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Quantitative Comparisons in $^{18}F$-FDG PET Images: PET/MR VS PET/CT ($^{18}F$-FDG PET 영상의 정량적 비교: PET/MR VS PET/CT)

  • Lee, Moo Seok;Im, Young Hyun;Kim, Jae Hwan;Choe, Gyu O
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.68-80
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    • 2012
  • Purpose : More recently, combined PET/MR scanners have been developed in which the MR data can be used for both anatometabolic image formation and attenuation correction of the PET data. For quantitative PET information, correction of tissue photon attenuation is mandatory. The attenuation map is obtained from the CT scan in the PET/CT. In the case of PET/MR, the attenuation map can be calculated from the MR image. The purpose of this study was to assess the quantitative differences between MR-based and CT-based attenuation corrected PET images. Materials and Methods : Using the uniform cylinder phantom of distilled water which has 199.8 MBq of $^{18}F$-FDG put into the phantom, we studied the effect of MR-based and CT-based attenuation corrected PET images, of the PET-CT using time of flight (TOF) and non-TOF iterative reconstruction. The images were acquired from 60 minutes at 15-minute intervals. Region of interests were drawn over 70% from the center of the image, and the Scanners' analysis software tools calculated both maximum and mean SUV. These data were analyzed by one way-anova test and Bland-Altman analysis. MR images are segmented into three classes(not including bone), and each class is assigned to each region based on the expected average attenuation of each region. For clinical diagnostic purpose, PET/MR and PET/CT images were acquired in 23 patients (Ingenuity TF PET/MR, Gemini TF64). PET/CT scans were performed approximately 33.8 minutes after the beginnig of the PET/MR scans. Region of interests were drawn over 9 regions of interest(lung, liver, spleen, bone), and the Scanners' analysis software tools calculated both maximum and mean SUV. The SUVs from 9 regions of interest in MR-based PET images and in CT-based PET images were compared. These data were analyzed by paired t test and Bland-Altman analysis. Results : In phantom study, MR-based attenuation corrected PET images generally showed slightly lower -0.36~-0.15 SUVs than CT-based attenuation corrected PET images (p<0.05). In clinical study, MR-based attenuation corrected PET images generally showed slightly lower SUVs than CT-based attenuation corrected PET images (excepting left middle lung and transverse Lumbar) (p<0.05). And percent differences were -8.01.79% lower for the PET/MR images than for the PET/CT images. (excepting lung) Based on the Bland-Altman method, the agreement between the two methods was considered good. Conclusion : PET/MR confirms generally lower SUVs than PET/CT. But, there were no difference in the clinical interpretations made by the quantitative comparisons with both type of attenuation map.

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Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

An Evaluation of the Accuracy of Mini-Wright Peak Flowmeters in Patients with Asthma and Chronic Obstructive Pulmonary Disease (천식 및 만성폐쇄성폐질환 환자에서 Mini-Wright Peak Flowmeter로 측정한 최대호기유속의 정확도)

  • Choi, Won-Il;Han, Seung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.310-319
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    • 2001
  • Background : The peak flowmeter is very useful in monitoring of out-patients as well as those in emergency departments because of its convenience and simplicity with low cost. There have been many studies aimed at determining the accuracy and reproducibility of the peak flow meter in normal population. However, there is a paucity of reports regarding its accuracy in patients with chronic obstructive pulmonary disease(COPD) or asthma. The accuracy of the peak expiratory flow(PEF) measured with a mini-Wright peak flowmeter was assessed by a comparison with the results of a mass flow sensor. Methods : The PEF measurements were performed in 108 patients aged 19-82 years presenting with either a chronic obstructive lung disease or asthma before and after inhaling salbutamol. The PEF measurements from the mini-Wright flowmeter were compared with those obtained by the calibrated mass flow sensor. Results : The average of the readings taken by the mini-Wright meter were 37-39 l/min higher than those taken by the mass flow sensor. The average percentage error of the mini-Wright meter were higher, ranging less than 300 l/min. The mean of the differences between the values obtained using both instruments (the bias)$\pm$limits of agreement(${\pm}2$ SD) were $37.1{\pm}90\;l/min$ for the PEF(p<0.001). Conclusions : The mini-Wright peak flowmeter overestimated the flows in patients with COPD or asthma. It was also found that the accuracy of the mini-Wright peak flowmeter decreased in its mid to low range. The limits of agreement are wide and the difference between the two instruments is significant. Therefore, the measurements made between the two types of machines in patients with asthma or COPD cannot be used interchangeably.

