• Clinical and Experimental Pediatrics
• /
• v.50 no.5
• /
• pp.443-448
• /
• 2007

Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.3
• /
• pp.253-258
• /
• 2004

Purpose: Chitosan has been studied as a non-viral gene delivery vector, drug delivery carrier, metal chelator, food additive, and radiopharmaceutical, among other things. Recently, galactose-graft chitosan was studied as a non-viral gene and drug delivery vector to target hepatocytes. The aim of this study was to investigate the usefulness of nuclear imaging for in vivo evaluation of targeting the hepatocyte by galactose grafting. Methods and Materials: Galactosyl methylated chitosan (GMC) was produced by methylation to lactobionic acid coupled chitosan. Cytotoxicity of $^{99m}Tc$-GMC was determined by MTT assay. Rabbits were injected via their auricular vein with $^{99m}Tc$-GMC and $^{99m}Tc$-methylated chitosan (MC), the latter of which does not contain a galactose group, and images were acquired with a gamma camera equipped with a parallel hole collimator. The composition of the galactose group in galactosylated chitosan (GC), as well as the tri-, di-, or mono-methylation of GMC, was confirmed by NMR spectroscopy. Results: The results of MTT assay indicated that $^{99m}Tc$-GMC was non-toxic. $^{99m}Tc$-GMC specifically accumulated in the liver within 10 minutes of injection and maintained high hepatic uptake. In contrast, $^{99m}Tc$-MC showed faint liver uptake. $^{99m}Tc$-GMC scintigraphy of rabbits showed that the galactose ligand principally targeted the liver while the chitosan functionalities led to excretion through the urinary system. Conclusion: Bioconjugation with a specific ligand endows some degree of targetability to an administered molecule or drug, as in the case of galactose for hepatocyte in vivo, and evaluating said targetabililty is a clear example of the great benefit proffered by nuclear imaging.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.17 no.1
• /
• pp.53-61
• /
• 2013

Objectives: It is certain that Radioactive iodine thyroid uptake(RAIU) rate should be measured with the standard counts considering the thyroid gland depth in enlarged thyroid patients for the variation from geometric factors. The purpose of this paper is to consider the effects of geometric factors according to detector to source distance and the effective thyroid depth on RAIU rate with experiment test. Materials and Methods: I-131 370 kBq ($10{\mu}Ci$) point source was measured by Captus-3000 thyroid uptake system (Capintec, NJ, USA) with a change Detector-Source Distance from 20 cm to 30 cm at an interval of 1 cm. And we changed the Neck phantom surface-Source Depth in the phantom with 1 cm, 2 cm, 5 cm using the neck phantom in order to reproduce the effective thyroid depth. Results: Every experimental group follows power curve as inverse square curve ($$R2{\geq_-}0.915$$). The average count rates in the case not using a phantom and the every case applied the effective thyroid depth using a phantom was not identical each other. There was significant fluctuations upon the effective thyroid depths applied the effective thyroid depth above 1 cm in $364.4 keV{\pm}10%$ energy ROI (p<0.01). There was not significant difference between the count rates of 1 cm and 2 cm in $364.4keV{\pm}20%$ and $637.1keV{\pm}6.2%$ (p=0.354, p=0.397). In assumed RAIU rate from regression equation, $364.4keV{\pm}20%$ was lower difference than $364.4keV{\pm}10%$ as 6.42% and 5.09% per 1 cm. Every change of count rate upon depth appears decreased line on Linear Regression, but the case of $284.3keV{\pm}10%$ increased only. And also, The graphs of coefficient of variation upon depth increased as straight line on every experimental group. Conclusion: The result appears that application of $364.4keV{\pm}20%$ energy ROI is more suitable for reducing error from the effective thyroid depth. And also, we can estimate the error of 20 cm should be highly reduced than 30 cm for Inverse Square Law. Therefore, If there is not information of the thyroid depth, it is considered that the error from thyroid depth can reduce through set up energy ROIs for $364.4keV{\pm}20%$, and increase Detector-Source Distances.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.9
• /
• pp.3773-3777
• /
• 2015

Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.4
• /
• pp.1811-1815
• /
• 2014

Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

• Economic and Environmental Geology
• /
• v.32 no.5
• /
• pp.435-444
• /
• 1999

The antimony deposits of the Hyundong mine, located in the northeastern part of the Sobaegsan massif, occur as hydrothermal quartz+carbonate veins and stockworks which fill the fault fractures developed in Precambrian metamOlphic rocks (mainly, granitic gneiss). Hydrothermal alteration occurs commonly in the vicinity of mineralized veins and is characterized by sericitization and silicification. A K-Ar age of alteration sericite is 139.2$\pm$ 4.4 Ma, implying the early Cretaceous age of mineralization, possibly in association with intrusion of nearby acidic dikes (mainly, quartz porphyry). The hydrothermal mineralization occurred in five mineralization stages. These are: (I) stage I, characterized by deposition of chalcedonic quartz; (2) stage II, deposition of quartz with base-metal sulfides and stibnite; (3) stage III, deposition of quartz and carbonates (calcite, dolomite, ankerite, rhodochrosite) with various antimony-bearing minerals such as stibnite, polybasite, berthierite, native antimony, gudmundite and ullmannite; (4) stage IV, deposition of calcite with stibnite; and (5) stage V, deposition of barren calcite. Antimony occurs mostly as stibnite within stages II to IV veins, which has various habits including disseminated, veinlets and euhedral coarse crystals. Fluid inclusion studies indicate that hydrothermal mineralization at Hyundong occurred from the fluids with temperature and salinity of $330^{\circ}$C to 120 and 5.3 wI. % equiv. NaCI. The temperature and salinity of ore fluids systematically decreased with elapsed time in the course of mineralization, possibly due to the influx of larger amounts of meteoric groundwater. The deposition of antimony-bearing minerals occurred at low temperatures «$250^{\circ}$C), mainly due to the cooling and dilution of fluids. Based on the evidence of fluid boiling during the early stage II mineralization, the mineralization occurred under low pressure conditions (about 80 bars, corresponding to depths of about 350 m under hydrostatic pressure regime). Thermodynamic considerations of ore . mineral assemblages indicate that antimony deposition also occurred as the results of decreases in temperature and sulfur fugacity of hydrothermal fluids. Calculated sulfur isotope composition of ore fluids ($\delta^{34}S_{\Sigma s}$=5.4 to 7.8$\textperthousand$) indicates an igneous source of sulfur.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.2
• /
• pp.12-17
• /
• 2012

Purpose : The patient's clothes and sheet after radioiodine therapy must be disposed of by related regulation. That must be disposed of as radioactive wastes, but that is reusing after radioactivity decay by keeping for the certain period of time. In general, The minimum storage period calculate by standard of take radioactive substance out of radiation controlled area based on measured surface contamination level. But the measurements of surface contamination level are able to differ by measurement method. In this paper, I wish to calculate the minimum storage period of patient's clothes and sheet after radioiodine therapy by measure nuclide concentration offered by the regulation on self-disposal of radioactive wastes. Materials and Methods : The whole area of patient's clothes and sheet measured 31 patients(male:9 patients, female:22 patients), who had radioiodine therapy(3.7 GBq:13 patients, 5.55 GBq:16 patients, 7.4 GBq:2 patients) from july 2011 to march 2012. The minimum storage period is calculated by the regulation on self-disposal of radioactive waste(100 Bq/g) and standard of take radioactive substance out of radiation controlled area(4 kBq/m2) Results : The minimum storage period of pillow sheet, upper uniform, lower uniform by standard of take radioactive substance out of radiation controlled area were each 4.6 days, 63days, 78 days. The minimum storage period of pillow sheet, upper uniform, lower uniform by the regulation on self-disposal of radioactive waste were each 18.1 days, 43 days, 62 days. Conclusion : We can verify that patient's clothes and sheet after radioiodine therapy exists a great deal of radioactive contamination. The minimum storage period calculation of patient's clothes and sheet is better suited to applying nuclide concentration offered by the regulation on self-disposal of radioactive waste. I recommend, To keep for at least 2 months of the patient's clothes and sheet contaminated radioactivity, for prevent contamination and unnecessary radiation exposure.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.1
• /
• pp.57-62
• /
• 2009

