• Title/Summary/Keyword: 고창만

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The Diagnostic Accordance between Transcranial Doppler and MR Angiography in the Intracranial Artery Stenosis (두개강내 혈관 협착에 대한 경두개도플러와 자기공명 혈관조영술의 일치도 평가)

  • Moon, Sang-kwan;Jung, Woo-sang;Park, Sung-uk;Park, Jung-mee;Ko, Chang-nam;Cho, Ki-ho;Bae, Hyung-sup;Kim, Young-suk;Cho, Seong-il
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.11-16
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    • 2006
  • Objectives : Transcranial Doppler (TCD) has been reported to be established as useful in detecting spasm after subarachnoid hemorrhage and to be probably useful in diagnosing stenosis or occlusion in intracranial arteries. In the detection of intracranial stenosis using TCD there have been reported some kinds of diagnostic criteria. This study was aimed to evaluate the accordance between TCD and magnetic resonance angiography (MRA) in detection of intracranial stenosis and to find out more accurate criteria for intracranial stenosis using TCD. Methods : Seventy-six stroke patients were evaluated by TCD and MRA. TCD criteria for middle cerebral artery (MCA) stenosis were used by 3 methods; ≥ 80cm/sec of mean velocity(Vm), ≥ 140 cm/sec of systolic velocity(Vs), and both. For stenosis of vertebral(VA) and basilar arteries(BA), the TCD criteria followed by 2 methods; ≥ 70 cm/sec of Vm and ≥ 100 cm/sec of Vs. The stenosis of intracranial artery in MRA followed by the interpretation of specialist in the department of radiology. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement were calculated in each criteria of TCD compared with the result of MRA. Results : The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement using ≥ 80cm/sec of Vm for MCA stenosis were 55.6%, 81%, 34.5%, 91.0%, 77.1%, and 0.293, respectively. Using 140 cm/sec of Vs, those were 44.4%, 92.0%, 50.5%, 90.2%, 84.7%, 0.380, and using both criteria those were 44.4%, 95.0%, 61.5%, 90.5%, 87.3%, 0.445, respectively. Those using ≥ 70 cm/sec of Vm for VA and BA stenosis were 71.4%, 93.7%, 26.3%, 99.0%, 93.0%, 0.186 and using ≥ 100 cm/sec of Vs those were 71.4%, 97.3%, 45.5%, 99.1%, 96.5%, 0.539, respectively. Conclusion : These results suggested that for the diagnosis of MCA stenosis using TCD we should use the criteria of both ≥ 80cm/sec of Vm and 140 cm/sec of Vs, and for the VA and BA stenosis we adapt the criteria of ≥ 70 cm/sec of Vm.

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Clinical Observation on East-West Integration Treatment in Stroke and Brain Disease (중풍 뇌 질환의 한 방향 협진에 관한 임상적 고찰)

  • Shin, Ae-sook;Lee, ln-whan;Kim, Na-hee;Kim, Hye-rni;Kim, Min-kyung;Sim, So-ra;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Bae, Hyung-sup;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.9-17
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    • 2010
  • Objectives : This study was aimed to evaluate the current status of East-West integrated treatment in stroke and brain disease and to discuss further plans. Methods : The medical records of patients who visited the stroke and brain disease center at Kyung Hee University, East-West Neo Medical Center from May 2006 to August 2010 were evaluated. The general characteristics of patients who underwent integrated treatment, trend in the number of cross referrals were initially evaluated. Later major disorders, the reasons of referrals and the number of visits in outpatients were analyzed. Results : 1. 3496 patients were referred from the eastern medical hospital to the western medical hospital and 2440 patients from the western medical hospital to the eastern medical hospital. The number of patients reached a peak alter the opening of the hospital and has decreased from then on. Referrals of female patients were more than those of male patients and patients over 50 years old were the most. 2. Admitted patients with stroke of chronic stage were most commonly referred from the eastern medical hospital to the western medical hospital and cerebral infarction was most common from the western medical hospital to the eastern medical hospital. Among the outpatients cerebral infarction topped from east to west, and stroke of chronic stage from west to east. 3. 36.6% of the patients from east to west received integrated treatment more than 3 times and 28.6% from west to east. Headache was the second most common reason to be referred from west to east and 36.7% of patients didn't continue to have either of the treatment and 30.3% received eastern treatment only, Conclusions: According to this study, chronic stroke management was successfully performed in the outpatient clinic in the form of East-West integration treatment. Further research on other diseases such as headache is recommended.

