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Lee MH, Ham H, Choi HW, Park DS. Isolation of Streptomycin-Resistant Erwinia pyrifoliae in Korea. Plant Dis 2023; 107:616-619. [PMID: 35852904 DOI: 10.1094/pdis-03-22-0553-sc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As a black shoot blight disease-causing agent, Erwinia pyrifoliae was first reported in 1995 in Korea. A total of 101 isolates of E. pyrifoliae were isolated from samples showing bacterial symptoms collected from apple and pear orchards between 2020 and 2021. These isolates were screened for streptomycin resistance, with one from an orchard in Gwangju showing resistance at 100 μg/ml streptomycin. This streptomycin-resistant E. pyrifoliae (EpSmR) isolate was identified via polymerase chain reaction amplification of the strA/strB gene and an internal region of the ribosomal rpsL gene containing codon 43. EpSmR has a point mutation that altered this codon from lysine (AAA) to threonine (ACA). The strA and strB genes were not identified in EpSmR. EpSmR showed a high resistance to streptomycin (>50,000 μg/ml). This is the first study reporting EpSmR, which emerged due to a mutation in codon 43 of the rpsL gene.
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Affiliation(s)
- M-H Lee
- Crop Protection Division, National Institute of Agricultural Sciences, Wanju 55365, Republic of Korea
| | - H Ham
- Crop Protection Division, National Institute of Agricultural Sciences, Wanju 55365, Republic of Korea
| | - H-W Choi
- Crop Protection Division, National Institute of Agricultural Sciences, Wanju 55365, Republic of Korea
| | - D S Park
- Crop Protection Division, National Institute of Agricultural Sciences, Wanju 55365, Republic of Korea
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Ham H, An SM, Lee EJ, Lee E, Kim HO, Koh JS. Itching sensation and neuronal sensitivity of the skin. Skin Res Technol 2015; 22:104-7. [DOI: 10.1111/srt.12236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 11/27/2022]
Affiliation(s)
- H. Ham
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
| | - S. M. An
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
| | - E. J. Lee
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
| | - E. Lee
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
| | - H. O. Kim
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
| | - J. S. Koh
- Skin Research Center/DERMAPRO Ltd.; Seoul Korea
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An SM, Ham H, Choi EJ, Shin MK, An SS, Kim HO, Koh JS. Primary irritation index and safety zone of cosmetics: retrospective analysis of skin patch tests in 7440 Korean women during 12 years. Int J Cosmet Sci 2013; 36:62-7. [PMID: 24117720 DOI: 10.1111/ics.12095] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/15/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cosmetics are products used over long periods by the public, and their safety is very important. Several types of human tests are used widely for the evaluation of cosmetics including single patch tests, in-use tests, human repeated insult patch test (HRIPT). However, there is no clear and well-defined published objective and standardized criteria for primary skin irritation in regard to the large variety of cosmetic products. METHODS This study analysed human patch tests conducted from May 2001 to December 2012 with 4606 materials of prototype or finished cosmetic products on 7440 normal Korean women aged 18-60 years. The tested products were patched under occlusion for 24 or 48 h, and skin tolerance was assessed twice at 30 min and 24 h after patch removal using a 5-step scale according to the CTFA guidelines. RESULTS Human patch tests for cosmetics were performed of 4606 cases, and 30-33 subjects participated in each case. The response in each case was calculated based on total subject number, skin reaction intensity and the number of respondents. The calculated response was standardized using the z-score, and a safety zone was provided in terms of human primary irritation in accordance with the human skin reaction evaluation criteria and usage or formula of cosmetics. CONCLUSIONS This study established the safety criteria for irritation in the cosmetics field.
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Affiliation(s)
- S M An
- Dermapro Skin Research Center, DERMAPRO LTD, 4F Jiho B/D, Bangbaejoongang-Ro 30, Seocho-Gu, Seoul, South Korea
| | - H Ham
- Dermapro Skin Research Center, DERMAPRO LTD, 4F Jiho B/D, Bangbaejoongang-Ro 30, Seocho-Gu, Seoul, South Korea
| | - E J Choi
- Dermapro Skin Research Center, DERMAPRO LTD, 4F Jiho B/D, Bangbaejoongang-Ro 30, Seocho-Gu, Seoul, South Korea
| | - M K Shin
- Dermapro Skin Research Center, DERMAPRO LTD, 4F Jiho B/D, Bangbaejoongang-Ro 30, Seocho-Gu, Seoul, South Korea.,Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - S S An
- Amorepacific R&D Center, 314-1, Bora-dong, Giheung-gu, Yongin-si, Gyeonggi-do, South Korea
| | - H O Kim
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University Seoul, South Korea
| | - J S Koh
- Dermapro Skin Research Center, DERMAPRO LTD, 4F Jiho B/D, Bangbaejoongang-Ro 30, Seocho-Gu, Seoul, South Korea
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Kim I, Ryu C, Choi I, Ham H, Shin E. Operation of a child injury prevention program in connection with local medical institutes: Safety Doctor. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Smeets P, Ham H, Ceelen W, Boterberg T, Verstraete K, Goethals I. Differentiation between peri-anastomotic inflammatory changes and local recurrence following neoadjuvant radiochemotherapy surgery for colorectal cancer using visual and semiquantitative analysis of PET-CT data. Q J Nucl Med Mol Imaging 2010; 54:327-332. [PMID: 20639817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM The aim of this study was to evaluate the usefulness of visual and semiquantitative [¹⁸F]fluorodeoxy-glucose (FDG) positron emission tomography-computed tomography (PET-CT) data for the diagnosis of peri-anastomotic colorectal cancer recurrence, taking into account the time period between surgery and [¹⁸F]FDG PET-CT scanning. METHODS The study population consisted of 70 patients who had prior preoperative radiochemotherapy and surgical resection of the primary tumor and who underwent whole body [¹⁸F]FDG PET-CT scanning for the detection of recurrent disease. Visual and semiquantitative (SUV(max)) analysis of [¹⁸F]FDG uptake at the peri-anastomosis was performed. The final diagnosis was based on pathological proof or clinical and/or imaging follow-up data. RESULTS On visual reading, 27 patients exhibited increased [¹⁸F]FDG uptake at the peri-anastomosis. Of these, 11 (41%) patients had a local tumor recurrence and 16 (59%) had no recurrent tumor. Among the 43 patients without increased [¹⁸F]FDG uptake at the peri-anastomosis, none had local tumor recurrence. On semiquantitation, SUV(max) in patients with and without a local recurrence overlapped. However, when the time period between surgery and [¹⁸F]FDG PET-CT scanning was taken into account, overlap of SUV(max) was mainly observed within a postoperative period of ≤12 months; thereafter, a threshold SUV(max) of 3.2 discriminated between benign and malignant lesions in all but one patient. CONCLUSION In our series, visually increased [¹⁸F]FDG uptake at the peri-anastomosis was 100% sensitive but non-specific (73% specificity) for the diagnosis of local tumor recurrence. On the other hand, normal [¹⁸F]FDG uptake at the peri-anastomosis precluded a local tumor recurrence (a negative predictive value of 100%). In addition, semiquantitative (SUV(max)) analysis of [¹⁸F]FDG uptake at the peri-anastomosis may increase specificity (up to 97%), while preserving maximum sensitivity, if the postoperative period is >12 months.
