Prognostic Significance of the Imaging Parameters of Adipose Tissue and Bone Marrow on F-18 Fluorodeoxyglucose PET/CT in Patients with Malignant Melanoma

PURPOSE@#Fluorodeoxyglucose (FDG) uptake of bone marrow (BM) and adipose tissue is known to reflect systemic inflammatory response to cancer cell. The objective of this study was to evaluate the prognostic value of F-18 FDG uptake of BM and determine characteristics of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) on PET/CT images in malignant melanoma.@*MATERIALS AND METHODS@#We retrospectively reviewed 33 patients histopathologically diagnosed with malignant melanoma via FDG PET/CT staging. BM-to-liver uptake ratio (BLR), volume of VAT and SAT, CT Hounsfield unit (HU), and mean of standardized uptake value (SUVmean) of VAT and SAT on PET/CT were measured and prognostic values of these parameters for prediction of disease progression-free survival (DPFS) were evaluated.@*RESULTS@#Patients with stage III–IV melanoma had higher CT HU and SUVmean for SAT and VAT but lower volume of VAT compared with patients at stage I–II (p 0.05).@*CONCLUSION@#CT HU, SUVmean of SAT and VAT, and BLR provide prognostic information for DPFS in malignant melanoma.

The Causal Relationships among Staff Nurses' Job Stress Factors, Patient Safety Culture Perception and Patient Safety Nursing Activities in a University Hospital / 간호행정학회지

PURPOSE: The objective of this study was to explore the causal relationships among staff nurses' job stress factors, patient safety culture perception, and patient safety nursing activities through path analysis. METHODS: The participants, 275 staff nurses with over a year of exp rience working at a university hospital in Seoul, completed structured questionnaires. The data were collected from January 5 to February 28, 2018. The data analysis included descriptive statistics, t-test, ANOVA, Scheffé test and Pearson correlation coefficients using the SPSS/WIN 24.0 program, and path analysis & bootstrapping using AMOS 24.0 program. RESULTS: The path analyses of the hypothesized causal model showed a considerable explanatory power for each of the endogenous variables. About 45 percent of organizational culture was explained by work overload, lack of knowledge/skill, inadequate reward, work environment, and communication. The finding in this study confirmed the mediating effect of patient safety culture perception on the relationships between job stress factors and patient safety nursing activities. CONCLUSION: The proper arrangement of nursing staff, proper treatment and rewards, positive work environment, organizational culture, and smooth communication are needed to promote patient safety nursing activities.

Acute Traumatic Lymphedema without Tissue Injury Detected by Lymphoscintigraphy

Lymphedema is an important disease that causes regional swelling. Although it is not life threatening, it significantly affects the physical and psychological status of the patient. Additionally, lymphedema treatment may be difficult, when its diagnosis is delayed. However, it is not possible to conclude a diagnosis of lymphedema, when the clinical history is uncertain. As observed in the current case, lymphedema caused by minor trauma without any fracture or internal wounds, was detected using a lymphoscintigraphy. Hence, even minor trauma can cause lymphedema and a lymphoscintigraphy can provide critical information for the diagnosis of lymphedema. For this reason, a lymphoscintigraphy test is considered in situations where patients there is differential diagnosis of lymphedema.

Early Evaluation of Inflammatory Focus and Treatment Response Using ¹⁸F-Sodium Fluoride Bone Positron Emission Tomography/Computed Tomography in Patients with Metallic Implants: A Case Report

We report a case of a 76-year-old woman with elevated serum C-reactive protein levels for two weeks after spinal surgery. ⁹⁹mTc-labeled white blood cell scan and dual ¹⁸F-sodium-fluoride (¹⁸F-NaF) bone positron emission tomography/computed tomography (PET/CT) were used to detect the site of inflammation. Using non-attenuation corrected images, soft tissue inflammation was detected without metal artifact. Antibiotic treatment attenuated inflammation as seen in an early-phase scan using follow-up ¹⁸F-NaF bone PET/CT. This case demonstrates the role of ¹⁸F-NaF bone PET/CT in the detection of inflammation sites, and can be used to evaluate treatment response in patients with metallic implants.

