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Long-term Prognostic Value of Dipyridamole Stress Myocardial SPECT (디피리다몰 부하 심근관류 SPECT의 장기예후 예측능)

  • Lee, Dong-Soo;Cheon, Gi-Jeong;Jang, Myung-Jin;Kang, Won-Jun;Chung, June-Key;Lee, Myoung-Mook;Lee, Myung-Chul;Kang, Wee-Chang;Lee, Young-Jo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.39-54
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    • 2000
  • Purpose: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. Materials and Methods: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. Results: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follows up. However, the ratio of abnormal SPECT was not. Conclusion: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.

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Studies on the Increase of Germination Percent of Angelica gigas Nakai I. Germination Characteristics and Cause of Lower Germination Percent (참당귀(當歸) 종자(種字)의 발아율(發芽率) 향상(向上)에 관(關)한 연구(硏究) I. 발아특성(發芽特性)과 발아율(發芽率) 저조(低調) 원인(原因))

  • Cho, Seon-Haeng;Kim, Ki-June
    • Korean Journal of Medicinal Crop Science
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    • v.1 no.1
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    • pp.3-9
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    • 1993
  • This experiment was conducted to study germination characteristics and the decrease cause of germination percent in Angelica gigas Nakai seed. The emergence percent of winter sowing was higher than that of spring sowing as 66.6% and 41.1%, respectively, and the first emergence date was also earlier in winter sowing. The seed germination speed, percent and coefficent showed the highest value at $20^{\circ}C$ of incubation temperature, but lower value at $10^{\circ}C\;and\;30^{\circ}C$. The water uptake speed was increased along with increasing water temperature. The weight of imbibed seed at germination was 3.4times higher based on the weight of intact dry seed and 2.3times on removal of seed coat. In terms of length of seed was large, the germination percent was higher. The germination percent of brown colored seeds showed higher value than that of green colored seeds. The prolonged storage period decreased germination percent. When A.gigas seeds stored at room temperatue for 2years, the seeds were lost their viability. The biological inhibition effect of methanol, water and ether extract on the germination and growth of A.gigas and lettuce seed showed the highest value in the methanol extract, followed by water extract and the least in ether extract.

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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.

Morphologic Follow-Up of the Anastomotic Sites Using One-year and Five-year Angiography after Coronary Artery Bypass Grafting (관상동맥우회술 후 1년 및 5년 추적 관상동맥조영술을 이용한 문합부위의 형태학적 변화)

  • Cho Kwang Ree;Kim Jun-Sung;Choi Jae-Sung;Chae In-Ho;Oh Byung-Hee;Lee Myoung-Mook;Park Young-Bae;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.191-196
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    • 2005
  • We analysed the characteristics of anastomotic sites after coronary artery bypass grafting (CABG) using coronary angiographies (CAGs) performed at one and five years postoperatively in the same patient population. Material and Method: Among the 219 patients who underwent isolated CABGs between January 1995 and December 1997, follow-up coronary angiograms were performed in 149 ($75.3\%$) patients at one year and in 115 ($58.1\%$) patients at five years postoperatively. FitzGibbon grading system was used to evaluate the anastomotic sites. Result: The patency rates of arterial grafts at one- and five-year were $96.5\%$ (192/199) and $93.1\%$ (134/144), which were higher than those of saphenous vein grafts (SVGs) ($82.9\%$ (224/270) and $77.5\%$ (141/182), respectively) (p=0.01). Although there were significant decreases in the patency rates between one- and five-year CAGs of both arterial and venous grafts, the proportion of FitzGibbon grade B among the SVGs was increased from $5.2\%$ (one-year) to $8.2\%$ (five-year), suggesting the progression of vein graft disease (p < 0.01). Conclusion: The patency rate of the arterial graft was higher than that of SVG in both one- and five-year CAGs. The attrition rate of saphenous vein graft was higher than arterial grafts.

