Tc-99m-DTPA Pulmonary Clearance in Normals

Shinn, Kyung Sub,Chung, Soo Kyo,Yang, Woojin,Bank, Yong Whee CATHOLIC MEDICAL CENTER 1995 Bulletin of the Clinical Research Institute Vol.23 No.1

Pulmonary clearance of Tc-99m-DTPA (PCD) has been used for the measurement of pulmonary epithelial permeability. It has been reported to be increased not only in variety of pulmonary diseases including ARDS, interstitial fibrosis, and smokers, but also in normal subjects on positive end expiratory pressure respirator, or after exercise. If was also noted that decrease of pulmonary blood flow due to pulmonary arterial obstruction results in delayed PCD. Normal range of PCD varies with institutes. We prospectively measured PCD in 17 normals (5 males and 12 females) consisted of staffs and trainees in the department of radiology of Kangnam St. Mary's hospital using original BARC nebulizer (India). Age ranged from 32 to 43 years. 370 MBq of Tc-99m-DTPA was inhaled in supine position and supine posterior images were subsequently obtained with 1 min/frame, 64×64 matrix and word mode for 30 min. Regions of interest were set on each lung, whole lungs, and upper, middle and lower thirds of right lung, respectively. Best fit regression curve was obtained from initial 7 min after peak activity on each curve and time for half clearance of maximum activity (t1/2) was calculated. Mean t1/2 was 51.5 min for whole lung. There was no significant difference in t1/2 of right and left lungs. Initial uptake was higher in the lower third and t1/2 was shorter in the lower third than in the upper third. We review several reports on PCD and compared our data with the others. Faster clearance in the lower third may be due to position imaged with or environment the subjects belong to, and further investigation is under way.

Effect of Microwave Hyperthermia on Radiotherapy of Human Malignant Tumors : An Analysis of Clinical Response of 42 Patients

Shinn, Kyung Sub,Gil, Hak Jun,Chung, Su Mi,Yoon, Sei Chul,Oh, Yoon Kyeong,Bahk, Yong Whee CATHOLIC MEDICAL CENTER 1987 Bulletin of the Clinical Research Institute Vol.15 No.1

In this paper, We report the experiences obtained from 42 patients with advanced malignant neoplasms managed with 2450 MHz microwave-induced local hyperthermia and ionizing radiation. A clinical analysis of 42 thermoirradiated patients with complete response(CR), partial response (PR), minor response(MR) and no response(NR), respectively, Histologically, there were 17 (40.2%) squamous cell carcinomas, 12(28.6%) adenocarcinomas and 6(14.8%) miscellaneous cancers. Eleven patients with CR consisted of five squamous cell carcinomas, five adenocarcinomas, and one chloroma. Among 15 patients with PR were five squamous cell carcinomas, five adenocarcinomas, three unknown primary tumors and one poorly differentiated and miscellaneous tumor each.

Ultrasonic Findings of Hepatocellular Carcinoma

Shinn, Kyung Sub,Lee, Myung Hee,Kang, Hyo Suck,Park, Jeong Mi,Bahk, Yong Whee CATHOLIC MEDICAL CENTER 1985 Bulletin of the Clinical Research Institute Vol.13 No.1

Primary hepatocellular carcinoma is one of the most common neoplasms in Korea. The ultrasonograpahy is simple and noninvasive yet highly accurate especially when it is used for the study of the liver diseases. The authors analyzed ultrasonographic findings of 30 cases with hepatocellular carcinoma seen at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic Medical College during the period from Aprill 1982 to September 1985. Diagnosis was established by clinical and pathological tests. The results were as follows: 1. Of 30 patients 22 were male and 8 were female. The age ranged from the 4th to 8th decade with highest incidence in the 6th and 7th decaded. 2. The echopatterns of the tumor appeared to be hyperechoic in 13 cases (43%), mixed in 11 cases (37%), isoechoic in 4 cases (13%), and hypoechoic in 2 cases (7%). Bull's eye sign was noted in 4 cases. 3. The size of the tumor was larger than 5 cm in diameter in 28 cases (93%). The tumor was massive in 16 cases (54%), nodular in 8 cases (26%), and diffuse in 6 cases (20%) and located in the right lobe in 18 cases (60%), the left lobe in 6 cases, both lobes in 6 cases. 4. Other associated findings of hepatocellular carcinoma were hump sign (28 cases), tangent sign (14 cases), right inferior marginal angle sign (20 cases), left inferior marginal angle sign (9 cases), and left marginal angle sign (13 cases).

