• Advances in pediatric surgery
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• v.15 no.1
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• pp.52-57
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• 2009

Situs inversus abdominis is a rare congenital condition commonly associated with serious cardiac and splenic malformations. The importance of recognizing the presence of situs inversus abdominis preoperatively is emphasized by the fact that the surgical incision is placed on the incorrect side of the abdomen. A 6 day-old girl was referred to our hospital because of bile stained vomiting. A plain radiography of abdomen and chest showed the heart to be normal position and a reversed "double-bubble" picture with no other gas shadow in the rest of the abdomen. Abdominal computed tomography scan revealed situs inversus with the stomach and polysplenia on the right side and the liver on the left side. A laparotomy confirmed the diagnosis of situs inversus with duodenal atresia. The obstruction was bypassed by constructing a side-to-side duodenoduodenostomy. The postoperative course was uneventful.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.625-630
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• 2006

Background: Pulmonary hypertension in COPD patients is the result of a direct effect of tobacco smoke on the intrapulmonary vessels with the abnormal production of the mediators that control vasoconstriction, vasodilatation, and vascular cell proliferation, which ultimately lead to aberrant vascular remodeling and physiology. COPD patients are prone to the developmint of an acute and chronic thromboembolism with an elevation of the plasma procoagulant and fibrinolytic markers However, the roles of the coagulation and fibrinolysis system on the right ventricular dysfunction in COPD patients are not well defined. We examined the alteration of the coagulation and fibrinolysis system in COPD patients according to the right ventricular function measured using cardiac multidetector computed tomography (MDCT). Methods: The right ventricular ejection fraction (RVEF) was measured using cardiac MDCT in 26 patients who were diagnosed with COPD according to the definition of the GOLD guideline. The plasma level of thrombin antithrombin (TAT) and plasminogen activator inhibitor (PAI)-1 were measured using an enzyme linked immunoassay. Results: The plasma TAT was markedly elevated in COPD patients ($10.5{\pm}19.8{\mu}g/L$) compared with those of the control ($3.4{\pm}2.5{\mu}g/L$) (p<0.01). However, the plasma PAI-1 in COPD patients ($29.6{\pm}20.7ng/mL$) was similar to that in the controls. The plasma TAT showed a significant inverse relationship with the RVEF measured by the cardiac MDCT in COPD patients (r=-0.645, p<0.01). However, the plasma PAI-1 did not show a relationship with the RVEF (r=0.022, p=0.92). Conclusion: These results suggest that the coagulation system in COPD patients is markedly activated, and that the plasma level of TAT might be a marker of a right ventricular dysfunction in COPD patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.57-61
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• 2015

Purpose We considered the correlation of Ejection Fraction (EF) which was analyzed by Multi Gated Blood Pool Scan (MUGA) and Echocardiography (ECHO) for the patients who were classified according to the condition of cardiac function. Materials and Methods We analyzed the patients (female 60) who were diagnosed with breast cancer and were examined by both MUGA and ECHO. The 30 patients (age: $58.27{\pm}13.48$) who were analyzed into less than 50% to 70% of EF were categorized as normal group and the other 30 patients (age: $53.70{\pm}8.45$) who were analyzed into less than 50% of EF were categorized as abnormal group. Statistical analysis with SPSS ver. 18 was applied. Results Each of the value of mean and standard deviation of normal group was $66.43{\pm}5.80$ (MUGA), $60.50{\pm}4.93$ (ECHO). There was a significant difference (p<0.001). Each of the value of mean and standard deviation of abnormal group was $41.93{\pm}7.58$ (MUGA), $41.70{\pm}11.49$ (ECHO). There was no significant difference (p>0.001). In the result, all 30 cases of normal group showed the same reading. 8 out of 30 cases in abnormal group showed inconsistency of the reading. Conclusion We could confirm the correlation of the EF in MUGA and ECHO statistically. There was difference between abnormal groups from the result of reading. If we are aware of the result according to the different cardiac function categorization, MUGA and ECHO can be used as even more accurate interchangeable test.

• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.19-27
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• 1980

Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

• The Journal of the Korea Contents Association
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• v.14 no.8
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• pp.233-242
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• 2014

The purpose of this study is to compare the reduction of the dose radioactivity by CARE kV with that of the Bismuth shielding. First, CT was performed with transparent materials, including a Bismuth shielder which is a well-known material for decreasing the dose of radiation. Moreover, we have estimated and compared the affects of the reduction of dose on eye lens, thyroid, breast and genitals. These steps aim to compare reactions with and without the application of the Rando phantom with PLD as well as with CARE kV or not. As a result, during the Brain angio scan, the dose of CARE kV set inspection test methods showed the least dose. Depending on whether we use CARE kV, which showed the effect of dose reduction by 63%. During the Carotid angio scan, the dose was increased by 13% by how to set CARE kV+Bismuth. During the Cardiac angio scan, which showed the effect of dose reduction by 31% by how to set CARE kV+Bismuth. During the Lower extremity angio scan, the dose was measured least by how to set up the whole Bismuth. Compared with CARE kV set of test methods, which showed the effect of dose reduction by 9%.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.67-72
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• 2010

