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Correct Closure of the Left Atrial Appendage Reduces Stagnant Blood Flow and the Risk of Thrombus Formation: A Proof-of-Concept Experimental Study Using 4D Flow Magnetic Resonance Imaging

  • Min Jae Cha;Don-Gwan An;Minsoo Kang;Hyue Mee Kim;Sang-Wook Kim;Iksung Cho;Joonhwa Hong;Hyewon Choi;Jee-Hyun Cho;Seung Yong Shin;Simon Song
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.647-659
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    • 2023
  • Objective: The study was conducted to investigate the effect of correct occlusion of the left atrial appendage (LAA) on intracardiac blood flow and thrombus formation in patients with atrial fibrillation (AF) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D)-printed phantoms. Materials and Methods: Three life-sized 3D-printed left atrium (LA) phantoms, including a pre-occlusion (i.e., before the occlusion procedure) model and correctly and incorrectly occluded post-procedural models, were constructed based on cardiac computed tomography images from an 86-year-old male with long-standing persistent AF. A custom-made closed-loop flow circuit was set up, and pulsatile simulated pulmonary venous flow was delivered by a pump. 4D flow MRI was performed using a 3T scanner, and the images were analyzed using MATLAB-based software (R2020b; Mathworks). Flow metrics associated with blood stasis and thrombogenicity, such as the volume of stasis defined by the velocity threshold ($\left|\vec{V}\right|$ < 3 cm/s), surface-and-time-averaged wall shear stress (WSS), and endothelial cell activation potential (ECAP), were analyzed and compared among the three LA phantom models. Results: Different spatial distributions, orientations, and magnitudes of LA flow were directly visualized within the three LA phantoms using 4D flow MRI. The time-averaged volume and its ratio to the corresponding entire volume of LA flow stasis were consistently reduced in the correctly occluded model (70.82 mL and 39.0%, respectively), followed by the incorrectly occluded (73.17 mL and 39.0%, respectively) and pre-occlusion (79.11 mL and 39.7%, respectively) models. The surfaceand-time-averaged WSS and ECAP were also lowest in the correctly occluded model (0.048 Pa and 4.004 Pa-1, respectively), followed by the incorrectly occluded (0.059 Pa and 4.792 Pa-1, respectively) and pre-occlusion (0.072 Pa and 5.861 Pa-1, respectively) models. Conclusion: These findings suggest that a correctly occluded LAA leads to the greatest reduction in LA flow stasis and thrombogenicity, presenting a tentative procedural goal to maximize clinical benefits in patients with AF.

Effect of modifying the thickness of the plate at the level of the overlap length in the presence of bonding defects on the strength of an adhesive joint

  • Attout Boualem;Sidi Mohamed Medjdoub;Madani Kouider;Kaddouri Nadia;Elajrami Mohamed;Belhouari Mohamed;Amin Houari;Salah Amroune;R.D.S.G. Campilho
    • Advances in aircraft and spacecraft science
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    • v.11 no.1
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    • pp.83-103
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    • 2024
  • Adhesive bonding is currently widely used in many industrial fields, particularly in the aeronautics sector. Despite its advantages over mechanical joints such as riveting and welding, adhesive bonding is mostly used for secondary structures due to its low peel strength; especially if it is simultaneously exposed to temperature and humidity; and often presence of bonding defects. In fact, during joint preparation, several types of defects can be introduced into the adhesive layer such as air bubbles, cavities, or cracks, which induce stress concentrations potentially leading to premature failure. Indeed, the presence of defects in the adhesive joint has a significant effect on adhesive stresses, which emphasizes the need for a good surface treatment. The research in this field is aimed at minimizing the stresses in the adhesive joint at its free edges by geometric modifications of the ovelapping part and/or by changing the nature of the substrates. In this study, the finite element method is used to describe the mechanical behavior of bonded joints. Thus, a three-dimensional model is made to analyze the effect of defects in the adhesive joint at areas of high stress concentrations. The analysis consists of estimating the different stresses in an adhesive joint between two 2024-T3 aluminum plates. Two types of single lap joints(SLJ) were analyzed: a standard SLJ and another modified by removing 0.2 mm of material from the thickness of one plate along the overlap length, taking into account several factors such as the applied load, shape, size and position of the defect. The obtained results clearly show that the presence of a bonding defect significantly affects stresses in the adhesive joint, which become important if the joint is subjected to a higher applied load. On the other hand, the geometric modification made to the plate considerably reduces the various stresses in the adhesive joint even in the presence of a bonding defect.

