• Journal of Chest Surgery
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• v.42 no.1
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• pp.63-71
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• 2009

Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1309-1315
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• 2000

Objectives : We performed an in vivo experiment to investigate the effect of $^{166}Holmium$ and $^{166}Holmium$-chitosan complex($^{166}Ho$-CHICO) on the normal brain of rats and to determine the sublethal dose of $^{166}Ho$-CHICO. Materials and Methods : $^{166}Ho$ is a beta and gamma ray emitter. $^{166}Ho$-CHICO is a novel radio-pharmaceutical complex with chitosan to facilitate the transport of $^{166}Ho$ obtained from Korea Atomic Energy Research Center(Taejon, Korea). It is in acidic form and becomes gel state at alkaline pH. One hundred and seventy consecutive rats were divided into four groups : $^{166}Ho$ treated(n＝50), $^{166}Ho$-CHICO treated(n＝57), saline treated(n＝5) and chitosan treated(n＝5) groups. $^{166}Ho$ and $^{166}Ho$-CHICO were injected into the rat brain stereotactically with various doses of 0.1mCi/$20{\mu}l$, 0.2mCi/$20{\mu}l$, 0.3mCi/$20{\mu}l$, and 0.4mCi/$20{\mu}l$ using an automated microinjector. Nuclear imaging, histopathological and hematological studies were performed in 10 rats in each group at 1 day, 3days, 7 days, 1 month and 3 months after the injections. Results : An infiltration of inflammatory cells and necrotic changes were noted in $^{166}Ho$ treated group at 1 week after the injection. A wedge-shaped tissue defect due to necrosis, lined with infiltrated glial cells in $^{166}Ho$ treated group and a cystic defect lined with reactive astroglial cells in $^{166}Holmium$-CHICO treated group at 3 months after the injection were observed. $^{166}Ho$ alone without chitosan leaked out and caused necrotic lesion on the cerebral surface but $^{166}Holmium$-CHICO treated group did not show this feature. As the dose of $^{166}Ho$ increased, the mortality rates were also increased. The mortality rate of the $^{166}Holmium$-CHICO group was higher than the $^{166}Ho$ treated group at a dose of 0.4mCi/$20{\mu}l$/300g. There was no detectable radioactivity due to the leakage or extravasation from the injected site of the brain on the scintigraphy performed at 1 hour, 24 hours and 48 hours after the injection. There was also no detectable activity of $^{166}Holmium$-CHICO in other organs including spleen, liver and kidney. Conclusions : $^{166}Ho$-CHICO did not leak out to the critical cortical surface of the brain from the injection site and induced radiation changes of the parenchyma around the injection site without cortical damage. The sublethal dose of $^{166}Ho$-CHICO for the normal brain in rats was determined to be 0.2mCi/$20{\mu}l$/300g.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.62-66
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• 2006

Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

• Journal of radiological science and technology
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• v.26 no.2
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• pp.57-61
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• 2003

The purpose of this study is to compare both 1.5T and 4.7T in Praietal White matter material Phantom using the same methodology at both field strengths. Data at both field strengths are compared in terms of $T_2$ relaxation times, line widths and SNRs MR imaging and $^1H$ MR spectroscopy were performed on GE 1.5T SIGNA system and Broker Biospec 4.7T/30 MRI/MRS system. After phantom axial scan $^1H$ MRS was obtained from T2 weighted image by 3-dimensional localization technique(PRESS : Point RE solved spectroscopy Sequence) this phantom is composed of an aqueous solution 36.7 mmol/L of NAA, 25.0 mmol/L of Cr, 6.3 mmol/L of choline chloride, 30.0 mmol/L or Glu, and 22.5 mmol/L of MI(adjusted to a pH of 7,15 in a phosphate buffet). Data processed using software developed inhouse. At 1.5T, T2 relaxation times for Cho, Cr, and NAA were $0.41{\pm}0.07,\;0.26{\pm}0.04,\;0.46{\pm}0.07$ while at 4.7T they were $0.17{\pm}0.03,\;0.14{\pm}0.05,\;0.20{\pm}0.03$ respectively. At 1.5T, line widths for water, Cho, Cr and NAA were $2.9{\pm}0.7,\;1.6{\pm}0.7,\;1.7{\pm}0.8,\;2.2{\pm}0.02Hz$ while at 4.7T they were $5.2{\pm}1.1,\;4.6{\pm}1.9,\;4.01{\pm}1.8,\;4.8{\pm}1.9Hz$ respectively. It can be seen that $T_2$ relaxation times were significantly shorter at 4.7 compared to 1.5T and that the line widths were also broader. The average SNRs for NAA for subjects at short and long TEs were $23.5{\pm}11.3$ at TE=20 msec ; $15.4{\pm}7.7$ at TE=272 msec at 1.5T and $40{\pm}8.3$ and $17{\pm}3.5$ respectively at 4.7T higher field strength is superior because of improved sensitivity and chemical shift dispersion. However these improvements are partially offset by increased line widths and decrease $T_2$ relaxation times, which act to reduce both sensitivity and resolution. In our experiments with the equipment available to us, 4.7T proton spectra at short TEs exhibit moderately improved sensitivity compared to 1.5T.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.136-142
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• 2009

Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

• Journal of Radiation Protection and Research
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• v.38 no.2
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• pp.78-90
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• 2013

Recently, the interest on exposure to radiation is rising. The radiation exposure of mammography is higher in absorbed dose than of X-ray, therefore unnecessary exposure needs to be reduced, and higher image quality is needed. Generally, ray quality of the radiation imaging is an important factor that determines image quality and the amount of ray exposure, and they are affected by tube voltage and added filter. The X-ray energy that is exposed from mammography device is generally a continuous spectrum, which includes low energy that has minute influence on the image quality, and high energy that hinders contrast on image. Currently, molybdenum (Mo) and rhodium (Rh) are the most used added filters for mammography device, and they are used differently according to the energy region of X-ray. This study aims to find out the degree of reduction in exposure dose according to the thickness of aluminum (Al), and to study the changes in image quality and dose when the added filter plates that are made with niobium (Nb) or zirconium (Zr) are used, other than molybdenum (Mo) and rhodium (Rh), the two most used added filters that have similar atomic number and K-absorption regions as Nb and Zr. In this study, single-added filters of molybdenum (Mo), niobium (Nb), and zirconium (Zr) are used, and in some cases, Aluminum (Al) is combined with the single filters. In this case, image quality is considered to be improved depending on the type of added filters, and by using Aluminum (Al) filter together with the others, unnecessary X-ray of low energy would be absorbed, therefore the dose is expected to decrease without any influence when the concentration level becomes identical.

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.327-335
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• 2016

The study is enforce to study image quality evaluation of condition provide the IEC and combination of clinical conditions each quality of radiation that image quality to assess the conditions provided to IEC in the clinical environment to conduct image quality assessment of the digital radiography system in the detector have environmental limits. First, image quality evaluation was evaluated by measuring the MTF, NPS using four quality of radiation and Using MCNPX simulation lastly DQE make a image quality evaluation after calculating the particle fluence to analyze spectrum quality of radiation. Second, Using MCNPX simulation of four quality of radiation was evaluated absorbed dose rate about electronic 1 per unit air, water, muscle, bone by using Radiation flux density and energy, mass-energy absorption coefficient of matter. Results of evaluation of image quality, MTF of four quality of radiation was satisfied diagnosis frequency domain 1.0 ~ 3.0 lp/mm of general X-ray that indicated 1.13 ~ 2.91 lp/mm spatial frequency. The NPS has added filter, spatial frequency 0.5 lp/mm at standard NPS showed a tendency to decrease after increase. Unused added filter, spatial frequency 0.5 lp/mm at standard NPS showed a certain NPS result value after decrease. DQE in 70 kVp / unuesd added filter(21 mm Al) / SID 150 cm that patial frequency 1.5 lp/mm at standard showed a tendency to decrease after certain value showed. Patial frequency in the rest quality of radiation was showed a tendency to decrease after increase. Results of evaluation of absorbed dose, air < water < muscle < bone in the order showed a tendency to increase. Based on the results of this study provide to basic data that present for the image quality evaluation method of a digital radiation imaging system in various the clinical condition.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.100-106
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• 2009

Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

• Journal of Yeungnam Medical Science
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• v.17 no.2
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• pp.146-154
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• 2000

Background and Purpose: Radioopaque lesions are commonly seen in patients who received thoracic radiotherapy for various kinds of thoracic neoplasm, But therir exact diagnos are sometimes uncertain. Patients and Methods: We examined simple chest radiograph and computed tomogram(CT) of 69 patients who received thoracic radiotherapy for lung cancer and were follow up at least 6 months in Yeungnam University Medical Center. Results: Of the 69 patients. thirty-eight patients showed radioopaque lesions in their chest radiographs except radiation fibrosis; radiation pneumonitis was witnessed in 24 patients. infectious pneumonia in 8 patients, and recurrence in 6 patients. In radiation pneumonitis patients, the pneumonitis occurred usually between 50 to 130 days after receiving radiation therapy, and interval between pneumonitis and fibrosis is 21 to 104 days. Simple chest radiographs of radiation pneumonitis(24 patients) represented ground glass opacities or consolidation in 4 cases(type I, 17%), reticular of reticulonodular opacities in 10 cases(type II, 42%), irregular patchy consolidations in 2 cases( type III, 8%), and consolidation with fibrosis in 8 cases(type IV, 33%), CT represent ground glass opacities or consolidation in 5 cases(type I, 29%), irregular nodular opacities in 3 cases(type II, 19%), irregular opacity beyond radiation fields in 3 cases(type III, 18%), and consolidation with fibrosis in 6 cased(type IV, 35%). The CT of four patients who represented type II on simple chest radiographs reveal type I and III, and CT of two patients with clinical symptoms who had no abnormal finding on simple radiograph revealed type I. Conclusions: In conclusion, computed tomogram is superior to the simple radiograph when trying to understand the pathologic process of radiation pneumonitis and provide confidence in the diagnosis of radiation induced lung disease.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.144-150
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• 1997

Purpose : The kidney is one of the most common sites of cyst formation. Cystic diseases of the kidney are a diverse group of clinicopathologic entities and variable prognosis. They span a wide range of both age of presentation and severity of the renal disease. And many of them are systemic disorders, sharing similar process of cyst formation in other organs. Recently, development of imaging studies has been contributing widely to the diagnosis of the diseases. Treatment, however, is not established satisfactorily. We performed this study to evaluate the occurrence and treatment of cystic diseases of the kidney. Methods : We reviewed retrospectively the medical records of 44 patients with cystic diseases of the kidney in the Department of Pediatrics, during last 11 years. Results : In the 44 patients with cystic diseases of the kidney, 31 patients(71%) had multicystic dysplastic kidney and 11(35%) of them received nephrectomy due to differentiation from neoplasms or severe abdominal distension. Seven patients(16%) had polycystic kidney disease, and all of them were infantile type. Five patients(11%) were diagnosed as having a simple renal cysts. Progression to renal failure was noted in none of the cases. In 14(32%) out of total 44 patients, the diagnosis was made in neonatal or infantile pelted. Conclusion : The incidence of cystic diseases of the kidney appeared very low, but further investigation on their pathogenesis, classification, and indication of treatment is needed.