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Affiliation(s)
- P Smeets
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
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Kim H, Keam B, Im S, Ham H, Han S, Oh D, Han W, Kim T, Noh D, Bang Y. MDR1/ABCB1 single nucleotide polymorphism (SNP) as a possible prognostic factor in breast cancer patients receiving docetaxel and doxorubicin neoadjuvant chemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Goethals I, Ham H, Dobbeleir A, Santens P, D'Asseler Y. The potential value of a pictorial atlas for aid in the visual diagnosis of 123I FP-CIT SPECT scans. Nuklearmedizin 2009; 48:173-8. [PMID: 19488462 DOI: 10.3413/nukmed-0230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 05/05/2009] [Indexed: 11/20/2022]
Abstract
UNLABELLED The aim of our study was to evaluate the value of a pictorial atlas of 123I FP-CIT SPECT images for aid in the visual diagnosis. PATIENTS, MATERIALS, METHODS Sixty patients, of whom 20 were clinically diagnosed as 'non-parkinsonian' and 40 as having Parkinson's disease or any related disorder, were included in the study. An atlas consisting of 12 123I FP-CIT SPECT images was constructed first. Validity of the atlas was investigated by performing a receiver operating characteristic (ROC) analysis with the clinical diagnosis as the gold standard. The remaining 48 SPECT images were visually assessed twice by 5 observers, first with and secondly without consulting the atlas, or vice versa. The added value of the atlas was investigated by comparing the diagnostic accuracy and the interobserver variability for both methods. RESULTS ROC analysis performed on the atlas yielded an area under the curve of 1 for a threshold discriminating between clinically non-parkinsonian and parkinsonian patients that was situated between image 4 and 5 of the atlas. For the diagnostic accuracy, we found that the area under the ROC curve was systematically higher if observers had access to the atlas compared to when they had not (Wilcoxon's test, p<0.05). Also, the interobserver variability was significantly lower when observers used the atlas when compared to when they did not (p = 0.05). CONCLUSION Diagnostic accuracy was significantly higher and interobserver variability significantly lower if observers had access to the atlas compared to when they had not. Hence, having a pictorial atlas available may facilitate the visual assessment of 123I FP-CIT SPECT scans.
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Affiliation(s)
- I Goethals
- Department of Nuclear Medicine, Ghent University Hospital, Gent, Belgium.
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Keam B, Kim H, Im S, Ham H, Han S, Cho E, Lee J, Oh D, Kim T, Bang Y. Comprehensive analysis of ERCC, XPD, and XRCC polymorphisms: Association with clinical outcomes in patients with advanced gastric cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4649 Background: Platinum-DNA adducts are repaired by nucleotide excision repair (NER) pathway, in which genes of the excision repair cross-complementation 1 (ERCC1), xeroderma pigmentosum group D (XPD) and X-ray repair cross-complementing group (XRCC) have an important role. The purpose of this study was to investigate the relationship between single nucleotide polymorphisms (SNPs) of these genes and the clinical outcomes to combination chemotherapy of 5-FU and oxaliplatin in advanced gastric cancer (AGC). Methods: We searched SNPs of NER pathway genes from database of the International Hapmap Project. Tagging SNPs and halpotype blocks were founded by linakage disequilibrium and haplotype analysis. Whole blood samples were obtained from the patients before chemotherapy. DNA was extracted from the peripheral blood mononuclear cells and the genotyping was performed by SNaPshot methods. Seventy three metastatic or relapsed AGC patients received modified FOLFOX-6 as a first-line palliative chemotherapy and were analyzed. Results: By searching the database of the International Hapmap Project, we found 17 SNPs in ERCC, 69 SNPs in XPD, 78 SNPs in XRCC. We found that some SNPs played a role as a tagging SNP and belonged to haplotype block (5 tapping SNPs and one haplotype block in ERCC, 8 tapping SNPs and two haplotype blocks in XPD, 9 tapping SNPs and two haplotype block in XRCC). Tagging SNPs were analyzed and matched with clinical significance. Among the 22 tagging SNPs of NER pathway genes, only XPD-C156A SNP (rs238406) showed clinical correlation. AA genotype of XPD C156A showed higher response rate (CC: CA: AA= 29.2%: 43.3%: 63.2%, p=0.083) and toxicities (neutropenia of grade 3 or 4) (CC: CA: AA= 4.3%: 3.2%: 21.1%, p=0.060) than CC or CA genotypes. Conclusions: Our results suggest that some SNPs of ERCC, XPD and XRCC showed linkage disequilibrium and belonged to haplotype blocks. And XPD-C156A SNP showed clinical correlation in AGC patients treated with modified FOLFOX-6 regimen. These findings require independent prospective confirmation. [Table: see text]
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Affiliation(s)
- B. Keam
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - H. Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - S. Im
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - H. Ham
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - S. Han
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - E. Cho
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - J. Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - D. Oh
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - T. Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
| | - Y. Bang
- Seoul National University Hospital, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; DNA Link Inc, Seoul, Republic of Korea
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Piepsz A, Tondeur M, Ham H. Revisiting normal 51Cr-ethylenediaminetetraacetic acid clearance values in children. Eur J Nucl Med Mol Imaging 2006; 33:1477-82. [PMID: 16865393 DOI: 10.1007/s00259-006-0179-2] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2006] [Accepted: 05/23/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE Normal (51)Cr-ethylenediaminetetraacetic acid (EDTA) clearance values as a function of age were published a number of years ago. These values were based on data from children with a normal left to right ratio and a normal appearance on DMSA scintigraphy, despite the presence of an acute renal infection. At that time, the authors were unaware that hyperfiltration is a common phenomenon in patients with acute renal infection and that their normal values could have been significantly overestimated. The present work therefore aimed to re-appraise these normal values. METHODS In a first step, in order to verify the previous results, the same type of population was selected, namely patients with present or past urinary tract infection but normal images and a normal left to right ratio on DMSA scintigraphy. In a second step, the selection was based on patients who had had no recent urinary tract infection. In both series, a single blood sample method was used for the evaluation of (51)Cr-EDTA clearance. RESULTS In the first group of patients, the results obtained were almost identical to those previously published. In the second group of patients, the results were significantly lower: after 2 years of age, the mean GFR value was 104 ml/min/1.73 m(2) (10th and 90th percentiles 81 and 135 ml/min/1.73 m(2), respectively), compared with 117 ml/min/1.73 m(2) in the first group. CONCLUSION The data of the second group are probably more representative of the true normal GFR values and can be applied to the entire paediatric population.
