Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.
Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
Clinical and Experimental Pediatrics
/
v.46
no.1
/
pp.67-75
/
2003
Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.
Jeon, Kyung Soo;Oh, Young Kee;Baek, Jong Geun;Kim, Ok Bae;Kim, Jin Hee;Choi, Tae Jin;Jeong, Dong Hyeok;Kim, Jeong Kee
Progress in Medical Physics
/
v.24
no.1
/
pp.35-40
/
2013
Recently, the uses of Multi-Detector Computed Tomography (MDCT) for radiation treatment simulation and planning which is used for intensity modulated radiation therapy with high technique are increasing. Because of the increasing uses of MDCT, additional doses are also increasing. The objective of this study is to evaluate the absorbed dose of body and skin undergoing in MDCT scans. In this study, the exposed dose at the surface and the center of the cylindrical water phantom was measured using an pencil ionization chamber, 30 cc ionization chamber and TL Powder. The results of MDCT were 31.84 mGy, 33.58 mGy and 32.73 mGy respectively. The absorbed dose at the surface showed that the TL reading value was 33.92 mGy from MDCT. These results showed that the surface dose was about 3.5% from the MDCT exposure higher than a dose which is located at the center of the phantom. These results mean that the total exposed dose undergoing MDCT 4 times (diagnostic, radiation therapy planning, follow-up et al.), is about 14 cGy, and have to be considered significantly to reduce the exposed dose from CT scan.
Kim, Jong-Sik;Jung, Chun-Young;Oh, Dong-Gyoon;Song, Ki-Won;Park, Young-Hwan
The Journal of Korean Society for Radiation Therapy
/
v.18
no.1
/
pp.13-19
/
2006
Purpose: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Materials and Methods: Modified MUPIT applicator basically consists of an acrylic cylinder with flexible brain applicator, an acrylic template with a predrilled array of holes that serve as guides for interstitial needles and interstitial needles. CT scan was peformed to determine tumor volume and the position of interstitial needles. Modified MUPIT applicator was applied to patient in operation room and the accuracy for position of interstitial needles in tumor volume was confirmed by CTscan. Brachytherapy was delivered using modified MUPIT applicator and RALS(192-lr HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3,000 cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Results: The application of modified MUPIT applicator improved dramatically dose distributions in tumor volume and follow-up of 3 month for this patient was clinically partial response without normal tissue complication, Rectal dose was measured 34.1 cGy, 57.1 cGy, 103.8 cGy, 162.7 cGy, 165.7 cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1 cGy, 57.1 cGy. Conclusion: Patients with locally recurrent tumor in uterine cervix cancel treated with modified MUPIT applicator can expect reasonable rates of local control. The advantages of the system are the fixed geometry provided by the template and cylinders. and improved dose distributions in irregular tumor volume without rectal complication.
The purpose of this study was to estimate the inbreeding level and effective population size of Korean indigenous chickens. In the study, two variables were considered to evaluate the pedigree completeness: (1) the proportion (%) of animals with complete pedigree, and (2) the proportion of animals with inbreeding coefficients greater than zero. In the proportion of animals having complete pedigree, all strains reached almost 100% completeness in 1~2 years. In the proportion of animals with inbreeding coefficients greater than zero, all strains reached almost 100% completeness in 5~6 years. We considered that the pedigree recoding system is well managed and that the inbreeding coefficient is a reliable measure. Over the past 20 years, the increase of inbreeding coefficients in Korean indigenous chicken strains has been 7.6~10.9%. The S strain showed the most rapid increase of inbreeding coefficient of 8.2% in 10 years. The reason for this rapid increase is considered to be associated with the fact that the numbers of sires and dams involved in reproduction was 115 and 91, respectively, which are lower than those of the other strains. According to average rates of increase in inbreeding coefficients (${\Delta}F$), all strains have ${\Delta}F$ values of 0.39~0.85%, which is lower than 1%, and the effective population size is above 50. The results showed that inbreeding levels were within the acceptable range and that Korean indigenous chicken population scan be regarded as safe from the threat of extinction.
