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Comparison of One-day and Two-day Protocol of $^{11}C$-Acetate and $^{18}F$-FDG Scan in Hepatoma (간암환자에 있어서 $^{11}C$-Acetate와 $^{18}F$-FDG PET/CT 검사의 당일 검사법과 양일 검사법의 비교)

  • Kang, Sin-Chang;Park, Hoon-Hee;Kim, Jung-Yul;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.3-8
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    • 2010
  • Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.

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Diagnostic Usefulness of Serum Level of Cyfra 21-1, SCC Antigen and CEA in Lung Cancer (폐암에서 혈중 Cyfra 21-1, SCC 항원 및 CEA의 진단적 유용성)

  • Kim, Kyoung-Ah;Lee, Me-Hwa;Koh, Youn-Suck;Kim, Seon-Hee;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Moon, Dae-Hyuk
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.846-854
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    • 1995
  • Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia such as respiratory epithelial cells and their malignant counterparts. An immunoradiometric assay is available to detect a fragment of the cytokeratin, referred to as Cyfra 21-1 in the serum. This study was conducted to evaluate the clinical utility of this new marker in the diagnosis of lung cancer compared with established markers of squamous cell carcinoma antigen (SCC Ag) and carcino-embryonic antigen(CEA). In addition, we compared the diagnostic sensitivity and specificity of Cyfra 21-1 with those of SCC Ag in squamous cell carcinoma of the lung. We also measured the level of Cyfra 21-1 in the different stages of squamous cell carcinoma of the lung. Method: We measured Cyfra 21-1(ELSA-CYFRA 21-1), SCC Ag(ABBOTT SCC RIABEAD) and CEA(ELSA2-CEA) in 79 patients with primary lung cancer and in 78 persons as a comparison group including 32 patients with pulmonary tuberculosis, 23 patients with benign lung disease and 23 cases with healthy individual. Cyfra 21-1 is measured by a solid-phase immunoradiometric assay(CIS Bio International, France) based on the two-site sandwich method. SCC Ag is measured by a radioimmunoassay(Abbott Laboratories, USA). CEA is measured by a immunoradiometric assay(CIS Bio International, France). All data were expressed as the mean$\pm$standard deviation. Results: 1) The mean value of Cyfra 21-1 was $18.38{\pm}3.65\;ng/mL$ in the lung cancer and $1.l6{\pm}0.53\;ng/mL$ in the comparison group(p<0.0001). SCC Ag was $3.53{\pm}6.06\;ng/mL$ in the lung cancer and $1.19{\pm}0.5\;ng/mL$ in the comparison group(p<0.01). CEA was $35.03{\pm}13.9\;ng/mL$ in the lung cancer and $2.89{\pm}1.01\;ng/mL$ in the comparison group(p<0.0001). 2) Cyfra 21-1 level in squamous cell carcinoma($31.52{\pm}40.13\;ng/mL$) was higher than that in adenocarcinoma($2.41{\pm}1.34\;ng/mL$)(p<0.0001) and small cell carcinoma($2.15{\pm}2.05\;ng/mL$)(p=0.007). SCC Ag level in squamous cell carcinoma($5.1{\pm}7.68\;ng/mL$) was higher than that in adenocarcinoma($1.36{\pm}0.69\;ng/mL$)(p=0.009) and small cell carcinoma($1.1{\pm}0.24\;ng/mL$) (p=0.024). 3) The level of Cyfra 21-1 was not correlated with the progression of stage in squamous cell carcinoma of the lung. 4) Using the cut-off value of 3.3ng/mL, the diagnostic sensitivity of Cyfra 21-1 was 83% in squamous cell carcinoma, 22% in adenocarcinoma and 17% in small cell carcinoma. The sensitivity of SCC Ag and CEA were 39% and 20%, respectively in squamous cell carcinoma, 11% and 39% in adenocarcinoma, and 0% and 33% in small cell carcinoma. 5) Comparison of the receiver operating characteristics curves(ROC curve) for Cyfra 21-1, SCC Ag and CEA revealed that Cyfra 21-1 showed highest diagnostic sensitivity among them in the diagnosis of lung cancer. Conclusion: Cyfra 21-1 is thought to be a better tumor marker for the diagnosis of lung cancer than SCC Ag and CEA, especially in squamous cell carcinoma of the lung.

