• Title/Summary/Keyword: LAD

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The application of photographs resources for constructive social studies (구성주의적 사회과 교육을 위한 사진자료 활용방안)

  • Lee, Ki-Bok;Hwang, Hong-Seop
    • Journal of the Korean association of regional geographers
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    • v.6 no.3
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    • pp.117-138
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    • 2000
  • This study is, from the view point of constructive social studies which is the foundation of the 7th curriculum, to explore whether there is any viable program and to investigate it by which students, using photo resources in social studies, can organize their knowledge in the way of self-directed thinking. The main results are as follows: If it is a principle of knowledge construction process of constructive social studies that individual construction (cognitive construction) develops into communal construction(social construction) and yet communal construction develops itself, interacting with individual construction, it will be meet the objectives of social studies. In social studies, photos are a powerful communication tool. communicating with photos enables to invoke not only the visual aspects but also invisible aspects of social phenomena from photos. It, therefore, can help develop thinking power through inquiry learning, which is one of the emphasis of the 7th curriculum. Having analyzed photo resources appeared on the regional textbooks in elementary social studies, they have been appeared that even though the importance and amount of space photo resources occupy per page is big with regard to total resources, most of the photos failed to lad to self-directed thinking but just assistant material in stead. Besides, there appeared some problems with the title, variety, size, position, tone of color, visibility of the photos, and further with the combination of the photos. Developing of photo resources for constructive social studies is to overcome some problems inherent in current text books and to reflect the theoretical background of the 7th curriculum. To develop the sort of photo that can realize the point just mentioned, it would be highly preferable to provide photo database to facilitate study with homepage through web-based interaction. To take advantage of constructive photo resources, the instruction is strategized in four stages, intuition, conflict, accommodation, and equilibration stage. With the advancement of the era of image culture, curriculum developers are required to develop dynamic, multidimensional digital photos rather than static photos when develop text books.

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Gender Difference of Accuracy in Detecting Coronary Artery Disease by Myocardial Perfusion SPECT (디피리다몰 심근관류 SPECT를 이용한 관동맥질환 진단에 있어 남녀간의 진단율 비교)

  • Min, Jung-Jun;Bom, Hee-Seung;Song, Ho-Cheon;Jeong, Hwan-Jeong;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.129-136
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    • 1998
  • Purpose: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. Materials and Methods: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTS were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of ${\geq}$ 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). Results: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (p<0.01), respectively. Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). Conclusion: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.

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Evaluation of Perfusion and Image Quality Changes by Reconstruction Methods in 13N-Ammonia Myocardial Perfusion PET/CT (13N-암모니아 심근관류 PET/CT 검사 시 영상 재구성 방법에 따른 관류량 변화와 영상 평가)

  • Do, Yong Ho;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.69-75
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    • 2014
  • Purpose: The aim of this study was to evaluate changes of quantitative and semi-quantitative myocardial perfusion indices and image quality by image reconstruction methods in $^{13}N$-ammonia ($^{13}N-NH_3$) myocardial perfusion PET/CT. Materials and Methods: Data of 14 (8 men, 6 women) patients underwent rest and adenosine stress $^{13}N-NH_3$ PET/CT (Biograph TruePoint 40 with TrueV, Siemens) were collected. Listmode scans were acquired for 10 minutes by injecting 370MBq of $^{13}N-NH_3$. Dynamic and static reconstruction was performed by use of FBP, iterative2D (2D), iterative3D (3D) and iterative TrueX (TrueX) algorithm. Coronary flow reserve (CFR) of dynamic reconstruction data, extent(%) and total perfusion deficit (TPD) (%) measured in sum of 4-10 minutes scan were evaluated by comparing with 2D method which was recommended by vendor. The image quality of each reconstructed data was compared and evaluated by five nuclear medicine physicians through a blind test. Results: CFR were lower in TrueX 18.68% (P=0.0002), FBP 4.35% (P=0.1243) and higher in 3D 7.91% (P<0.0001). As semi-quantitative values, extent and TPD of stress were higher in 3D 3.07%p (P=0.001), 2.36%p (P=0.0002), FBP 1.93%p (P=0.4275), 1.57%p (P=0.4595), TrueX 5.43%p (P=0.0003), 3.93%p (P<0.0001). Extent and TPD of rest were lower in FBP 0.86%p (P=0.1953), 0.57%p (P=0.2053) and higher in 3D 3.21%p (P=0.0006), 2.57%p (P=0.0001) and TrueX 5.36%p (P<0.0001), 4.36%p (P<0.0001). Based on the results of the blind test for image resolution and noise from the snapshot, 3D obtained the highest score, followed by 2D, TrueX and FBP. Conclusion: We found that quantitative and semi-quantitative myocardial perfusion values could be under- or over-estimated according to the reconstruction algorithm in $^{13}N-NH_3$ PET/CT. Therefore, proper dynamic and static reconstruction method should be established to provide accurate myocardial perfusion value.

