• Journal of Yeungnam Medical Science
• /
• 제11권1호
• /
• pp.146-152
• /
• 1994

저자들은 14명의 관상동맥질환이 의심되지 않는 건강한 젊은 남자를 대상으로 dipyridamole 부하 $^{99m}Tc$-MIBI 심근 SPECT를 시행하였다. 이를 이용하여 Cedars-Sinai방법으로 극성지도를 구하고 전체 심근을 9부분으로 나누어 각 부위의 상대적인 방사능 세기를 조사하고 분석하였다. 이와 함께 dipyridamole 부하 전후의 혈역동학적인 변화와 부작용을 알아보았다. 극성지도에서 부하기와 휴식기 모두 방사능 계수치가 가장 높은 부위는 Latero-anterior wall이었고, 가장 낮은 부위는 Infero-septal wall이었다. 부하기와 휴식기사이의 각 부위의 방사능세기는 서로간에 유의한 차이가 없었다. dipyridamole 투여후 심박수와 이완기 혈압 및 Double product는 유의한 변화를 보였다. dipyridamole에 의한 부작용은 14명 중 12명에서 나타나 비교적 높은 비율을 보였으나 중한 부작용은 관찰되지 않았다. 이상의 결과로 $^{99m}Tc$-MIBI 심근 SPECT에서 구한 극성지도에서 관상동맥질환을 판정할 때는 부위별로 혈류 저하를 판정하는 기준이 달라야만 할 것으로 생각된다.

• 대한핵의학회지
• /
• 제26권2호
• /
• pp.274-279
• /
• 1992

Clinical role of $^{99m}Tc-MIBI$ myocardial scintigraphy in the diagnosis of coronary artery disease (CAD) is now well accepted, however, the role of it in the identification of viable myocardium in patients with chronic CAD has not yet been clarified. To determine the usefulness of rest-injected $^{99m}Tc-MIBI$ scan as a marker of myocardial viability, the regional uptake of this agent at rest was compared with that of $^{201}Tl$ on reinjection and 24 hours after reinjection images. Subject patients were 13 chronic CAD patients who showed irreversible perfusion defect(s) on standard pharmacologic (dipyridamole) stress-redistribution images. Immediately after the redistribution images were obtained, 37 MBq thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. After then 740 MBq $^{99m}Tc-MIBI$ was injected, and 1 hour later rest MIBI myocardial imaging was performed. Five sets of imagestress, redistribution, reinjection, delayed images of thallium, and rest image of MIBI) were then analyzed qualitatively and quantitatively. Left ventricle was arbitrarily divided into 9 segments (apex, basal and apical portions of anterior, septal, inferior, and lateral walls). Seven patients and 30 regions showed a fixed perfusion defect on the stress-redistribution images. Among 30 regions, 15 showed positive uptakes and 6 showed negative uptakes on both $^{201}Tl$ reinjection/delayed images and $^{99m}Tc-MIBI$ rest images. Five regions showed only thallium uptake and were regarded as viable clinically. Of four regions which showed only $^{99m}Tc-MIBI$ uptake, two were regarded as viable, while the other two were regarded as a nonviable scar tissue clinically. In conclusion, $^{201}Tl$ reinjection technique was more reliable in the identification of viable myocardium. However, the role of $^{99m}Tc-MIBI$ in identification of viable myocardium was still remained to be clarified because 2 of 9 regions showed only $^{99m}Tc-MIBI$ uptake and were regarded as viable tissues.

