• Title/Summary/Keyword: CT/MRI

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AN EXPLORATORY STUDY COMPARING BLOOD METAL CONCENTRATIONS BETWEEN STROKE AND NON-STROKE PATIENTS IN KOREANS

  • Lee, Sun-Dong;Ko, Seong-Gyu;Kim, Rok-Ho;Hu, Howard;Amarasiriwardena, Chitra J.;Park, Hae-Mo
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2005.12a
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    • pp.87-94
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    • 2005
  • Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

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Scintigraphic Findings of Fibrous Dysplasia (섬유성 골 이형성증의 골 신티그라피 소견)

  • Kim, Jong-Ho;Kim, Jong-Soon;Han, Seung-Soo;Kim, Sang-Eun;Choi, Chang-Woon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kang, Heung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.219-226
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    • 1991
  • 골 신티 그라피는 섬유성 골 이형성증의 초기 병소와 다골성 형 섬유성 골 이형성증의 진단에 예민한 검사 방법이나, 양성 또는 악성 골 병변과의 감별진단에 어려움이 있었다. 이에 저자들은 조직학적으로 확진된 섬유성 골 이형성증 환자 17명에서 (단골성 형 12명, 다골성 형 : 5명) $^{99m}Tc-MDP$ (20 mCi 또는 7,400 MBq) 주사후 $2\sim4$시간에 전면, 후면 전신상과 부분상을 얻은 30부위 병소를 X선 사진과 비교분석 하였으며 CT, MRI 영상과 병리조직 소견을 얻었다. 병소 침습 부위별로는 대퇴골-10예, 경골-4, 요골-2, 늑골-2, 척추골-2, 후두골-2, 장골-2, 두정골-1, 하악골-1, 접형골-1, 견갑골-1, 쇄골-1, 척골-1예 였으며 5명의 다골성 형에서는 :우 대퇴골과 우 비골 : 양측 말단 대퇴골 :좌 경골과 좌 대퇴골 :우 요골과 우 장골 양측 대퇴골, 양측 경골, 접형골, 두정골, 척추골, 늑골과 장골이었다. 골 신티 그라피 소견상 30예중 28예에서(28/30, 93.3%) 방사능 섭취 증가를 보였으며 2예에서(2/30, 6.7%)는 정상 방사능 섭취 소견을 보였으나 각각은 X선상 불투명 유리상과 골흡수 병변을 보였다. 하악골의 골 3상 스캔상 병소에 현저한 혈류 증가가 관찰되었다. X선 소견상 30예중 11예에서 (l1/30, 36.7%) 불투명 유리상의 병변을, 골 변형을 동반한 1예를 포함한 18예에서는 (18/30, 60.0%) 골흡수 병변을 보였으며, 1예의 늑골 병변은 정상소견을 보였다(1/30, 3.3%). 이상에서 골 신티 그라피 만으로 섬유성 골 이형성증을 진단하는데는 주의를 요하나 골 대사의 동적 측면인 혈류와 골 재형성 양상 특히, 초기 병변과 단골성 형 침습에서 다골성 형을 진단하는데 필수적이며 결론적으로 골 신티 그라피와 X선 촬영등은 섬유성 골 이형성증 진단에 상호보완적인 검사 방법으로 사료된다.

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Detection of Tuberculous Lesion by Immunoscintigraphy Using Radiolabeled Specific Polyclonal Antibody Against M. bovis BCG in Rabbit: A Preliminary Result (가토에서 방사면역 신티그래피를 이용한 결핵병변의 진단 : 예비보고)