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Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly (농촌지역 노인들의 인지기능 장애와 사망과의 관련성)

  • Sun, Byeong-Hwan;Park, Kyeong-Soo;Na, Baeg-Ju;Park, Yo-Seop;Nam, Hae-Sung;Shin, Jun-Ho;Sohn, Seok-Joon;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.630-642
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    • 1997
  • The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

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A Study on the Investigation of Sanitary Knowledge and Practice Level of School Foodservice Employees in Jeonju (전주지역 학교급식 조리종사자의 위생지식 및 위생관리 수행에 관한 연구)

  • Han, Eun-Hui;Yang, Hyang-Sook;Shon, Hee-Sook;Rho, Jeong-Ok
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.8
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    • pp.1210-1218
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    • 2005
  • This study was to investigate the sanitary knowledge and its practice level of school foodservice employees in Jeonju area. A total of 508 questionnaires were usable; resulting in 79.0$\%$ response rate. Statistics data analysis was completed using the SPSS 10.0 program. The results of this study were summarized as follow : About 62$\%$ of school foodservice employees were 41 $\∼$50 years old and 84$\%$ of them had a irregular job and they had a sanitation training at least once a month. The school foodservice employees had more knowledge about 'personal hygiene' than that about 'equipment and facilities sanitation', 'foodborn disease and food microorganism' Their hygiene practice level were high for 'equipment and facilities sanitation' (4.90$\pm$0.25) and were lesser in the order from 'foodborn disease and food microorganism'(4.86$\pm$0.30), 'personal sanitation'(4.79$\pm$0.34) and the least for food processing hygiene (4.70$\pm$0.37). As a result of relationship between knowledge and hygiene practice level, knowledge of school foodservice employees was not influenced on tile hygiene practice level during their working.

Pulse wave velocity and ankle brachial index in normal adolescents (정상 청소년에서 맥파 속도와 발목 상완 동맥압 지수에 대한 연구)

  • Kim, Ji Hye;Gil, Tae Young;Lee, Hee Woo;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.549-555
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    • 2007
  • Purpose : Pulse wave velocity (PWV) and ankle brachial index (ABI) are simple, non-invasive methods to assess arterial stiffness. These parameters are also known to be closely related to cardiovascular risk factors and diseases. The purposes of this study were to measure blood pressure, PWV, ABI in healthy Korean adolescents, set up their normal values and assess their correlations. Methods : Three hundred ninety two healthy adolescents (213 boys and 179 girls) underwent measurement of brachial ankle pulse wave velocity (baPWV), ABI, body mass index(BMI) and blood pressure from four extremities. Linear regression analysis was performed to reveal the correlations between PWV, ABI and independent variables. Results : Blood pressure and PWV were significantly higher in all extremities in males compared to females. Blood pressure of both brachial and ankle showed positive correlation with body weight, height, and BMI, whereas ABI showed no correlation with any of these indices. Conclusion : Blood pressure increases as body weight, height and BMI increases. PWV shows positive correlation with blood pressure. It will be helpful to predict the risks of cardiovascular diseases in adolescents.

Study on Influencing Factors of Traffic Accidents in Urban Tunnel Using Quantification Theory (In Busan Metropolitan City) (수량화 이론을 이용한 도시부 터널 내 교통사고 영향요인에 관한 연구 - 부산광역시를 중심으로 -)

  • Lim, Chang Sik;Choi, Yang Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.35 no.1
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    • pp.173-185
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    • 2015
  • This study aims to investigate the characteristics and types of car accidents and establish a prediction model by analyzing 456 car accidents having occurred in the 11 tunnels in Busan, through statistical analysis techniques. The results of this study can be summarized as below. As a result of analyzing the characteristics of car accidents, it was found that 64.9% of all the car accidents took place in the tunnels between 08:00 and 18:00, which was higher than 45.8 to 46.1% of the car accidents in common roads. As a result of analyzing the types of car accidents, the car-to-car accident type was the majority, and the sole-car accident type in the tunnels was relatively high, compared to that in common roads. Besides, people at the age between 21 and 40 were most involved in car accidents, and in the vehicle type of the first party to car accidents, trucks showed a high proportion, and in the cloud cover, rainy days or cloudy days showed a high proportion unlike clear days. As a result of analyzing the principal components of car accident influence factors, it was found that the first principal components were road, tunnel structure and traffic flow-related factors, the second principal components lighting facility and road structure-related factors, the third principal factors stand-by and lighting facility-related factors, the fourth principal components human and time series-related factors, the fifth principal components human-related factors, the sixth principal components vehicle and traffic flow-related factors, and the seventh principal components meteorological factors. As a result of classifying car accident spots, there were 5 optimized groups classified, and as a result of analyzing each group based on Quantification Theory Type I, it was found that the first group showed low explanation power for the prediction model, while the fourth group showed a middle explanation power and the second, third and fifth groups showed high explanation power for the prediction model. Out of all the items(principal components) over 0.2(a weak correlation) in the partial correlation coefficient absolute value of the prediction model, this study analyzed variables including road environment variables. As a result, main examination items were summarized as proper traffic flow processing, cross-section composition(the width of a road), tunnel structure(the length of a tunnel), the lineal of a road, ventilation facilities and lighting facilities.

