Brain Perfusion SPECT에서 Image Registration의 유용성

송호준,임정진,김진의,김현주,Song, Ho-June,Lim, Jung-Jin,Kim, Jin-Eui,Kim, Hyun-Joo 대한핵의학기술학회 2011 핵의학 기술 Vol.15 No.2

Brain의 질병을 평가하는 유용한 검사방법 중의 하나인 brain perfusion SPECT는 환자의 움직임으로 인한 검사의 실패확률이 높아 one day method를 사용하지 못하고 two days method를 사용해야 하는 경우가 많다. 본 연구에서는 image registration을 사용하여 검사의 실패확률을 줄이고 one day method로 검사를 시행할 수 있는지 image registration을 적용할 경우 검사의 신뢰성을 알아보고자 하였다. Jaszczak phantom에 준비된 방사성동위원소 $^{99m}Tc$을 insert에 111 MBq/mL가 되도록 분배하여 넣고 나머지 background에 3,145 MBq/mL가 되도록 넣어 1:8의 비율로 phantom을 제작하고 Hoffman 2-D brain phantom과 cylindrical uniform phantom에는 111 MBq/mL가 되도록 만든다. 완성된 phantom은 기본 위치에서 frame 당 5 sec씩 총 120 frame을 획득하여 영상을 얻었다. 또 Phantom과 환자의 데이터를 가지고 original 영상과 registration 영상, registration 시행한 후에 original 영상을 subtraction한 영상과 registration하지 않은 영상에서 subtraction한 영상 간의 임의의 같은 위치에 ROI를 설정하고 영상에서 counts 차이를 알아보았다. 실험 결과 약간의 counts 차이를 보였으나 이것은 실험시간이 경과함에 따른 RI의 decay와 phantom의 구조물이 없는 cylindlical phantom에서 조차 약간의 counts의 차이를 보이는 바로 미루어 봤을 때 실험 결과 나온 counts의 차이는 적다고 할 수 있을 것이다. 따라서 registration을 활용하여 brain perfusion SPECT의 단점들을 개선하고 정확한 진단에 도움을 줄 수 있을 것으로 사료된다. Purpose: The brain perfusion SPECT is the examination which is able to know adversity information related brain disorder. But brain perfusion SPECT has also high failure rates by patient's motions. In this case, we have to use two days method and patients put up with many disadvantages. We think that we don't use two days method in brain perfusion SPECT, if we can use registration method. So this study has led to look over registration method applications in brain perfusion SPECT. Materials and Methods: Jaszczak, Hoffman and cylindrical phantoms were used for acquiring SPECT image data on varying degree in x, y, z axes. The phantoms were filled with $^{99m}Tc$ solution that consisted of a radioactive concentration of 111 MBq/mL. Phantom images were acquired through scanning for 5 sec long per frame by using Triad XLT9 triple head gamma camera (TRIONIX, USA). We painted the ROI of registration image in brain data. So we calculated the ROIratio which was different original image counts and registration image counts. Results: When carring out the experiments under the same condition, total counts differential was from 3.5% to 5.7% (mean counts was from 3.4% to 6.8%) in phantom and patients data. In addition, we also run the experiments in the double activity condition. Total counts differential was from 2.6% to 4.9% (mean counts was from 4.1% to 4.9%) in phantom and patients data. Conclusion: We can know that original and registration data are little different in image analysis. If we use the image registration method, we can improve disadvantage of two days method in brain perfusion SPECT. But we must consider image registration about the distance differences in x, y, z axes.

