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Pretherapy 18F-FDG PET/CT in Predicting Disease Relapse in Patients With Immunoglobulin G4-Related Disease: A Prospective Study

  • Mei-Fang Cheng;Yue Leon Guo;Ruoh-Fang Yen;Yen-Wen Wu;Hsiu-Po Wang
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.590-598
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    • 2023
  • Objective: To investigate whether the levels of inflammation detected by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) can predict disease relapse in immunoglobulin G4-related disease (IgG4-RD) patients receiving standard induction steroid therapy. Materials and Methods: This prospective study analyzed pretherapy FDG PET/CT images from 48 patients (mean age, 63 ± 12.9 years; 45 males and 3 females) diagnosed with IgG4-RD between September 2008 and February 2018, who subsequently received standard induction steroid therapy as the first-line treatment. Multivariable Cox proportional hazards models were used to identify the potential prognostic factors associated with relapse-free survival (RFS). Results: The median follow-up time for the entire cohort was 1913 days (interquartile range [IQR], 803-2929 days). Relapse occurred in 81.3% (39/48) patients during the follow-up period. The median time to relapse was 210 days (IQR, 140-308 days) after completion of standardized induction steroid therapy. Among the 17 parameters analyzed, Cox proportional hazard analysis identified whole-body total lesion glycolysis (WTLG) > 600 on FDG-PET as an independent risk factor for disease relapse (median RFS, 175 vs. 308 days; adjusted hazard ratio, 2.196 [95% confidence interval: 1.080-4.374]; P = 0.030). Conclusion: WTLG on pretherapy FDG PET/CT was the only significant factor associated with RFS in IgG-RD patients receiving standard steroid induction therapy.

A study on Huh-Joon's medical thoughts in Dong-Eui-Bo-Kham (동의보감(東醫寶鑑)을 통한 허준의 의학사상에 관한 고찰)

  • Kwon, Hak-Cheol;Park, Chan-Guk
    • Journal of Korean Medical classics
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    • v.6
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    • pp.89-130
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    • 1993
  • Huh-joon's medical thoughts shown on his medical book of the Doog-Eui-Bo-Kham can be summerized as follows. 1. The general trend of medical science in Koryo dynasty is that much more interests were concentrated upon the books about curative means rather than upon the books about theoretical knowledge of medical science. With the development of Hyang Yak(鄕樂) (the term referring either various kinds of domestic medical stuffs such as herbs or the curative methods using those stuffs) and the writing of books on Hyang Yak, independent medical science of the nation's own was established in late Koryo dynasty. And the national medical science was continuously further developed until early Choson dynasty. Briskly-expanded mutual exchanges with China in early Choson dynasty provided Choson opportunities to import Chinese medical science and to examine it. Under this circumstances, he wrote the Dong-Eui-Bo-Kham. 2. As we look over the preface and Chip-Rae-Muo(集例文), we can find the characterstic of Doog-Eui-Bo-Kham is that the philosophical theory of Taoism was quoted in explaining the principles of his medical science and that the main idea of Naekyuog is the basis in explaining the way of curing diseases. 3. 83 kinds of medical books were quoted in the Doog-Eui-Bo-Kham. Besides, as many as 200 kinds of books including Tao-tzu's teaching books(道書), history books(史書), almanac(曆書), and Confucius' teaching books(儒家書籍) were quoted in total. Naekyuog and Eue-Hak-Ip-Mun, Dan-Kye-Sim-Bup were the most frequently quoted books among them. 4. Huh-Joon's medical thoughts about health care were like these. 1) The reason why Huh-Joon regarded the idea of health care as of great importance was that he laid much more emphasises on the preventive medicines rather than on the remedial medicines. The direct reason was that he was greatly influenced by profound knowledge of Taoist's study of discipline and who participated in the editing the books from the beginning. 2) Huh-Joon's outlook on human body started from the theory of "Unity of Heaven and Man"(天人合一論), which implied man was a kind of miniature universe. In addition to that, he largely theory of essence(精), vital force(氣), and spirit(神) which were regarded very important as the three most valuable properties in Taoism. However, he took his medical ground on practical and pragmatic idea that he did not discuss fundamental essence(元精), fundamental vital force(元氣), and fundamental spirit(元神) which were given by Heaven from the received only the theory of essence, vital force, and spirit which were acquired after birth and worked mainly on realistic activity of life. 3) Huh-loon accepted Do-In-Bup(導引法) sharply as a method to prevent and cure diseases. 5. Huh-loon's medical thoughts on remedial aspects are as 1) Naekyung was considered so important in Dong-Eui-Bo-Kham that not only each paragraph was begun with the Quotations from Nackyung but also the edited order of the content of the book the same with that of Naekyung. And differently from the former korean medical books he accepted at large and recorded the theories of the four noted physicians of the Geum-Won era(金元四大家) by Dong-Eui-Bo-Kham. 2) For the first time, Huh-Joon introduced the theory of Un-Ki (運氣論) in the Dong-Eui-Bo-Kahm. However, he accepted it as a pathological function of human body but he did not apply physical constitution, physiological function, pathological function, and remedial methods. 3) Huh-loon liked to use Hyang Yak that he recorded korean name of Hyang Yak(鄕名), places of the production(産地), the time of collecting(採取時月), and the way of drying herbs(陰陽乾正法) in the remedial method of a single medicine prescription for diseases at the end of each paragraph. By doing so, he developed, arranged, and revived Hyang Yak. 4) He believed that since the natural features of China were different from those of Korea the reasons of being attacked with its remedial methods couldn't be the same with different from Chinese medical books which primarily focused on paralysis and the injury of the cold has his own structure in his book that he founded independent science of this nation. He consulted enormous documents He discovered and wrote the theory and therefore concrete methods for diseases so that the book hadthe principles of outbreak of diseases(理), methods of cure(法), prescription(方), and a single medicine prescription(藥) and set system of medical science in a good order. By doing so, he and pragmatic development of medical science.

