악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : $^{99m}Tc$-MDP 뼈스캔과의 비교

이경한,최창운,방영주,정준기,정홍근,이명철,김병국,김노경,고창순,Lee, Kyung-Han,Choi, Chang-Woon,Bang, Yung-Jue,Chung, Jun-Key,Chung, Hong-Keun,Lee, Myoung-Chul,Kim, Byoung-Kook,Kim, Noe-Kyeong,Koh, Chang-Soon 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, $^{99m}Tc$ labeled anti-granulocyte monoclonal antibody (anti-NCA-95 MAb) has been introduced as a new bone marrow imaging agent. To evaluate the usefulness of $^{99m}Tc$ anti-NCA MAb bone marrow scans for detecting skeletal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan findings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the remaining 50% did not. Most of these non matched lesions were suggested to be nonspecific lesions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, bit metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus $^{99m}Tc$ anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

급성 및 만성 B형 간염환자의 위배출시간에 관한 연구

이경한(Kyung Han Lee),김호정(Ho Jong Kim),추길연(Kil Yeon Choo),김정한(Jung Han Kim),김재명(Jae Myung Kim),원종현(Chong Hyun Won),박권택(Gwun Taek Park),김승욱(Seoung Wok Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A Anorexia, nausea, and vomiting are one of the most frequent symptoms in viral hepatits patients. These may be due to poorly detoxified substances by dysfunctioned hepatocytes or by gastritis, but the pathophysiology is not totally understood. The symptoms interfere with adequate nutrient intake and are managed by metoclopramide, which accelerates gastric emptying. Thus delayed gastric emptying may well be a contributing factor to such symptoms. To determine such a relationship, we measured gastric emptying time in 11 normal subjects, 9 acute (AVH), and 12 chronic B viral hepatitis (CVH) patients. All were males with a mean age of 23 years. An egg was labeled with 0.5 mCi of Tc-99m-sulfur colloid, fried, then eaten between 2 slices of bread with 100cc of water. Anterior and posterior images were taken at 20 minute intervals over a 2 hour period. A geometric mean of activity pertaining to the gastric region was measured, and T1/2 was calculated from the time activity curve. T1/2 for normal the group was 57.8±6.3 minutes while that for the AVH and CVH group was 58.2±8.2 (p=0.40) and 64.1±10.5 (p=0.09), respectively. There was 1 AVH patient and 4 CVH patients with prolonged T1/2. Anorexia and nausea was seen in 71% and 46% of the patients, respectively. 80% and 60% of the patients with prolonged T1/2 had anorexia and nausea, respectively.

두부외상 환자에서 HMPAO - SPECT를 이용한 국소 뇌혈류 변화의 평가

이경한(Kyung Han Lee),김철희(Chul Hee Kim),장하성(Ha Sung Chang) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A Patterns of abnormality in regional cerebral perfusion and its relation to clinical severity was evaluated with 32 head injury patients using Tc-99m-HMPAO single photon emission tomography (SPECT). The findings were compared with computed tomography (CT) done within 48 hours of each SPECT study. The initial SPECT study was done within 7 days of injury in 16 cases, between 1 week and 2 months in 12, and after over 2 months in 4. Nineteen of the patients underwent follow up SPECT and CT after a mean interval of 1 to 2 months. The initial SPECT showed abnormalities in 96% (31/32) of the patients while CT showed abnormal findings in only 81% (26/32). There were a total of 54 supratentorial SPECT lesions in all. Ninity percent (49/54) of these were of regional hypoperfusion, while 5 lesions showed focal hyperperfusion. The lesions were most often localized in the frontal and temporal lobes. Fifty five percent (30/54) were areas not detected as a lesion on CT. Cerebellar diaschisis was observed in 50% (16/32) of the patients. The degree of perfusion abnormality was quantified by the product of differential activity and a size factor. Correlation between the degree of perfusion abnormality and the clinical severity (Glasgow coma scale) failed to show statistical significance (p=0.053). The amount of change in the degree of perfusion abnormality on follow up SPECT was compared to the amount of change in clinical severity. Perfusion abnormality showed a tendancy to improve in most patients, and the degree of improvement showed significant correlation with the amount of clinical improvement (p〈0.01).