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Affiliation(s)
- A Piepsz
- CHU St Pierre, Department of Radioisotopes, Brussels, Belgium.
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10
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Abstract
OBJECTIVE A drop of split renal function often constitutes a criterion for pyeloplasty in hydronephrosis since it is considered as representing deterioration of the affected kidney. The aim of this work was to determine, in a selected population of patients with a drop of split function of at least 5%, if the evolution of single kidney glomerular filtration rate (SKGFR) was parallel to the one of split renal function. METHODS From a large data basis, we found retrospectively only 29 children (10 below and 19 above two years of age at first examination) having had at least two Tc-99m mertiatide (Tc-99m MAG3) renographic explorations for various urological diseases, with a decrease of split function of at least 5% between the two examinations. Evolution of split function was compared to evolution of SKGFR obtained by means of the combination of Tc-99m MAG3 split function and overall glomerular filtration rate as given by the chromium Cr 51 ethylenediamine tetraacetic acid (EDTA) clearance. RESULTS For the group above two years of age, SKGFR increased or remained stable in 63% of the cases, while in the children less than 2 years of age, a decrease of SKGFR was never observed, according to the maturation of overall GFR in this age group. Thus, the decrease of split function was not necessarily associated with a similar decrease of SKGFR. CONCLUSION In patients with unilateral or bilateral urological disorders, deterioration of split renal function does not necessary correspond to a loss of function of the affected kidney. SKGFR often modifies the interpretation of split function.
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Affiliation(s)
- A Piepsz
- Department of Radioisotopes, University Hospital Saint-Pierre, 322 rue Haute, B-1000 Brussels, Belgium.
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Jacobs F, Thierens H, Piepsz A, Bacher K, Van de Wiele C, Ham H, Dierckx RA. Optimised tracer-dependent dosage cards to obtain weight-independent effective doses. Eur J Nucl Med Mol Imaging 2004; 32:581-8. [PMID: 15619101 DOI: 10.1007/s00259-004-1708-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Accepted: 09/23/2004] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was twofold: firstly, to determine whether the European Association of Nuclear Medicine (EANM) dosage card results in weight-independent effective doses or weight-independent count rates; secondly, to determine whether one dosage card is sufficient for 95 different radiopharmaceuticals, and, if not, how many cards we reasonably need to take into account inter-tracer variability. METHODS Normalisation factors for count rate and effective dose were calculated as a function of body weight, with 70 kg as standard. Calculations were performed, using whole-body absorption fractions and MIRDOSE 3 software, for seven anthropomorphic phantoms and ten radionuclides. An analytic function for both relations was proposed. Normalisation factors for effective dose for 95 radiopharmaceuticals were investigated using cluster analysis. RESULTS Normalisation factors for count rate and effective dose can be estimated accurately as a function of body weight W by (W/70)a holding only one parameter, called the a value. The a values for 95 radiopharmaceuticals were classified into three clusters (nA=7, nB=76, nC=12). Cluster A contains tracers for renal studies. Cluster B contains all remaining tracers, except iodine-labelled tracers for thyroid studies and 89Sr for therapy, which belong to cluster C. CONCLUSION Correction factors proposed by the EANM task group mainly correct for effective dose. They are very similar to the factors obtained for cluster A. Using the EANM factors for tracers belonging to clusters B and C results in significantly higher effective doses to children. We suggest using three tracer-dependent dosage cards for which the correction factors have been calculated to obtain weight-independent effective doses.
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Affiliation(s)
- F Jacobs
- Department of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Gent, Belgium.
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Jacobs F, Koole M, Goethals I, Van de Wiele C, Ham H, Dierckx R. Registration accuracy of 153Gd transmission images of the brain. Eur J Nucl Med Mol Imaging 2004; 31:1495-9. [PMID: 15241630 DOI: 10.1007/s00259-004-1599-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 05/10/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the study was to determine the accuracy of non-rigid nine-parameter image registrations based on 153Gd transmission computed tomography (TCT) images as compared with those based on 99mTc-ethyl cysteinate dimer (ECD) images and to assess whether normalised mutual information (NMI) or count difference (CD) should be used. METHODS TCT and ECD data were acquired in 25 randomly selected patients. Emission images were registered to an ECD template with a CD cost function. The same registration parameters were applied to the transmission images to create a TCT template. All TCT images were registered to the TCT template and the same registration parameters were applied to the ECD images. The procedure was repeated with NMI as cost function. Accuracy of both ECD-based and TCT-based registrations was assessed by comparing the normalisation parameter values and regional activities in the spatially normalised ECD images, using a mixed-model analysis of variance (ANOVA). Scheffe post hoc tests were performed. RESULTS No significant differences were found between ECD/CD, ECD/NMI and TCT/CD, suggesting that ECD registration can be done with either CD or NMI, and that TCT registration using CD is equally as accurate as ECD registration. The accuracy of TCT registration with NMI was lower, with discrepancies occurring in the frontal inferior region and the cerebellum. The analysis of normalisation parameters indicated that z-scaling is underestimated and yz-rotation overestimated with TCT/NMI registration. CONCLUSION We conclude that ECD registrations with CD or NMI are as accurate as TCT registrations with CD and that TCT registrations with NMI should be avoided.
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Affiliation(s)
- F Jacobs
- Department of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
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Abstract
The aim of this work was to compare the quality of renal drainage obtained with two well-described procedures of diuretic renography (F+20 and F0 tests). We selected 36 clinically stable children, aged 10 days to 17 years, with unilateral (25) or bilateral (11) hydronephrosis, in whom both F+20 and F0 tests were successively performed. In all cases, a late image (PM) was acquired after micturition and after changing the position of the patient. The following parameters were calculated: the time to the maximum of the basic renogram (Tmax); and the normalized residual activity (NORA) and output efficiency (OE) at the end of the 20 min renogram, at the end of the furosemide test (35 min) and on the PM image. In F+20, the renal drainage was better on the PM image than at the end of the diuretic renogram, whereas, in F0, the renal drainage was better on the PM image than at the end of the 20 min diuretic renogram. When comparing F0 and F+20, both OE and NORA parameters revealed slightly better drainage at the end of the 20 min F0 renogram than at the end of the 35 min F+20 diuretic renogram. The drainage obtained on the late post-voiding image was comparable for both F0 and F+20 tests. In conclusion, the quality of drainage obtained during the F+20 and F0 procedures can easily be compared using both OE and NORA. A very similar quality of drainage was reached for both procedures when considering only the PM image. This PM view remains mandatory irrespective of the timing of the furosemide injection and despite the use of tracers with a high extraction rate.
