The purpose of this study was to examine the radiolabeling and biodistribution of 188Re(V)-DMSA as a therapeutic cancer radiopharmaceutical. We made a DMSA kit(NaHC03 1.5 mg, meso-2,3-dimercaptosuccinic acid 1.0 mg L(+)-ascorbic acid 0.7mg, SnCl2 2H2O 0.34 mg, pH 2.9) for labeling with 188Re. In this kit, 188ReO4- 5 mCi/2 ml added and boiled at 100 degree C for 3 hr in water bath. The final pH adjusted to 7.5 with 7% NaHCO3 solution. We checked the labelling efficacy with TLC-SG(n-butanol : acetic acid:H2O = 3 : 2 : 3) and examined the stability both in room temperature and in serum at 37 degree C. Biodistribution(l, 3, 13, 24, 48 hr) of 188Re(V)-DMSA compound was evaluated in Sarcoma 180 tumor-bearing mice. Each labeling efficiency and stability at room temperature for 48 hours was over 98% and 95%, respectely. The stability in serum were 82%(6 hr) and 85%(48 hr). Tumor uptake of 188Re(V)-DMSA in Sarcoma 180- bearing mice were 0.66+/-0.15%(1 hr), 0.51+/-0.10%(3 hr), 0.19+/-0..05%(24 hr) and 0.13+/-0.02%(48 hr). These result are consistent with those of 99mTc(V)-DMSA which were reported previously In conclusion, 188Re(V)-DMSA may be a useful therapeutic radiopharmaceutical for treating some cancers and metastatic bone lesion.
Animals ; Baths ; Hydrogen-Ion Concentration ; Mice ; Sarcoma ; Sarcoma 180 ; Succimer ; Water

Left ventricular(LV) diastolic filling is abnormal at rest in many patients with coronary arery disease, even in the presence of normal resting LV systolic function. To determine the effects of improved myocardial perfusion on impaired LV diastolic filling and to detect the most sensitive parameter to assess LV diastolic function, gated radionuclide ventriculography were performed in 14 patients with coronary artery disease before and after successful percutaneous transluminal coronary angioplasty(PTCA). All patients had no previous myocardial infarction and no abnormal wall motion in gated radionuclide and contrast ventriculography. The following results were obtained; 1) There were no significant differences in the parameters of LV systolic function, such as peak ejection rate(PER, time to peak ejection rate(TPER), ejection fraction(EF) after successful PTCA. 2) Peak filling rate(PFR) and time to peak filling rate(TPFR), indexes of LV diastolic function, had no significant changes after successful PTCA. 3) The percent contribution of late diastolic filling to stroke volume(%LDF/SV) decreased from 26.5+/-6.8% to 19.1+/-6.6%(p<0.005 by paired t-test). These data suggest that in many patients with angina and normal LV systolic function, impaired global diastolic filling is a reversible manifestation of impaired coronary flow, and percent contribution of late diastolic filling to stroke volume(%LDF/SV) can be a sensitive parameter to evaluate impaired LV diastolic filling in coronary artery disease.
Angina Pectoris* ; Angioplasty, Balloon, Coronary* ; Coronary Artery Disease ; Gated Blood-Pool Imaging ; Humans ; Myocardial Infarction ; Perfusion ; Radionuclide Ventriculography ; Stroke