Effect of Attenuation Correction, Scatter Correction and Resolution Recovery on Diagnostic Performance of Quantitative Myocardial SPECT for Coronary Artery Disease (감쇠보정, 산란보정 및 해상도복원이 정량적 심근 SPECT의 관상동맥질환 진단성능에 미치는 효과)

  • Hwang, Kyung-Hoon;Lee, Dong-Soo;Paeng, Jin-Chul;Lee, Myoung-Mook;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.288-297
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    • 2002
  • Purpose: Soft tissue attenuation and scattering are major methodological limitations of myocardial perfusion SPECT. To overcome these limitations, algorithms for attenuation, scatter correction and resolution recovery (ASCRR) is being developed, while quantitative myocardial SPECT has also become available. In this study, we investigated the efficacy of an ASCRR-corrected quantitative myocardial SPECT method for the diagnosis of coronary artery disease (CAD). Materials and Methods: Seventy-five patients (M:F=51:24, $61.0{\pm}8.9$ years old) suspected of CAD who underwent coronary angiography (CAG) within $7{\pm}12$ days of SPECT(Group-I) and 20 subjects (M:F=10:10, age $40.6{\pm}9.4$) with a low likelihood of coronary artery disease (Group-II) were enrolled. Tl-201 rest/ dipyridamole-stress Tc-99m-MIBI gated myocardial SPECT was performed. ASCRR correction was peformed using a Gd-153 line source and automatic software (Vantage-Pro; ADAC Labs, USA). Using a 20-segment model, segmental perfusion was automatically quantified on both the ASCRR-corrected and uncorrected images using an automatic quantifying software (AutoQUANT; ADAC Labs.). Using these quantified values, CAD was diagnosed in each of the 3 coronary arterial territories. The diagnostic performance of ASCRR-corrected SPECT was compared with that of non-corrected SPECT. Results: Among the 75 patients of Group-I, 9 patients had normal CAG while the remaining 66 patients had 155 arterial lesions; 61 left anterior descending (LAD), 48 left circumflex (LCX) and 46 right coronary (RCA) arterial lesions. For the LAD and LCX lesions, there was no significant difference in diagnostic performance. In Group-II patients, the overall normalcy rate improved but this improvement was not statistically significant (p=0.07). However, for RCA lesions, specificity improved significantly but sensitivity worsened significantly with ASCRR correction (both p<0.05). Overall accuracy was the same. Conclusion: The ASCRR correction did not improve diagnostic performance significantly although the diagnostic specificity for RCA lesions improved on quantitative myocardial SPECT. The clinical application of the ASC-RR correction requires more discretion regarding cost and efficacy.

Comparison of Dose When Prescribed to Point A and Point H for Brachytherapy in Cervical Cancer (자궁경부암 근접치료에서 A점과 H점을 이용한 치료계획 시 선량 비교)

  • Gang, Ji-Hyeong;Gim, Il-Hwan;Hwang, Seon-Boong;Kim, Woong;Im, Hyeong-Seo;Gang, Jin-Mook;Gim, Gi-Hwan;Lee, Ah-Ram
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.61-66
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    • 2012
  • Purpose: The purpose of this study is to compare plans prescribed to point A with these prescribed to point H recommended by ABS (American Brachytherapy Society) in high dose rate intracavitary brachytherapy for cervical carcinoma. Materials and Methods: This study selected 103 patients who received HDR (High Dose Rate) brachytherapy using tandem and ovoids from March 2010 to January 2012. Point A, bladder point, and rectal point conform with Manchester System. Point H conforms with ABS recommendation. Also Sigmoid colon point, and vagina point were established arbitrarily. We examined distance between point A and point H. The percent dose at point A was calculated when 100% dose was prescribed to point H. Additionally, the percent dose at each reference points when dose is prescribed to point H and point A were calculated. Results: The relative dose at point A was lower when point H was located inferior to point A. The relative doses at bladder, rectal, sigmoid colon, and vagina points were higher when point H was located superior to point A, and lower when point H was located inferior to point A. Conclusion: This study found out that as point H got located much superior to point A, the absorbed dose of surrounding normal organs became higher, and as point H got located much inferior to point A, the absorbed dose of surrounding normal organs became lower. This differences dose not seem to affect the treatment. However, we suggest this new point is worth being considered for the treatment of HDR if dose distribution and absorbed dose at normal organs have large differences between prescribed to point A and H.

