• Title/Summary/Keyword: Non-Invasive

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Comparative Study of 2 mm Video-thoracoscopic Examination and High-resolution Computed Tomography for Spontaneous Pneumothoarx Patients (자연기흉에서 고해상 전산화단층촬영술과 2 mm 비디오 흉강경검사의 비교 연구)

  • Lee, Song-Am;Chee, Hyun-Keun;Hwang, Jae-Joon;Cho, Seong-Joon;Lee, Sung-Ho;Kim, Kwang-Taik
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.362-368
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    • 2007
  • Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.

Development of Artificial Pulmonary Nodule for Evaluation of Motion on Diagnostic Imaging and Radiotherapy (움직임 기반 진단 및 치료 평가를 위한 인공폐결절 개발)

  • Woo, Sang-Keun;Park, Nohwon;Park, Seungwoo;Yu, Jung Woo;Han, Suchul;Lee, Seungjun;Kim, Kyeong Min;Kang, Joo Hyun;Ji, Young Hoon;Eom, Kidong
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.76-83
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    • 2013
  • Previous studies about effect of respiratory motion on diagnostic imaging and radiation therapy have been performed by monitoring external motions but these can not reflect internal organ motion well. The aim of this study was to develope the artificial pulmonary nodule able to perform non-invasive implantation to dogs in the thorax and to evaluate applicability of the model to respiratory motion studies on PET image acquisition and radiation delivery by phantom studies. Artificial pulmonary nodule was developed on the basis of 8 Fr disposable gastric feeding tube. Four anesthetized dogs underwent implantation of the models via trachea and implanted locations of the models were confirmed by fluoroscopic images. Artificial pulmonary nodule models for PET injected $^{18}F$-FDG and mounted on the respiratory motion phantom. PET images of those acquired under static, 10-rpm- and 15-rpm-longitudinal round motion status. Artificial pulmonary nodule models for radiation delivery inserted glass dosemeter and mounted on the respiratory motion phantom. Radiation delivery was performed at 1 Gy under static, 10-rpm- and 15-rpm-longitudinal round motion status. Fluoroscpic images showed that all models implanted in the proximal caudal bronchiole and location of models changed as respiratory cycle. Artificial pulmonary nodule model showed motion artifact as respiratory motion on PET images. SNR of respiratory gated images was 7.21. which was decreased when compared with that of reference images 10.15. However, counts of respiratory images on profiles showed similar pattern with those of reference images when compared with those of static images, and it is assured that reconstruction of images using by respiratory gating improved image quality. Delivery dose to glass dosemeter inserted in the models were same under static and 10-rpm-longitudinal motion status with 0.91 Gy, but dose delivered under 15-rpm-longitudinal motion status was decreased with 0.90 Gy. Mild decrease of delivered radiation dose confirmed by electrometer. The model implanted in the proximal caudal bronchiole with high feasibility and reflected pulmonary internal motion on fluoroscopic images. Motion artifact could show on PET images and respiratory motion resulted in mild blurring during radiation delivery. So, the artificial pulmonary nodule model will be useful tools for study about evaluation of motion on diagnostic imaging and radiation therapy using laboratory animals.

Changes in Subjective Symptom, Tear Film Stabilization and Blinking Rates when Wearing RGP Lenses with Different Polishing Conditions for Certain Period of Time (연마상태가 다른 RGP렌즈의 일정기간 착용 시 렌즈착용자의 자각적 증상, 눈물막 안정 및 순목횟수 변화)

  • Park, Mijung;Kim, Hyo Gyum;Bae, Jun Seob;Park, Jung Ju;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.1
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    • pp.31-42
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    • 2014
  • Purpose: The present study was conducted to investigate the effect of the physical properties of RGP lens induced by lens polishing on the actual wearer's subjective comfort, the tear film break-up time and the blinking rate as a follow-up study that revealed the relationship between the lens physical properties during lens manufacturing and lens wearer's factors. Methods: RGP lenses made from the three different polishing conditions (25, 50 and 100 seconds) were applied on 28 eyes of 17 subjects, aged 20 to 29 years, without any known disease and surgical history in the eyes. While the subjects were asked to wear the RGP lenses longer than a week, the questionnaire for the comfortability was administered everyday. Subjective and objective tear break-up time and blinking rate of the wearers were further measured. Results: The wearer's subjective comfortability showed some difference in the type of discomfort and satisfaction score according to the polishing status when wearing RGP lenses made from different polishing conditions longer than a week, and a bigger difference in satisfaction score induced by polishing condition was especially shown in experienced RGP lens wearer rather than un-experienced wearer. In the case of RGP lens wearer compared with the ones without the wearing experience, as the wearing time increased subjective and objective tear break-up time were increased and the blinking rate was decreased. However, subjective and objective tear break-up time were tended to decrease with even longer wearing time when wearing the RGP lens made from the polishment for 100 seconds. Conclusions: These results confirmed that the optimization of physical properties of the lens may not give the same effect on the wearer's subjective and objective symptoms and other factors when actual wearing. From the results, it can suggest that the success rate of RGP lens wear may be changed by physiological factors such as the stabilization of wearer's tear film, comfortability and lens wearing experience when wearing RGP lens based on 'The manufacturing standard for soft contact lens/hard contact lens' provided by Korea Food and Drug Administration.

