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The Diagnostic Utility of PET-CT for the Preoperative Evaluation of Lymph Node Metastasis in Gastric Cancer Patients (위암 환자의 수술 전 림프절 전이 평가를 위한 PET-CT의 진단적 유용성)

  • Park, Sung-Hyuk;Cho, Min-Su;Ryu, Hoon;Bae, Keum-Seok;Kim, Ik-Yong;Kim, Dae-Sung
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.250-255
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    • 2008
  • Purpose: The purpose of this study was to assess the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting the lymph node (LN) metastasis of gastric cancer. Materials and Methods: 119 patients (M : F=89 : 30; mean age: 64) with gastric cancer were referred for preoperative FDG-PET/CT scanning and spiral enhanced abdominal pelvic CT from June 2006 to July 2008, and these were the subjects of our study. All the patients underwent curative radical gastrectomy and lymph node dissection. A final diagnosis was made for all the patients by the histology of the surgical specimens. Results: Both PET/CT and enhanced CT showed similar sensitivity for detecting regional lymph node metastasis (32.6% vs 39.5%, respectively). PET/CT was more accurate than enhanced CT for detecting regional lymph node metastasis (67.2% vs 63.0%, respectively), and PET/CT showed better specificity (86.8% vs 76.3, respectively) and a better positive predictive value (PPV) (58.3% vs 48.6%, respectively). PET/CT showed better specificity (98.0% vs 88.2%, respectively) and accuracy (79.4% vs 73.9%, respectively) than enhanced CT for detecting early gastric cancer. PET/CT showed better specificity (64.0% vs 52.0%, respectively), a better PPV (60.9% vs 57.1%), a better negative predictive value (NPV) (48.5% vs 46.4%, respectively) and better accuracy (53.6% vs 51.8%, respectively) than enhanced CT for detecting advanced gastric cancer. Conclusion: FDG-PET/CT is more usefulness than enhanced CT for making the preoperative diagnosis of regional LN metastases from gastric cancers.

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The Relation between Microsatellite Instability and the Thymidylate Synthase Expression in Gastric Cancer (위암에서 Microsatellite Instability와 Thymidylate Synthase의 상관관계)

  • Ko, Hyun-Seok;Ahn, Chang-Wook;Kang, Hae-Youn;Kim, Kwang-Il;Hong, Sung-Pyo;Ahn, Dae-Ho
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.169-175
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    • 2008
  • Purpose: The main target of 5-fluorouracil (5-FU) is thymidylate synthase (TS). A high TS expression has been identified as promoting resistance to 5-FU. For colorectal cancers, the response to 5-FU based adjuvant chemotherapy is different according to the microsatellite instability (MSI) status. The reports on the relationship between MSI and the TS expression in colorectal cancer have been inconsistent. No data is available for gastric cancer regarding the relationship between MSI and the TS expression. Therefore, we studied the relationship between MSI and the TS expression in gastric cancer. Materials and Methods: Ninety-nine consecutive patients who underwent radical gastrectomy for gastric cancer from January 2004 to May 2006 at Bundang CHA hospital were studied. MSI was assessed for five markers (BAT25, BAT26, D2S123, D5S346, and D17S250) by PCR and with using an ABI prism 3100 Genetic analyzer. The TS expression was analyzed by immunohistochemistry with using mouse anti-thymidylate synthase monoclonal antibody to the TS 106 clone. Results: Out of the ninety-nine patients, MSS/MSI-L was detected in 92 (92.1%) cases and 7 cases (7.1%) were MSI-H. A negative TS expression was found in 46 (46.5%) cases, a low TS expression was found in 33 (33.3%) and a high TS expression was found in 20 (20.2%). Out of 92 MSS/MSI-L patients, the number of patients with negative, low and high TS expressions were 46 (50%), 30 (32.6%) and 16 (17.4%), respectively. Out of the 7 MSI-H patients, the number of patients with negative, low and high TS expressions were 0 (0%), 3 (42.9%) and 4 (57.1%), respectively. The relationship between MSI-H and a high TS expression was statistically significant. Conclusion: Gastric cancer with MSI-H showed higher levels of a TS expression compared to the gastric cancer with MSS/MSI-L.

