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Quantitative Analysis of $^{99m}Tc$-MIBI Scan for Localization of Parathyroid Lesions (부갑상선 신티그라피를 시행한 환자들의 병소 국소화에 따른 후향적 분석연구)

  • Lee, Moo-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.76-80
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    • 2009
  • Purpose: The uptake of $^{99m}Tc$-MIBI increases in the parathyroid adenoma, hyperplasia, and carcinoma. The purpose of this study is to evaluate and compare the results of the biopsy with quantitative analysis results in the localized parathyroid lesions (adenoma, hyperplasia, and carcinoma). Materials and Methods: From April 2002 to January 2009, double-phase $^{99m}Tc$-MIBI parathyroid scan (early 15 min, delayed 2 hrs) was performed after injection of 750 MBq of $^{99m}Tc$-MIBI in 27 diagnosed parathyroid patients (adenoma:15, hyperplasia:4, carcinoma:8). For quantitative analysis, early, delayed lesion to non-lesion ratios (L/NLs), washout rate (%, WR) and vertical axis were calculated. Results: In early images, lesion to non-lesion ratios were $1.53{\pm}0.41$ (adenoma), $1.38{\pm}0.27$ (hyperplasia) and $1.45{\pm}0.64$ (carcinoma). In delayed images, lesion to non-lesion ratios were $1.56{\pm}0.43$ (adenoma), $1.33{\pm}0.10$ (hyperplasia), $1.83{\pm}0.79$ (carcinoma). In vertical axis, the sizes were $2.11{\pm}0.67$ (adenoma), $2.23{\pm}0.75$ (hyperplasia) and $2.20{\pm}0.97$ (carcinoma). There was no statistical difference between lesion to non-lesion ratios and the size of vertical axis (p>0.05). However, washout rates were $31.59{\pm}13.97$ (adenoma), $37.8{\pm}5.69$ (hyperplasia), $17.73{\pm}11.02$ (carcinoma). As a result, there was a significant difference statistically between and that of carcinoma (p<0.05, p=0.028 by Kruskal-willis statistic, Dunn's Multiple comparison test SPSS Ver 12.0). Conclusions: There was no statistical difference between the lesion to non-lesion ratios and the size of vertical axis. However, there was a significant difference statistically between WR of hyperplasia and that of carcinoma.

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Improvement of the Result Related to Tumor Marker Test Through the OCS QC Program (OCS QC 프로그램을 통한 건진 센터 종양검사의 결과보고 개선)

  • Back, Song-Ran;Kim, Sung-Ho;Yoo, So-Yeon;Kim, Nyun-Ok;Moon, Hyoung-Ho;Yoo, Seon-Hee;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.185-188
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    • 2009
  • Purpose: Standard of retests were discrepant and inconsistent due to inaccuracy and lack of standardization within normal range limit of tumor marker test. To enhance the standardization of retests set standard value below normal range and the Order Communication System Quality Control (OCS QC) program was put in place. This program enables managing the results within lower limit of normal range which were used for tumor marker test in Health Center. Materials and Methods: At present the tumor marker study for AFP, CEA, CA19-9, CA125, and PSA included outpatients in Asan Medical Center from February to March, 2009. The standard value was obtained by using the percentage of CV of Inter Assay according to the normal range of each tumor test. The results were confirmed by using the OCS QC program via formatted assessment of screening test such as test items, standard value and medical department. The number of out-of-range results within plus and minus 30 percents regarding the five primary items of tumor marker test was assessed. The next step was to obtain the number of AFP, CEA, and CA125 according to the ratio of comparison between prior and post test result, 60%, 50%, and 40% within normal range, respectively. In addition, set standard value below normal range. Results: The first screening test with percentage of sample number was resulted between 30%-40% and the second one was AFP 26.1%, CEA 18.9%, CA19-9 17.3%, CA125 18.7%, and PSA 21.0% obtained screening percentage of average 20 percents. The limited value of retest was AFP less than 5.0 and more than 10.0, CEA less than 1.0 and more than 3.0, CA19-9 less than 10.0 and more than 30.0, and PSA less than 1.0 and more than 2.0 to set and the number of retest was obtained by applying to the limited value of retest to screening percentage of average 20 percents For two months, the number of retest was AFP 0, CEA 15, CA19-9 3, CA125 2, and PSA 5. Conclusions: Through using the OCS QC program in establishing the standard of retest systemically, there appeared to be reduced discrepancy among the examiners and to be expected improvement in relation to the error of results.

