• Title/Summary/Keyword: Mean Normal Stress

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Analysis of Myocardial Function Using Gated Myocardial SPET : Comparison of QGS, 4D-MSPECT Software and Echocardiography (게이트 심근관류 SPECT를 이용한 심기능 분석: 정량분석 소프트웨어 QGS, 4D-MSPECT 및 심초음파법의 비교)

  • Lee, Seok-Mo;Bae, Sang-Kyun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.435-443
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    • 2008
  • Purpose: Gated myocardial perfusion SPECT provides not only myocardial perfusion status but also various functional parameters of left ventricle. We compared left ventricular ejection fraction, end-diastolic volume, LV mass by cardiac SPECT using Quantitative Gated SPECT (QGS), 4D-MSPECT software and standard 2D-echocardiography. Materials and Methods: One hundred fourteen patients (male 51, female 63; 29-85 years old, mean $61.3\;{\pm}\;13.3$ years old) with normal perfusion status on Tc-99m tetrofosmin gated myocardial perfusion SPECT were analyzed retrospectively. Ejection fraction (LVEF), End-diastolic volume (LVED), LV mass (LVM) were calculated using QGS, 4D-MSPECT, and LVEF, LVM using 2D-echocardiography. Statistical analysis including Bland-Altman plot was performed using $MedCalc^{(R)}$ (MedCalc software, Mariakerke, Belgium). Results: The correlation of LVEF between methods was good: 0.95/0.96 (stress/rest) between QGS and 4D-MSPECT, 0.79 between QGS and echocardiography, 0.79 between 4D-MSPECT and echocardiography (p<0.001). Using Bland-Altman plot, the 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -12.7% to 7.3% / from -12.2% to 6.5% (stress/rest). The agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -17.4% to 24.0%, and -14.8% to 27.0% respectively. The correlation of LVM between methods was also good: 0.95 between QGS and 4D-MSPECT, 0.76 between QGS and echocardiography, 0.73 between 4D-MSPECT and echocardiography (p<0.001). The 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -33.8g to 14.1g (stress/rest), The 95% confidence interval of agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -148.7 g to 21.8. g, and -142.8 g to 35.5 g, respectively. Conclusion: There was a good correlation for LVEF, LVEO, LVM among methods (QGS, 4D-MSPECT, echocardiography), but the variance between methods was big. Therefore, the functional parameters by each method cannot be used interchangeably.

Arthroscopic ACL Reconstruction Using Fresh-Frozen Achilles Allograft -Clinical results, Recovery of sports activity- (아킬레스 동종건을 이용한 전방십자인대 재건술후 임상적 결과와 운동력 회복 평가)

  • Chun Churl Hong;Ha Dae Ho;Kim Dong Chul;Kim Hyun Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.31-36
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    • 2002
  • Purpose : ACL (anterior cruciate ligament) reconstruction using achilles allograft was done for whom ACL injured person in recreational sports activity. The purpose of this study was to evaluate the clinical results and return to their sports activity in these patients. Materials and Methods : ACL injured 56 amateur athletes who had experienced sports 3 times a week more than 5 years, reconstructed with Achilles allograft, and it was analyzed subjective and objective parameter, Tegner scoring, Telos stress arthrometer, Lysholm Knee Scoring System and modified Feagin scoring system. The average age was 25 years old (range: 18$\~$49), the average follow up period was 15 months (range: 12$\~$19). Morbid sports were football (29 cases), basket ball (14 cases), badminton (5 cases), tennis (3 cases), squash (2 cases) and otherwise (3 cases). Result : The mean Lysholm Knee Scoring System was improved to 88.2 from 60. Telos arthrometer in anterior stress test revealed 2.3 mm improved from 7.1 mm. The modified Feagin scoring system showed 50 cases (89$\%$) with excellent and good results. We had obtained 12 cases (21$\%$) of Tegner score VI, 32 cases (57$\%$) of score V, 20 cases (35%$\%$ of score IV, 3 (5.3$\%$) cases of score III. Conclusions : Reconstruction of anterior cruciate ligaments can restore stability sufficient to allow sports activity in ACL injured patients, but it’s difficult to achieve 'normal' sports activity. So we will have to solve the reasons of this dissatisfaction at furthermore.

