• Title/Summary/Keyword: metabolic patients

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Clinical Significance of Incidental Asymmetric Palatine Tonsillar Uptake on $^{18}F$-FDG PET/CT ($^{18}F$-FDG PET/CT에서 우연히 관찰되는 구개편도의 비대칭적 섭취증가의 임상적 의의)

  • Chae, Sun-Young;Baek, So-Ra;Ryu, Jin-Sook;Moon, Dae-Hyuk;Kim, Jae-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.402-410
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    • 2009
  • Purpose: The aim of this study was to determine the incidence and malignant rate of incidental asymmetric palatine tonsillar uptake (ATU) on $^{18}F$-FDG PET/CT in various clinical indications and to evaluate the clinical and PET/CT findings suggesting malignancy. Materials and Methods: We retrospectively reviewed a total of 2,901 patients ($58.4{\pm}12.3$ yrs, range 20~88 yrs, M:F = 1,841:1,060) who underwent $^{18}F$-FDG PET/CT during an 1-year period with various indications except primary tonsillar cancer and lymphoma evaluation. On $^{18}F$-FDG PET/CT, metabolic abnormality of the palatine tonsil and cervical lymph node were visually assessed. ATU was defined as increased palatine tonsillar uptake with diffuse, focal, or irregular pattern compared to contralateral side. The incidence and malignant ratio of ATU were evaluated according to clinical and PET/CT findings. Results: Of 2,901 cases, 290(10,0%) showed ATU. The incidence of ATU showed seasonal variation and was high in the winter (12.1%). Of 209 cases with ATU confirmed pathologically and/or clinically, five (2.4%) were malignant lesions. ATU with irregular uptake pattern (2/2) and in cases referred for cervical lymph node metastasis of unknown origin (3/5) were frequently associated with malignant lesion (p<0.05). Conclusion: ATU was not infrequently observed on $^{18}F$-FDG PET/CT, and the malignant risk of ATU was low. However, ATU with cervical lymph node metastasis or with irregular pattern on PET/CT would be further evaluated by the histopathologic examination.

Research Direction for Functional Foods Safety (건강기능식품 안전관리 연구방향)

  • Jung, Ki-Hwa
    • Journal of Food Hygiene and Safety
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    • v.25 no.4
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    • pp.410-417
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    • 2010
  • Various functional foods, marketing health and functional effects, have been distributed in the market. These products, being in forms of foods, tablets, and capsules, are likely to be mistaken as drugs. In addition, non-experts may sell these as foods, or use these for therapy. Efforts for creating health food regulations or building regulatory system for improving the current status of functional foods have been made, but these have not been communicated to consumers yet. As a result, problems of circulating functional foods for therapy or adding illegal medical to such products have persisted, which has become worse by internet media. The cause of this problem can be categorized into (1) product itself and (2) its use, but in either case, one possible cause is lack of communications with consumers. Potential problems that can be caused by functional foods include illegal substances, hazardous substances, allergic reactions, considerations when administered to patients, drug interactions, ingredients with purity or concentrations too low to be detected, products with metabolic activations, health risks from over- or under-dose of vitamin and minerals, and products with alkaloids. (Journal of Health Science, 56, Supplement (2010)). The reason why side effects related to functional foods have been increasing is that under-qualified functional food companies are exaggerating the functionality for marketing purposes. KFDA has been informing consumers, through its web pages, to address the above mentioned issues related to functional foods, but there still is room for improvement, to promote proper use of functional foods and avoid drug interactions. Specifically, to address these issues, institutionalizing to collect information on approved products and their side effects, settling reevaluation systems, and standardizing preclinical tests and clinical tests are becoming urgent. Also to provide crucial information, unified database systems, seamlessly aggregating heterogeneous data in different domains, with user interfaces enabling effective one-stop search, are crucial.

