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Patterns of FDG Uptake in Stomach on F-18 FDG Positron Emission Tomography: Correlation with Endoscopic Findings (F-18 FDG Positron Emission Tomography에서 보이는 위(stomach) 섭취 양상의 임상적 의의: 위 내시경 소견과 비교 평가)

  • Chae, Min-Jeong;Cheon, Gi-Jeong;Lee, Sang-Woo;Byun, Byung-Hyun;Kim, Sung-Eun;Kim, Yu-Chul;Choi, Chang-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.456-463
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    • 2005
  • Purpose: we often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. Materials and Methods: Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range:$32{\sim}79$), men and women were 28 and 10, respectively. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and S) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. Results: The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions was $7.95{\pm}4.83$ which was significantly higher than the other benign lesions ($2.9{\pm}0.69$ in ulcer, $3.08{\pm}1.2$ in chronic atrophic gastritis, $3.2{\pm}1.49$ in uncommon forms of gastritis (p=0.044)). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesion (4 of 15). Conclusion: Gastric malignant lesions had higher FDG uptake and focal pattern. However, benign inflammatory lesions had moderate degrees of uptake and diffuse and asymmetric patterns rather than focal. It is difficult to differentiate between benign lesions including normal.

A Study on Mother's Feeding Practice in a Urban Apartment Area (일부도시(一部都市) 아파트지역(地域) 어머니의 수유(授乳)에 관(關)한 조사연구(調査硏究))

  • Lee, Sung-Shoe
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.167-177
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    • 1982
  • This study was undertaken to observe relationships between patterns of feeding, supplementary-feeding and various maternal, family, and socioeconomic charactereistics in Hae Cheog Apartment area in Cheongdam-dong, Kangnamku, Seoul on July 2 to 12 in 1982. The results were based on a questionnaire from 179 mothers who have the last-born child under two years old. Results were as follows: 1) In socio-demographic characteristics, most of mothers were 25 to 30 years old and 52.0% of index children were under 6 months old. About 56.0% of families were the salaries and 47.0% of them earn over 500,000 won a month. 40.8% of mothers were college graduates and 81.6% of mothers had no occupation. 2) 89.4% of mothers received prenatal care in pregnancy of the index children and mothers who have delivered the child in medical institute were 88.3%. Mothers who recieved education of breast care and feeding technique through prenatal care were 22.4%, 31.8% respectively. 3) In the feeding method, 44.1% of mothers took the breast feeding, 24.0% of them chose the artificial feeding, and 20.7% of them chose the mixed feeding. Mothers who changed the-method from breast feeding to artificial feeding were 10.6% and only 0.6% of mothers changed from artificial feeding to breast feeding. 4) According to the questionnaire, 37 mothers have already finished lactation (no relation with. the beginning of weaning food). In breast feeding, one mother has lactated for $4{\sim}6$ months, one has lactated for $7{\sim}9$ months, four have lactated for $10{\sim}12$ months, and seven have. continued the lactation over 12 months. In artificial and mixed feeding, as the same phenomenon, most of mothers have lactated for more than 12 months. 5) The reasons for feeding method were as follows: In breast feeding, 64.6% of them took the method because they thought the breast milk nutrious, in artificial feeding, 34.9% of them chose it because they had occupation and in the mixed feeding, 67.6% of mothers took the method because of lack of their breast milk. In the case of changing the method from breast feeding to artificial feeding, 42.1% of them answered that they had to change the method because of lack of breast milk. 6) In most of cases, the 4th month was the proper period to begin the weaning food and 32.5% of breast feeding children and 27.6% of artificial feeding children began the weaning food in 4th month. After 4th month, there was no difference between breast feeding and artificial feeding in the beginning of weaning food. 7) In the matter of menstruation, 29.8% of mothers who had breast feeding started their menstruations in 3 months and the rest of them delayed until 12 months. 40% of mothers who had artificial feeding began to menstruate after 2 months and all the rest started within 5 months. 8) The birth interval between the index child and next new child (would-be-born): In breast feeding, the interval of $18{\sim}24$ months had a majority as 50.0%, and in the artificial feeding, the interval of over 24 months marked 66.7% of them. It was analyzed that the birth interval of artificial feeding was wider than that of breast feeding. 9) In the desirable number of children, the mothers who had breast feeding wanted two sons and two daughters as proper children. Those who want two children in disregard of the sex (son or daughter) were 89.3% of breast feeding, and 80.0% of artificial feeding respectively. Mothers who had breast feeding wanted two children rather than one child. 10) In the family planning practice, the rate of practice were 41.9% in breast feeding, and 58.1% in artificial feeding respectively. In the case of breast feeding, the using rate of family planning practice in men was higher than in women.

