• Title/Summary/Keyword: 전신계수

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Interobserver and Intraobserver Reproducibility of SUL Measurements in Reference Organs on FDG PET/CT (FDG PET/CT 검사 시 참고장기에서 측정한, 제지방체중으로 표준화한 표준화 섭취계수의 관찰자 사이 및 관찰자 내 재현성에 대한 연구)

  • Kim, Seong Su;Shin, Yong Cheol;Lee, Sun Do;Lee, Nam Ju;Kim, Jong Cheol;Lee, Chun Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.11-17
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    • 2013
  • Purpose: The use of SUV which should be normalized by lean body mass (LBM) is recommended for PET response criteria in solid tumors. LBM which was determined by whole body CT was used for SUV normalization (SUL) in this study. The purpose of the present study was to assess interobserver and intraobserver reproducibility of SUL measurements in reference organs. Materials and Methods: F-18 FDG PET/CT was conducted on 52 subjects and LBMs were directly determine by whole body CT for normalization of SUV. The 3 cm diameter spherical VOI, $1\times2$ cm cylindrical VOI, 2 cm diameter spherical VOI were placed in the liver, descending aorta and spleen, respectively. Experienced two observers measured SULmax and SULmean in each organ. Repeated measurements were conducted two weeks apart by observer 1 blind to previous results. Similarly, measurements were conducted on the same patients by observer 2. For assessing reproducibility(or repeatability), the paired t-test, Pearson's correlation coefficients (CC), and technical error of measurement (TEM) were calculated. Results: For interobserver reproducibility in liver SULmax and SULmean, no significant differences were found between observers(paired t-test, P=0.536, 0.293, respectively). CC and TEM for liver SULmean were 0.909 (P=0.000) and 0.067 SUL unit, respectively. Corresponding figures for liver SULmax were 0.882 (P=0.000) and 0.117 SUL unit, respectively. For intraobserver reproducibility in liver SULmax and SULmean, no significant differences were observed within observer1 (paired t-test, P=0.374, 0.268, respectively). CC and TEM for liver SULmean were 0.924 (P=0.000) and 0.061 SUL, respectively. Corresponding figures for liver SULmax were 0.908 (P=0.000) and 0.104 SUL, respectively. Similarly, no significant differences were found in SULmax and SULmean of the spleen and aorta between observers. Conclusion: The current study demonstrated that both SULmean and SULmax measurements in normal reference organs are highly reproducible. Reproducibility of SULmean in reference organs were slightly better than SULmax. Interobsever technical error of measurement was less than 0.10 SUL unit for liver SULmean, and 0.12 SUL unit for liver SULmax. Intraobsever technical error of measurement was less than 0.07 SUL unit for liver SULmean, and 0.11 SUL unit for liver SULmax.

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Bedside Estimation of the Length of Nares-Vocal Cord in Children (소아에서의 비공 - 성대간 거리에 관한 예측공식의 유도)

  • Lee, Young-Eun;Shin, Teo-Jeon;Kim, Chong-Chul;Lee, Sang-Hoon;Jang, Ki-Taeg;Kim, Jung-Wook;Kim, Youmg-Jae;Hyun, Hong-Keun;Han, Hyo-Jo;Kim, Hyun-Jeong;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.141-145
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    • 2011
  • 배경: 협조가 불가능하거나 진정법 하 치과치료가 여의치 않을 경우 전신마취 하 치료를 계획하게 된다. 하지만 전신마취 하 치료시 기관내 삽관이 여의치 않은 경우를 종종 경험하게 된다. 이와같은 경우 기관지경을 이용한 기관내 삽관을 시행한다. 기관지 내시경을 환자의 성문에 근접하게 전진시킬 경우 기관지 내시경 하 시야확보가 용이한 점을 감안 시 비공 - 성대간 거리를 예측하는 것은 매우 유용할 것으로 생각된다. 또한 비공 - 성대간 거리를 추정하게 되면 맹목적 비강내 기관내 삽관을 하는데도 도움이 된다. 방법: 본 연구는 전신마취하 치과치료가 예정되어 있는 62명의 소아환자들을 대상으로 하여 신체변수와 비공 - 성대거리와의 관계를 확인해보고자 하였다. 선형회귀분석을 시행하여 다음과 같은 결론을 도출하였다. 결과: 소아환자들에 있어 비공 - 성대간 거리는 환아의 신장, 체중, 연령 등과 상관관계를 나타내었다. 비공 - 성대간 거리와 상관관계를 보인 변수들 중 에서 신장과의 상관계수가 가장 높았다. 선형회귀분석을 통해 비공 - 성대간 거리를 예측하는 다음과 같은 회귀식을 구하였다. 비공 - 성대간 거리 = (4.8 + 신장(cm)) ${\times}$ 0.07 고찰: 본 연구에서 구해진 회귀식을 이용하여 기도유지가 어려운 소아의 기도유지 하는데 큰 도움이 될 것으로 생각된다.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