The coagulation cascade and inflammatory process are known to be associated with the pathophysiology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We retrospectively investigated laboratory values indicating coagulopathy obtained within 24 hr from diagnosis of ALI/ARDS in 79 children who received mechanical ventilation between 2008 and 2009 and their final outcomes. Prothrombin time (PT) (P = 0.001) and activated partial thromboplastin time PTT (APTT) (P = 0.001) were more prolonged in non-survivors than survivors (mean; 1.57 vs 1.33; 63 vs 57). In multivariate analysis with stratification by oxygenation-index (< 14.5, > or = 14.5), prolonged PT (> or = 1.46 international normalized ratio, [INR]) (hazard ratio; 2.043, 1.027-4.064) was associated with lower non-pulmonary-organ-failure-free survival rate (FFS), and prolonged APTT (> or = 50 seconds) (2.062, 1.031-4.121; 2.422, 1.227-4.781) was associated with lower overall survival rate (OS) and lower FFS. In stratification by ventilation-index (< 40, > or = 40), prolonged PT (2.232, 1.095-4.540; 2.177, 1.092-4.342) and prolonged APTT (2.574, 1.230-5.386; 3.089, 1.500-6.360) were associated with lower OS and lower FFS. Prolonged PT and APTT are associated with mortality in mechanically ventilated children with ALI/ARDS. We suggest PT and APTT as prognostic factors of ALI/ARDS in children.
Acute Lung Injury/*etiology/mortality ; Adolescent ; Blood Coagulation Disorders/*complications ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Partial Thromboplastin Time ; Prognosis ; Prothrombin Time ; Respiratory Distress Syndrome, Adult/*etiology/mortality ; Retrospective Studies ; Survival Rate ; Young Adult

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Electrocardiography* ; ROC Curve*

To evaluate left ventricular diastolic function in patients with coronary artery disease, gate radionuclide ventriculography was performed prospectively in 42 patients who were admitted to Seoul National University Hospital from November 1985 to August 1986 because of anterior chest pain. All patients had no valvular heart disease, congenital heart disease, cardiomyopathy and arrhythmia, and no abnormal vall motion in gated nuclide ventriculography and contrast left ventriculography. 25 patients with more than 50% of stenosis in coronary arteriography were compared with 17 control subjects without stenosis. The following results were obtained; 1) There were no significant differences between normal controls and patients with coronary artery disease in the analysis of the parameters of the left ventricular systolic function, such as ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER) and ejection time (TES, TES/BCL). 2) Same results were found with those of the left vnetricular diastolic function, such as peak filling rate (PFR), diastolic time interval (DTI, DTI/BCL), rapid diastolic filling interval and time to late diastolic filling (TLDF). 3) The percent contribution of late diastolic filling to stroke volume (%LDF/SV) was more increased in patients with coronary artery disease than the normal control subjects (38.2+/-12.4% vs 28.3+/-7.8%, P<0.01). 4) As the results of above, it can be concluded that the percent contribution of late diastolic filling to stroke volume (%LDF/SV) obtained by using the non-invasive method of gated radionuclide ventriculography can be a sensitive parameter for early evaluation of the left ventricular diastolic dysfunction in coronary artery disease.
Angiography ; Arrhythmias, Cardiac ; Cardiomyopathies ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Gated Blood-Pool Imaging ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Prospective Studies ; Radionuclide Ventriculography ; Seoul ; Stroke Volume

PURPOSE: Acute appendicitis is one of the most common diseases requiring surgical treatment. Delayed diagnosis, which causes complications like perforation of the appendix, abscess formation, or misdiagnosis, leads to unnecessary surgery. Many scoring systems have been suggested for the diagnosis of acute appendicitis. This study aims to evaluate the clinical value of previous scoring systems. METHODS: This study was conducted with a total of 270 patients who had visited the National Police Hospital (NPH) Emergency Room for acute abdominal symptoms from January to June 2008. The Alvarado and the Ohmann scores were applied retrospectively based on the patients' records. We found 3 criteria which were relatively objective and clinically meaningful; then, we designed a new 10 points scoring system. RESULTS: The sensitivity and the specificity of the Alvarado scoring system were 83.23% and 64.42%, respectively, whereas those of the Ohmann scoring system were 74.85% and 66.35%, respectively. The sensitivity and the specificity of the NPH scoring system were found to be 78.4% and 68.9%, respectively. The Ohmann scoring system showed a little lower sensitivity, and the NPH scoring system showed a little higher specificity, but the differences were not statistically significant. CONCLUSION: Our study indicates that the scoring systems considered are not useful diagnostic methods for primary screening and diagnosis of acute appendicitis.
Abscess ; Appendicitis ; Appendix ; Delayed Diagnosis ; Diagnostic Errors ; Emergencies ; Humans ; Mass Screening ; Police ; Retrospective Studies ; Sensitivity and Specificity ; Unnecessary Procedures

