Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.
A method to get a size of the radiation isocenter of linear accelerators using star-shot images was presented and a computer program was developed to automate the method. Accuracy of the method was verified. The developed program was used to measure sizes of the radiation isocenters for a Clinac 21EX (Varian, USA) using data of quality assurance (QA) performed from June 2008 to December 2010. To calculated the size of radiation isocenter, positions of two points on each central ray of the star-shot image were found and the equation of the central ray was determined using the positions of two points. Using the equations of central rays the radius of the minimum circle intersecting all the central rays, which is one half of the size of radiation isocenter, was calculated. The program measured x-intercepts and y-intercepts of the central rays within errors of 0.084 mm and sizes of radiation isocenters within 0.053 mm. All the errors were less than the spatial resolution of star-shot images 0.085 mm. The radiation isocenter sizes of Clinac 21EX were $0.33{\pm}0.27mm$, $0.71{\pm}0.36mm$, $0.50{\pm}0.16mm$ for collimator, gantry and couch respectively. During the measurement period all the measured sizes were less than 2.0 mm and within tolerance. The developed program could calculate the size of radiation isocenters and it would be helpful to routine QA.
Lee, Seung Jae;Bahn, Young Kag;Oh, Shin Hyun;Gang, Cheon-Gu;Lim, Han Sang;Kim, Jae Sam;Lee, Chang Ho;Seo, Soo-Hyun;Park, Yong Sung
The Korean Journal of Nuclear Medicine Technology
/
v.16
no.2
/
pp.81-86
/
2012
Purpose : Combined MR/PET scanners that use the MRI for PET AC face the challenge of absent surface coils in MR images and thus cannot directly account for attenuation in the coils. To make up for the weak point of MR attenuation correction, Three Modality System (PET/CT +MR) were used in Severance hospital. The goal of this work was to investigate the effects of MR Torso Coil on CT attenuation correction for PET. Materials and Methods : PET artifacts were evaluated when the MR Torso Coil was present of CTAC data with changing various kV and mA in uniformity water phantom and 1994 NEMA cylinderical phantom. They evaluated and compared the following two scenarios: (1) The uniform cylinder phantom and the MR Torso Coil scanned and reconstructed using CT-AC; (2) 1994 NEMA cylinderical phantom and the MR Torso Coil scanned and reconstructed using CT-AC. Results : Streak artifacts were present in CT images containing the MR Torso Coil due to metal components. These artifacts persisted after the CT images were converted for PET-AC. CT scans tended to over-estimate the linear attenuation coefficient when the kV and mA is increasing of the metal components when using conventional methods for converting from CT number. Conclusion : The presence of MR coils during PET/CT scanning can cause subtle artifacts and potentially important quantification errors. Alternative CT techniques that mitigate artifacts should be used to improve AC accuracy. When possible, removing segments of an MR coil prior to the PET/CT exam is recommended. Further, MR coils could be redesigned to reduce artifacts by rearranging placement of the most attenuating materials.
Purpose: PET/CT combines functional and morphologic data and increases diagnostic accuracy in a variety of malignancies. Especially reconstructed Fusion PET/CT images or MIP (Maximum Intensity Projection) images from a 2-dimensional image to a 3-dimensional one are useful in visualization of the lesion. But in Fusion & MIP 3D reconstruction image, due to hot uptake by urine or urostomy bag, lesion is overlapped so it is difficult that we can distinguish the lesion with the naked eye. This research tries to improve a distinction by removing parts of hot uptake. Materials and Methods: This research has been conducted the object of patients who have went to our hospital from September 2008 to March 2009 and have a lot of urine of remaining volume as disease of uterus, bladder, rectum in the result of PET/CT examination. We used GE Company's Advantage Workstation AW4.3 05 Version Volume Viewer program. As an analysis method, set up ROI in region of removal in axial volume image, select Cut Outside and apply same method in coronal volume image. Next, adjust minimum value in Threshold of 3D Tools, select subtraction in Advanced Processing. It makes Fusion & MIP images and compares them with the image no using Region Cut Definition. Results: In Fusion & MIP 3D reconstruction image, it makes Fusion & MIP images and compares them by using Advantage Workstation AW4.3 05's Region Cut Subtraction, parts of hot uptake according to patient's urine can be removed. Distinction of lesion was clearly reconstructed in image using Region Cut Definition. Conclusion: After examining the patients showing hot uptake on account of volume of urine intake in bladder, in process of reconstruction image, if parts of hot uptake would be removed, it could contribute to offering much better diagnostic information than image subtraction of conventional method. Especially in case of disease of uterus, bladder and rectum, it will be helpful for qualitative improvement of image.
