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The Clinical Analysis of Sulcus Vocalis (성대구증에 관한 임상적 고찰)

  • 김광문;서장수;오혜경;최홍식;김기령
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.11.2-12
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    • 1982
  • The major advancement in phonosurgery due to recent development of laryngomicrosurgery enabled more accurate diagnosis and treatment of patient with voice disorders. Among large proportion of voice disordered patients, prominent linear furrow running parallel along the free edge of vocal cord extending from the vocal process to anterior commissure can be seen as well as incomplete closure during phonation. These cases were illustrated and coined as sulcus vocalis by Salvi in 1901, since then other similar paper was reported in Europe and Japan, but has not been reported in Korea. The exact etiology and therapeutic methods of sulcus vocalis has not been elaborated. At Department of Otolaryngology of Yonsei University College of Medicine a series of voice analysis were performed among those 35 patients with sulcus vocalis visited to Vocal Dynamics Laboratory from May, 1981 to March, 1982. Following is the result of clinical statistical investgation and therapeutic modality. 1) The incidance of sulcus vocalis among 290 patients with voice disorder visited to Vocal Dynamics Laboratory was approximately 12%(35 cases). 2) Onset of this voice disorder was most frequent among patient under 10 year-old groups; 19 cases (54%) followed by second decade, third decade groups in decreasing frequency respectably. 3) The etiology of sulcus vocalis was mostly unknown. The sequelae after measle (4 cases) and severe upper respiratory infection (3 cases) and congenital deformity (2 cases) were the possible causes of sulcus vocalis. 4) These patients were involved bilaterally in 25 cases (71%), left side only in 8 cases (23%) and right side only in 2 cases (6%). 5) Almost all patients complained hoarseness and 7 patients were suffering from chronic laryngitis. 6) In aerodynamic analysis, Maximal Phonation Time was decreased in 20 cases (57%), Phonation Quotient was increased in 22 cases (63%) and Mean Air Flow Rate was increased in 23 cases (66%). 7) Among them, 33 cases were analyzed with stroboscopy. The findings were as follows; incomplete glottic closure during phonation in 31 cases (93%), regular vocal cord movement in whole cases, asymmetric cord movement in 4 cases (12%), decreased amplitude in 5 cases (21%) and small mucosal wave in 24 cases (73%). 8) Intracordal Teflon injection in 5 cases and Sulcusectomy in 1 cases were performed as therapeutic management, however, the therapeutic results were not effective except one case with Teflon injection.

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The Evaluation of Lateral Scatter Ray of Gamma Camera (Gamma Camera에 있어 측면 선란선의 영향에 대한 평가)

  • Kim, Jae-Il;Lee, Eun-Byeol;Cho, Seong-Wook;Noh, Kyeong-Woon;Kang, Keon-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.46-50
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    • 2018
  • Purpose Generally, a collimator that installed in front of detector set a direction of gamma ray and remove a scatter ray. By the way, a lateral or oblique scatter ray is detected into crystal through collimator. At this study, we will evaluate a mount of count and spectrums of lateral scatter ray. Materials and Methods We used the SKY LITE (philips, netherlands) as a gamma camera, and $^{99m}Tc$, 1.11 GBq point source as a phantom. we put this point source at backside 50 cm of detector. After acquiring this for 1 min, we turned a detector next 10 degrees. Likely this, we acquired images at every 10 degrees from $0^{\circ}$ to $360^{\circ}$, analyzed images and spectrums. In case of patient study, we choose a 3 phase bone scan patient who had a hand disease, because scatter rays from body would detect on crystal. After acquiring blood flow and blood pool images, we analyzed images and spectrums. Additional, we put a lead gown on patient's hand, body. And then we compared and evaluated 3 type blood pool images (non lead gown, lead gown on a hand and on body). Results In case of phantom study, scatter ray counts at backside ($270^{\circ}-90^{\circ}$) are same with a background count. By the way, counts of scatter ray of oblique side ($0^{\circ}-50^{\circ}$, $220^{\circ}-270^{\circ}$) are 100-600 cps, furthermore, counts at frontside are over 4 Mcps. In case of patient study, a counts of hand blood pool scan are 1510 cps. But counts of hand with lead gown on hands and on body are each 1554 cps, 1299 cps. Conclusion Therefore, even though there is a collimator in front of detector, lateral scatter rays detect on crystal and affect to images and spectrums. Especially, if there is a high activity source at outside of detector when we examine low activity organs like hands or foot, we have to shield and remove the source at outside for a good image.

Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow in Healthy Human - Evaluated by $^{99m}Tc-ECD$ Brain SPECT - (합곡-곡지 전침치료가 정상인의 뇌혈류에 미치는 영향 - Brain SPECT와 SPM을 이용하여 -)

  • Ryu Jong-Man;Kim Young-Suk;Park Sung-Uk;Jung Woo-Sang;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Kim Deok-Yoon;Moon Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.36-43
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    • 2006
  • Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

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Effect of LI4-LI11 Transcutaneous Electrical Nerve Stimulation on Regional Cerebral Blood Flow in Healthy Human Using SPECT and Statistical Parametric Mapping (뇌 SPECT와 SPM을 이용한 합곡-곡지 TENS 치료의 뇌혈류에 대한 효과)

  • Jeong, Dong-Won;Kim, Young-Suk;Park, Seong-Uk;Jung, Woo-Sang;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.205-212
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    • 2008
  • Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.

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A study on the effect of air velocity through a damper on smoke extraction performance in case of fire in road tunnels (도로터널 화재 시 집중배기방식의 배기포트 통과풍속이 배연성능에 미치는 영향에 관한 연구)

  • Ryu, Ji-Oh;Na, Kwang-Hoon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.22 no.4
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    • pp.347-365
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    • 2020
  • In order to resolve traffic problems in urban areas and to increase the area of green spaces, tunnels in downtown areas are being increased. Additionally, the application of large port smoke extraction ventilation systems is increasing as a countermeasure to smoke extraction ventilation for tunnels with high potential for traffic congestion. It is known that the smoke extraction performance of the large port smoke extraction system is influenced not only by the amount of the extraction flow rate, but also by various factors such as the shape of the extraction port (damper) and the extraction air velocity through a damper. Therefore, in this study, the design standards and installation status of each country were investigated. When the extraction air flow rate was the same, the smoke extraction performance according to the size of the damper was numerically simulated in terms of smoke propagation distance, compared and evaluated, and the following results were obtained. As the cross-sectional area of the smoke damper increases, the extraction flow rate is concentrated in the damper close to the extraction fan, and the smoke extraction rate of the damper in downstream decreases, thereby increasing the smoke propagation distance on the downstream side. In order to prevent such a phenomenon, it is necessary to reduce the cross-sectional area of the smoke damper and increase the velocity of passing air through the damper so that the pressure loss passing through the damper increases, thereby reducing the non-uniformity of smoke extraction flow rate in the extraction section. In this analysis, it was found that when the interval distance of the extraction damper was 50 m, the air velocity passing through damper was 4.4 m/s or more, and when the interval distance of the extraction dampers was 100 m, the air velocity passing through damper was greater than 4.84 m/s, it was found to be advantageous to ensure smoke extraction performance.

Usefulness of Flow Composite Image in Raynaud Scan ($^{201}Tl$) ($^{201}Tl$을 이용한 레이노 검사에서 동적 Composite 영상의 유용성)

  • Kim, Dae-Yeon;Shin, Gyoo-Seol;Oh, Eun-Jung;Kim, Gun-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.101-104
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    • 2010
  • Purpose: Raynaud scan is divided to flow, blood pool and local-delay image. Usually, we evaluate comparison through blood pool and local-delay image. We will evaluate about usability when comparative observe blood image and local-delay image in Raynaud scan that used $^{201}Tl$ as making flow image to one sheet of images. Materials and Methods: We have selected 29 Raynaud phenomenon patients aged 14~68 years who visited department of vascular surgery between Feb. 2008 and Aug. 2009. An intravenous injection $^{201}Tl$ of 111 MBq (3 mCi) to opposite side diagonal line limbs above an internal auditing department. Equipment used Philips gamma camera forte A-Z, and collimator used LEHR. Matrix size set up to each $64{\times}64$, $128{\times}128$, $256{\times}256$ and zoom factor used to full field. Protocol of dynamic is 2 second to 155 frames. Blood pool and delay count to 300 second. We set up ROI by a foundation to data acquired in PEGASYS processing program. Each results were analyzed with the SPSS 12.0 statistical software. Results: Each averages of count ratio (Rt / Lt) to have been given at composite image, a blood pool image, delay images analyzed at Raynaud phenomenon patients is $1.25{\pm}0.39$, $1.20{\pm}0.33$, $1.11{\pm}0.17$. The sample analysis results of blood pool image and delay image contented itself with p<0.029. Also, there don't have been each difference, and blood pool image, delay image regarding composite image was able to know. Conclusion: We were able to give help for comparison to evaluate a blood pool image and a local delay image at the Raynaud scan which used $^{201}Tl$ while making a flow image to one sheet image. Identification to be visual too was possible. If you are proceeded a researcher that there was further depth, you are more appropriate for, and you may get useful information.

