악성 흑색종에서 18F-FDG PET의 임상 이용

18F-FDG PET showed a high sensitivity and specificity in the initial staging of malignant melanoma, and it also predicted the prognosis correctly. In addition, it had a higher sensitivity and specificity in the detection of recurrence and restaging than conventional imaging modalities. Meanwhile, there’s less clinical evidence to support the use of 18F-FDG PET in the response evaluation for chemotherapy and the diagnosis/differential diagnosis of malignant melanoma

유방암에서 18F-FDG PET의 임상 이용

18F-FDG PET in combination with conventional imaging modalities could help avoid unnecessary biopsy for the primary mass, and it also has a high diagnostic accuracy in patients with dense breasts. In the assessment of metastasis, 18F-FDG PET was useful to select patients who required sentinel lymph node biopsy and to detect extra-axillary lymph node metastasis and distant metastasis. To increase the sensitivity for osteoblastic bone metastasis, bone scintigraphy should be added. In the detection of recurrence, 18F-FDG PET showed a higher diagnostic accuracy than tumor marker or computed tomography, and therefore it can be used in routine breast cancer follow-up. 18F-FDG PET has been reported that it correctly predicted the response of neoadjuvant chemotherapy on as early as 8th day of treatment. Therefore, it is useful for the early detect of therapeutic response in advanced breast cancer

고환암에서 18F-FDG PET의 임상 이용

18F-FDG PET has a higher diagnostic accuracy than CT in initial staging of testicular cancer. In seminoma, it can discriminate residual tumor from necrosis/fibrosis or mature teratoma. 18F-FDG PET is also useful for the response evaluation of chemotherapy. However, there’s no clinical evidence for the use of 18F-FDG PET in the diagnosis and differential diagnosis of testicular cancer

비흑색종 피부암에서 18F-FDG PET의 임상 이용

Nonmelanomatous skin cancer includes basal cell carcinoma, squamous cell carcinoma, merkel cell carcinoma and dermatofibrosarcoma protuberance. So far, there have been a few reports that 18F-FDG PET was useful in the evaluation of metastasis and therapeutic response in nonmelanomatous skin cancer, however, those are very weak evidences. Therefore, further studies on the usefulness of 18F-FDG PET in nonmelanomatous skin cancer are required

간의 18F-Fluorodeoxyglucose 섭취 양상과 지방간의 관계

Purpose: Liver demonstrates heterogeneous FDG uptake and sometimes it shows abnormally increased uptake even though there is no malignant tissue. However, there was no previous study to correlate these various pattern of hepatic FDG uptake with benign liver disease. Therefore, we evaluated the significance of hepatic FDG uptake associated with various clinical factors including fatty liver, liver function tests and lipid profiles. Materials and Methods: We reviewed a total of 188 patients (male/female: 120/68, mean age: 50±9) who underwent PET/CT for screening of malignancy. Patients with DM, impaired glucose tolerance, previous severe hepatic disease or long-term medication history were excluded. The FDG uptake in liver was analyzed semi-quantitatively using ROI on transaxial images (segment 8) and we compared mean standardized uptake value (SUV) between fatty liver and non-fatty liver group. We also evaluated the correlation between hepatic FDG uptake and various clinical factors including serum liver function test (ALT, AST), γ-GT, total cholesterol and triglyceride concentration. The effect of alcoholic history and body mass index on hepatic FDG uptake was analyzed within the fatty liver patients. Results: The hepatic FDG uptake of fatty liver group was significantly higher than that of non-fatty liver group. Serum total cholesterol and triglyceride concentration showed significant correlation with hepatic FDG uptake. However, there was no significant correlation between other factors (ALT, AST, and γ-GT) and FDG uptake. Also there was no difference of mean SUV between normal and abnormal groups on the basis of alcoholic history and body mass index within fatty liver patients. Fatty liver and high serum triglyceride concentration were the independent factors affecting hepatic FDG uptake according to multivariate analysis. Conclusion: In conclusion, hepatic FDG uptake was strongly correlated with fatty liver and serum triglyceride concentration

