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Reference Values of Functional Parameters in Gated Myocardial Perfusion SPECT : Comparison with $QGS^{\circledR}$ and $4DM^{\circledR}$ Program (게이트 심근 관류 스펙트의 심기능 지표의 정상 참고값 : $QGS^{\circledR}$ 프로그램과 $4DM^{\circledR}$ 프로그램의 비교)

  • Jeong, Young-Jin;Park, Tae-Ho;Cha, Kwang-Soo;Kim, Moo-Hyun;Kim, Young-Dae;Kang, Do-Young
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.430-437
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    • 2005
  • Purpose: The objectives of this study were - First, to determine the normal range of left ventricular end diastolic volume (EDV), end systolic volume (ESV) and election fraction (EF) from gated myocardial perfusion SPECT for Quantitative Gated SPECT (QGS) and 4D-MSPECT (4DM), respectively. Second, to evaluate the relationships between values produced by both software packages. Materials & Methods: Tc-99m MIBI gated myocardial perfusion SPECT were performed for 77 patients (mean age: $49.6{\pm}13.7y$, n=37(M), 40(F)) with a low likelihood (<10%) of coronary artery disease (CAD) using dual head gamma camera (E.CAM, Siemens, USA). Left ventricular EDV, ESV and EF were automatically measured by means of QGS and 4DM, respectively. Results: in QGS, the mean EDV, ESV and EF for all patients were $78.2{\pm}25.2ml,\;27.4{\pm}12.9ml\;and\;66.6{\pm}8.0%$ at stress test respectively, not different from rest test (p>0.05). In 4DM, the mean EDV, ESV and EF for all patients were $89.1{\pm}26.4ml,\;29.1{\pm}12.8ml\;and\;68.5{\pm}6.7%$ at stress test. Most cases in 4DM, there was no significant difference statistically between stress and rest test (p>0.05). But statistically significant difference was found in EF ($68.5{\pm}6.7%$ at stress vs $70.9{\pm}8.0%$ at rest, p<0.05). Correlation coefficients between the methods for EDV, ESV and EF were comparatively high (0.95, 0.93, 0.71 at stress test and 0.95, 0.90, 0.69 at rest test, respectively). However, Bland-Altman plots showed a large range of the limit value of agreement for EDV, ESV and EF between both methods ($-30ml{\sim}10ml,\;-12ml{\sim}8ml,\;-14%{\sim}11%$ at stress test and $-32ml{\sim}5ml,\;-13ml{\sim}13ml,\;-18%{\sim}12%$ at rest test). Conclusion: We found the normal ranges of EDV, ESV and EF for patients with a low likelihood of CAD in both methods. We expect these values will be a good reference to interpret gated myocardial perfusion SPECT. Although good correlation was observed between both methods, they should not be used interchangeably. Therefore, when both programs are used at the same site, it will be important to apply normal limits specific to each method.

The Effect of Adjuvant Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma after Induction Chemotherapy (국소진행 두경부 상피세포암에서 선행유도약물요법 후 보조약물요법의 효과)

  • Kim Cheol-Woo;Roh Jae-Kyung;Ahn Joong-Bae;Park Joon-Oh;Chung So-Young;Lee Seok;Lee Hey-Ran;Lee Kyung-Hee;Chung Hyun-Cheol;Kim Joo-Hang;Kim Byung-Soo;Suh Chang-Ok;Kim Gwi-Eon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.13-24
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    • 1994
  • Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

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Effect of Seeding Methods and Nitrogen Fertilizer Rates on the Forage Quality and Productivity of Whole Crop Rice (파종방법 및 질소시비량이 총체 벼의 수량 및 사료가치에 미치는 영향)

