• Journal of radiological science and technology
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• v.39 no.2
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• pp.149-156
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• 2016

Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were $96.17{\pm}19.12ml/sec$, $17.04{\pm}4.12cm/sec$ respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of $72.31{\pm}13.27ml$ and $12.32{\pm}3.85$. On the other hand, the average 2NEX blood flow and mean flow velocity is $101.90{\pm}24.09$, $16.84{\pm}4.32$, 3NEX $103.06{\pm}25.49$, $16.88{\pm}4.19$ did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were $76.68{\pm}19.72ml/s$, and $22.23{\pm}4.8$, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.160-170
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• 2006

Background : The aberrant promoter hypermethylation of p16INK4a, as a tumor suppressor gene, is contributory factor to non-small cell lung cancer(NSCLC). However, its potential diagnostic impact of lung cancer is unclear. This study measured the level of $p16^{INK4a}$ promoter hypermethylation in the sputum and blood, and compared this with the level measured in the tissue obtained from NSCLC and pulmonary inflammation. Methods : Of the patients who visited the Our Lady of Mercy Hospital in Incheon, Korea for an evaluation of a lung mass and underwent blood, sputum, and tissue tests, 23patients (18 NSCLC, 5 pulmonary inflammation) were enrolled in this study. DNA was extracted from each sample and the level of p16INK4amethylation was determined using methylation-specific polymerase chain reaction. Results : $p16^{INK4a}$ methylation of the blood was observed in 88.9% (16 of 18) and 20.0% (1 of 5) of NSCLC and from pulmonary inflammation samples, respectively (P=0.008). Methylation of the sputum was observed in 83.3% (10 of 12) 80.0% (4 of 5) of NSCLC and pulmonary inflammation samples, respectively (P=1.00). Among the 8 NSCLC tissue samples, methylation changes were detected in 75.0% of samples (6 cases). Four out of seven tissue samples (57.1%) showed concordance, being methylated in both the blood and sputum. Conclusions : There was a higher level of $p16^{INK4a}$ methylation of the blood from NSCLC patients than from pulmonary inflammation. The tissue showed a high concordance with the blood in the NSCLC samples. These findings suggest that $p16^{INK4a}$ promoter hypermethylation of the blood can used to discriminate between NSCLC and pulmonary inflammation.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.222-227
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• 2005

Purpose: There are several reports suggested the usefulness of serum tumor markers, AFP, CEA and CA19-9 as prognostic factors or indicators for recurrence in gastric cancer. This clinical study was peformed to evaluate positive rate of tumor markers according to site of recurrence in gastric cancer. Materials and Methods: From the database of patients who underwent radical gastrectomy for gastric cancer between January 1999 and January 2004, 52 patients who showed recurrence were included in this retrospective study. Serum levels of tumor markers were measured at the time of preoperative diagnosis of the gastric cancer and at the time of postoperative recurrence during follow up, respectively. Results: The overall positivity of tumor markers at the time of recurrence was found to be significantly higher than that of prior to surgery in the recurred group for the single test as well as the combination tests. For the peritoneum, the most common recurrent site, the positivity of CA19-9 was higher at the time of recurrence. And the significant positivity of CEA at the time of recurrence was detected in the liver cases. Conclusion: Having a preoperative positive tumor marker may identify the patient as having an increased chance of a recurrence. Although tumor markers continue to have limited diagnostic significance in gastric cancer, CA19-9 may be useful as a predictor for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.207-221
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• 2000

Purpose: Cost-effectiveness of myocardial SPECT for the diagnosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Materials and Methods: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (${\Delta}QALY$) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases. $Cost/{\Delta}QALY$ was calculated and compared between four different tactics according to pre-test probability. Results: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective. Conclusion: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7633-7640
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• 2015