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Variations on the Concentration of Dissolved Gaseous Mercury(DGM) at the Juam Reservoir, Korea (주암호의 용존가스상 수은의 농도변화 특성에 관한 연구)

  • Park, Jong-Sung;Oh, Se-Hee;Shin, Mi-Yeon;Yi, Seung-Muk;Zoh, Kyung-Duk
    • Journal of Korean Society of Environmental Engineers
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    • v.28 no.6
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    • pp.667-676
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    • 2006
  • The reduction of $Hg^{2+}$ in the aqueous phase results in the production of dissolved gaseous mercury(DGM), and the volatilization of DGM has been identified as an important mechanism for the loss of Hg from waterbodies to the atmosphere. Although mercury emission in the world is known to be mostly from Asia, there have been few studies of measuring DGM concentrations in lakes in Asia. In this study, DGM concentrations were measured at Juam reservoir($35^{\cir}00'N,\;127^{\circ}14'E$), Korea. The results showed that the average concentrations of DGM at the upper and down stream of the lake during summer time were $95{\pm}8\;and\;130{\pm}15$ pg/L, respectively and the concentration of total mercury(TM) at the upper and down stream was $2.1{\pm}0.7,\;1.7{\pm}0.3$ ng/L respectively. Average DGM concentration during summer time($101{\pm}14pg/L$) was approximately 5.5 times higher than that during fall($18{\pm}0.1pg/L$). The DGM concentrations ai the midstream decreased from 32 to 13.7 pg/L during rain event, while the TM concentrations increased from 2.2 ng/L to 2.7 ng/L indicating the deposition of mercury from the atmosphere. Also, the diurnal patterns between DGM concentrations and UV intensities were observed. Water temperatures and DOC concentrations were significantly related to DGM concentrations, while TM concentrations were negatively related to DGM concentrations(p<0.0001). Comparing with the study of Dill et al.,(2006) the average concentrations of DGM $(109{\pm}15pg/L)\;and\;TM(2.2{\pm} 0.4ng/L)$ at Juam reservoir were approximately 3 and 2.2 times higher than those measured in other lakes(DGM: $38{\pm}16pg/L$, TM: $1.0{\pm}1.2ng/L$).

Development of Abdominal Compression Belt and Evaluation of the Efficiency for the Reduction of Respiratory Motion in SBRT (체부 정위방사선치료 시 호흡운동 감소를 위한 복부 압박기구 개발 및 유용성 평가)

  • Hwang, Seon-Bung;Kim, Il-Hwan;Kim, Woong;Im, Hyeong-Seo;Gang, Jin-Mook;Jeong, Seong-Min;Kim, Gi-Hwan;Lee, Ah-Ram;Cho, Yu-Ra
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.13-19
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    • 2011
  • Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

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Imaging dose evaluations on Image Guided Radiation Therapy (영상유도방사선치료시 확인 영상의 흡수선량평가)