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Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection (급성 감염성 질환을 가진 영유아에서 철결핍 진단 지표로서의 망상적혈구혈색소량)

  • Kim, Jon Soo;Choi, Jun Seok;Choi, Doo Young;You, Chur Woo
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.827-833
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    • 2008
  • Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU (중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구)

  • Ko, Chanyoung;Kim, Jae-Jin;Cho, Dongrae;Oh, Jooyoung;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.101-110
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    • 2019
  • Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

Plasminogen Activator Inhibitor Type 1 Gene Polymorphism in Patients with Minimal Change Nephrotic Syndrome (소아 신증후군 환자에서 Plasminogen Activator Inhibitor Type 1 유전자 다형성)

  • Kim Young-Min;Hong Hyun-Kee;Kim Sung-Do;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.26-32
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    • 2004
  • Purpose : Hypercoagulability is present in patients with nephrotic syndrome. Plasminogen activator inhibitor type 1(PAI-1) is a major inhibitor of plasminogen activators. PAI-1 inactivates both tissue plasminogen activator(tPA) and urokinase plasminogen activator(uPA) by rapid formation of inactive 1:1 stoichiometric complexes. Recently some studies showed that the enhanced PAI-1 expression may be involved in the intraglomerular fibrinogen/fibrinrelated antigen deposition seen in nephrotic syndrome. Methods : PAI-1 gene promoter -844(G/A) polymorphism was evaluated in 146 children with minimal change nephrotic syndrome(MCNS) and 230 control subjects. The patients with MCNS were subdivided into 85 infrequent-relapser(IR) group and 61 frequent relapser(FR) group. PCR of PAI-1 gene promoter region including -844(G/A) and RFLP using the restriction enzyme Xhol were performed for each DNA samples extracted from the groups. Results : The distribution of PAI-1 genotype in the control group was G/G 81(32.5%), A/A 42(16.9%), and G/A 126(50.6%). The distribution of PAI-1 genotypes in the IR group of MCNS was G/G 29(34.1%), A/A 15(17.7%), and G/A 41(48.2%). The distribution of PAI-1 genotype in the FR group of MCNS was G/G 17(27.9%), A/A 18(29.5%), and G/A 26(42.6%). There was a significantly increased frequency of A/A genotype(P=0.0251) in the FR group of MCNS. Conclusion : Our results indicate that the PAI-1 gene promoter A/A genotype may be associated with the FR in MCNS.

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Comparison of Outcomes According to the Hospitals of Antenatal Care in Very Low Birth Weight Infants (극소 저체중 출생아에서 산전 관리 기관에 따른 임상 경과 및 예후 비교)

  • Lee, Byoung-Kook;Lee, Heun-Ji;Min, Sung-Joo;Kim, Do-Hyun;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.205-212
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    • 2009
  • Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.

Residual Pattern of Pesticide, Chlorfluazuron in Perilla Leaves Under Plastic House (들깻잎 재배 중 chlorfluazuron의 잔류량 변화 및 잔류분석법 시험)

  • Lee, Min-Ho;Kim, Seok-Ho;Park, Young-Guin;Jo, Gyeong-Yeon;Shin, Byung-Gon;Kim, Jong-Han;Kwon, Chan-Hyeok;Sohn, Jae-Keun;Kim, Jang-Eok
    • The Korean Journal of Pesticide Science
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    • v.11 no.2
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    • pp.106-116
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    • 2007
  • Pesticide, chlorfluazuron was subjected to determine the safety of terminal residues at the harvesting date of perilla leaves cultivated in plastic house. After the pesticide applied on a foliar spray in 2005 and 2006, leaf persistence of its residue was analysed for 10 days before leaf harvest. The degradation rate of chlorfluazuron in the leaf was 32.3 %(standard application), 43.6 %(double application) and 78.0 %(standard), 80.4 %(double) at second and tenth day, respectively, under analysis of GC/ECD in 2005. The degradation rate of chlorfluazuron in the leaf was 33.1 %(GC/ECD analyze), 34.0 %(HPLC/UVD analyze) and 77.9 %(GC/ECD), 78.4 %(HPLC/UVD) at second and tenth day, respectively, under the standard level of pesticide in 2006. The biological half-life of the chlorfluazuron residue was estimated by the regression equation calculated from daily dissipation of pesticide in the perilla leaves. The longest half-life of the chlorfluazuron residue in perilla leaves was 5.5 days. The maximum residual limit(MRL) for chlorfluazuron based on the longest half-life was estimated 2.0ppm at harvesting day, 2.5ppm at second day and 7.1ppm at tenth day before leaf harvesting of perilla.