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Supraclavicular Brachial Plexus block with Arm-Hyperabduction (상지(上肢) 외전위(外轉位)에서 시행(施行)한 쇄골상(鎖骨上) 상완신경총차단(上腕神經叢遮斷))

  • Lim, Keoun;Lim, Hwa-Taek;Kim, Dong-Keoun;Park, Wook;Kim, Sung-Yell;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.214-222
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    • 1988
  • With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

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The Prototype and Structure of the Water Supply and Drainage System of the Wolji Pond During the Unified Silla Period (통일신라시대 월지(月池) 입·출수 체계의 원형과 구조)

  • Kim, Hyung-suk;Sim, Woo-kyung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.124-141
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    • 2019
  • This research explored the relationship between the water quality issue of Wolji Pond (Anapji Pond) with the maintenance of the channel flow circulation system. The water supply and drainage system closely related to the circulation system of pond has been reviewed, rather than the existing water supply and drainage system that has been analyzed in previous studies. As a result of reviewing the water supply system, it has been learned that the water supply system on the southeastern shore of Wolji Pond, being the current water supply hole, has been connected to the east side garden facility (landscaping stone, curved waterway, storage facility of water) between the north and south fence and the waterway. This separate facility group seems to have been a subject of the investigation of the eastern side of Wolji Pond, with the landscaping stones having been identified in the 1920's survey drawings. The water supply facility on the southeastern shore, being the suspected water supply hole, seems to have some connection with the granite waterway remaining on the building site of Imhaejeon (臨海殿) on the southern side of Wolji Pond. It is inferred that it provides clean water, seeing that the slope towards the southwestern shore of Wolji Pond becomes lower, the landscaping stones have been placed in the filter area, and it is present in the 1920's survey drawings and the water supply hole survey drawing of 1975. The water drainage facility on the northern shore is composed of five stages. The functions of the wooden waterway and the rectangular stone water catchment facility seem not to be only for the water drainage of Wolji Pond. In light of the points that there are wood plugs in the wooden waterway and that there is a water catchment facility in the final stage, it is judged that the water of Balcheon Stream (撥川) may be charged in reverse according to this setup. Namely, the water could enter and exit in either direction in the water drainage facility on the northern shore It also seems that the supply to the wooden waterway could be opened and shut through the water catchment facility of rectangular stone group as well. The water drainage facility on the western shore is very similar to the water drainage facility on the northern shore, so it is difficult to avoid the belief that it existed during the Silla Dynasty, or it has been produced by imitating the water drainage facility on the northern shore at some future point in time. It seems to have functioned as the water drainage facility for the supply of agricultural water during the Joseon Dynasty. The water supply and drainage facilities in Wolji Pond have been understood as a systematized distribution network that has been intertwined organically with the facility of Donggung Palace, which was the center of the Silla capital. Water has been supplied to each facility group, including Wolji Pond, through this structure; it includes the drainage system connecting to the Namcheon River (南川) through the Balcheon Stream, which was an important canal of the capital center.

A Study on the Micro-Topography Landscape Characteristics and Waterfront Landscape Style of Waterfront in Korean Jingyeong Landscape Painting (겸재 정선의 진경산수화에 나타난 수변의 미지형 경관 특성과 하경양식)