심장 분자영상

이경한 ( Kyung Han Lee ) 대한핵의학회 2009 핵의학 분자영상 Vol.43 No.3

심부정맥 혈전증 및 폐전색증의 핵의학적 진단 및 임상상에 관한 분석

이경한(Kyung Han Lee),최창운(Chang Woon Choi),정준기(June Key Chung),이명철(Myung Chul Lee),김건열(Keun Youl Kim),고창순(Chang Soon Koh),한용철(Yong Chol Han) 대한내과학회 1989 대한내과학회지 Vol.37 No.4

N/A Pulmonary embolism (PE) is a disease caused by occlusion of the pulmonary vascular bed, usually by a dislodged thrombus whose origin is most commonly from the deep venous system of the lower extremities. It is a serious medical problem and is often the cause of significant morbidity or mortality in clinical practice. Its potential for significant sequelae necessitates its prompt recognition and managemnt. Unfortunately, however, there are many difficult problems in the accurate diagnosis of pulmonary embolism, and controversy exists as to which method of approach is best. Futhermore, the low reliability of clinical signs and symptoms adds to the confusion, In an attempt to better understand the clinical features of pulmonary embolism and to reevaluate the diagnostic value of radionuclide studies in this disease entity, we reviewed the clinical features, lung perfusion scans and radionuclide venographic studies of 71 patients who were diagnosed as having deep vein thrombosis (DVT). The results were as follows; 1) The DVTs were most commonly located in the lower extremities (67%), and of these, the left side showed a significantly higher incidence compared to the right (77% vs 23%). 2) Of the DVT patients, 40% showed high probability pulmonary embolism (HPPE) on lung perfusion scans. 3) DVTs involving the iliofemoral veins were more likely to present HPPE compared to those confined to the calf area. 4) Of the patients presenting with HPPE, 70% showed no chest symptoms. Thus, the high incidence of HPPE in patients with DVT and the few, if any, specific presenting symptoms in the majority of PE patients call for a high level of suspicion on the part of the physician. The combined use of radionuclide venography and lung perfusion scan seems to be a reasonable approach for patients suspected of DVT in order to evaluate the possibilitu of pulmonary embolism.

NIS 기능의 전사 및 전사외 조절과 방사성옥소 섭취

정경호 ( Kyung Ho Jung ),이경한 ( Kyung Han Lee ) 대한핵의학회 2007 핵의학 분자영상 Vol.41 No.5

Epidermal Growth Factor 수용체 영상을 위한 방사성추적자 기술

정경호 ( Kyung Ho Jung ),이경한 ( Kyung Han Lee ) 대한핵의학회 2008 핵의학 분자영상 Vol.42 No.3

거시계량투입산출 모형을 이용한 광산품 수입대체의 경제적 효과 추정 연구

김지환,이경한,김윤경,Kim, Ji-Whan,Lee, Kyung-Han,Kim, Yoon Kyung 대한자원환경지질학회 2014 자원환경지질 Vol.47 No.3