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Prevalence and Risk Factors of the Gallbladder Polyps Diagnosed by Ultrasound (복부초음파검사로 진단된 담낭용종의 유병률과 위험인자 분석)

  • LEE, Mi-Hwa;Cho, Pyong-Kon;Kwon, Duck-Moon
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.127-134
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    • 2015
  • This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above $23kg/m^2$ (OR 0.713, p=0.002) triglyceride (OR 0.571, P<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

Analysis of Relative Risk of Stroke by Nutrient Intake Levels - Case-Control Study in Daegu.Gyeongbuk Area, Korea - (영양소 섭취 수준에 따른 뇌졸중 위험도 분석 - 대구.경북지역 환자-대조군 연구 -)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.8
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    • pp.1050-1061
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    • 2009
  • The present study was performed to evaluate energy and nutrients intakes of stroke patients in Daegu Gyeongbuk region, and to analyze the relative risk of stroke related to the intake levels of energy and nutrients. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community residents who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were calculated by using unconditional logistic regression. In male subjects, patient group had significantly higher consumption than the control group in mean daily intakes of energy, all energy yielding nutrients, vitamin $B_1$, $B_6$, niacin, folic acid, vitamin E, phosphorus, potassium, zinc and dietary fiber, and also in the ratio of energy intake from protein and fat. In women subjects, the patient group consumed significantly lower intakes than the control group in fat, vitamin C, folic acid, vitamin E, iron, but vice versa in carbohydrate energy ratio. As for men, the increased intakes of energy, protein, carbohydrate vitamin $B_1$, E and niacin, zinc, total fatty acids, monoand poly-unsaturated, n-6 fatty acids significantly raised the relative risk of stroke. As for women, the increased intakes of fat, vitamin A, $B_2$, $B_6$, niacin, vitamin C and E, iron, sodium, potassium, selenium, mono-, poly-unsaturated, n-6 fatty acids, cholesterol, taurine and dietary fiber significantly lowered the relative risk of stroke. The results of the study demonstrated that the effect of several nutrient intake levels, such as niacin, vitamin E and fatty acids, on the relative risk of stroke was inconsistent between sex. The reason for this sex difference needs to be elucidated in a larger scale study.

Clinical Characteristics of Patients with Traumatic Diaphragm Injury and Comparison of Scoring Systems as Predictors (외상성 횡격막 손상환자의 임상적 고찰과 예후 예측 인자의 유용성 비교)

  • Lee Sang Jin;Jung Jin Hee;Sohn Dong Suep;Cho Dai Yun
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.56-62
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    • 2005
  • Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

Correlation of Clinical Outcome and Cuff Integrity after Open Repair in Large and Massive Rotator Cuff Tears (대형 및 광범위 회전근 개 파열의 개방적 봉합술 후 임상적 결과와 회전근 개 연속성(integrity)의 상관 관계)

  • Noh, Haeng-Kee;Wang, Joon-Ho;Kim, Dong-Hwee;Park, Jong-Woong;Kim, Jae-Gyoon;Park, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.65-72
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    • 2007
  • Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

The Effects of Obstructive Sleep Apnea Syndrome on Periodic Limb Movements in Sleep (폐쇄성 수면무호흡증이 주기성 사지운동증에 미치는 영향)

