• Title/Summary/Keyword: bilateral ratio

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Is $^{99m}Tc$-MDP Mammoscintigraphy Useful in Patients with Breast Mass Lesions? ($^{99m}Tc$-MDP 유방 스캔은 유방 종괴의 감별진단에 임상적인 유용성이 있는가?)

  • Park, Seok-Gun;Lee, Yeon-Hee;Rhyu, Jin-Woo;You, Sun-Mee
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.151-160
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    • 1998
  • Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.

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Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy- $3{\beta}$-(4-cholorophenyl) tropane) Brain SPECT (파킨슨병과 본태성 진전의 감별진단에서 I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy-$3{\beta}$-(4-cholorophenyl) tropane) 뇌 단일광전자방출 전산화단층촬영의 역할)

  • Pai, Moon-Sun;Choi, Tae-Hyun;Ahn, Sung-Min;Choi, Jai-Yong;Ryu, Won-Gee;Lee, Jae-Hoon;Ryu, Young-Hoon
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.100-106
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    • 2009
  • Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

THE RELATIONSHIP BETWEEN THE CONGENITALLY MISSING PRIMARY LOWER ANTERIOR TEETH AND THEIR SUCCEDANEOUS PERMANENT TEETH IN KOREAN CHILDREN (한국 어린이에서 하악 유절치와 그 계승 영구치의 선천적 결손 간의 관계)

  • Kim, Hyun-Jin;Hyun, Hong-Keun;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.91-96
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    • 2010
  • Many studies have shown that there is a strong relationship between the congenitally missing primary teeth and their succedaneous permanent teeth. However, especially in case of lower anterior region, we can observe the existence of permanent teeth even though their precedent primary teeth were missed at times. The purpose of this study was to reveal the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth in Korean children. Total of 14,307 children, under 6 years of age, who attended the department of pediatric dentistry, Seoul National University Dental Hospital, Seoul, Korea from January 1st 2005 to September 5th 2008 were radiologically examined using the panoramic x-ray in order to analyze the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth. The results were as follows : 1. The prevalence of congenitally missing lower anterior teeth in primary dentition was 0.24%. The odds ratio of both the primary and permanent anterior teeth being present was 7163.5 and only the permanent anterior teeth being present was 0.79. 2. The percentage of all succedaneous permanent teeth being present was 44.12% in cases of missing lower primary anteriors. The odds ratio of at least one succedaneous permanent teeth being present in cases of bilateral primary anterior teeth missing was 1.57 times more common than in cases of unilateral primary teeth missing. 3. The odds ratio of primary missing teeth being unilateral was 2.2 times higher in females. Moreover, the odds ratio of succedaneous permanent teeth being present in cases of primary teeth missing was 2.22 times higher in males.

Geochemical and Structural Geological Approach for clarifying Stratigraphy of Quartzite in the Paju Area: an Application of Rare Earth Element and Nd Isotope in Stratigraphy (파주지역 규암의 층서관계 규명을 위한 지구화학적-구조지질학적 연구: 층서규명을 위한 희토류원소 분포도와 Nd 동위원소의 응용)

  • Koh Hee Jae;Lee Seung-Gu;Lee Byung-Joo
    • The Journal of the Petrological Society of Korea
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    • v.14 no.2 s.40
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    • pp.116-126
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    • 2005
  • The Precambrian quartzite and calc-schist layers experienced multi-1310ing events are distributed along the two kinds of U-shaped 1310 (Fold I and II) with $N10^{\circ}E-directed$ fo1d axis in Wollong-myeon, Gwangtan-myeon, Jori-myeon of Paju city, the northeastern part of Gyeonggido. Occurrence of 10 layers of quartzite and 4 layers of calc-schist is not clear whether quartzite and schist layers were deposited sequentially each other or one to two layers of quartzite and schist were distributed repeatedly by isoclinal folding and thrusting, because of lack of sedimentary structures. In this paper, we tried to clarify the correlative relationship among the quartzite beds which are distributed along the U-shaped folds using geochemical tools such as rare earth element (REE) patterns and Nd isotope ratio. Quartzites have characteristics of LREE-flattened, HREE- slightly depleted patterns. They also show Ce negative anomaly whereas there are no Eu anomalies. As a result, quartzite beds occurred along the bilateral sides of fold axis show very similar REE patterns from outer side to inner side of 1314. The Nd model age of quartzite layers shows a trend that the inner part of fold is younger than the outer part of it. Such geochemical characteristics suggest that bilateral quartzite beds occurred along the fold axis were derived from the cogenetic source materials. The REE patterns and trace element geochemistry of mica schist intercalated within quartzite indicate that the quartzite and mica schist may be derived from different source materials. Our results suggest that REE and Nd isotope geochemistries may be very useful in clarifying the relationship of sedimentary deposits which do not show stratigraphical and structural connections in the field.

Clinical Evaluation of Surgical Resection on Pulmonary Tuberculosis -Multiple Drug Resistent Pulmonary Tuberculosis (폐결핵 환자에 적용된 폐절제술의 임상적 연구 -다제약제내성 결핵환자를 중심으로-)

  • 전희재;한동기
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.786-792
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    • 1997
  • A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows. 1. The ratio of male to female was 3.7:1 and in the age incidence the fourth decade was 22%, the third decade 15%. Although medical treatment was performed for more than 3 to 6 months, preoHeratively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%), 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indica ion for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR 6. group and the most common of complication was tuberculosis spreading. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2% Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions Slt to. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications su h as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have inireased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.

