• Title/Summary/Keyword: 관계적

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Intestinal Atresia - A Survey by the Korean Association of Pediatric Surgeons - (선천성 장폐쇄증 - 대한소아외과학회 정회원을 대상으로 한 전국조사 -)

  • Kim, I.K.;Kim, S.Y.;Kim, S.K.;Kim, W.K.;Kim, J.E.;Kim, J.C.;Kim, H.H.;Park, K.W.;Park, Y.S.;Park, W.H.;Song, Y.T;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chang, S.I.
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.75-81
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    • 1999
  • A survey on the intestinal atresias was made among 34 members of Korean Association of Pediatric Surgeons. The response rate was 82.4 %. Two hundred and fifteen patients from the January 1, 1994 to December 31, 1996 were analyzed. The lesions were 73 cases of duodenum(DA), 72 cases of jejunum(JA), 71 cases ileum(IA) and 2 cases cecum and sigmoid colon respectively. There were 2 cases of combined anomalies (DA + JA + IA and DA + JA). Male to female ratio was 1:1 in DA, and 1.8:1 in JA. Seventy four cases(34.3 %) were premature babies(DA 35.2 %, JA:48.6 %, IA:19.2 %), and 62 cases(28.7 %) had low birth weight (DA:39.4 %, JA 33.0 %, IA:13.7 %). Antenatal diagnosis was made in 92 cases(43.6 %). However 22 cases (23.9 %) of them were transferred to pediatric surgeon after delivery. Maternal polyhydramnios was observed in 63 cases(28.9 %). Seventy· five cases(34.4 %) were taken only simple abdominal film for diagnostic studies. The associated malformations were observed in 54 aresia and were observed more frequently in DA(35 cases, 47.9 %). Meconium peritonitis due to intrauterine bowel perforation was more frequently associated with IA compared to DA and JA. The overall mortality rate was 30 %. (Abbreuations: $P_{T}$;p-value in total, $P_{DJ,DI,JI}$;p value between two groups among duodenal, jejunal and ileal groups).

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Legal Issue in Case of Death or Injury of an International Crew While on Board (국제항공운송 승무원이 항공기내에서 사상(死傷)을 당한 경우 법률관계 - 국내외 판례의 분석을 중심으로 -)

  • Kim, Sun-Ah
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.2
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    • pp.137-168
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    • 2020
  • Air passengers may be compensated for damages based on the above agreement when the passenger suffers an accident to the extent that they are recognized as an accident under Article 17 of the Montreal Convention in 1999. If a flight or cabin crew and passengers both undergo an accident, passengers are subjected to compensation under the Montreal Convention however flight cabin crews will be compensated by the Labor Law, which is the governing law in the labor contract with the airline. The flight or cabin crew boarding the aircraft work is on a work contract, not a passenger transport contract. Therefore, if the flight or cabin crew on the aircraft is injured due to an accident, and the air carrier is liable for default due to a labor contract, the Labor Law, workers or survivors claim damages due to illegal acts against the employer. In which case, civil law will apply. In this regard, if a Chinese cabin crew working for a Chinese airline dies due to an accident in the Republic of Korea, whether the family of the deceased claims damages against the Chinese airline or not has international court jurisdiction in the Republic of Korea, which is the place of tort. We examined whether it is the law of the Republic of Korea or whether it's the Chinese law, the law applicable to the work contract, is applied. Also, Seoul District Court 1995.5.18. The sentence 94A 14144 was found that if the injured crew during the flight work was not satisfied with the insurance compensation under the Labor Standards Act and the Industrial Accident Compensation Insurance Act, he could claime to damage under the civil law against an air carrier or third parties responsible for the accident. This law case shows that you can claim a civil damage as a cause. In case of death due to an existing illness while on the way to work, the Korea Workers'Compensation and Welfare Service did not recognize the death of the deceased as an occupational accident, and the trial was canceled by the parents of the deceased for the survivor's benefit and funeral expenses. (Seoul Administrative Court 2017.8. 31. Although the sentence was judged as an occupational disaster in 2016, the 2016 8816 Decision), it was defeated in the appeals court (Seoul High Court 2018.7.19.Sentence 2017 No. 74186) and I criticized the judgment of the appeal by analyzing the deceased's disease and related the cause of it to workload. Sometimes, a flight or cabin crew is on board not for the flight duty such as transferring to another flight or returning to the home base or lay-over place after their scheduled flight, this is called "Deadheading". If the crew who is not considered the same as a passenger, but is not on duty, is injured in an accident, does the crew claim compensation for damages under the labor contract or whether the Montreal Convention is applied to the passenger. In conjunction with the discussion, there was a similar case, In re Mexico City Aircrash of October 31, 1979, 708 F.2d 400 (9th Cir. 1983), Demanes v. United Airlines, 348 F.Supp. 13 (C.D.Cal. 1972), Sulewski v. Federal Express Corp., 749 F.Supp. 506 (S.D.N.Y. 1990) and reviewed by the European Court of Justice (CJEU) at Wucher Helicopter GmbH and Euro-Aviation Versicherungs AG v. After examining several acts in several countries it's undeniably crucial to clearly understand the definition of "passenger" as stated in the Fridolin Santer case.

