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Lesion Localization in Patients with Hyperparathyroidism Using Double-phase Tc-99m MIBI Parathyroid Scintigraphy (부갑상선기능항진증 환자에서 Tc-99m MIBI 부갑상선 신티그라피를 이용한 병소 국소화)

  • Shin, Jung-Woo;Ryu, Jin-Sook;Kim, Jae-Seung;Moon, Dae-Hyuk;Hong, Seung-Mo;Gong, Gyung-Yub;Hong, Suk-Joon;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.120-130
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    • 1999
  • Purpose: This study was performed to evaluate the diagnostic usefulness of double-phase Tc-99m MIBI parathyroid scintigraphy with single photon emission computed tomography (SPECT) in patients with hyper-parathyroidism. We also evaluated the relationship between Tc-99m MIBI uptake and oxyphil cell contents in parathyroid glands. Materials and Methods: The subjects were 28 parathyroid glands of 10 patients who underwent Tc-99m MIBI parathyroid scintigraphy and parathyroidectomy for clinically suspected hyper-parathyroidism. Early and delayed pinhole images were obtained at 15 minutes and 2 hours after injection of Tc-99m MIBI, and SPECT images were followed. The weight and oxyphil cell contents of parathyroid tissue were obtained from pathologic specimen, and the scintigraphic findings were compared with histopathology. Results: In surgical histopathology, 6 parathyroid adenomas and 9 parathyroid hyperplasias were confirmed. The sensitivity, specificity, and positive predictive value of early and delayed images were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 66.7% (10/15), 92.3% (12/13), 90.9% (10/11), respectively. SPECT image detected an additional small hyperplasia.. The sensitivity, specificity, and positive predictive value of combined interpretation of early and delayed images with SPECT were 73.3% (11/15), 100% (13/13), 100% (11/11). The sensitivity was 100% (6/6) for adenoma, whereas that was 55.5% (5/9) for hyperplasia. Both adenomas and hyperplasias showed significantly increased oxyphil cell contents compared with normal parathyroid glands (p<0.0001), but the oxyphil cell content and weight were not significantly different between adenomas and hyperplasias. Conclusion: Double-phase Tc-99m MIBI parathyroid scintigraphy with SPECT is useful for lesion localization in patients with hyperparathyroidism. Although both adenoma and hyperplasia have increased oxyphil cell content, the sensitivity is high in adenoma, but low in hyperplasia.

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Influence of Gating and Attenuation-correction for Diagnostic Performance of Usual Rest/stress Myocardial Perfusion SPECT in Coronary Artery Disease (게이트 방법과 감쇠보정이 심근 관류 SPECT의 관상동맥질환 진단 성능에 미치는 영향)

  • Lee, Dong-Soo;Yeo, Jeong-Seok;So, Young;Cheon, Gi-Jeong;Kim, Kyeong-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.131-142
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    • 1999
  • Purpose: Either gated myocardial perfusion SPECT or attenuation corrected SPECT can be used to improve specificity in the diagnosis of coronary artery disease. We investigated in this study whether gating or attenuation correction improved diagnostic performance of rest/stress perfusion SPECT in patients having intermediate pre-test likelihood of coronary artery disease. Materials and Methods: Sixty-eight patients underwent rest attenuation-corrected T1-20l/dipyridamole stress gated attenuation-corrected Tc-99m -MIBI SPECT using an ADAC vertex camera (M:F=29:39, aged $59{\pm}12$ years, coronary artery stenosis ${\geq}70%$, one vessel: 13, two vessel: 18, three vessel: 8, normal: 29). Using a five-point scale, three physicians graded the post-test likelihood of coronary artery disease for each arterial territory (1:normal, 2: possibly normal, 3:equivocal, 4. possibly abnormal, 5: abnormal). Sensitivity, specificity and area under receiver-operating-characteristic curves were compared for each operator between three methods : (A) non-attenuation-corrected SPECT; (B) gated SPECT added to (A): and (C) attenuation-corrected SPECT added to (B). Results: When grade 3 was used as the criteria for coronary artery disease, no differences in sensitivity and specificity were found between the three methods for each operator. Areas under receiver-operating-characteristic curves for diagnosis of coronary artery disease revealed no differences between each modality (p>0.05). Conclusion: In patients at intermediate risk of coronary artery disease, gated SPECT and attenuation- corrected SPECT did not improve diagnostic performance.

