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A Case of Neuro-Behcet's Disease: Comparison of Neurological Symptoms with PET, SPECT, and MRI Findings.

Chang Woon CHOI ; So Yon KIM ; Min Koo CHO ; Sang Moo LIM ; Gwon Jun LEE ; Young Jung KIM ; Sung Woon HONG ; Jin Wook KIM ; Min AN

Korean Journal of Nuclear Medicine.1998;32(6):534-541.

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with 18F-fluorodeoxyglucose revealed severe hypometabolism in the cerebellum, in accordance wih cerebellar symptoms and sign of the patient. However, single-photon emission tomography with Tc-99m-HMPAO and Tc-99m-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.
Adult ; Brain ; Cerebellum ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Perfusion ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon*

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Cytogenetic Radiation Adaptive Response Assessed by Metaphase Analysis and Micronuclei Test in Human Lymphocytes and Mouse Bone Marrow Cells.

Ji Yeul KIM ; Hee Seung BOM ; Jung Jun MIN ; Ho Cheon SONG ; Keun Hee CHOI ; Hwan Jeong JEONG ; Seung Yeon LEE

Korean Journal of Nuclear Medicine.1998;32(6):525-533.

PURPOSE: Radiation adaptive response in human peripheral lymphocytes and mouse bone marrow cells was investigated using both metaphase analysis and micronucleus assay. We assessed the correlation between both tests. MATERIALS AND METHODS: Two groups of the human peripheral lymphocytes and mouse bone marrow cells were exposed to low dose (conditioning dose, 0.18 Gy) or high dose (challenging dose, 2 Gy) gamma-rays. The other 4 groups were exposed to low dose followed by high dose after several time intervals (4, 7, 12, and 24 hours, respectively). The frequencies of chromosomal aberrations in metphase analysis and micronuclei in micronucleus assay were counted. RESULTS: Chromosomal aberrations and micronuclei of preexposed group were lower than those of the group only exposed to high dose radiation. Maximal reduction in frequencies of chromosomal aberrations were observed in the group to which challenging dose was given at 7 hour after a conditioning dose (p<0.001). Metaphase analysis and micronucleus assay revealed very good correlation in both human lymphocytes and mouse bone marrow cells (r=0.98, p<0.001; r=0.99, p=0.001, respectively). CONCLUSION: Radiation adaptive response could be induced by low dose irradiation in both human lymphocytes and mouse bone marrow cells. There was a significant correlation between metaphase analysis and micronucleus assay
Animals ; Bone Marrow Cells* ; Bone Marrow* ; Chromosome Aberrations ; Cytogenetics* ; Humans* ; Lymphocytes* ; Metaphase* ; Mice* ; Micronucleus Tests

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In Vitro Properties and Biodistribution of Tc-99m and Re-188 Labeled Monoclonal Antibody CEA79.4.

Myung Chul LEE ; June Key CHUNG ; Dong Soo LEE ; Jae Min JEONG ; Young Soo CHANG ; Mee Kyoung HONG ; Jeong Seok YEO ; Yong Jin LEE ; Kyung Min KIM ; Seung Jin LEE

Korean Journal of Nuclear Medicine.1998;32(6):516-524.

PURPOSE: Radiolabeled CEA79.4 antibody has a possibility to be used in radioimmunoscintigraphy or radioimmunotheraphy of cancer. We investigated the in vitro properties and biodistribution of CEA79.4 antibody labeled with Re-188 or Tc-99m. MATERIALS AND METHODS: CEA79.4 was reduced by 2-mercaptoethanol to produce-SH reside, and was labeled with Re-188 or Tc-99m. For direct labeling of Tc-99m, methylene-diphosphonate was used as transchelating agent. CEA79.4 in 50 mM Acetate Buffered Saline (ABS, pH 5.3) was labeled with Re-188, using stannous tartrate as reducing agent. In order to measure immunoreactivity and the affinity constant of radiolabeled antibody, cell binding assay and Scatchard analysis using human colon cancer cells SNU-C4, were performed. Biodistribution study of labeled CEA79.4 was carried out at 1, 14 and 24 hr in ICR mice. RESULTS:. Labeling efficiencies of Tc-99m and Re-188 labeled antibodies were 92.4+/-5.9% and 84.7+/-4.6%, respectively. In vitro stability of Tc-99m-CEA79.4 in human serum was higher than Re-188-CEA79.4. Immunoreactivity and affinity constant of Tc-99m-CEA79.4 were 59.2% and 6.59x109 M-1, respectively, while those of Re-188-CEA79.4 were 41.6% and 4.2x109 M-1, respectively. After 24 hr of administrations of Re-188 and Tc-99m labeled antibody, the remaining antibody, the remaining antibodies in blood were 6.32 and 9.35% ID/g respectively. The biodistribution of each labeled antibody in other organs was similar because they did not accumulate in non-targeted organs. CONCLUSION: In vitro properties and biodistribution of Re-188-CEA79.4 were similar to those of Tc-99m-CEA79.4. It appears that Re-188-CEA79.4 can be used as a suitable agent for radioimmunotherapy.
Animals ; Antibodies ; Colonic Neoplasms ; Humans ; Hydrogen-Ion Concentration ; Mercaptoethanol ; Mice ; Mice, Inbred ICR ; Radioimmunodetection ; Radioimmunotherapy

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Assessment of Viability in Regional Myocardium with Reversed Redistribution by Thallium Reinjection in Patients with Acute Myocardial Infarction.