  • Lee, Jong-Doo;Shin, Kyoo-Ho;Cho, Sang-Nae;Shin, Jeon-Soo;Lee, Min-Geol;Yang, Woo-Ick;Park, Chang-Yoon;Yoo, Hyung-Sik;Lee, Jong-Tae;Awh, Ok-Doo;Park, Kyung-Bae;Kim, Jae-Rok
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.245-251
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    • 1991
  • 결핵성 병변의 단순 x-ray 촬영이나 CT, MRI 소견은 매우 다양하며, 결핵과 전이암 혹은 원발성 암과 감별이 어려운 경우가 있어 결핵으로 확진하기 위하여서 조직 생검이나 수술 등 침습적인 진단 방법을 이용하여야 하였다. 그러므로 이러한 결핵 병변을 비 침습적인 방법으로 정확히 감별할 수 있는 방법을 연구하던 바, 결핵균에 대한 항체를 동위원소에 부착시켜 신티그래피로 진단할 수 있는지의 가능성을 동물실험을 통하여 알아보고자 하였다. 15마리의 가토에서 M.tuberculosis H37Rv를 슬관절에 주입시켜 결핵병변을 유발시키고, 대조군으로 2마리의 가토의 고환에 T.pallidum을 주입하여 매독병변을 유발시킨 후 M.bovis BCG에 대한 특이항체 (specific polyclonal antibody)와 정상 가토의 immunoglobulin을 I-131에 부착시켜 각각의 가토에 주입하여 preset time 10분간 감마카메라로 주사한 결과 다음과 같은 결과를 얻었다. (1) 8마리의 결핵에 감염된 가토에 M.bovis BCG에 대한 $F(ab')_2$를 1 mCi의 I -131 labeling 시킨후 주사한 결과 모두에서 주사후 2시간 부터 72시간까지 병소가 hot uptake으로 보였으며 주사후 24 시간에 가장 높은 target/background ratio를 보였다. (2) 2마리의 매독에 감염된 가토에서 anti-BCG $F(ab')_2$를 주사한 결과 2시간에서는 병소에 hot activity를 보였으나 24시간부터 급격히 activity가 감소하였다. (3) $F(ab')_2$ 대신에 intact antibody를 결핵에 감염된 가토에 투여한 결과 specific polyclonal antibody나 정상가토의 immunoglobulin 모두 결핵병소에 96시간까지 hot uptake를 보였다. 그러므로 결핵균에 대한 specific antibody fragment를 이용하면 방사면역 신티그램으로 진단이 가능하리라 사료되었고, intact antibody를 사용할 경우 sensitivity는 높으나 specificity는 적을 것으로 사료되었다.

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Primary Traumatic Anterior Shoulder Dislocation in the Middle-aged And Elderly Patients (중장년층에서의 외상성 견관절 탈구)

  • Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;An Jae-Hun;Yum Jin-Sub;Kim Whoan-Jeang;Choy Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.75-78
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    • 2000
  • Purpose: The purpose of this study was to review primary traumatic anterior shoulder dislocation in the 40 years and older to determine the incidence of recurrence, rotator cuff injury and associated fractures. Materials and Methods: From May, 1991 to October, 1998, seventeen patients were available to participate in the study. The average age was 55 years(range, 40 to 75 years). Follow-up averaged 27 months(range, 12 to 48 months). There were 12 men and 5 women. 10 right and 7 left shoulders were involved. Any participant with a history of shoulder pain and limitation of motion was excluded from the study. Each shoulder was evaluated with UCLA shoulder functional assessment. Results: The overall results were excellent in 9 patients(52.9%), good in 3 patients(17 .6%), fair in 3 patients(17.6%), and poor in 2 patients(11.7%). Surgical treatment of the associated rotator cuff and greater tuberosity fracture injuries resulted in 5 patients with excellent(55.6%), 3 patients with good(33.3%) and I patient with poor(11.1 %) and Nonsurgical treatment of the associated injuries resulted in 2 patients with excellent(33.3%), 3 patients with fair(50%), 1 patient with poor(16.7%)(P=0.025). Conclusion : Our findings on small number of patients suggest that the diagnosis of a rotator cuff and other pathologies should be approached aggressively by an MRI, CT arthrogram if significant pain and weakness are still present and early surgical repair of rotator cuff and greater tuberosity can lead to restoration of shoulder function and better outcomes in selected patients.

