• Title/Summary/Keyword: 3D Bolus

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Comparison of Blenderized Diets and Commercial Enteral Formulas in the Unconscious Tube-fed Patients (의식불명 환자에서 경과급식에 의한 혼합형 식사와 상업용 조합식이의 효과 비교)

  • 정상섭
    • Journal of Nutrition and Health
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    • v.28 no.4
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    • pp.345-354
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    • 1995
  • Blenderized diets are not recommended because of difficulties in providing a constant content of nutrients, phoblems with viscosity and osmolarity, time needed for preparation, and increased risk of contamination. To determine the possibility of substituting commercial formulas for blenderized diets, 27 unconscious patients were randomized into two different groups : blenderized diet group(n=11) and commercial formula group(n=16). Blenderized diets were composed of food sources such as rice, milk, egg, juices and others, and its energy percentage of protein, fat, and carbohydrate was 15%, 30%, and 55%, respetively. Commercial enteral formulas provided 1 kcal/ml and the energy percentage of protein, fat and carbohydrate was 25%, 20% and 55% in greenbia(G) and 20%, 20%, and 60% in Greenbia-DM(GD), repectively. In commercial formula group, five patients with diarrhea, constipation, and high blood glucose level received GD, and the other eleven patients received G. All patients received their lipuid diet for 4 weeks through 16 French rubber nasogastric tube by bolus feeding 6 times daily. The patients in commercial formula group had a similar mean daily calorie intake to the patient in blenderized diet group, 32-34kcal/kg/d and 30-35kcal/kg/d, respectively. Patients given commercial formula gained an averge of 1.7kg in weight but those given blenderized diet lost an average of 2.6kg. There was a trend toward an increase in percent ideal body weight in commercial formula group(94$\pm$5 vs 99$\pm$6%). However, blenderized diet group showed a trend toward a decrease in percent ideal body weight(106$\pm$5 vs $101\pm$6%). The initial levels of total lymphocyte counts, serum albumin and tranferrin were below the normal rante, The mean daily protein intake was significanlty higher for commercial formula group(2.0-2.1g/kg/d) than for blenderized diet group(1.1-1.3g/kg/d). Patient fed cormmercial formula for 4 weeks showed a trend toward an increase in serum albumin(8.1%) and a significant increase in serum transferrin(32.1%) without increasing the levels of blood glucose. GOT, GPT, blood urea nitrogen and serum creatinine. In the blenderized diet group, however, no significant improvement were obseved in the concentration of serum albumin and transferin, compared to initial value. There was a trend toward a decrese in the level of hemoglobin and hematocrit in blenderized deit group but no significnat change in commercial formulas goups. All patients tolerated both diets well and no significant complications were encountered. The results indicate that the commercial enteral formulas tested in this study can be an effective substitution for blenderized diet in unconscious tube-fed patients.

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Influence of Phenobarbital on the Hepatic Clearance of Organic Anionic Drugs in Rats - On the Basis of Pharmacokinetics of Indocyanine Green - (Rat에 있어서 Phenobarbital이 유기음이온성 의약품의 간클리어란스에 미치는 영향 - Indocyanine Green의 체내동태를 중심으로 -)

  • Lee, Yong-Bok;Shin, Sang-Chul;Koh, Ik-Bae
    • Korean Journal of Clinical Pharmacy
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    • v.3 no.1
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    • pp.31-43
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    • 1993
  • The influence of phenobarbital(PB) pretreatment(75mg/kg/day, Lp. for 4 days) on the hepatic clearance of indocyanine green(ICG) as a model compound of organic anionic drugs was investigated in rats in order to elucidate the relative contributions of change in the hepatic blood flow versus increase in the hepatic intrinsic activity to remove ICG due to PB pretreatment. ICG(1mg/kg) was injected single bolus via femoral or portal vein to the control and the PB-pretreated rats. The initial hepatic uptake clearance$(V_{d.c.}K_{12})$ obtained from plasma concentration-time data was increased by $38.4\% in the PB-pretreated rats, which may be due to the increased hepatic blood flow by PB pretreatment. Using a pharmacokinetic approach, hepatic blood flows were estimated of 67.5ml/min/kg in control rats and 91.9ml/min/kg in PB-pretreated rats. They were in good agreement with other's blood flow estimates observed experimentally. It may be concluded that the $38\%$ increased initial hepatic uptake clearance of ICG was due to the $36\%$ increased hepatic blood flow with phenobarbital, and that the increased hepatic blood flow and the activated hepatic intrinsic clearance with phenobarbital contributed to $49\%\;and\;51\%$ of the increased systemic clearance of ICG, respectively.