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Sprachtypologische Fehleranalyse - Im Vergleich der deutschen und koreanischen Sprache - (독일어와 한국어를 비교한 언어 유형적 분석)

  • Park Jin-Gil
    • Koreanishche Zeitschrift fur Deutsche Sprachwissenschaft
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    • v.7
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    • pp.1-24
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    • 2003
  • 우리는 지금까지 독일어와 한국어 두 언어간의 오류분석을 논의해 왔다. 특히 언어유형학적인 측면에서 몇 가지 오류유형과 분석을 시도했다. 그 결과는 대체로 다음과 같이 요약될 수 있다. 독일어와 한국어가 서로 근본적으로 상반되는 언어현상과 더불어 약간의 공통성을 나타내며 일정한 유형을 나타낸다. 이는 두로 인간의 언어습득장치에 기인된 언어습득의 결정주의(Determinismus)에서 비롯될 것이다. 언어특성/문제의 체계성/규칙성 또는 일관성은 이를 반영한다. 거대한 언어자료 중에 극히 미미한 일부, 즉 언어최소량를 정복함으로써 그 효용성을 극대화할 수 있는 것은 매우 중요한 의미를 지닌다. 이를 연구 이용하는 경우에는 엄청난 효과와 가능성을 기대할 수 있을 것이다. (1) 독일어와 한국어의 학습 및 오류분석에서 가장 핵심적인 것은 언어유형학적으로 드러난 언어특성, 즉 전치성(독일어/영어)과 후치성(한국어)이다. 이를 토대로 형성된 대립적인 면과 공통적인 문제를 체계화하는 것이 역시 오류분석 문제의 관건이다. 또한 독일어가 아직 후치성 언어(한국어(TXV))에서 출발해서 전치성 언어(영어(SVX))로 발전/변화해 가는 과정, 즉 중간단계인 TVX에 머물고 있다는 사실이 중요한 의미를 지닌다. 즉 그들의 대극성과 유사성을 연결하는 실마리로 볼 수 있기 때문이다. (2) 일치(Kongruenz)/상관(Korrelation) 및 반복(Wiederholung) 현상, 그리고 격변화와 인칭변화 현상은 어순문제와 더불어 형태론적 문제를 통해 문법적인 확인수단으로 작용한다. 이들은 대부분 체계적/구조적으로 나타나기 때문에 학습자는 흔히 같은 유형에서 반복적으로 오류를 범하기 마련이다. 이를 극복하기 위해서 언어 유형학적 오류분석을 이해하고 또한 이를 통해 오류를 줄이거나 예방하는 학습이 필요하다. (3) 명사가 한정사구 안에서 성/수/격에 따라 변화하는 것과 동사가 동사구에서 주어의 인칭/수에 따라 인칭변화 하는 것은 우리 한국인에게는 아주 이색적인 현상이다. 이는 양면적인 수식구조에 대한 확인수단 및 원자가에 의한 강력한 형식위주 언어인 독일어와 전위적인 단일 수식구조와 부정형 동사를 특성으로 형성된 핵/최소문 언어간의 필연적인 적응관계 및 결과라고 볼 수 있다. 이 두 가지 유형 역시 언어특성에 따라 도식화/공식화 할 수 있다. (4) 괄호현상, 즉 으뜸머리(Hauptkopf)가 버금머리(Nebenkopf)와 분리하는 것은 우리 한국인에게는 아주 이색적인 언어현상이다. 