• Title/Summary/Keyword: Perfusion, regional

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전산화 폐관류주사를 이용한 폐절제술후 폐기능의 예측

  • Oh, Duck-Jin;Lee, Young;Lim, Seung-Pyeung;Yu, Jae-Hyun;Na, Myung-Hoon
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.897-904
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    • 1996
  • A preoperative prediction of postoperative pulmonary function after the pulmonary resection should be made to prevent serious complications and postoperative mortality. There are several methods to predict postoperative lung function but the 99m7c-MAA perfusion lung scan is known as simple, inexpensive and easily tolerated method for patients. We studied the accuracy of the perfusion lung scan in predicting postoperative lung function on 34 patients who received either the resection of one lobe(17 patients) or 2 lobes(2 patients) or pneumonictomy(15 patients). We performed pulmonary function test and lung scan immediately before the operation and calculated the postoperative lung function by substracting the regional lung function which will be rejected. We compared this predictive value to the observed pulmonary function which was done 20 days after the surgery. We also compared the data achieved from 12 patients ho received open thoracotomy due to intrathoracic disease that are not confined in the lung. The correlation coefficient between the predicted value and observed value of FEVI .0 was 0.423, FVC was 0.557 in the pneumonectomy group and FEVI . 0 was 0.693, FVC was 0.591 in the lobectomy group. The correlation coefnclent between the'postoperative value and preoperative value of FEVI .0 was 0.528, FVC was 0.502 in the resectional group and FEVI .0 was 0.871, FVC was 0.896 in the comparatives. We concluded that the perfusion lung scan is accllrate in predicting post-resectional pulmonary function.

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The Effect of LI4-LI11 Electrical Acupuncture at Unaffected Limb on Cerebral Blood Flow in Ischemic Stroke Patients using SPECT (SPECT를 이용한 뇌경색환자의 건측 합곡-곡지 전침치료가 뇌관류에 미치는 영향)

  • Moon, Sang-kwan;Kim, Young-suk;Park, Sung-uk;Jung, Woo-sang;Ko, Chang-nam;Cho, Ki-ho;Bae, Hyung-sup;Lee, Jae-dong;Kim, Deok-yoon
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.111-118
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    • 2004
  • Background and purpose: Opposing-needling technique involves selecting acupoints at unaffected limb. The aim of this study was to evaluate the effect of LI4-LI11 electrical acupuncture at unaffected limb on the cerebral blood flow in ischemic stroke patients using SPECT Methods: We selected 9 ischemic stroke patients. Baseline brain SPECT was done with triple head gamma camera(MultiSPECT3, Siemens, USA) after intravenous administration of 925 MBq of Tc-99m ECD). Fifteen-minute electro-acupuncture at Hapgok(LI 4) and Gokji(LI 11) were applied on unaffected upper limb of subjects. The same dose of Tc-99m ECD was injected during the electro-acupuncture, and the second SPECT images were obtained. Using the computer software(ICON 7.1, Siemens, USA), 3 SPECT slices(upper, middle, lower) surrounding the brain lesion were selected and each slice was divided by 10-16 brain regions. Asymmetry indexes were analyzed in each brain region. We regarded$\geq$10% changes of asymmetry index between before and after electro-acupuncture as significance. Results: Seven Patients(77.8%) had significantly increased perfusion and 2(22.2%) didn't show increased perfusion in post-acupuncture scans compared to pre-acupuncture scans(baseline). The regions of CBF improvement were mostly frontal lobes and anterior temporal lobes. Conclusions: This study demonstrated that LI4-LI11 electro-acupuncture at unaffected limb increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

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Expression and Secretion of the Insulin-like Growth Factor System Components by Pig Liver Cells