A Study on the Blasting Vibration Characteristics of Geomunoreum Lava Tubes System, Jeju Island (제주 거문오름 용암동굴계에 영향을 미치는 발파진동특성에 대한 연구)

  • Song, Jae-Yong;Lee, Geun-Chun;Ahn, Ung-San;Lim, Hyun-Muk;Moon, Seong-Woo;Seo, Yong-Seok
    • The Journal of Engineering Geology
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    • v.31 no.1
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    • pp.103-118
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    • 2021
  • For management and preservation measures of lava tube, it is studied how the blasting vibration by constructions near Geomunoreum lava tubes in Jeju affect lava tube. 11 boreholes were drilled in study area, and in-situ blasting tests were conducted by changing from 0.5 kg to 10 kg charge per delay in those boreholes. The vibration velocity, which meets the regulatory vibration criterion during daytime, was estimated as below 0.276 cm/sec by analyzing the relationship between vibration velocity and vibration level. In addition, SRE and CRE were calculated from the results of in-situ blasting tests, and k-values were shown as 130.04 in SRE, 199.71 in CRE, respectively. Also, n-values were shown as -1.717 in SRE, -1.711 in CRE, respectively. Charge per delay were assessed based on these equations, and charges per delay had ranges of 0.57~7.42 kg/delay in estimation equation of vibration velocity, 0.21~5.29 kg/delay in SRE, and 0.04~5.51 kg/delay in CRE, considering the 0.2 kine vibration criterion for cultural heritage and the 20~100 m distance from vibration source. Additionally, the relationships which meet the criteria of 0.2 kine, were calculated by combining CRE in this study with the result of previous study. Allowable charges per delay, which meet the criteria of 0.2 kine, were evaluated as 1.07 kg/delay in 50 m, 5.13 kg/delay in 100 m and 22.26 kg/delay in 200 m distances. These relationships for each vibration velocity are useful to deduce charge per delay for the ground near Geomunoreum lava tube.

High Speed Rail Station Distric Using Entropy Model Study to Estimate the Trip Distribution (엔트로피 모형을 활용한 고속철도 역세권 통행분포 추정에 관한 연구)

  • Cho, Hangung;Kim, Sigon;Kim, Jinhowan;Jeon, Sangmin
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.32 no.6D
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    • pp.679-686
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    • 2012
  • KTX step 1 April 2004, after the opening, the second phase of the project was opened in November 2010. High-speed rail after the opening and continue to increase the demand of high-speed rail, Have the speed of competitive advantage compared too the means of transportation. The opening of these high-speed rail has led to changes of the move, the company's position, and the spatial structure of the population of reorganization, such as the social, economic, transportation. In this study, survey data using the High Speed Rail Station EMME/2 of the program to take advantage of the 2-Dimentional Blancing trip distribution to investigate the passage through the trip distribution by the estimation of the parameters of the model to estimate the distribution of the means of access and high-speed rail station to reproduce and Analysis of the results by means of access parameters (${\theta}$) autos 0.0395, buses 0.0390, subway 0.0650, taxi 0.0415, the frequency distribution (Trip Length Frequency Distribution: TLFD) were analyzed survey data value model with the results of comparing $R^2$ cars analysis and model values similar survey data 0.909 bus 0.923, subway 0.745 to 0.922, taxi, F test P value analysis is smaller than 0.05 at the 95% confidence level as a note that was judged to have been. Trip frequency distribution analysis, but in the future, set the unit to 5km-trip frequency distribution middle zone Units from small zone units (administrative district) segmentation research is needed, and can reflect the trip distance 0~5 km interval combined function to take advantage of the gravity model and the 3-Dimentional Blancing applied research is needed to be considered.