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Study for the Synthesis of $[^{123}I]$Idoxifene and Its Uptake in the Breast Cancer Cell ($[^{123}I]$Idoxifene 합성과 유방암의 세포섭취에 관한 연구)

  • Cho, Young-Sub;Yang, Seung-Dae;Suh, Yong-Sup;Chun, Kwon-Soo;Ahn, Soon-Hyuk;Lim, Soo-Jung;Lim, Sang-Moo;Yu, Kook-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.410-417
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    • 2000
  • Purpose: Idoxifene is currently entering phase II clinical trials for the treatment of advanced breast cancer. The radiolabeled idoxifene using $[^{123}I]$ provides an opportunity for clinical pharmacology with single photon emission computed tomography (SPECT). The purpose of this study was to prepare radiolabeled idoxifene using $[^{123}I]$ and to determine its cell uptake of breast cancer cell line. Materials and Methods: With a view to evaluating new anticancer drugs, we are investigating the novel antiestrogen pyrrolidino-4-iodotamoxifen (idoxifene). $[^{123}I]$Idoxifene has been prepared in no-carrier-added form using a tributyl stannylated precursor which has been synthesized by means of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid on the basis of previously reported standard methods. The biodistribution and dynamic behavior of the compound were investigated using the comparative breast cancer cell line, MCF-7 (estrogen receptor-positive) and MDA-MB-468 (non-estrogen receptor). Results and Conclusion: Acylation of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid gave the versatile ketone (81%) which reacted with 1,4-diiodobenzene to give triphenylethylene as a mixture of E and Z geometric isomers, which were separated by the recrystallization in ethanol. The E-isomer was treated with pyrrolidine to give idoxifene (67%). In order to incorporate radioactive iodine into the 4-position, the 4-stannylated precursor was prepared (30%). The yield of radioiodination was 90-92% with a high radiochemical purity greater than 98%. The ratio of tumor uptake of the breast cancer cell line between MCF-7 and MDA-MB-468 was about 1.7.

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Dopamine Transporter Density of the Basal Ganglia in Children with Attention Deficit Hyperactivity Disorder Assessed with I-123 IPT PECT (I-123 IPT SPECT를 이용한 주의력결핍 과잉행동장애 아동에서의 methylphenidate 투여 전후의 기저 신경절 도파민 운반체 밀도 변화 측정)

  • Ryu, Won-Gee;Kim, Tae-Hoon;Ryu, Young-Hoon;Yun, Mi-Jin;Cheon, Keun-Ah;Chi, Dae-Yoon;Kim, Jong-Ho;Choi, Tae-Hyun;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.235-244
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    • 2003
  • Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

The Differentiation of Malignant and Benign Musculoskeletal Tumors by F-18 FDG PET/CT Studies - Determination of maxSUV by Analysis of ROC Curve (F-18 FDG PET/CT에서 양성과 악성 근골격 종양의 감별진단 - 수신자 판단특성곡선을 이용한 maxSUV의 절단값 결정)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Choi, Jun-Heok;Shin, Duk-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.553-560
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    • 2007
  • Purpose: We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Materials and Methods: Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. Results: There was a statistically significant difference in maxSUV between benign (n=11; maxSUV $3.4{\pm}3.2$) and malignant (n=12; maxSUV $14.8{\pm}12.2$) lesions in soft tissue tumor (p=0.001). Between benign bone tumor (n=9; maxSUV $5.4{\pm}4.0$) and malignant bone tumor (n=14; maxSUV $7.3{\pm}3.2$), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n=2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. Conclusion: The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

Sleep Patterns of Pregnant Women (임부의 수면양상)

