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Assessment of Hyperperfusion by Brain Perfusion SPECT in Transient Neurological Deterioration after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Surgery (천측두동맥-중대뇌동맥 문합술 후 발생한 일과성 신경학적 악화에서 뇌관류 SPECT를 이용한 과관류 평가)

  • Lee, Jeong-Won;Kim, Yu-Kyeong;Lee, Sang-Mi;Eo, Jae-Sun;Oh, Chang-Wan;Lee, Won-Woo;Paeng, Jin-Chul;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.267-274
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    • 2008
  • Purpose: Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery - middle cerebral artery (STA-MCA) anastomosis surgery. Materials and Methods: A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: $50{\pm}16$ yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. Results: In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of the cerebral perfusion ratio on preoperative and tenth postoperative day between patients with TND and other patients. Conclusion: In patients with TND, relative and moderate hyperperfusion was observed in affected side after bypass surgery. These finding may help to understand the pathophysiology of TND.

A Comparative Analysis According to a Presence or Absence of Metal Artifacts when a Dose Change and QAC Technique are Applied in PET/CT Tests (PET/CT 검사에서 선량변화와 QAC기법 적용 시 Metal Artifact 유무에 따른 SUV 비교분석)

  • Yun, Sun-Hee;Kim, Yang-Jung;Kang, Young-Jik;Park, Su-Young;Kim, Ho-Sin;Ryu, Hyoung-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.51-56
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    • 2015
  • Purpose As medical radiation exposures on patients are being social issues an interest in a relief of radiation exposures on patients is increasing. Further, there are many cases where some patients among who are getting PET/CT tests choose to get implanted with metal artifacts in their bodies. This study is to find out effects of presence or absence of metal artifacts when dose change or CT attenuation correction for the relief of radiation exposures are applied using phantoms through changes in standard uptake value (SUV). Materials and Methods GE company's Discovery 710 machine was used for PET/CT test equipments. We used NEMA IEC body phantoms. We also used screw and mesh cage made of titanium which are used in real clinical processes for the metal artifacts. Two experiments were conducted: One is to test and measure repeatedly about SUV about differences in CT attenuation corrections according to dose changes and another is to do the same procedure for SUV about the presence and absence of the metal artifacts. We injected $^{18}F-FDG$ into NEMA IEC body phantoms with a TBR ratio of 4:1 and then put the metal material into the transformation phantoms. Once a scanning for the metal artifacts was done we eliminated the metal artifacts and went on non-metal artifacts. For the each two experiments, we scanned repeatedly with CT kVp (140, 120, 100, 80) and mA (120, 80, 40, 20, 10) for an experimental condition. For PET, we reconstructed each with standard AC (STD) technique and quantitation achieved cnsistently QAC) technique among CT attenuation correction methods. We conducted a comparative analysis on measured average values and variations which were measured through repeated measure of SUV of region 1, 2, 3 spheres for each conditions of non-metal /metal scan. Results For each kVp, 120, 80, 40 (mA) of non/metal (screw, mesh cage) showed low frequency of fluctuation rates of above 2%. In 20, 10 mA above 2% of fluctuation rates appeared in high frequency. Also, when we compared the fluctuation rates of STD and QAC techniques in non/metal (screw, mesh cage) tests QAC technique showed about 1-10% of differences for each conditions compared to STD technique. In addition, metal types did not have significant effects on fluctuation rates. Conclusion We confirmed that SUV fluctuation rates for both STD and QAC techniques increase as dosage is lower. We also found that the SUV of PET data was maintained steadily in a low dosage for QAC technique when compared with STD technique. Hence, when the low dosage is used for the relief of radiation exposures on patients QAC technique may be exploited helpfully and this could be applied in the same way for patients with metal artifacts implanted in their bodies.