Blood Eosinophil and Serum Eosinophil Cationic Protein as a Marker of Bronchial Hyperresponsiveness in Children with Suspected Asthma (천식 증상 환아에서 기관지과민성의 지표로서 혈액 내 호산구와 혈청 호산구 양이온 단백(ECP))

  • Park, Yang;Kang, Hee;Kang, Eun Kyeong;Koh, Young Yull
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1577-1584
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    • 2002
  • Purpose : Airway inflammation is considered to be a characteristic feature of asthma, and eosinophils are recognized as the most important inflammatory cells. This study aims to assess the importance of blood eosinophil count and serum eosinophil cationic protein(ECP) levels as a noninvasive marker of bronchial hyperresponsiveness(BHR) in children with suspected asthma. Methods : This study used data from 87 subjects with asthma-like symptoms(6-18 years old). The $FEV_1$ and provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ on methacholin inhalation challenge test were measured. Four groups were classified based on $PC_{20}$[Group I : <2 mg/mL; Group II : 2-8 mg/mL; Group III : 8-18 mg/mL; Group IV : (18 mg/mL], and blood eosinophil count and serum ECP levels were analyzed. In addition, subjects were classified based on the cutoff value of $PC_{20}$(BHR positive group : <18 mg/mL; BHR negative group : (18 mg/mL). Then blood eosinophil count and serum ECP level were compared between these two groups. Results : Likelihood ratio test for trends revealed a significant association between the blood eosinophil count or serum ECP level, and the degree of BHR as measured by methacholine $PC_{20}$. Blood eosinophil count or serum ECP level was significantly higher in the BHR(+) group than in the BHR(-) group. Blood eosinophil count had a positive correlation with serum ECP level. Conclusion : Blood eosinophil count and serum ECP level may be a useful non-invasive clinical marker of BHR in subjects with suspected asthma. This supports the hypothesis that BHR in asthma is a consequence of airway eosinophilic inflammation.

The Usefulness of MRCP in the Evaluation of Pancreaticobiliary Diseases in Children (소아에서 담췌관 질환에 대한 자기공명 담췌관조영술의 진단적 유용성)

  • Uhm, Ji Hyun;Lee, Seung Yeon;Chung, Ki Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1381-1388
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    • 2002
  • Purpose : Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. Methods : From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. Results : A total of 70 patients, consisting of 31 males and 39 females, with a mean age of $2.6{\pm}3.3$ years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. Conclusion : MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.

Usefulness of Dynamic $^{18}F-FDG$ PET Scan in Lung Cancer and Inflammation Disease (폐암과 폐 염증성질환의 동적양전자방출단층검사 (Dynamic $^{18}F-FDG$ PET)의 유용성)