여과지가 장착된 3단 카세트를 이용한 입자상물질 채취용 펌프의 유량성능 평가방법

송호준 ( Ho June Song ),김남희 ( Nam Hee Kim ),김기연 ( Ki Youn Kim ),마혜란 ( Hye Lan Ma ),이광용 ( Gwang Yong Yi ),정지연 ( Jee Yeon Jeong ) 한국산업위생학회 2013 한국산업보건학회지 Vol.23 No.4

Objectives: In working environment measurement, sampling is an important stage for obtaining reliable result as analysis. A personal air sampling pump is one of the most fundamental and important element in the work environment measurement, but it remains at the level of calibrating the flow rate of the pump before and after sampling. There is no checking whether the flow rate set at the initial stage would be hold during sampling. The purpose of this study was to develop a method to evaluate the flow rate performance of particulate sampling pump with three-pieces cassette holder containing filters commonly used to sample particulate. Materials and methods: We tested back pressure of particulate sampling pumps commonly used in Korea with three-pieces cassette holder containing various filters, and tried to find out the combination conditions of filters in accordance with back pressure required by ISO standard 13137. Results: We found out the matrix of sampling media such as three-pieces cassette holder containing filters applicable to the pressure drop required by the ISO standard for evaluating the flow rate stability under increasing pressure drop and long term(8 hour) performance. Conclusions: This evaluation method using sampling media matrix for checking flow rate stability proposed by this study could be very useful tool to find out good performance pumps before sampling.

상복부 통증을 주소로 내원한 기능성 소화불량 환자에서의 역류성 식도염 (해외학회지에 게재된 국내연구소개)

송호준 ( Ho June Song ),정훈용 ( Hwoon Yong Jung ) 대한소화관운동학회 2008 Journal of Neurogastroenterology and Motility (JNM Vol.14 No.1

흡인성 폐렴을 유발한 미만성 식도경련에 의한 거대 식도게실

송호준 ( Ho June Song ),김나영 ( Na Young Kim ),황진혁 ( Jin Hyeok Hwang ),김진욱 ( Jin Wook Kim ),이동호 ( Dong Ho Lee ),김성은 ( Seong Eun Kim ),이혜승 ( Hye Seung Lee ),이창수 ( Chang Soo Lee ),정현채 ( Hyun Chae Jung ),송인성 대한소화기기능성질환·운동학회 2004 Journal of Neurogastroenterology and Motility (JNM Vol.10 No.1

Esophageal motility disorders have been considered to be important physiologic bases for the development of esophageal diverticulum, and to rarely cause severe complications. We report a case of aspiration pneumonia caused by esophageal diverticula in a patient with diffuse esophageal spasm (DES). A 44-year-old man suffered from cough due to aspiration pneumonia. He experienced intermittent vomiting for one year. Two years prior to admission, 2 large esophageal diverticula were first noticed in a single-contrast, upper gastro-intestinal tract examination, the size of which had increased one year later. Esophageal manometry and 24-hr esophageal pH monitoring were performed to investigate the underlying causes of aspiration pneumonia and he was diagnosed as DES. He underwent esophageal diverticulectomy and esophagomyotomy. Aspiration pneumonia, which had recurred even after operation, was controlled with percutaneous endoscopic gastrostomy. This case shows that serious pulmonary complications can develop in a ptient with esophageal diverticula related with DES. (Kor J Neur ogastr oenterol Motil 2004;10:76-80)

흡착튜브를 이용한 가스상물질 채취용 펌프의 유량성능 평가방법

김남희 ( Nam Hee Kim ),송호준 ( Ho June Song ),김기연 ( Ki Youn Kim ),마혜란 ( Hye Lan Ma4 ),이광용 ( Gwang Yong Yi ),정지연 ( Jee Yeon Jeong ) 한국산업보건학회 2014 한국산업보건학회지 Vol.24 No.2

Objectives: Flow rate stability is very important for obtaining reliable measurements. However there is no easily used method for checking whether the flow rate set at the initial stage is sustained during sampling. The purpose of this study was to develop a method to evaluate the flow rate performance of gas sampling pumps with adsorbents commonly used to sample gases. Materials and methods: We tested the back pressure of gas sampling pumps commonly used in Korea with adsorbents such as charcoal and silica tubes and attempted to discover the combination conditions of adsorbents in accordance with back pressure required by ISO standard 13137. Results: We found the combination of sampling adsorbents to be applicable to the pressure drop required by the ISO standard for evaluating flow rate stability under increasing pressure drop and long term (eight-hour) performance. Conclusions: This evaluation method of using a sampling media matrix for checking flow rate stability as proposed by this study could be a highly useful tool for determining the reliability of the performance pumps before sampling.

