• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.512-518
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• 1999

Purpose: We evaluated the usefulness of 24 hour/3 hour radio-uptake ratio, lesion to non-lesion ratio, in differentiating bony metastases from acute (<2 months) and healing (${\geq}2$ months) fractures. Materials and Methods: Sixty-three patients (age range: 26-81, 32 males, 31 females) having 90 lesions (30 bone metastases, 30 acute fractures, 30 healing fractures) were included. Bone scans were obtained 3 and 24 hours after administration of 740 MBq of $^{99m}Tc$-MDP. The ratio of radio-uptake in the lesion to normal area was measured as 24/3 hour radio-uptake ratio ([lesion/non-lesion RUR at 24 hour]/[lesion/non-lesion RUR at 3 hour], 24/3 RUR) and analyzed clinical significance in differentiating bone metastases from acute or healing fractures. Results: Mean 24/3 RUR were $1.22{\pm}0.18$ for bone metastases, $1.25{\pm}0.14$ for acute fractures, and $0.99{\pm}0.15$ for healing fractures. 24/3 RUR values of bone metastases and acute fractures were not significantly different. But 24/3 RUR values of bone metastases and healing fractures, and those of acute and healing fractures were found to be significantly different (p<0.001). When 24/3 RUR of 1.0 was considered as the cut off point separating metastases from fracture, a sensitivity of 100% (30/30) was obtained. The specificity was 0% (0/30) in separating metastases from acute fractures, and 47% (14/30) in separating metastases from healing fractures. When 24/3 RUR of 1.2 was considered as the cut off point, sensitivity of 53% (16/30) in the diagnosis of bone metastasis, and specificity of 37% (11/30) in separating metastases from acute fractures, and 100% (30/30) in separating metastases from healing fractures were obtained. Conclusion: 24/3 RUR is useful in differentiating bone metastases from healing fractures, but not in differentiating bone metastases from acute fractures. A 24/3 RUR of less than 1.0 suggests healing fractures. A 24/3 RUR of more than 1.2 suggests bone metastases or acute fractures.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.206-213
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• 2005

Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.66-76
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• 1999

Background : To assess the utility of HRCT in the evaluation of visceral pleural invasion and to determine whether visceral pleural invasion and bronchovascular bundle thickening on the same lobe could be related to the recurrence and survival in non-small cell lung cancer (NSCLC) Method: Eighty one patients, which were fulfilled long-term follow-up at least 18 months (maximum 103 months) among which 434 patients had underwent curative surgical resection for NSCLC from 1986 to 1995, were studied. They were analyzed to evaluate whether the prognostic factors such as the recurrence and survival depend on visceral pleural invasion and bronchovascular bundle thickening to the same lobe. Thirty two patients adjacent to a chest wall or a fissure were evaluated for visceral pleural invasion by HRCT. CT criteria included abutting pleura along the chest wall, abutting and/or compressing fissure, croosing fissure, and pleural tail. Results: The positive predictive value and the negative predictive value of crossing fissure were 100% and 100%, respectively. Two patients showing spiculated interface between a mass and abutting fissure were confirmed to have visceral pleural invasion at surgery. Visceral pleural invasion confirmed at surgery was significant to local recurrence and survival (p<.05. p<.05, respectively). Brochovascular bundle thickening to the same lobe on CT scan was significant to survival (p<.05) but was not significant to local and distant recurrence (p>.05). Conclusion : Visceral pleural invasion and bronchovascular bundle thickening to the same lobe have a role in predicting prognosis such as recurrence and survival in NSCLC. Therefore, the analysis of visceral pleural invasion on CT scan and the pathological analysis of bronchovascular bundle thickening to the same lobe may be necessary to predict the prognosis in NSCLC.

• Journal of radiological science and technology
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• v.36 no.3
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• pp.227-235
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• 2013

In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), oral cavity($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), parotid gland($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy) and temporomandibular joint($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.

• Journal of radiological science and technology
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• v.36 no.4
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• pp.313-318
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• 2013

Positron emission tomography/computed tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) have been used as a powerful fusion modality in nuclear medicine not only for detecting cancer but also for staging and therapy monitoring. Nevertheless, there are various causes of FDG uptake in normal and/or benign tissues. The purpose of present study was to investigate whether additional delayed imaging can improve the diagnosis to differentiate the rates of FDG uptake at axillary lymph nodes (ALN) between malignant and benign in breast cancer patients. 180 PET/CT images were obtained for 27 patients with ALN uptake. The patients who had radiotherapy and chemotherapy were excluded from the study. $^{18}F$-FDG PET/CT scan at 50 min (early phase) and 90 min (delayed phase) after $^{18}F$-FDG injection were included in this retrospective study. The staging of cancers was confirmed by final clinical according to radiologic follow-up and pathologic findings. The standardized uptake value (SUV) of ALN was measured at the Syngo Acquisition Workplace by Siemens. The 27 patients included 18 malignant and 9 ALN benign groups and the 18 malignant groups were classified into the 3 groups according to number of metastatic ALN in each patient. ALNs were categorized less than or equal 3 as N1, between 4 to 9 as N2 and more than 10 as N3 group. Results are expressed as the mean${\pm}$standard deviation (S.D.) and statistically analyzed by SPSS. As a result, Retention index (RI-SUV max) in metastasis was significantly higher than that in non-metastasis about 5 fold increased. On the other hand, RI-SUV max in N group tended to decrease gradually from N1 to N3. However, we could not prove significance statistically in malignant group with ANOVA. As a consequence, RI-SUV max was good indicator for differentiating ALN positive group from node negative group in breast cancer patients. These results show that dual-time-point scan appears to be useful in distinguishing malignant from benign.