Color-related Query Processing for Intelligent E-Commerce Search (지능형 검색엔진을 위한 색상 질의 처리 방안)

  • Hong, Jung A;Koo, Kyo Jung;Cha, Ji Won;Seo, Ah Jeong;Yeo, Un Yeong;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.25 no.1
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    • pp.109-125
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    • 2019
  • As interest on intelligent search engines increases, various studies have been conducted to extract and utilize the features related to products intelligencely. In particular, when users search for goods in e-commerce search engines, the 'color' of a product is an important feature that describes the product. Therefore, it is necessary to deal with the synonyms of color terms in order to produce accurate results to user's color-related queries. Previous studies have suggested dictionary-based approach to process synonyms for color features. However, the dictionary-based approach has a limitation that it cannot handle unregistered color-related terms in user queries. In order to overcome the limitation of the conventional methods, this research proposes a model which extracts RGB values from an internet search engine in real time, and outputs similar color names based on designated color information. At first, a color term dictionary was constructed which includes color names and R, G, B values of each color from Korean color standard digital palette program and the Wikipedia color list for the basic color search. The dictionary has been made more robust by adding 138 color names converted from English color names to foreign words in Korean, and with corresponding RGB values. Therefore, the fininal color dictionary includes a total of 671 color names and corresponding RGB values. The method proposed in this research starts by searching for a specific color which a user searched for. Then, the presence of the searched color in the built-in color dictionary is checked. If there exists the color in the dictionary, the RGB values of the color in the dictioanry are used as reference values of the retrieved color. If the searched color does not exist in the dictionary, the top-5 Google image search results of the searched color are crawled and average RGB values are extracted in certain middle area of each image. To extract the RGB values in images, a variety of different ways was attempted since there are limits to simply obtain the average of the RGB values of the center area of images. As a result, clustering RGB values in image's certain area and making average value of the cluster with the highest density as the reference values showed the best performance. Based on the reference RGB values of the searched color, the RGB values of all the colors in the color dictionary constructed aforetime are compared. Then a color list is created with colors within the range of ${\pm}50$ for each R value, G value, and B value. Finally, using the Euclidean distance between the above results and the reference RGB values of the searched color, the color with the highest similarity from up to five colors becomes the final outcome. In order to evaluate the usefulness of the proposed method, we performed an experiment. In the experiment, 300 color names and corresponding color RGB values by the questionnaires were obtained. They are used to compare the RGB values obtained from four different methods including the proposed method. The average euclidean distance of CIE-Lab using our method was about 13.85, which showed a relatively low distance compared to 3088 for the case using synonym dictionary only and 30.38 for the case using the dictionary with Korean synonym website WordNet. The case which didn't use clustering method of the proposed method showed 13.88 of average euclidean distance, which implies the DBSCAN clustering of the proposed method can reduce the Euclidean distance. This research suggests a new color synonym processing method based on RGB values that combines the dictionary method with the real time synonym processing method for new color names. This method enables to get rid of the limit of the dictionary-based approach which is a conventional synonym processing method. This research can contribute to improve the intelligence of e-commerce search systems especially on the color searching feature.

Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan (분화 갑상선암 수술 후 최초 고용량 방사성옥소 치료시 투여용량 결정: 병리적 병기, 혈청 갑상선글로불린치와 I-123 전신 스캔의 유용성 비교)

  • Jeong, Hwan-Jeong;Lim, Seok-Tae;Youn, Hyun-Jo;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.301-306
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    • 2008
  • Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.

The Relationships among Patient's Perception, Patient's Satisfaction of Nursing Service Quality and Revisiting intention (간호서비스 질에 대한 환자의 인식과 만족도 및 재방문의도와의 관계)

  • Lee, Sun-Ah
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.307-319
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    • 1998
  • This study is an empirical investigation and study on the measurement of nursing service quality as perceived by patients. A series of H1. H2. H3 alternative hypotheses were tested using a sample of 250 patients in Taegu City. Korea. HI hypothese were tested for application of five component of service quality (SERVQlTAL and SE RPERF : tangiblity. reliability. responsiveness. accessibility. understandability) in Taegu area Hospitals. Validity test - the five components of service quality were rearranged into two components of service quality (personal factor. nonpersonal factor). Although SERVQUAL was verified in USA. application for five components of service quality in Korea indicated that it need more analytical studies. Nobody can deny the fact that the recent growth of the nursing service quality is one of the most important driving forces of hospital management. In many hospitals. the nursing quality charges more than 50% of the medical service quality. As a result. many hospital managers should be enormous interests in the investment potentiality of the nursing service. However. doesn't many researchers invest their time and effort on the research of the quality control in nursing service. Nursing service management is the process to satisfy customer's desires and expectations through the various service activities. Presently nursing service are being faced with three Common tasks of improving quality of nursing service. competitively differential advantage and productivity because of quantitative expansion of Nursing service. Such a phenomenon is also found in our medical service industry. resulting from increasing demands for medical service owing to national medical insurance policy and consumer's attitude change emphasizing prevention of illness. excessiveness of medical facilities in large cities and increasing medical lawsuits due to influence of consumerism. Therefore. under such circumstances. this research on nursing service is conducted from nursing managements to improve the nursing service quality problems faced by medical institutions. The results of this theoretical/empirical research are as follows: 1. Nursing service Quality is regarded as patients' perceived quality and evaluated on the basis (5 dimension) of technical and functional quality. 2. Nursing service Quality is a concept of patients evaluation on the measurable multi-dimensions intrinsic and extrinsic attributes of service. 3. Nursing service Quality is conceptually defined as the difference between the perceived service and the expected service. 4. Korean consumers trend to evaluate nursing service quality based on such dimensions as responsiveness and reliability. understandability. accessibility. tangibility. 5. After analyzing whether or not there are some differences in respective medical institution. it was found that there are significant difference on understandability. reliability. communicability. courtesy. competence. 6. After analyzing the difference between the expected nursing service and the nursing perceived service, it was found that the expected nursing service is higher than the perceived service in every medical institution. 7. HI hypothesis was tested with regard to the validity test between SERVQUAL and SERVPERF in nursing service quality. The result of validity test between SERVQUAL and SERVPERF was found to have differential result. That is the R2 of SERVPERF is higher than that of SERVQUAL. Therefore. HI was verified in nursing management. H2. H3 hypotheses were tested whether or not the nursing service quality and patient satisfaction is the preceding variable. The result of H2 hypothes is that the nursing service quality is the preceding variable of patient satisfaction and the patient satisfaction is that of revisiting intention. After analyzing whether or not there is any differences on the demographic variable of five nursing service quality factor. it was found that there are statistically significant differences on communicability and courtesy at the sex. understand ability. accessibility and tangibility at the age. understandability at the academic background respectively.