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Affiliation(s)
- G Donoso
- Department of Nuclear Medicine, Centre Hospitalo-Universitaire St Pierre, Brussels, Belgium
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14
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Abstract
The split renal function, obtained using Technetium 99m mercaptoacetyltriglycine renography, is currently considered as a robust, accurate and reproducible parameter, provided that it is calculated at a time when no escape of the tracer from the kidney has occurred. The question arises as to whether the simultaneous administration of furosemide with the tracer (F0 test) might accelerate the escape of the tracer, resulting in an underestimation of the split renal function. From a large database, we selected 36 clinically stable children in whom both F0 and F+20 (administration of furosemide 20 min after the tracer) diuretic renography had been performed. In all cases, the F+20 test preceded the F0 test. The mean interval between the two tests was 17 months. The split renal function was calculated on the basis of the 1-2 min background-corrected renal activity using the integral method, slope method and Rutland-Patlak plot. In order to evaluate the effect on the split renal function of an early escape of the tracer, the patients were analysed according to the T(max) value of the renogram for both the F0 and F+20 tests. For the F+20 test, all T(max) values were more than 3 min. For the F0 test, the T(max) value was more than 3 min in 53 kidneys and less than 3 min in 19 kidneys (unilateral in all 19 patients). For the F0 test, for the kidneys with a T(max) value of less than 3 min, there was a tendency to underestimate the split renal function, taking as reference the split renal function observed in the F+20 test. This observation, however, was only statistically significant for the slope method (P=0.03). There was a tendency for lower values with the Rutland-Patlak plot (P=0.07), but, for the integral method, no difference was observed (P=0.5). In conclusion, the simultaneous administration of furosemide with the tracer induces an early acceleration of renal transit. This should be taken into account when calculating the split renal function, for example by favouring the integral method.
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Affiliation(s)
- G Donoso
- Department of Nuclear Medicine, Centre Hospitalo-Universitaire St Pierre, Brussels, Belgium
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Ladrón De Guevara Hernández D, Ham H, Franken P, Piepsz A, Lobo Sotomayor G. [Methodological aspects related to the determination of the relative renal function using 99mTC MAG3]. Rev Esp Med Nucl 2002; 21:338-42. [PMID: 12236908 DOI: 10.1016/s0212-6982(02)72104-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED The aim of the study was to evaluate three different methods for calculating the split renal function in patients with only one functioning kidney, keeping in mind that the split function should be zero on the side of the non-functioning kidney. PATIENTS We retrospectively selected 28 99mTc MAG3 renograms performed in children, 12 with unilateral nephrectomy, 4 with unilateral agenesis and 12 with a non-functioning kidney. METHODS A renal and perirenal region of interest (ROI) were delineated around the functioning kidney. The ROIs around the empty kidney were drawn symmetrically to the contralateral side. The split renal function was calculated using three different methods, the integral method, the slope method and the Patlak-Rutland algorithm. RESULTS For the whole group of 28 kidneys as well as for the three categories of patients, the three methods provided a split function on the side of the non-functioning kidney close to the zero value, regardless of whether the empty kidney was the left or the right one. CONCLUSION We recommend the use of the integral method for the whole range of split renal function with 99mTc MAG3. No significant improvement was obtained by means of the more sophisticated Patlak-Rutland method.
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Affiliation(s)
- D Ladrón De Guevara Hernández
- Hospital San Juan de Dios, Unidad de Medicina Nuclear, Santiago, Chile. Akademisch Ziekenhuis, Free University of Brussels, Dept of Nuclear Medicine, Brussels, Belgium
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Abstract
Patients frequently ask the nuclear medicine physician or the radiologist for conclusions at completion of a diagnostic procedure. The present study tried to assess opinions from both patients and referring physicians. Answers from both parties were grossly discordant: most of the referring physicians thought patients should not be given results of a diagnostic procedure by the nuclearist or radiologist an approach most of the patients disagreed with. Deontological guidelines of the official Belgian association do not authorize nuclear medicine physicians nor radiologists to give the patients any result directly; according to our data, this rule should be adapted.
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Affiliation(s)
- M Tondeur
- CHU Saint Pierre Service des Radioisotopes Rue Haute 290, 1000 Bruxelles
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Levtchenko E, Lahy C, Levy J, Ham H, Piepsz A. Treatment of children with acute pyelonephritis: a prospective randomized study. Pediatr Nephrol 2001; 16:878-84. [PMID: 11685593 DOI: 10.1007/s004670100690] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2001] [Accepted: 07/01/2001] [Indexed: 10/27/2022]
Abstract
The aim of this study was to compare, in children with acute pyelonephritis, the efficacy of 7 days' (group A) and 3 days' (group B) intravenous antibiotics, both followed by an oral treatment. Children were randomized after 3 days of intravenous treatment. Technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy was performed within the first days after admission and repeated 6 months later. Total or partial persistence of renal abnormalities on the 6-month DMSA scintigraphy was used as the endpoint of the study. Among the 92 children included in the study, 87 were followed for at least 6 months (43 in group A and 44 in group B) and were eligible for analysis. Late DMSA was abnormal in 9 kidneys of group A and 12 kidneys of group B, representing respectively 24% and 44% of kidneys with abnormalities on the initial DMSA (difference statistically not significant). When the patients were stratified according to the delay of treatment, the percentage of patients with sequelae in group A was comparable, whether the delay was less or more than 1 week. In group B, the percentage of patients with sequelae was significantly higher (P<0.01) when the delay was more than 1 week.
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Affiliation(s)
- E Levtchenko
- Department of Pediatrics, AZ VUB, Brussels, Belgium
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20
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Abstract
The feasibility of deconvolution depends on many factors, but the technique cannot provide accurate results if the maximal transit time (MaxTT) is longer than the duration of the acquisition. This study evaluated whether, on the basis of a 20 min renogram, it is possible to predict in which cases the MaxTT will exceed 20 min. Renograms of various shapes were simulated by convolution of a plasma disappearance curve and various created retention functions with a mean transit time (MTT) ranging from 3 to 23 min. The values of MaxTT were then derived from the created curves and compared to three parameters of transit measured on the renograms: the time to reach the maximum of the curve (Tmax), the output efficiency at 20 min (OE20), and the normalized residual activity at 20 min (NORA20). The proportion of retention functions (n=390) with MaxTT>20 min increased with increasing Tmax (e.g. 9% for 6< or =Tmax<10 min, and 34% for 11< or =Tmax<15 min), increasing NORA20 (e.g. 20% for 1.4< or =NORA20<3.0, and 84% for 3.0< or =NORA20<5.0) and decreasing OE20 (19% for 50% <OE20< or =75%, and 76% for 25% <OE20< or =50%). Use of Tmax, OE20 and NORA20 doesn't allow the differentiation of cases with a MaxTT longer or shorter than 20 min. Deconvolution can paradoxically only be used in cases of normal transit.
