• Title/Summary/Keyword: predictive value

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The Role of T1-201 Brain SPECT in the Differentiating Recurrent Tumor from Radiation Necrosis (뇌종양의 재발과 방사선 괴사의 감별을 위한 탈륨 SPECT의 역할)

  • Won, Kyoung-Sook;Ryu, Jin-Sook;Moon, Dae-Hyuk;Yang, Seoung-Oh;Lee, Hee-Kyung;Lee, Jung-Kyo;Kwun, Byung-Duk
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.476-483
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    • 1996
  • Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging rrere calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.

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Evaluation of Endoscopic and Histological Change of Gastritis Related to Helicobacter pylori Eradication in Children (소아 Helicobacter pylori 위염에서 균 박멸과 관련된 위염의 내시경 및 조직학적 변화에 대한 연구)

  • Chang, Ju-Young;Kim, Han-Seong;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.18-27
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    • 2001
  • Purpose: The aims of this study are to investigate the effect of the eradication of H. pylori on histological change of gastric mucosa in children with H. pylori gastritis and to determine whether the histological grading by the Sydney system is valuable in predicting the effect of treatment. Methods: 1) Histological scores by the Sydney system and the endoscopic characteristics were assessed before and at least four weeks after anti-H. pylori therapy in 42 children with H. pylori gastritis. 2) In 32 children treated with omeprazole, amoxicillin and clarithromycin (OAC), pretreatment histological scores and endoscopic findings were compared between the eradicated and the noneradicated to evaluate their predictive value for the successful eradication. Results: 1) In the eradicated (27 cases), nodular gastritis significantly decreased from 89% to 63% (p<0.05). There was an significant improvement in the mean activity score from 2.06 before treatment to 0.24 after treatment (p<0.01). The mean inflammatory score also improved from 2.61 before treatment to 1.89 after treatment (p<0.05). Lymphoid follicles significantly decreased from 48% to 15% (p<0.05). Epithelial damage improved in all 4 cases. But in the noneradicated (15 cases), there was no significant change in the frequency of nodular gastritis, the mean activity score, the mean inflammatory score and the frequency of the lymphoid follicles. 2) In 32 children treated with OAC, there was a tendency that the higher was the pretreatment score of the bacterial density, the lower was the eradication rate of H. pylori (p=0.072). Conclusion: The loss of the polymorphonuclear cell infiltration is the most prominent histological change after successful eradication. There may be negative correlation of the grade of the bacterial density with the success rate of the anti-H. pylori therapy.

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The Relation Between Bronchodilator Response, Airway Hyperresponsiveness and Serum Eosinophil Cationic Protein (ECP) Level in Moderate to Severe Asthmatics (중증 및 중등증 기관지천식 환자에서 기도과민성과 기관지확장제 반응성 및 혈청 Eosinophil Cationic Protein(ECP)와의 관계)

  • Park, Sung-Jin;Kang, Soon-Bock;Kwon, Jung-Hye;Lee, Sang-Hoon;Jung, Do-Youg;Yoo, Ji-Hoon;Kim, Sang-Hoon;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.196-204
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    • 2001
  • Background : Bronchial asthma is characterized by a reversible airway obstruction, airway hyperresponsiveness, and eosinophilic airway inflammation. The bronchodilator response(BDR) after short acting beta agonist inhalation and PC20 with methacholine inhalation are frequently used for diagnosing bronchial asthma. However, the relationship between the presence of a bronchodilator response and the degree of airway hyperresponsiveness is uncertain. Therefore, the availability of a eosinophil cationic protein (ECP) and a correlation ECP with a bronchodilator response and airway hyperresponsiveness was investigated. Method : A total 71 patients with a moderate to severe degree of bronchial asthma were enrolled and divided into two groups. 31 patients with a positive bronchodilator response and 38 patients with a negative bronchodilator response were evaluated. In both groups, the serum ECP, peripheral blood eosinophil counts, and total IgE level were measured and the methacholine bronchial provocation test was examined. Results : There were no differences observed in age, sex, atopy, and baseline spirometry in both groups. The peripheral eosinophil counts showed no difference in both groups, but the ECP level in group 1 (bronchodilator responder group) was higher than in group 2(non-bronchodilator responder group) ($22.4{\pm}20.7$ vs $14.2{\pm}10.4$, mean$\pm$SD). The PC20 in group 1 was significantly lower than in group 2 ($1.14{\pm}1.68$ vs $66{\pm}2.98$). There was a significant positive correlation between the BDR and ECP, and a negative correlation between the bronchial hyperresponsiveness and ECP. Conclusion : The bronchodilator response significantly correlated with the bronchial hyperresponsiveness and serum ECP in the moderate to severe asthma patients. Hence, the positive bronchodilator response is probably related with active bronchial inflammation and may be used as a valuable index in treatment, course and prognosis of bronchial asthma.