  • Choi, Byeung-Sun;Yoon, Jin-Sang
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.45-53
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    • 1998
  • Objectives : The change of sleep patterns commonly occurs in association with the pregnancy. This study was to investigate sleep habits during the course of normal pregnancy. Methods : Sleep habits questionnaire was administered to healthy women in their first trimester(TR1) of pregnancy and then the same questionnaire was repeatedly administered during their second(TR2) and third(TR3) trimesters. The following aspects were assessed : patterns of night sleep, daytime status, sleep posture, reasons for sleep alteration, and the experience of any particular parasomnias, as well as sleep problem-related treatment or medication. Data analysis was based on 26 women who maintaind good health throughout their pregnancy and completed the questionnaire three times. Results : In comparisons between each trimester and non-pregnant state, total night sleep time, daytime tiredness, and sleepiness were significantly increased in all trimesters. Sleep latency was significantly decreased in TR1 and TR2, but not in TR3. In addition, refreshed feeling on waking the following day was significantly decreased and the number of awakenings during night sleep was significantly increased in TR3, but not in TR1 and TR2. In comparisons between trimesters, there was a significant increase in sleep latency, daytime sleepiness and the number of awakenings during night sleep and a significant decrease in refreshed feeling on waking the following day in TR3 compared to TR1 and TR2. Over the course of pregnancy, the rate of lateral position during sleep was gradually increased and all the pregnant women took the lateral sleeping posture in TR3. The major reasons for sleep pattern alteration were nausea, vomiting and heartburn in TR1, urinary frequency, fetal movement and ache in hips in TR2, and urinary frequency, fetal movement, cramp in legs and backache in TR3. Conclusion : These findings are expected to be useful for educating pregnant women about sleep hygiene. In future studies, the underlying factors and mechanisms regarding sleep patterns during pregnancy will need to be clarified.

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Association between the Human Surfactant Protein-A(SP-A) Gene Locus and Chronic Obstructive Pulmonary Disease in Korean Population (한국인에서 만성폐쇄성폐질환과 인체 폐 표면 활성제 단백-A 유전자 대립형질의 상관관계)

  • Na, Joo Ock;Oh, Myung Ho;Choi, Jae Sung;Seo, Ki Hyun;Kim, Yong Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.638-644
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    • 2006
  • Backgrounds: This study investigated whether or not a polymorphism in the gene encoding the surfactant protein A(SP-A) has any bearing on the individual susceptibility to the development of chronic obstructive pulmonary disease(COPD) in a genetically homogenous Korean population. Methods: The genotypes of 19 COPD patients and 20 healthy neonates as controls were tested using a polymerase chain reaction followed by restriction fragment length polymorphism analysis for the SP-A gene. Results: The specific frequencies of the 6A2 and 6A18 alleles of SP-A1 and the 1A2 allele of SP-A2 were much higher in the COPD group than control group (p<0.05). However, the frequencies of the 6A3 and 6A4 alleles of SP-A1 and the 1A0 allele of SP-A2 in the COPD group were significantly lower than the control group. In the COPD group, the frequencies of the +50 locus genotypes GG of SP-A1 and the +9 locus genotypes CC of SP-A2 were 85.0% and 60.6%, respectively, and 19.7% and 24.8% in the control group, respectively. The frequencies of the polymorphic genotypes or alleles showed a statistically significant difference between the COPD group and the control group (P<0.05). Conclusion: A genetic polymorphism in SP-A is associated with the development of COPD in the Korean population.

The evaluation of clinical efficacy and longevity of home bleaching without combined application of In-office bleaching (자가미백술 단독사용시 임상적 효능 및 유지력 평가)

  • Shin, Byunk-Gyu;Yang, Sung-Eun
    • Restorative Dentistry and Endodontics
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    • v.35 no.5
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    • pp.387-394
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    • 2010
  • Objectives: The purpose of this study was to evaluate the whitening efficacy and longevity of home bleaching. Materials and Methods: A total of 28 patients were divided into either experimental group (Opalescence F; 15% carbamide peroxide) or control group randomly. The patients in experimental group were instructed to wear individual trays applied with bleaching gel for 2 hours a day for 4 weeks. Any treatments weren't applied to the patients in control group. The color measurements of central incisors, lateral incisors & canines of upper and lower arch were recorded at base line, immediately after the finishment of treatmemt (4 weeks), 8 weeks and 12 weeks using Colorimeter (Chroma Meter, 2600d Konica Minolta co.) and Vitapan classical shade guide (Vita Zahnfabrik). Results: A significantly stronger color change was observed for overall teeth samples in experimental group immediately after treatment (at 4 weeks) compared to ones in control group (p < 0.05). There was also a significant difference between baseline and 8 weeks or 12 weeks separately though color rebouncing phenomenon occurred as time went by (p < 0.05). Conclusions: The clinical effecacy and longevity of home bleaching without combined application of in-office bleaching was observed through this experiment.

