• Childhood Kidney Diseases
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• v.7 no.1
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• pp.44-51
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• 2003

Purpose : Acute pyelonephritis in children may result in permanant renal damage which later in life may lead to hypertension and renal failure. The purpose of this study was to evaluate the factors that might be useful for predicting the development of renal scar in children with urinary tract infection(UTI). Methods : We retrospectively reviewed 442 patients with UTI who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, during the period from April 1992 to March 2002. The patients were divided into two groups according to the presence of renal scar on the follow-up DMSA renal scan, and we compared the factors associated with renal scarring between the two groups. Results : There were no significant differences in sex, causative organism and acute phase reactants between the groups with and without renal scar. The age at diagnosis was significantly higher in the renal scar group compared to that without scar. Of the 60 patients with renal scar, 78% had vesicoureteral reflux(VUR), but 13% of patients without scar had VUR. Furthermore, the severity of VUR was significantly correlated with renal scar formation. 53% showed multiple cortical defects on the initial DMSA renal scan, compared to 32% in the non-scar group. In addition, 76% of patients showing multiple cortical defects on the initial DMSA renal scan with VUR had renal scar. Conclusion : The presence and grade of VUR, and findings on the initial DMSA renal scan would contribute to predict risk of renal scar formation in children with UTI.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.223-231
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• 2002

Purpose : We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. Methods : We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl-triglycerine scan and the degree of hydronephrosis by renal ultrasonography. Results : In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. Conclusion : We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.237-243
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• 1990

Pulmonary embolism demands rapid and accurate diagnosis. And ventilation imaging has greatly improved the diagnostic accuracy of pulmonary embolism in addition to perfusion imaging. Agents currently used include xenon-133, krypton-81m and technetium-99m radioaerosols. However radioactive gases are compromised by availability and cost for krypton-81m, radiation dose, gamma energy and non?physiologic behaviour for xenon-133. Radioaerosols of technetium-99m componds are rapidly cleared from the lung after inhalation, and their relative low effeciency (specific radioactivity) and wide distribution of particle sizes make them also suboptimum. A new ventilation agent, Technegas is a suspension of structured graphite ellipsoids with diameter below 20nm, labelled with $^{99m}Tc$ in a carrier gas of Argon. This report describes the authors' clinical experience with Technegas. This is the first reported clinical study of this agent in Korea. A comparison of Technegas and $^{99m}Tc-DTPA$ aerosol was performed in 12 patients with various pulmonary diseases such as COPD, pulmonary tuberculosis and pleural effusion. All patients were studied with $^{99m}Tc-DTPA$ aerosol inhalation and Technegas ventilation. In both studies image quality was assessed (1) semiquantitatively by scoring bronchial and gastric activity, (2) subjectively by direct visual comparison of peripheral lung images and (3) quantitatively by computing the peripheral penetration index(PI) for each lungs. The bronchial activites were seen in 7 out of 12 cases with $^{99m}Tc-DTPA$ aerosol and in 5/12 with Technegas. The gastric activities were seen in 5/12 and 1/12 cases respectively. The average values of PI were 61.26% with $^{99m}Tc-DTPA$ aerosol and 69.20% with Technegas (p>0.05). Using $^{99m}Tc-DTPA$ aerosol, COPD patients showed deposition in the central airways with poor visualization of the peripheral areas of the lungs. In Technegas studies these phenomena were less prominent, and the examination is well tolerated by pateients and requires only a minimum of patient cooperation. With superiority of easy availability and handling, better physical characteristics and favorable Image quality, Technegas is a Promising agent for lung ventilation scanning.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.101-107
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• 1999

We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients. all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more than 50% of coronary artery narrowing was considered significant, the overall sensitivity and specificity of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%. respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity for CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.63-69
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• 1989

In order to develop technetium-99m-labelled human albumin microsphere (HAM) for lung scintigraphy, various experimemts such as preparation and fractionation of HAM, establishment of optimal labelling conditions, determination of radiochemical purity, stability test and biodistribution of $^{99m}Tc-HAM$ were carried out. HAM was prepared from the suspension of 1ml aqueous human serum albumin (25%) in 130 ml of olive oil at $130\sim135^{\circ}$ with vigorous stirring. The resulting HAM was fractionated with microsieve to get the desired particle size $(15\sim50\mu)$ and autoclaved for sterilizaiton. The HAM particles were treated with stannous chloride and the pH of the suspension was adjusted to $3.0\sim3.5$ with phosphate buffer. After freeze-drying the contents of single reaction vial containing 5 mg of HAM and 0.2 mg of $SnCl_2$ it was reacted with $Na^{99m}TcO_4$. The labelling yield was higher than 99.5% and the stability of $^{99m}Tc-HAM$ was high enough to maintain 99.1% of radiochemical purity up to 24 hours. Lung and liver uptake in mice was found to be 94% and 0.9%, respectively. Excellent rabbit and human lung scans were also obtained.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.188-196
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• 1986

