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The comparison of lesion localization methods in breast lymphoscintigraphy (Breast lymphoscintigraphy 검사 시 체표윤곽을 나타내는 방법의 비교)

  • Yeon, Joon ho;Hong, Gun chul;Kim, Soo yung;Choi, Sung wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.74-80
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    • 2015
  • Purpose Breast lymphoscintigraphy is an important technique to present for body surface precisely, which shows a lymph node metastasis of malignant tumors at an early stage and is performed before and after surgery in patients with breast cancer. In this study, we evaluated several methods of body outline imaging to present exact location of lesions, as well as compared respective exposure doses. Materials and Methods RANDO phantom and SYMBIA T-16 were used for obtaining imaging. A lesion and an injection site were created by inserting a point source of 0.11 MBq on the axillary sentinel lymph node and 37 MBq on the right breast, respectively. The first method for acquiring the image was used by drawing the body surface of phantom for 30 sec using $Na^{99m}TcO_4$ as a point source. The second, the image was acquired with $^{57}Co$ flood source for 30 seconds on the rear side and the left side of the phantom, the image as the third method was obtained using a syringe filled with 37 MBq of $Na^{99m}TcO_4$ in 10 ml of saline, and as the fourth, we used a photon energy and scatter energy of $^{99m}Tc$ emitting from phantom without any addition radiation exposure. Finally, the image was fused the scout image and the basal image of SPECT/CT using MATLAB$^{(R)}$ program. Anterior and lateral images were acquired for 3 min, and radiation exposure was measured by the personal exposure dosimeter. We conducted preference of 10 images from nuclear medicine doctors by the survey. Results TBR values of anterior and right image in the first to fifth method were 334.9 and 117.2 ($1^{st}$), 266.1 and 124.4 ($2^{nd}$), 117.4 and 99.6 ($3^{rd}$), 3.2 and 7.6 ($4^{th}$), and 565.6 and 141.8 ($5^{th}$). And also exposure doses of these method were 2, 2, 2, 0, and $30{\mu}Sv$, respectively. Among five methods, the fifth method showed the highest TBR value as well as exposure dose, where as the fourth method showed the lowest TBR value and exposure dose. As a result, the last method ($5^{th}$) is the best method and the fourth method is the worst method in this study. Conclusion Scout method of SPECT/CT can be useful that provides the best values of TBR and the best score of survey result. Even though personal exposure dose when patients take scout of SPECT/CT was higher than another scan, it was slight level comparison to 1 mSv as the dose limit to non-radiation workers. If the scout is possible to less than 80 kV, exposure dose can be reduced, and also useful lesion localization provided.

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The Accuracy of Tuberculosis Notification Reports at a Private General Hospital after Enforcement of New Korean Tuberculosis Surveillance System (새로운 국가결핵감시체계 시행 후 한 민간종합병원에서 작성된 결핵정보관리보고서의 정확도 조사)

  • Kim, Cheol Hong;Koh, Won-Jung;Kwon, O Jung;Ahn, Young Mee;Lim, Seong Young;An, Chang Hyeok;Youn, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.178-190
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    • 2003
  • Background : The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. Materials and Methods : 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. Results : In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. Conclusion : Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.

A Study on the Distribution, Contents and Types of Stone Inscription of Wuyi-Gugok in China (중국 무이구곡 바위글씨(石刻)의 분포와 내용 및 유형에 관한 연구)