Adefovir-induced Fanconi syndrome associated with osteomalacia

Fanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in multiple bones and proteinuria. She had a 7-year history of taking adefovir at 10 mg/day for chronic hepatitis B. Three years previously she had received surgery for a nontraumatic right femur neck fracture, after which she continued to complain of pain in multiple bones, and proteinuria, glycosuria, and phosphaturia were noted. The findings of a light-microscope examination of a renal biopsy sample were normal, but mitochondrial damage of the proximal tubules was evident in electron microscopy. Western blot analysis revealed that the level of serum fibroblast growth factor 23 (FGF23) was lower than in normal controls. After 2 months of treatment, hypophosphatemia and proximal tubular dysfunction were reversed, and serum FGF23 had normalized. This case suggests that direct mitochondrial damage in proximal tubules can cause drug-induced Fanconi syndrome associated with osteomalacia.

Radiomics in Oncological PET/CT: Clinical Applications / 대한핵의학회잡지

¹⁸F–fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is widely used for staging, evaluating treatment response, and predicting prognosis in malignant diseases. FDG uptake and volumetric PET parameters such as metabolic tumor volume have been used and are still used as conventional PET parameters to assess biological characteristics of tumors. However, in recent years, additional features derived from PET images by computational processing have been found to reflect intratumoral heterogeneity, which is related to biological tumor features, and to provide additional predictive and prognostic information, which leads to the concept of radiomics. In this review, we focus on recent clinical studies of malignant diseases that investigated intratumoral heterogeneity on PET/CT, and we discuss its clinical role in various cancers.

Radiomics in Oncological PET/CT: Clinical Applications / 대한핵의학회잡지

¹⁸F–fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is widely used for staging, evaluating treatment response, and predicting prognosis in malignant diseases. FDG uptake and volumetric PET parameters such as metabolic tumor volume have been used and are still used as conventional PET parameters to assess biological characteristics of tumors. However, in recent years, additional features derived from PET images by computational processing have been found to reflect intratumoral heterogeneity, which is related to biological tumor features, and to provide additional predictive and prognostic information, which leads to the concept of radiomics. In this review, we focus on recent clinical studies of malignant diseases that investigated intratumoral heterogeneity on PET/CT, and we discuss its clinical role in various cancers.

The Normalization of Brain ¹⁸F-fluorodeoxy-D-glucose Positron Emission Tomography Hypometabolism following Electroconvulsive Therapy in a 55-year-old Woman with Treatment-resistant Late Onset Depression: A Case Report

Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. Symptomatically, psychomotor retardation, lack of energy, and apathy tends to be more common in people with late-onset depression (LOD). Despite recent advances in psychopharmacologic treatments, 20% to 30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However, the therapeutic mechanism of ECT is still unclear. By using ¹⁸F-fluorodeoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT), we can obtain the status of brain metabolism in patients with neuropsychiatric disorders and changes during psychiatric treatment course. The object of this case report is evaluating the effect of ECT on brain metabolism in treatment-refractory LOD by PET/CT and understanding the mode of action of ECT. In this case report, we presented a 55-year-old female patient who suffered psychotic depression that was resistant to pharmacological treatment. Several antidepressants and atypical anti-psychotics were applied but there was no improvement in her symptoms. The patient presented not only depressed mood and behaviors but also deficit in cognitive functions. We found decreased diffuse cerebral metabolism in her brain ¹⁸F-FDG PET/CT image. ECT resulted in amelioration of the patients' symptoms and another brain PET imaging 7 weeks after the last ECT course showed that her brain metabolism was normalized.

The Effects of Hospital Nurses' Self-Esteem and Communication Skill on Self-Leadership and the Quality of Nursing Service / 간호행정학회지

PURPOSE: The objective of this study was to investigate the influence of hospital nurses' self-leadership, communication skill, and self-esteem on the quality of nursing service. METHODS: The participants, 230 nurses working at a general hospital in Seoul, completed a cross-sectional descriptive questionnaire survey between January 17 and 28, 2014. The collected data were analyzed using the SPSS 19.0 program for descriptive statistics, t-test, one way & two way ANOVA, correlation, and multiple regression analysis. RESULTS: Nurses' self-esteem and communication skill had significant main effects on self-leadership and the quality of nursing service, but the interaction effect of the two independent variables was not significant. Variables that significantly influenced the quality of nursing service were self-leadership, communication skill, self-esteem, and career longevity. The explanatory power of these variables for the quality of nursing service was 54.4%. CONCLUSION: Findings indicate a need for education programs for nurses which are designed to promote communication skill and enhance self-esteem and self-leadership skills which will in turn enhance the quality of nursing service.

Evaluation of digital dental models obtained from dental cone-beam computed tomography scan of alginate impressions / 대한치과교정학회지

OBJECTIVE: To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. METHODS: Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study. RESULTS: All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions. CONCLUSIONS: The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken.