• The Korean Journal of Nuclear Medicine
• /
• v.36 no.6
• /
• pp.357-367
• /
• 2002

Purpose: While cerebral blood flow and cerebrovascular reserve could be evaluated with basal/acetazolamide Tc-99m-HMPAO SPECT in cerebrovascular disease, objective quantification is necessary to assess the efficacy of the revascularization. In this study we adopted the SPM method to quantify basal cerebral blood flow and cerebrovascular reserve on basal/acetazolamide SPECT in assessment of the patients who underwent bypass surgery for linternal carotid artery (ICA) stenosis. Materials and Methods: Twelve patients ($51{\pm}15$ years) with ICA stenosis were enrolled. Tc-99m-HMPAO basal/acetazolamide perfusion SPECT was peformed before and after bypass surgery. After spatia1 and count normalization to cerebellum, basal cerebral blood flow and cerebrovascular reserve were compared with 21 age-matched normal controls and postoperative changes of regional blood flow and reserve were assessed by Statistical Parametric Mapping method. Mean pixel values of each brain region were calculated using probabilistic anatomical map of lobes. Perfusion reserve was defined as the % changes after acetazolamide over basal counts. Results: Preoperative cerebral blood flow and cerebrovascular reserve were significantly decreased in involved ICA territory, comparing with normal control (p<0.05). Postoperative improvement of cerebral blood flow and cerebrovascular reserve was observed in grafted ICA territories, but cerebrovasculr reserve remained with significant difference with normal control. Improvement of the cerebrovascular reserve was most prominent in the superior temporal and the angular gyrus, nearest to the anastomosis sites. Conclusion: Using SPM quantification method on hasal/acetazolamide Tc-99m-HMPAO SPECT, the cerebral blood flow and cerebrovascular reserve could be assessed before revascularization and so could the efficacy of the bypass surgery.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.4
• /
• pp.388-397
• /
• 1999

Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.4
• /
• pp.398-404
• /
• 1999

Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of $^{99m}Tc$-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of $^{99m}Tc$-DMSA in predicting early diabetic nephropathy Materials and Methods: $^{99m}Tc$-DMSA scan was performed and a total renal uptake of $^{99m}Tc$-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of $^{99m}Tc$-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of $^{99m}Tc$-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of $^{99m}Tc$-DMSA of Group II ($40.8{\pm}11.0%$) was significantly lower than that of Group I ($54.4{\pm}6.3%$, p<0.001). The uptake of Group III ($27.7{\pm}12.0%$) was significantly lower than those of both Group I and Group II (p<0.001). $^{99m}Tc$-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.102, p<0.001). Conclusion: $^{99m}Tc$-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, $^{99m}Tc$-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

• The Korean Journal of Nuclear Medicine
• /
• v.34 no.4
• /
• pp.336-343
• /
• 2000

Purpose: Thallous-201 chloride produced at Korea Cancer Center Hospital(KCCH) is used in detecting cardiovascular disease and cancer. Thallium impurity can cause emesis, catharsis and nausea, so the presence of thallium and other metal impurities should be determined. According to USP and KP, their amounts must be less than 2 ppm in thallium and 5 ppm in total. In this study, the detection method of trace amounts of metal impurities in $[^{201}Tl]$TICI injection with polarography was optimized without environmental contamination. Materials and Methods: For the detection of metal impurities, Osteryoung Square Wave Stripping Voltammetry method was used in Bio-Analytical System (BAS) 50W polarograph. The voltammetry was composed of Dropping Mercury Electrode (DME) as a working electrode, Ag/AgCl as a reference electrode and Pt wire as a counter electrode. Square wave stripping method, which makes use of formation and deformation of amalgam, was adopted to determine the metal impurities, and pH 7 phosphate buffer was used as supporting electrolyte. Results: Tl, Cu and Pb in thallous-201 chloride solution were detected by scanning from 300 mV to -800 mV Calibration curves were made by using $TINO_3,\;CuSO_4\;and\;Pb(NO_3){_2}$ as standard solutions. Tl was confirmed at -450 mV peak potential and Cu at -50 mV Less than 2 ppm of Tl and Cu was detected and Pb was not detected in KCCH-produced thallous-201 chloride injection. Conclusion: Detection limit of thallium and copper is approximately 50 ppb with this method. As a result of this experiment, thallium and other metal impurities in thallous-201 chloride injection, produced at Korea Cancer Center Hospital, are in the regulation of USP and KP Polarograph could be applied for the determination of metal impurities in the quality control of radiopharmaceuticals conveniently without environmental contamination.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.4
• /
• pp.368-380
• /
• 1999

