• Title/Summary/Keyword: 이상치 판정

Search Result 118, Processing Time 0.021 seconds

Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging (급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측)

  • Choi, Joon-Young;Yang, You-Jung;Choi, Seung-Jin;Yeo, Jeong-Seok;Park, Seong-Wook;Song, Jae-Kwan;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
    • /
    • v.37 no.4
    • /
    • pp.219-228
    • /
    • 2003
  • Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

Hypofractionated Radiation Therapy for Early Glottic Cancer - Preliminary Results - (초기 성문암 환자에서의 소분할 조사법을 이용한 방사선치료 - 예비적 결과 -)

  • Wu Hong-Gyun;Hong Semie;Shin Seong Soo;Park Charn Il
    • Radiation Oncology Journal
    • /
    • v.19 no.4
    • /
    • pp.301-305
    • /
    • 2001
  • Purpose : This study was peformed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer Methods and Materials : From February 1999 to February 2000, 20 patients with Histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as fellows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range $31\~45\;days$). Results : Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia $(5\%)$, six cases of grade 3 hoarseness $(30\%)$. Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy. Conclusion : This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.

  • PDF

Clinical Features of Non-A, B, C Viral Hepatitis in Children (소아에서 발생한 비-A, B, C형 바이러스성 간염의 임상 고찰)

  • Son, Seung Kook;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.8 no.1
    • /
    • pp.41-48
    • /
    • 2005
  • Purpose: Non-A, B, C viral hepatitis is the name given to the disease with clinical viral hepatitis, but in which serologic evidence of A, B, C hepatitis has not been found. Little is known about the etiology and clinical features of non-A, B, C viral hepatitis in children. Methods: A clinical analysis of 45 cases with non-A, B, C viral hepatitis who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 2001 to June 2004 was carried out retrospectively. Patients who were positive for HBsAg, anti-HAV and anti-HCV and had toxic, metabolic, autoimmune, or neonatal hepatitis were excluded in this study. Results: Among 45 cases of non-A, B, C viral hepatitis, the etiology was unknown in 26 (57.8%), CMV (cytomegalovirus) in 14 (31.1%), EBV (Epstein Barr virus) in 2 (4.4%), HSV (herpes simplex virus) in 2 (4.4%) and RV (rubella virus) in 1 (2.2%). Twenty seven out of 45 (60.0%) patients were under 1 year of age. Sixteen (33.3%) patients had no specific clinical symptoms and were diagnosed incidentally. On physical examination, twenty seven out of 45 patients (60.0%) had no abnormal findings. Forty three out of 45 patients (95.6%) showed classic clinical course of acute viral hepatitis, whereas fulminant hepatitis developed in two patients. Mean serum ALT (alanine aminotransferase) level was $448.7{\pm}771.9IU/L$. Serum ALT level was normalized in 31 out of 45 patients (81.6%) within 6 months and all patients within 18 months. Aplastic anemia was complicated in a case. Conclusion: Although most patients with non-A, B, C viral hepatitis showed a good prognosis, a careful follow-up would be necessary because some of them had a clinical course of chronic hepatitis, fulminant hepatitis and severe complication such as aplastic anemia.

  • PDF

The Effectiveness of Spiral Computed Tomography as a Diagnostic Tool in Pulmonary Embolism(Comparison of Spiral CT with Ventilation-Perfusion Scan) (폐색전증 진단의 도구로서의 Spiral Computed Tomography의 유용성(폐환기관류주사와의 비교))

  • Koh, Jae-Hyun;Oh, Eun-Young;Park, Jung-Ho;Park, Sang-Joon;Yun, Jung-Hwan;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Lee, Kyung-Soo;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.4
    • /
    • pp.564-573
    • /
    • 1999
  • Background: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable morbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. Method: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. Results: PE could be excluded with spiral CT in 4 patients ; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT was helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. Conclusion: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.