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Comparisons of Cardiovascular Disease Risk Factors and Sarcopenia-related Factors according to Physical Activity Levels in Basic Livelihood Security Recipients Elderly Women (기초생활보장수급 여성노인의 신체활동수준에 따른 심혈관질환 위험요인 및 근감소증 관련요인의 비교 분석)

  • Hwang, Eun-Jin;Hong, JeeYoung;Park, Joonkyu;Kim, Jeongeun;Kim, Sukwha;Kong, Hyoun-Joong
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.507-516
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    • 2013
  • The purpose of this study is to identify physical activity levels of the basic livelihood security recipients elderly women, to investigate relation between cardiovascular disease risk factors and sacrcopenia based on the levels, and to develop physical activity programs for healthy life of the elderly. The subjects of this study were 134 old females with $71{\pm}6.67$ years old who used senior centers in K-gu. The authors used the International Physical Activity Questionnaire for investigating the physical activity levels of the elderly, measuring their physical activity levels for seven days on average and classifying them into two groups, the Low Physical Activity (n=77) and the Moderate Physical Activity (n=57) groups based on the levels. Blood pressure, waist measurement, TC, HDL-C, LDL-C, TG, Glucose, and atherogenic index (AI) were measured as the cardiovascular disease risk factors; percent body fat, appendicular skeletal muscle mass, total muscle mass, and skeletal muscle index were measured as factors related to sarcopenia. Independent samples t-Test was conducted to analyze differences on the two groups based on the physical activity levels, with ${\alpha}=.05$ the as significance level. According to the results, HDL (p=.017) were higher and AI (p=.007) was lower; percent body fat (p=.008) was lower, and ASM (p=.000), total muscle mass (p=.000), and SMI (p=.001) were higher. In conclusion, moderate intensity physical activities rather than low intensity ones may have positive effects on the cardiovascular disease risk factors and sarcopenia levels, and participation in regular physical activities with at least moderate intensity by various methods may be needed for prevention of illness and healthy life of the elderly.

