• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.262-266
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• 1999

Obstruction of the extrahepatic bile ducts is the most common cause of conjugated hyperbilirubinemia in early infancy. More than 90% of such obstructive lesions are accounted for by extrahepatic biliary atresia. A rare lesion is obstruction of the common duct by impacted, thickened secretions and bile. Bile plug syndrome is defined as extrahepatic obstruction of the bile ducts by bile sludge in term infants without anatomic abnormalities, congenital chemical defects of bile, or hepatocellular lesions. Obstruction of extrahepatic ducts by plugs of biliary material apperas to be due to the inspissation and precipitation of bile and mucus within the lumen of the ducts. Cholestasis and precipitation of bile develop in association with abnormal composition of bile in cystic fibrosis, hepatocellular damage, prolonged erythroblastic jaundice, altered biliary dynamics with total parenteral nutrition, gut dysfunction, diuretic therapy, exchange transfusions and perinatal hemolysis. In those cases, the term inspissated bile syndrome is used. The clinical and laboratory findings in bile plug syndrome are identical to those observed in biliary atresia and choledochal cyst. The diagnosis can be suspected based on the findings of clinical and laboratory examinations together with hepatobiliary imaging, ultrasonography, radionuclide scan and liver biopsy. We experienced a case of spontaneous resolution of bile plug syndrome in a 4-year-old girl. We report this case with brief review related literatures.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.233-239
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• 1999

Acrodermatitis enteropethica (AE) is a rare autosomal recessive disorder of zinc absorption leading to chronic diarrhea and characteristic skin lesion. The term is also applied to any acquired zinc deficiency state resulting in the same clinical pictures. We experienced one case of AE in 1 month old male infant who had bacterial enterocolitis. The skin around mouth, anus, eyes, ears, hands and legs became reddish, vesicular and eczematoid. Serum zinc level was decreased to $51.4\;{\mu}g/dL$ (N=70~150). Endoscopic finding revealed pale gastric mucosa and villous atrophy of small intestine. Biopsy finding of small intestine showed no villi due to mucosal atrophy. On 13 day of admission jaundice with DIC were noted and AST & ALT were elevated to 110 & 36.8 IU/L, respectively. Diarrhea was improved but jaundice and liver function were not recovered until discharge from hospital. After discharge when the patient was 4 months of age serum bilirubin and AST/ALT had not been normalized. CMV shell vial culture of urine and CMV Ig G antibody were positive. So intravenous ganciclovir injection of 7.5 mg/kg, two times a day for 2 weeks and then 10 mg/kg/day for 3 months was done from 4 to 6 months of age. No virus was found in the urine and AST & ALT were normalized at 2 months after stopping ganciclovir treatment.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.29-33
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• 2017

Purpose In this study, we evaluated image by applying normalization factor during 30 days to the PET images. Materials and Methods Normalization factor was acquired during 30 days. We compared with 30 normalization factors. We selected 3 clinical case (PNS study). We applied for normalization factor to PET raw data and evaluated SUV and count (kBq/ml) by drawing ROI to liver and lesion. Results There is no significant difference normalization factor. SUV and count are not different for PET image according to normalization factor. Conclusion We can get a lot of information doing the quality assurance such as performance of sinogram and detector. That's why we need to do quality assurance daily.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.1
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• pp.89-100
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• 2021

Objectives : The purpose of this study is to report the effect of Hwangryeonagyo-tang and Mahwangbujasesin-tang(《Shanghanlun》 prescription) on whole-body nummular eczema. Methods : We treated a female patient in her early twenties who has whole-body nummular eczema with Korean medicine. She was treated from 2020.10.8 to 2020.12.11. In this period, she received admission treatments twice because of the recurrence of the symptoms after the first admission. During the treatment, the two herbal medicines were changed depending on the patient's condition. 'Hwangryeonagyo-tang' and 'Mahwangbujasesin-tang' were used as herbal medicine. In addition, herbal external preparations and acupuncture treatment were also performed. The evaluation was conducted by photo comparison, VAS, and DLQI. Blood tests were also conducted for safety assessments. Results : After two months of treatment, the patient's condition improved. The itching and heat sensation decreased, and scabs were placed on the lesion of the eczema, reducing the oozing. VAS of itching decreased from 8 to 0. DLQI was also improved, and the stability of the herbal medicines for liver and kidney was also confirmed through blood tests. Conclusions : Hwangryeonagyo-tang and Mahwangbujasesin-tang helped relieve the itching and heat of eczema in currency. Therefore, it is believed that the proper use of thoes herbal medicine can be expected to have a useful effect on nummular eczema.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.8 no.2
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• pp.71-76
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• 2022