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Affiliation(s)
- J D Kuyvenhoven
- Department of Nuclear Medicine, University Medical Centre, Utrecht, E02.222, PO Box 85500, 3508 GA Utrecht, the Netherlands.
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Abstract
OBJECTIVE To study how gynaecologist manage postmenopausal bleeding in women not using HRT. The impact on the physicians' attitude of risk factors for endometrial cancer and of the endometrial thickness was essentially accounted for. METHODS Two different case-types were defined by modifying the risk level of developing endometrial cancer. Also the level of endometrial thickness, assessed by ultrasound, was made to vary. In total four case-types were constructed. One case-type was sent at random to each Belgian gynaecologist (n=970). RESULTS Response rate: 55%. The proportion of physicians who would not investigate the patients' endometrium varied between 2% (high-risk patient with abnormal ultrasound) and 34% (low risk patient, normal ultrasound). Significant differences were observed in relation to the level of risk factors for endometrial cancer and in relation to endometrial thickness. No significant relationship was found between the choice of the method of endometrial investigation and the risk situation or the ultrasound result. CONCLUSIONS The attitude of Belgian gynaecologists towards postmenopausal bleeding is modified by the presence of risk factors and by the level of endometrium thickness. About one third of physicians would not further investigate the endometrium of a patient with a low risk profile and a normal endometrium as assessed by ultrasound.
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Affiliation(s)
- S Rozenberg
- Department of Obstetrics and Gynaecology, CHU St Pierre, Free University of Brussels (ULB), rue Haute 322, B-1000, Brussels, Belgium.
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Abstract
BACKGROUND While it is obvious that patients should be involved in the decision making process, questions arise as to whether it is feasible to inform them objectively. OBJECTIVE To assess the impact of the physician's opinion, on the choice of treatment, to the patient. SETTING We imagined a hypothetical case of a 55-years-old woman with a high risk of osteoporosis. Two patient information letters were written, containing valid scientific information, but reflecting two diverging physicians' opinions, giving the choice between two available medications for osteoporosis prevention: hormone replacement therapy (HRT) and a selective estrogen receptor modulator (SERM), raloxifene. SUBJECTS We submitted one of the letters (by lottery) to 58 nurses. They were asked to act as this potential patient, and to choose which treatment they preferred to have prescribed. RESULTS 23/30 women receiving the version favouring the use of HRT, preferred HRT, 26/28 receiving the version favouring SERM preferred this treatment (Chi-Square Pearson 37.3; P<0.001). CONCLUSION The content of the information provided and its wording have a great influence on the patients' decision.
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Affiliation(s)
- S Rozenberg
- Department of Obstetrics and Gynaecology, Free University of Brussels (ULB), Hospital St Pierre, rue Haute 322, B-1000 Brussels, Belgium.
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Abstract
BACKGROUND Observational and experimental data underscore the cardioprotective effects of hormone replacement therapy (HRT). On the other hand, the randomised trial available, the 'Heart and Estrogen/Progestin Replacement Study (HERS)', showed no reduced risk of coronary heart disease (CHD), using HRT. AIM Opinion survey on the effect of HRT on CHD risk. SETTING Identification of articles on the related topic using a Medline search. Written survey of the authors' opinion towards HRT in relation to CHD. RESULTS Thirty-seven of the 108 principal authors responded. Among them, respectively, 16 (43%) and seven (19%) found that HRT has favourable effects on primary and secondary prevention, two (5%) and five (14%) that it had no effect, none (0%) and four ( 11%) that it had an unfavourable effect, seven (19%) and nine (25%) that it had both favourable and unfavourable effects, and nine (25%) and ten (27%), thought that there are not enough data. Considering a risk modification superior to 20% as clinically relevant, then 57% thought that HRT has a beneficial effect of on primary prevention and 30% on secondary prevention, while none of the responders considered that HRT has unfavourable effects on primary prevention and only 2% on secondary prevention of CHD. CONCLUSION Despite the negative results of the HERS study, about one-half of the responders still think that HRT has a beneficial effect on primary prevention of CHD and almost one-third on secondary prevention.
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Affiliation(s)
- S Rozenberg
- Department of Obstetrics and Gynaecology, Free Universities of Brussels (ULB), St Peter Hospital, rue Haute 322, 1000 Brussels, Belgium.
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Abstract
BACKGROUND Age-adjusted mortality from lung cancer in American women has increased dramatically and has even exceeded breast cancer mortality. Gynaecologists, are often involved as primary actors in prevention strategies but may not be aware of this epidemic. This is especially true in Europe where, lung cancer mortality for women is three times lower than in the US. OBJECTIVE We aimed to investigate whether smoking data could explain the lower death rates found in Europe. METHOD Analysis of smoking and mortality data in different European countries. RESULTS European lung cancer mortality data shows a huge heterogeneity between countries (ranging from as low as 5/100,000 to 37/100,000). A strong correlation exists between the smoking prevalence in different countries, in women aged 55 years and more, and the mortality rates from lung cancer (R(2)=0.8; p<0.001). Smoking prevalence of younger women is much higher today than that of women over 55 years. CONCLUSION These data strongly suggest that the epidemic of lung cancer will explode in Europe during the next decades. Gynaecologists should be aware of this and spend the necessary time to inform women adequately about the dangers of smoking and help them to quit.
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Affiliation(s)
- S Rozenberg
- Interdisciplinary Group on Osteoporosis, Free Universities of Brussels (VUB-ULB), St. Peter Hospital, rue Haute 322, B-1000, Brussels, Belgium.
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Ladron De Guevara D, Franken P, De Sadeleer C, Ham H, Piepsz A. Interobserver reproducibility in reporting on 99mTc-DMSA scintigraphy for detection of late renal sequelae. J Nucl Med 2001; 42:564-6. [PMID: 11337542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
UNLABELLED This study was designed to evaluate the interobserver variability in reporting on 99mTc-dimercaptosuccinic acid (DMSA) scanning performed 6 mo after an acute episode of pyelonephritis for the detection of late renal sequelae. METHODS Forty-six children were selected, who had early and late DMSA studies for evaluation of acute pyelonephritic lesions as well as sequelae. Three observers reported independently and separately on the early and late DMSA scans and, in a second step, on the late scan in the presence of the early scan. Interobserver reproducibility was evaluated for the early DMSA scan, the late DMSA scan alone, and the late DMSA scan with the early scan for comparison. RESULTS Complete agreement between the three observers was reached in 75%, 78%, and 77% for the early DMSA scan, the late DMSA scan alone, and the late DMSA scan with the early scan for comparison, respectively. CONCLUSION Interobserver reproducibility was high and was comparable for both early and late DMSA scintigraphy.
