Comparison with 99mTc MDP Bone Scintigraphy and Whole body 18FDG PET for the Evaluation of Bone metastases in Patients with Lung Cancer

Background: 99mTechnetium methylene diphosphonates(99mTc MDP) bone scintigraphy is current method of choice for the detection of bone metastases, but whole body 18F-fluoro-deoxy- D-glucose positron emission tomography(18FDG PET) offers superior spatial resolution and improved sensitivity. So we compared whole body 18FDG PET with 99mTc MDP bone scintigraphy in patients with skeletal metastases from lung cancer. Patients and Methods: Ninety-two patients with lung cancer taken 18FDG PET together with a 99mTc MDP bone scintigraphy within 1 month between March 2000 and March 2003 were investigated retrospectively. Results: The sensitivity, specificity and accuracy of the 99mTc MDP bone scintigraphy versus 18FDG PET for the detection of bone metastases in lung cancers were 59% vs 82%, 71% vs 94%, and 68% vs 91%, respectively. In the diagnosis of bone metastases from lung cancer, 18FDG PET was statistically superior to 99mTc MDP bone scintigraphy in its specificity and accuracy(p<0.0001). Conclusions: Whole body 18FDG PET may be useful in detecting bone metastases among patients with lung cancer.ope

A Case of Aortobronchial Fistula with Massive Hemoptysis after Aortic Stent Graft

Aortobronchial fistula may cause a massive fatal hemoptysis. Recently prosthetic aortic graft insertion or endovascular stent graft is a cause of aortobronchial fistula. We report a rare case of hemoptysis from a fistula between an aortic arch aneurysm and the left main bronchus in a patient who had undergone an endovascular stent graft in pseudoaneurysm of descending thoracic aorta one year before.ope

Diagnosis and Treatment of Primary Mediastinal Tumors and Cysts -Forty-two years report in a University Hospital-

Background : The diagnostic and therapeutic approaches to mediastinal tumors and cysts have changed over the past three decades. This report summarizes our forty-two years of experience with these tumors. Materials and Methods : This study retrospectively reviewed 479 patients with primary mediastinal tumors and cysts that were diagnosed and managed over the past 17-year period (1985～2002) and compared them to the report of the previous 25-year result (1960～1985) in Yonsei University College of Medicine, Severance Hospital in Seoul, Korea. Results : During the 17 years, there were 479 cases of pathologically proven mediastinal tumors and cysts. Thymoma (38.2%) was the most common mediastinal tumor and has increased noticeably during recent years. The gender ratio showed a male predominance (1.3:1) and the age distributions were even over all the age groups. The most common sites of the tumor and the proportion(28.6%) of malignant tumors were the same as that previously reported. A diagnosis of a tumor in asymptomatic patients was possible in 174 cases (36.3%), which was higher that reported previously. 　The diagnostic yield of a fine needle aspiration biopsy was 68.6% in the total tumors and 80.9% in the malignant tumors. A surgical resection was the most frequently chosen treatment modality and was performed in 405 cases (84.6%). The complete resection rate was 91.1%, which is higher than the previous result of 78.8%. Conclusion : These results showed that the prevalence of mediastinal tumors and cysts, particularly thymoma, increased. A fine needle aspiration biopsy was a valuable preoperative differential diagnostic method for malignant tumors. The surgical and complete resection rate increased remarkably possibly due to the better applicable chest CT scans, the more frequent health check-up provided by the regular health promotion program for all people as a health insurance policy, and the improved diagnostic techniques in the pathologic, radiological, and clinical fields.ope

A Case of Bronchioloalveolar Carcinoma Presenting with Initial Symptom of Visual Disturbance due to Intraocular Metastasis

Intraocular tumors are uncommon and an intraocular metastatic carcinoma is extremely rare. An intraocular metastasis in adults most often originates from the breast or the lung. An intraocular lesion may be the first presentation of cancer and a search should be made to locate the primary tumor. To our knowledge, an intraocular metastasis of a bronchioloaveolar carcinoma has not reported in Korea. We report a case of a bronchioloalveolar carcinoma presenting with the initial symptom of a unilateral visual disturbance due to an intraocular metastasis.ope

The Relationship between Age and Pleural Fluid Adenosine Deaminase Activity in Pleural Tuberculosis

연구 배경 : Adenosine deaminase (ADA)는 퓨린 (purine) 대사에 작용하는 효소로서 림프구, 특히 T-림프구의 증식과 분화에 관여하며,결핵성 흉수의 진단에 있어서 중요한 생화학적 표지자 중의 하나이다.한편, 노인의 경우, T-림프구의 수와 기능의 감소에 의하여 면역 기능이 감소하는 것으로 알려져 있다. 이에 저자 등은 노인 결핵성 흉수 환자에서 흉수내의 ADA 수치가 젊은 환자에서보다 감소하는지를 조사하였다. 방 법 : 4년 동안 세브란스 병원에서 1) 흉수 결핵균 배양 양성 또는 2) 흉막 조직 검사상 결핵에 합당한 소견을 보여 결핵성 흉수로 진단받은 환자 80명을 대상으로 후향적으로 조사하였다. 65세를 기준으로 두 군으로 분류하였으며, 연령과 흉수 ADA 수치의 연관 관계를 독립 표본 t-검정 및 선형 회귀 분석을 이용하여 연구하였다. 결 과 : 80명의 환자 중 65세 이상은 21명 (26.3%)이었다. 흉수 내의 ADA 수치는 65세 이상 및 이하 군에서 각각 71.2± 27.6 IU/L, 68.5 ± 25.8 IU/L 이었다 (p=0.69). 선형 회귀 분석에서도 연령과 흉수 내의 ADA 수치는 상관 관계를 보이지 않았다 (r²=0.05, p=0.59). 결 론 : 본 연구의 결과에 의하면,결핵성 흉수의 진단에서 흉수 ADA 수치를 보조 지표로 사용하는 데 있어서, 노인환자에서도 젊은 환자와 동일한 임상적 유의성을 가지고 동일한 결정 수치 (cut-off value)를 적용할 수 있을 것으로 판단된다.ope

A Case of Pleural Effusion due to Hypothyroidism

Serous effusions have been most commonly associated with ascites, pericardial effusion, and heart failure. But, they have been considered to be an unusual form of complication in hypothyroidism and pleural effusion, which has been observed as an isolated finding in hypothyroidism is apparently rare and complete analysis of these types of hypothyroid-associated pleural effusions has yet not been described. We report a case of hypothyroidism associated with unilateral pleural effusion in a 77 year-old male patient who was improved through levothyroxine sodium with brief review of the literature.ope

The Utility of Measurement of Plasma N-terminal Pre-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension

Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Materials and Methods : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.ope

Impact of prospective payment system on hospital provider`s behavior

Thesis (master`s)--서울대학교 대학원 :경영학과 경영학전공,2000.Maste

인터넷 백본에서의 서비스 거부 공격과 스캐닝 탐지 방법

학위논문(석사)--아주대학교 정보통신전문대학원 :정보통신공학과,2003Maste