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Critical Analyses of '2nd Science Inquiry Experiment Contest' (과학탐구 실험대회의 문제점 분석)

  • Paik, Seoung-Hey
    • Journal of The Korean Association For Science Education
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    • v.15 no.2
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    • pp.173-184
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    • 1995
  • The purpose of this study was to analyse the problems of 'Science Inquiry Experiment Contest(SIEC)' which was one of 8 programs of 'The 2nd Student Science Inquiry Olympic Meet(SSIOM)'. The results and conclusions of this study were as follows: 1. It needs to reconsider the role of practical work within science experiment because practical work skills form one of the mainstays in current science. But the assessment of students' laboratory skills in the contest was made little account of. It is necessary to remind of what it means to be 'good at science'. There are two aspects: knowing and doing. Both are important and, in certain respects, quite distinct. Doing science is more of a craft activity, relying more on craft skill and tacit knowledge than on the conscious application of explicit knowledge. Doing science is also divided into two aspects, 'process' and 'skill' by many science educators. 2. The report's and checklist's assessment items were overlapped. Therefore it was suggested that the checklist assessment items were set limit to the students' acts which can't be found in reports. It is important to identify those activities which produce a permanent assessable product, and those which do not. Skills connected with recording and reporting are likely to produce permanent evidence which can be evaluated after the experiment. Those connected with manipulative skills involving processes are more ephemeral and need to be assessed as they occur. The division of student's experimental skills will contribute to the accurate assess of student's scientific inquiry experimental ability. 3. There was a wide difference among the scores of one participant recorded by three evaluators. This means that there was no concrete discussion among the evaluators before the contest. Despite the items of the checklists were set by preparers of the contest experiments, the concrete discussions before the contest were necessary because students' experimental acts were very diverse. There is a variety of scientific skills. So it is necessary to assess the performance of individual students in a range of skills. But the most of the difficulties in the assessment of skills arise from the interaction between measurement and the use. To overcome the difficulties, not only must the mark needed for each skill be recorded, something which all examination groups obviously need, but also a description of the work that the student did when the skill was assessed must also be given, and not all groups need this. Fuller details must also be available for the purposes of moderation. This is a requirement for all students that there must be provision for samples of any end-product or other tangible form of evidence of candidates' work to be submitted for inspection. This is rather important if one is to be as fair as possible to students because, not only can this work be made available to moderators if necessary, but also it can be used to help in arriving at common standards among several evaluators, and in ensuring consistent standards from one evaluator over the assessment period. This need arises because there are problems associated with assessing different students on the same skill in different activities. 4. Most of the students' reports were assessed intuitively by the evaluators despite the assessment items were established concretely by preparers of the experiment. This result means that the evaluators were new to grasp the essence of the established assessment items of the experiment report and that the students' assessment scores were short of objectivity. Lastly, there are suggestions from the results and the conclusions. The students' experimental acts which were difficult to observe because they occur in a flash and which can be easily imitated should be excluded from the assessment items. Evaluators are likely to miss the time to observe the acts, and the students who are assessed later have more opportunity to practise the skill which is being assessed. It is necessary to be aware of these problems and try to reduce their influence or remove them. The skills and processes analysis has made a very useful checklist for scientific inquiry experiment assessment. But in itself it is of little value. It must be seen alongside the other vital attributes needed in the making of a good scientist, the affective aspects of commitment and confidence, the personal insights which come both through formal and informal learning, and the tacit knowledge that comes through experience, both structured and acquired in play. These four aspects must be continually interacting, in a flexible and individualistic way, throughout the scientific education of students. An increasing ability to be good at science, to be good at doing investigational practical work, will be gained through continually, successively, but often unpredictably, developing more experience, developing more insights, developing more skills, and producing more confidence and commitment.