EVALUATION OF SERUM LEVELS OF SYSTEMIC STATUS IN ORAL AND MAXILLOFACIAL SURGERY PATIENTS (구강악안면 수술을 받은 환자들에서의 전신영양평가)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.301-314
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    • 2003
  • The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same parameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(P<0.05). A positive correlation was also found between neutrophil and leukocyte(P<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(P<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(P<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(P<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(P<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.

RADAP-A PC Program for Real-Time Prediction of Doses Following a Nuclear Accident (RADAP-원자력 사고후 실시간 선량 예측용 PC 전산프로그램)

  • Park, Jae-Won;Kang, Chang-Sun
    • Nuclear Engineering and Technology
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    • v.25 no.1
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    • pp.102-109
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    • 1993
  • A PC-computer program RADAP has been developed in this study to perform a quick real-time analysis of dose assessment following an accident in a nuclear facility. RADAP uses an interactive LKagrangian puff model in simulating the transport and diffusion of radioactive plume in the atmosphere. For real-time analysis, RADAP treats one or multiple puffs of ground-level releases, simultaneously. It is assumed to maintain a Gaussian distribution within the puff and the diffusion coefficients are computed using the USNRC's normal sigma curve method. The program, however, does not consider the spatial variations but the temporal variations in wind conditions. Whole body and thyroid doses for 3$\times$31 grid are directed to output files, and they are also displayed through computer graphics on VGA or EGA color monitor. The results show that RADAP can be an excellent tool for quick estimation of accidental doses.

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Examination about Utility of Prone Position in PET/CT of Stomach Cancer Patient (위암 환자의 양전자 방출 컴퓨터 단층 검사에서 복와위(伏臥位) 촬영의 유용성에 대한 연구)

  • NamKoong, Hyuk;Park, Hoon-Hee;Oh, Shin-Hyun;Bahn, Yung-Kag;Kim, Jung-Yul;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.93-99
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    • 2010
  • Purpose: Currently, PET/CT scan has been known to provide useful information to both preoperative and postoperative examination of cancer patients. Contracted stomach by the long fasting could cause difficulties of interpretation because of its size on reconstructed image data. To solve this problem, after the whole body PET/CT scan, patients were administrated in drinking 300 mL of water to expand stomach and performed additional scan on stomach region. Not only PET/CT scan but also CT performs this water-administration, and patients were take oral solution to make stomach expand for stomach cancer. When this scan performed, patients lay supine position. In this study, we evaluated the capacity of stomach through PET/CT scan with drinking water performed in supine and prone position so that we can distinguish exact location of cancer around pylorus and inferior wall of stomach. Furthermore, image data from supine and prone positions were analyzed the difference of volume of stomach through the change of standardized uptake values. Materials and Methods: From July 2009 to January 2010 in severance hospital, 30 patients who were diagnosed as early gastric cancer or advanced gastric cancer were chosen. All patients had PET/CT scan before the operation and have had follow-up PET/CT. The patients fast for at least 8 hours, and had an injection intravenously with $^{18}F$-FDG, 7.4 MBq (0.2 mCi/kg) per kilogram. They were rested for 60 minutes. Before the examination, all patients were administrated to drink water for 300 mL Patients had PET/CT scan with supine position around the region of stomach, whole body, and around the region of stomach with prone position after drinking another 300 mL of water respectively. Results: As a results of comparison between stomach capacity of 30 patients in supine and prone position, the study draw results that average capacity of stomach body was 460.29 $mm^2$ in supine position, and 641.39 $mm^2$ in prone position for 30 patients. The change of capacity shows 41.3% expanded in prone position. And there was no noticeable difference at maximum standardized uptake values in supine position and prone position. Conclusion: As results, stomach would have more expanded capacity in prone position than supine position. For patients who have physical disabilities to move freely, additional scan in prone position will be obstacle to perform. However, if additional scan in supine position add with the scan in prone position, it will be easier to diagnose stomach cancer. Moreover, we believe that this study will help the research for inventing support tools for patients who have physical disabilities in prone position.

