Radiation Synovectomy by 166Holmium-Chitosan complex in Collagenase Induced Arthritis of the Knee in the Rabbit / 대한정형외과학회잡지

PURPOSE: To evaluate the histological changes of the synovial membrane treated by 166Ho-Chitosan complex in collagenase induced arthritis of the knee in the rabbit. MATERIAL AND METHOD: Arthritis was induced in sixteen rabbits by intra-articular injection of 1mg collagenase II and then treated by intra-articular injection of 0.4mCi 166Ho-Chitosan complex 2weeks later. The radioisotope scan was checked in each rabbit for the distribution and extra-articular leakage of the 166Ho-Chitosan complex. The synovial tissues from the femorotibial joints were evaluated for serial histological changes 2, 4, 8, 12 weeks after the 166Ho-Chitosan complex injetion. RESULTS: Two weeks after 166Ho-Chitosan complex administration, inflammatory cells such as giant cells, lymphocytes, histiocyte, and fibroblasts appeared in the subsynovial stroma. The most synovial cells were necrotized. Four weeks after 166Ho-Chitosan complex administration, the inflammatory cells were decreased and many fibroblasts appeared on the subsynovial stroma. There was neovasculization in the synovial membrane 4 weeks after administration. The fibers of collagen were noticed in the synovial membrane and subsynovial stroma at 8 weeks. There was no synoviocyte in the synovium and the thickness of fibrosis was increased at 12weeks. There were fragmentation of the nucleoli of synoviocyte and endothelial cell on the transmission electron microscope (TEM) . CONCLUSION: This study suggests that the synovial membranes treated by 166Ho-Chitosan complex in the collagenase induced arthritis of the knee in the rabbit show early radiation damage and then subsequently develop the fibrosis, and no synovial cell regeneration was observed until 12 weeks.

Prediction of Prognosis by Acetazolamide Brain Perfusion SPECT in Patients with Arteriovenous Malformation / 대한핵의학회잡지

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.

Results of Hyperthermic Treatment Combiced with Radiotherapy/Chemotherapy in Locally Advanced Inoperable Gastric Cancer / 대한암학회지

PURPOSE: This retrospective study is conducted to evaluate the local response rate, survival rate, median survival times and complication of hyperthermic treatment combined with radiotherapy/chemotherapy in locally advanced inoperable gastric cancer. MATERIALS AND METHODS: One hundred and twenty-seven patients treated with hyperthermia from April, 1992 to December, 1994 were enrolled. Among 127 patients, 13(10.2%) were treated with thermo-radiotherapy(Group I), 4(3.1%) were treated with thermo-radio-chemotherapy(Group II) and 110(86.6%) were treated with thermo-chemotherapy (Group III). Hyperfractionated radiotherapy(135 cGy/fr., 2 times/day) using 6-MV X-ray Linac was delivered with total doses of 40.5~67.5 Gy(median: 45 Gy). Chemotherapy by FI(5-FU+ Interferon) or EAP(Etoposide+ Adriamycin+ Cisplatin) regimens was administered. Hyperthermia using 8-MHz RF(radiofrequency) capacitive heating eqiupment (CANCERMIA GHT-8) was applied with interval of 2 times/week, 40~60 minutes /session within 10~15 minutes following radiation, and was simultaneously done with chemotherapy. The estimation of local response was used computed tomography and endoscopy, and was divided into complete response(CR), partial response(PR), and no response(NR). The survival rate was calculated by Kaplan-Meier method. RESULTS: Overall local response rate(CR+ PR) was 68.5% with 6.3% in CR and 62.2% in PR. The local response rates by treatment modality were 92.3% (CR: 15.4%, PR: 76.9%) in Group I, 100%(CR: 75.0%, PR: 25.0%) in Group II and 64.5%(CR: 2.7%, PR: 61.8%) in Group III. There was statistically significant difference(p=0.0001). The overall 1 and 2 years survival rates with median survival time(MST) were 20.5%, 7.1% with 9 months, respectively. The overall 1 and 2 years survival rates(with MST) by treatment modality were 7.7%, 0%(7 months) in Group I, 50.0%, 0%(9 months) in Group II and 20.9%, 8.2%(6 months) in Group III. There was no statistically significant difference. The incidence of side effect by heating was 3.1%(4 patients) and the most serious side effect was subcutaneous fat necrosis in anterior abdominal wall. CONCLUSION: From this study we concluded that hyperthermic treatment combined with radiotherapy/chemotherapy may increase the local response rate in locally advanced inoperable gastric cancer.