POEMS syndrome에서의 18F-FDG PET/CT 소견

POEMS syndrome is a rare disorder, also known as Crow-Fukase, PEP or Takatsuki syndrome. The acronym, POEMS, represents polyneuropathy, organomegaly, endocrinopathy, M protein and skin change.1,2) However, there are associated features not included in the acronym such as sclerotic bone lesions, Castleman disease, papilledema, thromobocytosis, peripheral edema, ascites, effusion, polycythemia, fatigue and clubbing.1-5) In most cases, osseous lesions in POEMS syndrome present as an isolated sclerotic deposit and that reveal as osteosclerotic myeloma.6,7) Several cases of 18F-FDG PET in multiple myeloma involvements were reported,8) but there was no previous literature that reported FDG PET findings in POEMS syndrome. We describe here a 66-year-old patient with POEMS syndrome who underwent 18F-FDG PET/CT image

17세기 멕시코 누에바 갈리시아의 유명 일본인

식민시대의 멕시코 역사를 다루면서 대부분의 텍스트는 고대 테노치티틀란 자리에 건설한 멕시코시티를 수도로 삼은 누에바 에스파냐 부왕령에 중점을 둘 뿐, 중앙정부와 독립적으로 발전한 다른 중요 지역들에 대해서는 별로 관심을 두지 않는다. 누에바 갈리시아 왕국은 누에바 에스파냐 내에 단 두 개밖에 없는 독립 왕국으로서 아래 지도에서도 볼 수 있듯이, 오늘날의 할리스코, 나야릿, 콜리마, 아구아스칼리엔테스, 사카테카스 등의 주(州)로 구성된 멕시코 서부 지역을 차지하고 있었다. 수도는 처음에는 콤포스텔라였다가 훗날 과달라하라로 바뀌었다

부비동 병변에 의하여 유발된 일측성 시력 소실 3예

Three cases of unilateral visual loss caused by sinus lesion were encountered and we report three cases with literature review. Sinus inflammatory disease like sinusitis or mucocele is a common disease, but visual loss complicated by which is rare. It can be fatal and is known to have a poor prognosis. Appropriate and prompt management like intravenous antibiotics and surgical drainage must be done, when a patient is suspected of having visual loss by sinus problem. We report a case of unilateral visual loss caused by sinusitis, two cases by mucocele. The clinical courses and possible management are discussed

난소 과립막 세포종의 임상병리학적 특징의 고찰

Objective：The purpose of this study was evaluate the clinicopathologic prognostic factors of granulosa cell tumors (GCTs) of the ovary. Methods：We reviewed the medical records retrospectively of 15 patients of GCT who confirmed GCT pathologically after surgery from June, 1994 to December, 2006. Initial symptom, age, size of tumors, FIGO stage, treamtment modality and mitotic index were investigated from medical records. Results：The median age of the patients were 47 (range 22-78). Distribution of patients by FIGO stage were stage I 80% (12/15), stage III 20% (3/15). Complete surgical staging was performed in 5 patients. Other patients were performed total abdominal hysterectomy with bilateral or unilateral salpingo-ophorectomy, bilateral or unilateral salpingo-ophorectomy 5 patients were given adjuvant chemotherapy. Recurrence were founded in 3 patients. Two patients were FIGO sage III and one was stage I with large tumor size. The mitotic index was 13, 11 and one patients was not described about that. Eight year survial rate of all patients was 62.5%. Conclusion：There was recurrence in high FIGO stage. Mitotic index was related with FIGO stage. Mitotic index and tumor size are the probable prognostic factors and need to study the relationship with recurrence in stage I

사지 운동성 행위상실증을 주소로 내원한 전두측두엽 치매 환자 1예

A 59-yr-old, right-handed woman developed bilateral clumsiness of the hands and dysarthria 6 months prior to admission. A detailed neurologic evaluation showed limb-kinetic apraxia with frontal lobe dysfunction. Brain MRI showed significant anterior temporal lobar atrophy. Brain PET revealed bilateral decreases in glucose metabolism around the motor cortices and temporal lobes, predominantly on the right side. This case suggests that limb-kinetic apraxia is a presenting symptom of frontotemporal dementia