• Title/Summary/Keyword: Stress Detection

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Viability Assessment with T1-201 Rest-24 hour Delay Redistribution SPECT before Coronary Artery Bypass Graft in Coronary Artery Diseases (관상동맥 질환에서 우회로 수술 전 T1-201 휴식-24시간 지연 심근 관류 SPECT를 이용한 심근생존능의 평가)

  • Yoon, Seok-Nam;Kim, Ki-Bong;Lee, Won-Woo;Chung, June-Key;Lee, Myung-Chul;Seo, Jung-Don;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.493-501
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    • 1996
  • To assess contribution of T1-201 rest-24 hour delay redistribution in detection of viable myocardium, we studied the predictive value of this redistribution in 17 patients who peformed rest-24 hour delay perfusion SPECT before bypass surgery. Regional wall motion was compared with gated SPECT in 10 patients and echocardiography in 7 patients before and after bypass surgery. Rest and 24 hour delayed uptakes were scored from 0 (normal perfusion) to 3 (defect). In rest SPECT, 56 segments showed perfusion decrease. Thirty four segments(61%) improved after surgery and were defined as viable Nineteen(34%) segments had more uptake of T1-201 at 24 hour delay, and the other 37 segments did not. In 81%(25/31) of segments with mildly decreased perfusion, wall motion after bypass surgery improved, 57% (8/14) of segments with severely decreased perfusion improved, and 9%(1/11) of segments with defects improved. In 14 among 19 segments which had more T1-201 uptakes at 24 hour delay, wall motion was improved(positive predictive value of redistribution: 74%). 20 among 37 segments which had persistent decreases in rest-24 hour redistribution improved and 17 did not(negative predictive value: 46%). Segments having severe perfusion decrease or defects showed improved wall motion after surgery in 64%(7/11), if it had redistribution at delay. Segments with either mildly decreased uptake in resting or rest-delayed redistribution showed improved wall motion in 76%(32/42). Among the 14 segments which showed improvement in wall motion, 10 had partial reversibility in stress-rest images and the other 4 had persistent perfusion defects in stress-rest images. These 4 segments were found viable only with rest-24 hour delayed perfusion SPECT. We concluded that rest T1-201 uptake or redistribution at 24 hour delay should be referred as an evidence to warrant postoperative improvement of abnormal wall motion and we could predict myocardial viability with preoperative rest-24 hour delay perfusion SPECT in the segments with rest perfusion decreases.

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Correlation Analysis between Damage of Expansion Joints and Response of Deck in RC Slab Bridges (RC 슬래브교의 신축이음 손상과 바닥판 응답과의 상관관계 분석)

  • Jung, Hyun-Jin;An, Hyo-Joon;Park, Ki-Tae;Jung, Kyu-San;Kim, Yu-Hee;Lee, Jong-Han
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.25 no.6
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    • pp.245-253
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    • 2021
  • RC slab bridges account for the largest portion of deteriorated bridges in Korea. However, most RC slabs are not included in the first and second classes of bridges, which are subject to bridge safety management and maintenance. The highest damaged components in highway bridges are the subsidiary facilities including expansion joints and bearings. In particular, leakage through expansion joints causes deterioration and cracks of concrete and exposure of reinforced bars. Therefore, this study analyzed the effect of adhesion damage at expansion joints on the response of the deck in RC slab bridges. When the spacing between the expansion joints at both ends was closely adhered, cracks occurred in the concrete at both ends of the deck due to the resistance rigidity at the expansion joints. Based on the response results, the correlation analysis between displacements in the longitudinal direction of the expansion joint and concrete stress at both ends of the deck for each damage scenario was performed to investigate the effect of the occurrence of damage on the bridge behavior. When expansion joint devices at both sides were damaged, the correlation between displacement and stress showed a low correlation of 0.18 when the vehicles proceeded along all the lanes. Compared with those in the intact state, the deflections of the deck in the damaged case at both sides showed a low correlation of 0.34 to 0.53 while the vehicle passed and 0.17 to 0.43 after the vehicle passed. This means that the occurrence of cracks in the ends of concrete changed the behavior of the deck. Therefore, data-deriven damage detection could be developed to manage the damage to expansion joints that cause damage and deterioration of the deck.

Nitroglycerin-Challenged Tc-99m MIBI Quantitative Gated SPECT to Predict Functional Recovery After Coronary Artery Bypass Surgery (니트로글리세린 투여 Tc-99m-MIBI 정량 게이트 심근SPECT를 이용한 관상동맥우회로술 후 심근 기능 회복 예측)

  • Lee, Dong-Soo;Kim, Yu-Kyeong;Cheon, Gi-Jeong;Paeng, Jin-Chul;Lee, Myoung-Mook;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.278-287
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    • 2003
  • Purpose: The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/24-hour redistribution Tl-201 SPECT Materials and Methods: In 22 patients with coronary artery disease, rest Tl-20l/ dipyridamole stress Tc-99m-MIBI gated/24-hour redistribution Tl-201 SPECT were peformed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution Tl-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.