Spirometry and regional function studies using 99m-Technetium were performed preoperatively to predict postoperative pulmonary function change in 34 patients who had various pulmonary resectional procedures at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Between two months and fourteen months postoperation all the patients were reinvestigated with spirometry and clinical examination to evaluate their functional respiratory status. The postoperative obtained values, especially forced vital capacity [FVC] and forced expiratory volume in one second [FEV1] among the other parameters were compared with the postoperative predicted values. Estimated values of FVC and FEV1 derived from preoperative spirometry and quantitative perfusion lung scan correlated well with the measured postoperative values. The linear regression line derived from correlation between postoperative estimated[X] and postoperative measured[Y] values of FVC and FEV1 in all patients are as follows; 1. Y=0.76x + 0.39 in correlation of FVC [r=0.91] 2. Y=0.88x + 0.17 in correlation of FEV1 [r=0.96],br> This method of estimation was one of the best methods of predicting postoperative pulmonary function change and valuable in determining the extent of safe resection and postoperative prognosis to a poor risk patient with chronic obstructive lung disease.

• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.61-66
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• 1980

We studied four patients with muscle necrosis associated with acute renal failure to evaluate the diagnostic value of the bone scan in this disease. The illness followed carbon monoxide poisoning in two patients, acute physical exertion in one and contaminated intramuscular injection in the other. Whole-body rectilinear bone scans using technetium 99m-methyldiphosphonate were done. In all patients, increased muscle labelling at the regions of suspected muscle injury was showed, and in one, it was after normalization of serum muscle enzyme levels. In one patient, the bone scan was rechecked 8 months later and showed no residual abnormality. Above all, the site and precise extent of muscle injury could be detected and the degree of muscle labelling seemed to correlate with the severy of muscle injury. These findings suggest that isotope scanning may be useful in the diagnosis of patients with acute muscle necrosis.

• Childhood Kidney Diseases
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• v.20 no.2
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• pp.74-78
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• 2016

Purpose: Early diagnosis and treatment of urinary tract infection have been emphasized to prevent renal scarring. If untreated, acute pyelonephritis could cause renal injury, which leads to renal scarring, hypertension, proteinuria, and chronic renal failure. The purpose of this study was to assess risk factors of renal scarring after treatment of acute pyelonephritis (APN). Methods: The medical records of 59 patients admitted at Daegu Fatima Hospital because of APN between March 2008 and April 2015 whose renal cortical defects were confirmed by using initial technetium-99m dimercaptosuccinic acid (DMSA) scans were reviewed retrospectively. We divided 59 patients into 2 groups according to the presence of renal scar and assessed risk factors of renal scar, including sex, age at diagnosis, feeding method, hydronephrosis, bacterial species, vesicoureteral reflux, and vesicoureteral reflux grade. Results: Of 59 patients (41%), 24 showed renal scar on follow-up DMSA scan. No significant differences in sex, hydronephrosis, bacterial species, and fever duration were found between the renal-scarred and non-scarred groups. As for age at diagnosis, age of >12 months had 5.8 times higher incidence rate of renal scarring. Vesicoureteral reflux (VUR) affected renal scar formation. VUR grade III or IV had 14.7 times greater influence on renal scar formation than VUR grade I or II. Conclusion: Our data suggest that the presence of VUR and its grade and age at diagnosis are risk factors of renal scar on follow-up DMSA scan after APN.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.171-174
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• 1988

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium- 99mTc-IDAs scan have shown that 99mTc-IDA s can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.133-137
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• 1996

A 17 month-old girl presented in the pediatric clinic on November 27th, 1990 with a neck mass. The mass was 2 cm in diameter, firm in consistency and movable on the upper pole of the thyroid cartilage in the midline. The technetium thyroid scan showed a hot reactivity at the compatible site of the mass, but no other radioactivity in either site of the normal thyroid positions. At her second visit on January 23th, 1996, the mass had enlarged up to 3.5cm in diameter in the same location of the neck. The follow up thyroid scan revealed a walnut sized, snowman-like radioactivity. One of the snowman-like double images seemed to be a lingual ectopic thyroid and the other a midline ectopic thyroid remnant in the infrahyoid level. This interpretation was supported by the computed tomography of the neck, which showed a ligual mass in the foramen cecum area and an another mass in the anterior comis-sure of the larynx in the mildline. Thyroid function test was normal except a slightly increased TSH. As a result of this changing pattern of thyroid radioactive images, a case of a lingual thyroid as well as another midline ectopic thyroid tissue at the infrahyoid level is reported.