Kim, Young Kwang;Lee, Kyoung Hoon;Yun, Ki Wook;Lee, Mi Kyung;Lim, In Seok
Pediatric Infection and Vaccine
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v.23
no.3
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pp.194-201
/
2016
Purpose: Monitoring pneumococcal carriage rates is important. We developed and evaluated the accuracy of a real-time reverse transcription polymerase chain reaction (RT-PCR) protocol for the detection of Streptococcus pneumoniae. Methods: In October 2014, 157 nasopharyngeal aspirates were collected from patients aged <18 years admitted to Chung-Ang University Hospital. We developed and evaluated a real-time PCR method for detecting S. pneumoniae by comparing culture findings with the results of the real-time PCR using genomic DNA (gDNA). Of 157 samples, 20 specimens were analyzed in order to compare the results of cultures, real-time PCR, and real-time RT-PCR. Results: The concordance rate between culture findings and the results of real-time PCR was 0.922 (P<0.01, Fisher exact test). The 133 culture-negative samples were confirmed to be negative for S. pneumoniae using real-time PCR. Of the remaining 24 culture-positive samples, 21 were identified as S. pneumonia -positive using real-time PCR. The results of real-time RT-PCR and real-time PCR from 20 specimens were consistent with culture findings for all S. pneumoniae -positive samples except one. Culture and real-time RT-PCR required 26.5 and 4.5 hours to perform, respectively. Conclusions: This study established a real-time RT-PCR method for the detection of pneumococcal carriage in the nasopharynx. Real-time RT-PCR is an accurate, convenient, and time-saving method; therefore, it may be useful for collecting epidemiologic data regarding pneumococcal carriage in children.
In Korea, there have been various methods of estimating groundwater recharge which generally can be subdivided into three types: baseflow separation method by means of groundwater recession curve, water budget analysis based on lumped conceptual model in watershed, and water table fluctuation method (WTF) by using the data from groundwater monitoring wells. However, groundwater recharge rate shows the spatial-temporal variability due to climatic condition, land use and hydrogeological heterogeneity, so these methods have various limits to deal with these characteristics. To overcome these limitations, we present a new method of estimating recharge based on water balance components from the SWAT-MODFLOW which is an integrated surface-ground water model. Groundwater levels in the interest area close to the stream have dynamics similar to stream flow, whereas levels further upslope respond to precipitation with a delay. As these behaviours are related to the physical process of recharge, it is needed to account for the time delay in aquifer recharge once the water exits the soil profile to represent these features. In SWAT, a single linear reservoir storage module with an exponential decay weighting function is used to compute the recharge from soil to aquifer on a given day. However, this module has some limitations expressing recharge variation when the delay time is too long and transient recharge trend does not match to the groundwater table time series, the multi-reservoir storage routing module which represents more realistic time delay through vadose zone is newly suggested in this study. In this module, the parameter related to the delay time should be optimized by checking the correlation between simulated recharge and observed groundwater levels. The final step of this procedure is to compare simulated groundwater table with observed one as well as to compare simulated watershed runoff with observed one. This method is applied to Mihocheon watershed in Korea for the purpose of testing the procedure of proper estimation of spatio-temporal groundwater recharge distribution. As the newly suggested method of estimating recharge has the advantages of effectiveness of watershed model as well as the accuracy of WTF method, the estimated daily recharge rate would be an advanced quantity reflecting the heterogeneity of hydrogeology, climatic condition, land use as well as physical behaviour of water in soil layers and aquifers.
Purpose: The aim of this study was to evaluate the fit accuracy of two zirconia and titanium abutments in internal hexagonal implants. Materials and methods: One titanium abutment and two zirconia abutments were tested in internal hexagonal implants (TSV, Zimmer). Prefabricated zirconia abutments (ZirAce, Acucera) and customized zirconia abutments milled by the Zirkonzahn system (Zirkonzahn Max, Zirkonzahn) were selected and prefabricated titanium abutments (Hex-Lock, Zimmer) were used as a control. Eight abutments per group were connected to implants with 30 Ncm torque. The marginal gaps at abutment-implant interface, the internal gaps at internal hex, vertical and horizontal gaps between screws and screw seats in abutments were measured after sectioning the embedded specimens using a scanning electron microscope. Data analysis included one-way analysis of variance and the Scheffe test (n=16, ${\alpha}=0.05$). Results: The mean marginal gap of customized zirconia abutment was higher than those of two prefabricated zirconia and titanium abutments. The internal gaps at internal hex showed no significant differences between customized and prefabricated abutments and were higher than those of prefabricated titanium abutments. The mean vertical and horizontal gaps at screw in prefabricated zirconia abutment were higher than those of prefabricated titanium abutment. In the case of customized zirconia abutment, the mean horizontal gap at screw was higher than those of both the prefabricated zirconia and the titanium abutment but the mean vertical gap was not even measureable. The screw seats were clearly formed but did not match with abutment screws in prefabricated zirconia abutments. They were not, however, precisely formed in the case of customized zirconia abutments. Conclusion: Within the limitations of this study, the prefabricated titanium abutments showed better fit than the zirconia abutments, regardless of customized or prefabricated. Also, the customized zirconia abutments showed significantly higher marginal gaps and the fit was less accurate between screws and screw seats than the prefabricated abutments, titanium and zirconia.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.10
