• Title/Summary/Keyword: tomography

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Diagnostic Efficacy of FDG-PET in Solitary Pulmonary Nodule (고립성폐결절에서 FDG-PET의 진단적 유용성)

  • Kim, Woo-Jin;Yim, Jae-Joon;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1263-1270
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    • 1997
  • Background : Differentiation of malignity and benignity is crucial for management of solitary pulmonary nodule(SPN). Clinical parameters such as patient's age, nodule size, smoking history, doubling time, typical calcification in X-ray and CT findings have been reported as helpful in this purpose. However, in most cases, these parameters are not conclusive. Glucose metabolism is increased in cancer tissues including lung cancer tissues. After uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose(FDG), the glucose analogue, by cancer cell, FDG is trapped in the cell without further metabolism after phosphorylation. Thus, hypermetabolic focus in FDG-positron emission tomography (PET) imaging suggest malignancy. We evaluated the diagnostic efficacy of FDG-PET imaging in distinguishing malignant and benign SPN. Methods : We evaluated 28 patients with SPN from Jan. 1995 to Jan. 1997. CT scan of chest and whole-body FDG-PET imaging were performed in all patients. Histologic diagnosis was confirmed by transthoracic fine needle aspiration and biopsy, bronchoscopic biopsy and open thoracotomy. Results : Of the 28 SPN's, 22 nodules were malignant and 6 nodules were benign. FDG-PET imaging diagnosed all malignant nodules correctly as positive, and diagnosed 4 of 6 benign nodules correctly as negative. One tuberculous granuloma and one aspergilloma showed hypennetabolic focus and were diagnosed falsely positve with FDG-PET imaging. In the diagnosis of SPN with FDG-PET, sensitivity and specificity were 100% and 66.7%, positive predictive value and negative predictive value were 92% and 100%. Conclusion : FDG-PET imaging is highly useful noninvasive diagnostic tool in distinguishing between malignant SPN and benign SPN.

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Alteration of Coagulation and Fibrinolysis System According to Right Ventricular Dysfunction in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서 우심실 기능 부전에 따른 혈액응고 및 섬유소용해계 변화)

  • Kim, Young;Jang, Yoon Soo;Kim, Hyung Jung;Kim, Se Kyu;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Kwak, Jin Young;Choi, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.625-630
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    • 2006
  • Background: Pulmonary hypertension in COPD patients is the result of a direct effect of tobacco smoke on the intrapulmonary vessels with the abnormal production of the mediators that control vasoconstriction, vasodilatation, and vascular cell proliferation, which ultimately lead to aberrant vascular remodeling and physiology. COPD patients are prone to the developmint of an acute and chronic thromboembolism with an elevation of the plasma procoagulant and fibrinolytic markers However, the roles of the coagulation and fibrinolysis system on the right ventricular dysfunction in COPD patients are not well defined. We examined the alteration of the coagulation and fibrinolysis system in COPD patients according to the right ventricular function measured using cardiac multidetector computed tomography (MDCT). Methods: The right ventricular ejection fraction (RVEF) was measured using cardiac MDCT in 26 patients who were diagnosed with COPD according to the definition of the GOLD guideline. The plasma level of thrombin antithrombin (TAT) and plasminogen activator inhibitor (PAI)-1 were measured using an enzyme linked immunoassay. Results: The plasma TAT was markedly elevated in COPD patients ($10.5{\pm}19.8{\mu}g/L$) compared with those of the control ($3.4{\pm}2.5{\mu}g/L$) (p<0.01). However, the plasma PAI-1 in COPD patients ($29.6{\pm}20.7ng/mL$) was similar to that in the controls. The plasma TAT showed a significant inverse relationship with the RVEF measured by the cardiac MDCT in COPD patients (r=-0.645, p<0.01). However, the plasma PAI-1 did not show a relationship with the RVEF (r=0.022, p=0.92). Conclusion: These results suggest that the coagulation system in COPD patients is markedly activated, and that the plasma level of TAT might be a marker of a right ventricular dysfunction in COPD patients.