Environmental Changes after Timber Harvesting in (Mt.) Paekunsan (백운산(白雲山) 성숙활엽수림(成熟闊葉樹林) 개벌수확지(皆伐收穫地)에서 벌출직후(伐出直後)의 환경변화(環境變化))

  • Park, Jae-Hyeon
    • Journal of Korean Society of Forest Science
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    • v.84 no.4
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    • pp.465-478
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    • 1995
  • The objective of this study was to investigate the impacts of large-scale timber harvesting on the environment of a mature hardwood forest. To achieve the objective, the effects of harvesting on forest environmental factors were analyzed quantitatively using the field data measured in the study sites of Seoul National University Research Forests [(Mt.) Paekunsan] for two years(1993-1994) following timber harvesting. The field data include information on vegetation, soil mesofauna, physicochemical characteristics of soil, surface water runoff, water quality in the stream, and hillslope erosion. For comparison, field data for each environmental factor were collected in forest areas disturbed by logging and undisturbed, separately. The results of this study were as follows : The diversity of vegetational species increased in the harvested sites. However, the similarity index value of species between harvested and non-harvested sites was close to each other. Soil bulk density and soil hardness were increased after timber harvesting, respectively. The level of organic matter, total-N, avail $P_2O_5$, CEC($K^+$, $Na^+$, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$) in the harvested area were found decreased. While the population of Colembola spp., and Acari spp. among soil mesofauna in harvested sites increased by two to seven times compared to those of non-harvested sites during the first year, the rates of increment decreased in the second year. However, those members of soil mesofauna in harvested sites were still higher than those of non-harvested sites in the second year. The results of statistical analysis using the stepwise regression method indicated that the diversity of soil mesofauna were significantly affected by soil moisture, soil bulk density, $Mg^{{+}{+}}$, CEC, and soil temperature at soil depth of 5(0~10)cm in the order of importance. The amount of surface water runoff on harvested sites was larger than that of non-harvested sites by 28% in the first year and 24.5% in the second year after timber harvesting. The level of BOD, COD, and pH in the stream water on the harvested sites reached at the level of the domestic use for drinking in the first and second year after timber harvesting. Such heavy metals as Cd, Pb, Cu, and organic P were not found. Moreover, the level of eight factors of domestic use for drinking water designated by the Ministry of Health and Welfare of Korea were within the level of the first class in the quality of drinking water standard. The study also showed that the amount of hillslope erosion in harvested sites was 4.77 ton/ha/yr in the first year after timber harvesting. In the second year, the amount decreased rapidly to 1.0 ton/ha/yr. The impact of logging on hillslope erosion in the harvested sites was larger than that in non-harvested sites by seven times in the first year and two times in the second year. The above results indicate that the large-scale timber harvesting cause significant changes in the environmental factors. However, the results are based on only two-year field observation. We should take more field observation and analyses to increase understandings on the impacts of timber harvesting on environmental changes. With the understandings, we might be able to improve the technology of timber harvesting operations to reduce the environmental impacts of large-scale timber harvesting.