  • Rho, Jae-Hyun;Cheng, Zhao-Xia;Kim, Hong-Gyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.1
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    • pp.115-131
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    • 2020
  • Through literature research and field investigation, this paper attempts to study the distribution, morphology and the typification of the visual and perceptual stone inscription in Wuyi-Gugok of China. The results are as follows: First, there are 350 stone inscriptions in total from the 1st Gok to 9th Gok in Wuyi-Gugok. Second, according to the analysis of the stone inscription distribution, 74(21.2%) stone inscriptions in the 5th Gok, 67(19.2%) in the 6th Gok, 65(18.6%) in the 1st Gok, 60(17.2%) in the 2nd Gok and 53(15.2%) in the 4th Gok are confirmed. The above five Goks contain 319(91.1%) stone inscriptions, so they have rich cultural landscape. Third, according to the survey, the number of the stone inscriptions existed in the Sugwangseok of the 1st Gok are 41(22.6%), in the Homagan of Cheonyubong of the 6th Gok are 29(8.3%), in the Jesiam of the 4th Gok are 23(6.6%), in the Nyeongam of the 2nd Gok are 22(6.3%), in the Hyangseongam of the 6th Gok are 21(6%), in the Unwa of the 5th Gok are 19(5.4%), in the Bokhoam of the 5th Gok are 18(5.1%), in the Eunbyeongbong of the 5th Gok are 17(4.9%), in the Daejangbong of the 4th Gok are 14(4%), in the Daewangbong of the 1st Gok and the Geumgokam of the 4th Gok are 12(3.4%). Thus, a total of 228 (65.1%) stone inscriptions are concentrated in these 11 sites, which represent the popularity and cultural value of these rocks. Fourth, the stone inscription of Wuyi-Gugok, praising the landform and topographical geological landscape of Mount Wuyi, mainly describe the scenic name of each Gok related to Zhu Xi's Gugok culture, appreciate Zhu Xi's tracks and the stone inscription in the sacred land of Neo-Confucianism culture, and also record the Confucian edification of mencius thoughts, Muigun(武夷君) and the myths and legends related to the site names of Wuyi mountain, which can remind people of the worldview of the celestial paradise where the gods live and the fairyland of the land of peach blossoms. In addition, it indicates that the historical and cultural landscape, which is full of colorful history and myths and legends, including allusions related to Confucian, buddhist and Taoist celebrities and the ancestor ancient things related to traditional culture of China is very diverse. Fifth, the results of the classification, based on the content of the stone inscription in Wuyi-Gugok, are classified as the scenery name inscription, the praise scene inscription, the recording travel inscription, the recording event inscription, the philosophy inscription, the expressing emotion inscription, the religion inscription, the inscription for auspiciousness, the slogan and expressing ambition inscription and the official document notice inscription, among which there are 102(29.1%) praise scene inscriptions, 93(26.6%) scenery name inscriptions and 61(17.4%) recording travel inscriptions. The stone inscriptions of Wuyi-Gugok have the characteristics of the special emphasis on scenery names, landscape praise and commemorative tours. Sixth, the analysis of the intertext between the 「Figure of Wuyi-Gugok」 and Wuyi-Gugok rock letters, in the study found that the method of propagation between media was mostly the method of propagation of quotations and maintained intermedia through extension, repetition, extension, and compression.

DC Resistivity method to image the underground structure beneath river or lake bottom (하저 지반특성 규명을 위한 전기비저항 탐사)

  • Kim Jung-Ho;Yi Myeong-Jong;Song Yoonho;Cho Seong-Jun;Lee Seong-Kon;Son Jeongsul
    • 한국지구물리탐사학회:학술대회논문집
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    • 2002.09a
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    • pp.139-162
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    • 2002
  • Since weak zones or geological lineaments are likely to be eroded, weak zones may develop beneath rivers, and a careful evaluation of ground condition is important to construct structures passing through a river. Dc resistivity surveys, however, have seldomly applied to the investigation of water-covered area, possibly because of difficulties in data aquisition and interpretation. The data aquisition having high quality may be the most important factor, and is more difficult than that in land survey, due to the water layer overlying the underground structure to be imaged. Through the numerical modeling and the analysis of case histories, we studied the method of resistivity survey at the water-covered area, starting from the characteristics of measured data, via data acquisition method, to the interpretation method. We unfolded our discussion according to the installed locations of electrodes, ie., floating them on the water surface, and installing at the water bottom, since the methods of data acquisition and interpretation vary depending on the electrode location. Through this study, we could confirm that the dc resistivity method can provide the fairly reasonable subsurface images. It was also shown that installing electrodes at the water bottom can give the subsurface image with much higher resolution than floating them on the water surface. Since the data acquired at the water-covered area have much lower sensitivity to the underground structure than those at the land, and can be contaminated by the higher noise, such as streaming potential, it would be very important to select the acquisition method and electrode array being able to provide the higher signal-to-noise ratio data as well as the high resolving power. The method installing electrodes at the water bottom is suitable to the detailed survey because of much higher resolving power, whereas the method floating them, especially streamer dc resistivity survey, is to the reconnaissance survey owing of very high speed of field work.