소화성궤양 가이드라인 비출혈 소화성궤양 치료의 가이드라인

정대영 ( Dae Young Cheung ),정훈용 ( Hwoon Yong Jung ),송호준 ( Ho June Song ),정성우 ( Sung Woo Jung ),정현채 ( Hyun Chae Jung ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.5

Over the past century, since the introduction of non steroidal anti-inflammatory drugs (NSAID), antacid, histamine H2-receptor antagonists (H2RA), proton pump inhibitors (PPI), and discovery of Helicobacter pylori infection, the paradigm of peptic ulcer disease has changed with marked decrease in morbidity and mortality. However, peptic ulcer disease still occupies a position as a major health problem with increase of aged population and NSAIDs usage. In daily general practice, the management of peptic ulcer disease is directed according to the presence of bleeding or not. For non-bleeding peptic ulcer disease, proper acid suppression and the correction of underlying causes such as Helicobacter pylori infection and NSAID use is the main stay of treatment. Though a complete understanding of pathophysiology and a perfect treatment strategy are still a challenge, this guideline aims to provide practical recommendations based on evidences or consensus of experts through in-depth literature review and expert meeting. (Korean J Gastroenterol 2009;54:285-297)

소화성 궤양 출혈 환자의 임상상 및 재출혈 위험인자

최진우 ( Jin Woo Choi ),김나영 ( Na Young Kim ),송호준 ( Ho June Song ),강형민 ( Hyung Min Kang ),유지연 ( Ji Youn Yoo ),이동훈 ( Dong Hun Lee ),최창규 ( Chang Kyu Choi ),박영수 ( Young Soo Park ),황진혁 ( Jin Hyeok Hwang ),김진욱 대한내과학회 2008 대한내과학회지 Vol.74 No.5

Background/Aims: Bleeding is a serious complication of peptic ulcer. Although endoscopic therapy is effective for achieving hemostasis of active bleeding, rebleeding occurs in 10~30% of these patients. Recently, treatment with proton pump inhibitor (PPI) after hemostasis has decreased the rate of rebleeding. In this study, we analyzed risk factors of peptic ulcer rebleeding and we evaluated whether the rebleeding rate could be different depending on the PPI treatment method. Methods: From March 2003 through February 2006, 639 patients visited the emergency room (ER) due to gastrointestinal hemorrhage. Among them, 191 patients were diagnosed to have peptic ulcer by endoscopy, and they were retrospectively analyzed for their clinical, laboratory and endoscopic findings. The PPI treatment method was categorized into the IV bolus group, the 8 mg/hr continuous infusion group and the others group. Results: Emergency endoscopy was performed within 24 hours in 86.9% of the patients with bleeding peptic ulcer. Rebleeding occurred in 9 cases (4.7%) within 7 days after hemostasis. On the basis of univariate analysis, shock on ER arrival (p=0.013) and over 5 units of packed red cells (PRCs) transfusion (p=0.016) were significant risk factors for rebleeding, yet the PPI treatment method did not affect the rate of rebleeding. Conclusions: The rebleeding rate of peptic ulcer in our study was 4.7%, and this was lower than the previous reports, and the rebleeding rate in our report may have been caused by the early hemostatic therapy together with intravenous infusion of PPI. These approaches are necessary as soon as the patients are stabilized, and especially for the group of patients who are at a high risk for rebleeding, such as those who experience shock at the ER and those who need over 5 units of PRC transfusion.(Korean J Med 74:481-490, 2008)

복부 방선균증이 동반된 크론병 1예

유수종 ( Su Jong Yu ),안동원 ( Dong Won Ahn ),송호준 ( Ho June Song ),김상균 ( Sang Gyun Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한내과학회 2006 대한내과학회지 Vol.70 No.6