  • PDF

Responsiveness of Muscarinic and Alpha Adrenergic Activation on Endothelial Cell in Isolated Canine Renal Arteries (개 신동맥 내피세포의 무스카린성 및 알파 아드레날린성 수용체에 대한 작용)

  • Chung, Soo-Youn;Chang, Ki-Churl;Lim, Jung-Kyoo
    • The Korean Journal of Pharmacology
    • /
    • v.25 no.1
    • /
    • pp.43-51
    • /
    • 1989
  • Responsiveness of muscarinic and alpha adrenoceptor activation on endothelial cells was studied in isolated canine renal artery rings. Ach (10-100 nM), dose dependently, relaxes endothelial intact rings precontracted with phenylephrine ($IC_{50}$ of Ach was 34.5 nM). Selective mechanical destruction of the endothelium transformed the activity of this substance from vasodilatation to vasoconstriction. Acetylcholine induced relaxations could be selectively inhibited competitively by atropine, but could not be inhibited by cyclooxygenase inhibitor. Methylene blue, however, an inhibitor of soluble guanylate cyclase activity, inhibited Ach as well as sodium nitroprusside (SNP) induced relaxation. Relaxation produced by prostacyclin was not modified by methylene blue. On the other hand, alpha adrenoceptor agonist did not relax but contract canine renal artery rings possessing an intact intima precontracted with U-46619. Clonidine, however, selective alpha-2 adrenergic agonist, is more susceptible than phenylepherine, selective alpha-1 adrenergic agonist, to the inhibitory effect of contraction. These results suggest that in canine renal artery rings, 1) muscarinic receptor is responsible for releasing endothelium dependent relaxation factor (EDRF). 2) alpha-1 and alpha-2 adrenergic receptors are present in canine renal artery. 3) relaxation via EDRF is antagonized by methylene blue, providing further evidence that EDRF acts through a cGMP mechanism.

  • PDF

Analysis of Taste Compounds in Traditional Korean Soy Sauce by Two Different Fermantation Jars (담금용기에 따른 한국 전통 간장의 맛 성분 분석)

  • Park, Ok-Jin;Sohn, Kyung-Hee;Park, Hyun-Kyung
    • Journal of the Korean Society of Food Culture
    • /
    • v.11 no.2
    • /
    • pp.229-233
    • /
    • 1996
  • This study was carried out to analyze the changes in nitrogen compounds, free-amino acids and volatile organic acids of traditional Korean Soy Sauce with two different fermentation jars and varying Meju concentration. Total nitrogen content in the glass jar was higher than that of the clay jar. However, the glass jar contained more nitrogen in ammonia type nitrogen and less in amino type nitrogen than clay jar, resulting in inferior quality. Total free amino acids content was highest on the 150th day. Among free amino acids, the concentration of glutamic acids, aspartic acid, serine, alanine and lysine, which give sweet and savory taste, were higher than that of the others. Phenylalanine, valine, leucine and isoleucine, which give bitter taste, were also present in significant quantities. Among identified volitile organic acids, acetic acid was present in the hightest concentration, and it's concentration was higher in the jar than in the glass jar. Meju concentration 1:4 showed slow increse while 1.3:4 showed similar trends in the glass jar 1:4 and clay jar 1.3:4, and it's concentration decreased after the ripening period in all samples. In addition valerie acid and capric acid were also present in small quantities.

  • PDF

Clinical Course of IgA Nephropathy in Children (소아 IgA 신병증의 추적 관찰)

  • Hong In-Hee;Lee Jun-Hwa;Go Cheol-Woo;Kwak Jung-Sik;Koo Ja-Hoon
    • Childhood Kidney Diseases
    • /
    • v.3 no.2
    • /
    • pp.153-160
    • /
    • 1999
  • Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children. Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas. Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{\pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V. Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.

  • PDF

The Study of Diagnostic Results Discordance Analysis on BMD Using DEXA (이중에너지 X선 흡수 계측법을 이용한 골밀도 검사 시 진단불일치에 대한 분석)

