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Accuracy of FDG-PET/CT for Detection of Incidental Pre-Malignant and Malignant Colonic Lesions - Correlation with Colonoscopic and Histopathologic Findings

  • Kunawudhi, Anchisa;Wong, Alexandra K;Alkasab, Tarik K;Mahmood, Umar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4143-4147
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    • 2016
  • Purpose: We evaluated all PET/CTs acquired for patients without a primary diagnosis of colorectal cancer, and compared results for those who had subsequent colonoscopy within 6 months, to assess the accuracy of FDG PET/CT for detection of incidental pre-malignant polyps and malignant colon cancers. Materials and Methods: Medical records of 9,545 patients who underwent F-18 FDG PET/CT studies over 3.5 years were retrospectively reviewed. Due to pre-existing diagnosis of colorectal cancer, 818 patients were excluded. Of the remainder, 157 patients had colonoscopy within 6 months (79 males; mean age 61). We divided the colon into 4 regions and compared PET/CT results for each region with colonoscopy and histopathologic findings. True positive lesions included colorectal cancer, villous adenoma, tubulovillous adenoma, tubular adenoma and serrated hyperplastic polyp/hyperplastic polyposis. Results: Of 157 patients, 44 had incidental colonic uptake on PET/CT (28%). Of those, 25 had true positive (TP) uptake, yielding a 48% positive predictive value (PPV); 9% (4/44) were adenocarcinoma. There were 23 false positive (FP) lesions of which 4 were hyperplastic polyp, one was juvenile polyp and 7 were explained by diverticulitis. Fifty eight patients had false negative PET scans but colonoscopy revealed true pre-malignant and malignant pathology, yielding 23% sensitivity. The specificity, negiative predictive value (NPV) and accuracy were 96%, 90% and 87%, respectively. The average SUVmax values of TP, FP and FN lesions were 7.25, 6.11 and 2.76, respectively. There were no significant difference between SUVmax of TP lesions and FP lesions (p>0.95) but significantly higher than in FN lesions (p<0.001). The average size (by histopathology and colonoscopy) of TP lesions was 18.1 mm, statistically different from that of FN lesions which was 5.9 mm (p<0.001). Fifty-one percent of FN lesions were smaller than 5 mm (29/57) and 88% smaller than 10 mm (50/57). Conclusions: The high positive predictive value of incidental focal colonic FDG uptake of 48% for colonic neoplasia suggests that colonoscopy follow-up is warranted with this finding. We observed a low sensitivity of standardly acquired FDG-PET/CT for detecting small polyps, especially those less than 5 mm. Clinician and radiologists should be aware of the high PPV of focal colonic uptake reflecting pre-malignant and malignant lesions, and the need for appropriate follow up.

Research Review on Turfgrass Insect Pests in Korea (한국의 잔디해충 연구사)

  • Choo, Ho Yul;Lee, Dong Woon
    • Weed & Turfgrass Science
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    • v.6 no.2
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    • pp.77-85
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    • 2017
  • Insect pests have been one of the main constraints affecting turf sod cultivation areas, playgrounds, parks, golf courses, airports and other related recreational grounds. However, turfgrass research has been very limited and confined within a limited period of time compared to other branches of crop science in Korea. This review was surveyed from all papers in KCI (Korea Citation Index), SCI (Scientific Citation Index) and SCIE (SCI Expended) journals related to turfgrass research in Korea. Fifty two papers concerning turfgrass insect pest in Korea have hitherto been published in 8 different scientific journals since 1990. Thirty three papers (63.5% of total) were published in Weed and Turfgrass Science. The main topics of focus were divided into two parts; ecological study and control of insect pests. Before the 1990 decade, there were no scientific papers published in relation to turfgrass insect pest science. However, during the 1990, 2000 and 2010 decades, 9, 10 and 14 papers were published respectively in Weed and Turfgrass Science. From 1997, about 2 papers were published per year in the scientific journals. Thirty three insect pest species belonging to 13 families in 6 orders, one Eriophyidae mite, Aceria zoysia and one Armadillidae sowbug, Armadillidium vulgare, have hitherto been listed as turfgrass arthropod pests in Korea. Fifty percent of turfgrass insect pest papers published were focused on whitegrub, Adoretus tenuimaculatus, Popillia quadrigutta and earthworm research in Korea.

Present Status of Dietetic Internship Program in Korea (우리나라 병원 수련영양사의 교육 프로그램 현황)

  • Kim, Su-Jeong;Im, Hyeon-Jeong;Jo, Yeong-Mi;Lee, Hye-Ok;Jo, Yeo-Won
    • Journal of the Korean Dietetic Association
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    • v.8 no.4
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    • pp.408-414
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    • 2002
  • The purpose of this study was to develop the standardized manual for dietetic internship. The general information of the dietetic internship program in Korea was gathered and of dietetic internship(DI) in the USA was also surveyed. The existence of DI program manual, the number of intern and length of the dietetic internship program, and other general information were investigated. At first, the questionnaire was developed and mailed to 130 hospitals in Korea and the number of returned questionnaires was 42 showing participating rate of 28%. Second, telephone survey was carried out and the number of response was 40 out of 46 participating rate of 87%. The results of this study could be summarized as follow. 1. eneral informations of dietetic internship program in Korea; The hospital having a dietetic internship program was 31.7% and of them 14.6%(12 hospitals) have a manual developed by themselves. The number of dietetic intern per hospital was 2.0$\pm$ 1.4. The length of the program was from 3 to 12 months. Ten hospitals (38.5%) have a only food service program and 16 hospitals (62.5%) have both food service and clinical program. Seventy one percent (58 hospitals) of total hospital were willing to use the well developed standardized dietetic internship manual. 2. eneral information of Dietetic Internship Program in the USA; Two hundred fifty nine hospital had the dietetic internship program approved by ADA. The number of dietetic intern in each hospital was 10.6$\pm$ 6.3. The mean length of the program was 13.6$\pm$ 6.3 months. Twenty seven percent of institution have coordinated internship/masters degree program. The range of tuition for DI program was from 300 to 30,855(otherwise, interns were payed by the hospital in Korea). As a conclusion, the standardized dietetic internship program for the clinical dietitian as nutrition professionals to carry out their job at the hospitals should be developed. And the coordinated internship/masters degree program could be considered to improve the skill levels and job performances of clinical dietitian.

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Development and Clinical Application of Critical Pathways for Vaginal Delivery and Cesarean Section (정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용)

  • Park, Yong Won;Bai, Sang Wook;Jung, Young Nae;Lee, Hae Woo;Kim, Young Ran;Hong, Sun Bok;Park, Heun Ju;Tark, Kwan Chul
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.32-45
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    • 2000
  • Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

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Human Resource Management on Dietitians in Contract-Managed Foodservice Companies (위탁급식 전문업체 영양사의 인력관리 실태조사)

  • Eom, Yeong-Ram;Ryu, Eun-Sun
    • Journal of the Korean Dietetic Association
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    • v.9 no.3
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    • pp.248-258
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    • 2003
  • This study was conducted to identify dietitians' position and role by assessing the present condition on management of human resources in contracted foodservice management company. Questionnaires were distributed to 79 contracted companies (eight large-size, 48 mid-size, 23 small-size companies) from March to May in 2002. Statistical analysis was performed with SPSSwin (version 8.0). The data were analyzed in group comparisons using frequencies and percentage for every item in the questionnaires, $x^2$-test, and oneway ANOVA. About eighty-five percent of contracted foodservice companies employed the new dietitians as full time employees, and seventy-five percent of them were promoted the dietitians by evaluation after a given period of time. As a starting payment for university graduates, large-size companies payed an average of 16,260,000 won/year, which was significantly higher (p<0.01) than those of mid-sized (11,320,000 won/year) and small-sized companies (11,620,000 won/year). The mean lengths of dietitians' service were 33.5 months in large-size companies, 26.5 months in mid-sized companies, 26.0 months in small-sized companies. It was less than 3 years in all companies (avg. 26.9 months). Fifty-four companies (68.4%) employed dietitians in each foodservice contract, whereas 25 companies didn't employ dietitians. The ratios of dietitians out of employees in each department of the companies were 42.6% in the department of contracted foodservice management, 19.9% in the department of menu development, 18.1% in the department of food safety, 8.7% in the department of distribution and purchase, 4.2% in the department of business, and 3.9% in the department of customer satisfaction. The dietitians' positions were directors in two companies (2.5%), general managers in two companies (2.5%), deputy managers in seven companies (8.9%), managers in twenty-nine companies (36.7%), assistant managers/chief clerks in twenty-four companies (30.4%), and chiefs in twenty-five companies (31.6%). The frequencies of training for dietitians were 6.2 times/year for the food safety training, 5.8 times/year for the cooking training, 4.8 times/year for nutrition-related training, and 4.7 times/year for service training.