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Comparative growth and development of the metacercariae of Fibricola seorszensis (Trematoda: Diplostomidae) in vitro, in vivo and on the chick chorioallantois (Fibricolu seoulensis (Trematoda: Diplostomidae) 피낭유충의 in vitro, in vivo 및 닭 장뇨막 상에서의 생존 및 발육 성장 비교)

  • 서병설
    • Parasites, Hosts and Diseases
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    • v.27 no.4
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    • pp.231-248
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    • 1989
  • The growth and development of the metacercariae of F. seoulensis cultivated in vitro or on the chick chorioallantois were assessed by comparison with the optimum process of maturation in albino rats and new born chickens. The process of maturation was divided for convenience into six stages: Stage 1 ; cell multiplication, Stage 2; body shaping, Stage 3; separation of genital anlagen, Stage :1 organogeny, Stage 5; gametogony, and Stage 6: oviposition. In Hank's and Tyrode's .solutions, the metacercariae were alive up to 200 days or more at $4^{\circ}C$ without any development. The in vivo maturation process in rats or chicks was as follows: stage 1 from 6 hours; stage 2 from 24 hours; stage 3 from 48 to 72 hours; stage 4 from 3 to 4 days; stage 5 from 4 to 5 days; and stage 6 from 5 to 8 days. Despite unsuccessful infection of the metacercariae to 12 day old chicks, fully mature worms of stage 5 or 6 were recovered from new born chicks (1 to 2 days old), The metacercariae of F. seoulensis grown in vitro were up to stage 3 and no further maturation was observed. Of various media employed, the medium NCTC 109 (Gibco) or NCTC 135(Gibco) supplemented with 20% egg yolk or 20% whole egg macerate or 0.5% yeast was basically required for the earlier development of the fluke. It took 16.1 days(in average) to reach the stage 3 after cultivation. The metacercariae cultivated on the chorioallantoic membranes of 6∼13 day old chick embryo at 37∼38℃ showed their full development up to stage 5 or 6. However, the worms were in general remarkably retarded, compared with those grown in rats or chickens. In the experiments of worm transplant, although the transfer was failed from in vitro culture to in vivo of rats(Per os), the transplants from in vitro culture to the chorioallantois and from the choriollantois to in vivo of rat host were successful with or without development of the transferred worms. In the present study, it was observed that the metacercariae of F, seoulensis can be maintained in vitro media with poor development as well as fully matured in 1 to 2 day-old chicks or on the chorioallantois at a very low rate.

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Investigation on Daily Life and Consciousness of Longevous People in Korea - (II) On Social Life and Daily Life Habit of Longevous People in the Past - (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) - 장수지역(長壽地域)의 과거(過去) 사회생활(社會生活)과 일상생활습관(日常生活習慣) -)

  • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok
    • Journal of the Korean Society of Food Culture
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    • v.1 no.3
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    • pp.183-196
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    • 1986
  • This study was designed to be link in the chain of the investigation on daily life and consciousness of longevous people in Korea, and to investigate the social life and daily life habit in the past of longevous people. The social life and daily life habit were surveyed on 379 subjects (male 121, female 258) of the aged who were above 80 years of age, from June to November in 1985. 1. 'Generally regular' in the rising time and bedtime between 40 and 60 years of longevous people had the highest figures of 81.8% and 63.1%, respectively. The longevous peoples of 59.4% got up by before 6 a.m., and 61.3% of these aged went to bed from 9 to 11 p.m. But there was no significant difference between male and female. 2. Of the occupation engaged in the longest term of longevous people, the self-management (86.3%) included farming, fishing and household affairs was the highest, whereas administrative position, small-scale management and white-collar worker were only 0.8%, 0.8% and 1.8%, respectively. Therefore, their work involved mainly physical labor (heavy 48.5%, light 47.2%), and mental work was only 2.8% of longevous people. It is believed that this fact was deeply related to the educational degree of them. 3. The longevous people of 58.3% retired from the occupation and household affairs abover 70 years of age, and especially 24.3% of them is including the aged above 80 years of age. 4. The longevous people of 57.2% were shared the role in the home after retirement from the occupation and household affairs, whereas 35.9% of them didn't share. Of the way in killing time in case having no role in the home, 'at home'(50.0%) was the highest, and decreased in the order of 'old people's home' (30.9%), 'ill in bed' (10.3%) and 'asylum for the aged' (8.8%). 5. The acquaintance frequency before retirement from the occupation and household affairs of longevous people showed in the order of 'wide' (38.5%), 'common' (38.0%) and 'narrow' (19.0%), and 56.5% of them had the acquaintance after retirement. 6. Only the longevous people of 38.5% had the hobby and recreation activities of 'more than once' after retirement from the occupation and household affairs, but 53.0% of them was none. Of the kinds of hobby and/or recreation, 'TV-watching' (79.2%) was the highest, and decreased in the order of 'talking with grandchild' (54.2 %), 'working at home' (35.4%), 'religion' (25.0%) and 'chess etc.' (18.1%).

