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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Optimal Imaging Time for Diagnostic I-123 Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Cancer: Comparison between 6- and 24-Hour Images of the Same Subjects (분화 갑상선 암의 추적 관찰에서 진단적 I-123 전신 스캔의 최적 영상 시점: 동일 환자에서 6시간과 24시간 영상의 비교)

  • Lee, Hong-Je;Lee, Sang-Woo;Song, Bong-Il;Kang, Sung-Min;Seo, Ji-Hyoung;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.129-136
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    • 2009
  • Purpose: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer(DTC), we compared the image quality of 6- and 24-hour images of the same subjects. Materials and Methods: Four hundred ninety-eight patients(M:F = 55:443, Age $47.6{\pm}12.9$ years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq(5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. Results: In 440 patients(88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients(11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue(4 patients) and cervical lymph node metastasis(3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. Conclusion: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.

A Case of Kabuki Syndrome Confirmed by Genetic Analysis: A Novel Frameshift Mutation in the KMT2D Gene (분자유전학적으로 진단된 가부키 증후군 1례)

  • Park, Su Jin;Ahn, Moon Bae;Jang, Woori;Cho, Won Kyung;Chae, Hyo Jin;Kim, Myung Shin;Suh, Byung Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.103-108
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    • 2017
  • Kabuki syndrome is a rare congenital disorder that causes multiple birth defects and mental retardation. Mutation of the lysine methyltransferase 2D (KMT2D) gene is the primary cause of Kabuki syndrome. We report a 4-year-old Korean girl diagnosed with Kabuki syndrome based on distinctive facial features (eversion of the lower lateral eyelid, arched eyebrows, depressed nasal tip, prominent ears), skeletal anomalies, short stature, and molecular analysis, which revealed a novel frameshift mutation in the KMT2D gene. A 4-year-old patient had a past history of congenital cardiac malformations (coarctation of the aorta, ventricular septal defect, atrial septal defect, patent ductus arteriosus), subclinical hypothyroidism and dysmorphic features at birth including webbed neck, short fingers, high arched palate, micrognathia and horseshoe kidney. She showed unique facial features such as a long palpebral fissure, long eyelashes, arched eyebrows with sparseness of the lateral third, broad nasal root, anteverted ears, and small mouth. Her facial features suggested Kabuki syndrome, and genetic analysis discovered a novel heterozygous frameshift mutation (c.4379dup, p.Leu1461Thrfs*30) in exon 15 of the KMT2D gene. The diagnosis of our 4-year-old patient was made through thorough physical examination and history taking, and genetic testing. It is challenging to diagnose patients with Kabuki syndrome at birth, since the characteristic facial features are expressed gradually during growth. Clinical suspicion aroused by regular follow-ups may lead to earlier diagnosis and interventions.

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A Study on the Relationship between the Experience of Sanhujori, the Traditional Postpartal Care in Korea and Present Health Status of Chronic Arthritis Female Patient (만성관절염 여성 환자의 산후조리 경험과 건강상태와의 관계)

  • Yoo, Eun-Kwang;Lee, Sun-Hyae;Kim, Myoung-Hee
    • Women's Health Nursing
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    • v.4 no.2
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    • pp.217-230
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    • 1998
  • The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

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Morpho-anatomical Characteristics of Different Panicles in Low and High Tillering Rices (벼 소얼성과 다얼성 품종에서 분얼별 이삭의 형태 해부학적 특성)

  • Kim, Je-Kyu;B.S. Vergara
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.6
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    • pp.568-575
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    • 1991
  • The morpho-anatomical characteristics of panicle in rice plant is generally correlated with the number of spikelets and grain weight per panicle. For the increase of grain yield potential in rice, a low -tillering plant type with large panicles has been suggested as an ideotype. This study was conducted to investigate the panicle morphology and peduncle anatomy of different tillers within a plant in low -and high-tillering cultivars and their relationships on the number of spikelets and grain weight per panicle. A low-tillering, large panicled IR25588 was compared with a high-tillering. small panicled IR58. IR25588 had more inner(IVB) and outer vascular bundles (OVB). bigger peduncle diameter and peduncle thickness just below the panicle neck node than IR58. The top six tillers(M. P1, P2, P3. P4 and S1P2) within a plant had more IVB and OVB. larger peduncle diameter and thickness than the rest of the tillers in both cultivars. Tillers that emerged earlier had more IVB and OVB than tillers that emerged Jater. The total number of primary and secondary rachis-branches of IR25588 was much higher than that of IR58. IR25588 had more number of spikelets per panicle than IR58. and the top six panicles showed more spikelets per panicle than the rest of the panicles in both cultivars. The peduncle diameter was more important than peduncle thickness on the spikelet differentiation and panicle weight. especially in low-tillering cultivars. The number of IVB and OVB were highly correlated with the number of rachis-branches. spikelets and grain weight per panicle. The number of spikelets per IVB and spikelets per primary branch were higher in IR25588 than IR58 indicating the higher sink strength in low -tillering with large panicled cultivars than in high-tillering with small panicled cultivars. Based on the morpho-anatomical characteristics of a low-tillering cultivar and the top six tillers within a plant. the present results could be support that 'a low-tillering sturdy culms with large panicles' is an ideo-type of rice plant for increasing grain yield potential.potential.