  • Kim, Jong Geun;Park, Hyung Soo;Lee, Sang Hoon;Jung, Jeong Sung;Ko, Han Jong
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.35 no.2
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    • pp.87-92
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    • 2015
  • This experiment was conducted to evaluate the effect of seeding methods and application levels of nitrogen fertilizer on the yield and forage quality of whole crop rice (WCR). The WCR variety "Namil" was directly seeded on April 25 and transplanted on May 25. Five levels of nitrogen fertilizer were applied (90, 110, 140, 170 and 200 kg/ha). There were no significant differences (p<0.05) of the emergence date, heading date and disease resistance based on the nitrogen fertilizer rates; however, the WCR became dark at higher nitrogen fertilizer rates. The plant height increased at higher nitrogen fertilizer rates and the tiller number showed the same trend. In contrast to a direct seeding method, transplanting increased the tiller number. The dry matter (DM) content did not show a certain tendency based on nitrogen fertilizer rates, while the fresh and dry matter yields increased with incremental changes of the nitrogen fertilizer rates (p<0.01), and the transplant method increased the yield size. In yield analysis, the plot direct-seeded with 140 kg N/ha and the transplanting with 170kg N/ha showed the highest yields. The crude protein (CP) content increased with higher nitrogen fertilizer rate, but there was no significant differences between transplant and direct-seeding methods. The content of ADF (acid detergent fiber) and NDF (neutral detergent fiber) increased with higher nitrogen fertilizer rate, but total digestible nutrient (TDN) content decreased with increased nitrogen levels. Although high nitrogen applications increased the fresh and DM yields, the 140 kg/ha nitrogen fertilizer level is recommended as the proper nitrogen fertilizer level, considering both yield and the environments.

The Comparison of Glomerular Filteration Rate by Kidney Depth in Dynamic kidney Scan (동적신장검사에서 신장깊이에 따른 사구체여과율 비교)

  • Hwang, Ju-Won;Lim, Young-Hyen;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Mu-Seok;Jung, Ji-Uk;Park, Se-Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.73-77
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    • 2014
  • Purpose Find out about the significance of the GFR values calculated by the kidney depth is measured by comparing the values obtained for kidney depth was measured GFR in the CT image kidney depth and is calculated by Tonnesen law in $^{99m}Tc$-DTPA dynamic kidney scan with each applies. Materials and Methods Among patients with normal value (75~120 mL/min) computed GFR conducted of dynamic renal scan to visit from February 2013 to February 2014 and donor GFR values in patients with normal value. The mean age was 46.9 years with 14 men 13 females. We used abdomen CT image which checked before conducting dynamic Kidney scan for measuring the depth of kidney. We only used CT image that contains renal hilum and measured outermost front of the kidney from the skin surface (a) and the final surface (b) caculated the average depth of [(a + b) / 2] respectively. Using the same ROI in order to limit the change in GFR values by the other additional element was set before and after the depth value was excluded from the GFR falls kidney disease. Results Using Tonnesen law the average value was caculated 5.94 cm from the right kidney 5.90 cm from the left kidney. It was 6.83 cm, 8.71 cm in the left kidney and the right kidney average value of the depth measured on the basis of the CT image. The respective increase in left kidney 0.93 cm and right kidney 2.77 cm calculated on the basis of CT image actually measured values. GFR was calculated as the average depth of the subject calculated by the method Tonnesen $83.3{\pm}9.79mL/min$. $98.6{\pm}14.07mL/min$ GFR was applied to calculate the average depth of the subjects using the CT image, is the difference appears 15.26 mL/min was increased after seting up depth value, P value was less than 0.01 which is significant. Conclusion The difference between GFR before-after setting up depth value cause that the different of depth value. Is a measured depth of the extension value of the calculated estimates Whereas Tonnesen kidney depth method is to use in calculating the value of GFR in a typical dynamic elongation test depth derived using the CT image depth. Is thought to be able to calculate more accurately the GFR value by the distance to the center of kidney more accurately measured in the skin thereby.

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The Evaluation of Lateral Scatter Ray of Gamma Camera (Gamma Camera에 있어 측면 선란선의 영향에 대한 평가)