본 연구는 산업연관표의 투입산출표와 거시계량경제모형을 연계하여 산업부문에 발생한 충격의 효과가 거시변수에 미치는 효과를 예측할 수 있도록 모형화 하였으며, 모형을 통해 광산품 부문의 수입대체에 따른 경제적 효과를 추정하였다. 구축한 모형의 전반적인 개요는 거시계량경제모형을 구축하고 산업연관표를 통해 도출된 피용자보수를 국민계정상 가처분소득의 대리변수로 이용하여 두 분석틀을 연계하였다. 거시계량경제모형은 한국은행이 작성한 1997년 기준 모형을 근간으로 하여 최근의 한국은행 모형을 통해 수정 및 보완하여 2011년 기준의 연간 거시계량경제모형을 구축하였으며, 산업연관분석과 연계되는 가처분소득과 총취업자수 부분을 수정도입하였다. 산업연관표 부분은 2005년~2011년의 통합대분류 경상표 및 그 계수표를 이용하였다. 구축된 모형을 적용하여 광산품 중간투입 중 1%의 수입대체가 미치는 경제효과를 추정하였는데, 2011년 기준으로 GDP 0.00073% 증가, 경상수지 0.01040% 증가, 실업률 0.00233%p 감소의 효과가 나타났다. 본 연구는 거시변수를 이용하여 지출측면 중심으로 활용되던 거시계량경제모형에 산업연관표를 활용함으로써 산업 수준의 충격과 투입부문을 고려할 수 있도록 하였다는 점에 의의가 있다. In this study, it is estimated how many changes of macroeconomic variables are happened under the proposition of import substitution of mining products 1% using macroeconometric input-output model. For this, used macroeconometric input-output model is composed of 141 behavioral equations representing the macroeconomy structure. In general, macroeconometrics models are constructed mainly on the side of the expenditure then it is not easy to estimate the effects of the shocks occurred from industry level. To mitigate that, this study tries to construct a macroeconometric input-output model. Macroeconometrics model which is useful to estimate the effects of macroeconomic shocks, economic policy and more, in this study, is linked with input-output table through the NDI(national disposable income) derived from compensation of employee. And this paper presents the estimation results of import substitution effects of mining products on Korean economy. As a results, GDP is increased 0.00073%, gross labor employed 0.00029%, current balanace 0.00010% and unemployment rate is mitigated 0.00233%.

Tc-99m-MIBI 심근 SPECT 의 분절 육안 분석시 판독자간의 일치도

여정석,이동수,이경한,김종호,손경수,조성욱,곽철은,정준기,이명철,서정돈,고창순 ( Jeong Seok Yeo,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,Kyung Soo Shon,Sung Wook Cho,Cheol Eun Kwark,June Key Chung,Myung Chul Lee,Jeong Don Seo,Chang Soon 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

The accuracy of dipyridamole stress/rest 99mTc-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent obervers, blinded to clinieal data, was evaluated in SPECT images of 131 patients (94 males, 38 fe- males, mean age 58+7 yr) with suspected coronary artery disease who underwent both dipyridamole st,ress/rest 99mTc-MJBI myocardial SPECT and coronary angiography, The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five point scale (segmental score : O=normal, 1 =equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear- sons correlat.ion coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlat,ion of 0.45 (all p<0,001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agr eement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather (han to a difference in perceiving the degree of the hypoactivity, Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and acruracy of scan ditagnosis.

선천성 담도폐쇄증에서 99mTc DISIDA 신티그라피의 진단정확성 ( Diagnostic Accuracy of 99mTc-DISIDA 신티그라피의 진단정확성

현인영,이동수,이경한,김종호,정준기,서정기,이명철,고창순 ( In Young Hyun,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,June Key Chung,Jung Key Suh,Myung Chul Lee,Chang Soon Koh ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

We evaluated the diagnostic accuracy of 99mTc-DISIDA scintigraphy as a mean of differentianting biliary tresia from neonatal hepatitis. Tc-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepat,ic retention index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake index was graded visually with 5 minute images using the following scoring scheme :grade 0(normal hepatic uptake), grade 1(decreased hepatic up take), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent int,estinal radioactivity. The results were as follows : l) None of the 30 hiliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity, The sensitivity, specificity, and accuracy of the presence of inlestinal radioactivity .or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patienis with absent intestinal radioactivity the mean hepatic retention index was 1.5+0.6 in the 16 biliary atresia patient,s, and 1.1+0.2 in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary at,resia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake index between biliary atresia and neonatal hepatit.is patients. However t.here were differences in age, total bilirubin, and hepatic uptake index bet.ween neonatal hepatitis patients with and without intestinal radioactivity. The hepatic upt,ake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioact,ivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake index and the hepatic retention index. Thus, we conclude that Tc DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patients age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.