Purpose: Brain SPECT study is more sensitive to motion than other studies. Especially, when applying 1-day subtraction method for Diamox SPECT, it needs shorter study time in order to prevent reexamination. We were required to have new study condition and analysing method on dual detector system because triple head camera in Seoul National University Hospital is to be disposed. So we have tried to increase image quality and make the dual and triple head to have equivalent study time by using a new analysing program. Materials and Methods: Using IEC phantom, we estimated contrast, SNR and FWHM. In Hoffman 3D brain phantom which is similar with real brain, we were on the supposition that 5% of injected doses were distributed in brain tissue. To compare with existing FBP method, we used fan-beam collimator. And we applied 15 sec, 25 sec/frame for each SEPCT studies using LEHR and LEUHR. We used OSEM2D and Onco-flash3D reconstruction method and compared reconstruction methods between applied Gaussian post-filtering 5mm and not applied as well. Attenuation correction was applied by manual method. And we did Brain SPECT to patient injected 15 mCi of $^{99m}Tc$-HMPAO according to results of Phantom study. Lastly, technologist, MD, PhD estimated the results. Results: The study shows that reconstruction method by Flash3D is better than exiting FBP and OSEM2D when studied using IEC phantom. Flowing by estimation, when using Flash3D, both of 15 sec and 25 sec are needed postfiltering 5 mm. And 8 times are proper for subset 8 iteration in Flash3D. OSEM2D needs post-filtering. And it is proper that subset 4, iteration 8 times for 15sec and subset 8, iteration 12 times for 25sec. The study regarding to injected doses for a patient and study time, combination of input parameter-15 sec/frame, LEHR collimator, analysing program-Flash3D, subset 8, iteration 8times and Gaussian post-filtering 5mm is the most appropriate. On the other hands, it was not appropriate to apply LEUHR collimator to 1-day subtraction method of Diamox study because of lower sensitivity. Conclusions: We could prove that there was also an advantage of short study time effectiveness in Dual camera same as Triple gamma camera and get great result of alternation from existing fan-beam collimator to parallel collimator. In addition, resolution and contrast of new method was better than FBP method. And it could improve sensitivity and accuracy of image because lesser subjectivity was input than Metz filter of FBP. We expect better image quality and shorter study time of Brain SPECT on Dual detector system.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.1
• /
• pp.122-126
• /
• 2010

Purpose: F-18-FPCIT that shows strong familiarity with DAT located at a neural terminal site offers diagnostic information about DAT density state in the region of the striatum especially Parkinson's disease. In this study, we altered the iteration and subset and measured SUV${\pm}$SD and Contrasts from phantom images which set up to specific iteration and subset. So, we are going to suggest the appropriate range of the iteration and subset. Materials and Methods: This study has been performed with 10 normal volunteers who don't have any history of Parkinson's disease or cerebral disease and Flangeless Esser PET Phantom from Data Spectrum Corporation. $5.3{\pm}0.2$ mCi of F-18-FPCIT was injected to the normal group and PET Phantom was assembled by ACR PET Phantom Instructions and it's actual ratio between hot spheres and background was 2.35 to 1. Brain and Phantom images were acquired after 3 hours from the time of the injection and images were acquired for ten minutes. Basically, SIEMENS Bio graph 40 True-point was used and True-X method was applied for image reconstruction method. The iteration and Subset were set to 2 iterations, 8 subsets, 3 iterations, 16 subsets, 6 iterations, 16 subsets, 8 iterations, 16 subsets and 8 iterations, 21 subsets respectively. To measure SUVs on the brain images, ROIs were drawn on the right Putamen. Also, Coefficient of variance (CV) was calculated to indicate the uniformity at each iteration and subset combinations. On the phantom study, we measured the actual ratio between hot spheres and back ground at each combinations. Same size's ROIs were drawn on the same slide and location. Results: Mean SUVs were 10.60, 12.83, 13.87, 13.98 and 13.5 at each combination. The range of fluctuation by sets were 22.36%, 10.34%, 1.1%, and 4.8% respectively. The range of fluctuation of mean SUV was lowest between 6 iterations 16 subsets and 8 iterations 16 subsets. CV showed 9.07%, 11.46%, 13.56%, 14.91% and 19.47% respectively. This means that the numerical value of the iteration and subset gets higher the image's uniformity gets worse. The range of fluctuation of CV by sets were 2.39, 2.1, 1.35, and 4.56. The range of fluctuation of uniformity was lowest between 6 iterations, 16 subsets and 8 iterations, 16 subsets. In the contrast test, it showed 1.92:1, 2.12:1, 2.10:1, 2.13:1 and 2.11:1 at each iteration and subset combinations. A Setting of 8 iterations and 16 subsets reappeared most close ratio between hot spheres and background. Conclusion: Findings on this study, SUVs and uniformity might be calculated differently caused by variable reconstruction parameters like filter or FWHM. Mean SUV and uniformity showed the lowest range of fluctuation at 6 iterations 16 subsets and 8 iterations 16 subsets. Also, 8 iterations 16 subsets showed the nearest hot sphere to background ratio compared with others. But it can not be concluded that only 6 iterations 16 subsets and 8 iterations 16 subsets can make right images for the clinical diagnosis. There might be more factors that can make better images. For more exact clinical diagnosis through the quantitative analysis of DAT density in the region of striatum we need to secure healthy people's quantitative values.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.1
• /
• pp.3-7
• /
• 2010

Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.