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Epstein-Barr Virus in Nasal Angiocentric Lymphoma with Malignant Histiocytosis-like Hemophagocytic Syndrome (악성조직구증과 유사한 혈구탐식증후군을 동반한 코의 혈관중심위 림프종과 Epstein-Barr 바이러스의 관련성 연구)

  • Han Ji-Youn;Kim Hoon-Kyo;Moon Han-Lim;Seo Eun-Joo;Kwon Hi-Jeong;Park Yeon-Joon;Min Ki-Ouk;Yoon Sei-Cheol;Kim Min-Shik;Cho Seong-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.9-15
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    • 1997
  • Malignant histiocytosis(MH)-like hemophagocytic syndrome(HS) is a fatal complication of nasal angiocentric lymphoma(AL) and difficult to distinguish from MH. Ten of total 42 patients with nasal AL had HS and 9 of them were initially suspected to have MH. Five patients had HS as initial manifestation, 3 at the time of relapse, and 2 during the clinical remission of lymphoma. Four patients were treated by combination chemotherapy(CHOP) and others had only supportive care. Immunohistochemical study and in situ hybridization were performed on the specimen obtained from 10 patients. The median survival of all patients from HS was 18 days(range 2 - 44 days) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1(CD45RO) and Epstein-Barr virus (EBV) by EBER in situ hybridization. MH-like HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in future.

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An Analysis of Epidemiological Investigation Reports Regarding to Pathogenic E. coli Outbreaks in Korea from 2009 to 2010 (최근 2년간(2009-2010) 우리나라 병원성 대장균 식중독 역학조사 보고서 분석)

  • Lee, Jong-Kyung;Park, In-Hee;Yoon, Kisun;Kim, Hyun Jung;Cho, Joon-Il;Lee, Soon-Ho;Hwang, In-Gyun
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.366-374
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    • 2012
  • Recently pathogenic E. coli is one of the main foodborne pathogens resulting in many patients in Korea. To understand the characteristics of pathogenic E. coli outbreaks in Korea, the epidemiological investigation reports of pathogenic E. coli outbreak in 2009 (41 reports) and in 2010 (27 reports) were collected in the web site of the Korea Centers for Disease Control and Prevention, reviewed and analysed in this study. The main places of the pathogenic E. coli outbreaks were food catering service area (64.8%) and restaurants (25.0%). The main type of the pathogens were EPEC (44.7%) and ETEC (34.2%). EAEC and EHEC was responsible for 10.5 and 9.2%, respectively. Eight of 68 outbreak cases were caused by more than 2 types of pathogenic E. coli which implicates the complicated contamination pathways of pathogenic E. coli. The incidence rate of pathogenic E. coli was $33.6{\pm}30.5%$ and the main symptoms were diarrhea, stomach ache, nausea, vomiting, and fever etc. The two identified food sources were identified as frozen hamburger pattie and squid-vegetable mixture. To improve the food source identification by epidemiological investigation, food poisoning notification to the agency should not be delayed, whole food items attributed the outbreak should be collected and detection method of the various pathogenic E. coli in food has to be improved. In conclusion, the characteristics between the EHEC outbreaks in the western countries and the EPEC or ETEC outbreaks in Korea needs to be distinguished to prepare food safety management plan. In addition, the development of the trace back system to find the contamination pathway with the improved detection method in food and systemic and cooperative support by the related agencies are necessary.

The Interpretation of Korean Traditional Garden in the View of Complexity Theory - Focusing on Soswaewon Garden - ('복잡성(Complexity) 이론'에 의한 한국 전통정원의 해석 - 한국의 명원 소쇄원을 중심으로 -)

  • Jang, Il-Young;Shin, Sang-Sup
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.2
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    • pp.75-85
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    • 2010
  • The purpose of this study is to attempt new analysis on Soswaewon Garden(瀟灑園) where is Korea's traditional garden, focusing on which the tendency of its change is a relational-formation tool similar to the Eastern Mode of Thought, with paying attention to conversion as the new view of world. Accordingly, the aim is to reanalyze by connecting with Soswaewon Garden based on the theory of complexity, which tries to look at the whole through relationship rather than characteristics in individual components. Given summarizing findings, those are as follows. First, it was found that complexity shown in space and open system of physical dimension was characterized by 'event(situation)', 'non-determination' and 'homogeneous relationships between part and whole', and a variety of techniques introduced the nature positively. In particular, it was found that there were many cases of topographic usage, since the Soswaewon Garden selected its construction site proactively and was a product from architectural works in compliance with a given flow of natural topography. This has a nature of open text in the situation of emergent behaviors. Second, it was found that complexity shown in experiences and open system on the invisible dimension was characterized primarily by 'event(situation)' and 'relationships of interactive response between actors and environment', and various techniques appeared as a space for interactive combination of nature and daily experiences. This is typical of bilateral harmony based on interactions between subject and object, and between mankind and nature, and becomes also a space to accommodate temporary emergent behaviors in our life. Third, the compositional elements are reconstituted as space of organic property with dismantling steady relations. Especially, 'Soswaewon Garden's 48 poems(瀟灑園四十八詠)' will be the origin of the emotionally spatial experience to the current performers. Ultimately, the performer in the space of Soswaewon Garden simultaneously becomes a creator of space, and will generate new space with intertextuality with environment. Therefore, Soswaewon Garden becomes a place of binding me and the other together while maintaining mutual relationship based on organic thinking between a human being and nature and between the whole and a part.

