• Title/Summary/Keyword: independent study

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Analysis of Prognostic Factors according to WHO Classification for Thymic Epithelial Tumor (흉선종의 WHO 분류에 따른 예후인자의 임상적 고찰)

  • 서영준;금동윤;권건영;박창권
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.684-690
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    • 2004
  • Background: Primary thymic epithelial neoplasm is a type of mediastinal tumors that have various biologic and morphologic features. In this study, we reclassified 59 cases of thymic epithelial tumors by the new WHO classification. We inquired whether the new WHO classification has independent prognostic relevance by analyzing clinical characteristics of thymic epithelial tumors including Masaoka's clinical stage. Material and Method: From December 1986 to August 2003, 59. patients who underwent surgery in the Keimyung University Dongsan Medical Center with definite diagnosis of thymic epithelial tumor were studied. We analyzed the histologic subtype (WHO classification). clinical stage (Masaoka's clinical stage) and patient's characteristics (sex, age, myasthenia gravis, tumor size, invasion. recurrence, metastasis) as prognostic factors. We analyzed the relationship between histologic subtype and clinical stage. Result: 32 patients were male and 27 were female. Mean age was 50.1$\pm$14.2. From WHO A to C, all thymic epithelial tumors were reclassified by the new WHO classification. Six patients (10.2%) had Type A, 7 (11.9%) had Type AB, 7 (11.9%) had Type B$_1$, 10 (16.9%) had Type B$_2$ and 7 (11.9%) had Type B$_3$, 22 (37.3%) had Type C. Two factors were shown by multivariate analysis to be associated with a favorable prognosis: completeness of resection (p=0.003) and non-invasiveness (p=0.001). The overall 5-year survival of the 59 patients was 53%, subtype A and AB were 92.3%, B$_1$ and B$_2$ were 70.2%, and B$_3$ and C were 26.1%. The association between histologic subtype and invasive behavior (stage) was statistically significant (p<0.001). Conclusion: The WHO classfication is not only a histologic classfication of the thymic epithelial tumors but also a significant prognostic factor that influence the survival of thymic epithelial tumors.

ROC Analysis of Visual Assessments Made in Gated Blood Pool Scans of Patients with Coronary Artery Disease (관상동맥질환에서 심장풀 스캔의 육안적 평가에 대한 ROC 분석)

  • Lee, Kyun-Han;Choi, Yoon-Ho;Lee, Bum-Woo;Moon, Dae-Hyuk;Koong, Sung-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.175-181
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    • 1989
  • Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.

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Development and Performance Test of Preamplifier and Amplifier for Gamma Probe (감마프로브용 전단증폭기와 주증폭기의 개발과 성능 평가)

  • Bong, Jung-Kyun;Kim, Hee-Joung;Lee, Jong-Doo;Kwon, Soo-Il
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.100-109
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    • 1999
  • Purpose: Preamplifier and amplifier are very important parts for developing a portable counting or imaging gamma probe. They can be used for analyzing pulses containing energy and position information for the emitted radiations. The commercial Nuclear Instrument Modules (NIMs) can be used for processing these pulses. However, it may be improper to use NIMs in developing a portable gamma probe, because of its size and high price. The purpose of this study was to develop both preamplifier and amplifier and measure their performance characteristics. Materials and Methods: The preamplifier and amplifier were designed as a charge sensitive device and a capacitor resistor-resistor capacitor (CR-RC) electronic circuit, respectively, and they were mounted on a print circuit board (PCB). We acquired and analyzed energy spectra for Tc-99m and Cs-137 using both PCB and NIMs. Multichannel analyzer (Accuspec/A, Canberra Industries Inc., Meriden Connecticut, U.S.A) and scintillation detectors (EP-047(Bicron Saint-Gobain/Norton Industrial EP-047 (Ceramics Co., Ohio, U.S.A) with $2"{\times}2"$ NaI(T1) crystal and R1535 (Hamamatsu Photonics K.K., Electron Tube Center, Shizuoka-ken, Japan) with $1"{\times}1"$ NaI(T1) crystal were used for acquiring the energy spectra. Results: Using PCB, energy resolutions of EP-047 detectors for Tc-99m and Cs-137 were 12.92% and 5.01%, respectively, whereas R1535 showed 13.75% and 5.19% of energy resolution. Using the NIM devices, energy resolutions of EP-047 detector for Tc-99m and Cs-137 were measured as 14.6% and 7.58%, respectively. However, reliable energy spectrum of R1535 detector could not be acquired, since its photomultiplier tube (PMT) requires a specific type of preamplifier. Conclusion: We developed a special preamplifier and amplifier suitable for a small sized gamma probe that showed good energy resolutions independent of PMT types. The results indicate that the PCB can be used in developing both counting and imaging gamma probe.

