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Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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Studies on Persistence of Pesticides in Soils and Crops under Polyethylene Film Mulching Culture II. Effect of Polyethylene Film mulching on Weed Emergence, Growth and Yield of Red pepper, Peanut and Sesame (폴리에틸렌 멀칭재배(栽培) 시(時) 농약(農藥)의 토양(土壤) 및 작물체중(作物体中) 잔류(殘留)에 관한 연구(硏究) 제(第) 2 보(報) 폴리에틸렌 멀칭이 잡초발생(雜草發生), 고추, 땅콩, 참깨의 생육(生育) 및 수량(收量)에 미치는 영향(影響))

  • Ryang, H.S.;Moon, Y.H.;Kim, N.E.;Lee, J.H.
    • Korean Journal of Weed Science
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    • v.7 no.3
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    • pp.306-315
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    • 1987
  • In the red pepper field under polythylene film mulching(P.E.-mulching) culture, the weed emergence was completely inhibited by black P.E.-mulching. The emergence in clear P.E.-mulching decreased 90% compared to that in non-mulching. Weeding effect was high in the order of pendimethalin, diphenamid, alachlor and napropamide. The effect of herbicides was higher in clear P.E.-mulching than in non-mulching. Plant height and number of branches increased in the order of clear P.E.-, black P.E.-mulching, while the yield between black P.E.- and clear P.E.-mulching was not different. The herbicides had no effect on the growth and yield. In the peanut field, weed emergence was 80% lower in clear P.E.-mulching than in non-mulching. Weeding effect was excellent in the plot applied with alachlor, napropamide and diphenamid. The total number of branches, main stem height and shoot weight were 2.0, 1.7 and 2.4 times greater in clear P.E.-mulching than in non-mulching, respectively. Peanut yield was about 38% higher under clear P.E.-mulching than under non-mulching. The herbicides had no effect on the growth and yield. In the sesame field, rate of weed emergence was 10 times lower in clear P.E.-mulching than in non-mulching. Weeding effect of alachlor, napropamide and diphenamid was higher under clear P.E.-mulching than under non-mulching. Germination percentage of sesame greatly decreased in non-mulching compared with in clear P.E.-mulching. The germination was inhibited by the treatment of herbicides. The inhibition effect was increased in the order of alachlor, napropamide, and diphenamid. The initial crop injury in treatment of herbicides was greater in non-mulching than in clear P.E.-mulching. The crop recovered from the injury and exhibited regrowth in clear P.E.-mulching except the alachlor treatment, but there was no recovery in non-mulching. There was no significant difference yield between herbicide treatment and hand weeding in non-mulching. Also, no significant difference was obseorbed between napropamide and diphenamid treatment and hand weeding in clear P.E.-mulching.

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Studies on Controlling Mixed Annual and Perennial Weeds in Paddy Fields - On the Herbicidal Properties of Perfluidone - (수종(數種) 다년생잡초혼생답(多年生雜草混生沓)에 있어서 제초제(除草劑)에 의한 효과적(效果的)인 잡초방제(雜草防除) - Perfluidone의 작용특성구명(作用特性究明)을 중심(中心)으로 -)

  • Ryang, H.S.;Han, S.S.
    • Korean Journal of Weed Science
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    • v.3 no.1
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    • pp.75-99
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    • 1983
  • The herbicidal properties of perfluidone [1,1,1-trifluoro-N-2-methyl-4-(phenylsulponyl) phenyl methanesulfonamide] were investigated in pots and paddy fields. At the rate of 2.0kg prod./10a, perfluidone did not cause any injury to the 4 leaf stage (LS) rice seedlings. Although the crop injury increased with increasing the application rate, the injury caused by 16kg prod. perfluidone/10a gave rise to only 30% yield reduction. The crop injury was greatest when perfluidone was applied 2 days before transplanting and decreased as the application time delayed. Perfluidone showed greater crop injury to the 3 LS seedlings, at more than 7cm water depth, and at high temperature than to the 4 LS seedlings, at 3-5cm water depth, and at low temperature. Indica and indica ${\times}$ japonica rice varieties were generally more sensitive to perfluidone than japonica rice variety. Perfluidone effectively controlled most of annual weeds and such perennial weeds as Sagittaria pygmaea MIQ., Potamogeton distinctus A. BENN, Cyperus serotinus ROTTB, Scirpus maritimus L., Eleocharis kuroguwai OHWL, and Scirpus hotarui OHWL, whereas Sagittaria trifolia L. and Polygonum hydropiper SPACH. were tolerent to perfluidone. The weeding effect decreased with increasing the leaching amount of water and the overflowing of irrigated water within 24 hours after the herbicide application. When the application time was done later than 8 days after transplanting, the perennial weeds were shown at deeper soil layers, and the standing water was deeper than 7cm, the effect tended to decrease. However, there was no difference in the weeding effect between soil types. Downward movement of perfluidone in flooded soil ranged from 2 to 8cm deep. The movement increased with increasing the leaching amount of water and the application rate and at a sandy loam soil which possessed less adsorptive capacity. Residual effect of perfluidone was found at 35 to 80 days after application, which varied such factors as Soil types. Increase in the leaching amount of water resulted in decrease in the period of the residual effect. The period was shorter at non-sterilized soil than at sterilized soil. The 0.75kg ai perfluidone + 1.5kg ai SL-49 (1,3-dimethyl-6-(2,4-dichlor-benzoyl)-5-phenacyloxy-pyrazole)/ha and 1.5kg ai perfluidone + 1.05kg ai bifenox (2,4-dichlorophenyl-3-methoxy carbonyl-4-nitro phenyl ether)/ha showed less crop injury than 1.5kg ai/ha perfluidone alone. However, the weeding effect of the former was similar to that of the later.