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Changes in Air Temperature of Plastic House as Affected by Light Control Film and Their Impacts on Korean Melon Yield (조광필름을 피복한 시설 내 기온변화와 참외의 수량)

  • Shin, Yong Seub;Lee, Ji Eun;Do, Han Woo;Chun, Hee;Chung, Doo Seok
    • Journal of Bio-Environment Control
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    • v.27 no.1
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    • pp.80-85
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    • 2018
  • This study was carried out to clarify the effect of CHO-CO and PO film on air temperature in greenhouse and Korean melon fruit characteristics and yield. On January 8 in 2017, the maximum, minimum and average air temperature in greenhouse covered with CHO-CO film were $38.9^{\circ}C$, $13.4^{\circ}C$ and $20.1^{\circ}C$, respectively. At the same date, the maximum, minimum and average air temperature in greenhouse covered with PO film were $40.0^{\circ}C$, $14.9^{\circ}C$ and $20.3^{\circ}C$, respectively. On August 7 in 2017, the maximum, minimum and average air temperature in greenhouse covered with CHO-CO film were $47.2^{\circ}C$, $23.1^{\circ}C$ and $32.4^{\circ}C$, respectively, and the maximum, minimum and average air temperature in greenhouse covered with PO film were $50.3^{\circ}C$, $23.6^{\circ}C$ and $34.0^{\circ}C$, respectively. The results of investigation of qualities and yields of Korean melons from May 26 to August 15 in 2017 were as follows. The fruit weight of Korean melon harvested in CHO-CO film's greenhouse was 371.6g which was 22.2g less than that of PO film greenhouse. The sugar contents of Korean melon harvested in CHO-CO film greenhouse was $14.5^{\circ}brix$ which was $1.4^{\circ}brix$ greater than that of the fruits harvested in PO film greenhouse. The chromaticity (a-value) of fruit skin of Korean melon harvested in CHO-CO film greenhouse was 12.3 which was 1.5 greater than that of the fruits harvested in PO film greenhouse. The marketable yield rate of Korean melon harvested in CHO-CO film's greenhouse was 89.4% which was 8.0% higher than the fruits harvested in PO film greenhouse. The yield of Korean melon harvested in CHO-CO film's greenhouse was 2694kg per 10 a which was 26% more than that harvested in PO film greenhouse. In conclusion, the CHO-CO film could be effective to produce Korean melon in high temperature season.

Enhancement of Fertilizing Ability of Frozen-Thawed Bovine and Human Spermatozoa Treated with Fertilizing Promoting Peptide or Pentoxifylline (Fertilizing Promoting Peptide와 Pentoxifylline으로 처리된 소와 사람 동결 정액의 수정능 향상)

  • Lee, K.S.;Kim, E.Y.;Park, S.Y.;Shin, H.A.;Park, S.P.;Lim, J.H.;Chung, K.S.;Lee, H.T.
    • Korean Journal of Animal Reproduction
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    • v.25 no.4
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    • pp.409-419
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    • 2001
  • This study was to examine whether the in vitro friability, motility and intact acrosome of frozen-thawed bovine and human sperm can be improved by adding Pentoxifylline (PF) or Fertilization Promoting Peptide (FPP). Human semen was frozen ultra-rapidly using Test yolk-buffer (TYB) freezing medium. Additive (PF, FPP) effects in frozen-thawed bovine and human sperm were analyzed by microscopic count for sperm motility and coomassie brilliant blue staining method f3r sperm acrosome intact. The in vitro motility of frozen-thawed bovine sperm with 5 mM PF treatment group (50.0%) was significantly higher than that of control (34.0%) (P<0.05). In the frozen-thawed bovine sperm was examined, the intact acrosome rate of 50 nM FPP treatment (49.0%) was significantly higher than those of control (30.0%) and 25 nM FPP (38.0%) treatment groups (P<0.01). In human semen, when in vitro motility of sperm with PF addition prior to freezing was examined, the result of 5 mM treatment group (51.0%) was significantly higher than those of control and 2.5 mM treatment group (39.0, 40.0%) (P<0.01). In addition, 50 nM (75.5%) FPP adding in all treatment procedures for human semen freezing (before freezing, freezing and after thawing) was significant effect on maintenance of the sperm intact acrosome percentage (control: 45.0; 25 nM: 53.0; 100 nM: 68.0%) (P<0.01). Also, the intact acrosome rate of human sperm with FPP (65.0%) was significantly higher than that with PF (43.0%) (P<0.05), although sperm motility was slightly higher in PF treatment group. These results suggest that improved sperm motility and intact acrosome of frozen thawed bovine and human sperm can be obtained by addition of PF or FPP, and that the enhanced in vitro viability, motility and intact acrosome can be obtained by addition of FPP in all semen freezing procedures.