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and it is responsible for most cases of cervical uterine cancer. Although HPV infections of the cervix do not always progress to cancer, 90% of cervical cancer cases have been found to be associated with high risk HPV (HR-HPV) infection. HPV DNA testing is widely used, along with Papanicolaou (Pap) testing, to screen for cervical abnormalities. However, there are no data on the prevalence of genotype-specific HPV infections assessed by measuring HPV E6/E7 mRNA in women representative of the Chinese population across a broad age range. Materials and Methods: In the present study, we compared the results with the CervicGen HPV RT-qDx assay, which detects 16 HR-HPV genotypes (Alpha-9: HPV 16, 31, 33, 35, 52, and 58; Alpha-7: HPV 18, 39, 45, 51, 59, and 68; and Alpha-5, 6: HPV 53, 56, 66, and 69), and the REBA HPV-ID assay, which detects 32 HPV genotypes based on the reverse blot hybridization assay (REBA) for the detection of oncogenic HPV infection according to cytological diagnosis. We also investigated the prevalence and genotype distribution of HPV infection with a total of 324 liquid-based cytology samples collected in western Shandong province, East China. Results: The overall HPV prevalences determined by HPV DNA and HPV E6/E7 mRNA assays in this study were 79.9% (259/324) and 55.6% (180/324), respectively. Although the positivity of HPV E6/E7 mRNA expression was significantly lower than HPV DNA positivity, the HPV E6/E7 mRNA assay showed greater specificity than the HPV DNA assay (88.6% vs. 48.1%) in normal cytology samples. The prevalence of Alpha-9 (HPV 16, 31, 33, 35, 52, and 58) HPV infection among these women accounted for up to 80.3% and 76.1% of the high-grade lesions detected in the HPV mRNA and DNA tests, respectively. The HR-HPV genotype distribution, based on HPV DNA and E6/E7 mRNA expression by age group in patients with cytologically confirmed lesions, was highest in women aged 40 to 49 years (35.9% for cytologically confirmed cases, Pearson correlation r value=0.993, p<0.001) for high-grade lesions. Among the oncogenic HR-HPV genotypes for all age groups, there was little difference in the distribution of HPV genotypes between the HPV DNA (HPV -16, 53, 18, 58, and 33) and HPV E6/E7 mRNA (HPV -16, 53, 33, 58, and 18) assays. HPV 16 was the most common HPV genotype among women with high-grade lesions. Conclusions: Our results suggest that the HPV E6/E7 mRNA assay can be a sensitive and specific tool for the screening and investigation of cervical cancer. Furthermore, it may provide useful information regarding the necessity for early cervical cancer screenings and the development of additional effective HPV vaccines, such as one for HPV 53 and 58. Additionally, gaining knowledge of HPV distribution may also inform us about ecological changes in HPV after the vaccination.

• 한국환경농학회:학술대회논문집
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• 2009.07a
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• pp.273-282
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• 2009

The transmissible spongiform encephalopathies (TSEs) disease group are fatal neurodegenerative disorders affecting a wide range of hosts. The group includes kuru and Creutzfeldt-Jakob disease (CJD) in humans, scrapie in sheep and goats and Bovine spongiform encephalopathy (BSE) in cattle. The exact nature of the infectious agent involved in the transmission of these diseases remains controversial. However, a central event in their pathogenesis is the accumulation in infected tissues of an abnormal form of a host-encoded protein, the prion protein (PrP). Whereas the normal cellular protein is fully sensitive to protease ($PrP^{sen}$), the disease-associated prion protein ($PrP^d$) is only partly degraded ($PrP^{res}$), its amino-terminal end being removed. BSE was first reported in the mid-80s in the UK. Ten years later, a new form of human prion disease, variant CJD (vCJD) developed in the wake of the BSE epidemic, and there is now strong scientific evidence that vCJD was initiated by the exposure of humans to BSE-infected tissues, thus indicating a zoonotic disease. However, the ban on the feeding of animal-derived proteins to ruminants, and the apparent lack of vertical transmission of BSE, have led to a decline in the incidence of the disease within cattle herd and therefore, an assumed decreased risk for human contacting vCJD. The origin of the original case(s) of BSE still remains an enigma even though three hypotheses have been raised. Hypotheses are i) sheep- or goat-derived scrapie-infected tissues included in meat and bone meal fed to cattle, ii) a previously undetected sporadic or genetic bovine TSE contaminating cattle feed or iii) originating from a human TSE through animal feed contaminated with human remains. A host cellular membrane protein ($PrP^C$), which is abundant in central nervous system tissue, appear to be conformationally altered in the diseased host into a prion protein ($PrP^{Sc}$). This $PrP^{Sc}$ is detergent insoluble and partially protease-resistant ($PrP^{res}$). The term $PrP^{res}$ is normally used to describe the protein detected after protease treatment, in techniques such as Western immunoblotting, and enzyme-linked immunosorbant assay using fresh/frozen tissue. Immunohistochemistry may performed with formalin-fixed tissues. Also, clinical signs of the BSE are one of the major diagnostic indicators. Recently, atypical forms (known as H- and L-type) of BSE have appeared in several European countries, Japan, Canada and the United States. An unusual case was also reported in a miniature zebu. The atypical BSE fall into two groups based on the relative molecular mass (Mm) of the unglycosylated $PrP^{res}$ band relative to that of classical BSE, one of the higher Mm (H-type) and the other lower (L-type). Both types have been detected worldwide as rare cases in older animals, at a low prevalence consistent with the possibility of sporadic forms of prion diseases in cattle. This raises the unwelcome possibility that vCJD could increase in the human population. Now, active surveillance program against BSE is going on in Korea. In regional veterinary service lab, ELISA is applied to screen the BSE in slaughter and confirmatory tests by Western immunoblotting and immunohistochemisty are carried out if there are positive or suspect in the screening test. Also, the ruminant feed ban is rigorously enforced. Removal of specified risk materials such as brain and spinal cord from cattle is mandatory process at slaughter to prevent the infected material from entering the human food chain.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.125-133
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• 1998