Re-188 is useful candidate for therapeutic radionuclide because it has a physical half life of 17 hours, contains beta ernissions suitable for therapy(maximum energy 2.12MeV) and emits a garnma ray that is suitable for quantitative diagnostic scanning(155keV). To use He-188 as a radionuclide compound of angioplasty balloon radiotherapy, we investigated the labelling method and biodistribution of Re-188- DTPA. We postulated that labeled Re-188-DTPA is preferable because it would be excreted via urinary system more easily than other compounds. To label Re-188 with DTI'A, 1ml of 222MBqI(6mCi) of Re-188 was added to DTPA solution(DTPA 20mg, SnC4 2HsO 10mg, pH 3.5) and boiled at 100C for 120min in water bath. pH was adjuted to 5 with 2.3Fo sodium acetate. I.abeling efficiency was measured using TLC-SG(acetone, saline). We evaluated biodistribution of Re-188-DTPA in sacrificed mice at 10 and 60 minutes after injection. We acquired images of kidneys, and drew tirne-activity r.urves in normal dogs and rats and calculated Trnax and Tl/2 in rats. The labelling efficiency was 95.7Yo on average. Labelling of Re-188-DTPA was stable(90% after 5hours) in vitro at room temperature. According to time-activity curves of dogs and rats, it took 15 to 20 minutes after injection for Re-188-DTPA to be washed out through kidneys. In conclusion, Re-188-DTPA was successfully labeled, Re-188-DTPA was stable in vitro and was excreted early via kidneys in animals. We could recornmend Re-188-DTPA as radionuclide of potential use in angioplasty balloon radiotherapy.
Angioplasty ; Animals ; Baths ; Dogs ; Half-Life ; Hydrogen-Ion Concentration ; Kidney ; Mice ; Pentetic Acid ; Radiotherapy ; Rats ; Sodium Acetate ; Water

I-123 labelled fatty acids are suitable for investigation of regional myocardial metabolism, so they are on the clinical trial. However, the precise properties of these materials are not characterized yet. We have synthesized phenylpentadecanoic acid and labeled this compound with I-123. The purpose of this study was to examine the stability, biodistribution, metabolism and SPECT imaging of [I-123]15-(p-iodophenyl)pentadecanoic acid(I-123-IPPA) that we made. The stability test of I-123-IPPA in serum of rat, mouse and human showed no free I-123 after 1 hour. In biodistribution study in mice for various time intervals after injection(5, 10, 15, 30, 60 minutes), uptake in myocardium was 14.5%ID/g(5 min), and 1.9%ID/heart(5 min), while uptake in muscles was 2.6%ID/g(5 min). Myocardium to blood ratio and myocardium to lung ratio increased for 5 min after injection and then decreased rapidly. Chromatographic data of rat blood and urine showed that little PPA was found in blood and urine 15-20 min after injection. The myocardial I-123-IPPA SPECT images of a dog with myocardial infarction showed defects similar to those of Tc-99m-MIBI and F-18-FDG. These data suggest that I-123-IPPA is quite stable in vitro and shows favorable biodistribution in mice. SPECT imaging with I-123-IPPA demonstrated infarct zone as photon defect in dog model of myocardial infarction. I-123-IPPA may be used for the evaluation of fatty acid metabolism in clinical trials in Korea.
Animals ; Dogs ; Fatty Acids ; Humans ; Korea ; Lung ; Metabolism* ; Mice ; Muscles ; Myocardial Infarction ; Myocardium ; Rats ; Tomography, Emission-Computed, Single-Photon