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Comparison of Glomerular Filtration Rate Using Gates Method and Serum Creatinine (Gates 방법과 혈청 크레아티닌을 이용한 사구체 여과율의 비교)

  • Yun, Jong-Jun;Lee, Hyo-Yeong;Lee, Hwa-Jin;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.61-66
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    • 2009
  • Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age $51.3{\pm}16.9$) with various renal function were examined. we compared the GFR using $^{99m}Tc$-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and $^{99m}Tc$-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with $3.0{\pm}3.1\;mg/dL$, In patients with normal renal function (Scr<1.5 mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5$^{99m}Tc$-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, $^{99m}Tc$-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.

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The Change of the Fracture Risk by a Fracture Risk Factor in the FRAX Tool (FRAX Tool에서 골절위험인자에 따른 골절위험도의 변화)

  • Song, Hyeon-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Moo-Seok;Park, Sae-Yoon;Jeong, Ji-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.132-136
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    • 2009
  • Purpose: WHO(world health organization) announced the FRAX Tool(fracture risk assessment) of new software in the beginning of 2008. FRAX Tool was considered various risk factor, being different from existing fracture risk. In this study, we wanted to know the fracture risk of following the changing of the risk factor of fracture. Materials and Methods: A total of 50 women aged 50~60 were studied. We measured BMD at the part of femur neck which was based on the age, weight, height of individual with GE, Lunar-prodigy. The control group is fracture risk without considering fracture risk factor. The experimental group is previous fracture, parent fracture, current smoking, glucocorticoid, rheumatoid arthritis, secondary osteoporosis, alcohol. if each items makes one 'existence', others are all 'nothing'. and the results produced major osteoporotic region and hip fracture risk in 10-years. Statistics used t-test of SPSS 12.0. Results: The average rate of increment of major osteoporotic region between control group and experimental group, previous fracture-74% increase, parent fracture-96% increase, current smoking-2% increase, glucocorticoid-61% increase, rheumatoid arthritis-29% increase, alcohol-20% increase, secondary osteoporosis-0.18% decrease. The average rate of increment of hip region between control group and experimental group, previous fracture-84% increase, parent fracture-5% increase, current smoking-72% increase, glucocorticoid-84% increase, rheumatoid arthritis-40% increase, alcohol-52% increase, secondary osteoporosis-1.69% decrease. Conclusions: Each fracture risk factor has different rate of increment between major osteoporotic and hip region while in occasion of the second osteoporosis it has little relation because of low P-value. We could know that a contribution of the risk factor is different between major osteoporotic and hip region.

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Studies on the Comparative Analysis Between GE Prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool (골절의 절대위험도 평가방법에서 GE Prodigy와 FRAX Tool의 비교분석에 관한 고찰)