Purpose: In Asan Medical Center we perform myocardial perfusion SPECT to evaluate cardiac event risk level for non-cardiac surgery patients. In case of patients with cancer, we check tumor metastasis using whole body bone scan and whole body PET scan and then perform myocardial perfusion SPECT to reduce unnecessary exam. In case of short term in patients, we perform $^{201}Tl$ myocardial perfusion SPECT after whole body bone scan a minimum 16 hours in order to reduce hospitalization period but it is still the actual condition in which the evaluation about the affect of the crosstalk contamination due to the each other dissimilar isotope administration doesn't properly realize. So in our experiments, we try to evaluate crosstalk contamination influence on $^{201}Tl$ myocardial perfusion SPECT using anthropomorphic torso phantom and patient's data. Materials and Methods: From 2009 August to September, we analyzed 87 patients with $^{201}Tl$ myocardial perfusion SPECT. According to $^{201}Tl$ myocardial perfusion SPECT yesterday whole body bone scan possibility of carrying out, a patient was classified. The image data are obtained by using the dual energy window in $^{201}Tl$ myocardial perfusion SPECT. We analyzed $^{201}Tl$ and $^{99m}Tc$ counts ratio in each patients groups obtained image data. We utilized anthropomorphic torso phantom in our experiment and administrated $^{201}Tl$ 14.8 MBq (0.4 mCi) at myocardium and $^{99m}Tc$ 44.4 MBq (1.2 mCi) at extracardiac region. We obtained image by $^{201}Tl$ myocardial perfusion SPECT without gate method application and analyzed spatial resolution using Xeleris ver 2.0551. Results: In case of $^{201}Tl$ window and the counts rate comparison result yesterday whole body bone scan of being counted in $^{99m}Tc$ window, the difference in which a rate to 24 hours exponential-functionally notes in 1:0.114 with Ventri (GE Healthcare, Wisconsin, USA), 1:0.249 after the bone tracer injection in 12 hours in 1:0.411 with 1:0.79 with Infinia (GE healthcare, Wisconsin, USA) according to a reduction a time-out was shown (Ventri p=0.001, Infinia p=0.001). Moreover, the rate of the case in which it doesn't perform the whole body bone scan showed up as the average 1:$0.067{\pm}0.6$ of Ventri, and 1:$0.063{\pm}0.7$ of Infinia. According to the phantom after experiment spatial resolution measurement result, and an addition or no and time-out of $^{99m}Tc$ administrated, it doesn't note any change of FWHM (p=0.134). Conclusion: Through the experiments using anthropomorphic torso phantom and patients data, we found that $^{201}Tl$ myocardium perfusion SPECT image later carried out after the bone tracer injection with 16 hours this confirmed that it doesn't receive notable influence in spatial resolution by $^{99m}Tc$. But this investigation is only aimed to image quality, so it needs more investigation in patient's radiation dose and exam accuracy and precision. The exact guideline presentation about the exam interval should be made of the validation test which is exact and in which it is standardized about the affect of the crosstalk contamination according to the isotope use in which it is different later on.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.338-343
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• 2007

BOLD T2*-weighted MR images reflects cortical blood flow and oxygenation alterations. fMRI study relies on the detection of localized changes in BOLD signal intensity. Since fMRI measures the very small modulations in BOLD signal intensity that occur during changes in brain activity, it is also very sensitive to small signal intensity variations caused by physiologic noise during the scan. Due to the complexity of movement of various organs associated with heart beat, it is important to reduce cardiac related noise rather than other physiological noise which could be required with relatively simple method. Therefore, a number of methods have been developed for the estimation and reduction of cardiac noise in fMRI study. But, each method has limitation. In this study, we proposed a new estimation method for brain activities influenced by blood pulsation effect using regression analysis with blood pulsation signal and the correspond slice of fMRI. We could find out that the right anterior cingulate cortex and right olfactory cortex and left olfactory cortex were largely influenced by blood pulsation effect for new method. These observed areas are mostly on the structure of anterior cerebral artery in the brain. That is convinced with that our method would be valid and our new method is easier to apply in practice and reduce computational burden than the retrospective method.

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.28-33
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• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.34.1-34.8
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• 2023

Background: Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident. Case presentation: In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge. Conclusions: We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

• Journal of Chest Surgery
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• v.57 no.4
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• pp.360-368
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• 2024

Background: The left pulmonary artery (LPA) may be kinked and stenotic, especially in tetralogy of Fallot, because of ductal tissue and anterior deviation of the conal septum. If LPA stenosis is not effectively treated during total correction, surgical angioplasty is occasionally performed. However, whether pulmonary artery (PA) angioplasty in adolescents or adults improves perfusion in the ipsilateral lung remains unclear. Methods: This retrospective review enrolled patients who underwent PA angioplasty for LPA stenosis between 2004 and 2019. Among patients who underwent a lung perfusion scan (LPS) or cardiac magnetic resonance imaging (cMRI) pre- and post-pulmonary angioplasty, those aged >13 years with <40% left lung perfusion (p-left) in the pre-angioplasty study were included. Preoperative and postoperative computed tomography, LPS, and cMRI data were collected. The perfusion ratio was analyzed according to the LPA's anatomical characteristics. Results: Seventeen adolescents and 16 adults (≥18 years old) were finally included (median age, 17 years). The most common primary diagnosis was tetralogy of Fallot (87.9%). In all patients, LPA angioplasty was performed concomitantly with right ventricular outflow tract reconstruction. No patients died. Preoperative p-left was not significantly different between adolescents and adults; however, adolescents had significantly higher postoperative p-left than adults. P-left significantly increased in adolescents, but not in adults. Seven patients had significant stenosis (z-score <-2.0) confined only to the proximal LPA and demonstrated significantly increased p-left. Conclusion: PA angioplasty significantly increased ipsilateral lung perfusion in adolescents. If focal stenosis is confined to the proximal LPA, PA angioplasty may improve ipsilateral lung perfusion, regardless of age.