Change of FDG Uptake According to Radiation Dose on Squamous Cell Carcinoma of the Head and Neck (두경부종양에서 방사선조사량에 타른 FDG-PET의 변화양상)

  • Lee Sang-wook;Kim Jae-Seung;Im Ki Chun;Ryu Jin Sook;Lee Hee Kwan;Kim Jong Hoon;Ahn Seung Do;Shin Seong Soo;Yoon Sang Min;Song Siyeol;Park Jin-hong;Moon Dae Hyuk;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.98-105
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    • 2004
  • Purpose : To evaluate whether positron omission tomography (PET) with 2-[F-18]fluoro-2-deoxy-D-giucose(FDG) can be used to predict of early response to definitive aim radlotherapy (RT) in squamous cell carcinoma of the head and neck using response rate and locoreglonal control as study endpoints. Materials and Methods : Twenty-two patients with head and neck cancer underwent a FDG-PET study before RT, after a flrst dose of 45 Gy, and after a second dose on more 4han 70 Gy. Standard uptake value (SUV) was calculated for primary tumor (n=22) and neck lymph node (n:10). Attenuation corrected PET scans acquired 60 min after tracer injection were used for evaluation of FDG uptake In tumors. A quantitative FDG uptake index was expressed as Suvlean (corrected for iean body mass). The follow-up time was at least 5 months (range S-1 S months). Results : A total of 22 primary tumors and 10 metastatic lymph nodes were analyzed In FDG-PET. In the first PET study the mean SUVlean the primary tumors and nodes were 5.4 (SD, 2.5) and 4.6 (SD, 2.3), respectively. In the second PET, study peformed after 46 Gy RT the mean SUV in primary tumor and node decreased to 2.9 (SD, 1.9, p<0.001) and 1.7 (SD, 1.3) respectively. in the third PET study peformed at the full dose (more than 70 Gy), RT the mean SUV In the primary tumors and nodes decreased to 2.3 (SD, 1.5, p<0.001) and 1.5 (SD, 1 .1) respectively. Conclusions: FDG uptake In tumors showed a significant decrease after the 45 Gy and more than 70 Gy of RT for squamous cell carcinoma of the head and neck. Reduction of metabolic activity after 46 Gy of radiotherapy Is closely correlated with radiation response.

A single case study using Contextual Support Model based music therapy intervention for a terminal pediatric patient (말기질환 아동을 위한 환경적 지지모델(The Contextual Support Model of Music Therapy)에 근거한 음악치료사례연구)

  • Jun, Mi Hye
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.15-31
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    • 2005
  • Terminal pediatric patient include congenital metabolic abnormalities, chromosome aberrations, congenital anomalies, neuromuscular diseases and other incurable conditions as well as malignant tumors. One third of these diseases are cancers, and two thirds of cancers are lymphadenoma and leukemia. Terminal pediatric patient may feel fear, anger and frustration against treatment process in hospitals, lose control of themselves and stay in helplessness due to restrictions within controlled hospital environment. This study examined the relationship between hospitalized childrens behavior and music using Contextual Support Model of Music Therapya theory stating therapeutic music environments possess three elements of Structure, Autonomy support and Involvement, and increase childrens active engagement. Focused on these three therapeutic elements, this study analyzed music therapy cases of terminally ill children to examine the relationship between childrens behavior and music as environmental supportive medium in the environment. This study is on a single case case subject, a 10-year-old girl with acute lymphocytic leukemia. Nine sessions of music therapy activities were conducted and analyzed using qualitative method. Focusing on three therapeutic elements of Contextual Support Model, analysis of sessions was made on the basis of activities specifically designed for this study. Main music therapy activities included singing while playing musical instruments, singing while listening to music through CD player, making up songs, and searching for song lines. The findings of this study are as follows: a) in terms of Structure, music therapy suggested a direction for effective musical activities for terminally ill children by providing environments where child can sing, play musical instruments and make up songs; b) in terms of Autonomy support, music therapy encouraged childs voluntary participation by giving her chances to make choice while singing or playing musical instruments; c) in terms of Involvement, child could gain positive approval of the therapist and conduct musical activities in cooperation with the therapist. Music therapy serves as supportive medium in the environment, develops spontaneity and self-reliance in emotionally depressed children, and promotes voluntary attitudes in the restricted hospital environment. Based on the positive effects of music therapy, more studies need to be conducted with an approach to more various terminal pediatric patients.

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Comparison of Effects of Normothermic and Hypothermic Cardiopulmonary Bypass on Cerebral Metabolism During Cardiac Surgery (체외순환 시 뇌 대사에 대한 정상 체온 체외순환과 저 체온 체외순환의 임상적 영향에 관한 비교연구)

  • 조광현;박경택;김경현;최석철;최국렬;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.420-429
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    • 2002
  • Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature >34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation: Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result: VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p<0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p<0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p<0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p<0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p<0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p<0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p<0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p<0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p<0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.