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Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea (한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구)

  • Choi Doo Ho;Kim Eun Seog;Kim Yong Ho;Kim Jin Hee;Yang Dae Sik;Kang Seung Hee;Wu Hong Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.61-70
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    • 2005
  • Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.

Study on the Painting of Gyeongwoo-gung Shrine (景祐宮圖) (국립문화재연구소 소장 '경우궁도(景祐宮圖)'에 관한 연구)

  • Kim, Kyung Mee
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.196-221
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    • 2011
  • The Royal Private Shrines or the Samyo(私廟), were dedicated to members of Choseon's royal family who could not be enshrined at the (official) Royal Ancestral Shrine, the Jongmyo(宗廟). The Samyo were constructed at the national level and were systematically managed as such. Because these private Shrines were dedicated to those who couldn't belong to the Jongmyo but were still very important, such as the ruling king's biological father or mother. The details of all royal constructions were included in the State Event Manuals, and with them, the two-dimensional layouts of the Samyo also. From the remaining "Hyunsa-gung Private Tomb Construction Layout Record(顯思宮別廟營建都監儀軌)" of 1824, which is the construction record of Gyeongwoo-gung Shrine(景祐宮) dedicated to Subin, the mother of King Sunjo(純祖), it became possible to investigate the so far unknown "The Painting of Gyeongwoo-gung Shrine", in terms of the year produced, materials used and other situational contexts. The investigation revealed that the "The Painting of Gyeongwoo-gung Shrine" is actually the "Hyunsa-gung Private Tomb Layout" produced by the Royal Construction Bureau. The bureau painted this to build Hyunsa-gung Private Shrine in a separately prepared site outside the court in 1824, according to the royal verdict to close down and move the temporary shrine inside the courtyard dedicated to Subin who had passed away in 1822. As the Construction Bureau must have also produced the Gyeongwoo-gung Shrine Layout, the painter(s) of this layout should exist among the official artists listed in the State Event Manual, but sadly, as their paintings have not survived to this day, we cannot compare their painting styles. The biggest stylistic character of the Painting of Gyeongwoo-gung Shrine is its perfect diagonal composition method and detailed and neat portrayalof the many palace buildings, just as seen in Donggwoldo(東闕圖, Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). A well-perceiving architectural painting employs a specific point of view chosen to fit the purpose of the painting, or it can opt to the multi-viewpoint. Korean traditional architectural paintings in early ages utilized the diagonal composition method, the bird-eye viewpoint, or the multi-viewpoint. By the 18th century, detailed but also artistic architectural paintings utilizing the diagonal method are observed. In the early 19th century, the peak of such techniques is exhibited in Donggwoldo(Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). From the perfect diagonal composition method employed and the details of the palace buildings numbering almost two hundreds, we can determine that the Painting of Gyeongwoo-gung Shrine also belongs to the same category of the highly technical architectural paintings as Donggwoldo(Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). We can also confirm this hypothesis by comparing the painting techniques employed in these two paintings in detailthe way trees and houses are depicted, and the way ground texture is expressed, etc. The unique characteristic of the Painting of Gyeongwoo-gung Shrine is, however, that the area surrounding the central shrine building(正堂), the most important area of the shrine, is drawn using not the diagonal method but the bird-eye viewpoint with the buildings lying flat on both the left and right sides, just as seen in the "Buildings Below the Central Shrine(正堂以下諸處)" in the State Event Manual's Painting Method section. The same viewpoint method is discovered in some other concurrent paintings of common residential buildings, so it is not certain that this particular viewpoint had been a distinctive feature for shrine paintings in general. On the other hand, when the diagonalmethod pointing to the left direction is chosen, the top-left and bottom-right sections of the painting become inevitably empty. This has been the case for the Painting of Gyeongwoo-gung Shrine, but in contrast, Donggwoldo shows perfect screen composition with these empty margins filled up with different types of trees and other objects. Such difference is consistent with the different situational contexts of these two paintings: the Painting of Gyeongwoo-gung Shrine is a simple single-sheet painting, while Donggwoldo is a perfected work of painting book given an official title. Therefore, if Donggwoldo was produced to fulfill the role of depiction and documentation as well as the aesthetic purpose, contrastingly, the Painting of Gyeongwoo-gung Shrine only served the purpose of copying the circumstances of the architecture and projecting them onto the painting.

