Purpose: The purpose of this study was to determine the lowest Tl-201 dose that does not reduce the image quality of myocardial perfusion SPECT (MPS) by Poisson resampling simulation. Methods: One hundred and twelve consecutive MPS data from patients with suspected or known coronary artery disease were collected retrospectively. Stress and rest MPS data were resampled using the Poisson method with 33%, 50%, 67%, and 100% count settings. Two nuclear medicine physicians assessed the image quality of reconstructed data visually by giving grades from − 2 to + 2. The summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were obtained on the workstation. Image quality grades and semi-quantitative scores were then compared among these resampled images. Results: The proportions of “adequate” image quality were 0.48, 0.75, 0.92, and 0.96 for the groups of images with 33%, 50%, 67%, and 100% data, respectively. The quality of the resampled images was significantly degraded at 50% and 33% count settings, while the image quality was not different between 67 and 100% count settings. We also found that high body mass index further decreased image quality at 33% count setting. Among the semi-quantitative parameters, SSS and SRS showed a tendency to increase with a decline in count. Conclusion Based on the simulation results, Tl-201 dose for MPS can be reduced to 74 MBq without significant loss of image quality. However, the SSS and SRS can be changed significantly, and it needs to be further verified under the different conditions.

Background: Hodgkin's lymphoma (HL) constitutes 10%–20% of all malignant lymphomas and has a high cure rate (5-year survival, around 90%). Recently, interest has increased concerning preventing secondary complications (secondary cancer, endocrine disorders) in long-term survivors. We aimed to study the epidemiologic features and therapeutic outcomes of HL in children, adolescents, and young adults in Korea. Methods: We performed a multicenter, retrospective study of 224 patients aged < 25 years diagnosed with HL at 22 participating institutes in Korea from January 2007 to August 2016. Results: A higher percentage of males was diagnosed at a younger age. Nodular sclerosis histopathological HL subtype was most common, followed by mixed cellularity subtype.Eighty-one (36.2%), 101 (45.1%), and 42 (18.8%) patients were classified into low, intermediate, and high-risk groups, respectively. Doxorubicin, bleomycin, vinblastine, dacarbazine was the most common protocol (n = 102, 45.5%). Event-free survival rate was 86.0% ± 2.4%, while five-year overall survival (OS) rate was 96.1% ± 1.4%: 98.7% ± 1.3%, 97.7% ± 1.6%, and 86.5% ± 5.6% in the low, intermediate, and high-risk groups, respectively (P = 0.021). Five-year OS was worse in patients with B-symptoms, stage IV disease, highrisk, splenic involvement, extra-nodal lymphoma, and elevated lactate dehydrogenase level.In multivariate analysis, B-symptoms and extra-nodal involvement were prognostic factors for poor OS. Late complications of endocrine disorders and secondary malignancy were observed in 17 and 6 patients, respectively. Conclusion This is the first study on the epidemiology and treatment outcomes of HL in children, adolescents, and young adults in Korea. Future prospective studies are indicated to develop therapies that minimize treatment toxicity while maximizing cure rates in children, adolescents, and young adults with HL.

Liver transplantation for patients with hepatocellular carcinoma (HCC) within the Milan criteria generally yields a 4-year overall survival rate of 75% and 4-year recurrence free survival rate of 83%. But, many HCC patients present with the disease beyond the Milan criteria. On the other hands, the overall survival of patients with advanced HCC with portal vein invasion is very poor. We report a case of successful living donor liver transplantation for advanced HCC with portal vein invasion by down-staging through radioembolization, hepatic arterial infusion chemotherapy, and stereotactic body radiation therapy.
Carcinoma, Hepatocellular* ; Drug Therapy* ; Hand ; Humans ; Liver Neoplasms ; Liver Transplantation* ; Liver* ; Living Donors* ; Portal Vein ; Recurrence ; Survival Rate