Studies on Chronic Mastitis of Dairy Cattle in Taegu-Kyungpook Provinces (대구(大邱).경북지방(慶北地方)에서 문제되는 젖소의 만성(慢性) 유방염(乳房炎)에 관한 연구(硏究))

  • Kim, Bong Hwan;Park, Hoo Yhul;Chang, In Ho
    • Current Research on Agriculture and Life Sciences
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    • v.2
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    • pp.115-121
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    • 1984
  • Some investigations on chronic mastitis in dairy cattle in Taegu-Kyungpook Provinces from the beginning of October, 1984 till the end of August, 1985 were conducted with the particular regard to the causative agents and their drug susceptibility. Milk samples from 83 isolated cases of chronic mastitis cattle were investigated bacteriologically and the causative organisms recovered were examined for their antibiotic susceptibility by using disc diffusion susceptibility technique against the major antibiotics of current veterinary use. Major causative agents involved in chronic mastitis in Taegu-Kyungpook Provinces were in order of prevalence Staphylococcus spp. (48.2 %), Escherichia coli (18.1 %), Candida spp. (10.8 %) and Corynebacterium spp. (8.4 %), Streptococcus agalactiae (3.6 %), Bacillus cereus (3.6 %) and Pseudomonas aeruginosa (2.4 %) were found to be one of the minor agents. The majority of staphylococcal isolates and E. coli were highly resistant to the most antibiotics tested. The percentages of staphylococcal cultures resistant to penicillin, methicillin, lincomycin, novobiocin, ampicillin and tetracycline were 87.2 %, 78.7 %, 68.1 %, 61.7% and 57.4 %, respectively, while the majority of them were susceptible to gentamicin(78.7 %), cephalothin(76.6 %) and chloramphenicol (74.5%). E. coli isolates were found to be highly resistant to streptomycin, cephalothin, tetracycline and ampicillin while the majority of them were susceptible to colistin (83.3 %), gentamicin (77.8 %) and chloramphenicol (66.7 %). Corynebacterium spp. were susceptible to ampicillin, chloramphenicol, erythromycin, gentamicin, oleandomycin and tetracycline although they showed resistance to novobiocin and penicillin. Two cultures of Pseudomonas aeruginosa recovered from mastitis milk were highly resistant to the antibiotics employed in the present study.

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A research on the introducing the waterproof corrugated cardboard box for the efficient shipment of chinese cabbages and radishes: Focusing on Garak-dong wholesale market as the center

