• Title/Summary/Keyword: technetium-99

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Successful Transcatheter Arterial Embolization following Diverticular Bleeding in the Third Portion of the Duodenum: A Case Report (경동맥 색전술을 이용한 십이지장 3부 게실 출혈의 성공적인 지혈: 증례 보고)

  • Seok Jin Hong;Sang Min Lee;Ho Cheol Choi;Jung Ho Won;Jae Boem Na;Ji Eun Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.237-243
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    • 2021
  • This is a rare case of a 73-year-old male patient who presented with hematochezia and was treated using transcatheter arterial embolization following upper gastrointestinal bleeding in the third portion of the duodenum. The cause of the bleeding was not found on gastrointestinal endoscopy and CT. On the third day of hospitalization, the hemoglobin level continued to decrease. A technetium-99m-labeled red blood cell scan revealed suspicious bleeding in the diverticulum of the third portion of the duodenum. Superior mesenteric artery angiography showed active bleeding from the posteroinferior pancreaticoduodenal artery, which was embolized with N-butyl cyanoacrylate. The patient was discharged on the seventh day after embolization without re-bleeding or complication. We report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. Herein, we report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. We also conducted a relavant literature review.

Pulmonary Embolism In Childhood Minimal Change Nephrotic Syndrome (소아 미세변화 신증후군에서 폐색전증에 대한 연구)

  • Sung, Seung-Joon;Hong, Ki-Woong;Kim, Eun-Ryoung;Kim, Il-Soo;Cho, Byung-Soo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.100-108
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    • 2001
  • Purpose : We investigated the incidence and predisposing factors of pulmonary embolism in minimal change nephrotic syndrome(MCNS). Methods : Lung perfusion scan using 99mTC-MAA were done on 14 patients who were diagnosed to minimal change nephrotic syndrome. Group h: Five patients who had perfusion defects on scan, Group B; Nine patients who had no perfusion defect on scan. Between the two groups, the differences of platelet number, hematocrits, albumin, cholesterol, triglyceride, proteinuria were evaluated. Results : Five patients were found to have perfusion defect consistent with pulmonary embolism($35.7\%$). However, there were minimal or no respiratory symptoms and signs. In our laboratory studies, the mean proteinuria on admissions was $676{\pm}31\;mg/m2/hr$ in the group with pulmonary embolism, and $313{\pm}28\;mg/m2/hr$ in the group without pulmonary embolism. There were more severe proteinuria in group with pulmonary embolism(P<0.05). The mean platelet count at early stage of remission after steroid treatment was $746,600{\pm}280,000/mm3$ in the group with pulmonary embolism, $511,890{\pm}90,000/mm3$ in the group without pulmonary embolism. There were significant difference of platelet count between the two groups(P<0.01). In patients with pulmonary embolism, there were more higher and sustained increasement of platelet count. All cases of pulmonary embolism were treated with dipyridamole(5 mg/kg). In 4 cases the perfusion defects were improved in two weeks, however, one case showed persistent perfusion defect after 1 month. Conclusion : Our study suggested that pulmonry embolism might be one of tile major complications in childhood MCNS The occurrence rate was correlated with severity of proteinuria before treatment and sustained increasement of platelet counts in early remission state after steroid treatment. Therefore, the scintigraphic pulmonary perfusion study is mandatory in childhood MCNS, especially in the high risk patients, such as the patients with severe proteinuria and sustained increasement of platelet count. (J Korean Soc Pediatr Nephrol 2001;5 : 100-8)

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Calculation of Renal Depth by Conjugate-View Method Using Dual-head Gamma Camera (이중 헤드 감마 카메라를 이용한 Conjugate-View 계수법에 의한 신장 깊이 도출)

  • Kim, Hyun-Mi;Suh, Tae-Suk;Choe, Bo-Young;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo;Lee, Hyoung-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.378-388
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    • 2001
  • Purpose: In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigrams in a dual-head gamma camera, considering the attenuation factor $e^{-{\mu}x}$ of the conjugate-view method. Material and Method: We developed abdomen and kidney phantoms to perform experiments using Technetium-99m dimercaptosuccinic acid ($^{99m}Tc$-DMSA). The phantom images were obtained by dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators (ICONf, Siemens). The equation was derived from the linear integration of omission ${\gamma}$-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Results : Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm ($0.029{\pm}0.15cm,\;mean{\pm}S.D.$). Conclusion: The present study showed that the use of the derived equations for renal depth measurements, combined with quantitative planar imaging using dual-head gamma camera, could provide more accurate results for individual variation than the conventional method.