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Studies on the inhibitory substance of yeast growth - (Part 1) Isolation and biochemical characteristics of yeast growth inhibitor - (항효모성물질(抗酵母性物質)에 관(關)한 연구(硏究) - (제 1 보)(第 1 報) 분리(分離) 및 그 생화학적작용(生化學的作用)과 성질(性質)에 대(對)해서 -)

  • Seu, Jung-Hwn;Kho, Yung-Hee
    • Applied Biological Chemistry
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    • v.15 no.1
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    • pp.19-25
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    • 1972
  • A kind of peptide which posseses an yeaststatic activity was isolated from Astragalus membranaceus Bunge and following characteristics was obtained. 1. The isoelectric pH of this peptide was 8.2 and histidine, an alkaline amino acid, was identified from this peptide. 2. This substance showes conspicuous heat stability and does not indicate any remarkable reduction of yeaststatic activity even for 5 hours treatment at $100^{\circ}C$. or for 30 minutes at $121^{\circ}C$. 3. The inhibitory activity of the yeast growth is not originated from the yeastcidal action but yeaststatic effect of this sample. 4. The sample shows strong stability ranging from pH 2 to 10. 5. The saccharide; glucose, sucrose, maltose, gives no effect on the yeaststatic activity of the sample even high concentration, 15 percent, and also no effect gives by magnesium, calcium and phosphate salts. 6. The available concentration of this sample on the inhibition of yeast growth was located at the ppm extent, for example, the concentration of fifty percent growth inhibition to Saccharomyces cerevisiae or S. carsbergensis was 4 ppm and 3 ppm to Candida pulcherrima, 13 ppm to S. coreanus, 18 ppm to S. sake and 38 ppm to C. tropicalis. 7. On the alcohol fermentation of S. coreanus, the peptide, an yeast growth inhibitor, gives no effect at all. 8. This substance is named as Astradix-P (Astragalus membranaceus, Radix, Peptide).

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A Study on the Defecation Pattern and Lifestyle Factors of Female High School and College Students in Gyeonggi Province (경기지역 여고생과 여대생의 배변양상에 영향을 미치는 생활습관 요인 조사)

  • Lee Jong-Hyun;O Ju-Hwan
    • Korean Journal of Community Nutrition
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    • v.10 no.1
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    • pp.36-45
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    • 2005
  • The aim of this study was to investigate the dietary and lifestyle factors related to bowel pattern of female high school and college students in Gyeonggi Province. The total of 202 self-administered questionnaires (high school students 77 ; college students 125) were analyzed. All respondents were devided into four groups based on their self-reported pattern of defecation: 18 subjects ($9.0\%$) comprised the normal group, 73 ($36.1\%$) the constipation group, 73 ($36.1\%$) the constipation/diarrhea group, and 38 ($18.8\%$) the diarrhea group. Regularity of exercise was significantly higher in the college students than high school students, and times spending on a chair were longer in the high school students than college students. Most students ($72.7\%$) reported that they had stress. Fourty point six percent of the subjects reported that they had 3 meals per day, which tended to be higher in the normal and diarrhea group than constipation and constipation/ diarrhea group. Most students (69.7) skipped breakfast which was lower in the normal group than the other groups. The most preferred dietary fiber food was korean cabbage kimchi. Fifty-eight point four percent of the subjects reported that they had irregular bowel movement. Bowel movement was more irregular in the high school students than college students, and in the constipation group than the other groups. Of the subjects, $77.7\%$ had defecation frequency between three per week and three per day. Those who spent within 10 minutes for defecation were $79.6\%$, and those had difficulty in evacuating were $76.0\%$. High school students and those with constipation and constipation/diarrhea had a significantly lower defecation frequency, longer time spent at the toilet, and greater difficulty in evacuating than college students and normal and diarrhea group. The percentage of those who had feelings of residue in the intestine after defecation was $92.5\%$, and it was greater in the constipation or diarrhea group than in the normal group. Most students ($93.5\%$) reported that they had abdominal pain or discomfort. These results suggest that decreasing times spending on a chair, decreasing stress, keeping 3 meal per day at regular hours, and increasing dietary fiber intake are associated with desirable bowel pattern.