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The Comparison on the General Characteristics of Acute Stroke Patient between Heat pattern group and Cold pattern group (한열변증에 따른 중풍 환자의 제반특성 비교)

  • Kim, Min-kyung;Lee, ln-whan;Shin, Ae-sook;Kim, Na-hee;Kim, Hye-mi;Shim, So-ra;Na, Byung-Jo;Cho, Seung-yeon;Park, Seong-uk;Jung, Woo Sang;Moon, Sang Kwan;Park, Jung-mi;Ko, Chang-nam;Cho, Ki Ho;Kim, Young Suk;Bae, Hyung-sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.18-25
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    • 2010
  • Object : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we aimed to evaluate the characteristics of acute stroke between heat pattern group and cold pattern group. Methods : We recruited stroke patients from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo medical center, Kyungwon university lncheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university llsan oriental medical center) from April, 2007 until February, 2010. We diagnosed them and selected 463 heat pattern patients and 182 cold pattern patients. Results : We find that the risk factor of smoking, alcohol, diet(prefer to meat) are more associated with the heat pattern group. On the other hand, inflammation history in recent 3 months and diet(prefer to sea food) are more associated with the cold pattern group. RBC, Hg, Hct, TG, CK and Cl are more related to the heat pattern group. CPT, total cholesterol and HDL are more related to the cold pattern group. Tae-eum type takes high distribution of the heat pattern group, and So-eum type takes high distribution of the cold pattern group. Conclusions : This study provides evidence that the heat pattern group have more risk factor than the cold pattern group.

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The Study about the Changes of the Fire and Heat Related Symptoms and Signs On the Acute Cerebral Infarction Patients. (급성기 뇌경색 환자에서 화열 관련 증상과 증후의 변화에 관한 연구)

  • Kwak, Seung-hyuk;Park, Su-kyung;Woo, Su-kyung;Lee, Eun-chan;Park, Joo-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Cho, Seung-yeon;Park, Sung-wook;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.24-31
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    • 2011
  • Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

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A Study on Method of Citizen Science and Improvement of Performance as a Ecosystem Conservation and Management Tool of Wetland Protected Areas (Inland Wetland) - Focused on the Target of Conservation·Management·Utilization in Wetland Protected Area Conservation Plan - (내륙 습지보호지역의 생태계 보전·관리 도구로서 시민과학연구 방법론 및 성과 제고 방안 - 습지보호지역 보전계획의 보전·관리·이용 목표를 중심으로 -)

  • Inae Yeo;Changsu Lee;Ji Hyun Kang
    • Journal of Environmental Impact Assessment
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    • v.32 no.6
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    • pp.450-462
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    • 2023
  • This study suggested methodology of Citizen Science as a tool of ecosystem conservation and management to achieve Wetland Protected Area (WPA) Conservation Plan and examined whose applicability in 3 WPAs (Jangrok of Gwangju metropolitan city, Madongho of Goseong in South Gyeongsang Province, and Incheongang estuary of Gochang in North Jeolla Province). It consists of a) figuring out main interests and stakeholder or beneficiaries of WPA and their information demand based on conservation, utilization, and management target in the WPA Conservation Plan, b) conducting research activities to gain outcome to address stakeholder's demand, and c) returning the research outcome to citizen scientists and making diffusion to the society. Based on the suggested method and process, citizen scientists conducted ecosystem monitoring (plants including Invasive Alien Plants, terrestrial insects, traces of mammals, discovering unknown wetland). As a result, citizen scientists contributed to collecting species information of 16 plans, 43 species of terrestrial insects, 5 mammals including Lutra lutra (Endangered Species I) and Prionailurus bengalensis (Endangered Species II). The authors constructed and provided distribution map of Invasive Alien Plants, which included information of location and density which citizen scientists registered, for Environment Agencies and local governments who manage 3 WPAs to aid data-based ecosystem policy, In further studies, not only accumulating research data and outcomes acquired from citizen science to suffice the policy demands but also deliberate reviewing policy applicability and social·economic ripple effect should be processed for the suggested Citizen Science in WPA to be settled down as a tool of ecosystem conservation and management.