  • Lee, Rae-Hyup;Sun, Il-Suck
    • Asian Journal of Business Environment
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    • v.2 no.1
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    • pp.25-34
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    • 2012
  • It is possible to use pallet for forwarding as chinese cabbages and radishes are general large-scale trading items at the agricultural wholesale market though, however, most of these are forwarded as it have packed in net bags or in P·E bags. Thus, it is still hard for palletizing. The type of packing the product in the net bag makes it difficult for palletizing. It is not a stable shape enough and easily collapsed for pallet loading. Because of this collapsibility, the corrugated cardboard box is being used to enhance forwarding efficiency, but the existing corrugated cardboard box could be crushed easily by moist what is from the agricultural product's property and it also could be squashed by the mass of the loaded box layers on itself. In contrary, the functional waterproof corrugated cardboard box is not collapsed through palletizing and it is efficient for product management with it's ventilation function in respond to pre-cooling effect. Furthermore, because it has various functional shapes as the open type, the partition type and so on, it is effective for maintaining freshness of the product and standardizing the distribution of agricultural product. It is well-known that it is possible to introduce this box to cargo-works of agricultural product. Consequently, the recognition of main distributors about the pallet distribution of the chinese cabbage and the radish was apprehended in this study for activating mechanization of loading and unloading. The survey was conducted to the main distributors such as the forwarder, the auction dealer and the commission merchant with Garak-dong wholesale market as the center. The appropriate packing materials and problems of the existing method for loading and unloading were derived through the survey. Especially, it was focused on analyzing the difference of recognition between the subject groups for the way of using waterproof cardboard corrugated box to deal with the difficult product for packing in normal corrugated box because of the box's absorption of moist from the agricultural product like a chinese cabbage and a radish. Total In the cases of the forwarders and the commission merchants, the net was highly responded as 45%, 74% from each groups for the best packing material for mechanization of distribution and the waterproof corrugated cardboard box was responded as 20%, 22% from each groups as much preferable than multi-stage wooden box. However, for the radish, the waterproof corrugated cardboard box was the best material as 56%, and the auction trader group supported it for 80%. So, the using the waterproof corrugated cardboard box for mechanization of distribution was negative for the chinese cabbage, but it was positive for the radish. The average was 2.42, the standard deviation was 1.24. The negative response(about 55%) was prevailing more than positive response(about 23%). It could be analyzed that even there was the positive recognition for using the waterproof corrugated cardboard box for the radish though the preference for low price of net bag in the chinese cabbage forwarding procedure. Still now, it seems that is a burden for using the waterproof corrugated cardboard box with high price. In the analysis on the recognition differences about using the waterproof corrugated cardboard box for the chinese cabbages and the radish between the forwarders and the commission merchants, generally the negative recognition was prevailing, but the forwarders(2.696) were more positive for using the waterproof corrugated cardboard box than the commission merchants(2.145).

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Arthroscopic Posterior Cruciate Ligament Reconstruction with Preservation of the Remnant Posterior Cruciate Ligament (남아 있는 후방 십자 인대 다발을 보존한 관절경하 후방 십자 인대 재건술)

  • Ahn Jin Hwan;Ha Kwon Ik;Chung Yoon Sung;Yang Il Soon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.97-104
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    • 2000
  • Purpose : The majority of PCL deficient knees have some intact remnant PCL bundles. In these cases, the remnant PCL bundles were removed fur easy passage of graft(especially in bone-patellar tendon-bone graft). The purpose of study is to report the results of PCL reconstruction by posterior transseptal portal technique and by preserving the remnant posterior cruciate ligament bundles. Materials & Methods : From November 1993 to June 1999, 44 arthroscopic posterior cruciate ligament reconstructions have been performed by one surgeon. We studied 37 knees those were followed up over 1 year among them. The mean age($14\~56$ years) was 31.8 years. The average follow-up period was 17.8 months($12\~61$ months). The graft materials were 29 double-loop hamstring autografts, 4 double-loop hamstring allografts and 4 Achilles tendon-bone allograft. Results : There are significant improvement of the preoperative subjective symptoms. The last follow-up shows that the average Lysholm knee score was markedly improved from 59.8 pre-operation to 89.2 post-operation and the average KT 2000 side difference was decreased from 11.1mm pre-operation to 2.3 mm post-operation. Follow-up MRI showed that the graft was healed with remnant posterior cruciate ligament bundles as one ligament. Conclusion : The posterior trans-septal portal makes it possible to locate the exact tibial tunnel. The arthroscopic PCL reconstruction preserving the remnant of original PCL bundles seems to provide the good result.

