• Title/Summary/Keyword: Stress-rest

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Transient Prolonged Stunning by Dipyridamole Stress Proved by Post-stress(1 hour) and 24 hour Tc-99m-MIBI Gated SPECT (반복 게이트 심근 Tc-99m-MIBI SPECT로 확인한 디피리다몰 부하에 의한 일과성 심근기절현상)

  • Lee, Dong-Soo;Yoon, Seok-Nam;Lee, Won-Woo;Chung, June-Key;Lee, Myoung-Mook;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.57-66
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    • 1997
  • We performed 1st day Tc-99m-sestamibi gated SPECT with dipyridamole/rest T1-201 SPECT and 2nd day 24 hour delay T1-201 SPECT/rest Tc-99m-sestamibi gated SPECT in 27 patients with coronary artery disease(24) or having chest pain(3). Stress and rest Tc-99m-sestamibi gated SPECT was acquired at 60min post-injection. A 4-point scoring system(0 to 3 for normal to absent tracer uptake) for 17 segments was used. Wall motion was scored on another 4 point scale(0 to 3 for normal to dyskinesia) in the 1st day post-stress gated and the 2nd day rest gated SPECT. Post-stress gated SPECT showed wall motion abnormality in 94 segments(20%). Fifty-five segments among these 94 showed the same wall motion between post-stress and rest gated SPECT: i.e. 1-1 23 segments, 2-2: 29 segments, 3-3: 3 segments. Remaining 39 segments(41.5%) showed different wall motion between post- stress and rest Tc-99m-sestamibi gated SPECT. Twenty one segments with wall motion abnormality had normal perfusion(rest : 15 segments, 24 hour delay: 6 segments) at either rest or 24 hour delay. Fifteen among these 21 segments showed persistent post-stress and the 2nd day rest wall motion abnormality(persistent stunning). However, in 6 segments with pro-longed (1 hour after stress) stunning, abnormal wall motion did improve in the 2nd day rest Tc-99m-sestamibi gated SPECT(transient prolonged stunning). These 6 segments had normal perfusion at rest(n=4) or at 24 hour delay(n=2). Post stress wall motions showed significantly higher scores in persistent stunning than in prolonged transient stunning(P value<0.05). It was concluded that we could find stunned myocardium with gated Tc-99m-sestamibi SPECT at either post-stress or rest and that some myocardial walls of post-stress 1 hour gated SPECT did not show truly rest wall motion. So, we should be cautious if we use post-stress Tc-99m-sestamibi wall motion to assess rest wall motion.

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Comparison of Stress-rest and Rest-stress One Day Myocardial Perfusion Scintigraphies in Detecting Coronary Artery Diseases (부하-휴식과 휴식-부하 1일 심근관류영상법의 관동맥질환 진단율 비교)

  • Bom, Hee-Seung;Min, Jung-Jun;Song, Ho-Cheon;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.30-35
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    • 1997
  • It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age $57{\pm}9$ years) and 120 patients (79 males, 41 females, mean age $59{\pm}10$ years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively. All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by ${\geq} 50%$. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35% and 68%, respectively. Those of rest-stress protocol were 96%, 47% and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using $^{99m}Tc$ agents were comparable and were very sensitive tests in detecting coronary artery diseases.

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A PHOTOELASTIC STRESS ANALYSIS ON THE SUPPOTING STRUCTURE IN THE MANDIBULAR DISTAL EXTENSION REMOVABLE PARTIAL DENTURE WITH VARIOUS DESINGS OF BACK-ACT10N CLASPS (하악 유리단 국소의치하에서 back-action 클래스프 설계 변화에 따른 광탄성 응력 분석)

  • Lim Soo-Lyoung;Kay Kee-Sung;Ko Yeong-Mu
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.3
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    • pp.379-400
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    • 1992
  • The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from the mandibular distal extension removable partial dentures with the mesial or distal placement of the occlusal rest and the mesial or distal connection in the back-action clasp with the five various designs of the back-action clasp, that is, the mesial connection and the distal rest, the distal connection and mesial rest, the mesial connection and mesial rest, the distal connection and the mesial and distal rest, and the mesial connection, and the mesial and distal rest. A photoelastic model was made of the epoxy resin(PC-1) and the hardner(PLH-1) with the acrylic resin teeth used and was coated with the plastic cement-1 at the lingual surface of the model and then five kinds of the removable partial dentures on the photoelastic model were set. A unilateral vertical load of 12.5 kg was applied on the central fossa of the first molar with the use of specially designed loading device and the pattern and distribution of the stress of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained. 1. In the back-action clasp with the mesial connection and mesial rest of the case 3, the effect of the stress distribution was the most favorable. 2. In the back-action clasp with the mesial and distal rest, of the case 4 and 5, the stress distribution was more greatly showed in the terminal abutment. 3. Generally, the stress distribution was more favarable in the mesial connection than in the distal connection. 4. In the back-action clasp with the mesial connection of the case 1, 3 and 5, the stress distribution was the most favorable in the mesial rest.

