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99mTc - DMSA와 99ㅡTc - DTPA의 상대적 신섭취율을 이용한 신기능의 평가
이규보(Kyu Bo Lee),이재태(Jae Tae Lee),조동규(Dong Kyu Cho),정병천(Byung Chun Chung),최정일(Chung Il Choi),김광원(Kwang Weon Kim),권태환(Tae Hwan Kwon) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.2
N/A Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individuai renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of 99mTc-DMSA and relative glomerular filteration rate of 99mTc-DTPA with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of Tc-DMSA and relative glornerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of 99mTc-DMSA and relative glomerular filterat.ion rate of 99mTc-DTPA were R=0.9190 (p<0.001), R=O. 9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p<0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake of 99mTc-DMSA had the best correlation with relative glomerular filteration rate of 99mTc-DTPA and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.
단일 폐병변에서 T1-201 SPECT 를 이용한 악성 종양의 감별진단
이규보(Kyu Bo Lee),이재태(Jae Tae Lee),손상균(Sang Kyun Sohn),천경아(Kyung Ah Chun),안병철(Byeong Cheol Ahn),김동환(Dong Hwan Kim),김창호(Chang Ho Kim),박재용(Jae Yong Park),정태훈(Tae Hoon Jeong),김천기(Chun K. Kim) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.2
N/A Purpose: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesions in a population with a high prevalence of begin pulmonary lesions, especially, tuberculosis. Materials and Methods: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergilloma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B-early L/B) ÷ early L/B]. Results: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions wefe also between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. Conclusion: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.
원발성 중추신경계 림프종의 치료 성적에 대한 다기관 후향적 분석
문준호 ( Joon Ho Moon ),김동환 ( Dong hwan Kim ),안병민 ( Byung Min Ahn ),김시내 ( Shi Nae Kim ),전석봉 ( Seok Bong Jeon ),백진호 ( Jin Ho Baek ),김종광 ( Jong Gwang Kim ),손상균 ( Sang Kyun Sohn ),이규보 ( Kyu Bo Lee ),황정현 ( J 대한내과학회 2006 대한내과학회지 Vol.71 No.6
Background: A primary central nervous system lymphoma (PCNSL) is a rare neoplasm with a poor prognosis. The treatment of PCNSL involves a combination of chemotherapy, intrathecal chemotherapy and radiotherapy. This study retrospectively evaluated the treatment outcomes and prognostic factors of Korean patients with PCNSL. Methods: Between 1995 and 2003, 58 patients diagnosed with PCNSL from the multi-center hospitals were enrol1ed in this study. Among 56 patients who had received treatment, 16 patients were treated with radiotherapy alone, while 40 patients were treated with combined chemotherapy (CHOP; 9 cases, high-dose methotrexate; 31 cases) and radiotherapy. Results: The median age of the patients was 58 years (range, 19-76). A diffuse large B-cell lymphoma was diagnosed in 56 cases (96.6%), while a peripheral T-cell lymphoma was diagnosed in 2 cases. Of the 47 patients who could be assessed for their response after treatment, a CR and PR was observed in 32 (68%) and 11 patients (23%), respectively, giving an overall response rate of 91% (95% CI, 82~100%). The estimated 3-year overall survival rate for all the patients was 67±7.9% and the 3-year disease free survival rate was 53±8.3%. The overall survival of the high-dose methotrexate group was superior to that of the CHOP group (77±10%) versus 47±19%, p=0.05). Leukoencephalopathy was observed as a late complication in 9 patients (21%). No significant prognostic factors affecting survival were found by univariate analysis. Conclusions: Approximately half of the patients could have long-term survival after treatment in this study. High-dose methotrexate containing chemotherapy followed by radiotherapy was found to be an effective treatment. (Korean J Med 71:65i4-661, 2000)
항과립구 항체 골수스캔을 이용한 다발성 골수종 병변의 평가 - 단순골 X-선검사 및 골스캔과의 비교
김동환,이재태,백진호,정진태,현동우,천경아,이영학,손상균,송홍석,이규보 ( Dong Hwan Kim,Jae Tae Lee,Jin Ho Baek,Jin Tae Jung,Dong Woo Hyun,Kyung Ah Chun,Young Hak Lee,Sang Kyun Sohn,Hong Seok Song,Kyu Bo Lee ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4
