• Title/Summary/Keyword: Low Perfusion

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Technetium-99m hand perfusion scintigraphy (Raynaud's scan) as a method of verification in hand arm vibration syndrome: a review

  • Taewoong Ha;Hyeoncheol Oh;Jungwon Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.26.1-26.13
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    • 2022
  • It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud's scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

Changes in drug metabolism during hypoxia/reoxygenation in isolated perfused rat

  • Seo, Min-Young;Cho, Tai-Soon;Lee, Sun-Mee
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.04a
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    • pp.98-98
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    • 1997
  • This study was done to investigate the effect of vitamin E on hypoxia/reoxygenation-induced hepatic injury in isolated perfused rat liver. Rats were pretreated with vitamin E or vehicle(soybean oil). Isolated livers from fasted 18 hours were subjected to 45min of low flow hypoxia or N$_2$ hypoxia followed by reoxygenation for 30min. The perfusion medium used was KHBB(pH 7.4) and 50${\mu}$㏖/$\ell$ of ethoxycoumarin was added to the perfusate to determine the ability of hepatic drug-metabolizing systems, In low flow hypoxia model, total glutathione and oxidised glutathione levels were significantly increased by hepoxia/reoxygenation with slight increase in LDH levels. These increases were prevented by vitamin E pretreatment. In N$_2$ hypoxia model, LDH, total glutathione and oxidized glutathione levels were increased significantly by hypoxia but restored to normal level by reoxygenation. Vitamin E had little effect on this hypoxic damage. There were no significant changes in the rate of hepatic oxidation of 7-EC to 7-HC in both hepoxic models. But, the subsequent conjugation of 7-HC by sulfate or glucuronic acid were significantly decreased by hypoxia, but restored by reoxygenation in both hypoxia models. As opposed to our expectation, treatment with vitamin E aggrevated the decrease of the rate of conjugation and even inhibited the restoration by reoxygenation. Our findings suggest that hypoxia/reoxygenation diminishes phase II drug metabolizing function and this is, in part, related to decreased energy level.

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Paradigm Shift in Intra-Arterial Mechanical Thrombectomy for Acute Ischemic Stroke : A Review of Randomized Controlled Trials after 2015

  • Sheen, Jae Jon;Kim, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.427-432
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    • 2020
  • Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was effective and safe in acute ischemic stroke with anterior circulation occlusion when performed within 6 hours of stroke onset. There are four reasons underlying the different results observed between the trials conducted in 2013 and 2015. First, the three RCTs of 2013 used low-efficiency thrombectomy devices. Second, the three RCTs used insufficient image selection criteria. Third, following the initial presentation at the hospital, reperfusion treatment required a long time. Fourth, the three RCTs showed a low rate of successful recanalization. Time is the most important factor in the treatment of acute ischemic stroke. However, current trends utilize advanced imaging techniques, such as diffusion-weighted imaging and multi-channel computer tomographic perfusion, to facilitate the detection of core infarction, penumbra, and collateral flows. These efforts demonstrate that patient selection may overcome the barriers of time in specific cases.

Robust Design of Pulse Oximeter Using Dynamic Control and Motion Artifact Detection Algorithms

  • Cho, Jung Hyun;Kim, Jong Cheol;Yoon, Gil Won
    • Journal of Electrical Engineering and Technology
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    • v.9 no.5
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    • pp.1780-1787
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    • 2014
  • Arterial oxygen saturation ($SpO_2$) monitoring for newborns requires special attention in neonatal intensive care units (NICUs). Newborns have very low photo-plethysmogram (PPG) amplitudes and their body movements are difficult to contain. Hardware design and its associated signal processing algorithms should be robust enough so that faulty measurements can be avoided. In this study, improved designs were implemented to deal with low perfusion, motion artifact, and the influence of ambient light. Dynamic range was increased by using different LED intensities and a feedback system. To minimize the effects of motion artifact and to discard other unqualified data, four additional algorithms were used, which were based on dual-trace detection, continuity of DC level, morphology of PPG, and simultaneity check of $SpO_2$. Our $SpO_2$ system was tested with newborns with normal respiration in the NICU. Our system provided fast, real-time responses and 100% artifact detection was accomplished under 84% of $SpO_2$.

Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications (혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구)

  • Lee, Hyung-Chae;Hwang, Youn-Ho;Wi, Jin-Hong;Jun, Hee Jae;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.25-32
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    • 2010
  • Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging

  • Yuehua Li;Mingyuan Yuan;Mengmeng Yu;Zhigang Lu;Chengxing Shen;Yining Wang;Bin Lu;Jiayin Zhang
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.621-630
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    • 2019
  • Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

Evaluation on Total Energy Consumption of Low-Energy House with Structural Insulated Panels (구조단열패널 적용 저에너지주택의 총에너지사용량 평가)

  • Lee, Hyeon-Ju;Nah, Hwan-Seon;Jo, Hye-Jin;Choi, Sung-Mo
    • Journal of the Korean Society for Advanced Composite Structures
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    • v.4 no.2
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    • pp.15-24
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    • 2013
  • This project is mainly related to evaluation of total energy consumption of low energy house, the exterior envelope of which was wholly composed of structural insulated panels(SIP). The U-value of applied SIP was in the range of 0.189 to $0.269W/m^2{\cdot}K$ and the U-value of pair glass from 0.78 to $1.298W/m^2{\cdot}K$ was applied for window dependent to its function respectively. For comparison of total energy performance, the energy simulation for pilot house was performed to compare with the control house having insulation criteria of Korean building regulation in 2009. Based on simulation of dynamic energy performance, the pilot house saved 48.3% of annual energy consumption while the control house in 2009 consumed as 85.7GJ/y. In case of heating, the result showed that the energy saving ratio amounted to 76.7%. For $CO_2$ emission, the pilot house diminished approximately 35.4% from $6,208.4kgCO_2$ to $4,009.2kgCO_2$. In payback period to early investment, it was analyzed the pilot house took 7.8 years, when the low energy house built by other insulation method with same thermal perfusion took 11.5 years. From this result, it is considered that the SIP is more effective, economic to Green Home application.

Distribution of growth hormone-releasing factor- and somatostatin-immunoreactive neurons in the hypothalamus of the Korean squirrel(sciurus vulgalis coreae) (청서 시상하부의 growth hormone-releasing factor 및 somatostatin 면역반응신경세포의 분포)

  • Jeong, Young-gil;Son, Hwa-young;Yoon, Won-kee;Kim, Kil-soo;Won, Moo-ho;Ryu, Si-yun;Cho, Sung-whan;Kim, Moo-kang
    • Korean Journal of Veterinary Research
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    • v.35 no.4
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    • pp.671-681
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    • 1995
  • This study was attempted to investigate the topographical distribution, shape and immunoreactivity of growth hormone-releasing factor(GRF)- and somatostatin(SOM)-immunoreactive neurons in the hypothalamus of the Korean squirrels(Sciurus vulgalis coreae). For the light microscopical examination of immunohistochemistry, the brains were fixed with 4% paraformaldehyde solution by means of intracardiac perfusion. And the frozen sections($40{\mu}m$ thick) were stained immunohistochemically by ABC method. Distribution of GRF immunoreactive neurons($12-17{\mu}m$) was highest in the paraventricular nucleus, moderate in the periventricular and supraoptic nuclei, and low in the arcuate nucleus and lateral hypothalamic area. Their immunoreactive fibers were found very high in the median eminence, moderately in the supraoptic, paraventricular and periventricular nuclei, and low in the arcuate nucleus and lateral hypothalamic area. SOM immunoreactive perikarya($14-18{\mu}m$) were found moderately in the periventricular nucleus near the subependymal layer of the third ventricle, and low in the arcuate and suprachiasmatic nuclei. SOM immunoreactive fibers were found high in the median eminence, and moderately or low in the arcuate and periventricular nuclei.

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Effect of Low-dose Aspirin on Implantation and Pregnancy Rates in Patients Undergoing Frozen-thawed Embryo Transfer (동결보존 배아 이식에서 저 용량 아스피린 투여가 임신율과 착상율에 미치는 영향에 관한 연구)

  • Kim, Min Ji;Lee, Hyun Jung;Yu, Young;Seo, Back Kyung;Cha, Sun Hwa;Kim, Hae Suk;Song, In Ok;Byun, Hye Kyung;Koong, Mi Kyoung;Kang, Inn Soo;Yang, Kwang Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.243-251
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    • 2005
  • Objective: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer Methods: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus <8 mm) and same variables above described were compared between study and control groups. Results: The mean age, infertility duration, endometrial thickness at embryo transfer day and mean number of transferred embryo were not significantly different in both groups. Also, implantation rates (study group: 15.8%, control group: 20.5%) and pregnancy rate (study group: 45.1%, control group: 43.5%) were not significantly different between two groups. (p>0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. Conclusions: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.