  • Kim, Yong-Hee;Kang, Young-Jo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.1
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    • pp.26-38
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    • 2019
  • This study is based on the analysis of the characteristics of waterfront scenery. Recently, waterfront development has expanded residentially, commercially and into leisure space. In the development of the waterfront, it is necessary to apply designs suitable for urban and various other waterfront areas. In this study, the natural scenery of the waterfront was researched with respect to the Korean Jingyeong landscape paintings and the main elements of the scenery were analyzed. In this study, 105 painting of Korean Jingyeong landscapes paintings were selected for the analysis of the waterside scenery. The paintings of Jeong Seon were studied to categorize streams topographically into mountainous, upper, middle, lower, and ocean types. In addition, major micro-topography elements, which are 13 water image elements and 13 staffage elements were analyzed. The main waterfront landscape elements are divided into 13 types. The waterfalls were divided into long waterfalls, short waterfalls, cascading waterfalls, and other aspects considered were line stream, curve stream, multi-curve stream, pond, water surface, flow surface, wave surface, rock side, pile sandy side, sandy side. There are 13 kinds of staffage elements, include pine forest, pine trees, fir trees, bamboo trees, willow trees, broadleaf tree, villages, houses, gazebo, boat, bridges, and people. The waterfront landscape by a river area was explained according to each characteristic of the waterfront landscape and staffage, and their changes were analyzed in each area. The 105 paintings were divided into 35 pieces of mountainous streams, 9 upper streams, 5 middle streams, 35 lower streams, and 21 oceans, and the change of each waterfront landscape and staffage was analyzed. Based on the topographical analysis of the waterfront landscape and staffage, the results can be summarized into 5 types of the waterfront landscape. Based on the micro-topographical characteristics of the waterfront landscape styles are as follow. In the mountainous streams, long waterfall and deep forest type are apparent, which depicts deep mountain waterfall scenery, and a multi-stream forest is the scenery of a picnic in the mountains, which is a representative form of mountainous streams landscape. In the upper-middle stream, the water-surface and gazebo type is predominant. In the lower stream, the sandy-gazebo typ scenery is predominant and the sandy depiction is unique to lower stream landscape. Pile sandy-dock type is life scenes where human activity highlighted, is a representative form of the lower stream landscapes. The characteristic of the coastal landscape is the serpentine rock scenery on the beach and the wave-serpentine rock type that forms the main coastal landscape. The study aims to propose significant design elements for a natural waterfront landscape planning based on the analysis of landscape in the paintings of Jeong Seon.

A Study on the Extraction Rate of Brain Tissues from a $^{99m}Tc$-HMPAO Cerebral Blood flow SPECT Examination of a Patient ($^{99m}Tc$-HMPAO 뇌혈류 SPECT 검사 시 환자에 따른 뇌조직 추출률에 대한 고찰)

  • Kim, Hwa-San;Lee, Dong-Ho;Ahn, Byeong-Pil;Kim, Hyun-Ki;Jung, Jin-Yung;Lee, Hyung-Nam;Kim, Jung-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.17-26
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    • 2012
  • Purpose: This study mainly focuses on the patients treated with chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO (d,l-hexamethylpropylene amine oxime) which yielded reduced image quality due to a decreased brain extraction rate. $^{99m}Tc$-HMPAO will be examined further to determine whether this product may be accounted as a factor for this cause. Material and Methods: From January 2010 until December 2010, out of 272 patients who were all subjected to $^{99m}Tc$-HMPAO brain blood flow SPECT scans resulting from Cerebral Infarction; 23 patients(ages $55.3{\pm}9$, 21 males, 3 females) with decreased tissue extraction rate were examined in detail. The radiopharmaceutical product $^{99m}Tc$-HMPAO was used on patients with normal brain tissue exchange rate as well as those with reduced rate in order to prove its' chemical stability. The patients' age, sex, blood pressure, existence of diabetes, drug use, current health status, known side effects from CT/MRI, examination of the patients' past SPECT before/after images were accounted to determine the factors and correlations affecting the rate of blood tissue extractions. Result: After multiple linear regression analysis, there were no unusual correlations between the 6 factors excluding sex, and before/after examination images. Male subjects showed reduced brain tissue extraction rate than the females ($p$ > 0.05) 91.3% male, 8.7% female. Wilcoxon Matched-Pairs Signed-Ranks Test was used on the before/after images which yielded a value of 0.06, which did not indicate a significant amount of difference on the 2 tests ($p$ > 0.05). As a result, the before/after images indicated similar brain tissue extraction rates, and there were variations depending on the individual patient. Conclusion: The effects of the chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO depended on the patient's personal characteristics and status, therefore was considered to be a factor in reducing brain tissue extraction rate. The related articles of $^{99m}Tc$-HMPAO cerebral blood flow SPECT speculates a cerebrovascular disease and factors resulting from portal veins, and it was not possible to pin point the exact cause of decreasing brain tissue extraction rate. However, the $^{99m}Tc$-HMPAO cerebral blood flow SPECT scan proved to be extremely useful in tracking and inspecting brain diseases, as well as offering accurate results from patients suffering from reduced brain tissue extraction rates.

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