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Clinical Utility of Turbo Contrase-Enhanced MR Angiography for the Major Branches of the Aortic Arch (대동맥궁 주요 분지들의 고속 조영증강 자기공명혈관조영술의 임상적 유용성)

  • Su Ok Seong
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.96-103
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    • 1998
  • Purpose : To assess the clinical utility of turbo contrast-enhanced magnetic resonance angiography(CE MRA) in the evaluation of the aortic arch and its major branches and to compare the image quality of CE MRA among different coils used. Materials and Methods : Turbo three-phase dynamic CE MRA encompassing aortic arch and its major branches was prospectively performed after manual bolus IV injection of contrast material in 29 patients with suspected cerebrovascular diseases at 1.0T MR unit. the raw data were obtained with 3-D FISH sequence (TR 5.4ms, TE 2.3ms, flip angle 30, slab thickness 80nm, effective slice thickness 4.0mm, matrix size $100{\times}256$, FOV 280mm). Total data acquisition time was 4. to 60 seconds. We subjectively evaluated the imge quality with three-rating scheme : "good" for unequivocal normal finding, "fair" for relatively satisfactory quality to diagnose 'normal' despite intravascular low signal, and "poor" for equivocal diagnosis or non-visualization of the origin or segment of the vessels due to low signal or artifacts which needs catheter angiography. At the level of the carotid bifurcation, it was compared with conventional 2D-TOF MRA image. Overall image quality was also compared visually and quantitatively by measuring signal-to-noise ratios (SNRs) of the ascending aorta, the innominate artery and both common carotid arteries among the three different coils used(CP body array(n=12), CP neck array(n=9), and head-and-neck(n=8). Results : Demonstration of the aortic arch and its major branches was rated as "good" in 55% (16/29) and "fair" in 34%(10/29). At the level of the carotid bifurcation, image quality of turbo CE MRA was same as or better than conventional 2D-TOF MRA in 65% (17/26). Overall image quality and SNR were significantlygreater with CP body array coil than with CP neck array or head-and-neck coil. Conclusions : Turbo CE MRA can be used as a screening exam in the evaluation of the major branches of the aortic arch from their origin to the skull base. Overall imagequality appears to be better with CP body array coil than with CP neck array coil or head-and-neck coil.

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Effects of Rice Straw and Rice Hull Supplement on Rumination and Chewing Behavior in Hanwoo Steers (볏짚 및 가공처리 왕겨의 급여가 한우의 사료섭취 및 반추행동에 미치는 영향)

  • Lee, W.S.;Lee, B.S.;Lee, S.C.;Lee, Sang-S;Lee, S.Y.;Lee, D.Y.;Ha, J.K.
    • Journal of Animal Science and Technology
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    • v.46 no.1
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    • pp.49-54
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    • 2004
  • Effects of low quality roughage sources on duration and frequencies of rumination and chewing in Hanwoo steers were determined, Animals were fed three diets; concentrate+rice straw(SO:SO), concentrate+ rice straw + popped rice hull(SO:3S: IS) and concentrate+ rice straw+ground rice hull(SO:3S: IS) to compare both rice straw alone and combination with rice hull. Eating and ruminating time of steers fed concentrate+ rice straw(SO:50), concentrate+ rice straw + popped rice hull(50:35:15) and concentrate + rice straw + ground rice hull(50:3S:15) were 78.8 and 338.4minlday; 98.0 and 362.5minlday, and 160 and 519.2min/day, respectively. When steers were fed popped rice hull and ground rice hull, time spent for both eating and ruminating was significantly increased(p <0.05). When steers fed popped and ground rice hull, number of ruminating chews and number of chews per rumination time were significantly decreased(p<0.05). The number of rumination boli and boli per rumination time had significantly decreased(p<0.05), but chewing time per boli, number of chew'S per bolus were significantly increased(p

An Optimization Method of Measuring Heart Position in Dynamic Myocardial Perfusion SPECT with a CZT-based camera (동적 심근관류 SPECT에서 심장의 위치 측정방법에 대한 고찰)