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Effects of Dietary Supplementation of Vitamin C and Sea Buckthorn on the Performance and Meat Quality in Old Laying Hens (비타민 C와 비타민나무 부산물 첨가가 산란 성계의 생산성 및 계육 품질에 미치는 영향)

  • Kang, Hwan Ku;Kim, Ji-Hyuk;Hwangbo, Jong;Kim, Chan Ho
    • Korean Journal of Poultry Science
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    • v.42 no.2
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    • pp.181-189
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    • 2015
  • The objective of this study was to investigate the effect of dietary supplementation of vitamin C and Sea buckthorn on the performance, blood biochemistry and meat quality in old laying hens. A total 200 Hy-Line Brown laying hens (101 weeks old) were randomly allotted to 1 of 5 dietary treatments : (1) Basal : basal diet, (2) Vit. C : basal diet + 0.1% vitamin C, (3) SB 0.1 : basal diet + 0.1% Sea buckthorn, (4) SB 0.5 : basal diet + 0.5% Sea buckthorn, and (5) SB 1.0 : basal diet + 1.0% Sea buckthorn. Each treatment was replicated 4 times with 10 birds units were arranged according to randomized block design. Feeding trial lasted 4 weeks under 16L:8D lighting regimen. The diets were fed to hens on an ad libitum basis for 4 weeks. Result indicated that during feeding trial of the experiment, hen-day egg production and feed conversion ratio were not significantly influenced by treatments. However, feed intake was significantly (P<0.05) higher in Vit. C and SB treated groups than the basal during 1 wks and 3 wks. Egg weight was significantly (P<0.05) higher in basal and Vit. C than the SB 1.0 treatment. There were no differences in carcass yield during feeding trials. However, partial ratio (breast and neck) was significantly (P<0.05) higher in SB 0.5 than other treatment. There were no differences in the level of leukocytes and erythrocytes. There were no significant differences on proximate analysis (DM, crude protein, crude fat, and crude ash), meat color, water holding capacity, cooking loss, and fatty acids concentrations. In conclusion, dietary supplementation of vitamin C and Sea buckthorn to the diet of old laying hens might be a potential ingredient for increasing partial weight (breast) in old laying hens.

The Study on Musculoskeletal Symptoms and it's Related Factors in Radio-Technologists (방사선사의 근골격계 증상과 유해 요인에 관한 연구)

  • Lee, Hyang-Seob;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.239-247
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    • 2008
  • In order to study the occurrence of symptoms of musculoskeletal disorders of radio-technologists employed at metropolitan general hospitals and the factors that influence such occurrence, standardized questionnaire by NIOSH that was modified and supplemented to be suitable for conditions in Korea was used. Answers collected from 143 radio-technologists in two weeks from June 13, 2007 were analyzed and the results are as follows. Factor that influence symptoms of musculoskeletal disorders by area were analyzed through multiple logistic regression analysis and the results found that in the neck area, risk increased as the burdening work category 2(Korea ministry of labor)(OR=3.94) and burdening work category 9(Korea ministry of labor)(OR=4.72) increased. In the shoulder region, risk increased as burdening work category 2(Korea ministry of labor)(OR=5.36), burdening work category 7(Korea ministry of labor)(OR=3.90), and burdening work category 9 (Korea ministry of labor)(OR=5.76) increased. In the arm/hand/wrist regions, risk increased as burdening work category 2 (Korea ministry of labor) (OR=6.91), and burdening work category 9 (Korea ministry of labor)(OR=3.76) increased. In the lower back region, risk increased as burdening work category 2 (Korea ministry of labor) (OR=3.06), and burdening work category 8 (Korea ministry of labor)(OR=8.14) increased. In the leg/knees/foot regions, risk increased as burdening work category 2 (Korea ministry of labor) (OR=3.63), and burdening work category 9 (Korea ministry of labor)(OR=2.96) increased. Conclusively, in factors that influence musculoskeletal disorder symptoms in radio-technologists, influence of subjective health conditions, total work experience, experience in current division, and burdening work category 2, 7, 8, and 9 (Korea ministry of labor) were most significant. Therefore, for preventive management, in addition to ergonomic and educational intervention for correcting improper posture during work, efforts for break time adjustment and stress reduction is needed, and encouragement and support for regular exercise is needed.