/
pp.136-152
/
2017
The thermodynamic models, PC-SAFT (Perturbed-Chain Statistical Associated Fluid Theory) state equation and the Two-model approach liquid activity coefficient model NRTL (Non Random Two Liquid) + Henry + Peng-Robinson, for modeling the Rectisol process using methanol aqueous solution as the $CO_2$ removal solvent were compared. In addition, to determine the new binary interaction parameters of the PC-SAFT state equations and the Henry's constant of the two-model approach, absorption equilibrium experiments between carbon dioxide and methanol at 273.25K and 262.35K were carried out and regression analysis was performed. The accuracy of the newly determined parameters was verified through the regression results of the experimental data. These model equations and validated parameters were used to model the carbon dioxide removal process. In the case of using the two-model approach, the methanol solvent flow rate required to remove 99.00% of $CO_2$ was estimated to be approximately 43.72% higher, the cooling water consumption in the distillation tower was 39.22% higher, and the steam consumption was 43.09% higher than that using PC-SAFT EOS. In conclusion, the Rectisol process operating under high pressure was designed to be larger than that using the PC-SAFT state equation when modeled using the liquid activity coefficient model equation with Henry's relation. For this reason, if the quantity of low-solubility gas components dissolved in a liquid at a constant temperature is proportional to the partial pressure of the gas phase, the carbon dioxide with high solubility in methanol does not predict the absorption characteristics between methanol and carbon dioxide.
Journal of the Korean Association of Geographic Information Studies
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v.21
no.1
/
pp.35-45
/
2018
Image data collected by an airborne hyperspectral camera system have a great usability in coastal line mapping, detection of facilities composed of specific materials, detailed land use analysis, change monitoring and so forh in a complex coastal area because the system provides almost complete spectral and spatial information for each image pixel of tens to hundreds of spectral bands. A few approaches after classifying by a few approaches based on SAM(Spectral Angle Mapper) supervised classification were applied for extracting optimal land cover information from hyperspectral images acquired by CASI-1500 airborne hyperspectral camera on the object of a coastal area which includes both land and sea water areas. We applied three different approaches, that is to say firstly the classification approach of combined land and sea areas, secondly the reclassification approach after decompostion of land and sea areas from classification result of combined land and sea areas, and thirdly the land area-only classification approach using atmospheric correction images and compared classification results and accuracies. Land cover classification was conducted respectively by selecting not only four band images with the same wavelength range as IKONOS, QuickBird, KOMPSAT and GeoEye satelllite images but also eight band images with the same wavelength range as WorldView-2 from 48 band hyperspectral images and then compared with the classification result conducted with all of 48 band images. As a result, the reclassification approach after decompostion of land and sea areas from classification result of combined land and sea areas is more effective than classification approach of combined land and sea areas. It is showed the bigger the number of bands, the higher accuracy and reliability in the reclassification approach referred above. The results of higher spectral resolution showed asphalt or concrete roads was able to be classified more accurately.
Purpose: We underwent this study to evaluate the diagnostic potential of I-123/I-131 metaiodobenzylguanidine (MIBG) scintigraphy alone in the initial diagnosis of pheochromocytoma, compared with biochemical test and anatomic imaging. Materials & Methods: Twenty two patients (M:F=13:9, Age: $44.3{\pm}\;19.3$ years) having the clinical evaluation due to suspicious pheochromocytoma received the biochemical test, anatomic imaging modality (CT and/or MRI) and I-123/I-131 MIBG scan for diagnosis of pheochromocytoma, prior to histopathological confirmation. MIBG scans were independently reviewed by 2 nuclear medicine physicians. Results: All patients were confirmed histopathologically by operation or biopsy (incisional or excisonal). In comparison of final diagnosis and findings of each diagnostic modality, the sensitivities of the biochemical test, anatomic imaging, and MIBG scan were 88.9%, 55.6%, and 88.9%, respectively. And the specificities of the biochemical test, anatomic imaging, and MIBG scan also were 69.2%, 69.2%, and 92.3%, respectively. MIBG scan showed one false positive (neuroblastoma) and one false negative finding. There was one patient with positive MIBG scan and negative findings of the biochemical test, anatomic imaging. Conclusion: Our data suggest that I-123/I-131 MIBG scan has higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy than those of biochemical test and anatomic imaging. Thus, we expect that MIBG scan is e tectively used for initial diagnosis of pheochromocytoma alone as well as biochemical test and anatomic imaging.
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