15 cm $H_2O$ of PS were sequentially applied in 14 patients($69{\pm}12$ yrs, M:F=9:5) and respiratory rate (RR), tidal volume($V_T$), work of breathing(WOB), pressure time product(PTP), $P_{0.1}$, and $T_1/T_{TOT}$ were measured using the CP-100 pulmonary monitor(Bicore, USA) in SIMV and CPAP modes respectively. Results: 1) Common effects of PS on respiratory mechanics in both CPAP and SIMV modes As the level of PS was increased(0, 5, 10, 15 cm $H_2O$), $V_T$ was increased in CPAP mode($0.28{\pm}0.09$, $0.29{\pm}0.09$, $0.31{\pm}0.11$, $0.34{\pm}0.12\;L$, respectively, p=0.001), and also in SIMV mode($0.31{\pm}0.15$, $0.32{\pm}0.09$, $0.34{\pm}0.16$, $0.36{\pm}0.15\;L$, respectively, p=0.0215). WOB was decreased in CPAP mode($1.40{\pm}1.02$, $1.01{\pm}0.80$, $0.80{\pm}0.85$, $0.68{\pm}0.76$ joule/L, respectively, p=0.0001), and in SIMV mode($0.97{\pm}0.77$, $0.76{\pm}0.64$, $0.57{\pm}0.55$, $0.49{\pm}0.49$ joule/L, respectively, p=0.0001). PTP was also decreased in CPAP mode($300{\pm}216$, $217{\pm}165$, $179{\pm}187$, $122{\pm}114cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0001), and in SIMV mode($218{\pm}181$, $178{\pm}157$, $130{\pm}147$, $108{\pm}129cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0017). 2) Different effects of PS on respiratory mechanics in CP AP and SIMV modes By application of PS (0, 5, 10, 15 cm $H_2O$), RR was not changed in CPAP mode($27.9{\pm}6.7$, $30.0{\pm}6.6$, $26.1{\pm}9.1$, $27.5{\pm}5.7/min$, respectively, p=0.505), but it was decreased in SIMV mode ($27.4{\pm}5.1$, $27.8{\pm}6.5$, $27.6{\pm}6.2$, $25.1{\pm}5.4/min$, respectively, p=0.0001). $P_{0.1}$ was reduced in CPAP mode($6.2{\pm}3.5$, $4.8{\pm}2.8$, $4.8{\pm}3.8$, $3.9{\pm}2.5\;cm$ $H_2O$, respectively, p=0.0061), but not in SIMV mode($4.3{\pm}2.1$, $4.0{\pm}1.8$, $3.5{\pm}1.6$, $3.5{\pm}1.9\;cm$ $H_2O$, respectively, p=0.054). $T_1/T_{TOT}$ was decreased in CPAP mode($0.40{\pm}0.05$, $0.39{\pm}0.04$, $0.37{\pm}0.04$, $0.35{\pm}0.04$, respectively, p=0.0004), but not in SIMV mode($0.40{\pm}0.08$, $0.35{\pm}0.07$, $0.38{\pm}0.10$, $0.37{\pm}0.10$, respectively, p=0.287). 3) Comparison of respiratory mechanics between CPAP+PS and SIMV alone at same tidal volume. The tidal volume in CPAP+PS 10 cm $H_2O$ was comparable to that of SIMV alone. Under this condition, the RR($26.1{\pm}9.1$, $27.4{\pm}5.1/min$, respectively, p=0.516), WOB($0.80{\pm}0.85$, 0.97+0.77 joule/L, respectively, p=0.485), $P_{0.1}$($3.9{\pm}2.5$, $4.3{\pm}2.1\;cm$ $H_2O$, respectively, p=0.481) were not different between the two methods, but PTP($179{\pm}187$, $218{\pm}181 cmH_2O{\cdot}sec/min$, respectively, p=0.042) and $T_1/T_{TOT}$($0.37{\pm}0.04$, $0.40{\pm}0.08$, respectively, p=0.026) were significantly lower in CPAP+PS than in SIMV alone. Conclusion: PS up to 15 cm $H_2O$ increased tidal volume, decreased work of breathing and pressure time product in both SIMV and CPAP modes. PS decreased respiration rate in SIMV mode but not in CPAP mode, while it reduced central respiratory drive($P_{0.1}$) and shortened duty cycle ($T_1/T_{TOT}$) in CPAP mode but not in SIMV mode. By 10 em $H_2O$ of PS in CPAP mode, same tidal volume was obtained as in SIMV mode, and both methods were comparable in respect to RR, WOB, $P_{0.1}$, but CPAP+PS was superior in respect to the efficiency of the respiratory muscle work (PTP) and duty cycle($T_1/T_{TOT}$).

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.54-61
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• 2016

Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.30-41
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• 2007

Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.