The clinical features of abdominal actinomycosis are nonspecific and commonly confused with a neoplasm. Although any condition that allows the agents of actinomycosis to breach the gastrointestinal mucosa has the potential to be complicated by this infecti 복통, 종괴, 누공 및 공동과 같은 복부 방선균증의 임상 양상은 위장관을 침범한 경우 비특이적이며, 크론병과 같은 염증성 장질환과 유사한 경과를 밟아 감별 진단에 어려움을 겪을 수 있다. 복부 방선균증은 주로 복부수술이나 외상과 관련하여 발생하며 거대세포바이러스에 의한 궤양 점막 병변 등이 선행질환이 될 수 있으나, 크론병에 합병된 복부 방선균증은 매우 드문 것으로 알려져 있다. 본 증례는 크론병에 동반된 복부 방선균증의 사례로서 복부 방선균증과 크론병을

내시경초음파 유도하 미세침 흡인생검으로 진단된 위점막하 종양 유사 부비장

안지용 ( Ji Yong Ahn ),정훈용 ( Hwoon Yong Jung ),김도훈 ( Do Hoon Kim ),최기돈 ( Kee Don Choi ),송호준 ( Ho June Song ),이진혁 ( Gin Hyug Lee ),김진호 ( Jin Ho Kim ),황희상 ( Hee Sang Hwang ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6

Accessory spleen can be mistaken as a gastric subepithelial mass, and may not be differentiated in CT or endoscopic ultrasonography (EUS). A gastric subepithelial mass was detected on routine endoscopy in a 39-year old woman with history of splenectomy. In subsequent CT and EUS, the subepithelial mass was located on the fourth layer of the stomach. To make a definite diagnosis, EUS-guided fine needle aspiration (FNA) was performed, and a splenic tissue was demonstrated in histologic examination. EUS-guided FNA can be beneficial in the diagnosis of accessory spleen which mimics a gastric subepithelial mass. (Korean J Gastroenterol 2012;59:433-436)

증례 : 소화기 ; 종격동 기종과 공기후복막증이 발현된 신경성 식욕부진 1예

김태협 ( Tae Hyup Kim ),최기돈 ( Kee Don Choi ),김민경 ( Min Kyung Kim ),김순주 ( Soon Joo Kim ),송호준 ( Ho June Song ),정훈용 ( Hwoon Yong Jung ),김진호 ( Jin Ho Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.3

신경성 식욕부진은 정신과적인 문제뿐만 아니라 여러 계통의 합병증을 유발한다. 월경이상, 혈액학적 이상, 간 기능 이상 등은 흔하게 알려져 있는 합병증이고, 원인은 정확히 알려지지는 않았으나, 신체 내 비정상적인 공기 축적을 보일 수 있는데, 종격동 기종, 피하 공기증, 공기후복막증 등이 나타날 수 있다. 이러한 합병증은 드물게 발생하는 것이라 소화기계의 천공 같은 다른 이차적인 문제는 없는지 확인해 보아야 할 것이다. 저자들은 이차적인 문제없이 신경성식욕부진과 병발된 종격동 기종, 공기후복막증, 피하공기증을 보인 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Since anorexia nervosa is a multi-systemic disorder, as well as a psychiatric disorder, it needs a multidisciplinary approach. It causes many medical problems, including irregular menstruation, hematologic problems, decreased bone density, electrolyte imbalance, and dysrhythmias. Sometimes, this disorder also causes rare, unexpected complications, including abnormal air collections, such as pneumomediastinum, retropneumoperitoneum, or subcutaneous emphysema. The cause of these phenomena is unknown, although fragile parenchymal tissue that is disrupted easily when the local pressure is increased by coughing, vomiting, or defecation is a suggested cause. We experienced a case of anorexia nervosa complicated with abnormal air collections. After we excluded other possible causes, such as perforation of the gastrointestinal tract, and ordered the patient to undergo a short fast and inhale oxygen, the abnormal air collections resolved. We report this case because of its rarity and benign course. (Korean J Med 76:338-342, 2009)