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Mucociliary Clearance in the Children with Bronchial Asthma (기관지 천식 환아에서의 점액섬모 청소율(Mucociliary Clearance))

  • Lee, Myung-Hyun;Sun, Yong-Han;Nam, Seung-Gon;Koh, Young-Yull;Chung, June-Key
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.173-181
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    • 1996
  • Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.

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Prediction of Post-operative Cardiopulmonary Function By Perfusion Scan (폐관류 검사를 이용한 폐절제술 후 심폐운동기능의 예측)

  • Ryu, Jeong-Seon;Lee, Ji-Young;Seo, Dong-Bum;Cho, Jae-Hwa;Lee, Hong-Lyeol;Yoon, Yong-Han;Kim, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.401-408
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    • 2001
  • Background : Perfusion scans are accurate predictors of postoperative lung function. There are few previous studies aimed at predicting the postoperative exercise capacity using the perfusion scanning and those that did reported contradictory results. Method : We prospectively studied the preoperative spirometric, exercise tests and perfusion scans from in 49 consecutive patients who were admitted to Inha University Hospital with surgically resectable lung cancer from Jan. 1998 to Jun. 1999 29 patients who had any condition affecting the lung function and exercise capacity, or refused a surgical resection or a follow-up study were excluded. Spirometric and exercise tests were performed 6 months after operation in 20 patients. Results : The predicted postoperative $FEV_1$, FVC and TLC correlated well with the following corresponding postoperative values : $r_s$ and p value, 0.809 and 0.000 for the $FEV_1$ 0.895 and 0.000 for the FVC ; 0.741 and 0.006 for the TLC, respectively. The measured postoperative exercise values were slightly higher than the postoperative exercise values predicted, $VO_{2max}$ and $Wr_{max}$, were as 112% of $VO_{2max}$ predicted and 119% of $WR_{max}$ predicted. The change in $FEV_1$, FVC and TLC had a weak correlation with the change in $VO_{2max}$ and $WR_{max}$. Conclusion : The perfusion scan was a useful tool for predicting the postoperative exercise capacity. However, they had a tendency to underestimate the exercise capacity, especially in the patients who had a pneumonectomy. A weak correlation between the change in lung function and exercise capacity was observed.

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Imaging Neuroreceptors in the Living Human Brain

  • Wagner Jr Henry N.;Dannals Robert F.;Frost J. James;Wong Dean F.;Ravert Hayden T.;Wilson Alan A.;Links Jonathan M.;Burns H. Donald;Kuhar Michael J.;Snyder Solomon H.
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.2
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    • pp.17-23
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    • 1984
  • For nearly a century it has been known that chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its exact nature. Positron-emitting radioactive tracers have made it possible to study the chemistry of the human mind in health and disease, using chiefly cyclotron-produced radionuclides, carbon-11, fluorine-18 and oxygen-15. It is now well established that measurable increases in regional cerebral blood flow, glucose and oxygen metabolism accompany the mental functions of perception, cognition, emotion and motion. On May 25, 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 methyl spiperone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine receptors than serotonin-2 receptors. Preliminary studies in patients with neuropsychiatric disorders suggests that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits quantitative assay of picomolar quantities of neuro-receptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress. The growth of any scientific field is based on a paradigm or set of ideas that the community of scientists accepts. The unifying principle of nuclear medicine is the tracer principle applied to the study of human disease. Nineteen hundred and sixty-three was a landmark year in which technetium-99m and the Anger camera combined to move the field from its latent stage into a second stage characterized by exponential growth within the framework of the paradigm. The third stage, characterized by gradually declining growth, began in 1973. Faced with competing advances, such as computed tomography and ultrasonography, proponents and participants in the field of nuclear medicine began to search for greener pastures or to pursue narrow sub-specialties. Research became characterized by refinements of existing techniques. In 1983 nuclear medicine experienced what could be a profound change. A new paradigm was born when it was demonstrated that, despite their extremely low chemical concentrations, in the picomolar range, it was possible to image and quantify the distribution of receptors in the human body. Thus, nuclear medicine was able to move beyond physiology into biochemistry and pharmacology. Fundamental to the science of pharmacology is the concept that many drugs and endogenous substances, such as neurotransmitters, react with specific macromolecules that mediate their pharmacologic actions. Such receptors are usually identified in the study of excised tissues, cells or cell membranes, or in autoradiographic studies in animals. The first imaging and quantification of a neuroreceptor in a living human being was performed on May 25, 1983 and reported in the September 23, 1983 issue of SCIENCE. The study involved the development and use of carbon-11 N-methyl spiperone (NMSP), a drug with a high affinity for dopamine receptors. Since then, studies of dopamine and serotonin receptors have been carried out in over 100 normal persons or patients with various neuropsychiatric disorders. Exactly one year later, the first imaging of opitate receptors in a living human being was performed [1].