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Plasma G-CSF and GM-CSF Concentration and Amount of Their Receptors on the Granulocyte in Kawasaki Disease (가와사키병 환아의 혈장내 G-CSF와 GM-CSF 농도 및 과립구에서의 이들 수용체의 발현 변화)

  • Yoo, Young-Kyoung;Lee, Gibum;Kim, Hyun-Hee;Kim, Soo-Young;Kim, You-Jeong;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.376-381
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    • 2003
  • Purpose : This study aimed to demonstrate the possible pathogenesis of granulopoiesis in patients of Kawasaki disease(KD) using quantitative analysis of G-CSF, GM-CSF and their CSFr. Methods : The plasma levels of G-CSF, GM-CSF, G-CSFr and GM-CSFr were studied in 14 patients in the acute phase of KD; 13 children with normal peripheral white blood cell counts were used as the normal control group. The plasma concentration of G-CSF, GM-CSF were analyzed by ELISA. The G-CSFr and GM-CSFr on the peripheral granulocytes were analyzed by a quantitative flow cytometric assay and QuantiBRITE, and the quantitative changes of receptors which did not combine with G-CSF and GM-CSF were measured. Results : The total number of leukocytes in KD was similar to normal control group, but the leukocytes increased according to the number of neutrophils. The plasma concentration of G-CSF were decreased similar to normal control group(P=0.133), but that of GM-CSF decreased more than the normal control group(P=0.227). The quantity of G-CSFr, GM-CSFr were revealed to be no less than the normal control(P=0.721, P=0.912). After incubation with excessive G-CSF, the expressed G-CSFr on the neutrophils were decreased in both groups(P=0.554). The quantities of expressions of GM-CSFr on the neutrophil after incubation with the excessive GM-CSF were always increased in both groups(P=0.255). The amount of GM-CSFr of neutrophils are in proportion to total white blood cells (r=0.788, P=0.035), but it wasn't in the case of KD(P=0.644). Conclusion : The leukocytosis in KD that mediated by increasing neutrophil was not correlated with the plasma concentrations of G-CSF and GM-CSF, and the amount of expression of G-CSFr and GM-CSFr on granulocyte. It is possible that the reduction of concentration of GM-CSF results by increasing the active GM-CSFr.

The Comparative Studies on Hatched Silkworm Dominance Seperation against Sex Seperation to meet Silk Promotion (잠견생산성 개선을 위한 의잠우열분리와 자웅분리의 비교연구)

  • Choe, Byong-Hee
    • Journal of Sericultural and Entomological Science
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    • v.15 no.2
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    • pp.21-28
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    • 1973
  • This report is prepared to promote cocoon natures for the use of silk reeling material. It is easily understandable that there must be disuniformity composed with superior group and inferior group in commercial silkworms. If such different groups be seperated by some method, it would be a great contribution for the cocoon production. For a comparative purpose, silkworm sex seperation carried out because male silkworms produce more silk than female worms. The author has developed a new chemical reagent available for the seperation of superior group and inferior group from commercial silkworms, which he has named it as Better Hybrid Controller (BHC). The obtained comparative results are summarized as followings. 1. Basic investigation of BHC application a) In case BHC applied with hybrid worms and pure line, the former one starts to adapt mulberry leaves earlyer than pure line variety. b) The mulberry adapting interval distribution of pure line worms after BHC application showed U type distribution, but hybrid worms showed L type or Poisson's distribution. c) In case of BHC application with silkworms, the longer period application is, the duller distribution was formed. d) When silkworms are seperated in two groups by use of BHC application, the earlyer mulberry adapted group is seemed as stronger than the other part and the group ratio is 2 : 1. 2. Comparation between sex seperation result and better hydrid control (BHC) seperation result. a) The cocoon shell per cent of male worm group showed betweer result than the female group but only 0.4% difference between sexes. b) The cocoon shell per cent of superior group, seperated by BHC, showed 0.7% more than the inferior group. c) The average cocoon shell per cent of BHC treated cocoons showed much more than the Control group as 1.6∼2.4% increase. Enven the inferior group showed better result than the Control. d) Such unexpected result is considered to be the result that BHC application is activating some thing with silkworm physiology. e) On the ether hand, the result of sexes seperated groups or male worm group did not show desirable conclusion as far as cocoon shell per cent is concerned. f) However, when the male group was reeled as silk, it showed much better silk yield or silk per cent of cocoon than the female group as much as one per cent difference between by sexes. Such result was brought by superior silk yield from cocoon shell as much as 87.4%. g) On the other hand, the male group showed lowest non breaking reelable ratio (63%) among all group comparation. h) When we compare cocoon qualities by sex seperation and BHC seperation against the Control, there is no qualitative change, but BHC group showed quantitative promotion with cocoon bave length as much as about hundred meters. i) In case of calculation for productive income of cocoon production, BHC applied group showed about ten per cent income promotion more than the Control. The sexes seperated group, however, showed rather negative result because the male cocoon produced poor weight per box eggs which could not cover it by the inclose of silk yield of it. j) So, the BHC application with the fetched worm stage brought about big promotion for cocoon production. k) BHC method may be used either for seperation purpose or quantitative promotion with whole silk-worms. 3. Only male silkworms rearing did not show desirable productivity, so there is no reason to work out it in the fetching stage of worm.

