• Korean Journal of Digital Imaging in Medicine
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• v.16 no.1
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• pp.13-19
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• 2014

Purpose: FLAIR image is beneficial for the diagnosis of various bran diseases including ischemic CVS, brain tumors and infections. However the border between the legion of brain metastasis and surrounding edema may not be clear. Therefore, this study aims to investigate the practical benefits of delayed imaging by comparing the image from a patient with brain metastasis before a contrast enhancement and the image 10 minutes after a contrast enhancement. Materials and methods: Of the 92 people who underwent MRI brain metastases in suspected patients 13 people in three patients there is no video to target the 37 people confirmed cases, and motion artifacts brain metastases in our hospital June-December 2013, 18 people measurement position except for the three incorrect patient (male: 11 people, female: 7 people, average age: 60 years) in the target, test equipment, 3.0T MR System (ACHIEVA Release, Philips, I was 8ChannelSENSE Head Coil use Best, and the Netherlands). TR 11000 ms, TE 125 ms, TI2800 ms, Slice Thickness 5 mm, gap 5 mm, is a Slice number 21, the parameters of the 3D FFE, T2 FLAIR variable that was used to test, TR 8.1 ms, TE 3.7 ms, Slice number 240 I set to. The experiment was conducted by acquiring the FLAIR prior to contrast enhancement (heretofore referred to as Pre FLAIR), and acquiring the 3D FFE CE five minutes after the contrast enhancement, and recomposing the images in an axial plane of S/T 3mm, G 0mm (heretofore referred to as MPR TRA CE). Using the FLAIR 10 minutes after the contrast enhancement (heretofore referred to as Post FLAIR) and Pi-View, a retrospective study was conducted. Using MRIcro on the image of a patient confirmed for his diagnosis, the images before and after the contrast media, as well as the CNR and SNR of the MPR TRA CE images of the lesion and the site absent of lesion were compared and analyzed using a one-way analysis of variance. Results: CNR for Pre FLAIR and Post FLAIR were 34.35 and 60.13, respectively, with MPR TRA CE at 23.77 showing no significant difference (p<0.050). Post-experiment analysis shows a difference between Pre FLAIR and Post FLAIR in terms of CNR (p<0.050), but no difference in CNR between Post FLAIR and MPR TRA CE (p>0.050), indicating that the contrast media had an effect only on Pre FLAIR and Post FLAIR. The SNR for the normal site Pre FLAIR was 106.43, and for the lesion site 140.79. Post FLAIR for the normal site was 107.79, and for the lesion site 167.91. MPR TRA CE for the normal site was 140.23 and for the lesion site 183.19, showing significant difference (p<0.050), and post-experiment analysis shows that there was a difference in SNR only on the lesion sites for Pre FLAIR and Post FLAIR (p<0.050). There was no difference in SNR between the normal site and lesion site for Post FLAIR and MPR TRA CE, indicating no effect from the contrast media (p>0.050). Conclusions: This experiment shows that Post FLAIR has a higher contrast than Pre FLAIR, and a higher SNR for lesions, It was not not statistically significant and MPR TRA CE but CNR came out high. Inspection of post-contrast which is used in a high magnetic field is frequently used images of 3D T1 but, since the signal of the contrast medium and the blood flow is included, this method can be diagnostic accuracy is reduced, it is believed that when used in combination with Post FLAIR, and that can provide video information added to the diagnosis of brain metastases.

• Tuberculosis and Respiratory Diseases
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• v.63 no.6
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• pp.480-485
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• 2007

Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. COPD has systemic effects, such as skeletal muscle dysfunction and abnormal weight loss. It also has been suggested that COPD is related to other chronic disease, such as cardiovascular disease, osteoporosis, and anemia. The aim of this study was to evaluate a symptom questionnaire and laboratory findings in subjects with air flow limitation. Methods: We evaluated a symptom questionnaire and laboratory findings in subjects with airflow limitation detected by spirometry in conjunction with the Second Korean National Health and Nutrition Examination Survey. A total of 9,243 adults over the age of 18 were recruited. Among the adults, we finally analyzed 2,217 subjects who met the acceptability and repeatability criteria of spirometry, showed normal findings on chest radiography, and were older than 40 years of age. Results: There were 288 subjects with airflow limitation as determined by spirometry. The frequency of respiratory symptoms such as cough, sputum and wheezing were significantly higher in subjects with airflow limitation (p <0.01). Hemoglobin and hematocrit levels were higher in subjects with airflow limitation (hemoglobin level 13.98 mg/dL vs. 13.62 mg/dL, hematocrit 42.10% vs. 40.89%; p<0.01). The HDL cholesterol level was lower in subjects with airflow limitation (44.95 mg/dL vs. 45.60 mg/dL; p<0.01). There was no significant difference in the total cholesterol, triglyceride, blood urea nitrogen, creatinine, and fasting glucose levels. Conclusion: In subjects with airflow limitation, prevalence of respiratory symptoms was higher than in normal spirometry subjects and the levels of hemoglobin and the hematocrit were higher. The HDL cholesterol level was lower in subjects with airflow limitation.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.607-621
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• 1997

GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.124-131
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• 2003

Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

• Tuberculosis and Respiratory Diseases
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• v.54 no.5
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• pp.495-509
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• 2003

Background : Neutrophil-mediated inflammation is usually self-limiting, because neutrophils have a remarkably short life span. Prolonged neutrophil survival, which is caused by decreased spontaneous apoptosis, leads to persistent inflammation in sepsis. Because many inflammatory cytokines, which generate signals that delay apoptosis, are regulated by nuclear factor-${\kappa}B$ transcription factor, we hypothesized that nuclear factor-${\kappa}B$ might be related to the reduced neutrophil apoptosis observed in sepsis. Methods : Neutrophils of healthy volunteers and sepsis patients were freshly isolated from venous blood. Neutrophil apoptosis was assayed with two approaches : by counting apoptotic cells under a microscope and by flow cytometry using Annexin V. The activity of nuclear factor-${\kappa}B$ was assessed by immunofluorescent staining or electrophoretic mobility shift assay. Expression of X-linked inhibitor of apoptosis was measured by western blot assay. Results : We confirmed reduced spontaneous neutrophil apoptosis in patients with sepsis. The number of apoptotic neutrophils in patients with sepsis increased to the level of that in healthy controls after cycloheximide treatment, suggesting that decreased spontaneous neutrophil apoptosis is dependent on de novo protein synthesis. In patients with sepsis, basal neutrophil nuclear factor-${\kappa}B$ was activated compared to the level in healthy controls. Moreover, a blockade of nuclear factor-${\kappa}B$ activity reversed the decreased spontaneous neutrophil apoptosis in sepsis patients. Meanwhile, X-linked inhibition of apoptosis expression, which is regulated by nuclear factor-${\kappa}B$, decreased 24 hours after incubation in healthy persons, but persisted for 24 hours in patients with sepsis. Conclusion : These observations suggest that the reduced spontaneous neutrophil apoptosis observed in patients with sepsis may be related to the induction of survival protein by nuclear factor-${\kappa}B$.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.530-537
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• 2007

Purpose: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Materials and Methods: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.787-791
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• 2001

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.205-214
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• 1995

Purpose : To investigate the effect of Ginkgo biloba extract (GBE) on hypoxic cell fraction and metabolic status in fibrosarcoma (FSa II) of C3H mouse. Materials and Methods : Fibrosarcoma (FSa II) 6 mm in diameter, growing in the right hindleg muscle of C3H mouse was used for estimation of hypoxic cell fraction using comparison of $TCD_{50}$. Radiation was given one hour after administration of GBE (100 mg/kg. i.p.) with or without priming dose of GBE (100 mg/kg, i.p.) given 24 hours earlier. Radiation was also given under air breathing condition or clamp hypoxia without GBE as controls. $^{31}p$ NMR spectroscopy was performed before and one hour after administration of GBE with or without priming dose of GBE. Results : $TCD_{50/120's}$ were 81.7 (77.7-86.0) Gy when irradiated under clamped hypoxia 69.6 (66.8-72.5) Gy under air breathing condition. 67.5 (64.1-71.1) Gy with a single dose of GBE (100 mg/kg) given one hour before irradiation, and 62.2 (59.1-65.5) Gy with two doses of GBE given at 25 hours and one hour before irradiation. The hypoxic cell fractions, estimated from $TCD_{50/120's}$, were $10.6{\%}$ under air breathing condition, $7.2{\%}$ after a single dose of GBE, and $2.7{\%}$ after two doses of GBE. The results of $^{31}P$ NMR spectroscopy were as follow. PCr/Pi ratio was $0.27{\pm}0.04$ and $0.40{\pm}0.04$ before and one hour after a single dose of GBE (p<0.05), respectively, without priming dose and $0.30{\pm}0.02$ and $0.71{\pm}0.04$, respectively, with priming dose (p<0.01). These findings indicate that the metabolic status is slightly improved after a single dose and markedly after repeated administrations. Conclusion : GBE decreases the hypoxic cell fraction and imprvoes the meta bolic status of tumor, probably by increasing the blood flow and delivery of oxygen and nutrients, resulting in increased radiosensitivity of tumor.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.388-397
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• 1999

Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.3
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• pp.243-251
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• 2005

Objective: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer Methods: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus <8 mm) and same variables above described were compared between study and control groups. Results: The mean age, infertility duration, endometrial thickness at embryo transfer day and mean number of transferred embryo were not significantly different in both groups. Also, implantation rates (study group: 15.8%, control group: 20.5%) and pregnancy rate (study group: 45.1%, control group: 43.5%) were not significantly different between two groups. (p>0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. Conclusions: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.