Finite element analysis of the effects of mouthguard produced by combination of layers of different materials on teeth and jaw (다양한 물성을 혼용하여 제작된 구강보호장치가 치아 및 악골에 미치는 영향)

  • So, Woong-Seob;Lee, Hyun-Jong;Choi, Woo-Jin;Hong, Sung-Jin;Ryu, Kyung-Hee;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.4
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    • pp.324-332
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    • 2011
  • Purpose: The purpose of this study was to compare the stress distribution of teeth and jaw on load by differentiating property of materials according to each layer of widely used mouthguard. Materials and methods: A Korean adult having normal cranium and mandible was selected to examine. A customized mouthguard was constructed by use of DRUFOMAT plate and DRUFOMAT-TE/-SQ of Dreve Co. according to Signature Mouthguard system. The cranium was scanned by means of computed tomography with 1mm interval. It was modeled with CANTIBio BIONIX/Body Builder program and simulated and interpreted using Alter HyperMesh program. The mouthguard was classified as follows according to the layers. (1) soft guard (Bioplast)(SG) (2) hard guard (Duran)(HG) (3) medium guard (Drufomat)(MG) (4) soft layer + hard layer (SG + HG) (5) hard layer + soft layer (HG + SG) (6) soft layer + hard layer + soft layer (SG + HG + SG) (7) hard layer + soft layer + hard layer (HG + SG + HG) The impact locations on mandible were gnathion, the center of inferior border, and the anterior edge of gonial angle. And the impact directions were oblique ($45^{\circ}$). The impact load was 800 N for 0.1 sec. The stress distribution was measured at maxillary teeth, TMJ and maxilla. The statistics were conducted using Repeated ANOVA and in case of difference, Duncan test was used as post analysis. Results: In teeth and maxilla, the mouthguard contacting soft layer of mandibular teeth presented lowest stress measure and, in contrast, in condyle, the mouthguard contacting hard layer of mandibular teeth presented lowest stress measure. Conclusion: For all impact directions, soft layer + hard layer + soft layer, the mouthguard with three layers which the hard layer is sandwiched between two soft layers, showed relatively even distribution of stress in impact.

ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

Study on Oneself Developed to Apparatus Position of Measurement of BMD in the Distal Radius (자체 개발한 보조기구로 원위 요골의 골밀도 측정 자세 연구)

  • Han, Man-Seok;Song, Jae-Yong;Lee, Hyun-Kuk;Yu, Se-Jong;Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.419-426
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    • 2009
  • Purpose : The aim of this study was to evaluate the difference of bone mineral density according to distal radius rotation and to develop the supporting tool to measure rotation angles. Materials and Methods : CT scanning and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 20 males. Twenty healthy volunteers without any history of operations, anomalies, or trauma were enrolled. The CT scan was used to evaluate the cross sectional structure and the rotation angle on the horizontal plane of the distal radius. The rotational angle was measured by the m-view program on the PACS monitor. The DXA was used in 20 dried radii of cadaveric specimens in pronation and supination with five and ten degrees, respectively, including a neutral position (zero degrees) to evaluate the changes of BMD according to the rotation. Results : The mean rotation angle of the distal radius on CT was 7.4 degrees of supination in 16 cases (80%), 3.3 degrees of pronation in three cases (15%), and zero degree of neutral in one case (9%), respectively. The total average rotation angle in 20 people was 5.4 degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained at 3.3 degrees of supination. Conclusion : In the case of the measurement of BMD in the distal radius with a neutral position, the rotational angle of the distal radius is close to supination. Pronation is needed for the constant measurement of BMD in the distal radius with the rotation angle measuring at the lowest BMD and about five degrees of pronation of the distal radius is recommended.

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Study for the Synthesis of $[^{123}I]$Idoxifene and Its Uptake in the Breast Cancer Cell ($[^{123}I]$Idoxifene 합성과 유방암의 세포섭취에 관한 연구)

  • Cho, Young-Sub;Yang, Seung-Dae;Suh, Yong-Sup;Chun, Kwon-Soo;Ahn, Soon-Hyuk;Lim, Soo-Jung;Lim, Sang-Moo;Yu, Kook-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.410-417
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    • 2000
  • Purpose: Idoxifene is currently entering phase II clinical trials for the treatment of advanced breast cancer. The radiolabeled idoxifene using $[^{123}I]$ provides an opportunity for clinical pharmacology with single photon emission computed tomography (SPECT). The purpose of this study was to prepare radiolabeled idoxifene using $[^{123}I]$ and to determine its cell uptake of breast cancer cell line. Materials and Methods: With a view to evaluating new anticancer drugs, we are investigating the novel antiestrogen pyrrolidino-4-iodotamoxifen (idoxifene). $[^{123}I]$Idoxifene has been prepared in no-carrier-added form using a tributyl stannylated precursor which has been synthesized by means of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid on the basis of previously reported standard methods. The biodistribution and dynamic behavior of the compound were investigated using the comparative breast cancer cell line, MCF-7 (estrogen receptor-positive) and MDA-MB-468 (non-estrogen receptor). Results and Conclusion: Acylation of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid gave the versatile ketone (81%) which reacted with 1,4-diiodobenzene to give triphenylethylene as a mixture of E and Z geometric isomers, which were separated by the recrystallization in ethanol. The E-isomer was treated with pyrrolidine to give idoxifene (67%). In order to incorporate radioactive iodine into the 4-position, the 4-stannylated precursor was prepared (30%). The yield of radioiodination was 90-92% with a high radiochemical purity greater than 98%. The ratio of tumor uptake of the breast cancer cell line between MCF-7 and MDA-MB-468 was about 1.7.