  • Park, Hoon-Hee;Roh, Dong-Wook;Kim, Sei-Young;Rae, Dong-Kyeong;Lee, Min-Hye;Kang, Chun-Goo;Lim, Han-Sang;Oh, Ki-Back;Kim, Jae-Sam;Lee, Chang-Ho
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.249-255
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    • 2006
  • Purpose: The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomograhpy ($^{18}F-FDG $PET) for the non-invasive differentiation of focal lung lesions originated from cancer or inflammation disease by combined visual image interpretation and semi-quantitative uptake value analysis has been documented. In general, Standardized Uptake Value(SUV) is used to diagnose lung disease. But SUV does not contain dynamic information of lung tissue for the glucose. Therefore, this study was undertaken to hypothesis that analysis of dynamic kinetics of focal lung lesions base on $^{18}F-FDG$ PET may more accurately determine the lung disease. So we compared Time Activity Curve(TAC), Standardized Uptake Value-Dynamic Curve(SUV-DC) graph pattern with Glucose Metabolic Rate(MRGlu) from Patlak analysis. Methods: With lung disease, 17 patients were examined. They were injected with $^{18}F-FDG$ over 30-s into peripheral vein while acquisition of the serial transaxial tomographic images were started. For acquisition protocol, we used twelve 10-s, four 30-s, sixteen 60-s, five 300-s and one 900-s frame for 60 mins. Its images were analyzed by visual interpretation TAC, SUV-DC and a kinetic analysis(Patlak analysis). The latter was based on region of interest(ROIs) which were drawn with the lung disease shape. Each optimized patterns were compared with itself. Results: In TAC patterns, it hard to observe cancer type with inflammation disease in early pool blood area but over the time cancer type slope more remarkably increased than inflammation disease. SUV-DC was similar to TAC pattern. In the result of Patlak analysis, In time activity curve of aorta, even though inflammation disease showed higher blood activity than cancer, at first as time went by, blood activity of inflammation disease became the lowest. However, in time activity curve of tissue, cancer had the highest uptake and inflammation disease was in the middle. Conclusion: Through the examination, TAC and SUV-DC could approached the results that lung cancer type and inflammation disease type has it's own difference shape patterns. Also, it has outstanding differentiation between cancer type and inflammation in Patlak and MRGlu analysis. Through these analysis methods, it will helpful to separation lung disease.

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Study on Flora and Comparative Example of Gulup-do in Ongjin, Incheon (인천 옹진 굴업도의 식물상과 비교사례 연구)

  • Oh, Hyun-Kyung;Han, Yun-Hee;Kim, Eun-Ok;Kim, Young-Ha
    • Journal of Environmental Impact Assessment
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    • v.25 no.2
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    • pp.103-123
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    • 2016
  • This study is a comparison of the flora and case studies distributed in Gulup-do Ongjingun, Incheon. The numbers of vascular plants were summarized as 282 taxa including 81 families, 201 genera, 252 species, 3 subspecies, 22 varieties and 5 forms. The Raunkiaer life forms are analyzed in hemicryptophytes were 66 taxa (23.4%) in dormancy form, non-clonal growth ($R_5$) were 160 taxa (56.7%) in propagation form of radicoid form, having no special modification for dissemination ($D_4$) were 197 taxa (48.6%) in propagation form of disseminule form, erect form (e) were 117 taxa (41.5%) in growth form. The halophytes were 23 taxa including Salsola collina, Asparagus oligoclonos and so on. The rare plants were 7 taxa including Pyrrosia hastata (VU), Senecio nemorensis (VU) and so on. The Korean endemic plants were 5 taxa including Hepatica insularis, Lespedeza maritima and so on. In the specific plants by floristic region were 38 taxa, a degree I were 23 taxa (Dictamnus dasycarpus, Vitex rotundifolia and so on), 6 taxa of a degree II (Morus cathayana, Euphorbia esula and so on), 8 taxa of a degree III (Pyrrosia hastata, Rhodotypos scandens and so on), Senecio nemorensis of a degree V and degree IV were not found. The naturalized plants were 17 taxa including Robinia pseudoacacia, Bromus tectorumand so on. Of those Ambrosia artemisiifolia is a invasive alien plants. Naturalization rate (NR) was 6.0% of all 282 taxa of vascular plants and urbanization index (UI) was 5.3% of all 321 taxa of naturalized plants. Gulup-do and adjacent Baega-do were locally investigated field work and it summarizes the results of a total of 41 islands literature in Ongjin-gun and Ganghwa-gun, Incheon including uninhabited islands, Baengnyeong-do, Daecheong-do and so on. The average number of species were each analyzed in about 89 taxa, rare plants are about 2 taxa, endemic plants are about 1 taxa, naturalized plants are about 4 taxa. This study was the comparison of the flora and literature distribution case that the Gulup-do maintain the naturalness and continuously conducted to explore the future conservation measures the adjacent islands.