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Stress/Rest Tc-99m-MIBI SPECT in Comparison with Rest/Stress Rubidium-82 PET (휴식/부하 심근 Rubidium-82 양전자단층촬영과 부하/휴식 심근 Tc-99m-MIBI 단일광자단층촬영의 비교)

  • Lee, D.S.;Kang, K.W.;Lee, K.H.;Jeong, J.M.;Kwark, C.;Chung, J.K.;Lee, M.C.;Seo, J.D.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.31-40
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    • 1995
  • We compared stress/rest myocardial Tc-99m-MIBl tomographic image findings with rest/stress rubidium-82 tomographic images. In 23 patients with coronary artery disease (12 of them received bypass grafts before) and 6 normal subjects, rest rubidium PET study was performed : rubidium-82 and Tc-99m-MIBI were injected simultaneously to each patient after dipyridamole stress for rubidium PET and MIBI SPECT; and rest MIBI SPECT was performed 4 hours thereafter. We scored segmental decrease of rubidium or MIBI uptakes into 5 grades for 29 segments from 3 short-axis, vertical and horizontal slices. Scores were summed for each major arterial territory. When more score than two grade-2's or one grade-3 was considered as the cue for significant stenosis for major arterial territories, 67% of 46 stenosed arteries were found with MIBI studies and 78% of them by rubidium studies. Fourteen among 28 grafted arterial territories of 12 post-CABG patients were found normal with both rubidium and MIBI. Segmental scores were concordant between rubidium and MIBI in 72% of 709 stress segments and in 80% of 825 rest segments. Stress rubidium segmental scores were less than stress MIBI scores in 9%, so were rest rubidium scores. Stress rubidium scores were more than stress MIBI scores in 20% of segments, and rest rubidium segmental scores were more than rest MIBl scores in 11%. Rank correlations (Spearman's rho's more than 0.7(stress) and 0.5(rest), slopes (MIBI/rubidium) around 0.7(stress) and 0.9 (rest)) suggested deeper and wider defects in stress with rubidium. Slope over 1 (MIBI/rubidium) with LAD segemental scores at rest and 7 territories which had much larger score with MIBI revealed exaggeration of rest defects with rest MIBI in same-day stress/rest study. Difference scores (stress-rest for each territory) suggesting Ischemia were larger with rubidium (slope of MIBI/rubidium around 0.45). As has been implied by animal or separate-day-human studies, these segmental analyses with simultaneous examination in patients told that rubidium PET flow studies disclose ischemia more often than MIBI studies and that rest MIBI studies in same-day stress/rest-sequence gave a little larger rest defect than they would have shown.

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A Study on the Measuring about the Coefficient of Earth Pressure at Rest 1 (정지토압계수 측정에 관한 연구 1)

  • 송무효
    • Journal of Ocean Engineering and Technology
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    • v.15 no.4
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    • pp.92-100
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    • 2001
  • It is very important to determine the coefficient of earth pressure at rest accurately in order to estimate the behavior of soil structure. For estimation of K/sub 0/-value depending upon the stress history of dry sand, a new type of K/sub 0/-oedeometer apparatus is devised, and the horizontal earth pressure is accurately measured. For this study, 2 types of one-cyclic K/sub 0/-Loading/unloading models have been studied experimentally using four relative densities of the sand. The results obtained in this test are as follows : K/sub on'/ the coefficient of earth pressure at - rest for virgin loading is a function of the angle of internal friction Φ' of the sand and is determined as K/sub on/=1 - 0.914 sin Φ', K/sub ou'/ the coefficient of earth pressure at rest for virgin unloading is a function of K/sub on/ and over consolidation ratio(OCR), and is determined as K/sub ou/=K/sub on/(OCR)K/sup a/. The exponent α, increases as the relative density increases. K/sub or'/ the coefficient of earth pressure at rest for virgin reloading decreases in hyperbola type as the vertical stress, σ/sub v/’, increases. And, the stress path at virgin reloading leads to the maximum prestress point, independent upon the value of the minimum unloading stress. The gradient of this curve, m/sub r/ increases as OCR increases.

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The Effect of Work Conditions on Job Stress of Social Workers (사회복지사의 근로조건이 직무 스트레스에 미치는 영향)

  • Choi, Soo-Chan;Kim, Sang-A;Hur, Young-Hye;Park, Woong-Sub
    • Journal of agricultural medicine and community health
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    • v.33 no.2
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    • pp.221-231
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    • 2008
  • Abstract - Objective: This study was conducted to investigate the effect of work conditions on job stress of social workers in Seoul. Method: For this survey, a self-reported questionnaire was administrated to 1,000 social workers working in all of organization for social welfare practice in Seoul. The number of responded questionnaires was 431. Multiple linear regression analysis was used for job stress as the dependent variables and control variables. Results: The result of multiple linear regression analysis indicated that regular rest breaks had significantly effect on job stress level but long working hours did not. When regular rest breaks was guaranteed job stress of social workers significantly lowered 8.4 point. In addition standardized regression coefficients and partial R2 of regular rest breaks was the highest score among the variables. Conclusion: This study suggests that it is the most important to guarantee regular rest breaks in the work schedule in order to alleviate job stress of social workers.