Purpose: The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomograhpy ($^{18}F-FDG $PET) for the non-invasive differentiation of focal lung lesions originated from cancer or inflammation disease by combined visual image interpretation and semi-quantitative uptake value analysis has been documented. In general, Standardized Uptake Value(SUV) is used to diagnose lung disease. But SUV does not contain dynamic information of lung tissue for the glucose. Therefore, this study was undertaken to hypothesis that analysis of dynamic kinetics of focal lung lesions base on $^{18}F-FDG$ PET may more accurately determine the lung disease. So we compared Time Activity Curve(TAC), Standardized Uptake Value-Dynamic Curve(SUV-DC) graph pattern with Glucose Metabolic Rate(MRGlu) from Patlak analysis. Methods: With lung disease, 17 patients were examined. They were injected with $^{18}F-FDG$ over 30-s into peripheral vein while acquisition of the serial transaxial tomographic images were started. For acquisition protocol, we used twelve 10-s, four 30-s, sixteen 60-s, five 300-s and one 900-s frame for 60 mins. Its images were analyzed by visual interpretation TAC, SUV-DC and a kinetic analysis(Patlak analysis). The latter was based on region of interest(ROIs) which were drawn with the lung disease shape. Each optimized patterns were compared with itself. Results: In TAC patterns, it hard to observe cancer type with inflammation disease in early pool blood area but over the time cancer type slope more remarkably increased than inflammation disease. SUV-DC was similar to TAC pattern. In the result of Patlak analysis, In time activity curve of aorta, even though inflammation disease showed higher blood activity than cancer, at first as time went by, blood activity of inflammation disease became the lowest. However, in time activity curve of tissue, cancer had the highest uptake and inflammation disease was in the middle. Conclusion: Through the examination, TAC and SUV-DC could approached the results that lung cancer type and inflammation disease type has it's own difference shape patterns. Also, it has outstanding differentiation between cancer type and inflammation in Patlak and MRGlu analysis. Through these analysis methods, it will helpful to separation lung disease.
Kim, Tae-Hun;Chang, Jin-Hwa;Yun, Seok-Ju;Yoon, Jung-Hee;Chang, Dong-Woo
Journal of Veterinary Clinics
/
v.27
no.3
/
pp.273-283
/
2010
The objective of this study was to measure densities in various areas of the normal canine lung with computed tomography (CT) depending on influences of gravity and the degree of lung inflation and to determine optimal positions and positive end expiratory pressure of canine lung for CT scanning. In each eight normal Beagle and Shihtzu dogs, a respiratory breathhold maneuver without spontaenous breathing at different positive end expiratory pressure (PEEP) of 0 mmHg, 10 mmHg and 20 mmHg was applied with the position of right and left lateral recumbency, sternal recumbency, and dorsal recumbency and spiral-CT scans of the total lung were acquired. Slices were selected at three levels through the apex, middle and basal lung at the aortic arch, carina and just above the diaphragm and lung density was measured in the dorsal, ventral, and lateral portions of the peripheral lung field. Lung density in dependent areas was higher than in nondependent areas (p < 0.05) regardless of species, positions, anatomic locations at the PEEP of 0 mmHg and 10 mmHg. However, no significant difference of lung density was found at PEEP of 20 mmHg in both species except the dorsal recumbency in Shihtzu dogs. This density gradient in the dependent areas is strongly influenced by PEEP (p < 0.05). In the four positions on the CT gantry, the lung density at the dependent and nondependent location of the lung was greater at the aortic arch than at the base (p < 0.05). Lung density decreased on identical location according to increase of PEEP (p < 0.05). There was no significant difference between right and left lung density at sternal and dorsal recumbency and no significant difference of the dorsal, ventral, and lateral portions of lung density at the right and left recumbency under identical pressure. It is implied that during chest CT scan with 20 mmHg of positive end expiratory pressure with right or left lateral recumbency, canine lung density do not influenced by gravity or anatomic location.
