Biochemical markers of bone turnover has received increasing attention over the past few years, because of the need for sensitive and specific tool in the clinical investigation of osteoporosis. Bone markers should be unique to bone, reflect changes of bone loss, and should be correlated with radiocalcium kinetics, histomorphometry, or changes in bone mass. The markers also should be useful in monitoring treatment efficacy. Although no bone marker has been established to meet all these criteria, currently osteocalcin and pyridinium crosslinks are the most efficient markers to assess the level of bone turnover in the menopausal and senile osteoporosis. Recently, N-terminal telopeptide (NTX), C-terminal telopeptide (CTX) and bone specific alkaline phosphatase are considered as new valid markers of bone turnover. Recent data suggest that CTX and free deoxypyridinoline could predict the subsequent risk of hip fracture of elderly women. Treatment of postmenopausal women with estrogen, calcitonin and bisphosphonates demonstrated rapid decrease of the levels of bone markers that correlated with the long-term increase of bone mass. Factors such as circadian rhythms, diet, age, sex, bone mass and renal function affect the RESULTS of biochemical markers and should be appropriately adjusted whenever possible. Each biochemical markers of bone turnover may have its own specific advantages and limitations. Recent advances in research will provide more sensitive and specific assays.
Aged ; Alkaline Phosphatase ; Biomarkers* ; Calcitonin ; Circadian Rhythm ; Diet ; Diphosphonates ; Estrogens ; Female ; Hip ; Humans ; Kinetics ; Osteocalcin ; Osteoporosis ; Treatment Outcome

CT guided percutaneous fine-needle aspiration (FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver mal- ignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were revi- ewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the cause of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows ; 1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell in the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' exper- ience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic.
Adenocarcinoma ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnostic Errors ; Humans ; Liver ; Nephrotic Syndrome* ; Retrospective Studies ; Sensitivity and Specificity

Compared with the earlier technique of dual photon absorptiometry (DPA) using 153Gd radionuclide source, dual energy X-ray absorptiometry (DXA) has advantages of higher precision, accuracy and shorter scanning time. Despite the change from DPA to DPX, the nuclear medicine physicians has remained one of major suplier of this service due to long-standing use of DPA. Among many kinds of bone densitometries, DXA is the "gold standard" for the noninvasive diagnosis of osteoporosis. Especially there is no role for peripheral devices in the monitoring of patients on therapy. But, there are some areas of controversy related to the application of DXA, such as proper site of measurement, accurate interpretation, appropriate use of T-score, and the reference population young database. And the accuracy, precision, and quality control issues relating to bone density measurement are important subjects. To address these issues, the International Society for Clinical Densitometry (ISCD) has convened two Position Development Conferences and addressed official positions. This review deals the key elements of ISCD position paper and other important issues on the management of bone densitometry.
Absorptiometry, Photon ; Bone Density* ; Congresses as Topic ; Densitometry ; Diagnosis ; Humans ; Nuclear Medicine ; Osteoporosis ; Quality Control

Radiosynovectomy has been used as an effective treatment in patients with resistant synovitis after failure of long-term medication and intraarticular steroid injection. Although 90Y silicate/citrate, 186Re sulfide, and 169Er citrate were approved in Europe for the appropriate radiopharmaceuticals for radiosynovectomy, other radionuclides such as 32P-chromic phosphate, 165Dy-ferric hydroxide macroaggregate, 188Rh-microspheres, 153Sm-particulate, and 166Ho-ferric hydroxide macroaggregate have been used in many countries. Reported success rates range from 40% to 90% for the different joints and underlying disease. In Korea, 188Re-tin-colloid and 166Ho-chitosan complex are now using as the major radionuclides in radiosynovectomy with good clinical results. A study on radiation synovectomy using 188Re-tin-colloid for patients with Korean rheumatoid arthritis shows the treatment resulted in the improvement of arthritis and well tolerated. In our study, the radiosynovectomy with 166Ho-chitosan complex in 53 hemophilic patients markedly decreased intra-articular bleeding frequency and need for coagulation factor. This review inculdes general priciples in the application of radiosynovectomy and the clinical experience in Korea.
Arthritis ; Arthritis, Rheumatoid ; Blood Coagulation Factors ; Citric Acid ; Europe ; Hemophilia A ; Hemorrhage ; Humans ; Joints ; Korea ; Radioisotopes ; Radiopharmaceuticals ; Synovitis

No abstract available.
Intracranial Thrombosis*

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Brain* ; Tomography, Emission-Computed, Single-Photon*

The authors report series of 360 cases of transthoracic fine-needle aspiration cytology (TFNA) from Oct. 1982, through Aug. 1986 at the Seoul National University Hospital. A diagnosis of neoplastic lesion was established in 50.3% of the cases. A non-neop- lastic diagnosis was made in 38.5%, nondiagnostic one in 6.5% and inadequate one in 4.7% of the total. Statistical findings on cytological diagnoses were as follows. Specificity was 100%: sensitivity, 92%; predictive value for positive, 1.0: predictive value for negative, 0.9; concordance rate, 84.2%: diagnostic accuracy in non-neoplastic lesion, 65.4%, and typing accuracy in malignant tumor, 0.77.
Biopsy, Fine-Needle ; Diagnosis ; Glomerulonephritis, IGA* ; Immunoglobulin A* ; Sensitivity and Specificity ; Seoul

Background: As recognized by the World Health Organization in 2016 with its inclusion in the International Classification of Diseases, Tenth Revision as M62.84, and by South Korea in 2021 as M62.5, the diagnostic guidelines for sarcopenia vary globally. Despite its prevalence in older populations, data on sarcopenia in Koreans aged 60 and above is scarce, highlighting the need for research on its prevalence in this demographic. Methods: Utilizing the 2022 Korea National Health and Nutrition Examination Survey dataset, sarcopenia was assessed among 1,946 individuals aged 60 or older according to the Asian Working Group for Sarcopenia 2019 criteria, incorporating grip strength and bioelectrical impedance analysis measurements. Statistical analyses were performed to differentiate categorical and continuous variables using logistic regression and Student’s t-tests, respectively. Results: The prevalence of sarcopenia was found to increase with age, with the highest prevalence observed in the oldest age group (80 years and older). The overall prevalence of sarcopenia in our study population was 6.8%. Among men, the prevalence of sarcopenia was 5.5% in the 60 or older age group, 9.6% in the 70 or older age group, and 21.5% in the 80 or older age group. Among women, the prevalence of sarcopenia was 7.9%, 10.5%, and 25.9%, respectively. Conclusions This study highlights the significant burden of sarcopenia in elderly Koreans, particularly among the oldest individuals. These findings call for targeted interventions to manage and prevent sarcopenia, along with further research on its risk factors, consequences, and effective mitigation strategies.