  • Seong, Ji Hye;Lee, Dong Hun;Kim, Eun Hye;Jung, Woo Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.75-79
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    • 2019
  • Purpose Cadmium-zinc-telluride (CZT) camera with semiconductor detector is capable of dynamic myocardial perfusion SPECT for coronary flow reserve (CFR). Image acquisition with the heart positioned within 2 cm in the center of the quality field of view (QFOV) is recommended because the CZT detector based on focused multi-pinhole collimators and is stationary gantry without rotation. The aim of this study was to investigate the optimal method for measuring position of the heart within the center of the QFOV when performing dynamic myocardial perfusion SPECT with the Discovery NM 530c camera. Materials and Methods From June to September 2018, 45 patients were subject to dynamic myocardial perfusion SPECT with D530c. For accurate heart positioning, the patient's heart was scanned with a mobile ultrasound and marked at the top of the probe where the mitral valve (MV) was visible in the parasternal long-axis view (PLAX). And, the marked point on the patient's body matched with the reference point indicated CZT detector in dynamic stress. The heart was positioned to be in the center of the QFOV in rest. The coordinates of dynamic stress and rest were compared statistically. Results The coordinates of the dynamic stress using mobile ultrasound and those taken of the rest were recorded for comparative analysis with regard to the position of the couch and analyzed. There were no statistically significant differences in the coordinates of Table in & out, Table up & down, and Detector in & out (P > 0.05). The difference in distance between the 2 groups was measured at $0.25{\pm}1.00$, $0.24{\pm}0.96$ and $0.25{\pm}0.82cm$ respectively, with no difference greater than 2 cm in all categories. Conclusion The position of the heart taken using mobile ultrasound did not differ significantly from that of the center of the QFOV. Therefore, The use of mobile ultrasound in dynamic stress will help to select the correct position of the heart, which will be effective in clinical diagnosis by minimizing the image quality improvement and the patient's exposure to radiation.

Concurrent Chemoradiotherapy versus Radiation Alone in Nasopharyngeal Carcinoma (비인강암에서 동시 항암방사선치료와 방사선치료 단독의 비교 연구)

  • Park Jin-Hong;Chang Hye-Sook;Kim Sung-Rae;Kim Sang-Yoon;Nam Soon-Yuhl;Cho Kyung-Ja;Kim Jong-Hoon;Ahn Seung-Do;Noh Young-Ju;Choi Eun-Kyung;Lee Sang-Wook
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.30-35
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    • 2002
  • Objective: To determine the effectiveness and toxicity of chemoradiation therapy in nasopharyngeal carcinoma by comparing with radiation therapy alone. Materials and Methods: Between October 1989 and July 2000, One hundred eleven patients with newly diagnosed and histologically proven nasopharyngeal carcinoma treated in Department of Radiation Oncology, Asan Medical Center were retrospectively reviewed. Forty-five patients were treated with radiation therapy alone (Group I) and 66 patients were treated with radiation therapy and concurrent cisplatin (Group II). Cisplatin was administered once a week, on the first day of each successive week of treatment, starting on day 1 of radiation therapy and given as a intravenous bolus at a dose of $20mg/m^2$ of body-surface area. Radiation therapy was given in doses of 1.8Gy, once a day, 5 days per week with 4MV or 6 MV photons. Initial field was received a total of 60Gy and a primary tumor and enlarged lymph nodes were boosted with an high dose intracavitory brachytherapy and 3D conformal therapy. Results: The complete response rate was 86.7% in Group I, and was 90.9% in Group II. The 5 year overall survival rate for Group I was 60% and for Group II was 45% (p=0.2520). The 5 year disease free survival rate was 52% versus 45%, respectively (p=0.7507). The median follow up was 44 months versus 34 months, respectively. Conclusion: Analysis of the III patients showed no significant difference in disease free survival and overall survival in two treatment group. This retrospective analysis did not demonstrate benefit with concurrent chemoradiation using cisplatin at a dose of $20mg/m^2$ of body-surface area in treatment result than radiation alone.

Usefulness Comparative Experimental Study of the CT and MR Imaging in the Dog Clonorchiasis (잡견 간흡충증의 전산화단층촬영과 자기공명영상의 유용성에 관한 실험적 연구)

  • Goo, Eun-Hoe;Kweon, Dae-Cheol;Kim, Dong-Sung;Choi, Chun-Kyu
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.33-39
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    • 2003
  • Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.

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The Synthesis and MR Properties of New Macromolecular MR Contrast Agent (새로운 거대분자 MR 조영제의 합성 및 MR 특성에 관한 연구)