  • Kim, I.;Jin, E.J.;Baik, K.;Park, C.H.;Kim, W.K.;Kang, C.W.;Ko, Y.;Jang, I.;Choi, W.S.;Lee, C.Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.21 no.9
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    • pp.1244-1251
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    • 2008
  • The aim of the present study was to delineate the expression and secretion of insulin-like growth factor (IGF) system components by pig liver cells. Hepatocytes were prepared from 3-wk-old weanling piglets following a two-step collagenase perfusion procedure, after which the cells were incubated for 24 or 48 h at a density of $2{\pm}10^5$ cells per 35-mm dish in 2-ml Williams' medium E. The cells were found to express the genes encoding IGF-I, IGF-binding proteins (IGFBPs)-2 and -3 and acid-labile subunit (ALS) by reverse transcription-polymerase chain reaction (RT-PCR) following the culture. However, IGF-I was localized to hepatocytes by immunohistochemical analysis, whereas IGFBP-3 was localized to endothelial cells, but not to hepatocytes. This indicated that the IGFBP-3 gene expression detected by RT-PCR was likely to have been contributed by unidentified non-parenchymal cells that had not been removed during the hepatocyte preparation. The conditioned culture medium (CCM) of the cells contained immunoreactive IGF-I and IGF-II, with the latter being seven-fold more abundant than the former. The CCM also contained 43-, 40-, 34-, 31-kDa doublet and 26-kDa IGFBPs as examined by Western ligand blotting. The 40-, 34- and 31-kDa doublet IGFBPs were approximately three-fold as abundant as the 43- and 26-kDa IGFBPs. Moreover, the 43- and 40-kDa doublet and the 34-kDa IGFBPs were immunoprecipitable with IGFBP-3 and IGFBP-2 antibodies, respectively. Overall, these results are similar to those known in the rat, which suggests that the IGF system components are likely to be expressed and secreted in pig liver in a manner similar to that in rat liver.

A Study on Pulmonary Toxic Effect of High-Dose Cisplatin Administered by Isolated Lung Perfusion in Dogs (잡견에서 분리폐관류 방법으로 투여된 고농도 cisplatin의 페독성에 관한 연구)

  • 김관민;한정호;김주현
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.697-706
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    • 2000
  • Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

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Perfusion Impairment in Infantile Autism on Brain SPECT Using Tc-99m ECD : Comparison with MR Findings (유아 자폐증 환아에서의 Tc-99m ECD를 이용한 뇌 단일 광전자 방출 전산화 단층 촬영술상의 관류 저하: 자기 공명 영상과의 비교 분석)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Yoon, Pyeong-Ho;Kim, Dong-Ik;Oh, Young-Taik;Lee, Sun-Ah;Lee, Ho-Bun;Shin, Yee-Jin;Lee, Byung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.320-329
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    • 1997
  • Neuroanatomic substrate of autism has been the subjects of continuing investigation. Because previous studies had not demonstrated consistent and specific neuroimaging findings in autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and anatomical abnormalities with brain SPECT using Tc-99m ECD and correlative MRI The patient population was composed of 18 children aged 28 to 89 months(mean age : 55 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPECT was performed after intravenous injection of 185-370MBq of Tc-99m ECD using brain dedicated annular crystal gamma camera. MRI was performed in all patients including T1, T2 axial and T1 sagittal sequences. SPECT data were visually assessed. Thirteen patients had abnormal SPECT scan revealing focal areas of decreased perfusion. Decreased perfusion of cerebellar vermis(12/18), cerebellar hemisphere(11/18), thalami(13/18), basal ganglia(4/18), posterior parietal(7/18), and temporal(4/18) area were noted on brain SPECT. Whereas, only 3 patients had abnormal MR findings which were subtle volume loss of parieto-occipital white matter in 3 and mild thinning of posterior body of corpus callosum in 2 and slightly decreased volume of cerebellar vermis in 1. Comparison of the numbers of abnormal findings revealed that regional cerebral blood flow (rCBF) abnormalities seen on SPECT were more numerous than anatomical abnormalities seen on MRI. In conclusion, extensive perfusion impairment involving cerebellum, thalami and parietal lobe were found in this study. SPECT may be more sensitive in reflecting pathophysiology of autism than MRI. However, further studies are mandatory to determine the significance of thalamic and parietal perfusion impairment in autism.