  • Hwang, Sun Boong;Kim, Ki Hwan;kim, il Hwan;Kim, Woong;Im, Hyeong Seo;Han, Su Chul;Kang, Jin Mook;Kim, Jinho
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.1-11
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    • 2015
  • Purpose : Evaluating absorbed dose related to 2D and 3D imaging confirmation devices Materials and Methods : According to the radiographic projection conditions, absorbed doses are measured that 3 glass dosimeters attached to the centers of 0', 90', 180' and 270' in the head, thorax and abdomen each with Rando phantom are used in field size $26.6{\times}20$, $15{\times}15$. In the same way, absorbed doses are measured for width 16cm and 10cm of CBCT each. OBI(version 1.5) system and calibrated glass dosimeters are used for the measurement. Results : AP projection for 2D imaging check, In $0^{\circ}$ degree absorbed doses measured in the head were $1.44{\pm}0.26mGy$ with the field size $26.6{\times}20$, $1.17{\pm}0.02mGy$ with the field size $15{\times}15$. With the same method, absorbed doses in the thorax were $3.08{\pm}0.86mGy$ to $0.57{\pm}0.02mGy$ by reducing field size. In the abdomen, absorbed dose were reduced $8.19{\pm}0.54mGy$ to $4.19{\pm}0.09mGy$. Finally according to the field size, absorbed doses has decreased by average 5~12%. With Lateral projection, absorbed doses showed average 5~8% decrease. CBCT for 3D imaging check, CBDI in the head were $4.39{\pm}0.11mGy$ to $3.99{\pm}0.13mGy$ by reducing the width 16cm to 10cm. In the same way in thorax the absorbed dose were reduced $34.88{\pm}0.93(10.48{\pm}0.09)mGy$ to $31.01{\pm}0.3(9.30{\pm}0.09)mGy$ and $35.99{\pm}1.86mGy$ to $32.27{\pm}1.35mGy$ in the abdomen. With variation of width 16cm and 10cm, they showed 8~11% decrease. Conclusion : By means of reducing 2D field size, absorbed dose were decreased average 5~12% in 3D width size 8~11%. So that it is necessary for radiation therapists to recognize systematical management for absorbed dose for Imaging confirmation. and also for frequent CBCT, it is considered whether or not prescribed dose for RT refer to imaging dose.

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The Effect of Platelet Derived Growth Factor - BB Loaded Chitosan/Calcium Metaphosphate on Bone Regeneration (혈소판유래성장인자를 함유한 Chitosan/Calcium Metaphosphate의 골조직재생효과에 관한 연구)

  • Lee, Seung-Yeol;Seol, Yang-Jo;Lee, Yong-Moo;Lee, Ju-Yeon;Lee, Seung-Jin;Kim, Suk-Young;Ku, Young;Rhyu, In-Chul;Han, Soo-Boo;Choi, Sang-Mook;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.1-23
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    • 2001
  • Chitosan is biodegradable natural polymer that has been demonstrated its ability to improve wound healing, and calcium metaphosphate(CMP) is a unique class of phosphate minerals having a polymeric structure. In this study, chitosan/CMP and platelet derived growth factor(PDGF-BB) loaded chitosan/CMP sponges were developed, and the effect of the sponges on bone regeneration and their possibility as scaffolds for bone formation by three-dimensional osteoblast culture were examined. PDGF-BB loaded chitosan/CMP sponges were prepared by freeze-drying of a mixture of chitosan solution and CMP powder, and soaking in a PDGF-BB solution. Fabricated sponge retained its 3-dimensional porous structure with $100-200\;{\mu}m$ pores. The release kinetics of PDGF-BB loaded onto the sponge were measured in vitro with $^{125}I-labeled$ PDGF-BB. In order to examine their possibility as scaffolds for bone formation, fetal rat calvarial osteoblastic cells were isolated, cultured, and seeded into the sponges. The cell-sponge constructs were cultured for 28 days. Cell proliferation, alkaline phosphatase activity were measured at 1, 7, 14 and 28 days, and histologic examination was performed. In order to examine the effect on the healing of bone defect, the sponges were implanted into rat calvarial defects. Rats were sacrificed 2 and 4 weeks after implantation and histologic and histomorphometrical examination were performed. An effective therapeutic concentration of PDGF-BB following a high initial burst release was maintained throughout the examination period. PDGF-BB loaded chitosan/CMP sponges supported the proliferation of seeded osteoblastic cells as well as their differentiation as indicated by high alkaline phosphatase activities. Histologic findings indicated that seeded osteoblastic cells well attached to sponge matrices and proliferated in a multi-layer fashion. In the experiments of implantation in rat calvarial defects, histologic and histomorphometric examination revealed that chitosan/CMP sponge promoted osseous healing as compared to controls. PDGF-BB loaded chitosan/CMP sponge further echanced bone regeneration. These results suggested that PDGF-BB loaded chitosan/CMP sponge was a feasable scaffolding material to grow osteoblast in a three-dimentional structure for transplantation into a site for bone regeneration.

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