• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.236-245
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• 2000

Background: Transbronchial lung biopsy(TBLB) has known to yield useful information for pulmonary infiltrates of uncertain etiology, However, its safety and usefulness have not been conclusive in the critically ill patients with respiratory failure. Moreover, TBLB has not been recommended for patients with mechanical ventilation. This study was conducted to investigate the diagnostic values and risks of Will performed on critically ill patients at bedside to obtain information on the pulmonary infiltrate of unknown etiology. Methods: Twenty patients(21 admissions with 23 cases) with diffuse pulmonary infiltrates who were treated in a medical intensive care unit of a tertiary referral hospital from January 1994 to May 1998, were enrolled for the study. Their medical records were retrospectively reviewed. TBLB was opted when a noninvasive diagnostic work-up failed to reveal the cause for the pulmonary infiltrate. The procedure was performed at patients' bedside without assistance of fluoroscopy. Bronchial washing or bronchoalveolar lavage was performed on the same pulmonary segment before performing TBLB. Results: Adequate specimens were obtained in 18 cases(78%). TBLB provided a specific diagnosis in two cases. The results of TBLB suggested the underlying etiology in 9 cases; bacterial pneumonitis(4), hypersensitivity pneumonitis(1), polymyositis(1), radiation fibrosis(1), idiopathic pulmonary fibrosis(1), and BOOP(1). Therapeutic decisions were altered in 11 cases(47.8%) based on the TBLB results. Pneumocystis carinii was found in the BAL fluid of another case. Ten patients with a therapeutic change and ten patients without a management change had mortality rates of 40% and 80%, respectively. The APACHE III scores were significantly higher in patients with complications($72.8{\pm}21.8$) compared with those without complications ($48.3{\pm}18.9$)(p<0.05). The complication rates were higher in those with mechanical ventilation(50%) than in those without Mechanical ventilation(33%), but the difference was not statistically significant(p=0.3). Conclusions: TBLB may be a useful diagnostic option for critically ill patients with unknown cause of pulmonary infiltrates. However, it should be cautious be used with care for patients with mechanical ventilation or for severely ill patients.

• Journal of the Korean Society of Radiology
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• v.7 no.3
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• pp.213-219
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• 2013

Currently, about 35 cyclotrons have been operating in South Korea. Most of them are mainly used for the synthesis of radiopharmaceuticals such as $^{18}FDG$, which is a cancer tracer for nuclear medicine. Highly enriched $H_2{^{18}}O$ containing up to 98% of $^{18}O/O$ isotope ratio is used as the target for $^{18}F$ production. The price of the highly enriched $H_2{^{18}}O$ ranges 60~70 USD/g, and all of them have been imported from foreign country in spite of the very expensive price. The target (enriched $H_2{^{18}}O$) is non-radioactive before the proton beam irradiation. But, the post-irradiation target (used $H_2{^{18}}O$) must be managed following the National Radiation Safety Regulations, because it turns into radioactive by the radioactivation of the impurities within the target. Recently, nevertheless of the fast increasing amount of used $H_2{^{18}}O$ in accordance with the increasing number of nuclear medicine cases, any activation analysis on the used $H_2{^{18}}O$ have been conducted yet in Korea. In this research, activation analysis have been conducted to confirm the specific radioactivity(Bq/g) of each radioisotopes within the used $H_2{^{18}}O$. The analysis have been done on the 3 of 20g samples collected from the used $H_2{^{18}}O$ storages at different cyclotron centers. Based on the results, it was confirmed that the "used $H_2{^{18}}O$" contains gamma emitters such as $^{56}Co$, $^{57}Co$, $^{58}Co$, and $^{54}Mn$ as well as the considerable amount of beta emitter $^3H$. It was also confirmed that the only one sample contained over exemption level of gamma emitters while the specific activity of tritium was lower than the exemption level in all samples. The specific activity of radioisotopes were measured different levels in the samples depending on the elapsed time after irradiation. Further study on the activation of the "used $H_2{^{18}}O$" is definitely necessary, nevertheless the as-is results of this research must be useful in establishing a rational "used $H_2{^{18}}O$" management protocol.