Toxic action of benfuracarb via oxidative bioactivation process by cytochrome $P_{450}$ (Procarbamate계 살충제 benfuracarb의 산화적 활성화 과정을 통한 독성발현)

  • Yu, Yong-Man;Kim, Eun-H.;Kim, Song-Mum;Hur, Jang-Hyun
    • The Korean Journal of Pesticide Science
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    • v.7 no.1
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    • pp.45-50
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    • 2003
  • This study was conducted to understand the role of oxidative enzyme cytochrome $P_{450}$ in the bioactivation of benfuracarb and to know metabolites of benfuracarb by cytochrome $P_{450}$. The bimolecular imhibition rate constant $(k_i)$ of benfuracarb on acetylcholinesterase (AChE) was as low as $1.1{\times}10^3\;M^{-1}\;min^{-1}$, suggesting that benfuracarb should be activated for its toxic action. The potency of benfuracarb on AChE in the oxidase system (cytochrome $P_{450}$ + NADPH) in vitro was 10-fold higher than that of control (cytochrome $P_{450}$). Such a similar result was also found in the oxidase + PBO system. In vivo the $I_{50}$ of benfuracarb was 22.7mg $kg^{-1}$, but pie-treatment of piperonyl butoxide (PBO) reduced the $I_{50}$ by >100mg $kg^{-1}$. This result suggests that cytochrome $P_{450}$ was involved in the activation of benfuracarb. Using microsomal oxidase system, metabolites of benfuracarb were elucidated. Fifty-eight percent of benfuracarb was converted to carbofuran, a major toxic metabolite, in the oxidase system, while only less than two percent of benfuracarb was converted to carbofuran in the oxidase + PBO system. These results also suggest that cytochrome $P_{450}$ was involved in the activation of benfuracarb. Overall results indicate that cytochrome $P_{450}$ could be involved in the bioactivation of benfuracarb to carbofuran.

A Study on Every possible Correlation between Daily Food Intake and Growth Rate of Senior High School Students (고등학생(高等學生)의 영양섭취실태(營養攝取實態)와 성장발육(成長發育)에 관(關)한 연구(硏究))

  • Lee, Hyun-Ok;Kim, Sook-He
    • Journal of Nutrition and Health
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    • v.6 no.3
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    • pp.27-36
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    • 1973
  • The primary purpose of this research paper is to study the nutrition intake status of high school students and their physical growth and development. Further, it made an attempt to find and define nutritional problems and assist in their growth and development through proper nutritional management. One hundred students in both sexes, first year grade in senior high school were provided with questionnaires. For six days the respondents filled out the questionnaires. They were asked to keep record of what they ate each meal. Their nutritional intake were analyzed in accordance with what they ate. Findings, conducted on percentage, CR test, t test, and F test, were as follows: 1. For the living circumstance a) Average numbers of brother and sister in sampled family were four. b) Seventy to eighty percent of the students were brought up by mother's milk at their infants and approximately 40% of students were weaned at the age of 7 to 18 months. c) Fifty percent of the respondents revealed irregulity in their meal time. d) Monthly average expenditure for daily food reached $20{\sim}40%$ out of total income. e) The most favorite foods reflect as follows: The most favorite main dish is boiled rice and side dish beaf. Fruits. juice, milk, ice cream are more popular snack among whole students. 2. Nutrition survey a) Calory sad nutrients were found to be below the recommended level, especially in calcium, vitamins A, $B_2$ and C. b) The total calory intake were composed of 73% from carbohydrate, 14% from protein and 13% from fat in the case of boys. The girls were 65%, 14%, 21% respectively. c) Both boys and girls in their animal protein intake averaged about 33% out of total protein intake. d) Meat consumption of the majority respondents were proportionate in $10{\sim}20%$ in their total food consumption. 3. The result of statistical analysis were as follows: a) Statistical significant differences in the relationship between the calory intake and physical growth index were observed at the level of p<0.05. b) Statistical significant differences in the relationship between the protein intake and physical growth index were observed at the level of p<0.05. c) Statistical significant differences in the relationship between meal time and physical growth index were observed at the level of 0.02<0.05. d) No statistical significant differences in the relationship among calory, protein intake and school records as well as intelligence were found. The experiment indicated that there is a direct relationship between nutrition and the physical growth and development, whereas There seems to be an indirect relationship between nutrition and intelligence.

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Incidence and Clinical Characteristic of Venous Thromboembolism in Gynecologic Oncology Patients attending King Chulalongkorn Memorial Hospital over a 10 Year Period

  • Oranratanaphan, S;Termrungruanglert, W;Khemapech, N
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6705-6709
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    • 2015
  • Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.