• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.66-73
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• 2014

Purpose: Various diagnostic imaging modalities have been used to evaluate the effect of neoadjuvant chemotherapy for osteosarcoma early and noninvasively. We evaluated the effectiveness of imaging studies of plain radiographs and positron-emission tomography/computed tomography (PET/CT) in predicting neoadjuvant chemotherapy effect for osteosarcoma and tried to establish a general principle in interpretation of PET/CT parameters. Materials and Methods: Eighteen patients who underwent two cycles of neoadjuvant chemotherapy and surgical excision for osteosarcoma were enrolled. There were 13 males and 5 females, with a median age of 19 (11-63) years. Fifteen patients of 18 had the American Joint Committe on Cancer (AJCC) stage IIB. They had plain radiographs and PET/CT before and after neoadjuvant chemotherapy. The resected tumor specimens were pathologically examined to determine histological response grade using a conventional mapping method. Statistical analysis was performed to evaluate the correlation between histopathological necrosis rate, and radiographic finding category, post-chemotherapy maximum standardized uptake value (SUVmax), average standardized uptake value and metabolic tumor volume (MTV) as well as reduction rates of them. Results: Eight patients were good responders to neoadjuvant chemotherapy based on histological evaluation. Median SUVmax reduction rate was 73 (23-77) % in good responders and 42 (-32-76) % in poor responders. Median MTV reduction rate was 93.5 (62-99) % in good responders and 46 (-81-100) % in poor responders. While radiographic finding category was not different according to histological response (p=1.0), SUVmax reduction rate was significantly different (p=0.041). Difference in MTV reduction rates approached statistical significance as well (p=0.071). Conclusion: While radiographic finding category was not reliable to assess neoadjuvant chemotherapy effect for osteosarcoma, reduction rate of SUVmax was a useful indicator in this study. As parameters of PET/CT can be influenced by various factors of settings, different centers have to make an effort to establish their own standard of judgement with reference of previous studies.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.137-144
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• 2002

Background: Hemoptysis is an often alarming presenting symptom and VEGF is a major regulator of both normal and abnormal angiogenesis, including many inflarrunatory diseases. In this report the clinical significance of the serum VEGF level in patients with hemoptysis was investigated. Methods: Thirty-two patients with hemoptysis were evaluated. The estimated amount of hemoptysis, etiology and serum VEGF level was examined at admission and bronchial angiography was performed in 22 patients. In order to objectify the neovascularization status, one point for the presence of the A-V shunt, hypervascularity, vascular tortuosity was designated for a total of 0-3 points. Results: Mean quantity of hemoptysis was $172.4{\pm}270.4ml$. The mean angiographic neovascularization score was $1.23{\pm}0.75$. The serum VEGF level correlated with the quantity of hemoptysis(r=0.524, p=0.002) and with the angiographic neovascularization score(r=0.441, p=0.04). Using the standard diagnostic criterion for massive hemoptysis, the serum VEGF level of patients with massive hemoptysis($642.4{\pm}545.6$ pg/ml, n=13) was found to be higher than that of patients with non-massive hemoptysis($394.6{\pm}225.8$ pg/ml, n=19) (p=0.069). Conclusion: Regardless of the etiology, the serum VEGF may contribute to abnormal neovascularization in patients with hemoptysis. Therefore, it is suggested that serum VEGF measurements may help in predicting a massive hemoptysis.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.155-163
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• 1991

Bronchoalveolar lavage had been done as the treatment of some diseases such as alveolar proteinsois, bronchiectasis, and severe asthma to remove excessive secretion or mucus. But in the recent decade it has been done as a diagnostic method and a tool to understand and evaluate the pathophysiology of diffuse interstitial lung diseases such as sarcoidosis, pneumoconiosis and hypersensitivity pneumonitis. To analyse the bronchoalveolar fluid, it might be useful to have a standard reference (especially cell counts and differetial count of the cells from bronchoalveolar lavage fluid) of normal person. But it is difficult to study the normal volunteers. We investgated the bronchoalveolar lavage fluid of 48 patients (28 nonsmokers, 20 smokers) who visited Severance Hospital because of minor pulmonary symptoms such as cough and sputum. They did neither complain of dyspnea nor cyanosis, and had normal or unilateral minor lesion on physical examination and chest X-ray. We analysed the recovery rate, viability, total cell count and differential count of the cells in fluid obtained by bronchoalveolar lavage. The following results were obtained: 1) Age ranged from 17 to 72 years-old with the mean age of 36.7; there was no difference of age between the nonsmoker and the smoker gorup. Male to female ratio was 2.43:1 for total group, 1.15:1 for nonsmokers, and 19:1 for smokers. 2) The diagnoses of the patients were undetermined in 41.9%, healed pulmonary tuberculosis in 37.5%, laryngitis or pharyngitis in 10.4% and others in 10.4%. 3) Total cell number of the recovered fluid by bronchoalveolar lavage was significantly higher in male[$9.6{\pm}6.2({\times}10^6)$] than in female[$5.1{\pm}3.0({\times}10^6)$](p<0.05), and there was no significant difference in the total cell number between the smokers and nonsmokers [$9.3{\pm}5.8({\times}10^6)$ vs $7.5{\pm}5.8({\times}10^6)$]. 4) The differential count of the cells from bronchoalveolar lavage fluid had no difference between the nonsmokers and the smokers. 5) There was no correlation between the total cell count and smoking or age. 6) In the smoker group, there was no correlation between the amount of smoking and the total cell count of the bronchoalveolar fluid. In conclusion, it should be careful to regard the patients with symptoms or minor radiologic abnormalities as a control group in bronchoalveolar lavage study and further study of cell analysis in bronchoalveolar lavage will be needed between smoker and nonsmoker in the male and female healthy people.