This study investigated effect of extract containing quercetin-3-O-beta-D-glucuronopyranoside from Rumex Aquaticus Herba (ECQ) against chronic gastritis in rats. To produce chronic gastritis, the animals received a daily intra-gastric administration of 0.1 ml of 0.15% iodoacetamide (IA) solution for 7 days. Daily exposure of the gastric mucosa to IA induced both gastric lesions and significant reductions of body weight and food and water intake. These reductions recovered with treatment with ECQ for 7 days. ECQ significantly inhibited the elevation of the malondialdehyde levels and myeloperoxidase activity, which were used as indices of lipid peroxidation and neutrophil infiltration. ECQ recovered the level of glutathione, activity of superoxide dismutase (SOD), and expression of SOD-2. The increased levels of total NO concentration and iNOS expression in the IA-induced chronic gastritis were significantly reduced by treatment with ECQ. These results suggest that the ECQ has a therapeutic effect on chronic gastritis in rats by inhibitory actions on neutrophil infiltration, lipid peroxidation and various steps of reactive oxygen species (ROS) generation.
Animals ; Body Weight ; Drinking ; Gastric Mucosa ; Gastritis* ; Glutathione ; Iodoacetamide* ; Lipid Peroxidation ; Malondialdehyde ; Neutrophil Infiltration ; Peroxidase ; Quercetin* ; Rats* ; Reactive Oxygen Species ; Rumex ; Superoxide Dismutase

PURPOSE: There were experimental evidences supporting that intrarenal activation of the renin-angiotensin system contributes to increase BP, proteinuria and urinary angiotensinogen (UAGT) excretion. The purpose of this prospective, open label, controlled study was to investigate the effect of losartan on proteinuria and UAGT excretion in chronic non-diabetic proteinuric (0.4 to 2.0 g/day) renal disease with normal renal function (glomerular filtration rate, GFR>60 mL/min/1.73m2). METHODS: Thirty two patients were randomly allocated to the losartan group (100 mg/day; n=17) or the control group (n=15). Systolic BP, diastolic BP, estimated GFR, urinary protein to creatinine ratio (UP/Cr), UAGT and plasma angiotensinogen (PAGT) level were compared between two groups at baseline, 6 months and 12 months. RESULTS: UP/Cr (1.13+/-0.36 g/g vs. 1.07+/-0.34 g/g) was similar in two groups at baseline. Target BP (<140/90 mmHg) was maintained in both groups. After 6 months, UP/Cr (0.63+/-0.35 g/g vs. 0.97+/-0.41 g/g, p<0.01) was significantly decreased in the losartan group compared to the control group. In addition, UAGT (baseline 1.0) was noticeably suppressed in the losartan group (0.72+/-0.42 vs. 1.07+/-0.81, p=0.13). However, PAGT was not changed in both groups. Moreover, our study at 12 months period has demonstrated continuous suppression of UP/Cr (0.79+/-0.53 g/g vs. 1.00+/-0.50 g/g, p=0.06) and UAGT (0.60+/-0.51 vs. 1.51+/-1.36, p<0.05) in the losartan group. UP/Cr was highly correlated with UAGT (Correlation Coefficient=0.74, p<0.01), but not with PAGT. CONCLUSION: Losartan not only induced a remarkable decrease in proteinuria but also contributed a reduction in UAGT in patients with chronic non-diabetic proteinuric renal disease.
Angiotensinogen ; Creatinine ; Filtration ; Humans ; Losartan ; Plasma ; Prospective Studies ; Proteinuria ; Renin-Angiotensin System

In 2006, we find 7 new cases and one relapse case, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. In new cases, the mean age is 59.3, mean BI is 3.3+, mean O.D. of PGL-I antibody is 0.941, numbers of TTC repeat are 13(3 cases), 11(2 case), 12(1 cases), and 31(1 case), and of GACATC repeats are 4(5 Koreans) and 3(2 foreigners). In relapse case, a 45 years-old male patient is revealed that BI is 5+, O.D. of PGL-I antibody is 1.096, numbers of TTC repeat are 12 and GACATC repeats are 4.
Biopsy ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lepromin ; Leprosy ; Male ; Middle Aged ; Recurrence ; Skin