Studies on the Hemodynamic Changes in Cirrhosis of the Liver (간경변증(肝硬變症)에서의 혈역학적(血力學的) 변화(變化)에 관(關)한 연구(硏究))

  • Kim, Jung-Il;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.11-27
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    • 1970
  • Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

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The Measurement of Blood Loss and Its Effect on Red Cell Survival Studies with $^{51}Cr$ (실혈(失血)이 적혈구수명(赤血球壽命) 측정(測定)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Lee, Mun-Ho;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.27-36
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    • 1970
  • 적혈구(赤血球) 수명의 측정에는 $^{51}Cr$-표지적혈구법(標識赤血球法)이 임상적(臨床的)으로 이용(利用)되고 있으며 이는 이론상(理論上) steady state 즉(卽) 측정기간(測定期間)동안 순환(循環) $^{51}Cr$량(量)-적혈구량(赤血球量)이 일정(一定)할 때에 한(限)하여 유효(有效)하며 unsteady state 때는 true red cell survival을 알기 위하여서는 측정치에 영향을 주는 요인(要因)에 대하여 각각(各各) 교정(校正)해 줄 필요(必要)가 있다. 이 요인(要因)중에 특히 실혈(失血)로 인(因)한 영향에 관(關)하여는 계통적인 연구(硏究)가 적다. 이에 저자(著者)들은 $^{51}Cr$표지적혈구법(標識赤血球法)을 이용(利用)하여 실혈(失血)이 적혈구(赤血球) 수명측정(測定)에 미치는 영향을 인체(人體)에서 실험 관찰하여 몇가지 성적을 얻었다. 연구대상(硏究對象)은 총(總) 56명(名)의 청장년(靑壯年)으로 급성실혈군(急性失血群)과 만성실혈군(慢性失血群)으로 구분(區分)하여 급성실혈군(急性失血群)은 위장출혈등(胃腸出血等)이 없는 2대(代)의 의대생(醫大生)으로 $^{51}Cr$표지적혈구법(標識赤血球法)을 사용하여 적혈구(赤血球) 수명을 측정하는 동안($10{\sim}14$ 일간(日間)) 1일당(日當) 10ml(6명(名)), 25ml(4명(名)), 50ml(4명(名)), 75ml(4명(名)), 100ml(6명(名))를 각각(各各) 사혈(瀉血)한 군(群)과 10일간(日間) 1,000ml를 사혈한 군(群) 즉 200ml씩 5회(回)(4명(名)), 500ml씩 2회(回)(4명(名))로 세분(細分)하였으며 만성실혈군(慢性失血群)은 직업적인 공혈자(供血者)로 반복사혈로 생긴 9명(名)의 빈혈자와 십이지장충증(十二指腸蟲症)에 감염(感染)되어 구충(驅蟲)한 중등도(中等度)의 철결핍성 빈혈환자 7명(名)으로 나누어 관찰하였다. 측정(測定) 방법(方法)으로는 Gray 및 Sterling법(法)을 개설한 방법(方法)으로 $^{51}Cr$표지적혈구(標識赤血球)의 계측시료(計測試料)로서 전혈(全血) 및 적혈구(赤血球)를 사용(使用)하였다. 실험(實驗)성적은 1. 1일당(日當) 실혈량(失血量)이 증가(增加)할수록 적혈구(赤血球)수명($T\frac{1}{2}$)은 짧아짐을 알 수 있었다. 즉(卽) 1일당(日當) $20{\sim}50ml$ 사혈군에서는 $T\frac{1}{2}$이 현저히 짧아지는 rapid phase을 나타내고 1일당(日當) 50ml이상(以上) 사혈군에서는 짧아지는 정도(程度)가 완만한 slow phase을 나타낸다(Fig. 6). 2. 1일량(日量) 10ml 및 25ml식(式) 사혈한 군(群)의 적혈구수명(赤血球壽命)을 측정(測定)하는데 있어 적혈구(赤血球)를 사용하였을 때에는 $T\frac{1}{2}$측 정치에 유의한 차(差)가 없었으며 이 범위 내에서는 Hct., Hb. 및 혈청철치(血淸鐵値)도 역시 유의한 차(差)가 없었다. 3. 1일량(日量) 50ml 및 75ml, 100ml씩 사혈한 군(群)에서는 적혈구(赤血球)만을 사용(使用)하였을 때와 전혈(全血)을 시료(試料)로 하였을 때 사이에 $T\frac{1}{2}$의 측정치에 유의한 차(差)가 있었으며 이 때는 Hct., Hb. 및 혈청철치(血淸鐵値)에도 변화(變化)가 있었다. 즉(卽), 전혈(全血)을 사용한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치가 적혈구(赤血球)만를 사용(使用)한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치 보다 짧았다. 4. 일정(一定)기간(10 일(日)) 사혈의 총량(1000ml)이 같을 매는 200ml를 5회(回) 사혈한 군(群)이나 500ml를 2회(回) 사혈한 군(群) 사이에 적혈구(赤血球) 수명($T\frac{1}{2}$)에 유의(有義)한 차(差)를 볼 수 없었다. 5. 직업적 공혈자의 반복사혈로 인(因)한 만성(慢性) 빈혈환자 9명(名)에서의 $^{51}Cr$적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 평균(平均) 19.2일(日)로 짧아져 있으나 적혈구수명측정전후(赤血球壽命測定前後)에 충분(充分)한 철제(鐵劑)를 투여(投與)하여 Hct., Hb. 및 혈청철치(血淸鐵値)를 증가(增加)시켰으며 이때 볼 수 있었든 Hct치(値)를 규준(規準)하여 교정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 거의 정상(正常)범위 안에 있어(27.6일(日)) 이러한 인자(因子)를 고려하지 않으면 잘못 이해할 수가 있다. 6. 구충자충(鉤蟲仔蟲)을 구충한 7명(名)의 중등도(中等度) 철(鐵)결핍성 빈혈환자에서의 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 25일(日)$\sim$31일(日)로 평균(平均) 28일(日)이었으며, 이때 장 출혈량은 1일(日) $1.0{\sim}3.5ml$이었다. 단시일내의 급성실혈시에는 이와같은 소량의 실혈(失血)도 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치에 영향을 보여 줌을 알 수 있었다. 따라서 이러한 정도의 실혈은 실험오차에 기인하는 것인지 아니면 장기 출혈에서는 이러한 소량의 실혈이 적혈구(赤血球)수명($T\frac{1}{2}$) 측정에 영향을 미치지 않는 것인지는 아직 확실히 말할 수 없다. 8. $^{51}Cr$-표지적혈구(標識赤血球)로 측정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 측정시의 실혈량(失血量)에 큰 영향을 받음을 알 수 있으며 저자(著者)들은 $^{51}Cr$표지적혈구(標識赤血球)를 이용(利用)한 적혈구(赤血球) 수명 측정때 검사기간중 실혈량이 적혈구수명치(赤血球壽命値)에 미치는 관계를 상술(上述)한 실험치(實驗値)를 기초(基礎)로 하여 다음과 같을 교정식(校正式)을 고찰(考察)해 보았다. $^{51}Cr\;T\frac{1}{2}=17.0e^{-0.0495}+18.4e^{-0.000924x}$ 단(但) X : 1일(日) 실혈량(失血量)(단위(單位) ml)