• Journal of radiological science and technology
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• v.36 no.1
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• pp.1-10
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• 2013

IEC publications have applied in many countries all over the world such as Europe or Japan and these also have been published as in dustrial standards (KS) and notifications of Korea Food and Drug Administration (KFDA) in Korea. As the general standard of IEC 60601 series for medical electric (ME) equipment was revised as $3^{rd}$ edition in 2005, additional and particular standards have been revised or established newly. Under these circumstances, it is importance for manufacturing and assembling companies or authorized testing companies to understand the trend for revisions of IEC publications. Therefore in this study, the latest version of 3 IEC standards related to medical X-ray equipment : IEC 60601-2-44 for X-ray equipment for computed tomography (CT), IEC 60601-2-45 for mammographic X-ray equipment and IEC 60601-2-54 for X-ray equipment for radiography or radioscopy were covered and analyzed for trends and features accompanied by revision based on IEC 60601-1 $3^{rd}$ Ed. As KFDA notifications in force have referred to the particular standards based on 2nd edition of IEC 60601-1, those revised version of 3 particular standards were compared to KFDA notifications in force. The features of the latest standards applying IEC 60601-1 $3^{rd}$ Ed were shown as following: 1) Requirements for mechanical hazards, especially (motorized) moving parts were emphasized. 2) Indication and recording of patient dose were required. 3) Risk management process was introduced and enabled to monitor potential risks systematically. 4) DR system (digital radiography system) as well as analogue system (film-screen system) was included in the scope. Presently, KFDA will revise the notifications applying the particular standards based on IEC 60601-1 $3^{rd}$ Ed in a few years. Therefore the features of particular standards applying IEC 60601-1 $3^{rd}$ Ed was expected to help manufacturers, assemblers or testing companies of medical electric equipment understand IEC publications or KFDA notifications slated to be published.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.45-52
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• 2007

Purpose : A simple, rapid, and highly sensitive analytical method for Gb3 in plasma was developed without labor-ex tensive pre-treatment by electrospray ionization MS/ MS (ESI-MS/MS). Measurement of globotriaosy lceramide (Gb3, ceramide trihex oside) in plasma has clinical importance for monitoring after enzyme replacement therapy in Fabry disease patients. The disease is an X-linked lipid storage disorder that results from a deficiency of the enzyme ${\alpha}$-galactosidase A (${\alpha}$-Gal A). The lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly Gb3. Methods : Only simple 50-fold dilution of plasma is necessary for the extraction and isolation of Gb3 in plasma. Gb3 in diluted plasma was dissolved in dioxane containing C17:0 Gb3 as an internal standard. After centrifugation it was directly injected and analyzed through guard column by in combination with multiple reaction monitoring mode of ESI-MS/MS. Results : Eight isoforms of Gb3 were completely resolved from plasma matrix. C16:0 Gb3 occupied 50% of total Gb3 as a major component in plasma. Linear relationship for Gb3 isoforms w as found in the range of 0.001-1.0 ${\mu}g$/mL. The limit of detection (S/N=3) was 0.001 ${\mu}g$/mL and limit of quantification was 0.01 ${\mu}g$/mL for C16:0 Gb3 with acceptable precision and accuracy. Correlation coefficient of calibration curves for 8 Gb3 isoforms ranged from 0.9678 to 0.9982. Conclusion : This quantitative method developed could be useful for rapid and sensitive 1st line Fabry disease screening, monitoring and/or diagnostic tool for Fabry disease.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.217-225
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• 2019