Multiplication of Infectious Flacherie and Densonucleosis Viruses in the Silkworm, Bombyx mori (가잠의 전염성 연화병 및 농핵병 바이러스 증식에 관한 연구)

  • 김근영;강석권
    • Journal of Sericultural and Entomological Science
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    • v.25 no.2
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    • pp.1-31
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    • 1984
  • Flacherie, as one of the most prevalent silkworm diseases, causes severe economic damage to sericultural industry and its pathogens have been proved to be flacherie virus (FV) and densonucleosis virus (DNV). Multiplications of the viruses in the larvae of the silkworm, Bombyx mori, were studied by the sucrose density gradient centrifugation and electron microscopy. The quantitative and qualitative changes of nucleic acids and proteins were investigated from the midgut and hemolymph in the silkworm larvae infected separately with FV and DNV. The histopathological changes of epithelial cells of infected midgut also were examined by an electron microscope. 1. Purified fractions of FV or DNV in a sucrose density gradient centrifugation yielded one homogenous and sharp peak without a shoulder, suggesting no heterogenous materials in the preparation. Electron microscopy also revealed that FV and DNV were spherical particles, 27nm and 21nm in diameter, respectively. 2. Silkworm larvae showed a decrease in body weight on the 6th day and in midgut weight on the 3rd day after inoculation with FV or DNV. 3. DNA content was higher in the midgut when infected with FV or DNV, but the hemolymph of the infected larvae showed no difference during first 6 days after inoculation, after which DNA concentration declined rapidly. 4. RNA synthesis of silkworm larvae infected separately with FV and DNV was stimulated in the midgut, but RNA content was reduced in the hemolymph at the early stage of virus multiplication. At the late stage of virus multiplication, however, it was extremely reduced in both midgut and hemolymph. 5. The concentration of protein in the midgut and hemolymph of silkworm larvae infected separately with FV and DNV showed no difference from that of the healthy larvae at the early stage of virus multiplication, but it was significantly reduced at the late stage of virus multiplication. 6. There was no difference in the electrophoretic patterns of RNAs extracted from the midgut of healthy or virus-infected larvae. 7. The electrophoresis of proteins extracted from the midgut infected with FV or DNV, when carried out on the 1st and 5th day after virus inoculation, showed no difference from that of the healthy larvae. But, there was an additional band with medium motility in the proteins on the 8th day after virus inoculation, while a band with low mobility shown in the proteins of healthy larvae disappeared in the infected larvae. However, a band with high mobility in the healthy larvae was separated into two fractions in the infected larvae. 8. The electrophoretic pattern of hemolymph proteins of the silkworm larvae infected separately with FV and DNV was similar to that of the healthy larvae, but the concentration of hemolymph proteins in the infected larvae was lower than that of the healthy larvae at the late stage. 9. Two types of inclusion bodies were shown by the double staining of pyronin-methyl green in the columnar cell of the midgut on the 8th day after FV inoculation. 10. Electron microscopy of the infected midgut revealed that the 'cytoplasmic wall' of the goblet cell thickened on the 5th day after FV inoculation and several types of the cytopathogenic structures, such as virus$.$specific vesicles, virus particles, linear structures, tubular structures, and high electron-dense matrices were observed in the cytoplasm of the goblet cell. The virus particles were also observed in the microvilli and the structures similar to spherical virus particles were observed around the virus-specific vesicles, suggesting the virus assembly in the cytoplasm. 11. Fluorescence micrograph of the infected midgut stained with acridine orange showed that the nucleus, the site of DNV multiplication in the columnar cell, enlarged on the 5th day after virus inoculation. 12. Electron microscopic examination of DNV infected midgut revealed that the nucleolus of the columnar cell was broken into granules and those granules dispersed into apical region of the nucleus on the 5th day after virus inoculation. On the 8th day after inoculation, it was also observed that the nucleus of the columnar cell was full with the high electron-dense virogenic stroma which were similar to virus particles. These facts suggest that the virogenic stroma were the sites of virus assembly in the process of DNV multiplication.