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The Diagnostic Value of Clinical and Radiologic Findings in Children after the First Episode of Acute Pyelonephritis (소아에서의 첫 번째 급성 신우신염에 따른 임상 소견 및 방사선학적 검사의 진단적 유용성)

  • Kim Ji Hae;Kim Mi Jung;Choi Byung Min;Yoo Kee Hwan;Hong Young Sook;Lee Joo Won
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.201-212
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    • 2005
  • Purpose : Acute pyelonephritis is one of the most common causes of unexplained fever in children. It may lead to the development of progressive renal damage. However, the deteclion of acute pyelonephritis can be difficult, especially in infants. The objective of this study was to evaluate the diagnostic value of various lab tests and imaging studies for acute renal parenchymal changes in children with APN. We correlated the clinical and laboratory manifestations of acute pyelonephritis with the Imaging studies. Methods : We reviewed the records of 115 children (85 males and 30 females) who were hospitalized Outing the period of January 1998 to December 2002 with initial clinical symptoms suggestive of pyelonephritis. The patients' age, sex, duration of fever, laboratory findings, and causative organisms were compared with the findings of imaging studies (Technetium-99m dimercaptosuccinic acid renal scan, renal ultrasonography, intravenous pyelography, voiding cystourethrography). Results : No significant relation between the number of febrile days, leukocyte count, causative organism, and the renal abnormalities in the imaging studies were observed. On the other hand, both C-reactive protein and erythrocyte sedimentation rate levels were significantly elevated in children with positive dimercaptosuccinic acid renal scan. Furthermore, females and children older than 1 year presented with significantly higher rate of abnormal dimercaptosuccinic acid renal scan findings and vesicoureteral reflux presented by voiding cystourethrography. Conclusion : We recommend females and children older than 1 year who are suspected of acute pyelonephritis be evaluated carefully for renal involvement by performing imaging studies including dimercaptosuccinic acid renal scan and voiding cystourethrography. (J Koroan Soc Pediatr Nephrol 2005;9:201-212)

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Urine endothelin-1 as a Biomarker for Urinary Tract Infections in Children (Urine endothelin-1의 소아 요로 감염 환아에서의 진단적 유용성)

  • Kee, Hyung Min;Yi, Dae Yong;Yun, Ki Wook;Lim, In Seok;Ha, Tae-Seon
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.36-41
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    • 2014
  • Purpose: Urinary tract infections (UTIs) are the most common source of bacterial infections in infants and young children. Accurate diagnosis and treatment is important because of their association with renal scarring, which can lead to complications. Urine endothelin-1 (ET-1) is the major renal isoform produced and released by renal mesangial cells in response to glomerular injury. This study aimed to investigate whether urinary levels of ET-1 can be used as a biomarker for UTI diagnosis. Method: We conducted a prospective study using medical records of 70 patients below the age of 18 years, who visited Chung-Ang University Hospital from July 2012 to July 2013. We classified the patients into the UTI and control groups based on urine culture studies. The UTI group was further divided into upper and lower UTI groups using 99m-Technetium dimercaptosuccinic acid scintigraphy. Urine ET-1 was measured using enzyme linked immunosorbent assay with 0.3 mL urine. Results: The UTI and control groups were comprised of 45 and 25 patients, respectively. Mean urine ET-1 levels were significantly higher in the UTI group than in the control group ($1.41{\pm}0.35$ pg/mL vs. $0.33{\pm}0.07$ pg/mL, P =0.04). There was no significance difference in the quantitative value between the upper and lower UTI groups (P =0.552). There was no correlation between urine ET-1 and serum C-reactive protein (Pearson correlation [R]=0.24), urine ET-1 and serum white blood cell count (R=0.19). Conclusion: Our study suggests that urine ET-1 can be used for early diagnosis of UTI in children.