The purpose of this study was to quantitate signal to noise ratio and contrast to noise ratio of the portal vein using CT and 3.0T MRI and to investigate the optimal imaging device. Twenty patients who inspective CT and 3.0T MRI between February 2018 and April 2018 were randomly assigned to receive data from the picture archiving communication system. The SNR and CNR values were evaluated by measuring the mean and standard deviation of the region of interest of the four regions of the portal vein (the main portal vein, the right vein, the left vein, and the middle vein). The results showed that SNR was 9.180.72 in the right context, 9.410.84 in the left context, 9.540.59 in the middle context, 9.550.75 in the order context, and 22.292.03 in the right context and 25.893 in the 3.0T MRI. 19, median context: 24.392.87, and order Mac: 26.642.30 (p<0.05). CNR was 3.790.68 in the CT context, 3.740.65 in the left context, 3.710.39 in the middle context, 3.790.68 in the order context, 9.490.65 in the right context, and 11.0001.90 in the 3.0T MRI, Intermediate context: 12.701.75, order Mac: 10.010.98, 3.0T MRI was higher than CT (p<0.05). In conclusion, SNR and CNR values were higher in the 3.0T MRI than CT in the 4 portal regions. Therefore, 3.0T MRI using non-ionizing radiation was the most superior imaging equipment than CT.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.663-670
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• 2018

Objective: Radio-contrast abdomino-pelvic computed tomography (APCT) is considered the gold standard diagnostic tool for an acute abdomen in the emergency department. On the other hand, APCT has a risk of contrast-induced nephropathy. Emergency physicians evaluate the creatinine (Cr) level prior to taking a APCT for the above reason but it takes time to evaluation the serum Cr level. This study hypothesized that Cr measured by a point-of-care test (POCT) can shorten the time to making clinically important decisions for patients with an acute abdomen. Methods: This prospective randomized study was conducted between March 2017 and October 2017. The subjects were divided into two groups (Cr measured by laboratory vs. Cr measured by POCT). To analyze the clinical acceptability for creatinine, agreement was demonstrated graphically by Bland-Altman plots. This study compared the time to make a clinically important decision by physicians and the length of stay at the emergency department in both groups. Results: A total of 76 patients were eligible for the study, 38 patients were assigned to each group. There was no statistically significant difference in the time to the first medical examination (P=0.222) and emergency department stay time (P=0.802). On the other hand, the time to recognition of the Cr level (P<0.001), time to performing APCT (P<0.001), time to decision making (P<0.001), and time to initiation of treatment (P<0.001) were shortened significantly in the point-of-care creatinine group. Conclusion: In this study, the POCT for creatinine can allow rapid decision making by shortening the time to performing the radio-contrast APCT than the laboratory for patients with an acute abdomen.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.343-352
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• 2019

Purpose: The purpose of this study was to document the sonographic morphology of the subscapularis footprint, particularly the 1st facet, of the non-pathologic subscapularis tendon and footprint, and analyze the correlation between the size of the 1st facet and the demographic variables. Materials and Methods: Between March 2015 and December 2017, retrospectively data analysis was performed for the ultrasound (US) scans of 115 consecutive shoulder (mean age 53.4 years, range 23-74 years) with non-pathologic subscapularis tendon and footprint. The sonographic findings of the 1st facet of the subscapularis footprint was a very unique, flat, broad, and plane angle in the upward direction, which were distinguished from the other facets. On US, the transverse (medio-lateral) and longitudinal (superior-inferior) length of the 1st facet on axis of the humerus shaft were recorded. The demographic variables, including age, site, body height, weight, body mass index (BMI), and arm length, were reviewed. Results: On US, the mean transverse length of the 1st facet was 12.75 mm (range 10.54-14.50 mm, standard deviation [SD] 0.712) and the mean longitudinal length was 12.22 mm (range 9.20-13.30 mm, SD 0.888). The transverse and longitudinal length of the size of the 1st facet were significantly greater in males than in females (p<0.001, p=0.001). Of the demographic data (body height, weight, BMI, arm length) that showed a significant positive linear correlation, the correlation with body height (transverse r=0.749, p<0.001; longitudinal r=0.642, p<0.001) showed the strongest relationship, and the correlation with the BMI was weakly related. The relationships between the size of the 1st facet to site/age were not statistically significant or appeared to have no linear correlation. Conclusion: The structural and morphologic features of the 1st facet of the subscapularis footprint on the US were identified. This will provide anatomic knowledge of an US examination for subscapularis tendon pathology.

• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.331-343
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• 2022

Purpose To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT). Materials and Methods Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression. Results For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53). Conclusion The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.3-8
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• 2010

Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.