  • Kim, Jae-Il;Lee, Eun-Byeol;Cho, Seong-Wook;Noh, Kyeong-Woon;Kang, Keon-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.46-50
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    • 2018
  • Purpose Generally, a collimator that installed in front of detector set a direction of gamma ray and remove a scatter ray. By the way, a lateral or oblique scatter ray is detected into crystal through collimator. At this study, we will evaluate a mount of count and spectrums of lateral scatter ray. Materials and Methods We used the SKY LITE (philips, netherlands) as a gamma camera, and $^{99m}Tc$, 1.11 GBq point source as a phantom. we put this point source at backside 50 cm of detector. After acquiring this for 1 min, we turned a detector next 10 degrees. Likely this, we acquired images at every 10 degrees from $0^{\circ}$ to $360^{\circ}$, analyzed images and spectrums. In case of patient study, we choose a 3 phase bone scan patient who had a hand disease, because scatter rays from body would detect on crystal. After acquiring blood flow and blood pool images, we analyzed images and spectrums. Additional, we put a lead gown on patient's hand, body. And then we compared and evaluated 3 type blood pool images (non lead gown, lead gown on a hand and on body). Results In case of phantom study, scatter ray counts at backside ($270^{\circ}-90^{\circ}$) are same with a background count. By the way, counts of scatter ray of oblique side ($0^{\circ}-50^{\circ}$, $220^{\circ}-270^{\circ}$) are 100-600 cps, furthermore, counts at frontside are over 4 Mcps. In case of patient study, a counts of hand blood pool scan are 1510 cps. But counts of hand with lead gown on hands and on body are each 1554 cps, 1299 cps. Conclusion Therefore, even though there is a collimator in front of detector, lateral scatter rays detect on crystal and affect to images and spectrums. Especially, if there is a high activity source at outside of detector when we examine low activity organs like hands or foot, we have to shield and remove the source at outside for a good image.

A Family Screening of Patients with Vesicoureteral Reflux (방광 요관 역류 환아의 가족 선별 검사에 관한 연구)

  • Kang Hee;Kim Hyung Jin;Yoo Kee Hwan;Hong Young Sook;Lee Joo Won;Kim Soon Kyum
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.36-42
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    • 2001
  • Purpose : Vesicoureteral reflux is the most commonly inherited disease detected in children with urinary tract infection. The incidence of vesicoureteral reflux among siblings of children with known vesicoureteral reflux is 8$\%$ to 45$\%$ according to different authors. Family screening of a patient with vesicoureteral reflux is important in order to prevent reflux nephropathy. The purpose of this study is to determine the incidence of vesicoureteral reflux in asymptomatic family of children with vesicoureteral reflux and the factors which influence the family history. Methods : The study group consisted of 27 families of patients with vesicoureteral reflux. The total number in the group were 79 persons. BUN, Cr, urineanalysis, voidingcystourethrography(VCUG) and 99mTc -dimercaptosuccinic acid(DMSA) renal scan were performed oil tile siblings. As for tile parents the same tests were performed except the VCUG. Results : The abnormality was detected in 7 of 27 families(25.9$\%$). Vesicoureteral reflux was detected in 5 of 20 siblings and renal scar ns detected in 3 of 32 parents. In children with vesicoureteral reflux, renal scar was detected in 24 of 32 children. Between the group with the abnormality in its family(Group A) and the group without the abnormality in its family(Group B), There was no difference of creatinine clearance between two groups. More renal scars were detected in group A according to the DMSA(A:100$\%$, B:75$\%$. t-test P<0.05). There was no difference of grade of VCUG between two groups. There was no difference between one site and both sites in two groups. In tile case of tile siblings with vesicoureteral reflux, there was high incidence of renal scar in a patient with vesicoureteral reflux according to the DMSA. Conclusion : It is important to screen vesicoureteral reflux and renal scar in case of urinary tract infection to prevent reflux nephropathy. This study implies that it is necessary to screen the family of a patient with vesicoureteral reflux especially with renal scar. (J, Korean Soc Pediatr Nephrol 5 : 36- 42, 2001)

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Early Diagnosis of Fatty Liver-Hemorrhagic Syndrome using Blood Biochemistry in Commercial Layers (산란계의 혈액화학치 측정에 의한 지방간 출혈 증후군의 조기 진단)