한국어에는 머리의 이동이 없기 때문이다. 긴 구문에서 버금머리를 잊어버리거나 실수하는 것은 모든 괄호구문에서 예견되는 결과이다. 그러나 이는 정치성과 후치성 언어간의 전이 과정으로 이해될 수 있다. 으뜸머리가 원래의 자리를 박차고 소속 구/문의 앞자리로 도약한 것처럼 느껴지기 때문이다. (5) 전치 및 후치 수식이 유동적으로 작용하는 독일어는 전치 수식만으로 고정된 한국어보다 복잡하지만 균형적인 언어구조이다. 이러한 수식구조에서 한국인은 흔히 형태 및 어순에서, 그리고 번역에서 오류를 범하고 만다. (6) 그러나 가장 중요한 것은 아는 것을 제대로 이용하는 문제이다. 모국어/L2를 자유로이 말하고 쓸 때까지, 즉 언어습득에는 일체이 문법이나 도표/도식을 이용할 필요가 없다는 사실이다. 이는 17세기 서구의 이성주의 철학자들의 한결같은 경고이다. 오늘날 초고속 과학문명에서 더욱 빛을 발하는 것은 당연한 결과이다. 한 언어 속에 들어있는 문법체계를 익혀 가는 것이 곧 언어습득 과정이지만, 이를 달성하는 가능성 내지 첩경은 실제적인 언어자료와 체험이지 결코 문법이나 추상적인 개념적 접근이 아님을 웅변하고 있기 때문이다. 핵심적인 문제는 모국어교육에서도 최대 장점인 대화를 통한 언어연습/대화 기회를 최대한 보장하는 데 있다. 또한 언어간섭 현상을 조장하는 분위기를 막아야 할 것이다. 이러한 의미에서 교수법 개발이 외국어/L2 성공의 관건일 것이다. (7) 언어학습에서 오류를 극복하는 데는 일차적인 실제 상황에 부합하는 대화적인 연습, 그리고 효과적인 언어자료 접촉, 즉 독서와 모방이 중요하다. 이차적이고 직접적인 것은 통사(Syntax) 및 형태론(Morphologie)를 익힐 수 있는 말/문을 끊임없이 익히는 일이다. 이것이 또한 언어최소량을 충족시켜 언어습득에 이르는 첩경이다. 자연 생태적인 모국어 학습 또는 조정 및 제도적인 언어학습에서도 실제상황에 어긋나는 문법적인 체계에 얽매이는 도식 및 도표 위주의 텟스트는 일시적인 기대일 뿐이다. 인간의 언어습득장치를 이해하지 못한 결과이기 때문이다. 문법적인 개념위주 접근은 상당한 설명이 필요해서 절박한 자료와 체험까지 앗아가기 마련이다. 더구나 이를 위해 수준을 무시하고 모국어로 일관하여 벙어리와 문맹을 자초하는 것은 참으로 어리석은 일이다. 지식 정보화 시대 및 세계화 시대에는 무엇보다도 교육 및 언어정책이 국가 발전의 원동력이다. 특히 영어를 비롯한 외국어 학습능력과 학습방법은 매우 중요하다. 학습자에게 말하고 쓰는 기본 능력을 보장하는 것이 급선무이다. 이를 위한 작업의 하나가 바로 언어간의 오류분석일 것이다. 언어의 습득과 활용이 체계적이듯이 오류분석 역시 상당히 체계적이다. 그래서 인간의 언어습득과 언어습득장치를 두고 결정론(Determinismus)이 지배적이다. 이러한 의미에서 언어습득의 3대 요소, 즉 언어습득장치를 구비한 인간으로 태어나고, 해당 언어를 통한 일관된 언어체험/학습으로 언어최소량을 충족해야 한 언어를 정복할 수 있다는 것은 결정적인 사실이다. 학생고객에게 다가서는 책임교육으로 교육개방에 대비하는 일 역시 시대적인 상황이요 또한 결정적인 단계임엔 틀림이 없을 것이다.