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Predictive Factors of Renal Scarring in Children with Acute Urinary Tract Infection (급성 요로감염 환아의 신장 반흔 예측요인)

  • Baik, Jun-Hyun;Park, Young-Ha;Hwang, Sung-Su;Jeon, Jung-Su;Kim, Sung-Hoon;Lee, Seong-Yong;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.245-253
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    • 2003
  • Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

The Differentiation of Malignant and Benign Musculoskeletal Tumors by F-18 FDG PET/CT Studies - Determination of maxSUV by Analysis of ROC Curve (F-18 FDG PET/CT에서 양성과 악성 근골격 종양의 감별진단 - 수신자 판단특성곡선을 이용한 maxSUV의 절단값 결정)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Choi, Jun-Heok;Shin, Duk-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.553-560
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    • 2007
  • Purpose: We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Materials and Methods: Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. Results: There was a statistically significant difference in maxSUV between benign (n=11; maxSUV $3.4{\pm}3.2$) and malignant (n=12; maxSUV $14.8{\pm}12.2$) lesions in soft tissue tumor (p=0.001). Between benign bone tumor (n=9; maxSUV $5.4{\pm}4.0$) and malignant bone tumor (n=14; maxSUV $7.3{\pm}3.2$), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n=2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. Conclusion: The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

Comparison of the Results for Sentinel Lymph Node Mapping in the Breast Cancer Patients using $^{99m}Tc$-Antimony Trisulfide Colloid, $^{99m}Tc$-Tin Colloid, and $^{99m}Tc$-Human Serum Albumin (유방암 환자에서 $^{99m}Tc$-Antimony Trisulfide Colloid, $^{99m}Tc$-Tin Colloid, $^{99m}Tc$-Human Serum Albumin을 이용한 감시림프절 매핑 성적의 비교)

  • Jang, Sung-June;Moon, Seung-Hwan;Kim, Seok-Ki;Kim, Bom-Sahn;Kim, Seok-Won;Chung, Ki-Wook;Kang, Keon-Wook;Lee, Eun-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.546-552
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    • 2007
  • Purpose: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [$^{99m}Tc$-antimony trisulfide colloid (ASC), $^{99m}Tc$-tin colloid (TC), and $^{99m}Tc$-human serum albumin (HSA)] for sentinel lymph node mapping. Subjects and Methods: Totally, 397 patients with clinically N0 stage were enrolled. $^{99m}Tc$-ASC was injected in 202 out of 397 patients, $^{99m}Tc$-TC was injected in 120 patients, and $^{99m}Tc$-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. Results: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. Conclusion: Those three $^{99m}Tc$-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.

Differences of Tc-99m HMPAO SPECT Imaging in the Early Stage of Subcortical Vascular Dementia Compared with Alzheimer's Disease (초기 단계의 피질하 혈관성 치매와 알쯔하이머병에서 Tc-99m HMPAO SPECT 영상 소견 차이)

  • Park, Kyung-Won;Kang, Do-Young;Park, Min-Jeong;Cheon, Sang-Myung;Cha, Jae-Kwan;Kim, Sang-Ho;Kim, Jae-Woo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.530-537
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    • 2007
  • Purpose: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Materials and Methods: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

Effect of Amino Terminus of Gap Junction Hemichannel on Its Channel Gating (간극결합채널의 아미노말단이 채널개폐에 미치는 영향)