• 대한핵의학회지
• /
• 제21권2호
• /
• pp.167-174
• /
• 1987

Among noninvasive approaches for the evaluation of left ventricular performance, radionuclide ventriculography (RVG) has been shown to be of particular values. Phase analysis, recently introduced as more objective means for evaluating the temporal sequence of systolic ventricular wall motion than cine image of RVG comprises a pixel by pixel Fourier transformation of the time activity curve of a multiple gated acquisition equilibrium blood pool study. To examine the regional wall motion of ventricles in myocardial infarctions, we evaluated the phase image and histogram constructed for each ventricle by total phase angle range and full width of half maximum (FWHM). This study consisted of 7 normal subjects and 23 subjects with acute myocardial infarction. Contrast ventriculography and coronary angiography was performed in all partients with myocardial infarction. And we compared the result of phase analysis with cine image of RVG and examined the interrelationship between phase analysis and contrast ventriculography with coronary angiography. The results were as follows; 1) The total phase angle range and FWHM of LV phase histogram in myocardial infarction ($86^{\circ}\;and\;32^{\circ}$, repectively) were wider than those in normal control ($38^{\circ}\;and\;18^{\circ}$, respectively p<0.01). 2) RV phase angle range and FWHM in patients with right coronary artery (RCA) occlusion ($79^{\circ}\;and\;37^{\circ}$, respectively) were wider than those in normal control ($39^{\circ}\;and\;18^{\circ}$, respectively p<0.001) and the patients without RCA occlusion ($52^{\circ}\;and\;19^{\circ}$, respectively p<0.01). 3) Phase analysis was more sensitive (95%) than cine image of RVG (70%) for the detection of regional wall motion abnormality of LV.

• Journal of Preventive Medicine and Public Health
• /
• 제45권5호
• /
• pp.323-328
• /
• 2012

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

• 보건교육건강증진학회지
• /
• 제23권2호
• /
• pp.109-119
• /
• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• 한국환경과학회지
• /
• 제25권6호
• /
• pp.839-851
• /
• 2016

The effect of weather on disease was investigated based on results reported in academic papers. Weather-sensitive disease was selected by analyzing the frequency distributions of diseases and correlations between diseases and meteorological factors (e.g., temperature, humidity, pressure, and wind speed). Correlations between disease and meteorological factors were most frequently reported for myocardial infarction (MI) (28%) followed by chronic ischemic heart disease (CHR) (12%), stroke (STR) (10%), and angina pectoris (ANG) (5%). These four diseases had significant correlations with temperature (meaningful correlation for MI and negative correlations for CHR, STR, and ANG). Selecting MI, as a representative weather-sensitive disease, and summarizing the quantitative correlations with meteorological factors revealed that, daily hospital admissions for MI increased approximately 1.7%-2.2% with each $1^{\circ}C$ decrease in physiologically equivalent temperature. On the days when MI occurred in three or more patients larger daily temperature ranges ($2.3^{\circ}C$ increase) were reported compared with the days when MI occurred in fewer than three patients. In addition, variations in pressure (10 mbar, 1016 mbar standard) and relative humidity (10%) contributed to an 11%-12% increase in deaths from MI and an approximately 10% increase in the incidence of MI, respectively.

• Journal of Preventive Medicine and Public Health
• /
• 제35권2호
• /
• pp.92-98
• /
• 2002

Objective : To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide ($SO_2$) in Korea using the YLD (years lived with disability) measurement. Methods : Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and $SO_2$ levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and $SO_2$ was estimated using the number of years that the patient lived with a disability. Results : The VLD of the CHF due to the TSP and $SO_2$ was attributed to the TSP (94.4 person-year) and $SO_2$ levels (35.0 person-year). The YLD of the ME due to the TSP and $SO_2$ was attributed to the TSP (148.4 person-year) and $SO_2$ levels(27.6 person-year). Conclusion : The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.

• 한국치위생학회지
• /
• 제21권6호
• /
• pp.763-771
• /
• 2021

Objectives: The purpose of this study was to examine the association between periodontitis and health behavior in women aged ≥40 years. In addition, related factors were compared according to the presence or absence of cardiovascular disease. Methods: Data from the 7th Korean National Health and Nutrition Examination Survey (2016-2018) were used. The study included 3,801 women aged 40-79 years, who participated in a questionnaire health survey related to hypertension, stroke, myocardial infarction, and angina pectoris, as well as completed blood tests, anthropometry, and oral examination. Statistical analyses were performed using complex sample general linear, complex sample crosstabs, and complex sample logistic regression analyses. Results: In all subjects, smoking and drinking, use of interdental care products, and dental checkups were confirmed to be significantly related to periodontitis. In the group with cardiovascular disease, the use of interdental care products, experience in dental checkups, and toothbrushing more than three times a day were confirmed as significant factors for lowering the prevalence of periodontitis. In the group without cardiovascular disease, smoking and drinking, use of interdental care products, and experience in dental checkups were confirmed as the significant factors. Conclusions: To improve the periodontal health of women over 40 years of age with cardiovascular disease, a health education program including self-care methods for proper dental plaque management and regular dental checkups are critical. Additionally, awareness of the risks of smoking and drinking would be helpful even for women without cardiovascular diseases.