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Correction of Artifacts due to Patient Arm Motion in PET/CT: Scatter-Limit Correction (PET/CT 검사에서 움직임에 의한 인공물의 산란제한보정법 적용 영상 평가)

  • Bahn, Young Kag;Lee, Seung Jae;Kim, Jung Yul;Oh, Sin Hyun;Nam-Koong, Hyuk;Park, Hoon-Hee;Kang, Chun Koo;Lim, Han Sang;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.44-48
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    • 2012
  • Purpose : Arm motion can give rise to striking cold artifact on PET/CT. We investigated that evaluation of scatter-limit correction and correct the patient arm motion artifact in Discovery 600 PET/CT. Materials and Methods : To evaluate a radioactivity uptake (Bq/ml) and a standard uptake value (SUV), the scatter limit correction and scatter correction were compared using 1994 NEMA Phantom$^{TM}$ in Discovery 600 PET/CT (GE Healthcare, Mi, We). Arm motion phantom study was involved a central 20 cm diameter cylinder simulating the neck and 2 peripheral 10 cm diameter cylinders simulating arms. The positions of the arms were altered so as to introduce different amounts of misalignment. The evaluation of arm motion phantom study used the radioactivity uptake and SUV in scatter correction and scatter limit correction. Results : The statistical significance of radioactivity uptake and SUV did not show the differences in comparisons of the scatter limit correction and the scatter correction that not show (p<0.05). Radioactivity uptake of the scatter correction was up to 3.1 kBq/ml in the 0.04 kBq/ml. It was approximately 98.7% undervalued in the arm motion phantom study. However, Radioactivity uptake of the scatter limit correction was up to 3.0 kBq/ml in the 2.11 kBq/ml. It was approximately 30% undervalued in arm motion phantom study. SUV of the scatter correction was 1.05 to 0.006 and underestimated about 98%. However, an applying SUV of the scatter limit correction changed the value as 0.67 which is underestimated about 25%. Radioactivity uptake and SUV of the scatter limit correction was increased approximately 60%, or more than the scatter correction. Conclusion : It is considered that if the patient arm motion artifact was occurred the scatter limit correction will be applicable to give an accurate diagnosis.

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Effects of Dansambohyultang on the Gastrointestinal Mucosa of Rats Stressed by Heating, Immobilization and Starvation (단삼보혈탕(丹蔘補血湯)이 Stress로 유발(誘發)된 백단삼보혈탕(白丹蔘補血湯)이 Stress로 유발(誘發)된 백서(白鼠) 위장관(胃腸管)의 조직손상(組織損傷)에 미치는 영향(影響))

  • Ryu, Bong-Ha;Park, Dong-Won;Ryu, Ki-Won;Kong, Hyun-Sig
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.74-86
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    • 2000
  • Objectives : This is the experimental paper to study the curative and preventive effects of Dansambohyultang, Methods : Oriental herb medicine for gastro-intestinal disease caused by stress, on the rats put under the stress through starvation, heating and immoblization, the author used four different group; the normal group, which was not put under stress and well fed, and the control group, to which the drug was not administered and put under the stress through starvation, heating and immoblization, the Sample I, to which the drug was administered before they were put under stress, the Sample lI, to which the drug was administered after they were put under stress. Results : When a Masson's trichrome stain method was applied to the control group, a small size of ulcer was found in the fundus and the pylorus, and atrophy was observed in the neck region of mucous membrane. When the drug was administered to the Sample I and the Sample II, the former recovered from the ulcer and atrophy to almost normal and showed better results than the latter. When a Masson's trichrome stain method was applied to the control group, atrophy of mucous membrane was found all over the intestines. When the drug was administered to the Sample I and the Sample ll, the curative and recovered effects was seen in both, but the former showed better results than the latter. After application of Mayer's hematoxylin stain method, the observation of numerical changes of goblet cells in the small intestines showed the most significant decrease in the control group. In the Sample I, the number of the cells in the duodenum, the jejunum and the ileum returned to an almost normal level. In the Sample II, a slight increase was observed only in the ileum. After application of Mayer's hematoxylin stain method, the observation of numerical changes of goblet cell in the large intestines showed a significant decreased in the control group. Both the Sample I and the Sample II showed an increase in the number of goblet cells in comparison with the control group. When a serotonin-immunoreaction test was applied, the control group showed a general decrease in the number of gastro-entero-endocrine cells, The Sample I showed the effect in all over gastro.intestinal tract as compared with control group and the Sample II showed the effect in all over gastro-intestinal tract except the duodenum and the former showed better results than the latter. Conclusion : According to the above results, the regions which are most sensitive to stress were observed to the ileum and the colon. It was concluded that Dansambohyultang has a remedical value particularly on the abnormalities caused by stress in all over gastro-intestinal tract and it was found to be more effective in the Sample I than in the Sample ll. Judging from the fact that the Sample I showed better results than the Sample ll, Dansambohyultang can be said to have a preventive effect more than a curative effect on gastro-intestinal tract disease.

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CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.