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Subsurtace Geological Structure of the Downstream Area of the Jangsung Lake (장성호 하류지역의 지하지질구조)

  • 김성균;김용준;오진용;김민선;서구원
    • The Journal of Engineering Geology
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    • v.7 no.2
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    • pp.101-112
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    • 1997
  • Gravity and electrical resistivity surveys were carried out across the Kwangju fault in the downstream area of the Jangsung Lake, to investigate the location and geometrical feature of the fault. In the resistivity survey, dipole - dipole array method was adopted for 3 survey lines of which length and electrode spacing are 500m and 25m, respectively. Resistivity data are interpreted with aid of computer program "RESIS" which is widely used in resistivity data analysis and two dimensional resistivity profiles are obtained for 3 survey lines. Two large fracture zones relevant to the Kwangju fault are identified in the resistivity profiles. The total of 80 gravity data are observed with the mean spacing of 40 m and the exact leveling is accompanied to obtain more precise gravity anomalies. The subterranean density discontinuities calculated from the inverse method are appeared at the depths of 650rn and 120m. It is considered that the deep discontinuity indicates boundary between Jurassic granites and oveflying Cretaceous tuff formation. while, the shallow discontinuity is interpreted to be a boundary between alluvial deposits and basements. The subsurface geological structure to satisfy the observed Bouguer anomaly is determined from the iterative forward method in which results from existing surface geological informations, the inverse method, and from the resistivity interpretations are employed as an iuitial model. In conclusion, Kwangju fault is appeared to be a high angle normal fault mainly formed in tension stress filed.

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Classification of Shear Strength according to Breccia Content in Fault Core (단층각력 함량에 따른 전단강도의 분류)

  • Yun, Hyun-Seok;Moon, Seong-Woo;Seo, Yong-Seok
    • Economic and Environmental Geology
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    • v.53 no.2
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    • pp.167-181
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    • 2020
  • Analysis of variance (ANOVA) and multiple comparison analysis were performed for shear strengths categorized by breccia content of 5 wt.% (Case-I), 10 wt.%, (Case-II) and 15 wt.% (Case-III) in fault cores. The relationship between breccia contetnt and shear strength was quantitatively classified by calculating the mean and standard deviation of shear strength for each population in each case and then the grouping the breccia contents that had a statistically similar effect on the dispersion of shear strength. As a result, shear strength was clearly classified into group 1 (breccia content of 0-15 wt.%) and group 2 and 3 (breccia coantent of 15-30 wt.% and 30 wt.% or more) in Case-III. Shear strength of the standard line at breccia content of 15 wt.% were determined to be 43.6 kPa, 77.6 kPa, and 118.6 kPa at each normal stress (54 kPa, 108 kPa, and 162 kPa), respectively. In addition, the distribution range of cohesions is 0-43.6 kPa at breccia content of 15 wt.% or less, and 0-70.0 kPa at 15 wt.% or more. Distribution range of friction angles is 0-45.7 ° at breccia content of 15 wt.% or less, and 16.7-57.5 ° at 15 wt.% or more.

Prevalence of Distress and Its Influence on Quality of Life in Breast Cancer Patients (유방암 환자에서의 디스트레스의 유병률 및 디스트레스가 삶의 질에 미치는 영향)

  • Chun, Soo-Yeon;Shim, Eun-Jung;Hwang, Jun-Won;Hahm, Bong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.72-81
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    • 2010
  • Objectives : Early detection and proper management of distress are known to be important for efficient care in cancer patients. The aim of this study was to investigate the prevalence of distress and to evaluate its influence on quality of life in subjects with breast cancer. Methods : A total of 95 patients were recruited from a breast cancer patient community of a general hospital in Seoul. The Hospital Anxiety and Depression Scale(HADS), the Insomnia Severity Index(ISI), the Impact of Event Scale-Revised(IES-R) and the Functional Assessment of Cancer Therapy-Breast(FACT-B) were measured. Results : The prevalence of anxiety, depression, insomnia and posttraumatic stress disorder symptom among breast cancer patients was 26.3%, 26.3%, 13.7%, 24.3%, respectively. Nearly half(47.4%) of total subjects were under one or more significant distress, and they showed significantly lower mean FACT-B total score than patients without distress(82.91 vs. 107.20, p<0.001). Distress was negatively correlated with the quality of life to a significant level even in patients who were in normal range of distress scale scores. Conclusion : These results support the importance of regular screening and proper management of distress for breast cancer patients.