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Osteoporotic Vertebral Fractures: SPECT Findings (골다공증에 동반된 척추골절의 골 SPECT 소견)

  • Baik, Jun-Hyun;Park, Young-Ha;Ihn, Yon-Kwon;Kim, Sung-Hoon;Chung, Yong-An;Yoo, Ie-Ryung;Kim, Jee-Yeung;Jung, Hyun-Seok;Sohn, Hyung-Seon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.522-527
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    • 2004
  • Purpose: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. Materials and Methods: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: $67{\pm}8$, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. Results: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type war similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). Conclusion: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.

Principle and Recent Advances of Neuroactivation Study (신경 활성화 연구의 원리와 최근 동향)

  • Kang, Eun-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.172-180
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    • 2007
  • Among the nuclear medicine imaging methods available today, $H_2^{15}O-PET$ is most widely used by cognitive neuroscientists to examine regional brain function via the measurement of regional cerebral blood flow (rCBF). The short half-life of the radioactively labeled probe, $^{15}O$, often allows repeated measures from the same subjects in many different task conditions. $H_2^{15}O-$ PET, however, has technical limitations relative to other methods of functional neuroimaging, e.g., fMRI, including relatively poor time and spatial resolutions, and, frequently, insufficient statistical power for analysis of individual subjects. However, recent technical developments, such as the 3-D acquisition method provide relatively good image quality with a smaller radioactive dosage, which in turn results in more PET scans from each individual, thus providing sufficient statistical power for the analysis of individual subject's data. Furthermore, the noise free scanner environment $H_2^{15}O$ PET, along with discrete acquisition of data for each task condition, are important advantages of PET over other functional imaging methods regarding studying state-dependent changes in brain activity. This review presents both the limitations and advantages of $^{15}O-PET$, and outlines the design of efficient PET protocols, using examples of recent PET studies both in the normal healthy population, and in the clinical population.

Relationship between inter-condylar width and inter-maxillary first molar width (과두간 폭경과 상악 제1대구치간 폭경 사이의 관계)

  • Oh, Sang-Chun;Kong, Hyun-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.214-219
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    • 2019
  • Purpose: The aim of this study was to evaluate the correlation between inter-condylar width and inter-maxillary first molar width to present the criteria for prosthetic reconstruction of dental arch width in maxillary and mandibular fully edentulous patients. Materials and Methods: 120 Koreans (60 males and 60 females) who underwent the cone beam computerized tomography (Cone-beam CT) were selected. The Cone-beam CT images were analysed using Invivo 5.1. After reorientation of axis, inter-maxillary first molar width was measured by clicking both mesio-buccal cusp tip of maxillary first molar. And inter-condylar width was measured by clicking both middle points of condyles. The collected data were analysed with SPSS Version 20.0 and statistical significance of the correlation between inter-condylar width and inter-maxillary first molar width was verified by Pearson's correlation analysis. Results: The mean inter-condylar width of Korean was 105.9 mm, and that of male (108.3 mm) was statistically significantly wider than the female (103.4 mm). The inter-maxillary first molar width of Korean was 57.1 mm, and that of male (57.9 mm) was statistically significantly wider than the female (56.2 mm). Pearson's correlation analysis between inter-condylar width and inter-maxillary first molar width showed a Pearson correlation coefficient of 0.614 and statistically significantly positive correlation. Conclusion: Intercondylar width and inter-maxillary first molar width showed positive correlation and the average ratio of inter-condylar with and inter-maxillary first molar width was 1:0.54. Based on the results of this limited study, inter-condylar width can be used as a guide for setting up dental arch width in fully edentulous patient.

Diagnosis and Treatment of Endobronchial Actinomycosis (기관지 방선균증의 임상적 고찰)

  • Choi, Jae Chol;Koh, Won-Jung;Kwon, Yong Soo;Ryu, Yon Ju;Yu, Chang-Min;Jeon, Kyeongman;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Kim, Tae Sung;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.576-581
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    • 2005
  • Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.