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Rozenberg S, Ham H. The role of HRT in cardiovascular disease. Arch Intern Med 2001; 161:773-4. [PMID: 11231720 DOI: 10.1001/archinte.161.5.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Rozenberg S, Carly B, Liebens F, Ham H. Effect of screening programme on mortality from breast cancer. Women might not accept mammography if benefit is lower than is currently thought. BMJ 2000; 321:1527-8. [PMID: 11118188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Abstract
Output efficiency (OE) has been proposed as an objective tool for the estimation of renal emptying. The aim of this paper was to evaluate some factors that may affect the value of this parameter obtained by a 99Tcm MAG3 renogram. In 22 patients, the effect of different types of renal background correction was calculated. In 10 patients, simultaneous gamma camera renography and multiple blood sampling allowed the error of using a heart curve instead of a plasma curve to be evaluated. Finally, an evaluation was carried out on the effect of neglecting the change of plasma activity between the end of the furosemide acquisition and the post-micturition view obtained after repositioning of the patient on the gamma camera: 142 patients who had had multiple blood sampling were retrospectively selected for that purpose. It has been shown that all these factors may significantly affect the value of OE, particularly in cases with poor renal drainage. Unless standardization of the procedure is introduced for some of these factors, the cut-off levels for good, fair and poor drainage may vary between centres.
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Affiliation(s)
- A Piepsz
- Dept Radioisotopes, CHU St Pierre, Brussels, Belgium.
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Piepsz A, Ham H. Deconvolution analysis or renal outflow efficiency? J Nucl Med 2000; 41:1595-6. [PMID: 10994744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Abstract
Patients often ask for the results after a radioisotope procedure, which can make nuclear medicine physicians feel uncomfortable. In Belgium, nuclear medicine physicians are not supposed to disclose results directly to patients, but to send them to the referring physician. We undertook this work to determine the official rules and practical attitudes in other countries. An introductory letter and a questionnaire were sent to 103 eminent nuclear medicine specialists from 37 countries. Seventy responses (32 countries) were received. Official rules seemed to exist in only seven countries. Most of the respondents indicated that their attitude depended on the clinical situation and the results of the test. Many respondents emphasized that, while in some situations the results should be communicated directly to patients in order to initiate treatment rapidly, in other situations, such as cancer, the referring physician was better suited to disclose the results. The advantages and drawbacks of different attitudes are discussed. Practically and universally applicable rules are difficult to establish, but choosing one solution remains preferable to no standardized attitude at all. An official body, including the medical community, representatives of the population and legal experts, should define an official rule which should be widely communicated, stressing its advantages and drawbacks. In practice, all nuclear medicine physicians would have to do would be to stick to the rule.
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Affiliation(s)
- M Tondeur
- Service des Radioisotopes, CHU Saint-Pierre, Brussels, Belgium
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Rozenberg S, Ham H, Liebens F. Screening mammography in elderly women. Research on Breast Cancer in Older Women Consortium. JAMA 2000; 283:3203; author reply 3204. [PMID: 10866864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Rozenberg S, Twagirayezu P, Paesmans M, Ham H. Health perception by women who work in a medical environment. Maturitas 2000; 35:119-24. [PMID: 10924837 DOI: 10.1016/s0378-5122(00)00122-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A mail survey was sent to 1154 women working in a university hospital, to assess the perception of health and the uptake of prevention strategies in an optimal setting. A list of 13 diseases was submitted and the women were asked to list the five diseases they found to be the most important for a woman of their age. Breast cancer was ranked among the five most important diseases by 85% of the women and uterus cancer by 71.3%. Other diseases, which have a high occurrence and mortality, like myocardial infarction, colon- and lung cancer were only ranked by approximately 30% of them. A high uptake of medical follow-up was reported by the surveyed women; 89% of them had seen a general practitioner or a gynaecologist during the past 12 months. Among women aged 50 and over, 92% had had at least one mammography in the past. However, only 20% had ever had faecal occult blood testing. Even among women who benefit from superior conditions for medical follow-up, the awareness of some diseases is low. Campaigns to increase awareness should consider the prevalence of diseases, their mortality and morbidity and also their actual perception in the targeted population.
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Affiliation(s)
- S Rozenberg
- Department of Obstetrics and Gynaecology, Free University of Brussels (ULB), Hospital St. Pierre, Rue Haute 322, B-1000, Brussels, Belgium.
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Abstract
99Tcm-DMSA planar images of 49 randomly selected patients (10 adults, 39 children) were sent to 15 physicians at various centres in Belgium. They were asked to calculate, using their own routine program, the relative uptake (expressed as a percentage) of each kidney. The data were sent on disks formatted so that they could be read by all participants, using their own computer systems. For each scan, the inter-observer variability was expressed using the maximum difference and the standard deviation of left renal uptake. Left renal uptake measured by the 15 observers in the 49 patients was 29.0-72.0% (mean +/- s = 49.8 +/- 6.4%). The maximum differences in left renal uptake ranged between 1.7% and 12.0% (4.5 +/- 2.6%); however, the maximum difference did not exceed 8% in about 90% of the patients. The standard deviations of the individual left renal uptake were between 0.6 and 3.9 (1.3 +/- 0.8). The standard deviations were significantly higher in adults (mean standard deviation = 2.05) than in children (mean standard deviation = 1.12) (P < 0.001); this was probably related to the high background observed in three adults with severe renal impairment. Indeed there was a significant correlation (P < 0.001) between the standard deviation and both the signal-to-noise ratio and the degree of asymmetry between the right and left kidneys. The differences between right and left kidney uptake were systematically lower for some observers, suggesting an influence of the calculation programs.
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Affiliation(s)
- M Tondeur
- Department of Radioisotopes, Free Universities of Brussels (ULB-VUB), Belgium.
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Abstract
The aim of this study was to evaluate a simple parameter describing renal output, namely NORA (normalized residual activity). We first compared, in a simulated model, different parameters of transit to an ideal standard; we then compared, in a clinical study, NORA and output efficiency. 123I-hippurate, 99Tcm-DTPA and 99Tcm-MAG3 plasma curves, each with two levels of renal clearance, were convoluted by means of different types of simulated retention functions, with different mean transit times. On the reconstructed renograms, several parameters reflecting renal transit were determined and compared with mean transit time. In a second step, in 33 patients, we compared output efficiency and NORA (i.e. the residual renal activity), normalized by the renal activity at 2 min. These two parameters were calculated at the end of the renogram, at the end of the frusemide test and after the micturition phase. In the simulated model, both output efficiency and NORA were only slightly influenced by the level of overall renal function. In the clinical study, a good correlation was found between output efficiency and NORA, whatever part of the study considered (renogram, frusemide test, post-voiding image). NORA is a simple and reliable parameter that allows quantification of renal output; it is almost independent of the level of renal function and can be used whatever the timing of the frusemide injection.