Concurrent Chemoradiation Therapy in Stage Ⅲ Non-small Cell Lung Cancer

Song, Jung Sub,Jang, Jie Young,Shinn, Kyung Sub,Lee, Sun Hee,Choi, Ihl Bhong,Kim, In Ah,Kang, Ki Mun,Park, Jae Gil,Kuak, Mun Sub THE CATHOLIC UNIVERSITY OF KOREA 1997 Bulletin of The Catholic Research Institutes of Me Vol.25 No.-

This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy(low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage Ⅲ non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Between April 1992 and March 1994, 32 patients who had stage Ⅲ non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks(250 cGy given 10 times up to 2500 cGy) was combined with 6㎎/M^2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage Ⅲ non-small cell lung cancer were received conventionally fractionated(daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. Complete reponse rate was higher in chemoradiation therapy(CRT) group than radiation thernpy(RT) group(18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%). The overall survival rate and no significant differences in between CRT group and RT group(17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis(17% vs. 4.6% at 3 years) also had no significant differences. In subgroup analyses for patients with good performance status(Karnofsky performance scale≥80), CRT group showed significantly higher overall survival rate compared with RT group(62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype(sqamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (Ⅲa vs. Ⅲb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs. 6%) and bone marrow toxicities(25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group(16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group(38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200㎠ had significantly higher rates of pulmonary toxicities. Conclusions: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of con- current chemoradiation therapy, systematic follow-up for long termsurvivors are needed.

Results in the Treatment of Nasopharyngeal Carcinoma Using combined Radiotherapy

Su Mi Chung(정수미) , Sei Chul Yoon(윤세철) , Kyung Sub Shinn(신경섭) , Yong Whee Bahk(박용휘) , Hoon Kyo Kim(김훈교) , Kyung Shik Lee(이경식) , Seung Ho Cho(조승호) 대한방사선종양학회 1991 Radiation Oncology Journal Vol.9 No.1

1983년에서 1989년까지 가톨릭의대 부속 성모병원 방사선치료실에서 비인강종양으로 확진되어 치요를 시행한 환자 31명중 치료가 불완전했던 환자 8명을 제외한 23명의 치료성적으로 후향조사 하였다. 이들 중 11명의 환자에 있어서는 방사선 단독요법을 시행하였으며, 12명의 환자에소는 cisplatin+5-fluorouracil 혹은 cisplatin-bleomycin-vincristine을 이용하여 1회 내지 3회에 걸친 유도 화학요법후 방사선치료를 시행하였다. 방사선 단독요법으로 치료된 11명의 환자에서 완전 관해율은 55%(6/11). 부분관해율은 45%(5/11)였다. 유도화학요법을 시행한 12명의 환자중 약물 치료후 완전관해율은 25%(3/12)였으며, 부분 관해율은 75%(9/12)였고, 연속적으로 시행된 방사선 치료후에는 완전 관해율이 83%(10/12)로 증가되었으며, 부분 관해율은 17%(2/12)였다. 유도 항암요법에 부분관해를 보였던 환자중 stage Ⅲ 환자 1명과 stage Ⅳ 환자 6명이 추가 방사선 치료후 완전 관해를 보였다. 방사선 단독요법군에서는 4명에 국소재발이 발생했으며, 약물요법과 방사선치료를 병행했던 군에서는 국소재발 3명과 폐로의 원격전이가 1명에서 발생되었다. 방사선단독으로 치료한 환자군과 유도화학요법과 방사선 치료를 병행한 환자군에서의 생존율의 차이가 통계적으로 유의하지 않았다. (M±SD=28.55±17.15 and M±SD=28.588±25.39, p>0.05) 치료 환자군의 수가 적은 이유로 통계분석 결과 큰 의의를 발견할 수 없었다. Thirty-one patients with previously untreated and locally advanced nasopharyngeal cancer were retrospectively reviewed for comparing the effects of radical radiotherapy alone with that of combining chemotherapy and radiotherapy from 1983 to 1989 at Kangnam St. Mary's hospital. 23/31 were evaluable for recurrence and survival. There were 8 patients for stage Ⅲ, and 15 patients for stage Ⅳ. Eleven patients were treated with radical radiation therapy alone (arm I). Twelve patients were given 1~3 courses of cisplatin-5FU or cisplatin-bleomycin-vincristine prior to radiation therapy (arm Ⅱ). The two arms were comparable in patient characteristics Of 11 radiotherapy patients, complete response was 55% (6/11) and partial response 45% (5/11). Among 12 patients after induction chemotherapy, complete response was 25% (3/12) and partial response 75% (9/12). After subsequent radiotherapy, complete response was increased to 83% (10/12) and partial response was 17% (2/12). Treatment failure was 36% (local recurrence; 3/11, and regional recurrence; 1/11) in arm I and 33% (local recurrence; 1/12, regional recurrence; 2/12 and distant metastasis; 1/12) in arm Ⅱ. There was no significant difference in survival between arm I and arm Ⅱ (p>0.05). The toxicities of treatment were acceptable. More controlled clinical trials must be completed before acceptance of chemotherapy as part of a standard radical treatment for locally advanced nasopharyngeal cancer.