Purpose: Simple X-ray study and bone scan have limiitations for early diagnosis of bone or bone marrow lesions in multiple myeloma. The purpose of this study was to evaluate the diagnostic usefulness of bone marrow imrnunoscintigraphy using anti-granulocyte monoclonal antibody for the evaluation of bone involvement I:n multiple myeloma. Materials and Methods: In 22 patients (Male: 15, Female: 7) with multiple myeloma, we perforrned whole-body immunoscintigraphy using ' Tc-labelled antigranulocyte antibody (BW 250/183, Scintimum Granulozyt CIS, France) and compared the findings with those of simple bone radiography and Tc-MDP bone scan. Abnonnal findings in bone marrow scintigraphy were, considered to be present in case of expansion of peripheral bone marrow or focal photan defect in axial bones. Results: Marrow expansion was noted in 15 of 22 patients (68%). Focal photon defects were found in 18 patients (82%). While one (33%) of 3 patients with Stage II disease showed focal defects in bone marrow scan, abnormal focal defects were observed in 17 of 19 (90%) patients with Stage III. Among 124 focal abnormal sites which were observed in bone marrow scan, bone scan or simple bone radiography, bone rnarrow scan detected 92 sites (74%), whereas 82 sites (66%) were observed in simple bone radiography(58 sites, 47%) or bone scan(40 sites, 32%). Fifty-one (41%) out of 124 bone lesions were detected by bone marrow scan only, and located mostly in thoracolumbar spine. Conclusion: Bone marrow scan using Tc-labelled antigranulocyte antibody seems to be a more sensitive procedure for the detection of pathologic bone lesions than simple bone X-ray ar bone sean in patients with multiple myeloma. (Korean J Nucl Med 1998;32:354-64)
(99m)Tc-MIBI 운동부하 심근관류 SPECT에서 정상소견을 보인 환자의 예후 : 운동부하 심전도와 관동맥 조영소견과의 비교
이상우(Sang Woo Lee),이재태(Jae Tae Lee),천경아(Kyung Ah Chun),강도영(Do Young Kang),김동환(Dong Hwan Kim),조용근(Yong Keun Cho),채성철(Shung Chull Chae),이규보(Kyu Bo Lee) 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.3
N/A Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise (99m)Tc-MIRI myocardial perfusion single photon emission computed tomography (SPECT) an(l to analyze results with regard to those of exercise. electrocardiography or coronary angiography. Materials and Methods: We evaluated 30) patients (mean age S2±10 years, 166 males and 135 females) with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subjects were evaluated for cardiac events and followed for 8-55 months (mean 19±10 months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0,21%: per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n-235) exercise electrocardiography (p:NS), There was no cardiac event in ]7 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings. (Korean J Nucl Med 2000;34: 199-206)
김동환,정진태,김정균,조동규,권태환,김용림,이규보,손상균,배선근,김찬덕,이영학 대한내과학회 1997 대한내과학회지 Vol.53 No.3
Primary lymphoma of the central nervous system is a rare disease, occurring spontaneously and/or in conjunction with immunosuppressive state. Its incidence is increasing according to the increment of organ transplantation and AIDS. Recently we experienced a case of primary lymphoma occurred in central nervous system after renal transplantation in a 58-year-old women who had complained of persistent headache and left hemiparesis. CT scan of the brain showed two hyperdense mass lesions in right frontal and right basal ganglia areas. Immunohistochemical stain of the excised mass lesion revealed that tumor cells were derived from B cells. The patient was treated with discontinuance of immunosuppressive drug and irradiation, but expired due to pneumonia.
다발성 림푸종성 용종증의 임상상으로 나타난 mantle cell lymphoma 4예
김동환,정진태,곽동석,서장수,박태인,김기연,배한익,이규보,손상균,박소향 대한내과학회 2000 대한내과학회지 Vol.59 No.4
Multiple lymphomatous polyposis(MLP) is an interesting clinical entity of non-Hodgkin's lymphoma(NHL) and is defined as B-cell lymphoma characterized by the presence of multiple lymphomatous polyps along the gastrointestinal tract. Recently MLP has been considered as a variant form of mantle cell lymphoma(MCL). The median survival of patients with MCL is only 3 years, and none of the available conventional chemotherapy regimens appears curative. Encouraging results have been reported with high dose chemotherapy with autoSCT and alloSCT for its treatment. We introduce 4 cases of MLP diagnosed as MCL by morphologic and immunologic method. The common clinical findings of these cases were splenomegaly (4/4), multiple intraabdominal lymphadenopathy (4/4), and advanced stage (3/4) at presentation. The overall remission duration was relatively short (5-27 months) and three of four cases relapsed after conventional chemotherapy or autologous stem cell transplant. Our report suggests that MCL presented as MLP is a high risk subgroup of NHL and more aggressive approach may be needed for cure.(Korean J Med 59:413-422, 2000)