  • Park, Won-Kyu;Kang, Yeong-Han;Jo, Gwang-Ho
    • Journal of radiological science and technology
    • /
    • v.31 no.1
    • /
    • pp.25-31
    • /
    • 2008
  • Purpose : This study was conducted to understand for the diagnostic discordance of bone mineral density(BMD) in DEXA(Dual Energy X-ray Absorptiometry). And the diagnostic difference between lumbar spine and femur neck, forearm was evaluated using T-score. Materials and Methods : We studied 220 females measured BMD on lumbar spine, and femur neck, forearm including ward's triangle and ultra digital(UD). We were distinguished T-score into normal, osteopenia, osteoporosis(WHO classification) and evaluated discordance rate according to age and degree of bone loss. Correlation analysis and chi-square test between L-spine, L-4, femur neck, Ward, Forearm, UD were carried out. Results : In the lumbar spine, the number of normal were in 57(25.9%), osteopenia in 86(39.1%), osteoporosis in 77(35.0%). In the L-4 and ward's triangle, the number of osteoporosis were in 78(35.5%), in 126(57.3%). There was significant correlation between lumbar, femur neck and forearm BMD in all cases. The discordance of BMD between lumbar and femur were 57%, lumbar and forearm 43%, forearm and femur 51%. The discordance rates of normal, osteopenic, osteoporotic groups were 39%, 64%, 43%, respectively, showing the highest discordance rate in osteopenia patients. In normal group of lumbar spine, the discordance rate was 25%, 23%, 11%, 65%, 86% in 30', 40', 50', 60', 70', respectively. In osteopenia, osteoporosis group of lumbar spine, the discordance rate was 62%, 55%, 36%, 20%, 9% in 30', 40', 50', 60', 70', respectively. Conclusion : It was different of the results of BMD with lumbar, femur and forearm site. The discordance rate was decreased with age in osteopenia, osteoporosis lumbar spine. In osteopenia group, the discordance rate was the highest. So, it is necessary that the BMD of lumbar, femur neck and forearm should be checked.

  • PDF

Echocardiographic Parameters of Pulmonary Atresia with Intact Ventricular Septum(PA/IVS) (심실 중격 결손을 동반하지 않은 폐동맥 폐쇄 환아에서의 심초음파 계측치)

  • Lee, Young Seok;Kim, Yeo Hyang;Hyum, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.5
    • /
    • pp.484-489
    • /
    • 2003
  • Purpose : To understand morphologic and hemodynamic variations in patients with pulmonary atresia with intact ventricular septum(PA/IVS), and to decide the best treatment modalities, we measured right ventricular volume, inflow, and outflow valvular annulus size in these patients and compared them with those of normal newborns. Methods : Eight patients with PA/IVS diagnosed by echocardiography from January to December 2001 were enrolled in this study. Among the total eight patients, five were male and three were female. The mean age of patients was 6.9 days(1-34 days), and the mean body weight was 3,343 gm (2,970-4,000 gm). Ten fullterm newborn infants with sepsis or hyperbilirubinemia without heart disease were enrolled as a control group. Echocardiographic and Doppler studies using Acuson Aspen (7Mh probe) were recorded on super-VHS videotape and later on, with review mode. We measured volumes of right and left ventricles, aortic, pulmonic, mitral and tricuspid valvular annulus sizes using an installed program, and then these parameters were compared with those of the control group. Results : Mean Z-value of tricuspid valvular annulus in PA/IVS was $-3.69{\pm}2.80$(-8.4--0.45), and tricuspid/mitral valvular annulus size ratio $0.68{\pm}0.15$(0.43--0.84). The more the tricuspid/mitral valvular annulus size ratio, the more Z-value of tricuspid valvular annulus(P=0.003, r=0.885). Those patients who underwent pulmonary valvuloplasty(balloon or surgical) had a tendency toward larger volume of the right ventricle, more Z-value of pulmonic and tricuspid valvular annulus, and more tricuspid/mitral valvular annulus size ratio than those patients who underwent a shunt operation. Conclusion : Compared to a measurement of the volume of the right ventricle, measurements of tricuspid/mitral valvular annulus size ratio and Z-value of tricuspid valvular annulus may be easier and better parameters to decide the treatment method and to predict prognosis in PA/IVS patients.

Change of Cerebral Blood Flow Distribution and Vascular Reserve according to Age in Koreans Measured by Tc-99m HMPAO Brain SPECT (한국 정상인에서 연령에 따른 뇌혈류분포와 혈류예비능의 변화: Tc-99m HMPAO SPECT에 의한 연구)

  • Song, Ho-Cheon;Bom, Hee-Seung;Sohn, Hye-Kyung;Jeong, Hwan-Jeong;Min, Jung-Jun;Kim, Ji-Yeul;Lee, Jae-Tae;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
    • /
    • v.33 no.3
    • /
    • pp.247-261
    • /
    • 1999
  • Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO, Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age $40.3{\pm}24.9$ years, range 4 to 82 years) were underwent rost/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in (rental, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018, rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was $29.9{\pm}12.9%$. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

  • PDF