Usefulness of three-phase scintigraphy in suspected osteomyelitis / 대한정형외과학회잡지

No abstract available.

The Usefulness of Dipyridamole 99mTc-MIBI Myocardial Scintigraphy in the Detection of Coronary Artery Disease

Though exercise T1-201 myocardial perfusion-scintigraphy is an important test in the diagnosis and evaluation of coronary artery disease, this test is limited in cases with poor physical conditions and unstable angina and the physical characteristics of thallium are not ideal for nuclear imaging of the myocardium. Recently, technetium-99m-labelled agent(99mTc-MIBI) has been developed to improved the quality of imaging and for easy usage in myocardial perfusion scan. Therefore, we performed dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 25 subjects who were suspeced to have coronary artery disease and the results obtanined were as follows ; 1) The overall diagnostic sensitivity of dipyridamole 99mTc-MIBI perfusion scintigraphy was 73.4%, while specificity was 66.7%. 2) Per vessel sensitivity for coronary artery disease diagnosis by the test was 71.4% and a per vessel specificity for coronary artery disease was 95.7%. 3) In all 75 coronary arteries, LAD had a sensitivity of 66.7%(10/15) and a specificity of 100%(10/10); RCA had a sensitivity of 75%(6/8) and a specificity of 82.4%(14/17); LCX had a sensitivity of 60%(3/5) and a specificity of 100%(20/20). 4) After infusion of dipyridamole, the most frequent adverse effect was chest pain which was seen in 8 cases(32%). The headache was seen in 7 cases(28%). Most of the symptoms were mild in severity and subsided spontaneously but 3 subjects were severe enough to require intravenous administration of aminophylline. In conclusion, dipyridamole 99m2011-06-17Tc-MIBI myocardial perfusion scintigraphy is a useful and safe test for diagnosis of coronary artery disease.

The Usefulness of Color-Coded Phase Image for the Evaluation of Regional Wall Motion Abnormalities in Coronary Artery Disease

Phase and Amplitude Image were developed to overcome the subjective nature of interpretation for cinematic endless loop display of radionuclide gated blood pool scan. To evaluate the usefulness of color coded phase image in coronary artery disease, we conducted a clinical study with coronary angiography and phase image in 23 patients, and compared the results of those studies. 1) The results of coronary angiography revealed normal coronary artery in 6, 1 vessel disease in 11, 2 vessel disease in 4, and 3 vessel disease in 2 patients. 2) Color-coded Phase Image revealed abnormal phase area in 2/2(100%) of 3 vessel disease patients and in 3/4(75%) of 2 vessel disease patients, in 5/11(45%) of 1 vessel disease patients, and only 1/6(16%) of normal coronary artery. 3) Among the patients who disclosed abnormal phase image, 5 patients of 2-or3-vessl disease revealed abnormal phase through whole left ventricular area, but 3 patients with right coronary artery lesion and 2 patients with left antrior descending artery lesion showed localized abnormal phase area, infero-apical and anterior portion respectively, which were in accord with each coronary lesion. We concluded that the phase image may be useful in evaluation of the regional wall motion abnormalities in the patients of coronary artery disease. Further studies seem to be neccessary to clarify the sensitivity and specificity of the phase image in the each disease entity group.