• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.31-36
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• 2013

Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.16-21
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• 2007

Purpose: We evaluated the diagnostic value of $^{18}F-FDG$ PET/CT (PET/CT) in lymph node staging of non-small cell lung cancer (NSCLC) considering calcification and histologic types as well as FDG uptake. Materials and Methods: Fifty-three patients (38 men, 15 women; mean age, 62 years) with NSCLC underwent surgical resection (tumor resection and lymph node dissection) after PET/CT. After surgery, we compared PET/CT results with the biopsy results, and analyzed lymph node metastases, based on histologic types. PET diagnosis of lymph node metastasis was determined by maximum SUV (maxSUV) > 3.0, and PET/CT diagnosis was determined by maxSUV > 3.0 without lymph node calcification. Results: By PET diagnosis, the sensitivity, specificity, and accuracy of overall lymph node staging were 45% (13 of 29), 91% (228 of 252), and 86% (241 of 281). Specificity was 91% in both squamous cell carcinoma and adenocarcinoma, while sensitivity was 71% in squamous cell carcinoma and 36% in adenocarcinoma. When we excluded calcified lymph node with maxSUV > 3.0 from metastasis by PET/CT diagnosis, specificity improved to 98% in squamous cell carcinoma and 97% in adenocarcinoma. The degree of improvement was not dependent on histologic types. Conclusion: PET/CT improved specificity of lymph node staging by reducing false positive lymph node regardless of histologic types of NSCLC.

• Journal of the Korean Society of Radiology
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• v.5 no.2
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• pp.81-92
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• 2011

This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.11-16
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• 2000

Purpose :We peformed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. Methods and Materials : One hundred and six Patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (94$\%$) and ranged from 1 month to 92 months (median; 6 months). Results :The median age was 62 years old and male to female ratio was 104 2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was peformed in 83$\%$. Mean tumor dose delivered with curative aim was 58.6 Gy (55$\~$70.8 Gy) and median duration of the radiation therapy was 53 days. The median survival of all patients was 6 months and )-year and 2-year overall survival rate was 27$\%$ and 12$\%$, respectively, Improvement of dysphagia was obtained in most patients except for 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32$\%$ (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30$\%$ respectively, while those of the nonresponder was 4 months and 0$\%$ respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 months and 16$\%$ while those of the patients who could not tolerate regular diet was 3 months and 0$\%$, respectively (p=0.004). The survival difference between the patients with S cm or less tumor length and those with more than 5 cm tumor length was marginally statistically significant (u=0,06). However, the survival difference according to the periesophageal invasion or mediastinal tyrnphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9$\%$). Conclusion :The survival outcome for advanced esophageal cancer patients treated by external beam radiotherapy alone was very poor. In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.177-181
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• 2002

Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.473-479
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• 2005

Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.276-284
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• 2000

Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.