Purpose: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). Materials and Methods: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: $49.1{\pm}10.8$). Results: Eighteen lesions of primary HPT consisted of 13 adenomas and S hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). Conclusion: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.4
• /
• pp.292-300
• /
• 2008

Purpose: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and Methods: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). Results: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: $2.9{\pm}1.4$, group 2: $1.5{\pm}0.6$). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. Conclusion: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.19 no.1
• /
• pp.12-16
• /
• 2015

Purpose Principal component analysis (PCA) is a method often used in the neuroimagre analysis as a multivariate analysis technique for describing the structure of high dimensional correlation as the structure of lower dimensional space. PCA is a statistical procedure that uses an orthogonal transformation to convert a set of observations of correlated variables into a set of values of linearly independent variables called principal components. In this study, in order to investigate the usefulness of PCA in the brain PET image analysis, we tried to analyze C[11]-PIB PET image as a representative case. Materials and Methods Nineteen subjects were included in this study (normal = 9, AD/MCI = 10). For C[11]-PIB, PET scan were acquired for 20 min starting 40 min after intravenous injection of 9.6 MBq/kg C[11]-PIB. All emission recordings were acquired with the Biograph 6 Hi-Rez (Siemens-CTI, Knoxville, TN) in three-dimensional acquisition mode. Transmission map for attenuation-correction was acquired using the CT emission scans (130 kVp, 240 mA). Standardized uptake values (SUVs) of C[11]-PIB calculated from PET/CT. In normal subjects, 3T MRI T1-weighted images were obtained to create a C[11]-PIB template. Spatial normalization and smoothing were conducted as a pre-processing for PCA using SPM8 and PCA was conducted using Matlab2012b. Results Through the PCA, we obtained linearly uncorrelated independent principal component images. Principal component images obtained through the PCA can simplify the variation of whole C[11]-PIB images into several principal components including the variation of neocortex and white matter and the variation of deep brain structure such as pons. Conclusion PCA is useful to analyze and extract the main pattern of C[11]-PIB image. PCA, as a method of multivariate analysis, might be useful for pattern recognition of neuroimages such as FDG-PET or fMRI as well as C[11]-PIB image.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.24 no.1
• /
• pp.33-38
• /
• 2020

Purpose Vitamin D is essential for maintaining bone health, controling cell proliferation or differentiation, strengthening immune function by controlling calcium metabolism in the body. Vitamin D deficiency can lead to increase the risk of rickets, osteoporosis, cardiovascular disease, diabetes and cancer. Especially, South Korea is one of the highest population proportion of vitamin D deficiency. Accurate determination of levels of 25-OH-VitD or 25-OH-VitD3 in blood serum is required for the diagnosis and treatment of vitamin D deficiency. In this study, radioimmunoassay of 25-OH-VitD and 25-OH-VitD3 was performed and compared to evaluate the effectiveness of Vitamin D radioimmunoassay. Materials and Methods Serum 25-OH-VitD and 25-OH-VitD3 levels were measured using radioimmunoassay. The interrelationship, reproducibility and population distribution rate were evaluated. In addition, the internal quality control was performed at Asan Medical Center from April 2017 to June 2019 and the result of external quality control (Interagency proficiency evaluation) of first and second half of 2018 hosted by the Korean Society of Nuclear Medicine Technology (KSNMT). Both tests were measured by same manufacturer's reagent. Results 25-OH-VitD showed a strong positive correlation on 97 samples, as 25-OH-VitD3 x 0.9 + 0.3 (R>0.9). In repeated measurement, the average Diff(%) value of the reproducibility evaluation of 25-OH-VitD and 25-OH-VitD3 were 7.7% and 7.4%, respectively. Population distribution results showed no statistically significant differences(p>0.05). The resultant value of internal quality control, which measured from April, 2017 to June 2019 in Blood test room of Nuclear Medicine at Asan Medical Center, showed average (CV%) 6.2% and 6.8%, respectively. As a result of the external quality control (interagency proficiency evaluation) Z value obtained under 2.0, as shown below; Conclusion The interrelationship, reproducibility, population distribution rate, internal quality control and external quality control between 25-OH-VitD and 25-OH-VitD3 radioimmunoassay shows superior outcome. Radioimmunoassay, which can be alone measured in the blood as 25-OH-VitD or 25-OH-VitD3, is considered suitable screening tests for the diagnosis of vitamin D deficiency.

