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( Bom Sahn Kim ),( Won Jun Kang ),( So Won Oh ),( Dong Soo Lee ),( June-key Chung ),( Myung Chul Lee ) 대한갑상선학회 2009 International Journal of Thyroidology Vol.2 No.2
Background and Objectives: We investigated the usefulnesses of SUV and SUV ratios in terms of discriminating focal thyroid lesions incidentally detected by F-18 FDG PET/CT (FDG PET) in patients with various cancers. Materials and Methods: Among 2,635 patients, 20 patients with 22 thyroid incidentalomas (benign vs. malignant=10 vs. 12) on FDG PET were assessed. Maximal SUV was measured by drawing a ROI on thyroid lesions, on contralateral thyroid lobes, and on the liver. SUV ratio was calculated as the thyroid lesions versus the contralateral lobes and liver. Results: A marginally significant difference in maximal SUV was found between malignant and benign nodules (4.67±2.78 vs. 2.59±1.84, p=0.05). However, more significant differences were found using SUV ratio to normal organs than that of SUV. Malignant nodules had a higher SUV ratio versus liver than benign nodules (2.09±0.96 vs. 1.13±0.65, p=0.012). The SUV ratio of lesions versus contralateral lobes were found to significantly predict the presence of malignancy (3.74±2.19 vs. 1.89±1.17, p=0.027). By ROC curve analysis, the best SUV value cut-off for the prediction of malignancy was 2.42 with a sensitivity of 91.7% and a specificity of 60.0% (AUC=0.758). Similarly, the best SUV ratio cut-off versus the liver was 1.34 with a sensitivity of 91.7% and a specificity of 70.0% (AUC=0.808). But, there was no significant difference between areas of the ROC curves (p=0.736). Conclusion: The SUV ratio had a tendency to discriminate benign from malignant thyroid incidentalomas better than the SUV method. Further investigations with larger number of patients are needed.
Acute and chronic effects of repeated 1 Hz rTMS on the temporal cortex
Kim, Won Sup,Lee, Mina,Han, Joo Man,Kim, Song E.,Kim, Hee-Jin,Kim, Bom Sahn,Kim, Byung Gon,Lee, Hyang Woon Lippincott Williams Wilkins, Inc. 2012 NEUROREPORT - Vol.23 No.9
Electroencephalography amplitude, phase synchronization, and directionality of phase coupling within and between hemispheres were compared for different frequency components in 27 healthy individuals before and after 5 days of daily 1 Hz repetitive transcranial magnetic stimulation (rTMS), and at 2 weeks after the last session. Instantaneous amplitudes of α (8–13 Hz) and &bgr; (13–30 Hz) frequency components were increased after daily rTMS, the effects of which were declining over time, suggesting an adapting response with repeated rTMS sessions. The phase synchronization of electroencephalography increased significantly in the α frequency, especially the upper-α band (11–13 Hz), in both the frontal and the temporal areas, predominantly in the ipsilateral hemisphere. Asymmetric directional interactions of the upper-α band were stronger from the stimulated area to the contralateral hemisphere. No significant differences were found at 2 weeks after rTMS in any of these values. Focal 1 Hz rTMS induces an enhancement in the ipsilateral dominant corticocortical interaction drastically by interhemispheric asymmetric coupling from the stimulated cortical area with an adapting response with repeated sessions. This kind of method can be valuable for possible clinical applications in various neuropsychiatric conditions to study the therapeutic mechanisms of 1 Hz rTMS.
특발성 폐섬유증에서 발견된 폐결절의 악성여부 감별에서 F-18 FDG PET의 유용성
김범산 ( Bom Sahn Kim ),강원준 ( Won Jun Kang ),이동수 ( Dong Soo Lee ),정준기 ( June Key Chung ),이명철 ( Myung Chul Lee ) 대한핵의학회 2006 핵의학 분자영상 Vol.40 No.3
목적: 특발성 폐섬유증(Idiopathic pulmonary fibrosis: IPF)에서 폐암의 발생빈도가 정상인에 비하여 증가되어 있음이 알려져 있다. IPF 환자의 흉부전산화단층촬영(chest CT)에서 폐 결절이 관찰되는 경우 폐암의 발생과 자체 IPF자체의 결절을 감별하기 어렵다. 이 연구에서는 IPF 환자의 chest CT에서 관찰된 결절의 악성 여부를 FDG PET을 이용해 분석하였다. 대상 및 방법: IPF로 진단된 환자 중, chest CT에서 악성 결절이 의심되어 FDG PET을 시행한 16명을 대상으로 하였다. 총 16명 (남: 14, 여: 2, 나이: 67.53±9.83세)의 환자에서 관찰된 28개의 결절에 대하여 FDG PET과 CT소견을 분석하였다. 대상 환자 중 2명은 소세포암과 성문하암으로 치료 받은 병력이 있었으며, 나머지 환자는 악성종양의 기왕력이 없었다. 결절의 악성도 여부는 조직검사와 CT 추적검사로 판정하였다. 결과: 10개의 결절은 폐암으로 진단되었고, 18개의 결절은 양성 결절로 판정되었다(조직병리검사: 6예, chest CT 추적검사: 22예). FDG PET의 예민도는 100%이었으며 특이도는 94.4%이었다. 크기와 형태 및 크기 변화 등을 참고한 CT의 예민도는 70%이었고, 특이도는 44.4%이었다. 악성 결절의 maxSUV는 7.68±3.96, 양성 결절은 1.22±0.65이었다(p<0.001). 폐섬유증부위에서 측정한 maxSUV는 1.80±0.43로써 악성 결절보다 낮은 값이었으며, 양성 결절보다는 높은 값이었다(p<0.001; p<0.001). CT에서 측정한 악성 결절의 크기는 23.95±10.15 mm, 양성결절은 10.83±5.23 mm이었다(p<0.02). 결론: FDG PET은 IPF 환자의 CT에서 발견된 폐 결절을 감별하는데 도움이 되었다. Purpose: Incidence of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; 67.53±9.83, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: From 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules (7.68±3.96 vs. 1.22±0.65, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules (1.80±0.43, p<0.001). The size of malignant and benign nodule were 23.95±10.15 mm and 10.83 ±5.23 mm (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF. (Nucl Med Mol Imaging 2006;40(3):163-168)