Journal of Yeungnam Medical Science

Ihn Ho Cho

13 Articles

Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease.: Ihn Ho Cho, Eun Jung Kong; Yeungnam Univ J Med. 2009;26(1):15-23. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.15

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Abstract PDF: Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can be done using single photon emission computed tomography(SPECT) or positron emission tomography(PET) and multidetector CT(MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronary lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate developmnt of a comprehensive non-invasive assessment of coronary artery disease.

The Role of Dynamic CT for the Differential Diagnosis of Solitary Pulmonary Nodule.: Jin Hong Chung, Won Jong Park, Ihn Ho Cho; Yeungnam Univ J Med. 2008;25(2):102-107. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.102

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Abstract PDF: BACKGROUND
Malignant pulmonary nodules account for 30 to 40 percent of all solitary pulmonary nodules (SPNs). Therefore, characterization of SPNs is very important for treatment. Recently, dynamic CT has been widely used for tissue characterization and formation of differential diagnoses. The purpose of this study was to evaluate the ability of dynamic CT to formulate the differential diagnosis of SPNs. MATERIALS AND METHODS: Nineteen patients with SPNs underwent dynamic CT (unenhanced scans, followed by a series of images at 20, 40, 60, 80, 100, 120, 140, 160, and 180 sec after intravenous injection of contrast medium). Diagnosis of SPN was performed based on pathologic findings in needle biopsy samples. Peak enhancement, net enhancement, slope of enhancement, and maximum relative enhancement ratio of the SPN were measured on dynamic CT, and Levene's test was performed to assess benignancy and malignancy. RESULTS: Twelve SPNs were confirmed to have malignant pathology. There were no significant differences between benign and malignant nodules with respect to peak enhancement (p=0.787), net enhancement (p=0.135), or slope of enhancement (p=0.698). The maximal enhancement ratio was increased in malignancy compared to benignancy, but the difference was not statistically significant (p=0.094). CONCLUSION: In our study, the hemodynamic characteristics of dynamic CT were not significantly different between benign and malignant nodules. Therefore, long-term studies of larger patient samples are required to confirm our findings.

The Usefulness of Integrated PET/CT to Distinguish between Benignancy and Malignancy in Solitary Pulmonary Nodule.: Won Jong Park, Dong Hee Kim, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Kyung Ah Chun, Ihn Ho Cho; Yeungnam Univ J Med. 2006;23(2):205-212. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.205

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Abstract PDF: BACKGROUND
Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.

Langerhans Cell Histiocytosis with Central Diabetes Insipidus: A Case Report.: Jin Ho Kim, Jun Sung Moon, Sun Jung Mun, Ji Eun Lee, Jae Won Choi, Mi Jung Eun, Kyung A Chun, Ihn Ho Cho, Ji Sung Yoon, Kyu Chang Won, Kyung Hee Lee, Duk Seop Shin, Hyoung Woo Lee; Yeungnam Univ J Med. 2005;22(2):259-265. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.259

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Abstract PDF: Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain, polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased from 109 mOsmol/kg to 327 mOsmol/kg (300%). Brain MRI showed a thickened pituitary stalk and air bubble like lesions sized with 5cm, 7cm was shown on fifth L-spine and right hip bone at hip bone CT. CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes. The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

Treatment of Coronary Artery Perforation and Tamponade Complicating Balloon Angioplasty by PTFE-Covered Stent. A Case Report.: Jong Seon Park, Gu Ru Hong, Jun Ho Bae, Ihn Ho Cho, Bong Sup Shim, Young Jo Kim, Dong Gu Shin; Yeungnam Univ J Med. 2005;22(1):90-95. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.90

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Abstract PDF: A coronary artery perforation is a rare but often fatal complication of angioplasty. We experienced a coronary artery perforation and cardiac tamponade during balloon angioplasty. A polytetrafluorethylene (PTFE) -covered stent was used to successfully close the perforation.

Comparison of Ga-67, Tl-201 and Tc-99m MIBI Imaging in Lymphoma Patients.: Kyung Ah Chun, Ihn Ho Cho, Kyu Chang Won, Kyung Hee Lee, Hyung Woo Lee, Myung Soo Hyun, Jae Tae Lee, Kyu Bo Lee; Yeungnam Univ J Med. 2002;19(2):107-115. Published online December 31, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.2.107

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Abstract PDF: PURPOSE: Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. MATERIALS AND METHODS: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin's lymphoma and others were Hodgkin's lymphoma. RESULTS: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. CONCLUSION: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.