  • 장용민;장영환;황문정;박현정;전경녀;이종민;배경수;강봉석
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.35-40
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    • 2002
  • Purpose : To evaluate the NMR relaxation properties and imaging characteristics of tissue-specificity for a newly developed macromolecular MR agent. Materials and methods : Phthalocyanine (PC) was chelated with paramagnetic ion, Mn.2.01g (5.2 mmol) of Phthalocyanine was mixed with 0.37g (1.4 mmol) of Mn chloride at $310^{\circ}C$ for 36 hours and then purified by chromatography (CHC13/CH3OH 98/2 v/v, Rf, 0.76) to obtain 1.04g (46%) of MnPC (molecular weight= 2000d). The $T1}T2$ relaxivity of MnPC was measured in 1.5T(64 MHz) MR using 0.1 mM MnPC. The MR image characteristics of MnPC was evaluated using spin-echo (TR/TE=500/14 msec) and gradient-echo (FLASH) (TR/TE=80/4 msec, flip angle=60) techniques in 1.57 MR scanner. The images of rabbit liver were obtained every 10 minutes up to 4 hours. To study the effect of concentration on image, 20 mM, 50 mM, 100 mM of MnPC were tested. Results : The relaxivities of MnPC at 1.5T(64MHz) were Rl=7.28 $mM^{-1}S^{-1},{\;}R2=55.56mM^{-1}S^{-1}$. Compared to the values of Gd-DTPA (Rl[=4.8 $mM^{-1}S^{-1})$], R2[=5.2 $mM^{-1}S^{-1}])$]), both T1/T2 relaxivities of MnPC were higher than those of Gd-DTPA. For both of SE and FLASH techniques, the contrast enhancement reached maximum at 10 minutes after bolus injection and the enhancement continued for more than 2 hours. When compared with small molecular weight liver agents such as Gd-EOB-DTPA, Gd-BOPTA and MnDPDP, MnPC was characterized by more prolonged enhancement time. The time course of MR images also revealed biliary excretion of MnPC. Conclusion : We developed a new macromolecular MR agent, MnPC. The relaxivities of MnPC were higher than those of small molecular weight Gd-chelate. Hepatic uptake and biliary excretion of MnPC suggests that this agent is a new liver-specific MR agent.

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Smoking-Induced Dopamine Release Studied with $[^{11}C]Raclopride$ PET ($[^{11}C]Raclopride$ PET을 이용한 흡연에 의한 도파민 유리 영상 연구)

  • Kim, Yu-Kyeong;Cho, Sang-Soo;Lee, Do-Hoon;Ryu, Hye-Jung;Lee, Eun-Ju;Ryu, Chang-Hung;Jeong, In-Soon;Hong, Soo-Kyung;Lee, Jae-Sung;Seo, Hong-Gwan;Jeong, Jae-Min;Lee, Won-Woo;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.421-429
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    • 2005
  • Purpose: It has been postulated that dopamine release in the striatum underlies the reinforcing properties of nicotine. Substantial evidence in the animal studies demonstrates that nicotine interacts with dopaminergic neuron and regulates the activation of the dopaminergic system. The aim of this study was to visualize the dopamine release by smoking in human brain using PET scan with $[^{11}C]raclopride$. Materials and Methods: Five male non-smokers or ex-smokers with an abstinence period longer than 1 year (mean age of $24.4{\pm}1.7$ years) were enrolled in this study $[^{11}C]raclopride$, a dopamine D2 receptor radioligand, was administrated with bolus-plus-constant infusion. Dynamic PET was performed during 120 minutes ($3{\times}20s,\;2{\times}60s,\;2{\times}120s,\;1{\times}180s\;and\;22{\times}300s$). following the 50 minute-scanning, subjects smoked a cigarette containing 1 mg of nicotine while in the scanner. Blood samples for the measurement of plasma nicotine level were collected at 0, 5, 10, 15, 20, 25, 30, 45, 60, and 90 minute after smoking. Regions for striatal structures were drawn on the coronal summed PET images guided with co-registered MRI. Binding potential, calculated as (striatal-cerebellar)/cerebellar activity, was measured under equilibrium condition at baseline and smoking session. Results: The mean decrease in binding potential of $[^{11}C]raclopride$ between the baseline and smoking in caudate head, anterior putamen and ventral striatum was 4.7%, 4.0% and 7.8%, respectively. This indicated the striatal dopamine release by smoking. Of these, the reduction in binding potential in the ventral striatum was significantly correlated with the cumulated plasma level of the nicotine (Spearman's rho=0.9, p=0.04). Conclusion: These data demonstrate that in vivo imaging with $[^{11}C]raclopride$ PET could measure nicotine-induced dopamine release in the human brain, which has a significant positive correlation with the amount or nicotine administered bt smoking.

Effects of Motion Correction for Dynamic $[^{11}C]Raclopride$ Brain PET Data on the Evaluation of Endogenous Dopamine Release in Striatum (동적 $[^{11}C]Raclopride$ 뇌 PET의 움직임 보정이 선조체 내인성 도파민 유리 정량화에 미치는 영향)

  • Lee, Jae-Sung;Kim, Yu-Kyeong;Cho, Sang-Soo;Choe, Yearn-Seong;Kang, Eun-Joo;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.413-420
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    • 2005
  • Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.