• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.59-66
• /
• 2011

Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

• Journal of Chest Surgery
• /
• v.36 no.4
• /
• pp.267-272
• /
• 2003

Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.15 no.1
• /
• pp.94-100
• /
• 2011

Purpose: Basal/Acetazolamide-challenged brain perfusion SPECT is very useful to assess cerebral perfusion and vascular reserve. However, as there is a trade off between sensitivity and spatial resolution in the selection of collimator, the selection of optimal collimator is crucial. In this study, we examined three collimators to select optimal one for 1-day brain perfusion SPECT. Materials and Methods: Three collimators, low energy high resolution-parallel beam (LEHR-par), ultra resolution-fan beam (LEUR-fan) and super fine-fan beam (LESFR-fan), were tested for 1-day imaging using Triad XLT 9 (TRIONIX). The SPECT images of Hoffman 3D brain phantom filled with 99mTc of 170 MBq and a normal volunteer were acquired with a protocol of 50 kcts/frame and detector rotation of 3 degree. Filterd backprojection (FBP) reconstruction with Butterworth filter (cut off frequencies, 0.3 to 0.5) was performed. The quantitative and qualitative assessments for three collimators were performed. Results: The blind tests showed that LESFR-fan provided the best image quality for Hoffman brain phantom and the volunteer. However, images for all the collimator were evaluated as 'acceptable'. On the other hand, in order to meet the equivalent signal-to-noise ratio (SNR), total acquisition time or radioactivity dose for LESFR-fan must have been increased up to almost twice of that for LEUR-fan and LEHR-par. The volunteer test indicated that total acquisition time could be reduced approximately by 10 to 14 min in clinical practice using LEUR-fan and LEHR-par without significant loss on image quality, in comparison with LESFR-fan. Conclusion: Although LESFR-fan provides the best image quality, it requires significantly more acquisition time than LEUR-fan and LEHR-par to provide reasonable SNR. Since there is no significant clinical difference between three collimators, LEUR-fan and LEHR-par can be recommended as optimal collimators for 1-day brain perfusion imaging with respect to image quality and SNR.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.125-133
• /
• 2007

[ $\underline{Purpose}$ ]: This study was to design and fabricate a phantom for prostate cancer brachytherapy to validate a developed program applying a 3-film technique, and to compare it with the conventional 2-film technique for determining the location of an implanted seed. $\underline{Materials\;and\;Methods}$: The images were obtained from overlapped seeds by randomly placing a maximum of 63 seeds in the anterior-posterior (AP) position and at $-30^{\circ} to $30^{\circ} at $15^{\circ} intervals. Images obtained by use of the phantom were applied to the image processing procedure, and were then processed into the development program for seed localization. In this study, cases were set where one seed overlapped, where two seeds overlapped and where none of the three views resolved all seeds. The distance between the centers of each seed to the reference seed was calculated in a prescribed region. This distance determined the location of each seed in a given band. The location of the overlapped seeds was compared with that of the 2-film technique. $\underline{Results}$: With this program, the detection rate was 92.2% (at ${\pm}15^{\circ}), 94.1% (at ${\pm}30^{\circ}) and 70.6% (compared to the use of the 2-film technique). The overlaps were caused by one or more than two seeds that overlapped; the developed program can identify the location of each seed perfectly. However, for the third case the program was not able to resolve the overlap of the seeds. $\underline{Conclusion}$: This program can be used to improve treatment outcome for the brachytherapy of prostate cancer by reducing the number of errors in the process of reconstructing the locations of perfectly overlapped seeds.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.18 no.1
• /
• pp.26-32
• /
• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.18 no.1
• /
• pp.33-42
• /
• 2014

Purpose: I-131 scan using High Energy (HE) collimator is generally used. While, Medium Energy (ME) collimator is not suggested to use in result of an excessive septal penetration effects, it is used to improve the sensitivities of count rate on lower dose of I-131. This research aims to evaluate I-131 SPECT/CT image quality using by HE and ME collimator and also find out the possibility of ME collimator clinical application. Materials and Methods: ME and HE collimator are substituted as Siemens symbia T16 SPECT/CT, using I-131 point source and NEMA NU-2 IQ phantom. Single Energy Window (SEW) and Triple Energy Windows (TEW) are applied for image acquisition and images with CTAC and Scatter correction application or not, applied different number of iteration and sub set are reconstructed by IR method, flash 3D. By analysis of acquired image, the comparison on sensitivities, contrast, noise and aspect ratio of two collimators are able to be evaluated. Results: ME Collimator is ahead of HE collimator in terms of sensitivity (ME collimator: 188.18 cps/MBq, HE collimator: 46.31 cps/MBq). For contrast, reconstruction image used by HE collimator with TEW, 16 subset 8 iteration applied CTAC is shown the highest contrast (TCQI=190.64). In same condition, ME collimator has lower contrast than HE collimator (TCQI=66.05). The lowest aspect ratio for ME collimator and HE collimator are 1.065 with SEW, CTAC (+) and 1.024 with TEW, CTAC (+) respectively. Conclusion: Selecting a proper collimator is important factor for image quality. This research finding tells that HE collimator, which is generally used for I-131 scan emitted high energy ${\gamma}$-ray is the most recommendable collimator for image quality. However, ME collimator is also applicable in condition of lower dose, lower sensitive if utilizing energy window, matrix size, IR parameter, CTAC and scatter correction appropriately.