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Outcome of Non-surgical and Surgical Treatments in Dogs with Cervical Intervertebral Disc Disease: 60 cases (개에서 경추 추간판 탈출증의 비수술적 치료와 수술적 치료의 결과 : 60 증례)

  • Sung, Gyu-Jin;Ryu, Hak-Hyun;Park, Sung-Su;Kang, Byung-Jae;Lim, Sung-Jun;Kim, Yong-Sun;Lee, Seung-Hoon;Cho, Sung-Ho;Kim, Jun-Young;Yoon, Jung-Hee;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.713-717
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    • 2010
  • Outcomes of non-surgical and surgical treatments for thoracolumbar intervertebral disc disease (IVDD) are well-reported. However, little is known regarding the outcome for treatments of cervical IVDD. This study systematically reviewed the outcomes in dogs with cervical IVDD that were managed non-surgically and surgically. Clinical success rates for surgical treatment were significantly higher (100%) than for non-surgical treatment (51.4%). In the non-surgical treatment group, clinical success rates were negatively correlated with spinal cord compression rates. Based on the results of this study, surgical treatment is deemed more effective than non-surgical treatment for dogs with cervical IVDD. Also, the degree of spinal cord compression on computed tomography or magnetic resonance imaging is a useful prognostic indicator before non-surgical treatment.

Development of a Hospital Service-based Costing System and Its Application (병원서비스별 원가분석모형의 개발과 적용)

  • 박하영
    • Health Policy and Management
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    • v.5 no.2
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    • pp.35-69
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    • 1995
  • The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

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Recurrent Extraventricular Neurocytoma with Malignant Glial Differentiation - Case Report - (악성신경교 분화를 보이는 재발성 뇌실외 신경세포종 - 증례보고-)

  • Chang, In-Bok;Park, Se-Hyuck;Hwang, Hyung-Sik;Kim, Duck-Hwan;Nam, Eun Sook;Cho, Byung-Moon;Shin, Dong-Ik;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.522-527
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    • 2001
  • We present a case of recurrent extraventricular neurocytoma with malignant glial differentiation in left temporoparietal area. A 37-year-old man with presentation of generalized seizure had undergone biopsy of brain tumor in left parietal area in 1987, which revealed extraventricular neurocytoma and radiotherapy was followed. Postoperative course was uneventful until eleven years after biopsy, when he became gradually aphasic and right hemiplegic. Brain CT and MRI revealed enlargement of tumor with peritumoral edema and calcifications. He underwent subtotal tumor removal in 1998. Microscopic examination of second biopsy specimen revealed presence of large areas composed of anaplastic glial cells with frequent mitosis, nuclear pleomorphism, large eosinophilic cytoplasm and eccentric nuclei, resembling gemistocytes, which were strongly immunoreactive to glial fibrillary acidic protein(GFAP) but not to synaptophysin(SNP). Also focal areas of neuronal cells were found, which were immunoreactive to SNP but not to GFAP. These histologic findings imply that this recurred tumor was a high grade, mixed tumor with divergent differentiation of neuronal and astrocyte lineage. We report a rare case of extraventricular cerebral neurocytoma with malignant glial differentiation with review of the literature.

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Optimal Localization through DSA Distortion Correction for SRS