Indium Tin Oxide (ITO) thin films were prepared by RF magnetron sputtering with different flow rates of $O_2$ gas from 0 to 12 sccm. Electrical and optical properties of these films were characterized and analyzed. ITO deposited on soda lime glass and RF power was 2 kW, frequency was 13.56 MHz, and working pressure was $1.0{\times}10^{-3}$ Torr, Ar gas was fixed at 1,000 sccm. The transmittance was measured at 300~1,100 nm ranges by using Photovoltaic analysis system. Electrical properties were measured by Hall measurement system. ITO thin films surface were measured by Scanning electron microscope. Atomic force microscope surface roughness scan for ITO thin films. ITO thin films secondary electron emission coefficient(${\gamma}$) was measured by ${\gamma}$-Focused ion beam. The resistivity is about $2.4{\times}10^{-4}{\Omega}{\cdot}cm$ and the weighted average transmittance is about 84.93% at 3 sccm oxygen flow rate. Also, we investigated Work-function of ITO thin films by using Auger neutralization mechanism according to secondary electron emission coefficient(${\gamma}$) values. We confirmed secondary electron emission peak at 3 sccm oxygen flow rate.
Kim, In-Ju;Kim, Seong-Jang;Kim, Yong-Ki;Kim, Yun-Seong;Lee, Min-Ki;Park, Soon-Kew
The Korean Journal of Nuclear Medicine
/
v.32
no.3
/
pp.266-275
/
1998
Purpose: We measured pulmonary epithelial permeability by $^{99m}Tc-DTPA$ radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate $^{99m}Tc-DTPA$ radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. Materials and Methods: We performed $^{99m}Tc-DTPA$ radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) was calculated, then compared with the result of chest radiography and pulmonary function test. Results: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiopathy were significantly older (p<0.05). The $T_{1/2}$ of normal subjects and asymptomatic smokers were significantly different ($65.2{\pm}23.7min$ vs $39.6{\pm}9.8min$, p<0.05). For diabetic patients with microangiopathy, the $T_{1/2}$ was $90.5{\pm}46.5min$ and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the $T_{1/2}$ of diabetic patients without microangiopathy, $70.0{\pm}12.7min$, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the $T_{1/2}$ and spirometric parameters including DLco, FVC, $FEV_1,\;FEV_1/FVC$ (%) and $FEF_{25-75%}$ in all subjects, and between the $T_{1/2}$ and duration of diabetes ;in diabetic patients. Conclusion: Eventhough the influence of age can't be excluded, delayed $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Kim, Dong-Seok;Kim, Seong-Hwan;Shim, Dong-Oh;Yoo, Hee-Jae
The Korean Journal of Nuclear Medicine Technology
/
v.15
no.1
/
pp.17-24
/
2011
Purpose: Presently in the nuclear medicine field, the high-speed image reconstruction algorithm like the OSEM algorithm is widely used as the alternative of the filtered back projection method due to the rapid development and application of the digital computer. There is no to relate and if it applies the optimal parameter be clearly determined. In this research, the quality change of the Jaszczak phantom experiment and brain SPECT patient data according to the iteration times and subset number change try to be been put through and analyzed in 3D OSEM reconstruction method of applying 3D beam modeling. Materials and Methods: Patient data from August, 2010 studied and analyzed against 5 patients implementing the brain SPECT until september, 2010 in the nuclear medicine department of ASAN medical center. The phantom image used the mixed Jaszczak phantom equally and obtained the water and 99mTc (500 MBq) in the dual head gamma camera Symbia T2 of Siemens. When reconstructing each image altogether with patient data and phantom data, we changed iteration number as 1, 4, 8, 12, 24 and 30 times and subset number as 2, 4, 8, 16 and 32 times. We reconstructed in reconstructed each image, the variation coefficient for guessing about noise of images and image contrast, FWHM were produced and compared. Results: In patients and phantom experiment data, a contrast and spatial resolution of an image showed the tendency to increase linearly altogether according to the increment of the iteration times and subset number but the variation coefficient did not show the tendency to be improved according to the increase of two parameters. In the comparison according to the scan time, the image contrast and FWHM showed altogether the result of being linearly improved according to the iteration times and subset number increase in projection per 10, 20 and 30 second image but the variation coefficient did not show the tendency to be improved. Conclusion: The linear relationship of the image contrast improved in 3D OSEM reconstruction method image of applying 3D beam modeling through this experiment like the existing 1D and 2D OSEM reconfiguration method according to the iteration times and subset number increase could be confirmed. However, this is simple phantom experiment and the result of obtaining by the some patients limited range and the various variables can be existed. So for generalizing this based on this results of this experiment, there is the excessiveness and the evaluation about 3D OSEM reconfiguration method should be additionally made through experiments after this.
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