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The Study on the Effect of Oriental Music Therapy in Ischemic Stroke Patients Classified by Sasang Constitutional Medicine (한방음악치료가 사상체질에 따라 분류된 뇌경색환자에 마치는 효과에 관한 연구)

  • Lee, Seung-Hyun;Kim, Deok-Yoon;Koh, Byung-Hee;Lee, Soo-Kyung;Kim, Sang-Bok
    • Journal of Sasang Constitutional Medicine
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    • v.18 no.2
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    • pp.125-132
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    • 2006
  • 1. Objectives The purpose of this study was to examine the regional cerebral blood-flow(r-CBF) difference between OMT(Oriental Music Therapy) group and control group using brain SPECT, to evaluate the effect of OMT in ischemic stroke patients Classified by Sasang Constitutional. 2. Methods We selected 10 ischemic storke patients, classified groups into OMT group or control group. r-CBF of two groups were examined by brain SPECT. in all group we applied SCM(Sasang constitutional medicine)treatment for 4-5 weaks, and additionally in OMT group We applied OMT for 4-5 weaks. after that all the r-CBF of two groups took brain SPECT again. r-CBF difference and change before and after SCM treatment and OMT were quantified and analyzed using SPM. 3. Results r-CBF of OMT groups were increased compared to control groups. 4. Conclusions This study demonstrated that Sasang Constitutional OMT increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

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Preliminary Study for Changes in Brain Perfusion in the Drug-Naive Patients with Panic Disorder with SPECT Following Cognitive-Behavioral Therapy (약물에 노출되지 않은 공황장애 환자들에서 인지행동치료 후 뇌혈류 변화에 대한 예비연구)

  • Kim, Jung-Bum;Shin, Young-Ah;Chae, Jeong-Ho;Chang, Eun-Jin;Ryu, Seol-Young;Won, Kyoung-Sook;Zeon, Seok-Kil;Chung, Yong-An
    • Anxiety and mood
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    • v.4 no.2
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    • pp.148-156
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    • 2008
  • Objective : Although cognitive-behavior therapy (CBT) is effective in patients with panic disorder, its the-rapeutic mechanism of action in the brain remains unclear. This study was performed to investigate regional blood flow changes associated with successful completion of CBT in drug-naive patients with panic disorder. Method : The regional blood flow in 4 patients with panic disorder was compared to that in 11 healthy controls before and after a 12-week group CBT using $^{99m}Tc$-ECD SPECT imaging. Psychopathology was assessed using Panic Disorder Severity Scale. Data were analyzed using software for statistical parametric mapping (SPM2). Results : Before CBT, significantly decreased blood flow was found in the parietal and occipital area in panic patients than normal volunteers. In all the patients who showed remission after CBT, increased blood flow was detected in the right cingulate gyrus, left lingual gyrus, and left superior parietal lobule, whereas decreased blood flow was seen in the left inferior temporal gyrus. Conclusion : These results suggested that CBT is effective for panic disorder and change the activity of cingulate gyrus and left temporal gyrus, a part of the brain areas associated with fear in panic disorder.

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Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder (주 우울증 환자의 국소 뇌혈류 변화 연구)

  • Lee, Won-Hyoung;Chung, Yong-An;Seo, Ye-Young;Yoo, Ik-Dong;Na, Sae-Jung;Jung, Hyun-Suk;Kim, Ki-Jun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.107-111
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    • 2009
  • Purpose: The authors analyzed how the regional cerebral blood flow(rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Materials and Methods: Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4weeks(male: 7, female: 5, age range: $19{\sim}52$ years, average age: $29.3{\pm}9.9$ years) and 14 normal volunteers(male: 8, female: 6, age range: $19{\sim}53$ years, average age: $31.4{\pm}9.2$ years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. Results: The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. Conclusion: The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated.

Hybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection

  • Kim, Seon Hee;Song, Seunghwan;Kim, Sang-Pil;Lee, Jonggeun;Lee, Han Cheol;Kim, Eun Soo
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.163-166
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    • 2014
  • A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

Change of Regional Myocardial Blood Flow After Transmyocardial Laser Revascularization in Porcine Model of Chronic Myocardial Ischemia (돼지 만성 심근허혈 모델에서 경심근레이저혈류재건술 후 국소 심근 혈류량의 변화)

  • Park, Kay-Hyun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.662-671
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    • 2001
  • Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

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