• Korean Journal of Organic Agriculture
• /
• v.22 no.3
• /
• pp.503-519
• /
• 2014

This study was conducted to investigate ginger growth and its nutrient uptake depending on changes of soil properties as affected by applications of green manure crop and/or charcoal in continuous cropping system. The green manure crops applied were barley and hairy vetch, and charcoal was additionally treated in selected plots as a soil conditioner. Experimental plots were prepared as Plot 1 (control), Plot 2 (barley of 8kg $10a^{-1}$), Plot 3 (hairy vetch of 12kg $10a^{-1}$), Plot 4 (charcoal of 1,000kg $10a^{-1}$ and barley 8kg $10a^{-1}$), and Plot 5 (charcoal of 1,000kg $10a^{-1}$ and hairy vetch of 12kg $10a^{-1}$) with two different soil conditions (high clay content, HCC and low clay content, LCC). When comparing selected chemical properties of soils before and after cultivating ginger plant, soil pH decreased from 6.9~8.1 to 6.8~7.6, and electrical conductivity (EC) also declined from $0.45{\sim}1.25dSm^{-1}$ to $0.30{\sim}0.61dSm^{-1}$. However, the content of soil organic matter (SOM) and total nitrogen (T-N) increased. Thus, the soil chemical properties were improved with the applications of green manures and charcoal. Also, macro- and micro-nutrient contents of ginger plants in the different plots were various between normal and diseased plants grown in soils with HCC and LCC. In particular, the concentration of manganese (Mn) was 3~4 folds higher in the diseased plant than in the normal plants. Ginger growth status and yield was relatively improved with the applications of green manures and charcoal as comparing with control plot. Especially in the Plot 4 with LCC, the ginger plant was not infected by root-rot disease.

• Journal of Hospice and Palliative Care
• /
• v.4 no.1
• /
• pp.4-13
• /
• 2001

Purpose : Since the acquired immune deficiency syndrome (AIDS) was first recognized in the United States in the summer of 1981, the number of these patients has been increasing in the world. But do not find out a cure and a vaccine for ARS (5). And so, the best treatment for AIDS is the prevention. People can find out accurate knowledge about AIDS, and they can prevent themselves from AIDS approximately 100%. In this study, we investigate with AIDS knowledge and attitudes in unmarried young men (<24 age) and suggest accurate preventive education for AIDS and good sexual behaviors. Methods : Un-married young soldiers and college students who were not diagnosed as AIDS until June 30, 2000 were included in the study. The study included a total of 923 men. A self evaluation questionnaire, included questions on 36 items(the part of demographic data - 9; the part of knowledge - 20; the part of attitudes - 8), was drawn up by three physicians. The demographic data, AIDS knowledge and attitudes were analyzed by chi-square analysis, and the total score of AIDS knowledge - comparison according to demographic factors and attitudewere analyzed by one-way ANOVA test. Results : In demographic characteristics, as for the first recognized time of AIDS, most of men knew it when they were in their middle school, as for sources of information on AIDS, most of them knew it through the TV-media, and as for the educational need about AIDS, most of them agreed with it. In AIDS knowledge, mean scores were $14.0{\pm}1.8$ (70.3%). Items of the misconceptions concerning AIDS, reported as less than 50% correct answers, were 6 among 20 items (30%). In AIDS attitudes, as for the item about that if I will be an AIDS patient, I will have an AIDS treatment, it showed that the number of men agreed with 759 (82.2%), and as for the item about that I will help for AIDS patient even though I don't know him, it showed that the number of them agreed with 412 (45.8%). In correlation of AIDS knowledge and demographic factors, the mean scores of knowledge of men with higher than college degree were higher than them of others. The mean scores of knowledge of men with total income of family with more than US$1667 were higher than them of others. The mean scores of knowledge of men with sources of information on AIDS through the TV-media were higher than them of others. And the mean scores of knowledge of men with past medical history of STD(sexually transmitted disease) were higher than them of others. Conclusions : The higher the knowledge he has, the lower the possibility of risk and the more positive the attitude he has. And then we think that the education program for AIDS will be included as a regular part of the curriculum in high school, and young men must be effectively educated by it.