  • Seo, Cheon-Seok;Youn, Tak;Kim, Eui-Joong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.34-42
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    • 2000
  • Objectives: Periodic limb movements in sleep(PLMS) is a moderately prevalent disorder, of which pathophysiology remains largely unknown. PLMS has been reported to be common in patients with obstructive sleep apnea syndrome(OSAS), but reports on their relationship have been inconsistent in previous studies. Inconsistency of results may be attributable to insufficient number of the study subjects. We attempted to explore the influence of OSAS on PLMS in a large number of subjects. Methods: Three hundred and twenty subjects(M : F=192:128) with PLMS, as identified by the nocturnal polysomnography, were studied. Sample mean age was 53.1(SD=15.1) years and their mean periodic limb movement index(PLMI) is 25.2/hr (SD=24.8). PLMS subjects were divided into two groups, based on the presence or absence of OSAS. Periodic limb movement indices and sleep parameters between two groups were analyzed to evaluate the effects of OSAS on PLMS. Results: Each of PLMI and PLMI with arousal(PLMAI) correlated positively with age. PLMI of men was larger than that of women (p<0.01). The presence of comorbid OSAS independently had influence on PLMI(t=-2.20, p<0.05), but not PLMAI. There were no significant differences between the two groups in their PLMI, PLMAI and sleep parameters. However, the two groups differed in PLMI-correlated sleep parameters. In PLMS subjects with comorbid OSAS, PLMI was negatively correlated with each of slow wave sleep time and REM sleep time. In subjects without comorbid OSAS, PLMI was negatively correlated with sleep efficiency. Conclusion: PLMS patients with OSAS turned out to have increased PLMI than those without OSAS We suggest that OSAS patients may have subtle autonomic arousals and these arousals could, in part, express themselves as PLM.

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Clincal Manifestations of Patients Dying of Severe Community Acquired Pneumonia (중증 원외폐렴으로 사망한 환자의 임상적 분석)

  • Choi, Won-Il;Sohn, Jeong-Ho;Kwun, Oh-Yong;Heo, Jeong-Sook;Whang, Jae-Seok;Han, Seong-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.537-545
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    • 1994
  • Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.

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A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs (첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구)

  • Park Yong-Sin;Cho Byung-Hee;Kim Ho;Lee Si-Baek
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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Evaluation of Fibrosis in Liver Cirrhosis by Superparamagnetic Iron Oxide (SPIO)-Enhanced MR Imaging: Does the Radiological Non-Invasive Fibrosis Index Correlate with the Laboratory Non-Invasive Fibrosis Index? (Superparamagnetic Iron Oxide-Enhanced MRI를 이용한 간섬유화의 평가: 영상의학적 비침습적 간섬유화 지표가 AST/혈소판 비와 상관 관계가 있는가?)

  • Kim, Shin-Kee;Lee, Chang-Hee;Kim, Kyeong-Ah;Choi, Jae-Woong;Lee, Jong-Mee;Park, Cheol-Min
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.115-122
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    • 2008
  • Purpose : To evaluate the correlation between the radiological non-invasive hepatic fibrosis index (RNHFI), as determined by SPIO-enhanced MRI, and the laboratory non-invasive hepatic fibrosis index. Materials and Methods : Patients (99 total: 61 men and 38 women; mean age: 58 years) who underwent SPIO-enhanced MRI (1.5T) during 5 years included. These patients were subdivided into a liver cirrhosis group (LCG) and a non-liver cirrhosis group (non-LCG). Using PACS view, we measured the RNHFI (mean standard deviation of hepatic signal intensity (SD), noise-corrected coefficient of variation (CV)) of three ROIs in the liver parenchyma by SPIO-enhanced MRI. The laboratory non-invasive hepatic fibrosis index (AST-platelet ratio index (APRI)) of all patients was calculated from the laboratory data. We compared the RNHFI and APRI of LCG with those of non-LC group using Student's t-test. A bivariate correlation was performed to investigate the relationship between the RNHFI and APRI in the LCG. Results : For the LCG, mean values of SD and CV by SPIO-enhanced MRI were $10.3{\pm}3.7$ and $0.19{\pm}0.08$, respectively. For the non-LCG, mean values of SD and CV were $6.5{\pm}1.6$ and $0.08{\pm}0.05$, respectively. The mean APRI of the LCG and the non- LCG were $2.04{\pm}1.7$ and $0.32{\pm}0.32$, respectively. The RNHFI and APRI were significantly different between both groups (p<0.05). For the LCG, the bivariate correlation between SD and APRI revealed a statistically significant positive correlation (r=0.5, p<0.001). In both groups, there was no statistically significant correlation between CV and APRI. Conclusion: A measurement of SD can be a simple and useful method for the evaluation of hepatic fibrosis.

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