Optimization of Correction Factor for Linearization with Tc-99m HM PAO and Tc-99m ECD Brain SPECT.: Ihn Ho Cho, Kohei Hayashida, Kyu Chang Won, Hyoung Woo Lee, Hiroshi Watabe, Norihiko Kume, Chikao Uyama; Yeungnam Univ J Med. 1999;16(2):237-243. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.237

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Abstract PDF: No abstract available.

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis.: Sang Yob Nam, Jae Hong Kim, Jung Hyn Oh, Jin Chul Park, Hyun Dae Yoon, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee, Cha Kyung Sung; Yeungnam Univ J Med. 1999;16(2):228-236. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.228

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Abstract PDF: BACKGROUND
Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.

Dual-Isotope SPECT Imaging with Thallium-201 and Technetium-99m MIBI in Detecting Coronary Artery Disease.: Gyu Gwang Lee, Ihn Ho Cho, Hyoung Woo Lee, Jong Sun Park, Kyu Chang Won, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 1999;16(1):101-107. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.101

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Abstract PDF: We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients, all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more then 50% of coronary artery narrowing was considered significant. The overall sensitivity and specification of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%, respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity of CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.

Vertebral compression fractures: distinction between benign and malignant causes with Tc-99m labeled antigranulocyte antibody immunoscintigraphy.: Ihn Ho Cho, Hyong Woo Lee, Sang Ho An, Kyu Chang Won, Jang Ho Bae, Soo Ho Cho; Yeungnam Univ J Med. 1998;15(2):254-262. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.254

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Abstract PDF: We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis , three patients had a 3 vertebral compression fractures due to metastasis and 5 patients had a 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.

A Case of Parathyroid Carcinoma with Systemic Calcification.: Heui Sik Kim, Chan Woo Lee, Sang Yiup Nam, Jin Chul Park, Ji Sang Yoon, Jae Chun Lee, Kyu Chang Won, Ihn Ho Cho, Tae Nyun Kim, Hyoung Woo Lee, Myung Soo Hyun, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(2):459-466. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.459

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Abstract PDF

Hyperparathyroidism due to parathyroid cancer is rare. It is difficult to diagnose preoperatively but there should be an increased index of suspicion in those parathyroid Patient with palpable neck masses, profound hypercalcemia(greater than 14mg/dl), made increase of the parathyroid hormone level to greater than twice normal, and significant metabolic complications. In parathyroid cancer, systemic calcinosis is an extremely rare manifestation. The most common metastatic calcification site is lung and the other involved site is stomach, liver, skin and heart. After resection of parathyroid tumor, this systemic calcinosis is self-limiting. We experienced a patient with primary hyperparathyroidsm, presented with metastatic calcification in the lung and stomach disappeared by successful parathyroidectomy.

Citations

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A Case of Parathyroid Carcinoma in a Patient with Stage 3 Chronic Kidney Disease
Youn Hee Cho, Moo Yong Park, Soo Jeong Choi, Jin Kuk Kim, Seung Duk Hwang, Jung Mi Park, Jeong Ja Kwak
Korean Journal of Medicine.2012; 83(6): 796. CrossRef

Analysis of Polar Maps of Dipyridamole Stress/Rest Tc-MIBI Myocardial SPECT in 14 Healthy Young Men.: Ihn Ho Cho, Dong Gu Shin, Hyoung Woo Lee, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):146-152. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.146

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Abstract PDF: We performed the same day dipyridamole stress/rest myocardial SPECT in 14 healthy young men, reconstructed the polar maps according to Cedars-Sinal method and quantitated the radioactivity of myocardial wall. We divided the whole myocardium to 9 sectors. The latero-anterior wall contains the highest count. The infero-septal wall contains the lowest count. There isn't any significant differences of radioactivity in each segment between stress and rest polar map. The hemodynamic parameters after dipyridamole injection in the subjects were significantly changed except systolic blood pressure : the heart rate was increased and diastolic blood pressure was decreased. Adverse effects were reported in 85.7%. We suggest that these data can be used to dectect perfusion defect in the coromary artery disease.

Estimation of Glomerular Filtration Rate(GFR) Using (99m)Tc-DTPA Renal Scan and the Parameters for Renal Function.: Ihn Ho Cho, Hyun Dae Yoon, Kyu Chang Won, Chan Woo Lee, Hyoung Woo Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):101-108. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.101

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Abstract PDF: Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of (99m)Tc-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using (99m)Tc-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GRF calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of (99m)Tc-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GRF. In conclusion, the determination of GFR according to Gates' formula shows good and reproducible of GRF with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

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