  • Yim Jaegil;Cheon Misaek;Jung Jin;Oh Seunghoon
    • Journal of Life Science
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    • v.16 no.1
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    • pp.37-43
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    • 2006
  • Gap junction is an ion channel forming between adjacent cells. It also acts as a membrane channel like sodium or potassium channels in a single cell. The amino acid residues up to the $10^{th}$ position in the amino (N)-terminus of gap junction hemichannel affect gating polarity as well as current-voltage (I-V) relation. While wild-type Cx32 channel shows negative gating polarity and inwardly rectifying I-V relation, T8D channel in which threonine residue at $8^{th}$ position is replaced with negatively charged aspartate residue shows reverse gating polarity and linear I-V relation. It is still unclear whether these changes are resulted from the charge effect or the conformational change of the N-terminus. To clarify this issue, we made a mutant channel harboring cysteine residue at the $8^{th}$ position (T8C) and characterized its biophysical properties using substituted-cysteine accessibility method (SCAM). T8C channel shows negative gating polarity and inwardly rectifying I-V relation as wild-type channel does. This result indicates that the substitution of cysteine residue dose not perturb the original conformation of wild-type channel. To elucidate the charge effect two types of methaenthiosulfonate (MTS) reagents (negatively charged $MTSES^-$ and positively charged $MTSET^+$) were used. When $MTSES^-$ was applied, T8C channel behaved as T8D channel, showing positive gating polarity and linear I-V relation. This result indicates that the addition of a negative charge changes the biophysical properties of T8C channel. However, positively charged $MTSET^+$ maintained the main features of T8C channel as expected. It is likely that the addition of a charge by small MTS reagents does not distort the conformation of the N-terminus. Therefore, the opposite effects of $MTSES^-$ and $MTSETT^+$ on T8C channel suggest that the addition of a charge itself rather than the conformational change of the N-terminus changes gating polarity and I-V relation. Furthermore, the accessibility of MTS reagents to amino acid residues at the $8^{th}$ position supports the idea that the N-terminus of gap junction channel forms or lies in the aqueous pore.

Effects of Fermented Rice Wine by Using Mycelium of Phellinus linteus on the Expression of Inflammation-Related Proteins in Human Hepatoma Cells and Rat Liver (상황버섯 균사체를 이용한 발효주가 인체간암세포와 흰쥐 간의 염증관련 단백질 발현에 미치는 영향)

  • Ahn Seung-Min;Lee Jun-Hyuk;Choi Yung-Hyun;Lee Yong-Tae;Chung Kyung-Tae;Jeong Young-Kee;Jo Un-Bock;Choi Byung-Tae
    • Journal of Life Science
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    • v.16 no.1
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    • pp.101-107
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    • 2006
  • We have recently discovered that mycelium of Phellinus linteus, popular medical mushrooms in Korea, possess alcohol dehydrogenase and produce alcohol. In the present study, it was examined that the effect of fermented rice wine made by using mycelium of P. linteus (FLMP) on the expression of in-flammation-related proteins in both $HepG_2$ cells and rats. To examine the effect of FLMP on the morphology and expression of inflammatory proteins in $HepG_2$ cells, the cells were incubated with ethanol, and FLMP for 24 hours, and then analyzed by microscopic observation and Western blot and reverse transcription polymerase chain reaction (RT-PCR). While ethanol induced the morphological change accompanied with cell debris formation and scattering on $HepG_2$ cells, FLMP had no effect. The results of Western blot and RT-PCR analyses showed that the level of inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-1 and COX-2 was induced by ethanol, however, FLMP inhibited the expression of these proteins and its mRNAs. In the animal model, the value of flutamate oxaloacetate transaminase and glutamate pyruvate transaminase was significantly increased by administration with ethanol. But the group administrated with FLMP showed lower levels on the changes of these markers compared with ethanol-administrated group. Besides, the results of Western blot and RT-PCR analyses showed that the expression of inflammatory proteins such as iNOS, COX-1 and COX-2 was not affected by FLMP administration in rat liver. About histopathological and immunohistochemical observations, inflammatory loci were markedly decreased in the FLMP-administrated rat compared to ethanol-administrated rats and showed weaker COX-2 and iNOS jmmunoreactions. These results suggested that FLMP showed slight changes on the inflammatory proteins expression compared to ethanol and FLMP may be used as a functional alcoholic beverage.

Analysis and the Standardization Plan of the Terms Used by Seafarers on Small Vessel (소형선박 종사자 사용용어 실태 분석 및 표준화 방안)