• Journal of the Korean association of regional geographers
• /
• v.3 no.2
• /
• pp.209-225
• /
• 1997

Today, rapid progress of urbanization is discovered commonly in many countries, especially in developing countries, which has led to spatial order and development process of city. Historically, Taegu was a walled city and formed mono-nucleus which was restricted by the castle. As the city grew gradually, the castle was removed as a result of diversification in traffic network, change of socio-economic environment, formation of industrial base and functional distribution. According to reconstruction maps of residential patterns, there was distinctive residential segregation among ethnic groups. Koreans in Taegu in 1939, aggregated densely in the southern and western parts of the city. The Japanese were concentrated densely in the northern and eastern parts of Taegu. And the street pattern within residential areas of the Korean people was shaped like a maze type in contrast with Japanese residential areas, which showed grid pattern of streets. This is another general pattern of almost all colonial cities, especially in Asia. Through this process, today it appears that, out of overall residential areas which occupy the highest ratio in urban land use, those for eminent people influence the functional development of urban spatial structure very heavily as a key point in urban residetial structure. Truly, residential segregation can be seen as the spatial manifestation of uneven distribution of such important scarce resources as housing and residential environment. In this study, the characteristics of locational distribution of the eminent people show their socially and economically stabilized standing in Taegu, taking the aforesaid situation as a background of the study. And the process of this study is as follows ; to examine the forming process of residential areas in the city as a theoretical supporting, to put in order on classical interpretation to formation of residential areas, and general type modern residential areas formation, and economic decision factor of land use. Therefore, this study aims to examine growth and development of eminent persons' residential areas and, at the same time, extract locational characteristics through the pattern of eminent persons' location and predict changes in the future.

• Korean Journal of Head & Neck Oncology
• /
• v.14 no.2
• /
• pp.236-243
• /
• 1998

Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.5 no.2
• /
• pp.141-149
• /
• 2004

The aim of this study was to test the validity of the hypothesis that the karyotypes of four species of Lepilemuridae were formed spontaneously from their ancestral hybrid karyotype. Hypothetical ancestral haploid Karyotype of Lepilemuridae is composed of 18 autosomes and X chromosomes. Lepilemur mustelinus karyotype has four tandem fused chromosomes and one Robertsonian translocated chromosome pairs. Lepilemur septentrionalis septentrionalis karyotype has only two pairs of translocated chromosomes. We reconstruct and suggest ancestral karyotype of LMU(ancLMU) and LSS(ancLSS), from which all four studied species were derived. Hybrids of ancLMU and ancLSS were formed and produce differently fused equilibrated gametes via circular form arrangement during gametogenesis. Five unit of trivalent homologous chromosome pairs were engaged in a circular form to give new gamete corresponding to the karyotype of L. dorsalis, orientation of one unit of trivalent was inversed in the circle to gave new gamete corresponding to the karyotype of L. leucopus. Seven homologous chromosome pairs were engaged in circular form to give haploid karyotype of Lepilemur ruficaudatus. Only one homologous chromosome pair is dissociated and the other chromosome pairs rearranged in the circle to form haploid karyotype of Lepilemur edwardsi. The new gametes could be produced from these circular forms. When the new gamete fertilized with the same type of gamete, The new homozygote is produced as existing L. dorsalis, L. leucopus, L. edwardsi and L. ruficaudatus. These results support the theory that new species could be formed in hybrid population through activated chromosome fusion, chromosome rearrangement in circular from at zygotene stage and production of equilibrated gametes to form homozygote new species.

• Development and Reproduction
• /
• v.3 no.1
• /
• pp.75-85
• /
• 1999

To investigate the origin and action mechanism of cytoplasmic factors as regulators of morphogenesis, the embryonic development, RNA synthesis and protein phosphorylation were examined in reconstituted embryos. A half of 1-cell mouse embryo with both pronuclei was electrofused with the enucleated cytoplasm of 1- or 2-cell embryos which were cultured for 24 hrs from post 20 hrs hCG in CZB with or without cycloheximide (CHX, an inhibitor of protein synthesis; P+P-CHX group), genistein (Gen, an inhibitor of tyrosine protein kinase; P+2-Gen group) and 6-dimethylaminopurine (6-DMAP, an inhibitor of serine-threonine protein kinase; P＋2-DMAP group), and co-cultured with Vero cells for 5 days. And their development, cell numbers at compaction, [5, 6-$^3$H]-uridine incorporation into RNA and the pattern of protein phosphorylation after labeling of [$^{32}$ P] orthophosphate were compared with that of the reconstituted embryos such as P+2 or P+P (control group). Embryonic development and the time of RNA synthesis in P+P-CHX were similar to those in P+P. But the time and the cell stages of embryonic compaction in P+P-CHX were similar to those in P+2. The compaction was initiated at 4-cell in P+2 and P+2-Gen, but at 8-cell in P+P and P+2-DMAP. On a two-dimensional gel electrophoresis, phosphorylation of 80KD and 110KD proteins were inhibited after 3 hrs of reconstruction in the embryo of P+2-DMAP when compared with that of P+2 and P+2-Gen. These results suggest that protein synthesis between 1- and 2-cell stage affects the timing of embryonic genome activation, and that cytoplasmic factors derived from oocyte or their modification regulates the time schedule of embryonic compaction in mouse. Also, serine-threonine protein kinase has an important role on the regulation of compaction.