Indigenous diagnostic dose of ¹³¹I-labeled meta-iodobenzylguanidine ([¹³¹I]mIBG) was prepared via Cu⁺ catalyzed isotope exchange reaction generated in situ by sodium metabisulfite for imaging of neuroblastoma tumor. [¹³¹I]mIBG was produced in overall 85-90% radiochemical yield. The average amount of radioactivity of [¹³¹I]mIBG was 2164 MBq (1998-2331MBq) with an average specific activity > 1000 MBq/mg at the end of synthesis. The radiochemical purity was ≥ 99.9% after purification through Dowex-1 × 8 ion exchange resin (100-150 mesh) at the date of preparation. The stability of [¹³¹I]mIBG at concentration 480-555 MBq/mL was > 97% at 4 ℃ after 4 days. The room temperature (25 ℃) stability of [¹³¹I]mIBG was > 98% after 24 h. Biodistribution of [¹³¹I]mIBG in patient showed uptake in salivary glands, liver, spleen and excreted though urinary bladder. Neuroendocrine medicated uptake into tumor lesion and metastatic sites were noted which strongly correlate with the morphological abnormalities of patient.

• Toxicological Research
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• v.14 no.4
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• pp.547-555
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• 1998

The subchronic toxicity of a combined preparation of ticlopidine and ginkgo biloba extract (EGb 761) mixed in a ratio of 10: 4 was examined in male and female Sprague-Dawley rats. Rats were treated with the test substance at a dose of 52 mg/kg, 156 mg/kg, or 467 mg/kg intragastrically for 30 consecutive days. Control rats were treated with vehicle only. Each group consisted of 10 rats. No death or abnormal clinical signs were observed throughout the administration period. A transient decrease in body weight gain and food intake was observed in the rats treated with the high dose (467 mg/kg), which was recovered to normal in a week. There were no drug-related differences in urinalysis and hematological results. A significant increase in serum total cholesterol and total protein was observed in both sexes of the rats treated with a dose of 467 mg/kg daily, but all the other values obtained in serum chemistry appeared to be within normal range. A dose dependent increase in liver weight was observed in both male and female rats. Relative kidney weight was also increased in the high dose groups. There was no gross pathological finding at terminal sacrifice. Microscopic histopathological examination did not show any lesion in terms of correlation with administration of the test substance. The results suggest that under the conditions employed in this study no observable effect level (NOEL) of the test substance be 52 mg/kg/day.

• Toxicological Research
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• v.16 no.4
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• pp.293-301
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• 2000

Toxicity of a combined preparation of ticlopidine and ginkgo biloba extract (EGb 761) in a ratio of 10: 4 was examined in male and female Sprague-Dawley rats. Rats were treated with the test substance intragastrically at a dose of 0 mg/kg, 17 mg/kg, 52 mg/kg or 156 mg/kg for 91 consecutive days. No death or abnormal clinical sign was observed throughout the administration period. There was no difference in body weight gain, food intake or water consumption among different dose groups. Test sub-stance-related differences were not observed in urinalysis. In hematological results mean corpuscular hemoglobin (MCH) of low and high dose male group was increased. Prothrombin time of medium and high dose female group was decreased. A significant increase in serum total cholesterol was observed in both sexes of rats treated with a daily dose of 156 mg/kg, but all the other values obtained in serum chemistry appeared to be within normal ranges. A dose dependent increase in the relative liver and kidney weights was observed in both male and female rats. There were no gross pathological findings at terminal sacrifice. Microscopic histopathological examination did not show any lesion associated with administration of the test substance. The results suggest that under the conditions employed in this study no observable effect level (NOEL) of the test substance be greater than 17 mg/kg/day, but less than 52 mg/kg/day.

• Journal of Digestive Cancer Research
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• v.5 no.2
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• pp.91-96
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• 2017

Background: To evaluate whether DM affects the SUVmax of metastatic lesions on ¹⁸F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.86-92
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• 2009