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Utility of FDG-PET in Solitary Pulmonary Nodules and the Relationship Between Standardized Uptake Values of PET and Serum Glucose (폐 결절에서 FDG-PET의 유용성과 표준섭취계수와 혈당농도의 상관관계)

  • Kim, Kyu Sik;Lim, Sung Chul;Ko, Young Chun;Park, Kyung Ha;Ju, Jin Young;Jo, Kae Jung;Kim, Soo Ok;Oh, In Jae;Kim, Yu Il;Kim, Young Chul;Kim, Sung Min;Song, Ho Chun;Bom, Hee Seung;Park, Kyung Ok
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.589-596
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    • 2003
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patients in the our nation with high incidence of tuberculoma. We could not exclude whether the SPN was benign or malignant by the change of the size at chest radiograph and findings of chest CT. Recently, positron emission tomography(PET) have been tried as the differential diagnostic method of SPN. We evaluated the efficacy of PET for differentiating malignant from benign SPN and the relationship between standardized uptake values(SUV) of PET and serum glucose. Method : Between January 2001 and July 2002, sixty-one patients with pulmonary nodule were examined by the chest CT and PET. The SPN has been finally diagnosed by the transthorasic needle aspiration and biopsy, bronchoscopic biopsy, and open lung biopsy. Results : Forty eight patients had a malignant nodule(23 squamous cell lung carcinoma, 16 adenocarcinoma, 9 small cell lung cancer) and thirteen patients had a benign nodule(3 tuberculoma, 9 inflammatory granuloma, 1 cryptococcosis). The mean size of malignant and benign nodule was 40.6 mm and 20.0 mm, respectively. All malignant nodules showed a marked increase in 18 fluorodeoxyglucose (FDG) uptake. Mean SUV of malignant was $9.52{\pm}5.20$ and benign nodule was $1.61{\pm}3.60$. There were false positive cases with an increase in 18-FDG uptake (2 tuberculoma, 1 inflammatory granuloma). The SUV of malignant nodule in diabetes patients has no difference in non diabetes patients($9.10{\pm}4.51$ vs $9.65{\pm}5.46$). The sensitivity and specificity of the PET scan for SPN were 100%, 77%, respectively. The positive and negative predictive values were 94% and 100%. Conclusion : PET scanning showed highly accurate result in differentiating the malignant and benign SPN. There were no significant differences between the SUV and serum glucose in the patients with lung cancer.

Targeted Therapies and Radiation for the Treatment of Head and Neck Cancer (두경부 암의 표적 지향적 방사선 치료)

  • Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.77-90
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    • 2004
  • Purpose: The purpose of this review Is to provide an update on novel radiation treatments for head and neck cancer Recent Findings: Despite the remarkable advances In chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) Is an appealing target for novel therapies In head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression Is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuxlmab) and tyrosine kinase inhibitors (ZD1839 and 051-774) have been assessed and have been most extensively studied In preclinical models and clinical trials. Additional TKIs In clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted In rapid translation Into the clinic. Results from Initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or In combination with chemotherapy. In this review, we begin with a brief summary of erbB- mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinlcal and clinical data on the role of EGFR antagonists alone or in combination with radiation In the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR biockade and efforts In the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1 ) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2) how to sequence these agents with radiation and/or cytotoxlc compounds, (3) reliable markers for patient selection and verification of effective blockade of signaling in vivo, and (4) mechanisms behind intrinsic or acquired resistance to targeted agents to facilitate rational development of multi-targeted therapy, Other molecuiar-targeted approaches In head and neck cancer were briefly described, Including angloenesis Inhibitors, farnesyl transferase inhibitors, cell cycle regulators, and gene therapy Summary: Novel targeted theraples are highly appealing in advanced head and neck cancer, and the most premising strategy to use them Is a matter of intense Investigation.