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Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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A study on absorbing the Cr (Ⅵ) in the body and clearance (크롬(Ⅵ)의 체내 흡수와 소실속도에 관한 연구)

  • 김현영;이성배;이권섭;정용현;한정희;최종윤;김성화;김무강;이용묵
    • Proceedings of the Korea Society of Environmental Toocicology Conference
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    • 2003.10a
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    • pp.182-182
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    • 2003
  • 1.연구목적 : Cr $O_3$은 금속 도금용, 페인트 둥에 많이 사용되며 독성이 강하여 그동안 근로자 건강장해 및 직업병 사례가 많이 발생하였다. 그러나 산화크롬의 흡입에 의한 연구자료는 매우 부족하다. 이에 흡입챔버를 이용 Rats에 흡입노출을 통하여 유해성을 평가하고 각 장기에 흡수되는 크롬의 농도평가와 회복기간에 따라 각 장기별로 흡수된 크롬의 소실속도 둥을 연구하였으며 더불어 회복기간과 제거율의 상관관계 및 체내 반감기 등을 연구하였다. 2. 연구방법 : Cr $O_3$를 폐내 침착율 및 흡수율이 높은 0.5~5$\mu\textrm{m}$ 크기의 aerosol형태로 SD Rats 수컷에 전신폭로 하였다. 노출농도는 0.00, 0.20, 0.50, 1.25mg/㎥(Cr)으로 하여 1일 6시간, 주 5일, 13주간 반복 노출하였고 회복군은 시험물질 종료일을 기준으로 2주, 8주 경과 후 조직장기와 전혈, 혈장 및 적혈구내, 뇨 중 각각의 크롬농도를 분석하였으며 혈액 및 혈액 생화학적 검사도 병행하였다 3. 연구결과 : 혈액검사에서 0.20, 0.50 mg/㎥ 농도군 실험동물의 RBC와 HGB, HCT 둥은 감소의 경향을 보였으나 농도 의존적이지는 않았다. 신장의 절대중량은 대조군에 비해 유의하게 (p<0.05) 감소하고 폐장의 경우는 대조군에 비해 유의한(p<0.05) 절대중량 증가를 보였다 시험물질 노출 후 혈액 중 전혈, 혈장, 적혈구의 회복기간(x)별 크롬농도(y)의 소실속도 상관계수 (노출농도 0.50mg/㎥군의 경우)는 y = 66.51 $e^{0.057}$x/, y = 67.2 $e^{0.101}$x/, y = 70.01 $e^{0.030}$x/, 반감기는 12.0, 6.86, 23.0 일이고 폐장, 간장, 신장의 회복기간(x)별 크롬농도(y)의 소실속도 상관계수 (노출농도 0.50 mg/㎥군의 경우)는 y = 1808 $e^{0.004}$93x/, y = 12.02 $e^{0.029}$7x/, y = 67.61 $e^{0.029}$2x/ 반감기는 140.6, 23.3, 23.7 일로 평가되었다. 4. 고찰 : 실험동물의 전혈, 혈청, 뇨에서의 크롬농도와 시험물질 노출농도는 밀접한 상관을 가졌으나 농도에 정비례하지는 않았다. 뇨 중 흡수된 크롬의 경우 회복기간 초기 (12시간 내)에 대부분 배설이 일어나는 것으로 나타났다. 폐장이 간장, 신장 등 다른 장기에 비해 높은 축적량을 보였으며 축적된 크롬농도가 높을수록 크롬의 소실속도는 현저히 저하하는 경향을 보였다. 노출농도가 높을수록 각 장기조직 내 크롬의 소실속도 (clearance)는 크게 감소경향이 있었으며 이는 체내 과부하시 자정작용이 감소하는 것으로 판단되었다. 본 연구 결과 SD rat를 이용 반복흡입노출의 경우 생체의 무유해영향농도 (NOAEL)는 0.2mg/㎥이하이며 발암물질을 감안하여 안전계수를 100으로 할 경우 사람에 대한 NOAEL은 0.002mg/㎥이하로 판단되었다. 특히 호흡기와 폐장에 강한 유해성을 나타내는 것으로 확인되었다. 것으로 확인되었다.