The Correlation Analysis of Stress/Rest Ejection Fraction of $^{201}Tl$ Gated Myocardial Perfusion SPECT ($^{201}Tl$ 게이트 심근관류 스펙트에서의 휴식기와 부하기 좌심실 구혈률 상관관계 분석)

  • Kim, Dong-Seok;Yoo, Hee-Jae;Shim, Dong-Oh
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.3-9
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    • 2009
  • Purpose: It is well-known that stress-induced stunning and reversible perfusion defect have impact on ejection fraction (EF) when performing myocardial perfusion SPECT. Due to these reasons, gated SPECT is recommended at stress and rest studies. And there was many experiments to analyze between Stress and Rest EF by using $^{99m}Tc$-MIBI. The aim of this study is to analyze between stress EF and rest EF at myocardial perfusion SPECT by using $^{201}Tl$ and define possible predictors of EF variability. Materials and Methods: From 2008 June to 2009 February, we analyzed 144 patients undergoing $^{201}Tl$ gated myocardial perfusion SPECT in ASAN medical center. To analyze the data, we use QGS (Quantitative gated SPECT) software, and derived End-systolic volume (ESV), End-diastolic volume (EDV), EF from the result. In this study, we comparatively analyzed stress/rest EF correlation based on stress/rest EF, EDV, ESV and reversibility of myocardial perfusion defect by using paired t-test, Bland-Altman analysis. Results: Mached pairs of stress EF and rest EF demonstrated excellent correlation (r=0.92) with no statistically significant difference (p=0.11). Bland-Altman analysis demonstrated a mean ${\Delta}EF$ was 0.52% (95% confidential interval[CI], -1.17~0.12%). No statistically significant difference between a mean ${\Delta}EF$ and hypothetic mean of 0 (${\Delta}EF$=0) (p=0.10). In the correlation of ${\Delta}EF$ according to stress/rest EDV and ESV, except rest ESV of <28mL (p<0.05), there was no statistically significant difference. In the correlation of ${\Delta}EF$ according to reversibility of perfusion defect, patients with reversible perfusion defect has statistically significant difference of ${\Delta}EF$ (p<0.05). ${\Delta}EF$ of stress/rest EF showed no statistically significant difference except 55% of rest EF (p<0.05). Conclusion: Like studies with $^{99m}Tc$-MIBI, there was generally no statistically significant difference between stress and rest EF in this study results. However a stress EF of <55%, a rest ESV of <28mL and patients with reversible perfusion defect showed statistically significant difference in ${\Delta}EF$. If performing $^{201}T$ myocardial perfusion SPECT to patients with abnormal cardiac function or reversible perfusion defect, consider this study results and apply it. We expect this study results could be useful predictors of ${\Delta}EF$ variability.

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THREE DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE MANDIBULAR CANTILEVERED PROSTHESIS SUPPORTED BY IMPLANTS (임프란트로 지지된 하악 켄티레버 보철물의 3차원 유한요소 분석)

  • Cho, Chul;Shin, Sang-Wan;Kwon, Jong-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.5
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    • pp.724-743
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    • 2000
  • One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

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Three-dimensional finite element analysis on stress distribution of the mandibular implant-supported cantilever prostheses depending on the designs (임플란트 지지 하악 캔틸레버 보철물의 디자인에 따른 저작압 분산에 관한 삼차원 유한요소 분석)

  • Ban, Jae-Hyurk;Shin, Sang-Wan;Kim, Sun-Jong;Lee, Jeong-Yeol
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.1
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    • pp.70-81
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    • 2009
  • Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.

The Role of Rest Image in Patients Showing Normal Stress Image on Tc-99m Myocardial Perfusion Scan (심근 관류스캔 중 정상 부하영상 소견을 보인 환자에서 휴식기 영상의 필요성에 대한 평가)

  • Bom, Hee-Seung;Song, Ho-Chun;Min, Jung-Jun;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.502-506
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    • 1996
  • Tc-99m myocardial perfusion agents such as Tc-99m sestamibi or Tc-99m tetrofosmin has advantages over T1-201 for myocardial perfusion scan fuck as low attenuation and easy availability. However, Tc-99m agents do not redistribute so they need to be given T times, namely after stress and at rest. To evaluate whether rest image is needed in patients showing normal stress image, 43 patients who underwent both myocardial perfusion scan and coronary angiography and showed normal stress images were evaluated. Findings of rest images of them were evaluated whether they change the diagnosis or treatment plans. Among 43 patients who showed normal stress myocardial perfusion imaging, 31 (72.1%) showed no additional informations. However, among 5 patients with vasospastic angina 4 (80%) showed abnormal rest images in spite of normal stress images. So, when vasospastic angina is suspected clinically, rest image could be helpful in identifying patients with coronary vasospasm. In conclusion, rest myocardial perfusion images were not helpful in 72.1 % of patients with angina when stress images were normal. In only exception was those with vasospastic angina.

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