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Prognostic Usefulness of Maximum Standardized Uptake Value on FDG-PET in Surgically Resected Non-small-cell Lung Cancer (수술로 제거된 비소세포폐암의 예후 예측에 있어 FDG-PET 최대 표준화 섭취계수의 유용성)

  • Nguyen Xuan Canh;Lee Won-Woo;Sung Sook-Whan;Jheon Sang-Hoon;Kim Yu-Kyeong;Lee Dong-Soo;Chung June-Key;Lee Myung-Chul;Kim Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.4
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    • pp.205-210
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    • 2006
  • Purpose: FDG uptake on positron omission tomography (PET) has been considered a prognostic indicator in non-small cell lung cancer (NSCLC). The aim of this study was to assess the clinical significance of maximum value of SUV (maxSUV) in recurrence prediction in patients with surgically resected NSCLC. Materials & methods: NSCLC patients (n=42, F:M =14:28, age $62.3{\pm}12.3$ y) who underwent curative resection after FDG-PET were enrolled. Twenty-nine patients had pathologic stage 1, and 13 had pathologic stage II. Thirty-one patients were additionally treated with adjuvant oral chemotherapy. MaxSUVs of primary tumors were analyzed for correlation with tumor recurrence and compared with pathologic or clinical prognostic indicators. The median follow-up duration was 16 mo (range, 3-26 mo). Results: Ten (23.8%) of the 42 patients experienced recurrence during a median follow-up of 7.5 mo (range, 3-13 mo). Univariate analysis revealed that disease-free survival (DFS) was significantly correlated with maxSUV (<7 vs. $\geq7$, p=0.006), tumor size (<3 cm vs. $\geq3$ cm, p=0.024), and tumor tell differentiation (well/moderate vs. poor, p=0.044). However, multivariate Cox proportional analysis identified maxSUV as the single determinant for DFS (p=0.014). Patients with a maxSUV of $\geq7$(n=10) had a significantly lower 1-year DFS rate (50.0%) than those with a maxSUV of <7 (n=32, 87.5%). Conclusion: MaxSUV is a significant independent predictor for recurrence in surgically resected NSCLC. FDG uptake can be added to other well-known factors in prognosis prediction of NSCLC.

The Accuracy of Barr, Blethyn and Leech Scoring Systems on Plain Abdominal Radiographs in Childhood Constipation (소아에서 단순 복부 X-선 사진으로 변비를 진단하는데 있어 Barr, Blethyn과 Leech 점수체계의 정확도)

  • Moon, Ji-Young;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.44-50
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    • 2007
  • Purpose: The role of plain, abdominal radiography in childhood constipation has not been fully evaluated. The aim of this study was to determine the accuracy and reliability of scoring systems assessing a fecal load on plain, abdominal radiographs in children with functional constipation. Methods: Plain, abdominal radiographs from 38 constipated children and 39 control children were examined by four independent inspectors, pediatric residents. Four inspectors independently scored the radiographs according to three different scoring systems Barr, Blethyn, and Leech. No clinical information about the patients was available to the inspectors. Each abdominal radiograph was evaluated on two separate occasions, one week apart. Kappa coefficients were calculated as indicators of inter-and intra-inspector variability, coefficients <0.20, 0.21~0.40, 0.40~0.60, 0.61~0.80 and 0.81~1.00 were considered to indicate poor, fair, moderate, good, and very good agreement, respectively. Results: The Leech score showed the highest reproducibility: the inter-inspector agreement was uniformly very good on two separate occasions (${\kappa}$ values of 0.88, 0.91, 0.92, 0.86 in the first time and 0.81, 0.88, 0.89, 0.84 in the second time). Agreement using the Barr score was good (${\kappa}$ values of 0.66, 0.67, 0.69, 0.66 in the first time and 0.68, 0.65, 0.71, 0.68 in the second time). However, agreement for the Blethyn score was the lowest of the three scoring systems. The Leech scoring system had the highest sensitivity and specificity compared to the Barr scoring system for the diagnosis of functional constipation by plain, abdominal radiographs. Conclusion: The Leech score appeared to be a more accurate and reliable method because of its high sensitivity and specificity for evaluating the fecal load on plain, abdominal radiographs in children with functional constipation. Therefore, the Leech scoring system was found to be the most useful for assessment for the degree of constipation on plain, abdominal radiographs in children.

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Analyses of the Studies on Cancer-Related Quality of Life Published in Korea (암 환자 삶의 질에 대한 국내 연구논문 분석)

  • Lee Eun-Hyun;Park Hee Boong;Kim Myung Wook;Kang Sunghee;Lee Hye-Jin;Lee Won-Hee;Chun Mison
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.359-366
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    • 2002
  • Purpose : The purpose of the present study was to analyze and evaluate prior studies published in Korea on the cancer-related quality of life, in order to make recommendations for further research. Materials and Methods : A total of 31 studies were selected from three different databases. The selected studies were analyzed according to 11 criteria, such as site of cancer, domain, independent variable, research design, self/proxy rating, single/battery instrument, translation/back translation, reliability, validity, scoring, and findings. Results : Of the 31 studies, approximately half of them were conducted using a mixed cancer group of patients. Many of the studies asserted that the concept of quality of life had a multidimensional attribute. Approximately 30% were longitudinal design studies giving information about the changes in quality of life. In all studies, except one, patients directly rated their level of quality of life. With respect to the questionnaires used for measuring the quality of life, most studies did not consider whether or not their reliability and validity had been established. In addition, when using questionnaires developed in other languages, no studies employed a translation/ back-translation technique. All studies used sum or total scoring methods when calculating the level of quality of life. The types of variables tested for their influence on qualify of life were quite limited. Conclusion : It is recommended that longitudinal design studies be peformed, using methods of data collection whose validity and reliability has been confirmed, and that studies be conducted to identify new variables having an influence on the quality of life.

Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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A Suitability Study on the Indicator Isotopes for Graphite Isotope Ratio Method (GIRM) (흑연 동위원소 비율법의 지표 동위 원소 적합성 연구)

  • Han, Jinseok;Jang, Junkyung;Lee, Hyun Chul
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.18 no.1
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    • pp.83-90
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    • 2020
  • The Graphite Isotope Ratio Method (GIRM) can verify non-proliferation of nuclear weapon by estimating the total plutonium production in a graphite-moderated reactor. Using the reactor, plutonium is generated and accumulated through the 238U neutron capture reaction, and impurities in the graphite are converted to nuclides due to the nuclear reaction. Therefore, the amount of plutonium production and concentration of the impurities are correlated. However, the plutonium production cannot be predicted using only the absolute concentration of the impurities. It can only be predicted when the initial concentration of the impurities is obtained because the concentration, at a certain time, depends on it. Nevertheless, the ratios of the isotopes in an element are known regardless of the impurity of an element in the graphite moderator. Thus, the correlation between the isotope ratio and amount of plutonium produced helps predict plutonium production in a graphite-moderated reactor. Boron, Lithium, Chlorine, Titanium, and Uranium are known as indicator elements in the GIRM. To assess whether the correlation between the indicator isotope and amount of plutonium produced is independent of the initial concentration of the impurities, four different impurity compositions of graphite were used. 10B/11B, 36Cl/35Cl, 48Ti/49Ti, and 235U/238U had a consistent correlation with the cumulative plutonium production, regardless of the initial impurity concentration of the graphite, because these isotopes were not generated through the nuclear reaction of other elements. On the other hand, the correlation between 6Li/7Li and plutonium production depended on the initial concentration of the impurities in graphite. Although 7Li can be produced through the neutron capture reaction of 6Li, the (n, α) reaction of 10B was the major source of 7Li. Therefore, the initial concentration of 10B affected the production of 7Li, making Li unsuitable as an indicator element for the GIRM.

Estimating the Yield of Marketable Potato of Mulch Culture using Climatic Elements (시기별 기상값 활용 피복재배 감자 상서수량 예측)

  • Lee, An-Soo;Choi, Seong-Jin;Jeon, Shin-Jae;Maeng, Jin-Hee;Kim, Jong-Hwan;Kim, In-Jong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.61 no.1
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    • pp.70-77
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    • 2016
  • The object of this study was to evaluate the effects of climatic elements on potato yield and create a model for estimating the potato yield. We used 35 yield data of Sumi variety produced in mulching cultivation from 17 regions over 11 years. According to the results, some climatic elements showed significant level of correlation coefficient with marketable yield of potato. Totally 22 items of climatic elements appeared to be significant. Especially precipitation for 20 days after planting (Prec_1 & 2), relative humidity during 11~20 days after planting (RH_2), precipitation for 20 days before harvest (Prec_9 & 10), sunshine hours during 50~41 days before harvest (SH_6) and 20 days before harvest (SH_9 & 10), and days of rain during 10 days before harvest (DR_10) were highly significant in quadratic regression analysis. 22 items of predicted yield ($Y_i=aX_i{^2}+bX_i+c$) were induced from the 22 items of climatic elements (step 1). The correlations between the predicted yields and marketable yield were stepwised using SPSS, statistical program, and we selected a model (step 2), in which 4 items of independent variables ($Y_i$) were used. Subsequently the $Y_i$ were replaced with the equation in step 1, $aX_i{^2}+bX_i+c$. Finally we derived the model to predict the marketable yield of potato as below. $$Y=-336{\times}DR_-10^2+854{\times}DR_-10-0.422{\times}Prec_-9^2+43.3{\times}Prec_-9\\-0.0414{\times}RH_-2^2+46.2{\times}RH_-2-0.0102{\times}Prec_-2^2-7.00{\times}Prec_-2-10039$$.

THE EFFECT OF THE pH OF REMINERALIZED BUFFER SOLUTIONS ON DENTIN REMINERALIZXATION (재광화 완충용액의 pH 변화가 상아질의 재광화에 미치는 영향)

  • Kim, Sung-Chul;Roh, Bung-Duk;Jung, Il-Young;Lee, Chan-Young
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.151-161
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    • 2007
  • Dental caries is the most common disease in the oral cavity However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss or inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM. The results were as follows, 1. In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p<0.05). 2. In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 3. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size. In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.