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Quantitative Analysis of Electrophysiological Characteristics of CIDP and CMT Type 1: Sensory Nerve Research (CIDP와 CMT 1형의 전기생리학적 특성에 대한 정량 분석: 감각신경연구)

  • Kang, Ji-Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.151-157
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

Consideration of Standardized Uptake Value (SUV) According to the Change of Volume Size through the Application of Astonish TF Reconstruction Method (Astonish TF 재구성 기법의 적용을 통한 체적 크기의 변화에 따른 표준섭취계수(SUV)에 관한 고찰)

  • Lee, Juyoung;Nam-Kung, Sik;Kim, Ji-Hyeon;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.115-121
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    • 2014
  • Purpose: In addition to improving the quality of the PET image, through much research, the development of various programs are performed. Astonish TF reconstruction techniques by Philips can confirm the improved contrast of the lesion. Also, It's image reconstruction of 2 mm is possible with rapid reconstruction rate than conventional. In this study, we compared and evaluated Standardized Uptake Value (SUV) in accordance with the 2 mm reconstruction techniques and traditional 4 mm from the $^{18}F-FDG$ PET whole body image. Materials and Methods: In the phantom experiment, NEMA IEC body phantom (sphere: 10, 13, 17, 22, 28, 37 mm) was used to obtain images by using GEMINI TF 64 PET/CT (Philips, Cleveland, USA). Also, In the clinical images, we performed $^{18}F-FDG$ PET/CT examination to 30 women (age: $55.1{\pm}11.3$, BMI: $24.1{\pm}2.9$) with a diagnosis of breast cancer. After that, we reconstructed images in 2 mm and 4 mm respectively. The region of interest was drawn to acquired images. Since then, we measured SUV and statistically analyzed with SPSS ver.18 by using EBW (Extended Brilliance Workstation) NM ver.1.0. Results: After analyzing the result of the phantom study, there was a tendency that the bigger hot sphere size, the higher SUV. If you compared the 2 mm reconstruction techniques to 4 mm, it increased 95.78% in 10 mm, 50.60% in 13 mm, 25.00% in 17 mm, 30.04% in 22 mm, 31.81% in 28 mm, and 27.84% in 37 mm. Through the result of the analysis of the 2 mm reconstruction techniques and 4 mm in clinical images, it appeared that SUV of 2 mm was higher than that of 4 mm. Also the smaller the volume was, the more the change rate increased. Conclusion: After analyzing the result of the clinical picture and phantom experiments applied by Astonish TF reconstruction techniques, as the size of the volume was small, the change rate of the SUV increased. Therefore, it was necessary to further research about the SUV correction for accurate and active utilization of 2 mm reconstruction techniques which had excellent lesion discrimination ability and contrast in clinic.

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