  • Shin, Dong-Hoon;Suh, Tae-Suk;Huh, Soon-Nyung;Son, Byung-Chul;Lee, Hyung-Koo;Choe, Bo-Young;Shinn, Kyung-Sub
    • Progress in Medical Physics
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    • v.11 no.1
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    • pp.39-47
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    • 2000
  • In Stereotactic Radiosurgery (SRS), there are three imaging methods of target localization, such as digital subtraction Angiography (DSA), computed tomography (CT), magnetic resonance imaging (MRI). Especially, DSA and MR images have a distortion effect generated by each modality. In this research, image properties of DSA were studied. A first essential condition in SRS is an accurate information of target locations, since high dose used to treat a patient may give a complication on critical organ and normal tissue. Hut previous localization program did not consider distortion effect which was caused by image intensifier (II) of DSA. A neurosurgeon could not have an accurate information of target locations to operate a patient. In this research, through distortion correction, we tried to calculate accurate target locations. We made a grid phantom to correct distortion, and a target phantom to evaluate localization algorithm. The grid phantom was set on the front of II, and DSA images were obtained. Distortion correction methods consist of two parts: 1. Bilinear transform for geometrical correction and bilinear interpolation for gray level correction. 2. Automatic detection method for calculating locations of grid crosses, fiducial markers, and target balls. Distortion was corrected by applying bilinear transform and bilinear interpolation to anterior-posterior and left-right image, and locations of target and fiducial markers were calculated by the program developed in this study. Localization errors were estimated by comparing target locations calculated in DSA images with absolute locations of target phantom. In the result, the error in average with and without distortion correction is $\pm$0.34 mm and $\pm$0.41 mm respectively. In conclusion, it could be verified that our localization algorithm has an improved accuracy and acceptability to patient treatment.

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Metabolic impairment pattern analysis of the Alzheimer's disease (Alzheimer's Disease의 대사영상패턴 분석)

  • Juh, Ra-Hyeong;Lee, Chang-Uk;Chung, Yong-An;Choe, Bo-Young;Suh, Tae-Suk
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.91-95
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    • 2004
  • Several MRI studies have reported reductions in temporal lobe volumes in Alzheimer's disease (AD). Measures have been usually obtained with regions-of-interest (ROI) drawn manually on selected medial and lateral portions of the temporal lobes, with variable choices of anatomical borders across different studies. We used the automated voxel-based morphometry (VBM) approach to investigate gray matter abnormalities over the entire extension of the temporal lobe in 10AD patients (MM5E 22)and 22 healthy controls. Foci of significantly reduced gray matter volume in AD patients were detected in both medial and lateral temporal regions, most significantly in the right and left posterior parahippocarmpal gyri. At a more flexible statistical threshold (P<0.01, uncorrected for multiple comparisons), circumscribed foci of significant gray matter reduction were also detected in the right amygdala/enthorinal cortex, the anterior and posterior borders of the superior temporal gyrus bilaterally, and the anterior portion of the left middle temporal gyrus. These VBM results confirm previous findings of temporal lobe atrophic changes in AD, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.

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A Study on the Artifact Reduction Method of Magnetic Resonance Imaging in Dental Implants and Prostheses (치아 임플란트와 보철에서 발생하는 자기공명영상의 인공물 감소방안 연구)

  • Shin, Woon-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.7
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    • pp.1025-1033
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    • 2019
  • Although magnetic resonance imaging without linear hardening of CT is recognized as a method of obtaining high contrast of tissue and excellent resolution image in brain disease and head and neck examination, magnetic susceptibility artifact is generated in case of metal implants in the oral cavity, which is an obstacle to image diagnosis. Therefore, an effort was made in this thesis to find a method to reduce artifacts caused by dental implants and prosthesis in MRI. Implant-induced artifacts in magnetic resonance imaging showed that the signal size increased with shorter TE in GE technique and was inconsistent with water temperature change. In SE technique as well, the signal size of water was generally higher than that of air, but the signal to noise ratio (SNR) was not different by air and temperature. In EPI technique, images with fewer artifacts were obtained quantitatively and qualitatively when there was more water than air, and the signal to noise ratio was measured the highest, especially at water temperatures of 20° and 30°. In conclusion, when examining using the EPI technique rather than the SE or the GE technique, obtaining brain diffusion using a 20° and 30° water bag reduces the magnetic susceptibility artifacts caused by implants and prosthesis, suggesting that it may provide images with high diagnostic value.