Pelvic MRI Application to the Dosimetric Analysis in Brachytherapy of Uterine Cervix Carcinoma (자궁경부암의 강내조사치료에 있어서 흠수선량평가시 골반강 자기공명사진의 응용)

  • Chung, Woong-Ki;Nah, Byung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.57-64
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    • 1997
  • Purpose : Before we report the results of curative radiotherapy in cervix cancer patients, we review the significance and safety of our dose specification methods in the brachytherapy system to have the insight of the potential Predictive value of doses at specified points. Matersials and Methods : We analyze the 리5 cases of cervix cancer patients treated with intracavitary brachytherapy in the lateral simulation film we draw the isodose curve and observe the absorbed dose rate of point A, the reference point of bladder(SBD) and rectum(SRD). In the sagittal view of Pelvic MRI film we demarcate the tumor volume(TV) and determine whether the prescription dose curve of point A covers the tumor volume adequately by drawing the isodose curve as correctly as possible. Also we estimate the maximum Point dose of bladder(MBD) and rectum(MRD) and calculate the inclusion area where the absorbed dose rate is higher than that of point A in the bladder(HBV) and rectum(HRV), respectively. Results : Of forty-five cases, the isodose curve of point A seems to cover tumor volume optimally in only 24(53%). The optimal tumor coverage seems to be associated not with the stage of the disease but with the tumor volume. There is no statistically significant association between SBD/SRD and MBD/MRD, respectively. SRD has statistically marginally significant association with HRV, while TV has statistically significant association with HBV and HRV. Conclusion : Our current treatment calculation methods seem to have the defect in the aspects of the nonoptimal coverage of the bulky tumor and the inappropriate estimation of bladder dose. We therefore need to modify the applicator geometry to optimize the dose distribution at the position of lower tandem source. Also it appears that the position of the bladder in relation to the applicators needs to be defined individually to define 'hot spots'.

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The Difference of the Cleaning and Wettability-maintaining Efficacy of Lens Care Solution to RGP Lens (관리 용품에 따른 RGP 렌즈의 세척효과 및 습윤성 차이)

  • Kim, Myoung-Hea;Park, Mi-Jung
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.1
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    • pp.27-34
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    • 2006
  • We investigated the question whether the efficacy of cleaning tear components on RGP lens and preserving the superior wettability of RGP lens depended on the different type of contact lens care system - RGP lens care solution, SCL care solution, combined solution both for SCL and RGP lens or saline solution. The removal efficacy of the deposited protein was examined by Lowry protein assay and Scanning Electro Microscope(SEM) and residual lipid concentration on RGP lens was determined by High Pressure Liquid Chromatology(HPLC). Wettability was assessed with an equilibrium water-in-air contact angle method. When cared by RGP lens solution, it was demonstrated that 62 percent out of the adhered protein on RGP lens were removed and the removal efficacy of RGP lens solution was not only 4 times than saline solution and the alternative but also higher twice than SCL solution. Contrarily, the SCL solution had the most excellent removal efficacy of the adhered protein on SCL. These results suggest that the cleaning efficacy is thought to be affected by the other factors like the viscosity of care solutions, which mutual contact between RGP lens and care solutions is on the increase due to the viscosity enhancer in RGP lens care solution. RGP lens solution had the greatest removing efficacy to cholesterol and the residual cholesterol concentration was decreased to 50%. It is significant for RGP lens to preserve the superior wettability which means the predictive value for comfortable wearing and it showed that the RGP lens solution offered the most excellent efficacy to maintain the surface wettability. Combined solution both for SCL and RGP lens had weak efficacy of cleaning and maintaining wettability for RGP lens compared to RGP lens care solution.

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Crime Incident Prediction Model based on Bayesian Probability (베이지안 확률 기반 범죄위험지역 예측 모델 개발)

  • HEO, Sun-Young;KIM, Ju-Young;MOON, Tae-Heon
    • Journal of the Korean Association of Geographic Information Studies
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    • v.20 no.4
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    • pp.89-101
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    • 2017
  • Crime occurs differently based on not only place locations and building uses but also the characteristics of the people who use the place and the spatial structures of the buildings and locations. Therefore, if spatial big data, which contain spatial and regional properties, can be utilized, proper crime prevention measures can be enacted. Recently, with the advent of big data and the revolutionary intelligent information era, predictive policing has emerged as a new paradigm for police activities. Based on 7420 actual crime incidents occurring over three years in a typical provincial city, "J city," this study identified the areas in which crimes occurred and predicted risky areas. Spatial regression analysis was performed using spatial big data about only physical and environmental variables. Based on the results, using the street width, average number of building floors, building coverage ratio, the type of use of the first floor (Type II neighborhood living facility, commercial facility, pleasure use, or residential use), this study established a Crime Incident Prediction Model (CIPM) based on Bayesian probability theory. As a result, it was found that the model was suitable for crime prediction because the overlap analysis with the actual crime areas and the receiver operating characteristic curve (Roc curve), which evaluated the accuracy of the model, showed an area under the curve (AUC) value of 0.8. It was also found that a block where the commercial and entertainment facilities were concentrated, a block where the number of building floors is high, and a block where the commercial, entertainment, residential facilities are mixed are high-risk areas. This study provides a meaningful step forward to the development of a crime prediction model, unlike previous studies that explored the spatial distribution of crime and the factors influencing crime occurrence.