Predictive Value for Vesicoureteral Reflux in Children with Urinary Tract Infection (요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구)

  • Lee, Seung-Hyun;Noh, Sung-Hoon;Oh, Jeung-Eun;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.62-69
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    • 2008
  • Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

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Analysis of Prognostic Factors according to WHO Classification for Thymic Epithelial Tumor (흉선종의 WHO 분류에 따른 예후인자의 임상적 고찰)

  • 서영준;금동윤;권건영;박창권
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.684-690
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    • 2004
  • Background: Primary thymic epithelial neoplasm is a type of mediastinal tumors that have various biologic and morphologic features. In this study, we reclassified 59 cases of thymic epithelial tumors by the new WHO classification. We inquired whether the new WHO classification has independent prognostic relevance by analyzing clinical characteristics of thymic epithelial tumors including Masaoka's clinical stage. Material and Method: From December 1986 to August 2003, 59. patients who underwent surgery in the Keimyung University Dongsan Medical Center with definite diagnosis of thymic epithelial tumor were studied. We analyzed the histologic subtype (WHO classification). clinical stage (Masaoka's clinical stage) and patient's characteristics (sex, age, myasthenia gravis, tumor size, invasion. recurrence, metastasis) as prognostic factors. We analyzed the relationship between histologic subtype and clinical stage. Result: 32 patients were male and 27 were female. Mean age was 50.1$\pm$14.2. From WHO A to C, all thymic epithelial tumors were reclassified by the new WHO classification. Six patients (10.2%) had Type A, 7 (11.9%) had Type AB, 7 (11.9%) had Type B$_1$, 10 (16.9%) had Type B$_2$ and 7 (11.9%) had Type B$_3$, 22 (37.3%) had Type C. Two factors were shown by multivariate analysis to be associated with a favorable prognosis: completeness of resection (p=0.003) and non-invasiveness (p=0.001). The overall 5-year survival of the 59 patients was 53%, subtype A and AB were 92.3%, B$_1$ and B$_2$ were 70.2%, and B$_3$ and C were 26.1%. The association between histologic subtype and invasive behavior (stage) was statistically significant (p<0.001). Conclusion: The WHO classfication is not only a histologic classfication of the thymic epithelial tumors but also a significant prognostic factor that influence the survival of thymic epithelial tumors.

Gastric Emptying in Patients with Diabetes: Gastric Emptying Time, Retention Rate and Effect of Cisapride (당뇨병 환자의 위배출능 : 위배출시간, 위저류율 및 Cisapride의 영향)

  • Chung, Byung-Chun;Choi, Chung-Il;Gwak, Dong-Suck;Lee, Jae-Tae;Lee, Kyu-Bo;Kim, Bo-Wan;Chung, Jun-Mo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.299-306
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    • 1992
  • Gastic emptying scan in diabetic patients is widely used to assess the degree of motility disturbance and the symtoms such as nausea, vomiting, bloating, abdominal pain and early gastric fullness which we can't find anatomic lesion by fiberoscopic or barium study In order to determine the relationship among diabetic gastropathy, neropathy, retinopathy and disease duration, gastric emptying scan using $^{99m}Tc-tin$ colloid labeled scramble egg in hamburger was performed in 10 healty male controls and 50 diabetic patients which were subdivided to no neuropathy, peripheral neuropathy and autonomic neuropathy groups according to the degree of diabetic neuropathy and no retinopathy, background retinopathy and proliferative retinopathy groups according to the degree of diabetic retinopathy. After medication of cisapride for 2 weeks, we observed the presence of improvement of gastric motility in diabetics. The results were as following: 1) In controls, gastric emptying time (GET1/2) was $75{\pm}13.6$ min and 2 hour gastric retension rate (GRR2) was $32{\pm}11.1%$. 2) In diabetics, GET/2 was prolonged more than 2 hours and GRR2 was $58{\pm}23.1%$. According to degree of neuropathy, GET1/2 was prolonged more than 2 hours in all three groups and GRR2 was $54{\pm}24.1%$ in no neuropathy group, $57{\pm}24.3%$ in peripheral neuropathy group and $69{\pm}24.6%$ in autonomic neuropathy group. According to degree of retinopathy, GET1/2 was $110{\pm}23.4$ min in no retinopathy group and prolonged more than 2 hours in other two groups and GRR2 was $45{\pm}21.6%$ in no retinopathy group, $71{\pm}19.7%$ in background retinopathy group and $73{\pm}21.5%$ in proliferative retinopathy group. 3) After cisapride medication for 2 weeks, GET1/2 and GRR2 were improved as $90{\pm}14.6$ min and $40{\pm}13.8%$ (initial GET1/2 and GRR2 were above 2 hours and $61{\pm}15.4%$). We can conclude from above findings that gastropathy in diabetic neuropathy suggesting main underlying factor in motility disorder The degree of retinopathy and disease duration were correlated with severity of gastropathy in diabetics. From the results of gastric emptying scan, we can conclude that cisapride was useful drug for improving diabetic gastropathy and gastric emptying scan was valuable for assessing severity of diabetic gastropathy as non-invasive method.

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