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A Study on The Health Status of Island Community People in Island (도서지역 주민의 건강상태에 관한 연구)

  • Shin, Kyung Rim
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.296-310
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    • 2000
  • During the past 10 years, concern for community people's health has increased together with the changes. Public health policies and studies for community people's health, however, have influenced those in childmaternal health care to want more general coverage and studies of health and wellness. Particularly, the study of community people's health in the extent an island area is almost rare as that personal and the material benefits in this area are lacking of community people's work is large, and the basic elements of living, such as diet and elimination, are irregular due to the schedule of the tide. Thus, there are many potential health problems. In this regard, the study attempted to understand the health problems of island community people and to provide a basis for developing health promotion and health education programs. In collecting data for the study, face to face interviews were made through a structured questionnaire from October 1 to December 30, 1996. Collected data were analyzed with the SAS statistics program, descriptive statistics, t-test and ANOVA. Subjects' health status was examined by classifying into such categories as their health perception, complaints of health problem, related lifestyle, psychosocial health staus, the result of examination is as follows; 1. For subjects' health perception, 26.9% of the subject answered not sick, but not so healthy'; 30.9% thought they were healthy, while 22.9% answered that they were not healthy. 2. For the health problem complaints many complained of pains in their muscles and skeletal system, especially knee joint pain. Women's health problems related with breast and the reproductive system included 52.3% of cases doing breast self examination, while 56.55% received the cervical cancer screening test. In men's health problems, 44.2% of subjects answered that they have moderate to severe BPH(Benign Prostatic Hypertrophy) symptom. 3. There were statistically a significant difference in the degree of physical health according to marital status(p=0.0028), occupation(p=0.0442), income(p=0.0357). 4. For stress status, 17.2% was to need the intervention, 50.2% was to need observation. 5. The mean score of self-esteem was 27.7 showing a relatively high score. 6. For the rate of smoking, 37.7% used to smoke, while 28% used to take alcohol. 7. The rate of substance abuse was 45.9% of subjects. 8. Most of subjects' health behaviors included most of the acupuncture (52%). 9. The rate of subjects receiving comprehensive medical testing was 34.36% while 34.78% did after care managing behavior. 10. For the obesity grade, 53% is normal weight, low-weight 32.8%, obesity 33%. 11. For nutrition status, 78.7% illy balanced to need intervention of nutritional education. 12. For 78.7% of subjects, muscle strength and 40.7% of stretching were not good enough to need health education on physical exercises. Therefore, based on the results, appropriate health education programs need to be developed to promote health of community people on an island.

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Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

An Investigation of Reliability and Safety Factors in RC Flexural Members Designed by Current WSD Standard Code (현행(現行) 허용응력설계법(許容應力設計法)으로 설계(設計)되는 RC 휨부재(部材)의 신뢰성(信賴性)과 안전율(安全率) 고찰(考察))

  • Shin, Hyun Mook;Cho, Hyo Nam;Chung, Hwan Ho
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.1 no.1
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    • pp.33-42
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    • 1981
  • Current standard code for R.C. design consists of two conventional design parts, so called WSD and USD, which are based on ACI 318-63 and 318-71 code provisions. The safety factors of our WSD and USD design criteria which are taken primarily from ACI 318-63 code are considered to be not appropriate compared to out country's design and construction practices. Furthermore, even the ACI safety factors are not determined from probabilistic study but merely from experiences and practices. This study investigates the safety level of R.C. flexural members designed by the current WSD safety provisions based on Second Moment Reliability theory, and proposes a rational but efficient way of determining the nominal safety factors and the associated flexural allowable stresses of steel bars and concretes in order to provide a consistent level of target reliability. Cornell's Mean First-Order Second Moment Method formulae by a log normal transformation of resistance and load output variables are adopted as the reliability analysis method for this study. The compressive allowable stress formulae are derived by a unique approach in which the balanced steel ratios of the resulting design are chosen to be the corresponding under-reinforced sections designed by strength design method with an optimum reinforcing ratio. The target reliability index for the safety provisions are considered to be ${\beta}=4$ that is well suited for our level of construction and design practices. From a series of numerical applications to investigate the safety and reliability of R.C. flexural members designed by current WSD code, it has been found that the design based on WSD provision results in uneconomical design because of unusual and inconsistent reliability. A rational set of reliability based safety factors and allowable stress of steel bars and concrete for flexural members is proposed by providing the appropriate target reliability ${\beta}=4$.