Changes in the Titer of Tooth Root Antibodies Accompanying Root Resorption Associated with Orthodontic Tooth Movement (치아이동시 치근 흡수에 따른 치근항체의 역가 변화)

  • Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.24 no.2
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    • pp.303-317
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    • 1994
  • This study was designed to measure the changes in the titer of tooth root antibodies accompanying root resorption associated with orthodontic tooth movement in dogs to explore a role of the specific immune response in root resorption during orthodontic tooth movement. Five adult mongrel dogs, 2 years of age, were used in the study. Six lower incisors were extracted as sources of homologous antigen in the dogs. Tooth root antigen preparations were made from a 6M Guanidine-HCl-10% EDTA(pH5.0) extract of these root dentins. Root resorption was elicited by intrusion of six maxillary incisors with 200-250gm intrusive force. In 9th week, resorbing six maxillary anterior teeth were extracted. Serum samples were taken from each dog prior to intrusion and weekly for 11 consecutive weeks. Serum autoantibody titers were determined with an enzyme-linked immunosorbent assay. As controls for antibody specificity, sera which were previously incubated with tooth root antigen as well as sera to an unrelated bacterial antigen (Porphyromonas gingivalis 33277) for 3 hours at 25 were measured in all runs. Root resorption was monitored monthly using occlusal radiographs. And then root resorption patterns were observed with a zoom stereo microscope (Model SZH-121, Olympus optical Co. Ltd.). Incisors did not show clear radiographic evidence of significant and progressive root resorption, but periodontal ligament space had widened. But root resorption was observed on the apical regions of the maxillary incisors with a zoom stereo microscope. Teeth showed the shallow depression generally accompanying deep resorption. These demonstrate a slight tendency for an immediate decrease followed by rebound to levels above the pre-treatment baseline. A peak titer of autoantibody to dentin antigen occurred on day 28, then steadily decreased during the 9th week period as the roots resorbed and then rapidly spiked in animals when the resorbing teeth were extracted. When sera is incubated with tooth root antigen, serum activity in the ELISA was almost absent. This is because serum activity in the ELISA could be removed by absorption of the serum with dog dentin antigen. Serum ELISA activity to the unrelated bacterial antigen remained essentially unchanged in all animals throughout the experimental period. When the time course of changes in autoantibody to homologous tooth root antigen prepatration and unrelated bacterial antigen was compared, no significant differences were found(${\alpha}=0.05$). In general, the overall pattern of changes in autoantibody was similar to the two antigens. These findings suggest the possibility that these immunologic changes precede a significant development of root resorption lesions rather than merely reflecting their presence. Therefore, this suggests that the changes of antibody levels may have some predictive value for root resorption.

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Comparison of $^{67}Ga$ Planar Imaging and SPECT for the Evaluation of Activity in Undetermined Minimal Pulmonary Tuberculosis (흉부 X-선상 활동성 미정으로 판독된 경증 폐결핵 환자에서 활동성 판정에 대한 $^{67}Ga$ 평면영상과 SPECT의 비교분석)

  • An, Min;Chang, Won-Kyu;Kim, Kyoung-Gon;Kim, Sung-Min;Kim, Yun-Kwon;Kim, So-Yeon;Kim, Young-Jung;Park, Byung-Yik;Cho, Min-Koo;Lee, Gwon-Jun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.870-878
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    • 2000
  • Background : We have studied the $^{67}Ga$ SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and $^{67}Ga$ planar imaging, we compared $^{67}Ga$ planar imaging with SPECT to evaluate minimal pulmonary tuberculosis activity. Methods : $^{67}Ga$ planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. Results : 1) $^{67}Ga$ planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no uptake on $^{67}Ga$ planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on $^{67}Ga$ SPECT imaging. Conclusions : According to the results of our study, $^{67}Ga$ planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of the $^{67}Ga$ SPECT is not higher than that of $^{67}Ga$ planar imaging.

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