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Affiliation(s)
- A Piepsz
- Department of Radioisotopes, Centre Hospitalier Universitaire St. Pierre, Brussels, Belgium
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Tondeur M, Ham H. [Should we give the examination results to the patients?]. Rev Med Brux 2000; 21:95-8. [PMID: 10829602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Immediately after medical imaging procedures, patients often ask for the results of their examination. Such a request is very uncomfortable for the physician performing the examination, who usually does not know the whole medical file, the psychological status of the patient, how he is informed about his illness, etc. By the means of a questionnaire we asked belgian nuclear medicine physicians about the frequency of such situations and about their practical attitude. 204 questionnaires were sent; we received 119 answers (58%) after a 6 weeks delay. In more than 85% of the cases, this situation occurs regularly, and more than 50% of the participating physicians encounter the problem in more than 20% of the cases. Less than 10% of the participating physicians never give any result to the patient asking for it, while more than 20% always give it. Most of the physicians takes into account the clinical situation of the patient. Unfortunately, the official guidelines do not help to clarify the situation. This work confirms that physicians who perform diagnostic procedures frequently encounter difficulties in patients information. It would be necessary that all people who are concerned by this problem collaborate in order to define a clear and accurate attitude which would be easily applicable in our daily clinical practice.
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Affiliation(s)
- M Tondeur
- Service des Radio-Isotopes, C.H.U. Saint-Pierre, U.L.B
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Rozenberg S, Liebens F, Ham H. Screening mammography re-evaluated. Lancet 2000; 355:751-2; author reply 752. [PMID: 10703827 DOI: 10.1016/s0140-6736(05)72160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Piepsz A, Ham H. [On what is renal clearance based]. Arch Pediatr 2000; 7:213-4. [PMID: 10701069 DOI: 10.1016/s0929-693x(00)88094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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De Sadeleer C, Tondeur M, Melis K, Van Espen MB, Verelst J, Ham H, Piepsz A. A multicenter trial on interobserver reproducibility in reporting on 99mTc-DMSA planar scintigraphy: a Belgian survey. J Nucl Med 2000; 41:23-6. [PMID: 10647601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
UNLABELLED Conflicting opinions have been expressed regarding reproducibility in 99mTc-dimercaptosuccinic acid (DMSA) planar renal image interpretation. The purpose of this investigation was to determine the level of interobserver variability among a large group of Belgian nuclear medicine physicians who evaluated a randomly selected series of DMSA planar scintigraphic examinations performed on children and adults. METHODS All Belgian nuclear medicine centers (n = 82) were invited to participate in a reproducibility study on 99mTc-DMSA scintigraphy. 99mTc-DMSA scans obtained on 10 adults and 40 children were randomly selected from the databases of 2 hospitals. Those participating in this investigation (65 centers = 79%) received a series of computer disks containing 50 99mTc-DMSA studies. To avoid potential problems related to unfamiliar display, the disks were formatted to be interpretable using the participants' own computer systems. Each participant was then free to use his or her usual display (hard copies, contrast enhancement, color scale, gray scale, and so forth). For each kidney, the observers had to choose between the following answers: normal, abnormal, equivocal, and lack of quality. RESULTS Forty-two responses were obtained from a wide variety of institutions and from observers with different levels of experience in interpreting 99mTc-DMSA scintigraphy. Altogether, the following data were obtained: 60.8% normal, 25.2% abnormal, 7.0% equivocal, and 3.2% lack of quality. The median percentage of agreement (overall reproducibility) for the 42 observers was 92%. When the results of all 42 observers were compared, the median agreements on normality and abnormality were 93.5% and 90.5%, respectively. In a small number (n = 4) of kidneys, reproducibility was poor and ranged from 51% to 70%. Except for 2 outliers, all observers had almost the same level of performance. CONCLUSION A large number of Belgian nuclear medicine physicians participated in evaluating a large randomly selected sample of 99mTc-DMSA studies, and excellent interobserver agreement was found.
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Affiliation(s)
- C De Sadeleer
- St. Pierre Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Piepsz A, Ham H. Estimation of differential renal function by means of 99mTc-MAG3: integral method or Rutland-Patlak plot? Eur J Nucl Med 1999; 26:1627-8. [PMID: 10638417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Piepsz A, Tondeur M, Ham H. Relative 99mTc-MAG3 renal uptake: reproducibility and accuracy. J Nucl Med 1999; 40:972-6. [PMID: 10452313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
UNLABELLED The aim of this study was to estimate the reproducibility and accuracy of 99mTc-mercaptoacetyltriglycine (MAG3) relative percentage uptake. METHODS Reproducibility was evaluated on healthy volunteers who were submitted twice to a 99mTc-MAG3 renographic study, which used different uptake algorithms, different background corrections and different time intervals. Accuracy was evaluated in a group of patients with symmetrical or asymmetrical relative renal function, who underwent both 99mTc-dimercaptosuccinic acid (DMSA) and 99mTc-MAG3 studies, using the DMSA relative percentage uptake as a reference. RESULTS AND CONCLUSION The methods that combined the best reproducibility and accuracy for estimating 99mTc-MAG3 left-to-right uptake ratio were the integral method, with subrenal or perirenal background correction, and the Patlak-Rutland plot. The use of the integral method without background correction introduced a systematic bias, whereas the slope method resulted in high variability. Therefore these methods cannot be recommended.