만성정신분열증 환자에서 우측 전두엽 전부 백질의 양성자 대사물질 변화

신경섭,최보영,이철,이창욱,이수정,백인호 대한신경정신의학회 1994 신경정신의학 Vol.33 No.3

Objects : Magnetic resonance spectroscopy is being used to survey functional activity throughout the brain and thus bring together the disparate lines of neurochemical, neuroanatomical approaches to various psychiatric illness. The most frequently reported morphometric changes in schizophrenia are in ventricle and temporolimbic tissue. Other abnormalitis reported are sulcal enlargement and alterations in whole-brain gray matter frontal lobes, subcortical structures, corpus callosum, and cerebellum. With these aspects in mind, this study was designed to test the so-called ‘hypofrontality’hypothesis, one of pathophysiology in schizophrenia in terms of neurochemical aspects. Mechods : The subjects consisted of 16 hospitalized patients who fulfilled criteria for chronic schizophrenia by DSM-IIIR-R. All subjects were further interviewed to rate the severity of clinical symptoms on Brief Psychiatric Rating Scale(BPRS), and Positive and Negative Syndrome Scale(PANESS). All were examined with localized in vivo ¹H MR spectroscopy in right prefronal white matter to measure proton metabolites and their change possibly associated with treatment. Results : The results were as follows : 1) The spectral features of some distinct proton metabolites such as NAA, Cr, Cho, Glu, GABA were clearly identified in both schizophrenics and healthy controls. 2) The mean signal intensity ratios of proton metabolites were 1.17±0.23 for Cr/Cho, 1.48±0.24, for NAA/Cho, 1.29±0.19 for NAA/Cr, 0.32±0.18 for Glu/NAA, 0.63±0.20 for GABA/NAA, 0.94±0.32 for GABA/Cho, and 0.78±0.21 for GABA/Cr, respectively in schizophrenics. The schizophrenics had significantly higher ratios of Cr/Cho, GABA/NAA, GABA/Cho, and GABA/Cr compared to controls(P=0.002, P=0.0022, P=0.001, P=0.033). Those were 0.89±0.14, 0.38±0.14, 0.53±0.21, 0.60±0.21, respectively in normal controls. However, a significant decrease in NAA/Cr ratio was found in schizophrenics(P=0.017). 3) The correlation between the signal intensity ratio of proton metabolites and symptom severity rated by BPRS showed that the higher were the BPRS scores, the higher was the ratio of GABA/Cho(P=0.05, P=0.027). However increased ratio of NAA/Cr was correlated with decrease of BPRS scores(P=-0.68, P=0.004). 4) The increase of NAA/Cr ratio was correlated with the decrease of negative symptoms assessed by PANSS(P=-0.55, P=0.029). Conclusion : In light of our results, it seems likely that the decrease of NAA/Cho ratio which would be closely associated with neuronal damage supports the hypofrontality hypothesis, and clinical symptoms would be related to the change of GABA.

先天性 無眼球症 2例

孫京燮,辛仁善,金在浩,金尙敏,辛璟燮 大韓眼科學會 1969 大韓眼科學會雜誌 Vol.10 No.1

Frequency of Multiple Consecutive Rib Fractures After Blunt Chest Trauma

Ah, Kyung,Kim, Young Joo,Shinn, Kyung Sub,Park, Seog Hee,Son, Young Bo,Kim, Sung Hoon THE CATHOLIC UNIVERSITY OF KOREA 1997 Bulletin of The Catholic Research Institutes of Me Vol.25 No.-

Rib fractures often are not seen on initial radiographs. This study was undertaken to determine the frequency of the multiple consecutive rib fractures after blunt chest trauma. We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single and multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple factures, there were 73 cases(88%) of consecutive fractures, 5 cases(6%) of interrupted continuous fractures and 5 cases(6%) of random fractures. Among the multiple rib fractures consecutive rib fractures are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.

Power Doppler Ultrasound Findings of Renal infarct after Experimental Renal Artery Occlusion : Comparison with Spiral CT

Jung, Seung Eun,Shinn, Kyung Sub,Kim, Hak Hee,Mun, Seok Hwan,Lee, Young Joon,Lee, Bae Young,Choi, Byung Gil,Lee, Hee Jeong 가톨릭대학교 2000 Bulletin of The Catholic Research Institutes of Me Vol.28 No.-

Purpose : To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction in rabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CT scanning. Materials and Methods : In 28 rabbits weighing 2.5 - 4kg, the segmental renal artery was occluded through the left main renal artery by embolixation with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography and spiral CT scanning were performed before and at 2, 5, 8, 15 and 24 hours, and 3 and 7 days after occlusion of the segmental renal artery. The localtion of infracted areas and collaterals, as seen on PDUS and CT scans, was evaluated by two radiologists. Results : In all cases, as seen on power Doppler ultrasonography, infarected areas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. The location of the lesion closely corresponded to the location seen during in the kidney. The location of the lesion closely corresponded to the location seen during CT scanning. After renal arterial occluson, transiently congested capsular arteries, which were named capsular sign, were seen in 63% of rabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Doppler ultrasonography, through it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterial occlusion. Conclusion : Power Doppler ultrasonography wa suseful for the diagnosis of renal infarction. Congested capsular artery seen in the early stage of renal infarction might be a characteristic fidning of this condition, as seen on power Doppler ultrasonography. (Journal Korean Radiology Society 40:307-315, 1999)

Ultrasonic Findings of Hepatocellular Carcinoma

Park, Jeong-Mi,Shinn, Kyung-Sub,Kang, Hyo-Suck,Lee, Myung-Hee,Bahk, Yong-Whee Catholic Medical Center 1985 Bulletin of the Clinical Research Institute Vol.13 No.-