  • Kang, Suk-Young;Ryu, Won;Bae, Chang-Won;Kim, Jong-Kwan
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.25 no.7
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    • pp.867-873
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    • 2019
  • As of August 2019, there were 3,823 vessels under 30 tons that could be included in the category of small vessels; these account for 42.5 % of the 9,001 registered vessels in Korea. The problem is that many small vessel seafarers face many problems such as an board communication disconnection, difficulties in communication in maritime license interviews, or education related to maritime training using a large number of nonstandard terms, which are derived from foreign languages; this is leading to a decline the job skills of small vessel seafarers. Therefore, in this study, we closely analyzed the terminology of small vessel seafarers and proposed a standardization plan. In the terminology analysis, the preliminary terms of the maritime license interview and the high-frequency terms of the small vessel educational textbook were identified and the corresponding nonstandard terms were examined. Based on a survey, an expert meeting was held and incorrect Japanese notation, English notation, and the standard language for key terms were presented to analyze which questionnaire was most familiar. The ratio of the use of standard words is relatively high in the case of nautical terms, however, the wrong Japanese notation is used more for engine terms; the analysis results by age and tonnage also generally use the Japanese notation and the use frequency of English notation was determined to be low. Based on this, short- and long-term plans for the use of standard words by small vessel seafarers were proposed, including the production of a standard language dictionary for terms used by these seafarers, a promotion of the importance of using standard terms, active education through educational institutions, and the systematic preparation and implementation of Korean-language education for foreign sailors.

Efficiency and continuancy of basic CPR (Cardiopulmonary Resuscitation) education for the higher grade students of elementary schools (초등학교 고학년생의 기본심폐소생술 교육효과 및 지속성)

  • Kim, Hee-Jung
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.3
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    • pp.87-98
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    • 2008
  • Purpose : This study was designed to figure out the necessity of continuing basic CPR education for the higher grade students of elementary school. The assessment contents were knowledge, practice ability, precision level of CPR skills and continuation of the educational efficiency. Methods : Twenty two students of 4th and 5th grade of elementary school in K city in Chungcheongnam-do were recruited for this study. The study method was a control group of non-synchronized design. A preliminary study was done on October 27 in 2006. The main study was performed from February 14 to May 11 in 2007. The researcher adopted the method of Kyung-hui, Kang (1998) such as awareness, attitude and knowledge in control group, emergency medical technician test protocol, Anne/SkillReporter$^{(R)}$ in case of the basic CPR knowledge. Four times of measures were done in shortly after practicing CPR, 4 weeks after the education, 8 weeks after the education, and 12 weeks after the education. By using SPSS/PC+ (version 12.0), the researcher analyzed the collected data based on frequency, percentage, repeated measurement, ANOVA (analysis of variance), and sidak (multiple comparison - sidak). Results : 1) The confidence of people in the control group in terms of practicing CPR showed a statistically meaningful difference (t = 10.230, p = .000) before/after CPR education. Therefore, hypothesis No.1-1 was accepted. 2) The educational necessity of people in the control group showed no statistically meaningful difference (t = -1.695, p = 0.105) before/after CPR education. Therefore, hypothesis No.1-2 was rejected. 3) The knowledge points of people in the control group showed a statistically meaningful difference (t = -7.731, p = .000) before/after CPR education. Therefore, hypothesis No.2 was accepted. 4) The confidence of people in the control group in terms of practicing CRP showed no meaningful difference (F = 2.789, p = 0.072) as time passed. Therefore, hypothesis No.3 was rejected. 5) The knowledge of people in the control group showed a meaningful difference (F = 9.090, p = .000) as time passed. Therefore, hypothesis No.4 was accepted. 6) The capability of people in the control group in terms of practicing CPR showed a statistically meaningful difference (F = 42.795, p = .000) as time passed. Therefore, hypothesis No.5 was accepted. 7) The precision level of CPR skill of people in the control group showed a statistically meaningful difference (F = 25.198, p = .000) as time passed. Therefore, hypothesis No.6-1 was accepted. 8) The precision level of chest compression skill of people in the control group showed a statistically meaningful difference (F = 5.188, p = .003). Therefore, hypothesis No.6-2 was accepted. Conclusion : In a nutshell, CPR education for the 4th and 5th graders of elementary schools had an influence on their confidence in practicing CPR and on their knowledge. This study showed that as time passed. the educational effect declined in terms of knowledge point, capability of practicing CPR, and the precision level of CRP skill. The results of the study could be postulated into the fact that re-education within 8 weeks after the first education was essential to retaining the educational effect. Therefore, we need to vitalize the CPR education for elementary school students repeatedly on a regular basis in order to continue the educational effect after they were grown-ups and to make them play their roles as a first aider.

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