This study was designed to identify the efficiency of serum troponin-T(s-TnT) level as a diagnostic indicator for the perioperative myocardial damage with open heart surgery(OHS) and to compare with the conventional myocardial enzyme tests such as isoenzyme fraction of creatine kinase(% CK-MB) and isoenzyme ratio of lactate dehydrogenase(LDH1/LDH2 ratio). The study was performed on 30 adult patients who underwent OHS from Jan. 1996 to June 1996 at Inje University Pusan Paik Hospital, and they were divided into two groups accor- ding to aortic clamping time(ACT) duration : group I(ACT＜60 minutes, n=15); group II (ACT＞60 minutes, n=15). S-TnT, % CK-MB, and LDH1/LDH2 ratio were measured in serial blood samples from all subjected patients. The results were obtained as follows. 1. In both groups, s-TnT concentrations increased gradually during OHS and elevated significantly at CPB-10(p＜0.001). The peak level was noticed at POD 1 in group I(1.10 $\pm$0.19 ng/ml), whereas, at CPB-off in group II(1.88$\pm$0.42 ng/ml). The elevated levels remained until POD 7 in both groups. 2. %CK-MB was risen significantly with the initiation of operations(p＜0.001) and the peak levels were noticed at CPB-off in both groups(7.14$\pm$0.86% in group I, 10.69$\pm$1.27% in group II). Thereafter, these levels returned to normal values at POD 3. 3. There were no significant changes in the values of LDH1/LDH2 ratio during and after OHS compared with the control levels(p＞0.05). 4. The serial changes of s-TnT were relatively well correlated with those of changes of % CK-MB(r=0.64, p＜0.05). 5. The serial s-TnT levels were significantly higher in group II than group I from B-ACR to POD 1(p＜0.05), suggesting that duration of aortic clamping time was a major factor concerned with perioperative myocardial injury. In conclusion, measurement of s-TnT is a very useful indicator in assessing the myocardial cell damage and therefore it is expected that serial checking and evaluation of the s-TnT is very available for identification of the perioperative myocardial damage and for postoperative cares in patients with OHS.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.519-531
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• 1993