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『Chūn-qiū』Wáng-lì(『春秋』王曆)① - A Study on the Discussion of 'the Changes in the Names of Months and a Season(改月改時)' in the calendar of 『Chūn-qiū(春秋)』 since Song(宋) Dynasty (『춘추(春秋)』왕력(王曆)① - 송대(宋代) 이후 춘추력수(春秋曆數)의 개월(改月)·개시(改時) 논의에 대한 소고(小考))

  • Seo, Jeong-Hwa
    • (The)Study of the Eastern Classic
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    • no.67
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    • pp.345-378
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    • 2017
  • In the scriptures of "$Ch{\bar{u}}n-qi{\bar{u}}$(春秋)", the expression method of '$Ch{\bar{u}}n-w{\acute{a}}ng-zh{\bar{e}}ng-yu{\grave{e}}$(春王正月 : It's spring. It's the first month regulated by the king.)' was used as Jì-yuè-fǎ(紀月法 : the rules to determine the first month(正月)), the month of winter solstice was regarded as the first month of a year, and three years since then were named as $Ch{\bar{u}}n$(春 : spring). With regard to this "$Ch{\bar{u}}n-qi{\bar{u}}$"Wáng-lì("春秋"王曆 : the calendar regulated by the king of $Zh{\bar{o}}u$(周) dynasty in "$Ch{\bar{u}}n-qi{\bar{u}}$"), depending on whether Confucius(孔子) changed and recorded the names of the months and the season or not, there were three different arguments; the theory that 'Confucius changed the names of both the months and the season'(孔子改月 改時說), the view that 'Confucius changed the name of the season, not the names of the months'(孔子不改月 改時說), and then the theory that 'Confucius changed neither the names of the months nor the name of the season'(孔子不改月 不改時) since Song(宋) dynasty. The first view was taken by $Hh{\acute{u}}-{\bar{a}}n-gu{\acute{o}}$(胡安國) and $C{\grave{a}}i-ch{\acute{e}}n$(蔡沈), and the second theory was mentioned by Chéng-yí(程?) and Zhū-zǐ(朱子). The advocates of the third view had become remarkable since Ming(明) dynasty, and one of representatives was Wàng-yáng-míng(王陽明). All of them based their arguments on ancient scriptures and Confucian legal books, and there were cases of taking the same records as the support for different opinions. Confucius' so-called 'Chūn-qiū-bǐ-fǎ(春秋筆法 : the method to describe historical facts by making clear discrimination between right and wrong)' and '$Sh{\grave{u}}-{\acute{e}}r-b{\grave{u}}-zu{\grave{o}}$(述而不作 : the attitude to succeed virtuous men's achievements and only explain and describe them not creating and adding new contents)' could come from thoughts of $Z{\bar{u}}n-w{\acute{a}}ng$(尊王 : to respect the king with the virtues of benevolence, righteousness, propriety, wisdom and sincerity). Therefore, even though Confucius is assumed to have been the writer of "$Ch{\bar{u}}n-qi{\bar{u}}$(春秋)", whether he actually changed and recorded the names of the months and the season in the calendar used in "$Ch{\bar{u}}n-qi{\bar{u}}$" is doubtful. These theories on Confucius's intervention in the calendar of "$Ch{\bar{u}}n-qi{\bar{u}}$" hadn't been discussed as conflicting in reality until Tang(唐) dynasty.

Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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