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A Basic Study on the Euryale ferox Salisbury for Introduction in Garden Pond - Focusing on the Flora and Vegetation - (정원내 가시연꽃(Euryale ferox Salisbury) 도입을 위한 기초연구 - 식물상과 식생을 중심으로 -)

  • Lee, Suk-Woo;Rho, Jae-Hyun;Oh, Hyun-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.83-96
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    • 2016
  • Through the research and analysis on the vegetation environment, flora of habitats through documentary and field studies over 14 habitats of Euryale ferox Salisbury within Jeollabukdo, with the objective of acquiring the basic data for forming an environment based on plantation of reservoirs that are composed with Euryale ferox, the following results were obtained. 1. The entire flora of the 14 habitats appeared to be 79 families, 211 genus, 298 species, two subspecies, 30 varieties and six forma, thus, a total of 336 taxa was confirmed. Among these, emergent water plants appeared to compose 17 taxa, floating-leaved plants to compose seven taxa including Euryale ferox floating plants to compose five taxa and submerged water plants to compose two taxa. As a result of analyzing the similarity only over the water plants. The lowest similarity rate appeared between Gamdong Reservoir and Aedang Reservoir, as the similarity rate between the two regions appeared to be 0% as a result of the analysis. Floating-leaved plants, lotuses and caltrops, appeared to be equally inhabiting in Hanseongji at Jeongeup and Seoknam Reservoir at Gochang, which showed the highest similarity rate, in addition to Euryale ferox. 2. When examining the appearance frequency of aquatic plants per growth type, Actinostemma lobatum and Phragmites communis, in addition to Euryale ferox each appeared 11 times, showing a high frequency of 78.6% and Trapa japonica, which is a floating-leaved water plant, appeared ten times(71.4%) and Zizania latifolia appeared eight times(57.1%). In addition, the appearance rate appeared to be high in the order of Persicaria thunbergii, Leersia sayanuka, Ceratophyllum demersum, Echinochloa crusgalli var. oryzicola, Scirpus maritimus, and Nelumbo nucifera. 3. The rare plants discovered in the Euryale ferox habitats pursuant to the IUCN evaluation standards was confirmed to be composed of five taxa, with three taxa including the least concerned species(LC), Melothria japonica at Yanggok Reservoir, Hydrocharis dubia at Myeongdeokji and Ottelia alismoides at Daewi Reservoir, in addition to vulnerable species(VU), Utricularia vulgaris at Sangpyeong Reservoir, along with Euryale ferox. 4. Most of the group or community types of the natural habitats of Euryale ferox appeared to be the Euryale ferix community' and the Daewi Reservoir of Gunsan was defined as caltrop + Euryale ferox + Nymphoides indica community. The green coverage ratio of Euryale ferox per natural habitats showed a considerably huge deviation from 0.03 to 36.50 and as the average green coverage ratio was appropriated as 9.8, it can be considered that maintaining the green coverage ratio of Euryale ferox in a 10% level would be advisable when forming a reservoir with Euryale ferox as the key composition species. 5. The vegetation community nearby the natural habitats of Euryale ferox per research subject area appeared to be composed of three Leersia japonica communities, two communities each for Zizania latifolia community and Trapa japonica community and one community each for Nelumbo nucifera community, Nymphoides peltata + Typha orientalis community, Trapa japonica + Nelumbo nucifera community, Hydrocharis dubia community, Leersia japnica + Paspalum distichum var. indutum community and Euryale ferox + Trapa japonica community, showing a slight difference depending on the location conditions of each reservoir. Thus, this result may be suggested as a guideline to apply when allocating the vegetation ratio and the types of floating-leaved plants upon planting plants in reservoirs with Euryale ferox as the main companion species.