  • So, H.H.;Jeon, E.O.;Byun, S.H.;Mo, I.P.
    • Korean Journal of Poultry Science
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    • v.36 no.2
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    • pp.165-175
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    • 2009
  • Fatty liver-hemorrhagic syndrome (FLHS) is a common nutritional disease in commercial layers and breeders. The most important clinical sign of FLHS is a sudden drop in egg production and increased mortality which causes significant economic loss in the poultry industry. However, the current diagnostic method for FLHS is based on the gross findings at necropsy which is not helpful to reduce the economic loss because of lateness of diagnosis. Therefore, we need early diagnosis and diagnostic methods before chickens were affected by FLHS. In this study we tried to evaluate the effectiveness of clinical pathology including blood chemistry as an early diagnostic method for FLHS in commercial chickens. Profiles of blood biochemistry were compared between two flocks selected in the same commercial layer farm based on the presence of FLHS clinical sings. A flock with clinical signs of FLHS was designated as FLHS and other flock without clinical signs of FLHS as Non-FLHS. Several parameters of blood biochemistry were selected and compared between FLHS and Non-FLHS to evaluate the possibility of early diagnosis. Average concentrations of serum cholesterol, serum calcium, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) were $139.4\;{\pm}\;87.2$ (mg/dL), $24.5\;{\pm}\;5.4$ (mg/dL), $153.6\;{\pm}\;23.1$ (IU/L), $1238.3\;{\pm}\;475.2$ (IU/L) and $1107.3\;{\pm}\;422.8$ (IU/L) in Non-FLHS flock, respectively, and $210.2\;{\pm}\;173.2$ (mg/dL), $25.2\;{\pm}\;4.1$ (mg/dL), $174.3\;{\pm}\;53.5$ (IU/L), $1694.9\;{\pm}\;691.3$ (IU/L) and $1104.9\;{\pm}\;472.9$ (IU/L) in FLHS flock, respectively. The activities of serum cholesterol, AST and LDH except CK, were significantly higher in FLHS than those in Non-FLHS flock (p<0.05). Some birds of FLHS flock showed 2~17 times greater than in Non-FLHS flock. For the definitive diagnosis of FLHS in the flocks tested for blood chemistry, we analyzed fat content and histological lesion score in the liver sampled from both FLHS and Non-FLHS flock. Average liver fat contents based on dry weight were $16.1\;{\pm}\;0.4$ (%) in Non-FLHS flock and were $21.6\;{\pm}\;16.0$ (%) in FLHS flock. These result confirmed that FLHS flock was definitely affected by FLHS. The above results suggest that selected parameters of blood biochemistry, particularly AST, could be useful to diagnose FLHS before significant liver damage occurred in commercial layers.

Studies on the Duration of Immunity and Production of Antibody following Immunization with Inactivated Killed Japanese Encephalitis Vaccine (일본뇌염 백신 접종후 항 일본뇌염 항체의 생성율과 지속적인 면역반응에 대한 연구)

  • Cho, H.W.;Nam, J.H.;Lee, H.D.;Koh, H.C.;Kim, J.J.;Kim, E.J.;Lee, Y.S.;Lu, J.J.
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.116-125
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    • 1997
  • Purpose : Studies on the duration of immune response against Japanese encephalitis virus from recipients with JE vaccine (Nakayama-NIH strain) in Korea. Methods : To determinate the immune response and the duration of antibody against JE vaccine, 213 students were examined since 1994 using hemmaglutination inhibition test and plaque reduction neutralization test (PRNT). Results : 24 months after the first vaccination, haemmaglutination inhibition and neutralizing antibody maintained from the recipients 63.4% (>1:20) and 100% (>1:20), respectively. In April 1996, one dose booster to the same recipients those who were vaccinated in 1994, the GMT antibody for HI and PRNT titer were both increased from 1:11.6 to 1:13.2 and 1:275.7 to 1:348.1, respectively, after 6 months booster (after 30 months from the initial vaccination). This results showed that the antibody from the active immunity could be maintained more than 12 months after the initial vaccination. On the basis of these results, inactivated killed JE vaccine (Nakayama-NIH strain) using for preventing against JE purpose seems to produce antibody enough to protect against JE at present. Conclusions : Along with the results of this study demonstrating duration of antibody, the active immunization could be maintained as long as by initial vaccination of 2 doses, a single dose of booster vaccination made during a period of 1 month to 12 months and the successive booster vaccination by 2 or 3 year intervals. However, the immunization schedule should be concerned with both epidemiology of disease and the immune response of vaccinated individuals.

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Evaluation and Comparison of Myocardial Perfusion Defects in Patients with Early Breast Cancer Subjected to Different Radiation Simulation Techniques (조기유방암 환자에서 방사선 모의치료 방법의 차이에 따른 심근관류결손의 비교 평가)