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Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT (소아 모야모야병에서 뇌확률지도를 이용한 수술전후 혈역학적 변화 분석)

  • Lee, Ho-Young;Lee, Jae-Sung;Kim, Seung-Ki;Wang, Kyu-Chang;Cho, Byung-Kyu;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.192-200
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    • 2008
  • To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Methods: Total fifty six (M:F = 33:24, age $6.7{\pm}3.2$ years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was $33{\pm}21$ months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. Results: In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal lobe of the hemispheres with EDAS and frontal EGS, the post-operative CVRI, and ${\Delta}CVRI$ showed a significant difference between patients with a good and poor clinical outcome (p<0.05). In a multivariate logistic regression analysis, the ${\Delta}CVRI$ and the post-operative CVRI of medial frontal gyrus on the hemispheres where EDAS with frontal EGS was performed were the significant predictive factors for the clinical outcome (p =0.002, p =0.015), Conclusion: With probabilistic map, we could objectively evaluate pre/post-operative hemodynamic changes of pediatric patients with moyamoya disease. Specifically the post-operative CVRI and the post-operative CVRI of medial frontal gyrus where EDAS with frontal EGS was done were the significant predictive factors for further clinical outcomes.

Respiratory Gas Exchange and Ventilatory Functions at Maximal Exercise (최대운동시의 호흡성 가스교환 및 환기기능)

  • Cho, Yong-Keun;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.900-912
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    • 1995
  • Background: Although graded exercise stress tests are widely used for the evaluation of cardiorespiratory performance, normal standards on respiratory gas exchange and ventilatory functions at maximal exercise in Koreans have not been well established. The purpose of this study is to provide reference values on these by sex and age, along with derivation of some of their prediction equations. Method: Symptom-limited maximal exercise test was carried out by Bruce protocol in 1,000 healthy adults consisting of 603 males and 397 females, aged 20~66 years. Among them VC, $FEV_1$ and MVV were also determined in 885 cases. All the subjects were members of a health center, excluding athletes. During the exercise, subjects were allowed to hold on to front hand rail of the treadmill for safety purpose. Results: The $VO_2\;max/m^2$, $VCO_2\;max/m^2$ and $V_E\;max/m^2$ were greater in males than in females and decreased with age. The RR max in men and women was similar but decreased slightly with age. The $V_T$ max was markedly greater in men but showed no significant changes with age in either gender. The mean of $V_T$ max/VC, $V_E$ max/MVV and BR revealed that there were considerable ventilatory reserves at maximal exercise even in older females. The regression equations of the cardinal parameters obtained using exercise time(ET, min), age(A, yr), height(Ht, cm), weight(W, kg), sex(S, 0=male; 1=female), VC(L), $FEV_1$(L) and $V_E$ max(L) as variables are as follows: $VO_2\;max/m^2$(L/min)=1.449+0.073 ET-0.007A+0.010W-0.006Ht-0.209S, $VCO_2\;max/m^2$(L/min)=1.672+0.063ET-0.008A+0.010W-0.005Ht-0.319S, VE max/$m^2$(L/min)=58.161+1.503ET-0.315A-9.871S or VE max/$m^2$(L/min)=47.873+6.548 $FEV_1$-5.715 S, and VT max(L)=1.497+0.223VC-0.493S. Conclusion: Respiratory gas exchange and ventilatory variables at maximal exercise were studied in 1,000 non-athletes by Bruce protocol. During exercise, the subjects were allowed to hold on to hand rail of the treadmill for safety purpose. We feel that our results would provide ideal target values for patients and healthy individuals to be achieved, since our study subjects were members of a health center whose physical fitness levels were presumably higher than ordinary population.

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