Purpose: The PET/CT has a clear distinction on the lesion of the functional image by adding anatomical information. It also could reduce the examination time using CT data as the attenuation-correction. When the stomach was contracted from a fast, it could bring a misinterpretation of the cancer of the lesion with a presence of physiological $^{18}F$-FDG uptake in stomach and it occasionally would bring an additional scan to confirm. To complement this shortcoming, the method that the patients had water before the examination to extend the stomach had been attempted. However, a short excretion time of the stomach did not give sufficiently extended image of the stomach. Then the patients had additional water and had the examination again. Therefore, the noticed fact is that the stomach excretion time depends on calories, protein content, and the level of carbohydrate. In this study, we use an orange juice to evaluate the extension of the stomach and usefulness of it. Materials and Methods: PET/CT scan were obtained on total 150 of patient from February 2008 to October2008, There were 3 groups in this study and each group had 50 patients. First group drank nothing, Second group drank water and third group drank orange juice. The patients (man 25, female 25) not drinking are the age of 30~71 years old (average: 54), the patients (man: 25, female: 25) drinking water (400 cc) are the age of 28~71 years old (average: 54) and the patients (man: 25, female: 25) drinking orange juice (400 cc) are the age of 32~74 years old (average: 56). The patients were fasted in 6-8 hours before the test, the patients were not diabetic. $^{18}F$-FDG 370~555 MBq were injected intravenously. The patients were in stable position for 1 hour, than the image was obtained. The patients drank water and other patients drank orange juice before Whole body scan. The image scan started from mid-femur to skull base. The emission scan acquired for three minutes per bed and the images were reconstructed. Stomach extension analysis is measured from vertical and horizontal length. Results: Stomach Extension was described as the vertical length of the Non Drink Group was $1.20{\pm}0.50\;cm$, horizontal length was $1.4{\pm}0.53\;cm$, the vertical length of the Water Drink Group was $1.67{\pm}0.63\;cm$, horizontal length was $1.65{\pm}0.77\;cm$, the vertical length of Orange juice Drink Group was $3.48{\pm}0.77\;cm$, horizontal length was $3.66{\pm}0.77\;cm$ in coronal image. Stomach Extension was described the vertical length of the Non Drink Group was $2.03{\pm}0.62\;cm$, horizontal length was $1.69{\pm}0.68\;cm$, the vertical length of Water Drink Group was $5.34{\pm}1.62\;cm$, horizontal length was $2.45{\pm}0.72\;cm$, the vertical length of Orange juice Drink Group was $7.74{\pm}1.62\;cm$, horizontal length was $3.57{\pm}0.77\;cm$ in transverse image. The Stomach Extension has specific differences (p<0.001). The SUVs shows the Non Drink Group were measured as Liver $2.52{\pm}0.42$, Lung $0.51{\pm}0.14$, the Water Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$, Orange juice Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$. The SUVs did not have specific differences (p>0.759). Conclusions: There was not a large difference of SUV in three groups. When the patients drank Orange juice and water, the range extension of stomach was higher than without drinking nothing and it was possible to acquire fully extended images. Therefore, it will be possible that unnecessary additional stomach scans will be reduced by drinking orange juice before the examination so that the patients' claim from uncomfortable and long period of fast will be minimized.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.1-7
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• 2018

$^{68}Ga$ was eluted from a $^{68}Ge/^{68}Ga$ radionuclide generator. $^{68}Ga$ decays into $^{68}Zn$, with a half life=67.8min. The decay is 88.9 % by ${\beta}$+ and 11.1 % by EC. The main ${\beta}$+ decay (87.7 %) is to the ground level of $^{68}Zn$ and it is a pure positron emission branch. A small fraction decays ${\beta}$+ (1.2 %) into an excited level of $^{68}Zn$, which promptly decays into the ground level with a ${\gamma}$ (1.077 Mev). This can constitute prompt gamma contamination in the PET data, if the 1.077 Mev ${\gamma}$ has a scatter interaction in the patient, and generates a lower energy ${\gamma}$ in coincidence with the positron annihilation pair. The purpose of this study was to evaluate standardized uptake value(SUV) before and after applying prompt gamma rays correction on $^{68}Ga$-DOTATOC PET/CT image. Fifty patient underwent PET/CT 1 hour after injection of the $^{68}Ga$-DOTATOC. The SUVmax and SUVmean of lesions and normal tissues (Pituitary, Lung, Liver, Spleen, Kidney, Intestine) were evaluated before and after applying prompt gamma correction on $^{68}Ga$-DOTATOC PET/CT image. Additionally, the SUVmax of each lesions and SUVmean of the soft tissues were measured on images. and target to background ratios (TBR) were calculated as quantitative indices. Among 15 patients, 25 of lesions (Pancreas, Liver, Thoracic Spine, Brain) with increased uptake on $^{68}Ga$-DOTATOC PET/CT image. SUVmax and SUVmean were increased in lesion site and normal tissue after prompt gamma rays correction. TBR was $51.51{\pm}49.28$ and $55.50{\pm}53.12$ before and after prompt gamma rays correction, respectively. (p<0.0001)