Assessment of nutritional status of patients with chronic obstructive pulmonary disease (만성 폐쇄성 폐질환 환자의 영양상태 평가)

  • Park, Kwang Joo;Ahn, Chul Min;Kim, Hyung Jung;Chang, Joon;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.93-103
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    • 1997
  • Background : Malnutrition is a common finding in patients with chronic obstructive pulmonary disease, especially in the emphysema group. Although the mechanism of malnutrition is not confirmed, it is believed to be a relative deficiency caused by hypermetabolism due to increased energy requirements of the respiratory muscles, rather than a dietary deficiency. Malnutrition in chronic obstructive pulmonary disease is not a merely coincidental finding. It is known that the nutritional status correlates with physiologic parameters including pulmonary function, muscular power, and exercise performance, and is one of the important and independent prognostic factors of the disease. Methods : Patients with chronic obstructive pulmonary disease Yongdong Severance Hospital from May, 1995 to March, 1996 and age-matched healthy control group were studied. Survey of nutritional intake, anthropometric measurements and biochemical tests were done to assess nutritional status. Relationship between nutritional status and FEV1 (forced expiratory volume at one second), which was a significant functional parameter, was assessed. Results : 1) The patient group was consisted of 25 males with mean age of 66.1years and FEV1 of $42{\pm}14%$ of predicted values. The control group was consisted of 26 healthy males with normal pulmonary function, whose mean age was 65.0 years. 2) The ratio of calorie intake/calorie requirement per day was $107{\pm}28%$ in the patient group, and $94{\pm}14%$ in the control group, showing a tendency of more nutritional intake in patient group(B=0.06). 3) There were significant differences between the patient group and control group in percent ideal body weight(92.8% vs 101.6%, p=0.024), body mass index($20.0kg/m^2$ VS $21.9kg/m^2$, p=0.015), and handgrip strength(29.0kg vs 34.3kg, p=0.003). However, there were no significant differences in triceps skinfold thickness, mid-arm muscle circumference, albumin, and total lymphocyte count between two groups. Percentage of underweight population was 40%(10/25) in the patient group, and 15%(4/26) in the control group. 4) The percent ideal body weight, triceps skinfold thickness, and mid-arm muscle circumference had significant correlation with FEV1. Conclusion : The patients with chronic obstructive pulmonary disease showed significant depletion in nutritional parameters such as body weight and peripheral muscle strength, while absolute amount of dietary intake was not insufficient. Nutritional parameters were well correlated with FEV1.

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A Study on Cinematic Representations of Posthuman Girls in South Korea-Focused on The Silenced and The Witch: Part 1. The Subversion (한국 영화에 나타난 포스트휴먼 소녀의 재현 양상 연구 -<경성학교: 사라진 소녀들>, <마녀>를 중심으로)

  • Kim, Eun Joung
    • Journal of Popular Narrative
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    • v.27 no.3
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    • pp.95-124
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    • 2021
  • As the symbolic images of girls besides its definition have varied according to the age and society, a posthuman girl character recently appears in the digital cinema. This study aims to analyze its cinematic representations and the social contexts in which they are created. For this purpose, the study focuses on what extent the society allows its imagined figurations as a future female body and the meanings revolving around the image of 'technologically body-enhanced female fighter'. Current digital visualization technology has developed to the extent any imaged future humans can be represented, but posthuman girls' representations have its limitation that only a human-like figuration can be allowed in accord with the traditionally idolized image of girls. It is because of the representation logic in which digital cinema is visualized based on perceptual realism that values audiences' experiences. Despite such less critical figuration which does not dare to cross the boundary between the image of human and inhuman, the posthuman girl characters create a new category of the 'dangerous girls' who are both void of sexual femininity and independent of motherhood and heterosexual romance narrative. Of course, they support the modern human-centered belief that humans can take entire control of technology with their moral behaviors and dispel the fear about the negative impact the nature of technology may have on society at large by showing their child-like figuration protecting ethical values. However, the new character of 'unruly girl' exerts her subversive act that seeks to fight against the human-centered liberal humanistic values and melancholic feeling and vulnerability that the neoliberalism and technocracy enforce. When posthuman girl characters are considered to be a marker through which we can see how different social forces are intervening and competing each other in the upcoming posthuman age, the limited figuration of the posthuman girl characters in South Korean movies illustrates the opinionated thoughts toward the instrumentalism in technology but their bloodshed struggles reveal how the corporate or state-governed techno-biopower has oppressively treated and appropriated the human body as the technology-object and also provide a meaningful opportunity to rethink its unethical violence.

Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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Pulse wave velocity and ankle brachial index in normal adolescents (정상 청소년에서 맥파 속도와 발목 상완 동맥압 지수에 대한 연구)

  • Kim, Ji Hye;Gil, Tae Young;Lee, Hee Woo;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.549-555
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    • 2007
  • Purpose : Pulse wave velocity (PWV) and ankle brachial index (ABI) are simple, non-invasive methods to assess arterial stiffness. These parameters are also known to be closely related to cardiovascular risk factors and diseases. The purposes of this study were to measure blood pressure, PWV, ABI in healthy Korean adolescents, set up their normal values and assess their correlations. Methods : Three hundred ninety two healthy adolescents (213 boys and 179 girls) underwent measurement of brachial ankle pulse wave velocity (baPWV), ABI, body mass index(BMI) and blood pressure from four extremities. Linear regression analysis was performed to reveal the correlations between PWV, ABI and independent variables. Results : Blood pressure and PWV were significantly higher in all extremities in males compared to females. Blood pressure of both brachial and ankle showed positive correlation with body weight, height, and BMI, whereas ABI showed no correlation with any of these indices. Conclusion : Blood pressure increases as body weight, height and BMI increases. PWV shows positive correlation with blood pressure. It will be helpful to predict the risks of cardiovascular diseases in adolescents.

Can the Sasang Constitutional Type Trait Act as an Independent Risk Factor for Dyslipidemia? (사상체질이 이상지질혈증의 위험인자가 될 수 있는가?)

  • Lee, Jiwon;Jang, Hyunsu;Park, Byungjoo;Lee, Euiju;Koh, Byunghee;Lee, Junhee
    • Journal of Korean Medicine for Obesity Research
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    • v.14 no.2
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    • pp.63-71
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    • 2014
  • Objectives: This study was designed to investigate the correlation between Sasang constitution and dyslipidemia and the possibility that Sasang constitution can be a risk factor of dyslipidemia. Methods: This study was a retrospective cross-sectional study based on chart review. Seventeen thousand sixty-nine charts which were collected from May 2007 to June 2010 in International Healthcare Service Center, Kyung Hee University Medical Center, were reviewed for the study. Fifteen thousand two hundred fifty charts including Sasang constitutional diagnosis and lipid profiling were selected and we examined the correlation between Sasang constitution and dyslipidemia. Results: After adjusted for body mass index, the levels of total cholesterol and triglyceride were highest in Taeeum group, and lowest in Soeum group. High-density lipoprotein was highest in Soeum group, and lowest in Taeeum group. After adjusted for age, sex, and body mass index, the odds ratios for 'high triglyceride' were 1.716 (1.411~2.087) in Soyang group and 2.021 (1.650~2.475) in Taeeum group compared to Soeum group. The odds ratio for 'high low-density lipoprotein' was 1.229 (1.006~1.501) in Soyang group compared to Soeum group. The odds ratios for 'low high-density lipoprotein' were 1.195 (1.033~1.381) in Soyang group and 1.414 (1.212~1.649) in Taeeum group compared to Soeum group. Conclusions: The lipid profiles and dyslipidemic risk differed across constitutional types, showing constitution type-specific patterns, so that we could infer the possibility that Sasang constitutional types can be a risk factor of dyslipidemia.