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Ecological variation between two populations of Thecodiplosis japonensis uchida et Inouye in Korea (솔잎혹파리 두 집단간(集團間)의 생태변이(生態變異))

  • Hwang, Yu Chul;Yim, Kyong Bin
    • Journal of Korean Society of Forest Science
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    • v.79 no.2
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    • pp.115-126
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    • 1990
  • This study was performed to find differences in phototaxis response of the larva, adult emergence, sex ratio and gall formation rate of Thecodiplosis japonensis Uchida et Inouye between two areas, north and south. Larvae from these two areas, Hweng-sung in north and Moo-an in south, both considered to be the sities of severe outbreak of the insect recently, were collected from the floor and transported to the entomology larboratory, Won-Kwang University in Iri, then overwintered. These larvae were used for various experimental purposes on various dates. The following results were obtained. 1. The sizes of larvae reached 2.45 in length, 0.70 in width for north, and 2.50 in length, 0.72 in width for sourth. It seems that the differents were not significant. 2. It is known that Leaving gall of larvae to the ground for the hibernation usually occurs on rainy days. For the larvae dispersion, the phototaxis response of the larvae was hypothesized. To check this, the author manipulated some different illumination intensities adjusting the distance between the glass tube in which 100 larvae were contained and electric bulb. The glass tubes were blackened all but except a small portion. The phototaxis responses between two areas seemed to be different particularly at low light intensities, 45, 145 and 1000 lux, The larvae from north assembled to the clear portion of the glass tube were more than 30 out of 100, however less than 30 in south sample regardless of the time passage. In either cases, the saturation points came after about 8 to 10 hours. If temperature units were used, the phototaxis curve= after 1 hour illumination between two areas provided significant differences. 3. The adult emergence of south area was lagged 10 days later than that of north area. The accumulated effective day-degrees of temperature for adult emergence were $934^{\circ}C$ for north area and $1180^{\circ}C$ for south area. The emerging duration of north area appeared to be in late May through the early of July and the peak emergence occurred in middle June that was approximately 15days earlier than that of south area. The sex ratio of female to male, regardless of area, was approximately 3 : 1. 4. The rates of gall formation of the red pine(Pinus densiflora Siebold et Zuccarini), 6-year-old seedlings, were as low as 9.94% for north area and 8.87% for south area. Through the close observation, the author presumed that the population reduction was greatly affected during the prepupa stage by relative moisture content and predators, such as spiders and ants presented on the ground.

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Genomic analysis of Mycobacterium fortuitum by pulsed-field gel electrophoresis (Pulsed-field Gel Electrophoresis를 이용한 Mycobacterium fortuitum의 유전형 분석)

  • Lee, Tae-Yoon;Do, In-A;Kim, Sung-Kwang
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.366-385
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    • 1995
  • Epidemiological studies are important in both the prevention and treatment of mycobacterial infections. This study was initiated to establish the pulsed-field gel electrophoresis (PFGE) method, which are not yet extensively studied. The most apprpriate restriction endonucleases included DraI, AsnI, and XbaI. The optimal PFGE condition was different according to the enzymes used. Two stage PFGE was performed, in case of DraI first stage was performed with 10 seconds of initial pulse and 15 seconds of final pulse, while the second stage was performed with 60 seconds of initial pulse and 70 seconds of final pulse. The electrophoresis time for DraI-PFGE was 14 hours for each stage. Electrophoresis was performed for 22 hours, in case of XbaI, with 3 seconds of initial pulse and 12 seconds of final pulse. Electrophoresis was performed for 22 hours, in case of AsnI, with 5 seconds of initial pulse and 25 seconds of final pulse. In all cases the voltage of the electrophoresis was maintained constantly at 200 voltage. Standard mycobacterial strains, which included Mycobacterium bovis BCG, M. tuberculosis, and M. fortuitum, could not be differentiated by PFGE analysis. PFGE analysis was performed to differentiate 9 clinically isolated M. fortuitum strains using AsnI. All M. fortuitum strains showed different genotypes except 2 strains. Cluster analysis divided M. fortuitum strains into 2 large groups. PFGE analysis was performed to further differentiate M. fortuitum isolates using XbaI. The undifferentiated 2 M. fortuitum strains showed different PFGE patterns with Xba I. Cluster analysis of the XbaI-PFGE patterns showed more complex grouping than AsnI-PFGE patterns, which showed that XbaI-PFGE analysis was better than AsnI-PFGE in M. fortuitum genotyping. The top dissimilarity values of AsnI-PFGE and XbaI-PFGE were 0.74 and 0.75, respectively. This value was higher than that of arbitrarily primed polymerase chain reaction (AP-PCR) analysis and lower than that of restriction fragment length polymorphism (RFLP) analysis. This suggested that PFGE can be used as a supportive or alternative genotyping method to RFLP analysis.

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