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Clinical Evaluation of Surgical Resection of Pulmonary Tuberculosis (폐결핵에 대한 외과적 치험)

  • Park, Seung-Kyu;Shon, Mal-Hyun;Han, Dong-Gi;Ha, Hyun-Chul;Jin, Young-Ho;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.474-480
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    • 1995
  • Background: In spite of initial intensive and long-term chemotherapy for pulmonary tuberculosis, many problems remain in the treatment of the residual lesion. The role of surgical intervention for pulmonary tuberculosis is getting rid of such residual lesion of pulmonary tuberculosis to support the healing process and to induce bacteriologically negative conversion in the end. Method: We experienced 30 cases of pulmonary resection for pulmonary tuberculosis from Aug. 1994 through Apr. 1995 in National Masan Tuberculosis Hospital. We conducted retrospective study to analyze several variables for the cases. Results: 1) The ratio between male and female was 4:1(male 24, female 6) and the age of peak incidence was in 3rd and 4th decades. 2) Indications for pulmonary resection in the radiographic findings were cavitary lesions of 19 cases(63.3%), destroyed one side of 8 cases(26.7%) and destroyed one lobe of 3 cases(10%). 3) 16 of 20 cases with unilateral lesions and all of 10 cases with bilateral lesions on chest X-ray films showed AFB positive on preoperative sputum smears. 14 cases(87.5%) of unilateral lesions and 9 cases(90%) of bilateral ones were converted into AFB negative postoperatively. Negative conversion rates of pneumonectomy and lobectomy cases were 100% and 85.7%, respectively. 4) Preoperative combined disease was 3 cases(10%) of DM and postoperative complications were 2 cases(6.7%) of dead space and no death. Conclusion: Chemotherapy only has some limitation in treatment of all tuberculosis. So, surgical intervention for pulmonary tuberculosis is an effective method as partner of chemotherapy.

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Continuous Positive Airway Pressure during Bronchoalveolar Lavage in Patients with Severe Hypoxemia (심한 저산소혈증 환자에서 기관지폐포세척술 시 안면마스크를 이용한 지속성 기도양압의 유용성)

  • An, Chang Hyeok;Lim, Sung Yong;Suh, Gee Young;Park, Gye Young;Park, Jung Woong;Jeong, Seong Hwan;Lim, Si Young;Oui, Misook;Koh, Won-Jung;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.71-79
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    • 2003
  • Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

Study on the Ventilation System Applicability of High-rise Hog Building for Growing-fattening (고상식 육성비육돈사에 적합한 환기시스템에 관한 연구)

  • Yoo, Yong-Hee;Song, Jun-Ik;Choi, Dong-Yoon;Chung, Eui-Soo;Jeon, Kyoung-Ho;Lee, Poong-Yeon;Kim, Sang-Woo;Jeung, Jong-Won
    • Journal of Animal Environmental Science
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    • v.16 no.1
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    • pp.41-50
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    • 2010
  • The goal of this study was to develop a suitable ventilation system for high-rise hog building (HRHB) for growing-fattening with combined slatted floor pen in second story and in situ manure management system in Korea. The HRHB was constructed as 29m long, 9m wide and 7.6m high for outer dimension with an indoor height of 3.1m and 2.4 for lower and upper floor, respectively. Ventilation systems for each treatment were installed in separated rooms of HRHB. The ventilation types installed in each room were following 3 types: ventilation type 1 (V1), where air was pulled through a circular duct inlet and exhausted by fans; ventilation type 2 (V2), where air was pulled through eave inlet (side ceiling inlet) and exhausted by fans; and ventilation type 3 (V3), where air was pulled through baffled ceiling inlet and exhausted by fans. For each ventilation system, investigated air velocity under minimum, medium and maximum ventilation ratio and air flow pattern inside. The results were as follows; For air flow pattern from top to bottom, V1 showed a homogeneous vertical type, V2 showed a bilateral symmetry type and V3 showed an vertical umbrella type. Under minimum ventilation ratio, air velocity in upper floor (80cm above the slated floor) was similar for V1, V2, and V3. Under maximum ventilation ratio, air velocity in upper floor was undeviating for V1 (0.10~0.26m/s) and varied for V2 (0.12~0.63m/s) while those for V3 was relatively slow and less varied (0.07~0.15m/s). In conclusion, Duct inlet type (V1) can be applied to the development of a new HRHB with additional evaluations such as field test hog feeding.

A Clinical Analysis of Surgically Managed Thyroid Nodule (외과적으로 치료한 갑상선 결절에 대한 임상적 고찰)

  • Jung In-Kyu;Kim Lee-Su;Choi Won-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.1
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    • pp.16-24
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    • 1993
  • During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

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Clinical application of RapidArc volumetric modulated arc therapy as a component in whole brain radiation therapy for poor prognostic, four or more multiple brain metastases

  • Lee, Seung-Heon;Lee, Kyu-Chan;Choi, Jin-Ho;Kim, Hye-Young;Lee, Seok-Ho;Sung, Ki-Hoon;Kim, Yun-Mi
    • Radiation Oncology Journal
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    • v.30 no.2
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    • pp.53-61
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    • 2012
  • Purpose: To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. Materials and Methods: Nine patients with multiple (${\geq}4$) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10-12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. Results: The median biologically effective dose to metastatic tumors was 68.1 $Gy_{10}$ and 67.2 $Gy_{10}$ and the median brain volume irradiated more than 100 $Gy_3$ were 1.9% (24 $cm^3$) and 0.8% (13 $cm^3$) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. Conclusion: RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.