Background: Lymphangioleiomyomatosis(LAM) is a very rare disease occurring in women of reproductive age and leading to progressive respiratory failure despite therapy. But the natural history of this disease is uncertain and although anti-estrogenic agents have been used for more than twenty years, it's efficacy is still in debate. This study was performed to enhance understanding of this fatal disease in Korea by examining clinical, radiological, and pathologic findings of all the previously reported cases of LAM on Korea along with four new cases of LAM whom we report in this paper. Method: Out of twlve cases of LAM previously unpublished and published in domestic papers, two cases whose diagnoses were considered doubtful after review of clinical, radiological, and pathologic findings at "Asian Congress on Lymphangioleiomyomatosis" at Kyoto, Japan in feburary of 1993 were excluded from this study. Six cases which were reported previously and four new cases of LAM whom we report in this paper were analysed for the clinical, radiological, and pathologic characteristics. Results: All ten patients were women with mean age of $33{\pm}7$. The most common symptom was exertional dyspnea and most patients had history of pneumothoraces. Pulmonary function tests showed decreased diffusing capacity. on high resolution computed tomography(HRCT), all the cases had characteristic cysts. Most of the patients did not respond to hormonal therapy. Conclusion: In women of reproductive age, presenting with dyspnea who has a history of pneumothorax, LAM should always be considered as one of the diagnostic possibilities. If suspected, HRCT should be done to look for characteristic cysts and if needed, open lung biopsy should be done to confirm the diagnosis.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.519-524
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• 2010

Purpose : To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) as a useful diagnostic method in children with incomplete Kawasaki disease (KD). Methods : Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control. Results : Thirty-three patients (34%) had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%). Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control ($1,407.7{\pm}1633.5pg/mL$ vs $126.2{\pm}135.5pg/mL$, $P$<0.001). An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD. Conclusion : NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.

• Journal of environmental and Sanitary engineering
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• v.13 no.1
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• pp.123-134
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• 1998

The study was performed to investigate the differences among various evaluation criteria for noise-induced hearing loss(NIHL). The subjects were 100 workers who had received detailed audiometric examinations after the periodic annual examination for hearing loss. The evaluation criteria included were as follows: The criterion I was NIHL of 50dB or greater at 4,000Hz in either ear which is one of the legal requirements for determining occupational hearing loss in Korea. The criterion II was NIHL of 40dB or greater by 4-divided classification(a+b+c+d/4 at 500Hz(a), 1,000Hz(b), 2,000Hz(c), 4,000Hz(d)) which is also one of the legal requirements for determining occupational hearing loss in Korea. The criterion III was NIHL of 31dB of greater by 6-divided classification(a+2b+2c+d/6) which is the workers' compensation standard. The criterion IV was NIHL of 40dB or greater by 6-divided classification(a+2b+2c+d/6), the criterion used to prohibite workers to be employed in the noisy workplace. The criterion V was NIHL of 40dB or greater by 3-divided classification(a+b+c/3) which is the guideline of the Japanes Labour Department. The results were as follows; 1. The percentage of workers with NIHL by the criterion I was the highest(96%) and covered all workers with NIHL diagnosed by other criteria. Therefore, this criterion was the most sensitive one for early detection of NIHL among various evaluation criteria. 2. The percentage of workers with NIHL by the criterion II was 29% of the subjects, but all of them could be diagnosed as having NIHL by the criterion I and 33.1% of the NIHL by the criterion III could not be covered by the criterion II. Thus, this criterion was not considered suitable as an initial step for determining occupational hearing loss. 3. The percentage of workers with NIHL by the criterion III was 45% of the subjects. This percentage was 46.9% of the NIHL by the criterion I and was estimated to cover 3.6% of all noise exposed workers. 4. The percentage of workers with NIHL by the criterion IV was 28% of the subjects, but 37.8% of the NIHL by the criterion III and 70.8% of the NIHL by the criterion I were not covered by the criterion. Therefore, these workers could have been employed in the noisy workplaces. 5. Employed relocation which was one of the post management methods was an option in the criterion I in Korea and in the criterion V in Japan. The number of NIHL by the criterion I was 6.7times greater than that by the criterion V. Thus, although employee relocation was not used exclusively, many more workers with NIHL could have been relocated. In conclusion, this study revealed that the criteria being used for managing occupational hearing loss showed a lack uniformity among them. In addition, since these criteria are all relied on the total threshold shifts caused by the noise exposure at the time of hearing test with no consideration given to the past noise exposure history nor age, it can be said that they are not an effective tool for occupational hearing loss management. Since legal requirements are usually followed after being diagnosed as having NIHL, it is recommended that a uniform diagnostic criterion should be used to minimize confusion. Pre-employment hearing tests should also be utilized so as to managing occupational hearing loss after employment rather than being used as a legal roadblock of prohibiting workers with mild hearing loss from being employed. Thus, what is needed is an establishment of a rational criterion for occupational hearing loss management rather than for legal requirements.