• Journal of Chest Surgery
• /
• 제32권6호
• /
• pp.525-531
• /
• 1999

배경: 본 연구는 1981년 11월부터 1997년 6월까지 관상동맥 우회술을 받은 500례의 협심증 환자를 대상으로 술전 진단, 수술방법, 수술사망률, 수술합병증, 술후 증상의 재발과 치료에 대해 알아보았다. 대상 및 방법: 500례 중 남자는 330례, 여자는 170례였고 평균 연령은 57.4$\pm$8.9세였다. 술전 환자의 평가를 위해 심전도, 심에코, MIBI scan, 내경동맥과 대퇴동맥에 대한 Duplex Sono, CK, LDH를 포함한 일반적인 혈액 검사, 관상동맥 조영술 등을 시행하였으며, 술후 부정맥과 심근경색증 등의 합병증에 대한 판정 지표로 삼았다. 결과: 술전 진단으로 불안정성 협심증이 282례 (56.4%), 안정성 협심증이 141례 (28.2%), 심근경색후 협심증이 58례 (11.6%), 급성 심근경색증이 8례 (1.6%), 이형 협심증이 7례 (1.4%), 경피적 관상동맥확장술 실패가 4례 (0.8%)였다. 술전 관상동맥 조영술 상 삼혈관 질환이 263례 (52.6%), 이혈관 질환이 93례 (18.6%), 단일혈관 질환이 71례 (14.2%)였으며, 좌주관상동맥 질환이 68례 (13.6%), 그외 5례(1.0%) 있었다. 환자들은 술전 여러 가지 관상동맥 질환의 위험인자들에 노출되어 있었으며 고혈압, 흡연, 비만, 당뇨 등의 빈도가 점차 증가하고 있었다. 수술은 대복재정맥 1143문합, 내흉동맥 442문합, 요골동맥 17문합, 위대망막 동맥 1문합으로 환자당 평균 3.2$\pm$1.2문합을 시행하였으며, 인공판막 치환술 또는 성형술이 동시에 시행된 경우가 31례 (6.2%), 관상동맥 내막절제술 또는 성형술이 27례 (5.4%), 좌주관상동맥 성형술이 13례 (2.6%), 내경동맥 내막절제술이 5례 (1.0%), Maze 술식이 3례 (0.6%), 기타 술식이 11례 (2.2%) 등에서 시행되었다. 수술시간은 대동맥차단 시간이 평균 99$\pm$67분이었다. 수술사망률은 6.8% (34/500)이었고, 여성, 심근경색증 \ulcorner과거력, 급성 심근경색증과 응급수술 등이 유의한 위험인자로 나타났다. 합병증으로서 부정맥 109례 (21.8%), 신경학적 합병증 27례 (5.4%), 출혈 25례 (5.0%), 수술전후 심근경색증 25례 (5.0%), 종격동염을 포함한 창상감염 20례 (4.0%), 저심박출증 18례 (3.6%), 급성 신부전증 12례 (2.4%), 폐렴 등의 기타 합병증이 10례(2.0%)있었다. 술후 추적기간은 평균 25$\pm$23개월이었으며, 증상의 재발로 인한 재수술은 5명의 환자에서 시행되었다. 결론: 수술경험의 축적, 심근보호법의 다양한 적용, 심기능 보조장치의 적극적인 사용으로 고위험군 환자의 증가에도 불구하고 수술사망률을 감소시킬 수 있으리라 기대된다.

• 한국환경보건학회지
• /
• 제42권5호
• /
• pp.324-332
• /
• 2016

Objectives: The annual average of PM10 in Seoul was $45{\mu}/m^3$, which surpasses the WHO annual guidelines ($20{\mu}/m^3$). Most previous analyses of the effects of PM exposure have been retrospective studies using single hospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This study was conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospital costs in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 from National Institute of Environmental Research were used to identify the effects of PM10 on hospital visits, admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per $10{\mu}/m^3$ increase in PM10 were 23.11%, 10.2% and 6.9% increases for acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per $10{\mu}/m^3$ increase in PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis, respectively. For cardiovascular disease, the relative risk for admissions per $10{\mu}/m^3$ increase in PM10 were 2.2% and 2.1% increases in angina and acute myocardial infarction, respectively. A $10{\mu}/m^3$ increase in the monthly average of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won (95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increases in hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.