Diagnostic Ability of Tc-99m MIBI SPECT in Coronary Artery Diseases is not Affected by the Degree of Exercise (운동 정도와 무관한 Tc-99m Methoxyisobutyl Isonitrile 심근관류 스캔의 진단능)

  • Lee, Jae-Tae;Kim, Jong-Soo;Chun, Kyung-Ah;Lee, Sang-Woo;Kang, Do-Young;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.40-48
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    • 1999
  • Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

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Added Value of 3D Cardiac SPECT/CTA Fusion Imaging in Patients with Reversible Perfusion Defect on Myocardial Perfusion SPECT (심근관류 SPECT에서 가역적인 병변을 보인 환자의 3차원 심장 SPECT/CTA 퓨전영상의 유용성)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Kang, Won-Jun;Kim, Seong-Min;Won, Kyoung-Sook;Lim, Seok-Tae;Hwang, Kyung-Hoon;Lee, Byeong-Il;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.513-518
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    • 2009
  • Purpose: Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. Materials and Methods: Forty-eight patients (M:F=26:22, Age: $63.3{\pm}10.4$ years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. Results: Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. Conclusion: Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.

Cytosolic Phospholipase A2 Activity in Neutrophilic Oxidative Stress of Platelet-activating Factor-induced Acute Lung Injury (Platelet-activating Factor에 의한 급성폐손상에서 호중구성 산화성 스트레스에 관여하는 Cytosolic Phospholipase A2 활성도의 변화)

  • Kwon, Young Shik;Hyun, Dae Sung;Lee, Young Man
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.497-506
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    • 2007
  • Background: The present investigation was performed in rats and isolated human neutrophils in order to confirm the presumptive role of the positive feedback loop of cytosolic phospholipase $A_2$ ($cPLA_2$) activation by plateletactivating factor (PAF). Methods: The possible formation of the positive feedback loop of the $cPLA_2$ activation and neutrophilic respiratory burst was investigated in vivo and in vitro by measurement of the parameters denoting acute lung injury. In addition, morphological examinations and electron microscopic cytochemistry were performed for the detection of free radicals in the lung. Results: Five hours after intratracheal instillation of PAF ($5{\mu}g/rat$), the lung leak index, lung myeloperoxidase (MPO) activity, the number of neutrophils and the concentration of cytokine-induced neutrophil chemoattractant (CINC) in bronchoalveolar lavage fluid were increased by PAF as compared with those of control rats. The NBT assay and cytochrome-c reduction assay revealed an increased neutrophilic respiratory burst in isolated human neutrophils following exposure to PAF. Lung and neutrophilic $cPLA_2$ activity were increased following PAF exposure and exposure to hydrogen peroxide increased $cPLA_2$ activity in the lung. Histologically, inflammatory findings of the lung were observed after PAF treatment. Remarkably, as determined by $CeCl_3$ cytochemical electron microscopy, increased production of hydrogen peroxide was identified in the lung after PAF treatment. Conclusion: PAF mediates acute oxidative lung injury by the activation of $cPLA_2$, which may provoke the generation of free radicals in neutrophils.

Establishment of the High-Throughput Hair Roots' DNA Isolation System and Verification of Its Appicability for Hanwoo Traceability Using the 11 Microsatellite Makes (대량 모근 시료 DNA 분리 체계 확립과 11 microsatellite maker를 사용하는 한우 생산이력제로의 적용가능성 검증)

  • Lim, Hyun-Tae;Lee, Sang-Ho;Yoo, Chae-Kyoung;Sun, Du-Won;Cho, In-Cheol;Yoon, Du-Hak;Yang, Dae-Young;Cheong, Il-Cheong;Lee, Jung-Gyu;Jeon, Jin-Tae
    • Journal of agriculture & life science
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    • v.44 no.6
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    • pp.91-99
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    • 2010
  • We used a multiplex PCR primer set composed of 11 microsatellite (MS) markers and two sexing markers for gender detection. Genomic DNA extracted from hair roots of 3,510 Hanwoo were genotyped. Based on the 11MS markers, no animals had identical genotypes(TGLA227, BM2113, TGLA53, ETF10, SPS115, TGLA122, ETH3, ETH225, BM1824 and INRA23). The expected probability of identity among genotypes of random individuals (PI), the probability of identity among genotypes from random half-sibs ($PI_{half-sibs}$) and among genotypes of random individuals, and the probability of identity among genotypes from random sibs ($PI_{sibs}$) were estimated as $1.31{\times}10^{-23}$, $2.52{\times}10^{-16}$and $1.09{\times}10^{-6}$, respectively using the API-CALC program, version 1.0. We successfully completed the genotype analysis of 3,510 Hanwoo with a 3.93% genotyping failure rate. It was revealed that extracting DNA from the hair root was a time-efficient and cost-effective method to collect specimens for DNA isolation from live animals. This method also minimized stress for the animals during specimen collection. Among the hair roots from the back, belly, upper tail and lower tail, 5~13 hair roots of the lower tail led to the best genotype analysis results. Finally, we established a 96-well-format method of DNA preparation applicable for high- throughput genotype analysis.