  • Lee, Hwa-Jin;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.137-142
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    • 2009
  • Purpose: World Health Organization (WHO) have suggested that an individual's 10-year absolute fracture risk is more reliable than Bone Mineral Density (BMD) measurement as the predictor of osteoporotic fracture. In 2008, Fracture Risk Assessment Tool ($FRAX^{TM}$) was developed by WHO to evaluate fracture risk of patients based on individual's clinical risk factors. The purpose of this study is to offer the comparative analysis of the existing GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Materials and Methods: 201 women ($55{\pm}3.5$ years) underwent femoral neck BMD measurement using GE Prodigy. The 10-year probability (%) of hip fracture (or a major osteoporosis-related fracture) was estimated using T-scores of GE prodigy and $FRAX^{TM}$. We made a comparative analysis of these data using SPSS (Ver.12). Results: There was a significant difference statistically between T-score ($-0.52{\pm}0.97$) of GE prodigy and T-score ($-1.45{\pm}0.81$) of $FRAX^{TM}$ (r=0.977, p=0.000). Also, there was a significant difference statistically between a major osteoporosis- related fracture ($9.15{\pm}3.71$) of GE prodigy and a major osteoporosis-related fracture ($4.87{\pm}1.51$) of $FRAX^{TM}$ (r=0.909, p=0.000). Moreover, a statistically significant difference was found in the 10-year probability of hip fracture of GE prodigy ($1.56{\pm}1.48$) and of hip fracture ($0.53{\pm}0.61$) of $FRAX^{TM}$ (r=0.905, p=0.000). Conclusions: There was a significant difference statistically between GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Especially, T-score, a major osteoporosis-related fracture and the 10-year probability of hip fracture that were estimated using GE prodigy tended to show the higher results than one evaluated by $FRAX^{TM}$ Tool. In conclusion, $FRAX^{TM}$ Tool may provide a better tool. The application of $FRAX^{TM}$ Tool as a fracture predictor remains to be clarified.

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Reconstruction of Anterior Cruciate Ligament in Adolescent (청소년기에 시행한 전방십자인대 재건술)

  • Song Eun Kyoo;Shim Sang Don;Kim Hyung Jong;Kim Hyung Won
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.101-108
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    • 2002
  • Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

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Downregulatory Effect of Extracts from Mistletoe (Viscum album) and Pueraria Root (Pueraria radix) on Cellular NF-κB Activation and heir Antioxidant Activity (겨우살이(Viscum album)와 칡뿌리(Pueraria radix) 추출물의 NF-κB활성 억제 및 항산화 효과)

  • Song, Hee-Sun;Park, Yeon-Hee;Kim, Seung-Kyoon;Moon, Won-Kuk;Kim, Dong-Woo;Moon, Ki-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.10
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    • pp.1594-1600
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    • 2004
  • Effects of mistletoe (Viscum album) extract and pueraria (Pueraria radix) extract on cellular NF-$textsc{k}$B activity were evaluated in human malignant keratinocytes (SCC-13) to elucidate the possible correlation of NF-$textsc{k}$B with antioxidant activity. The antioxidant activities of these natural extracts were examined in four different evaluation methods, i.e., lipid peroxidation value (POV) evaluation test, I,l-diphenyl-2-picrylhydrazyl radical (DPPH), nitric oxide (NO) scavenging test, and reducing power assay. Pueraria extract (0.5 mg) and mistletoe extract (5 mg) downregulated the cellular NF-$textsc{k}$B activation up to 35% and 10% compared to the control, respectively, although their effects were lower than the known NF-$textsc{k}$B downregulator, vitamin C (8.8 mg, 53%) in a cell-based NF-$textsc{k}$B activity assay system. In the POV test, relative antioxidant activities of mistletoe extract (86%) and pueraria extract (75%) were significantly higher than the known antioxidant, vitamin C (48%) at the same concentration (10 mg) and the degree of activity increased in a dose-dependent manner. Pueraria extract showed more potential radical scavenging activities than those of mistletoe extract evaluated in both DPPH and NO test. Especially, the NO radical scavenging activity of pueraria extract ($SC_{50}$/, 88 $\mu$g) was comparable to that of vitamin C ($SC_{50}$/, 77 $\mu$g). Even pueraria extract possessed a much less reducing power compared to vitamin C, it also revealed higher reducing power than that of mistletoe extract. These results indicate that mistletoe extract and pueraria extract may serve as an useful natural antioxidant agents, and led to suggest the hypothesis that compounds having an antioxidant activity, i.e., radical scavenging activity or reducing power may be correlated with the downregulation of NF-$textsc{k}$B activation in human keratinocytes.