Seok Nam YOON ; Moon Sun PAI ; Chan H PARK

Korean Journal of Nuclear Medicine.1998;32(6):509-515.

PURPOSE: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. MATERIALS AND METHODS: We studied 42 patients with acute myocardial infarction (age, 55+/-12 years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. RESULTS: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed all motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (56%) with severely decreased uptake. CONCLUSION: In patients with acute myocardial ifarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium* ; Perfusion ; Thallium* ; Tomography, Emission-Computed, Single-Photon

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Prediction of Improvement of Myocardial Wall Motion after Coronary Artery Bypass Surgery Using Rest T1-201/Dipyridamole Stress Gated Tc-99m-MIBI/24 Hour Delay T1-201 SPECT.

Myung Chul LEE ; June Key CHUNG ; Dong Soo LEE ; Won Woo LEE ; Ki Bong KIM ; Jeong Seok YEO ; Seok Ki KIM

Korean Journal of Nuclear Medicine.1998;32(6):497-508.

PURPOSE: Using rest T1-201/dipyridamole stress Tc-99m-MIBI/24 hour T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. MATERIALS AND METHODS: In 39 patients (M:F=34:5, age 58+/-8), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0:normal to 3:defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. RESULTS: After bypass surgery, ejection fraction increased from 37.8+/-9.0% to 45.5+/-12.3% in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). CONCLUSION: Among independent predictors obtained by rest T1-201/stress gated Tc-99m-MIBI/delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.
Arteries ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Logistic Models ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

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Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings.

Young Hoon RYU ; Jong Doo LEE ; Pyeong Ho YOON ; Jai Keun KIM ; Sang Joon PARK ; Tae Joo JEON ; Ji Eun NAM ; Choon Sik YOON

Korean Journal of Nuclear Medicine.1998;32(6):490-496.

PURPOSE: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. MATERIALS AND METHODS: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were performed and imaging features were analyzed. RESULTS: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. CONCLUSION: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.
Basal Ganglia ; Brain* ; Female ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondrial Encephalomyopathies ; Mitochondrial Myopathies* ; Occipital Lobe ; Perfusion ; Rabeprazole ; Seizures ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

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Radionuclide Cisternographic Findings in Patients with Spontaneous Intracranial Hypotension.

Dae Hyuk MOON ; Hee Kyung LEE ; Jin Sook RYU ; Jung Woo SHIN ; Dong Jin JUNG ; Jae Seung KIM ; Joo Hyuk IM ; Myoung Chong LEE ; Sun Joo JUNG

Korean Journal of Nuclear Medicine.1998;32(6):482-489.

PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder

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Recent Developments in Nuclear Medicine Instrumentation.

Byung Tae KIM ; Sang Eun KIM ; Joon Young KIM ; Yong CHOI ; Kyung Han LEE ; Yearn Seong CHOE ; Jong Ho KIM ; Ki Chun IM

Korean Journal of Nuclear Medicine.1998;32(6):471-481.

The goals of developments in nuclear medicine instrumentation are to offer a higher-quality image and to aid diagnosis, prognosis assessment or treatment planning and monitoring. It is necessary for physicists and engineers to improve or design new instrumentation and technique, and to implement, validate, and apply these new approaches in the practice of nuclear medicine. The researches in physical properties of detectors and crystal materials and advance in image analysis technology have improved quantitative and diagnostic accuracy of nuclear medicine images. This review article presents recent developments in nuclear medicine instrumentation, including scatter and attenuation correction, new detector technology, tomographic image reconstruction methods, 511 keV imaging, dual modality imaging device, small gamma camera, PET developments, image display and analysis methods.
Diagnosis ; Gamma Cameras ; Image Processing, Computer-Assisted ; Nuclear Medicine* ; Prognosis

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Demonstration of stunned myocardium by gated blood pool scan.

Hee Seung BOM ; Ji Yeul KIM ; Jeong Gwan CHO ; Jong Chun PARK ; Jung Chaee KANG

Korean Journal of Nuclear Medicine.1992;26(1):166-167.

No abstract available.
Myocardial Stunning*

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Radionuclide cisternography of arachnoid cyst.

Sang Kyun BAE ; Hyung In YANG ; Chang Woon CHOI ; Sang Eun KIM ; Dong Soo LEE ; June Key CHUNG ; Myung Chul LEE ; Chang Soon KOH

Korean Journal of Nuclear Medicine.1992;26(1):164-165.

No abstract available.
Arachnoid*

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