The Study for the Relationship of Weight Loss with Plasma Leptin and TNF-α Level in Patients with Chronic Bronchitis and Emphysema (만성기관지염과 폐기종 환자에서 체중감소와 혈중 Leptin 및 TNF-α와의 관계에 대한 연구)

  • Pack, Jong Hae;Park, Ji Young;Park, Hye Jeong;Baek, Suk Hwan;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.199-209
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    • 2003
  • Background : Unexplained weight loss, which commonly occurs in patients with chronic obstructive pulmonary disease(COPD), is important because weight loss is an independent risk factor of mortality and morbidity in these patients. Leptin is known to play an important role in regulating body weight. In addition, the tumor necrosis factor($TNF-{\alpha}$) might also play a potential role in the weight loss experienced in chronic wasting disease. The aim of this study was to determine the influence of plasma leptin and the circulating $TNF-{\alpha}$ system to the difference in the body compositions in patients with COPD. Methods : Spirometry, body composition analysis and the plasma concentrations of leptin, $TNF-{\alpha}$ and a soluble TNF receptor (STNF-R55, -R75) were measured in 31 patients with chronic bronchitis and 10 patients with emphysema. The COPD subtype was classified by the transfer coefficient of carbon monoxide, DLco/VA. Results : The circulating levels of leptin were significantly lower in those patients with emphysema($108.5{\pm}39.37pg/ml$) than those with chronic bronchitis($180.9{\pm}57.7pg/ml$). The circulating levels of sTNF-R55 were significantly higher in the emphysema patients($920.4{\pm}116.4pg/ml$) than in those with chronic bronchitis($803.2{\pm}80.8pg/ml$). There was no relationship between the circulating leptin levels and the activated TNF system in patients with chronic bronchitis and emphysema. However, the circulating leptin levels correlated well with the BMI and fat mass in both patient groups. Conclusion : These results suggest that the weight loss noted in emphysema patients may be associated with the activation of the $TNF-{\alpha}$ system rather than the plasma leptin level.

Efficacy of fumagillin against Telohanellus kitauei Infection of Israel carp, Cyprinus carpio nudus (향어의 장포자충증에 대한 Fumagillin의 예방 및 치료 효과시험)

  • Lee, Jae-Gu;Kim, Hyeon-Cheol;Park, Bae-Geun
    • Parasites, Hosts and Diseases
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    • v.31 no.1
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    • pp.57-66
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    • 1993
  • The potential of fumagillin dicyclohexylamine salt to treat and prevent intestinal giant-cystic disease in Israel carp, Cyprinus carpio nudus, was monitored in field experimental studies. In experiment 1 (therapeutic), most fish were already naturally infected with more advanced stage of Relohqnellu: kitnuet. Fumagillin was administered to ash (mean body weiht of 830 g for a Penod of one month at a dose of 10.62 mg in the first group and 5.3 mg in the second group per fi sh per day. In experiment 2 (fprophylactlcl), most flesh also were already naturally infected with an early developmental stage of the protozoa and fish (average body weight of 484 g) were administered fumagillln for 45 days at a dose of 3.95 mg per fish per day. In both experiments, the cumulative mortalities of fish and the extrusion rates of the polar filaments of the spores were significantly decreased in a dose-independent fashion. In experiment 2 no dead fish were observed. No adverse side effects of the drug were observed among fish from any dosage group. In experiment 2, an oval or dot-like concave lesion of most cysts developed at the 7th day and the vegetative form was never observed at the 17th day postmedication and the cysts were grossly reduced in size as compared with the control group, beginning at the 24th day until the end of the study. In contrast, it was scarcely effective to the cysts in experiment 1. Taking the seasonal development of the protozoa into consideration, the above results revealed that oral administration of fumagillin at 3.95 mg/500 g body weight/day for a month Is the optimal dose for the treatment and prevention of thelohanellosls caused by T kitnuei among C. carpio nudus.

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