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Consumer's Negative Brand Rumor Acceptance and Rumor Diffusion (소비자의 부정적 브랜드 루머의 수용과 확산)

  • Lee, Won-jun;Lee, Han-Suk
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.65-96
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    • 2012
  • Brand has received much attention from considerable marketing research. When consumers consume product or services, they are exposed to a lot of brand related stimuli. These contain brand personality, brand experience, brand identity, brand communications and so on. A special kind of new crisis occasionally confronting companies' brand management today is the brand related rumor. An important influence on consumers' purchase decision making is the word-of-mouth spread by other consumers and most decisions are influenced by other's recommendations. In light of this influence, firms have reasonable reason to study and understand consumer-to-consumer communication such as brand rumor. The importance of brand rumor to marketers is increasing as the number of internet user and SNS(social network service) site grows. Due to the development of internet technology, people can spread rumors without the limitation of time, space and place. However relatively few studies have been published in marketing journals and little is known about brand rumors in the marketplace. The study of rumor has a long history in all major social science. But very few studies have dealt with the antecedents and consequences of any kind of brand rumor. Rumor has been generally described as a story or statement in general circulation without proper confirmation or certainty as to fact. And it also can be defined as an unconfirmed proposition, passed along from people to people. Rosnow(1991) claimed that rumors were transmitted because people needed to explain ambiguous and uncertain events and talking about them reduced associated anxiety. Especially negative rumors are believed to have the potential to devastate a company's reputation and relations with customers. From the perspective of marketer, negative rumors are considered harmful and extremely difficult to control in general. It is becoming a threat to a company's sustainability and sometimes leads to negative brand image and loss of customers. Thus there is a growing concern that these negative rumors can damage brands' reputations and lead them to financial disaster too. In this study we aimed to distinguish antecedents of brand rumor transmission and investigate the effects of brand rumor characteristics on rumor spread intention. We also found key components in personal acceptance of brand rumor. In contextualist perspective, we tried to unify the traditional psychological and sociological views. In this unified research approach we defined brand rumor's characteristics based on five major variables that had been found to influence the process of rumor spread intention. The five factors of usefulness, source credibility, message credibility, worry, and vividness, encompass multi level elements of brand rumor. We also selected product involvement as a control variable. To perform the empirical research, imaginary Korean 'Kimch' brand and related contamination rumor was created and proposed. Questionnaires were collected from 178 Korean samples. Data were collected from college students who have been experienced the focal product. College students were regarded as good subjects because they have a tendency to express their opinions in detail. PLS(partial least square) method was adopted to analyze the relations between variables in the equation model. The most widely adopted causal modeling method is LISREL. However it is poorly suited to deal with relatively small data samples and can yield not proper solutions in some cases. PLS has been developed to avoid some of these limitations and provide more reliable results. To test the reliability using SPSS 16 s/w, Cronbach alpha was examined and all the values were appropriate showing alpha values between .802 and .953. Subsequently, confirmatory factor analysis was conducted successfully. And structural equation modeling has been used to analyze the research model using smartPLS(ver. 2.0) s/w. Overall, R2 of adoption of rumor is .476 and R2 of intention of rumor transmission is .218. The overall model showed a satisfactory fit. The empirical results can be summarized as follows. According to the results, the variables of brand rumor characteristic such as source credibility, message credibility, worry, and vividness affect argument strength of rumor. And argument strength of rumor also affects rumor intention. On the other hand, the relationship between perceived usefulness and argument strength of rumor is not significant. The moderating effect of product involvement on the relations between argument strength of rumor and rumor W.O.M intention is not supported neither. Consequently this study suggests some managerial and academic implications. We consider some implications for corporate crisis management planning, PR and brand management. This results show marketers that rumor is a critical factor for managing strong brand assets. Also for researchers, brand rumor should become an important thesis of their interests to understand the relationship between consumer and brand. Recently many brand managers and marketers have focused on the short-term view. They just focused on strengthen the positive brand image. According to this study we suggested that effective brand management requires managing negative brand rumors with a long-term view of marketing decisions.

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.