• Childhood Kidney Diseases
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• v.15 no.1
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• pp.66-75
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• 2011

Purpose: Early diagnosis and treatment of febrile urinary tract infection (UTI) in children is important to prevent kidney damage. This study aims to evaluate the relationship between the presence of pyuria, the severity, and underlying genitourinary anomalies in patients with UTI. Methods: We retrospectively reviewed 293 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from June, 2007 until January, 2010. We divided the patients into two groups, one with the finding of pyuria at admission, and the other without, and compared the fever duration, white blood cell counts (WBC) and C-reactive protein (CRP) in peripheral bloods, hydronephrosis, cortical defects, vesicoureteral reflux and admission period. Results: Among the 293 patients with febrile UTI, 189 patients showed findings of pyuria whereas 104 patients did not. Patients with pyuria showed an increment of WBC ($14,694{\pm}485.2$ vs. $11,374{\pm}451.2/uL$, P <0.05) and CRP ($46.9{\pm}3.9$ vs $17.1{\pm}3.6$ mg/L, P <0.05) in peripheral blood sample. The presence of cortical defects (21.7 Vs 5.8%, P <0.05) and vesicoureteral reflux (15.9 Vs 6.7%, P <0.05) was also increased in patients with pyuria compared to patients without pyuria. There were no specific differences in fever duration, admission period, and hydronephrosis. Within the group with pyuria, CRP in peripheral blood sample increased proportionally with the increment of pyuria (P <0.05). Conclusion: In patients with febrile UTI, the increment of WBC in the urine sample can be a helpful predictor for increased CRP in peripheral blood and acute pyelonephritis.

• Journal of the Korean Society of Radiology
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• v.9 no.1
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• pp.1-7
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• 2015

Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.1
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• pp.25-30
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• 2010

Purpose: This study was conducted to estimate the changes of corrected diopter and corrected visual acuity with the change in vertex distance. Also we aimed to provide basic data for refraction test. Methods: Using the trial lens, we measured the corrected diopter and corrected visual acuity after performing binocular balance test. We measured the changes of corrected diopter and corrected visual acuity in change of vertex distance. We analyzed statistical significance and relations between vertex distance and corrected diopter and corrected visual acuity. Results: There was no difference in corrected diopter with the change of vertex distance within -1.00D, but the corrected diopter increased with it over - 1.25D. In particular, the change of diopter was largest when the vertex distance increased 15 mm. At over 11.00D, there was large changes of diopter with the changes of vertex distance at 5 mm, 10 mm and 15 mm. On correlation analysis between the vertex distance and the corrected diopter, there was strong correlation (r=0.999 at 5 mm increase of vertex distance, r=0.982 at 10 mm increase and r=0.957 at 15 mm increase) and also there was significant (p<0.01). At the change of visual acuity in increased of vertex distance, the range of a decrease in visual acuity was large when the changes of vertex distance was largest. On correlation analysis between the vertex distance and the corrected visual acuity, there was strong correlation (r=0.969 at 5 mm increase of vertex distance, r=0.985 at 10 mm increase and r=0.994 at 15 mm increase) and also there was significant (p<0.01). Conclusions: The vertex distance was very important at the refraction test and at wearing spectacle. On correlation analysis between the vertex distance and the corrected diopter, and the corrected visual acuity, there was strong correlation and statistically significant. Therefore, the vertex distance should be kept at the refraction using trial lens, and the best fitting was made not to slipping forward, and so we suggested regular refitting of spectacle and the managing method of spectacle were educated to the spectacle wearers.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10445-10449
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• 2015

Objective: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. Methods: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. Results: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P>0.05). Baseline pain score of patients with moderate pain in treatment and control group was $4.9{\pm}0.8$ and $5.1{\pm}0.8$, respectively; and decreased to $1.8{\pm}1.1$ and $1.2{\pm}1.1$ after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P=0.028). Average daily consumption of oxycodone prolonged-release tablets was ($54.0{\pm}19.6$) mg and ($44.7{\pm}18.7$) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were $8.3{\pm}1.1$ and $8.3{\pm}1.1$, respectively; and pain intensity after treatment decreased to $2.9{\pm}1.0$ and $2.3{\pm}1.0$. Pain intensity was significantly reduced in the treatment group, with statistical significance (P=0.026). Average daily consumption of oxycodone prolonged-release tablets was ($132.0{\pm}42.2$) mg and ($110.7{\pm}33.9$) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). Conclusion: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.903-908
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• 2003

Purpose : Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. Methods : Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. Results : The significant increased plasma elastase activity, $6.19{\pm}0.74U/mL$, found in Kawasaki disease patients compared with the other febrile disease patients, $4.86{\pm}1.17U/mL$(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. Conclusion : Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.