PURPOSE: The prevalence of coronary artery disease and left ventricular hypertrophy (LVH) is higher in patients with chronic kidney disease (CKD) than in the general population. In the general population, BNP, NT-proBNP, and cTnT are useful markers of cardiac disease. Recently, studies on biomarkers in patients with CKD have been reported. However, the effect of renal disease on these markers is still uncertain particularly in hemodialysis patients. We investigated the potential of BNP, NT-proBNP, and cTnT as biomarkers of cardiac disease in hemodialysis patients. Methods: We prospectively studied 27 hemodialysis patients without cardiovascular event within the last 6 months. We performed an echocardiography and blood samples for plasma BNP, NT-proBNP and cTnT. RESULTS: Median BNP, NT-proBNP, and cTnT level (pg/mL) were 433, 10,598, and 0.021, respectively. NT-proBNP was correlated with BNP (r=0.940, p=0.000) and cTnT (r=0.504, p=0.009). There was a negative correlation between BNP and left ventricular ejection fraction (LVEF) (r=-0.502, p=0.008), between NT-proBNP and LVEF (r=-0.556, p=0.003), and between cTnT and LVEF (r=-0.513, p=0.007). There was a positive correlation between BNP and LV mass index (LVMI) (g/m2) (r=0.619, p=0.001). Also, a positive correlation between NT-proBNP and LVMI was shown (r=0.718, p=0.000). There was an insignificant positive correlation between cTnT and LVMI (r=0.369, p=0.063). Albumin, cholesterol, LDL-cholesterol, and NT-proBNP had an independent effect on LVEF (R2=0.80). Age, body mass index, LDL-cholesterol, NT-proBNP, and cTnT had an independent effect on LVMI (R2=0.78). Conclusion: BNP, NT-proBNP, and cTnT may be as a noninvasive diagnostic or prognostic marker of cardiac disease in stable hemodialysis patients.
Biomarkers ; Body Mass Index ; Brain* ; Cholesterol ; Coronary Artery Disease ; Echocardiography ; Heart Diseases* ; Humans ; Hypertrophy, Left Ventricular ; Natriuretic Peptide, Brain* ; Natriuretic Peptides ; Plasma ; Prevalence ; Prospective Studies ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Stroke Volume ; Troponin T* ; Troponin*

PURPOSE: The combination of intravenous cyclophosphamide (CYC) and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Mycophenolate mofetil (MMF) Is a new immunosuppressive agent that selectively inhibits activated lymphocytes. This study reports on the clinical experiences at our clinic with MMF and intravenous CYC for the initial induction treatment in patients with lupus nephritis. METHODS: 50 patients with lupus nephritis received induction therapy consisting of MMF and prednisolone (n=22) or intravenous CYC and prednisolone (n=28), and followed up for six months. Complete remission was defined as a value for urinary protein: urinary creatinine ratio (U(p/Cr)) that was less than 0.3, with normal urinary sediment, a normal serum albumin concentration and values for serum creatinine that were no more than 15 percent above the base-line values. Partial remission was defined as a value for U(p/Cr) that was between 0.3 and 2.9, with a serum albumin concentration of at least 3.0 g/dL. RESULTS: 22 patients treated with MMF and 28 patients with intravenous CYC resulted in complete remission (31.8% vs 39.3%), partial remission (45.5% vs 39.3%) and treatment failure (22.7% vs 21.4 %). Fewer severe infections occurred among patients treated with MMF and prednisolone. CONCLUSION: As for the induction therapy of lupus nephritis, the combination of MMF and prednisolone may be an effective regimen. However, further randomized, prospective studies are needed to prove the effectiveness of MMF therapy in lupus nephritis.
Creatinine ; Cyclophosphamide* ; Humans ; Lupus Nephritis* ; Lymphocytes ; Prednisolone ; Serum Albumin ; Treatment Failure

PURPOSE: The significance of metabolic syndrome (MS) was recently raised as a risk factor in chronic kidney disease (CKD). Diabetes and hypertension are not only well known diagnostic criteria for MS, but also risk factors for CKD. However, the association between MS and CKD in patients without diabetes and hypertension is unknown. METHODS: A total of 9586 subjects who registered in the health check service at Samsung Medical Center between January 2004 and December 2005 were included. MS was defined according to the criteria of the revised ATP III, and CKD was defined by the reduction of the glomerular filtration rate or the appearance of albuminuria. RESULTS: The prevalence of MS was 9.0% of study subjects. CKD was noticed in 6.2% of the subjects without MS, and 13.1% with MS. MS was a significant determinant of CKD {Odd ratio (OR) 1.80 and 95% confidence interval (CI) 1.42-2.28, p<0.001}. Compared with subjects lacking components of MS, subjects with one, two, three, four or five components of MS had a higher risk of acquiring CKD (OR, 1.04, 1.43, 1.89, 2.48, 3.29, Respectably). The relationship between each component of MS and CKD was different according to sex and age groups. Abdominal obesity was a significant determinant for CKD in female subjects, while high fasting glucose levels were a significant determinant in younger subjects (<60 years) (p<0.05). CONCLUSION: Even in non-diabetic and non-hypertensive adults, MS is independently associated as a risk factor for CKD.
Adenosine Triphosphate ; Adult* ; Albuminuria ; Fasting ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Hypertension ; Metabolic Syndrome X ; Obesity, Abdominal ; Prevalence ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Risk Factors