For estimation of regional myocardial blood flow with O-15 water PET, a few modifications considering partial volume effect based on single compartment model have been proposed. In this study, we attempted to quantify the degree of heterogeneity and to show the effect of tissue flow heterogeneity on partition coefficient(lamda) and to find the relation between perfusable tissue index(PTI) and (lamda) by computer simulation using two modified models. We simulated tissue curves for the regions with homogeous and heterogenous blood flow over a various flow range(0.2-4.0ml/g/min).Simulated heterogeneous tissue composed of 4 subregions of the same or different size of block which have different homogeneous flow and different degree of slope of distribution of blood flow. We measured the index representing heterogeneity of distribution of blood flow for each heterogeneous tissue by the constitution heterogeneity(CH). For model I, we assumed that tissue recovery coefficient (FMME) was the product of partial volume effect(FMMF) and PTI. Using model I, PTI, flow, and FMM were estimated. For model II, we assumed that partition coefficient was another variable which could represent tissue characteristics of heterogeneity of flow distribution. Using model II PTI, flow and (lamda) were estimated. For the simulated tissue with homogeneous flow, both models gave exactly the same estimates of three parameters. For the simulated tissue with heterogeneous flow distribution, in model I, flow and FMM were correctly estimated as CH was increased moderately. In model II, flow and (lamda) were decreased curvi-linearly as CH was increased. The degree of underestimation of (lamda) obtained using model II, was correlated with CH. The degree of underestimation of flow was dependent on the degree of underestimation of (lamda). PTI was somewhat overestimated and did not change according to CH. We conclude that estimated (lamda) reflect the degree of tissue heterogeneity of flow distribution. We could use the degree of underestimation of (lamda) to find the characteristic heterogeneity of tissue flow and use (lamda) to recover the underestimated flow.
Computer Simulation ; Constitution and Bylaws ; Electrons* ; Myocardium* ; Population Characteristics* ; Positron-Emission Tomography*

OBJECTIVES: It is suggested that frequency of low turnover bone disease is much higher in diabetic renal osteodystrophy. We tried to find out whether bone scan images show less 99mTc-MDP uptake in diabetic renal ostwdystrophy. METHODS: We compared bone scan images of renal failure patients with and without diabetes. The number of patients studied was 134 (43 patients had diabetes and 91 patients did not). Two experienced nuclear physicians read Tc-99m-MDP bone scan twice separately and gave the score either 1 or 0 on 6 areas; axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction and sternum. The means of summed scores were compared using Students t-test. To exclude the effects of sex, age and serum creatinine concentration, we analysed these factors together with the effect of diabetes using analysis of covariance. We also interpreted on bone scan images, as classical renal osteodystrophy, renal failure and normal. RESULTS: The intra- and interobserver variations were very low. Patients of diabetes group showed significantly lower mean of summed score(2.0+/-0.95) compared to patients of non-DM group(3.3+/-1.2). Analysis of covariance revealed that lower score of diabetes group was independent of sex, age and serum creatinine level. of diabetes group, 2 nuclear physicians interpreted bone scans as classical renal osteodystrophy in 60% and 56%, However, they interpreted bone scans of non-DM group in 80%, 88%(between-observer k: 0.74). Chi-square test showed that this difference was statistically significant (p<0.05). CONCLUSION: Bone scan image of diabetic renal osteodystrophy showed less 99mTc-MDP uptake, which meant low osteoblastic activity. This influence of diabetes upon bone uptake was significant after considering other confounding factors.
Bone Diseases ; Creatinine ; Diabetes Mellitus ; Humans ; Kidney Failure, Chronic* ; Mandible ; Observer Variation ; Osteoblasts ; Renal Insufficiency ; Renal Osteodystrophy* ; Skeleton ; Skull ; Sternum ; Technetium Tc 99m Medronate