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Clinical Characteristics of Pulmonary Aspergilloma (폐국균종의 임상적 고찰)

  • Kang, Tae-Kyung;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Sohn, Jeong-Ho;Lee, Jun-Ho;Han, Seong-Beom;Jeon, Young-Jun;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Shin, Hyeon-Soo;Lee, Sang-Chae;Kweon, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1308-1317
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    • 1997
  • Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

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Variations in Growth Characteristics and Seed Qualities of Korean Soybean Landraces (한국 재래종 콩의 수집지대별 생태적 특성 및 품질 차이)

  • Han, Won-Young;Park, Keum-Yong;Kim, Hyun-Tae;Ko, Jong-Min;Baek, In-Youl;Lee, Chung-Yeol;Choung, Myoung-Gun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.53 no.spc
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    • pp.96-102
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    • 2008
  • This study was carried out to examine agronomic characteristics and seed qualities of 827 Korean soybean landraces according to the collecting areas. Agronomic characteristics and seed qualities was examined according to the localities by weather characteristics. Days to flowering was the longest (mean 70.9 days) in the northwest seashore, and the most short in the south inland (mean 63.8 days). Growth days was the longest in the Gyeongbuk inland (mean 136.0 days), and the most short in the mountain-high (mean 132.8 days). The stem height was the most short in the north-west seashore (mean 81.3 cm), and in the south seashore (mean 58.8 cm). The seed weight of 100 seeds was the lightest in the north-west seashore (mean 17.1 g), and the heaviest in the south-west seashore (mean 21.5 g). The crude protein contents was the lowest in the north-west seashore (mean 40.1%), the highest in the south seashore (mean 42.8%), and vice versa in the crude oil. The contents of sucrose and oligo-saccharide was the highest 5.8% and 8.6%, respectively, in the mountain-high, and the lowest 4.8% and 7.6% in the Gyeongbuk inland and south seashore, respectively. Among the iso-flavone contests, the contents of genistein and total was the highest, $635.6\;{\mu}g/g$ and $1258.1\;{\mu}g/g$, respectively, in the mountain inland, and the lowest $319.2\;{\mu}g/g$ and $835.3\;{\mu}g/g$ in the south-west seashore. The contents of glycitein was the highest $124.3\;{\mu}g/g$ in the south seashore.

A Study of Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET-CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Kim, Bit-Na;Cho, Suk Won;Lee, Juyoung;Lyu, Kwang Yeul;Park, Hoon-Hee
    • Journal of radiological science and technology
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    • v.38 no.1
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    • pp.23-30
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    • 2015
  • Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to 99mTc emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radio technologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radio technologists. Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8cm$, mean weight: $65.9{\pm}1.4kg$). Radiation was measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150, and 200 cm, respectively. Then, all the procedure was given with a portable radiation shielding on the location of head, chest, and abdomen at the distance of 100, 150, and 200 cm and transmittance was calculated. In 10 cm, head ($105.40{\mu}Sv/h$) was the highest and foot($15.85{\mu}Sv/h$) was the lowest. In 200 cm, head, chest, and abdomen showed similar. On head, the measured dose rates were $9.56{\mu}Sv/h$, $5.23{\mu}Sv/h$, and $3.40{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.24{\mu}Sv/h$, $1.67{\mu}Sv/h$, and $1.27{\mu}Sv/h$ in 100, 150, and 200 cm on head. On chest, the measured dose rates were $8.54{\mu}Sv/h$, $4.90{\mu}Sv/h$, $3.44{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.27{\mu}Sv/h$, $1.34{\mu}Sv/h$, and $1.13{\mu}Sv/h$ in 100, 150, and 200 cm on chest. On abdomen, the measured dose rates were $9.83{\mu}Sv/h$, $5.15{\mu}Sv/h$, and $3.18{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.60{\mu}Sv/h$, $1.75{\mu}Sv/h$, and $1.23{\mu}Sv/h$ in 100, 150, and 200 cm on abdomen. Transmittance was increased as the distance was expanded. As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the technologists.