The Study on the Contents and Satisfaction of Oriental Medicine Examination Program (한방건강검진 프로그램의 내용과 참가자들의 만족도에 관한 연구)

  • Lee Eun-Kyoung;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.51-95
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    • 2002
  • 1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

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STUDIES ON THE PROCESSING AND UTILIZATION OF SARDINE PROTEIN CONCENTRATE (정어리 분말단백질 가공 및 이용에 관한 연구)

  • Lee Eung-Ho;Park Yeung-Ho;Pyeun Jae-Hyeung;Kim Se-Kweun;Yang Sung-Tack;Song Yeung-Ok
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.11 no.1
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    • pp.25-37
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    • 1978
  • Since 1976 the catches of sardine increased rapidly in Korea. However due to the poor facilities of preservation, most sardine landed was used only for fish meal as feeds. The aims of this study are to investigate the processing of sardine as a protein. concentrate and to solve related problems under our particular circumstances. Using the ethyl alcohol and isopropyl alcohol, the storage effect for further processing, the optimum processing conditions of sardine protein concentrate and amino acid composition of the product were determined. The utilization of sardine protein ,concentrate as a supplement of bread and noodles was also studied. Chopped sardine meat could be stored in isopropyl and ethyl alcohol without significant deterioration as a raw material for tile further processing. High qualify sardine Protein concentrate could be produced by the method, that is five times five minutes extraction with isopropyl or ethyl alcohol at $80^{\circ}C$ under adequate mixing. In the first step of the extraction, the solvent was added as much as 10 times tile sample amount and the equal volume of additional solvent was also used for the second to fifth step extraction. In the products extracted using isopropyl alcohol and ethyl alcohol, the yields of sardine protein concentrate were $21.2\%$ and $20.3\%$ respectively, and the dry basis contents of protein in the two products were $80.5\%$ and $75.8\%$, the lipid being $0.22\%$ and $0.27\%$ respectively. Isoproyl alcohol was superior to superior alcohol for the extraction of fresh sardine. In amino acid composition of sardine protein concentrate, no difference was found between the products of isopropyl and ethyl alcohol extraction except a little difference in the amount of amino acid between them. In the supplementation of bread and noodles, taste panel showed that supplemented bread and noodles were well accepted when $3\%$ of wheat flour was replaced by sardine protein concentrate.

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Antibacterial Effect of Cinnamon (Cinnamomum cassia) Bark Extract against Fish Pathogenic Bacteria (계피 추출물의 어류 질병 세균에 대한 항균 효과)

  • MOK Jong-Soo;SONG Ki-Cheol;CHOI Nack-Joong;YANG Ho-Shik
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.5
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    • pp.545-549
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    • 2001
  • To develop a natural antibacterial agent for fish bacterial diseases, antibacterial activity, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and bactericidal effect of cinnamon bark extract were examined against fish pathogenic bacteria. The antimicrobial effect of the extract to the fish diet was also estimated, Cinnamon bark extract showed the broad spectrum of antibacterial activity against fish pathogenic bacteria, especially, it had strong activity against Streptococcus iniae, Edwardsiella tarda and Listonella anguillarum. Its MIC was $75.8\sim189.6{\mu}g/mL$ against Cram positive bacteria, and $75.8\sim113.8{\mu}g/mL$ against Gram negative bacteria in liquid medium, It was found to show stronger bactericidal action against Gram negative bacteria than Cram positive bacteria. According to increasing concentrations of the extract, it resulted in a proportional reduction of viable cell counts of both S. iniae and L. anguillarum. The former was not detected by addition of $189.6{\mu}g/mL$ after 12 hours incubation and the latter by addition of $151.6{\mu}g/mL$ after 24 hours incubation, respectively. It was reasonable that fish diet was soaked in cinnamon bark extract for ten minutes. The relationship formula between the weight of fish diet and the extract absorbed to fish diet was Y=7.2726X+4.5083 ($R^2=0.9998$). The fish diet soaked in the extract inhibited the growth of all strains used in this study. Its antibacterial activity was stable at the range from $10^{\circ}C\;to\;35^{\circ}C$ during the storage period of 28 days. When the diet soaked in the extract was incubated in liquid medium at $35^{\circ}C$, it inhibited the growth of microorganisms inhabited in the diet.

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