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Deep inspiration breath-hold (DIBH) 적용한 림프절이 포함된 왼편 유방암의 방사선 치료계획에 따른 주변 장기 선량 평가

  • Jeong, Da-Lee;Gang, Hyo-Seok;Choe, Byeong-Jun;Park, Sang-Jun;Lee, Geon-Ho;Lee, Du-Sang;An, Min-U;Jeon, Myeong-Su
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.27-35
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    • 2017
  • Purpose: On the left side, breast cancer patients have more side effects than those on the right side because of unnecessary doses in normal organs such as heart and lung. DIBH is performed to reduce this. To evaluate the dose of peripheral organs in the left breast cancer including supraclavicular lymph nodes and internal mammary lymph nodes according to the treatment planning method of Conventional Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy. Materials and Methods: We performed CT-simulation using free breathing and deep inspiration breath-hold technique for 8 patients including left supraclavicular lymph nodes and internal mammary lymph nodes. Based on the acquired CT images, the contour of the body is drawn and the convention is performed so that $95%{\leftarrow}PTV$, $Dmax{\leftarrow}110%$. Conventional Radiation Therapy used a one portal technique on the supraclavicular lymph node and used a field in field technique tangential beam on the breast. Intensity Modulated Radiation Therapy was composed of 7 static fields. Volumetric Modulated Arc Therapy was planned using 2 ARC with a turning radius of $290^{\circ}$ to $179^{\circ}$. The peripheral normal organs dose was analyzed by referring to the dose volume of Eclipse. Results: By applying the deep inspiration breath-hold technique, the mean interval between the heart and chest wall increased $1.6{\pm}0.6cm$. The mean dose of lung was $19.2{\pm}1.0Gy$, which was the smallest value in Intensity Modulated Radiation Therapy. The V30 (%) of the heart was $2.0{\pm}1.9$, which was the smallest value in Intensity Modulated Radiation Therapy. In the left anterior descending coronary artery, the dose was $25.4{\pm}5.4Gy$, which was the smallest in Intensity Modulated Radiation Therapy. The maximum dose value of the Right breast was $29.7{\pm}4.3Gy$ at Intensity Modulated Radiation Therapy. Conclusion: When comparing the values of surrounding normal organs, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy were applicable values for treatment. Among them, Intensity Modulated Radiation Therapy is considered to be a suitable treatment planning method.

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Preoperative Risk Factors for the Prognosis of Mitral Regurgitation in Patients with Coronary Artery Stenosis and Mitral Regurgitation Who Underwent Coronary Artery Bypass Surgery Alone (승모판폐쇄부전증을 동반한 관상동맥협착증 환자에서 시행한 단독 관상동맥우회술 후 승모판폐쇄부전증의 예후에 영향을 미치는 수술 전 요인)

  • Jin, Ung;Park, Chan-Beom;Choi, Si-Young;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.410-415
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    • 2004
  • Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.

Abnormal Perfusion on Myocardial Perfusion SPECT in Patients with Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군 환자의 심근 관류 이상)

  • Kang, Do-Young;Cha, Kwang-Soo;Han, Seung-Ho;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.9-14
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    • 2005
  • Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome. Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients (mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent ($11.0{\pm}8.5%$, range:$3{\sim}35%$) and mild to moderate severity ($-71{\pm}42.7%$, range:$-2l7{\sim}-39%$) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

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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