  • Nam, Ji-Ho;Ki, Yong-Kan;Kim, Dong-Won;Kim, Won-Taek
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.26-33
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    • 2007
  • [ $\underline{Purpose}$ ]: The aim of this study is to evaluate and compare the incidence and aspects of myocardial perfusion defects in patients who were subjected to either two-dimensional or three-dimensional simulation techniques for early left-sided breast cancer. The myocardial perfusion defects were determined from using single photon emitted computerized tomography (SPECT) myocardial perfusion images. $\underline{Materials\;and\;Methods}$: Between January 2002 and August 2003, 32 patients were enrolled in this study. The patients were diagnosed as having early (AJCC stage T1-T2N0M0) left-sided breast cancer and were treated with tangential irradiation after breast-conserving surgery and systemic chemotherapy. The patients were divided into two groups according to the type of simulation received: two-dimensional simulation using an X-ray fluoroscope simulator or three-dimensional simulation with a CT simulator. All patients underwent technetium-99m-sestamibi gated perfusion SPECT at least 3 years after radiotherapy. The incidence and area of myocardial perfusion defects were evaluated and were compared in the two groups, and at the same time left ventricular ejection fraction and cardiac wall motion were also analyzed. The cardiac volume included in the radiation fields was calculated and evaluated to check for a correlation between the amount of irradiated cardiac volume and aspects of myocardial perfusion defects. $\underline{Results}$: A myocardial perfusion defect was detected in 11 of 32 patients (34.4%). There were 7 (46.7%) perfusion defect cases in 15 patients who underwent the two-dimensional simulation technique and 4 (23.5%) patients with perfusion defects in the three-dimensional simulation group (p=0.0312). In 10 of 11 patients who had myocardial perfusion changes, the perfusion defects were observed in the cardiac apex. The left ventricular ejection fraction was within the normal range and cardiac wall motion was normal in all patients. The irradiated cardiac volume of patients in the three-dimensional simulation group was less than that of patients who received the two-dimensional simulation technique, but there was no statistical significance as compared to the incidence of perfusion defects. $\underline{Conclusion}$: Radiotherapy with a CT simulator (three-dimensional simulation technique) for early left-sided breast cancer may reduce the size of the irradiated cardiac volume and the incidence of myocardial perfusion defects. Further investigation and a longer follow-up duration are needed to analyze the relationship between myocardial perfusion defects and clinical ischemic heart disease.

Effect of Preoperative White Blood Cell Count on Postoperative Course in Patients with Coronary Artery Bypass Grafting (관상동맥우회술 환자에서 술 전 백혈구 수치가 수술 후 경과에 미치는 영향)

  • Son Kuk Hui;Kim Jae Ho;Kim Joung Taek;Yoon Yong Han;Kim Kwang Ho;Baek Wan Ki
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.669-674
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    • 2005
  • Background: There are several studies that report the relationship between leukocytosis and cardiovascular disease mortality. Most of these studies stand on the basis that atherosclerosis is mediated by inflammatory process. By the same token, preoperative white blood cell count is suggested as an independent predictable factor of postoperative mortality and morbidity in coronary artery bypass grafting. The purpose of this study is to define the influence of preoperative white blood cell count on postoperative morbidity and mortality after coronary artery bypass grafting. Material and Method: The medical records of the 133 patients who had undergone isolated coronary artery bypass grafting at Inha University Hospital from 1996 to 2003 were reviewed. Patients were evenly divided into four groups, and named as group A, B, C, and D respectively based on their preoperative white blood cell count in ascending order. The number of patients in each group were 33 with exception of 34 in group A. The range of white blood cell count were from $1.3\times10^3/{\mu}L\;to\;5.9\times10^3/{\mu}L\;in\;group\;A,\; from\;6.0\times10^3/{\mu}L\;to\;7.0\times10^3/{\mu}L\;in\;group\;B,\;from\;7.1\times10^3/{\mu}L\;to\;8.9\times10^3/{\mu}L$ in group C, and from $8.9\times10^3/{\mu}L\;to\;16.9\times10^3/{\mu}L$ in group D. Result: The number of patients with recent myocardial infarction was 0 in group A, $2(6.1\%)$ in group B, $4(12.1\%)$ in group C, and $8(24.3\%)$ in D group, showing proportional increase to the white blood cell count (p<0.01). There were six postoperative deaths; $1(2.9\%)$ in group A, $1(3.0\%)$ in group B, $2(2.6\%)$ in group C, and $2(6.1\%)$ in group D (p=0.44), showing no significant difference between the groups. Postoperative wound infection occurred in 3 patients; all 3 patients were in group D, showing that postoperative wound infection is closely related to the preoperative white blood cell count. Conclusion: The association between preoperative white blood cell count and postoperative mortality could not be defined. The incidence of postoperative wound infection was found to be proportional to the preoperative white blood cell counts.