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Affiliation(s)
- A Piepsz
- Department of Radioisotopes, Centre Hospitalo-Universitaire Saint-Pierre Brussels, Belgium
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Rozenberg S, Lefever A, Kroll M, Vandromme J, Paesmans M, Ham H. Prescription attitudes among gynecologists towards two particular risk factors of osteoporosis: the patient's age and her bone mineral density. Maturitas 1999; 32:19-24. [PMID: 10423712 DOI: 10.1016/s0378-5122(99)00002-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The present report assesses, among Belgian gynecologists, the effect of age and bone mineral density on osteoporosis prescription strategy in postmenopausal women. METHODS Charts of postmenopausal women were summarized. We constructed cases by modifying some parameters. Ten years of age were added or subtracted to the real age of the patient. The bone mineral density (BMD) result was also modified (three levels: normal BMD, osteopenia, osteoporosis). A total of 612 cases were constructed. Twelve cases were sent out of these 612 files to every Belgian gynecologist (n = 1010). For each chart the gynecologists were asked whether they would treat the patient with HRT. They were also asked whether they would prescribe other therapies than HRT and if so, which ones. RESULTS The chance to have an osteoporosis prevention or treatment prescribed increased when BMD decreased (respectively 57.4% for normal BMD, 73.1% for osteopenia cases and 89.4% for osteoporosis cases; P < 0.001). HRT was the most frequently prescribed medication (67% of the cases), but its prescription rate does not reflect only osteoporosis prevention. Nevertheless, for similar cases with osteopenia, the HRT prescription rate increased by a factor 1.25 and for similar cases with osteoporosis, HRT prescription rate increased by a factor 1.39. Calcium was the 2nd most frequent prescribed regimen. It was prescribed in 17% of the cases. A 3.4-fold increase for osteopenia cases and 7.6-fold increase for osteoporosis cases was observed, compared to women with normal BMD. When calcium was prescribed, it was in association with HRT in 64% of the osteopenia cases and in 76% of osteoporosis cases. Other drugs were less often prescribed. For the "younger age group", that is, with a mean age of 55 years, a prescription rate of 82.9% for any osteoporosis regimen was reached, whereas in the age group that was 10 years older a 20% lower prescription rate was reached (62.6%, P < 0.001). This was mostly due to a decrease in HRT prescription. CONCLUSIONS Prescription of medication known to reduce osteoporosis occurred more often in cases with low BMD. In the older patients with osteoporosis, gynecologists prescribed HRT less frequently. This was not compensated by a higher prescription rate of other medication.
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Affiliation(s)
- S Rozenberg
- Interdisciplinary Group on Osteoporosis, Free Universities of Brussels (VUB-ULB), St Peter Hospital, Belgium
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Affiliation(s)
- M Tondeur
- Department of Radioisotopes, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
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Abstract
Campaigns to increase 'awareness' of osteoporosis have been organized. The aim of this study was to assess how Belgian women who benefit from superior conditions favoring 'awareness' perceive osteoporosis as being an important disease. A survey sent to the private home of all the women working in a university hospital in Brussels (n = 1154). From a list of 13 diseases the women were asked to rank, by order of importance, the five which they found to be the most important for a woman of their age. They were also asked about visits to physicians, and screening procedures. The response rate was 55.4%. A high uptake of medical visits and screening procedures was reported: 89% of the women had seen a general practitioner or a gynecologist and 81.6% had undergone at least one gynecologic examination during the previous year. Three times more women had ever undergone mammography than a bone mineral density (BMD) measurement. Overall, 18.1% reported having had a BMD measurement in the past. In women over 50 years, 61% reported having had a BMD measurement and 92.7% having had a mammogram. Osteoporosis was ranked among the five most important diseases by 19.4% of women before the age of 50 years and by 39.3% after that age, far behind breast cancer (respectively 86.3% and 77.7%) and uterine cancer (respectively 74.2% and 58.0%). Thus even among a population of women who benefit from superior conditions for information and screening, the perception of osteoporosis remains low, as does the uptake of osteoporosis screening.
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Affiliation(s)
- S Rozenberg
- Interdisciplinary Group on Osteoporosis, St Peter Hospital, Brussels, Belgium.
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Tondeur M, Ham H, Piepsz A. Regional stability of cerebral blood flow. J Nucl Med 1998; 39:216-7. [PMID: 9443765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Abstract
OBJECTIVE To assess the effects of age, bone mineral density, risk of cardiovascular disease, and of breast cancer on the prevalence of hormone replacement therapy (HRT) prescriptions. METHODS Seventeen charts of postmenopausal women were summarized. For each chart, we constructed 36 different cases by modifying the age (two levels), the bone mineral density (three levels), the cardiovascular risk (three levels), and the breast cancer risk (two levels). Twelve cases of these 612 files were sent to each Belgian gynecologist (n = 1010). RESULTS Overall, HRT was prescribed in 67% of the cases. It was prescribed in 54.6% of women who had a normal bone mass, 67.9% of women with a low bone mass, and 79.0% of those with osteoporosis (P < .001). The prescription rate was higher in younger women (mean +/- standard deviation 55 +/- 4 years) than in their peers who were 10 years older (79.3% versus 55.2%; p < .001). No significant variation was observed in relation to the cardiovascular risk profile or to breast cancer risk. CONCLUSION Osteoporosis is associated with an increased rate and older age with a decreased rate of HRT prescription, whereas no difference is observed in association with cardiovascular or breast cancer risk.
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Affiliation(s)
- S Rozenberg
- Interdisciplinary Group on Osteoporosis, St. Peter Hospital, Brussels, Belgium
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Cadiere GB, Himpens J, Rajan A, Muls V, Lemper JC, Bruyns J, Urbain D, Ham H. Laparoscopic Nissen fundoplication: laparoscopic dissection technique and results. Hepatogastroenterology 1997; 44:4-10. [PMID: 9058110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND/AIMS Proton Pump inhibitors and laparoscopic techniques have had a dramatic impact on the therapy of gastroesophageal reflux disease. These techniques have introduced new complications associated with the treatment. This study compares the results of a laparoscopic Nissen fundoplication with life-long proton pump inhibitor treatment. MATERIALS AND METHODS Between May 1991 and February 1996, 274 patients were treated by laparoscopic Nissen fundoplication (LNF). Two hundred twenty-four patients were included in this prospective study. Thirteen patients presented stage V esophagitis (Barrett); 4 had esophagitis stage IV; 16 had stage III, 181 had stage II and 11 had stage I. Five trocars were needed for the operation. After mobilization of the greater curvature, a fundic wrap of 5 cm was created and fixed on the esophagus. RESULTS Median operating time was 60 min (39-300). There were 5 perioperative complications (a gastric perforation, three pleural perforations, and one liver laceration treated by coagulation). Three conversions to laparotomy were necessary. There were 4 early complications: two pulmonary infections and two re-operations; one case of wrap necrosis with peritonitis, and one case of small bowel perforation. Gastroscopy was performed in 133 cases. The esophagus was normal in 121 cases, an esophagitis stage I was present in 9, esophagitis stage II in 2, esophagitis stage III in one. Median lower esophageal sphincter pressure was 10 mmHg (2.9-30) preoperatively and 19 mmHg (9-40) post-operatively. Median reflux time was 10% (0-65) preoperatively and 1% (0-38) post-operatively. One hundred fifty-four patients were interviewed with a median follow up of 30 months (1-58). One hundred thirty patients were Visick I, 11 Visick II, 8 Visick III and 5 patients needed re-operation; three reoperations because of dysphagia, 1 because of epigastric pain and 1 for heartburn recurrence. CONCLUSIONS From these results, we conclude that LNF seems to be an attractive alternative to long term medical treatment.
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Affiliation(s)
- G B Cadiere
- Department of Gastro-Intestinal Surgery, C.H.U. Saint-Pierre, Brussels, Belgium
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