Clinical assessment of whitening efficacy and safety of in-office tooth whitening system containing 15% hydrogen peroxide with or without light activation (15% 과산화수소 함유 전문가용 치아 미백제의 광활성화 여부에 따른 미백효과 및 안전성에 관한 임상평가)

  • Noh, Young-Suk;Rho, Young-Jee;Yoo, Yeon-Jee;Lee, Hyang-Ok;Lim, Sang-Min;Kweon, Hyun-Jeong;Kim, Ye-Un;Park, Seong-Yeon;Yoon, Hee-Young;Lee, Jung-Hyun;Lee, Chan-Hee;Oh, So-Ram;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.36 no.4
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    • pp.306-312
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    • 2011
  • Objectives: This clinical study evaluated the effect of light activation on the whitening efficacy and safety of in-office bleaching system containing 15% hydrogen peroxide gel. Materials and Methods: Thirty-three volunteers were randomly treated with (n = 17, experimental group) or without light activation (n = 16, control group), using Zoom2 white gel (15% $H_2O_2$, Discus Dental) for a total treatment time of 45 min. Visual and instrumental color measurements were obtained using Vitapan Classical shade guide and Shadepilot (DeguDent) at screening test, after bleaching, and 1 month and 3 month after bleaching. Data were analyzed using t-test, repeated measure ANOVA, and chi-squared test. Results: Zoom2 white gel produced significant shade changes in both experimental and control group when pre-treatment shade was compared with that after bleaching. However, shade difference between two groups was not statistically significant (p > 0.05). Tooth shade relapse was not detected at 3 months after bleaching. The incidence of transient tooth sensitivity was 39.4%, with being no differences between two groups. Conclusions: The application of light activation with Zoom2 white gel system neither achieved additional whitening effects nor showed more detrimental influences.

Elemental analysis of the fluoride varnish effects on root caries initiation (불소 바니쉬 도포 후 초기 치근 우식 발현에 대한 정량원소분석)

  • Park, Se-Eun;Yi, Kee-Wook;Kim, Hae-Young;Son, Ho-Hyun;Chang, Ju-Hea
    • Restorative Dentistry and Endodontics
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    • v.36 no.4
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    • pp.290-299
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    • 2011
  • Objectives: The usage of fluoride varnish for a moderate to low caries-risk group has not been well validated. This study aimed to evaluate the preventive and therapeutic efficacies of fluoride varnish on the initiated root caries. Materials and Methods: Ten premolars were sectioned into quarters, further divided into two windows, one of which was painted with Fluor Protector (1,000 ppm fluoride, Ivoclar Vivadent). An initial lesion with a well-preserved surface layer was produced by pH cycling. Scanned line analysis using energy dispersive spectrometry determined the weight percentages of Ca and P in the demineralized layer. Scanning Electron microscopy and confocal laser scanning microscopy (CLSM) evaluated the varnish-applied root surfaces. Results: The mean lesion depth (SD) was 12.3 (2.6) ${\mu}m$ (single cycling) and 19.6 (3.8) ${\mu}m$ (double cycling). Double cycling extended the lesion depth, but induced no more mineral loss than single cycling (p < 0.05). The mean weight percentages of Ca and P between groups with and without varnish were not significantly different (p < 0.05). A CLSM showed varnish remained within 15 ${\mu}m$ of the surface layer. Conclusions: When a mild acid challenge initiated root tissue demineralization, the application of low-concentration fluoride varnish did not influence the lesion depth or the mineral composition of the subsurface lesion.