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Circulating Cytokine Levels and Changes During the Treatment in Patients with Active Tuberculosis in Korea (결핵 환자의 치료경과 중 혈청 내 Cytokine 분비와 변화)

  • Ryu, Yon-Ju;Kim, Yun-Jung;Kwon, Jung-Mi;Na, Youn-Ju;Jung, Yu-Jin;Seoh, Ju Young;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.140-153
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    • 2003
  • Background : The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. Method : Serum interleukin-1 beta(IL-$1{\beta}$), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-${\alpha}$), interferon-gamma(IFN-${\gamma}$) and transforming growth factor-beta(TGF-${\beta}$) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-${\alpha}$, IFN-${\gamma}$ and TGF-${\beta}$ levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. Results : 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-$1{\beta}$, IL-6(p<0.05), TNF-${\alpha}$, and IFN-${\gamma}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-2, Il-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-${\alpha}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-${\gamma}$ level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 AND TNF-${\alpha}$ and between IL-12, Il-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-${\gamma}$ was significantly decreased(p<0.05). Conclusion : These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.

Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix (다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究))

  • Kim, Ho-Kyoung;Ma, Jin-Yeul;Cheon, Won-Kyung;Yun, Su-Young;Kang, Eun-Jung;Joo, Hye-Jeong;Ko, Byoung-Seob
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.183-197
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    • 1997
  • In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri (足三里) of rat, repeatedly. We compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days(p<0.05) and after 7 days(p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight : In Palkang aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of Hwanggum aqua-aqupuncture$({\times}10\;group)$ was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture$({\times}100\;group)$, D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound(CPA group) and HG, there were significant value iii statistically. The diluted solution was more significant decrease than Hwanggum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupunture tended to decrease level of TG, regardless of its concentration. In acupunture guoup, we gained some interesting result In meaningful decrease in 7G. 5. Haematological examination showed significant increment of granulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

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Effect of the Angle of Ventricular Septal Wall on Left Anterior Oblique View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 심실중격 각도에 따른 좌전사위상 변화에 대한 연구)

  • You, Yeon Wook;Lee, Chung Wun;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae;Bang, Ji-In;Lee, Soo Jin;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.13-19
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    • 2016
  • Purpose In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (${\theta}$) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view. Materials and Methods From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (${\theta}$) between ventricular septum and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of ${\theta}$ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO ${\theta}$ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed. Results $Mean{\pm}SD$ of ${\theta}$ on total 253 patients was $37.0{\pm}8.5^{\circ}$. Among them, the patients whose difference between 45 and ${\theta}$ degrees were more than ${\pm}10$ degrees were 88 patients ($29.3{\pm}6.1^{\circ}$). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=62.0{\pm}6.6%$ vs. LVEF ${\theta}=64.0{\pm}5.6%$; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=66.7{\pm}7.2%$ vs. LVEF ${\theta}=69.0{\pm}6.4%$; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO ${\theta}$, there was no significant difference statistically. Conclusion We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO ${\theta}$ view.

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