• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.199-206
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• 2000

Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

• 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.

• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.232-239
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• 2014

Purpose: Mitochondrial disease (MD) and Duchenne muscular dystrophy (DMD) are often associated with cardiomyopathy, but the myocardial variability has not been isolated to a specific characteristic. We evaluated the left ventricular (LV) mass by echocardiography to identify the general distribution and functional changes of the myocardium in patients with MD or DMD. Methods: We retrospectively evaluated the echocardiographic data of 90 children with MD and 42 with DMD. Using two-dimensional echocardiography, including time-motion (M) mode and Doppler measurements, we estimated the LV mass, ratio of early to late mitral filling velocities (E/A), ratio of early mitral filling velocity to early diastolic mitral annular velocity (E/Ea), stroke volume, and cardiac output. A "z score" was generated using the lambda-mu-sigma method to standardize the LV mass with respect to body size. Results: The LV mass-for-height z scores were significantly below normal in children with MD ($-1.02{\pm}1.52$, P<0.001) or DMD ($-0.82{\pm}1.61$, P =0.002), as were the LV mass-for-lean body-mass z scores. The body mass index (BMI)-for-age z scores were far below normal and were directly proportional to the LV mass-for-height z scores in both patients with MD (R =0.377, P<0.001) and those with DMD (R =0.330, P=0.033). The LV mass-for-height z score correlated positively with the stroke volume index (R =0.462, P<0.001) and cardiac index (R =0.358, P<0.001). Conclusion: LV myocardial atrophy is present in patients with MD and those with DMD and may be closely associated with low BMI. The insufficient LV mass for body size might indicate deterioration of systolic function in these patients.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.72-81
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• 1992

Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine $^{99m}Tc-MIBI$ myocardial scintigraphy were evaluated and comparison with exercise $^{99m}Tc-MIBI$ was performed. Twenty-eight subjects underwent $^{99m}Tc-MIBI$ imaging after adenosine infusion and exercise $^{99m}Tc-MIBI$ imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate ($64{\pm}12$ at baseline versus $74{\pm}16$ beats/min at peak effect, p<0.001), a mild decrease in systolic and diastolic blood pressure and a slightly increase in PR interval(p; NS). Side effects were reported in 92% of patients and were mostly mild in nature and promptly resolved within 1 or 2 minutes of termination of adenosine infusion. Facial flushing (53%), chest pain (36%), mild dyspnea (39%), headache (21%), throat discomfort (21%) were frequent symptoms. ST segment depression (> 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, $^{99m}Tc-MIBI$ myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise $^{99m}Tc-MIBI$ scintigraphy.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.265-273
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• 1992

Rest gated blood pool scan (Rest GBP scan) and dipyridamole $^{99m}Tc-MIBI$ SPECT were Performed in 34 patients with or suspected coronary artery disease. Both studies were performed within $2\sim32$ days (mean 8.1 days). A significant correlation was present between left ventricular ejection fraction (r= -0.7356, p<0.001) and peak ejection rate and peak filling rate in rest GBP scan and perfusion defect in MIBI SPECT. And there were acceptable correlations (0.05$26.2{\pm}10.8%$, severe hypokinesia, akinesia or dyskinesia in 16 regions: $78.2{\pm}23.7$, p<0.001). These data indicate there is a significant coupling between the degree of myocardial perfusion and the myocardial functional change in coronary artery disease.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.603-610
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• 2020

Objectives: This study was aimed at investigating the oral hygiene device use by cardiovascular disease patients and assessing related factors. Methods: We used data of 1,630 cardiovascular disease patients (including hypertension, stroke, and myocardial infarction) from the 7th Korean National Health and Nutrition Examination Survey (2016-2018). The χ² test and logistic regression analysis were performed to analyze the oral hygiene device use by the subjects and assess related factors. All statistical analyses were performed with the IBM SPSS Statistics, version 20.0. Results: The oral hygiene device use and related factors were significantly higher in patients with an educational level of middle school or below high school, with a score of 1.85 (95% confidence interval [CI] = 1.35-2.53), or college, with a score of 1.93 (95% CI = 1.19-3.14), compared to those with an educational level below primary school. Further, the oral hygiene device use and related factors were significantly higher in patients who answered 'yes', with a score of 1.96 (95% CI = 1.42-2.73), compared to those who answered 'no' to the question on oral examination. Conclusions: More patients with cardiovascular disease did not use oral hygiene devices than those who did. It is necessary to expand the approach of preventive treatment to increase the utilization rate of oral hygiene devices.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.633-643
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• 1986

Five hundred cases of open heart surgery were operated in the Dept. of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1986. The clinical data were summarized as follows: 1. The age distribution of congenital heart disease patients was 2 to 41 years old and mean age was 13.4 years and of acquired heart disease was 11 to 57 years old and mean age was 32.7 years. 2. There were 319 cases [63.8%] of acyanotic congenital heart anomalies, 56 cases [11.2%] of cyanotic anomalies and 125 cases [25.[%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and since 1983, GIK solution is being used repeatedly every 30 to 40 minutes time interval with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, mannitol, sodium bicarbonate, potassium, chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 94 cases of mild hypothermia, 280 cases of moderate hypothermia and 126 cases of intermediate hypothermia. 6. The overall mortality was 8.2%. And the mortality rate in each disease entity is 2.5% in acyanotic congenital cases, 33.9% in cyanotic congenital cases and 11.2% in acquired heart disease.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.36-47
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• 1988

610 cases of open heart surgery was performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July 1981 to September 1987. The clinical data was summarized as follows: 1. The age distribution of congenital heart surgery patients was 2 to 41 years old [mean; 13.2 years] and surgery for acquired heart disease was 10 to 57 years old [mean: 32.8 years]. 2. There were 389 cases [63.8%] of acyanotic congenital heart anomalies, 63 cases [10.3%] of cyanotic congenital anomalies and 158 cases [25.9%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and then since 1983, GIK solution has been used with repeated infusion method once for every 20 to 30 minutes of time interval after starting initial cardioplegia during operation with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, sodium bicarbonate, mannitol, potassium chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 96 cases [15.7%] of mild hypothermia, 333 cases [54.6%] of moderate hypothermia and 181 cases [29.7%] of intermediate hypothermia. 6. The mortality rate was 2.3% [9 out of 389 cases] in acyanotic congenital heart disease, 36.5% [23 out of 63 cases] in cyanotic congenital heart disease and 10.8% [17 out of 158 cases] in acquired heart disease, with overall mortality rate of 8.0% [49 out of 610 cases].

• Journal of Sasang Constitutional Medicine
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• v.14 no.2
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• pp.125-131
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• 2002

An ischemic heart disease(IHD) is a anemic state of heart caused by disproportion between heart's demand and supply of oxygen. A patient who has this IHD feels serious chest pain called angina pectoris. In a keen condition it leads to a necrosis of heart muscles, known as myocardial infarction. In an ischemic heart disease the ECG waves gives us useful information of patients' heart. And CK(creatine kinase) in serum and Troponin T are the principal factors in diagnosis of IHD. In this study, the IHD patient classified by Sasang Constitutional Medicine had a notable medical effects. The symptoms of patient are disappeared and waves of ECG is closed to normal. The result of CK in serum is also recovered. So we report the healing process and results of this patient in this study.

• 대한핵의학회:학술대회논문집
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• 1999.11a
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• pp.31.1-31.1
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• 1999