An evaluation of the adequacy of pont's index (Pont 지수의 임상적 적합성에 대한 평가)

  • Kim, Seong-Hun;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.115-126
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    • 2000
  • Dental arch expansion is one of the method used to solve the dental crowding problem by non-extraction. Many formulae using tooth size have been suggested to predict ideal inter-premolar and inter-molar width. The purpose of this study was to evaluate the adequacy of some upper dental arch width prediction methods, namely Pont's method, Schmuth's method and Cha's method. The sample consisted of the casts of 119 Korean young adults who had no muscular abnormality, no skeletal discrepancy, and Angle's Class I molar relationships. Measurements were obtained directly from plaster casts; they Included mesiodistal crown diameters of the four maxillary incisors, as well as maxillary inter-first-premolar and inter-first-molar arch widths as specified by Pont. The correlation coefficients between the sum of incisors(SI) and upper dental arch width were calculated. The differences between predicted width and actual width were classified as overestimated, properestimated, and underestimated. The data obtained from each group were analyzed for statistical differences. The results were as follows : 1. Upper dental arch width indices were calculated from SI in normal occlusion (81.96 : premolar index, 62.55 : molar index). 2. Low correlations between SI and arch width were noted in normal occlusion (0.50 in the inter-premolar width, 0.39 in the inter-molar width). 3. Pont's formula and Schmuth's formula tended to overestimate the inter-premolar width. A more even distribution of estimates was noted in Cha's fomula. 4. Cases within $\pm$1 mm range of observed inter-premolar width were $45\%$ in the Cha's formula, $40\%$ in the Pont's formula, and $39\%$ in the Schmuth's formula. 5. All formulae had a tendency to underestimate the inter-molar width, but Cha's formula had better predictability than others. 6. Cases within $\pm$1 mm range of observed inter-molar width were $40\%$ in the Cha's formula, $29\%$ in the Pont's formula, and $13\%$ of Schmuth's formula. The data presented in this study does not support the clinical usefulness of ideal arch width prediction methods using the mesiodistal width of maxillary incisors.

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Changes of root length and crestal bone height before and after the orthodontic treatment in nail biting patients (손톱 깨물기 습관을 가진 아동의 교정 치료 시 전치부 치근 길이와 치조골 높이의 변화)

  • Hwang, Chung-Ju;Yang, Jae-Hong
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.47-61
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    • 2004
  • Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root Is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages $10\~15$ without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.

Enhancing Technology Learning Capabilities for Catch-up and Post Catch-up Innovations (기술학습역량 강화를 통한 추격 및 탈추격 혁신 촉진)

  • Bae, Zong-Tae;Lee, Jong-Seon;Koo, Bonjin
    • The Journal of Small Business Innovation
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    • v.19 no.2
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    • pp.53-68
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    • 2016
  • Motivation and activities for technological learning, entrepreneurship, innovation, and creativity are driving forces of economic development in Asian countries. In the early stages of technological development, technological learning and entrepreneurship are efficient ways in which to catch up with advanced countries because firms can accumulate skills and knowledge quickly at relatively low risk. In the later stages of technological development, however, innovation and creativity become more important. This study aims to identify a) the factors (learning capabilities) that influence technological learning performance and b) barriers to enhancing innovation capabilities for the creative economy and organizations. The major part of this study is related to learning capabilities in the post-catch-up era. Based on a literature review and observations from Korean experiences, this study proposes a technological learning model composed of various influencing factors on technological learning. Three hypotheses are derived, and data are collected from Korean machine tool manufacturers. Intense interviews with CEOs and R&D directors are conducted using structured questionnaires. Statistical analysis, such as correlation and ANOVA are then carried out. Furthermore, this study addresses how to enhance innovation capabilities to move forward. Innovation enablers and barriers are identified by case studies and policy analysis. The results of the empirical study identify several levels of firms' learning capabilities and activities such as a) stock of technology, b) potential of technical labor, c) explicit technological efforts, d) readiness to learn, e) top management support, f) a formal technological learning system, g) high learning motivation, h) appropriate technology choice, and i) specific goal setting. These learning capabilities determine firms' learning performance, especially in the early stages of development. Furthermore, it is found that the critical factors for successful technological learning vary along the stages of technology development. Throughout the statistical and policy analyses, this study confirms that technological learning can be understood as an intrinsic principle of the technology development process. Firms perform proactive and creative learning in the late stages, while reactive and imitative learning prevails in the early stages. In addition, this study identifies the driving forces or facilitating factors enhancing innovation performance in the post catch-up era. The results of the preliminary case studies and policy analysis show some facilitating factors such as a) the strategic intent of the CEO and corporate culture, b) leadership and change agents, c) design principles and routines, d) ecosystem and collaboration with partners, and e) intensive R&D investment.

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