Growth Response of Pinus rigida × P. taeda to Mycorrhizal Inoculation and Efficiency of Pisolithus tinctorius at Different Soil Texture and Fertility with Organic Amendment (리기테다 소나무의 균근(菌根) 접종(接種) 반응(反應)과 토양비옥도(土壤肥沃度)에 따른 모래밭 버섯의 효과(効果) 및 그 생태학적(生態學的) 의미(意味))

  • Lee, Kyung Joon
    • Journal of Korean Society of Forest Science
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    • v.64 no.1
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    • pp.11-19
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    • 1984
  • Potted, germinating Pinus rigida ${\times}$ P. taeda seedlings were inoculated with Pisolithus tinctorius (Pt) ectomycorrhizal fungus to test the effectiveness of Pt in relation to organic amendment and changes in soil fertility and soil texture. Pt was cultured as mycelia in vermiculite-peat moss mixture with nutrients and added to sterilized pot soils with or without organic amendment (fully fermented compost) at three soil texture levels (sand, loamy sand, and sandy loam) in a factorial design. Plants were grown in a greenhouse for 4 months and harvested to compare their growth with non-mycorrhizal plants and plants infected by natural fungi. Regardless of sod texture, soil fertility, or organic amendment, seedlings inoculated with Pt were better in dry weight and height than non-mycorrhizal plants or those infected by natural fungi. An exception was observed in the most fertile soil (0.075% N and 1.32% organic matter content in sandy loam with organic amendment), where non-mycorrhizal plants were slightly bigger (8%) and heavier (18%) than Pt-inoculated plants. In over-all average, Pt-inoculated seedlings were 30% taller and 107% heavier than those infected by natural fungi and 31 % taller and 60% heavier than non-mycorrhizal plants. Growth stimulation of seedlings by Pt was more pronounced in less fertile sand soil when organic was not amended. Mycorrhizal frequency of Pt (% of mycorrhizal root tips) was reduced to about half (from 84 to 33% in sandy loam and from 77 to 40% in loamy sand) by organic amendment, while that of natural fungi was not significantly affected. Severe nitrogen deficiency was observed in the needles of non-mycorrhizal plants (1.38% N), while both Pt-inoculated plants (1.68% N) and those infected by natural fungi (1.89% N) did not develop symptom, suggesting an active role of mycorrhizae in absorption of soil nitrogen. Top to root ratio increased with organic amendment to non-mycorrhizal plants, but was not significantly affected by fungal treatment. It was concluded from this study that relative effectiveness of Pt was determined by soil fertility. Organic amendment to less fertile sand soil increased effectiveness of Pt, while the same amendment to more fertile loamy sand and sandy loam decreased effectiveness of Pt. Benefits of Pt mycorrhizae would be expected most either when organic was not added to the soil, or when soil nutrients were not abundant.

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A Study on the Characteristics of Dietary Behaviors and Food Intake Patterns of University Student according to the Obesity Index (대학생의 비만도에 따른 식생활 특성 및 식이섭취 양상에 관한 연구)

  • Oh Se-In;Lee Mee-Sook
    • The Korean Journal of Food And Nutrition
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    • v.19 no.1
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    • pp.79-90
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    • 2006
  • This study was performed to investigate the dietary behaviors and food intake patterns of university students according to the obesity index(OI). The subjects were 349 students(107 males and 242 females) who were assigned to one of the following groups based on the percentage of ideal body weight: underweight(OI< 90%), normal ($90%{\leq}Ol<10%$) and overweight($OI{\geq}110%$). The dietary behaviors and food intake patterns were evaluated by questionnaires and 24 hour recall method. The results were summarized as follows. The rates of underweight, normal, and overweight students were 33.8%, 61.0%, and 5.2% respectively. The ratios of underweight was higher than overweight, especially in case of female. The 60.46% of subjects responded that they had an irregular eating habits, especially in overweight group(72.22%). The 52.44% of subjects showed skipping mealtime more than one time per day. The overweight group had a tendency to overeat themselves than other groups. The normal group had less unbalanced dietary pattern than the other groups(p<0.0019). Most subjects had a snack(96.27%). The percentage of those who drank and smoked were 86.74% and 19.54%, respectively. The smoking value was significantly higher in the overweight group(p<0.0009). The food consumption frequency by food groups was not different among the groups except instant and fast food. More than 50% subjects consumed fish, legumes & its products, and vegetables everyday. There was significantly less rate of the instant and fast food consumption frequency in the normal group(p<0.0177). The 3/4 subjects that showed the lower consumed level in RDA(< 75%) were under-nutritional state in the Fe and Ca. In case of Ca, there was a higher NAR value in the overweight group(p<0.0257) significantly, and Fe, protein, vitamin $B_1$, vitamin $B_2$, and niacin showed similar tendencies. The INQ of Fe was significantly higher in the overweight group than other groups(p<0.0335).

A Study to Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET/CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Ban, Yung-Kak;Lim, Han-Sang;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Purpose: Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to $^{99m}Tc$ emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radiotechnologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radiotechnologists. Materials and Methods: Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8$ cm and mean weight: $65.9{\pm}1.4$ kg). Radiation were measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150 and 200 cm. Then, all the procedure was given with a portable radiation shielding on the location of head, chest and abdomen at the distance of 100, 150 and 200 cm and transmittance was calculated. Results: In 10 cm, head (105.40 ${\mu}Sv/h$) was the highest and foot (15.85 ${\mu}Sv/h$) was the lowest. In 200 cm, head, chest and abdomen showed similar. On head, the measured dose rates were 9.56 ${\mu}Sv/h$, 5.23 ${\mu}Sv/h$, and 3.40 ${\mu}Sv/h$ in 100, 150 and 200 cm respectively. When using shielder, it shows 2.24 ${\mu}Sv/h$, 1.67 ${\mu}Sv/h$, and 1.27 ${\mu}Sv/h$ in 100, 150 and 200 cm on head. On chest, the measured dose rates were 8.54 ${\mu}Sv/h$, 4.90 ${\mu}Sv/h$, 3.44 ${\mu}Sv/h$ in 100, 150 and 200 cm, respectively. When using shielder, it shows 2.27 ${\mu}Sv/h$, 1.34 ${\mu}Sv/h$, and 1.13 ${\mu}Sv/h$ in 100, 150 and 200 cm on chest. On abdomen, the measured dose rates were 9.83 ${\mu}Sv/h$, 5.15 ${\mu}Sv/h$ and 3.18 ${\mu}Sv/h$ in 100, 150 and 200cm respectively. When using shielder, it shows 2.60 ${\mu}Sv/h$, 1.75 ${\mu}Sv/h$ and 1.23 ${\mu}Sv/h$ in 100, 150 and 200 cm on abdomen. Transmittance was increased as the distance was expanded. Conclusion: As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the radiotechnologists.

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Clinical Study of Tuberculous Meningitis in Children (소아 결핵성 뇌막염의 임상적 고찰)

  • Kim, Woo Sik;Kim, Jong Hyun;Kim, Dong Un;Lee, Won Bae;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.64-72
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    • 1997
  • Purpose : The incidence of tuberculous meningitis in Korean children has been markedly decreased after 1980s, but this disease has still occurred with low rate. Therefore, it may be suspected that delayed diagnosis and treatment will be happened because of lacking of clinical experiences and indistinguishable other meningitis, so it is important to make early diagnosis and treatment of tuberculous meningitis concerning with the prognosis. In this aspect, we conducted study to concern and investigate sustainly about the diagnostic criteria, clinical characteristics, radiological findings, complications, and prognosis of typical or atypical tuberculous meningitis in children. Methods : Forty four children who were hospitalized and treated due to tuberculous meningitis in pediatric wards of Our Lady of Mercy Hospital, St. Holy Hospital, St. Vincent Hospital and Uijungbu St. Mary Hospital from January 1985 to June 1996 were included in this study. We reviewed medical records of these patients retrospectively. Results : 1) The tuberculous meningitis has occured continuosly since mid-1980s. The highest 2) The diagnosis was made by contact history of active tuberculous patients, positive tuberculin test, responses of antituberculous antibiotics and discovery of Mycobacterium tuberculosis from CSF or other specimens. Among patients, 7 children(16%) were not vaccinated with BCG, and only 18 children(40%) were positive in tuberculin test. 3) The symptoms and signs of our patients on initial examinations were fever, vomiting, headache, lethargy, poor feeding, weight loss, neck stiffness, convulsion, abdominal pain and motor deficits. 4) The findings of initial CSF samples revealed leukocyte $239.5/mm^3$(mean) with lymphocyte predominant, elevated protein levels(mean;259.5mg%) and low sugar level(mean;40.7mg%). And the ratio of CSF/blood sugar was 0.407. But, atypical CSF findings were seen in 31.8% patients. 5) On brain imaging study, 34 out of 39 children had findings of hydrocephalus, basilar meningeal enhancement, infarction and subarachnoidal inflammations etc. On chest X-ray, the findings of miliary tuberculosis(34.1%), normal finding(29.5%), parenchymal infiltrations (11.4%) and calcifications(9.1%) were showed. 6) In neurological clinical stage, there were twenty-six children(59%) in stage 1, fourteen children(32%) in stage 2 and four children(9%) in stage 3. The late sequeles were encountered by 29.5% with mild and 4.6% with severe neurological injury. The most common neurological injury was quadriplegia and the mortality rate was 6.8%. 7) The SIADH was developed in 20 children(45.5%) after the 4th hospital day. Half of all SIADH patients were symptomatic. Conclusion : Tuberculosis meningitis is still an important extrapulmonary disease with high morbidity and mortality. Early diagnosis with clinical contact history of active tuberculosis and radiological imaging examinations and early treatments are essential in order to prevent and decrase the rate of late sequeles and death.

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Studies on Persistence of Pesticides in Soils and Crops under Polyethylene Film Mulching Culture II. Effect of Polyethylene Film mulching on Weed Emergence, Growth and Yield of Red pepper, Peanut and Sesame (폴리에틸렌 멀칭재배(栽培) 시(時) 농약(農藥)의 토양(土壤) 및 작물체중(作物体中) 잔류(殘留)에 관한 연구(硏究) 제(第) 2 보(報) 폴리에틸렌 멀칭이 잡초발생(雜草發生), 고추, 땅콩, 참깨의 생육(生育) 및 수량(收量)에 미치는 영향(影響))

  • Ryang, H.S.;Moon, Y.H.;Kim, N.E.;Lee, J.H.
    • Korean Journal of Weed Science
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    • v.7 no.3
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    • pp.306-315
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    • 1987
  • In the red pepper field under polythylene film mulching(P.E.-mulching) culture, the weed emergence was completely inhibited by black P.E.-mulching. The emergence in clear P.E.-mulching decreased 90% compared to that in non-mulching. Weeding effect was high in the order of pendimethalin, diphenamid, alachlor and napropamide. The effect of herbicides was higher in clear P.E.-mulching than in non-mulching. Plant height and number of branches increased in the order of clear P.E.-, black P.E.-mulching, while the yield between black P.E.- and clear P.E.-mulching was not different. The herbicides had no effect on the growth and yield. In the peanut field, weed emergence was 80% lower in clear P.E.-mulching than in non-mulching. Weeding effect was excellent in the plot applied with alachlor, napropamide and diphenamid. The total number of branches, main stem height and shoot weight were 2.0, 1.7 and 2.4 times greater in clear P.E.-mulching than in non-mulching, respectively. Peanut yield was about 38% higher under clear P.E.-mulching than under non-mulching. The herbicides had no effect on the growth and yield. In the sesame field, rate of weed emergence was 10 times lower in clear P.E.-mulching than in non-mulching. Weeding effect of alachlor, napropamide and diphenamid was higher under clear P.E.-mulching than under non-mulching. Germination percentage of sesame greatly decreased in non-mulching compared with in clear P.E.-mulching. The germination was inhibited by the treatment of herbicides. The inhibition effect was increased in the order of alachlor, napropamide, and diphenamid. The initial crop injury in treatment of herbicides was greater in non-mulching than in clear P.E.-mulching. The crop recovered from the injury and exhibited regrowth in clear P.E.-mulching except the alachlor treatment, but there was no recovery in non-mulching. There was no significant difference yield between herbicide treatment and hand weeding in non-mulching. Also, no significant difference was obseorbed between napropamide and diphenamid treatment and hand weeding in clear P.E.-mulching.

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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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