Stress/Rest Tc-99m-MIBI SPECT in Comparison with Rest/Stress Rubidium-82 PET (휴식/부하 심근 Rubidium-82 양전자단층촬영과 부하/휴식 심근 Tc-99m-MIBI 단일광자단층촬영의 비교)

  • Lee, D.S.;Kang, K.W.;Lee, K.H.;Jeong, J.M.;Kwark, C.;Chung, J.K.;Lee, M.C.;Seo, J.D.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.31-40
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    • 1995
  • We compared stress/rest myocardial Tc-99m-MIBl tomographic image findings with rest/stress rubidium-82 tomographic images. In 23 patients with coronary artery disease (12 of them received bypass grafts before) and 6 normal subjects, rest rubidium PET study was performed : rubidium-82 and Tc-99m-MIBI were injected simultaneously to each patient after dipyridamole stress for rubidium PET and MIBI SPECT; and rest MIBI SPECT was performed 4 hours thereafter. We scored segmental decrease of rubidium or MIBI uptakes into 5 grades for 29 segments from 3 short-axis, vertical and horizontal slices. Scores were summed for each major arterial territory. When more score than two grade-2's or one grade-3 was considered as the cue for significant stenosis for major arterial territories, 67% of 46 stenosed arteries were found with MIBI studies and 78% of them by rubidium studies. Fourteen among 28 grafted arterial territories of 12 post-CABG patients were found normal with both rubidium and MIBI. Segmental scores were concordant between rubidium and MIBI in 72% of 709 stress segments and in 80% of 825 rest segments. Stress rubidium segmental scores were less than stress MIBI scores in 9%, so were rest rubidium scores. Stress rubidium scores were more than stress MIBI scores in 20% of segments, and rest rubidium segmental scores were more than rest MIBl scores in 11%. Rank correlations (Spearman's rho's more than 0.7(stress) and 0.5(rest), slopes (MIBI/rubidium) around 0.7(stress) and 0.9 (rest)) suggested deeper and wider defects in stress with rubidium. Slope over 1 (MIBI/rubidium) with LAD segemental scores at rest and 7 territories which had much larger score with MIBI revealed exaggeration of rest defects with rest MIBI in same-day stress/rest study. Difference scores (stress-rest for each territory) suggesting Ischemia were larger with rubidium (slope of MIBI/rubidium around 0.45). As has been implied by animal or separate-day-human studies, these segmental analyses with simultaneous examination in patients told that rubidium PET flow studies disclose ischemia more often than MIBI studies and that rest MIBI studies in same-day stress/rest-sequence gave a little larger rest defect than they would have shown.

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Diagnostic Accuracy of $^{99m}Tc$-DISIDA Scintigraphy in Biliary Atresia (선천성 담도폐쇄증에서 $^{99m}Tc$ DISIDA 신티그라피의 진단정확성)

  • Hyun, In-Young;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Chung, June-Key;Suh, Jung-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.357-363
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    • 1994
  • We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.

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