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Anatomical Variations in the Communicating Rami of the Upper Thoracic Sympathetic Ganglia Related to the Essential Palmar Hyperhidrosis (본태성 수부 다한증에 관련된 상부 흉부교감신경절 교통가지의 해부학적 변이)

  • Cho, Hyun-Min;Kim, Kil-Dong;Lee, Sak;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.182-188
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    • 2003
  • Background: Although ramicotomy (division of the rami communicantes of the thoracic sympathetic ganglia) is a selective and physiological surgical method for essential hyperhidrosis, it has some problems such as higher recurrence rates and the different surgical results among the patients and between left and right sides in the same individual. As one of the factors that are related to the differences in surgical result and recurrences, we investigated the anatomical variations of the rami communicantes. The purpose of this study is to help develop new surgical methods to decrease surgical differences among the patients or between the left and right sides of the same individual and recurrence rates in the clinical application of ramicotomy. Material and Method: We dissected 118 thoracic sympathetic chains in 59 adult Korean cadavers (male: 33, female: 26) to examine the anatomical variations of the rami communicantes from the second to the fourth thoracic sympathetic ganglia that have major components innervating to the hands. After the dissection of bilateral thoracic sympathetic chains, we compared the anatomy of left and right sides and examined the anatomical variations of rami communicantes. Result: The number and variation of communicating rami connecting the spinal nerves and the second sympathetic thoracic ganglion were much larger than lower levels. There was considerably less variability in the anatomy of the rami communicantes at successive levels. Among the 59 cadavers dissected, only 14.3% (9/59) had similar anatomy of thoracic sympathetic chains at both sides. As the components related to the essential palmar hyperhidrosis, intrathoracic nerve of Kuntz from the second thoracic sympathetic ganglion to the first intercostal nerve or brachial plexus were observed in 55.9% (66/118). The incidence of descending rami communicates from the second thoracic sympathetic ganglion to the third intercostal nerve and from the third thoracic sympathetic ganglion to the fourth intercostal nerve were 49.2% (58/118) and 28.0% (33/118). And the incidence of ascending rami communicates from the third thoracic sympathetic ganglion to the second intercostal nerve and from the fourth thoracic sympathetic ganglion to the third intercostal nerve were 6.8% (8/118) and 3.4% (4/118), respectively. Conclusion: Based on the various anatomical evidences of the rami communicantes from this study, only the ramicotomy at the third sympathetic ganglion level is insufficient for the treatment of the essential palmar hyperhidrosis to decrease the difference of surgical results and recurrences. When one is planning to perform the ramicotomy for the essential palmar hyperhidrosis, it is advantageous to divide the intrathoracic nerve of Kuntz on the second rib and the descending or ascending rami communicantes on the third and the fourth ribs as well as all the communicating rami from the third sympathetic ganglion.

Improvement in Regional Contractility of Myocardium after CABG (관상동맥 우회로 수술 환자에서 심근의 탄성도 변화)

  • Lee, Byeong-Il;Paeng, Jin-Chul;Lee, Dong-Soo;Lee, Jae-Sung;Chung, June-Key;Lee, Myung-Chul;Choi, Heung-Kook
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.4
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    • pp.224-230
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    • 2005
  • Purpose: The maximal elastance ($E_{max}$) of myocardium has been established as a reliable load-independent contractility index. Recently, we developed a noninvasive method to measure the regional contractility using gated myocardial SPECT and arterial tonometry data. In this study, we measured regional $E_{max}(rE_{max}$ in the patients who underwent coronary artery bypass graft surgery (CABG), and assessed its relationship with other variables. Materials and Methods: 21 patients (M:F=17:4, $58{\pm}12$ y) who underwent CABG were enrolled. $^{201}TI$ rest/dipyridamole stress $^{99m}Tc$-sestamibi gated SPECT were performed before and 3 months after CABG. For 15 myocardial regions, regional time-elastance curve was obtained using the pressure data of tonometry and the volume data of gated SPECT. To investigate the coupling with myocardial function, preoperative regional $E_{max}$ was compared with regional perfusion and systolic thickening. In addition, the correlation between $E_{max}$ and viability was assessed in dysfunctional segments (thickening <20% before CABG). The viability was defined as improvement of postoperative systolic thickening more than 10%. Results: Regional $E_{max}$ was slightly increased after CABG from $2.41{\pm}1.64 (pre)\;to\;2.78{\pm}1.83 (post)$ mmHg/ml. $E_{max}$ had weak correlation with perfusion and thickening (r=0.35, p<0.001). In the regions of preserved perfusion (${\geq}60%$), $E_{max}$ was $2.65{\pm}1.67$, while it was $1.30{\pm}1.24$ in the segments of decreased perfusion. With regard to thickening, $E_{max}$ was $3.01{\pm}1.92$ mmHg/ml for normal regions (thickening ${geq}40%$), $2.40{\pm}1.19$ mmHg/ml for mildly dysfunctional regions (<40% and ${\geq}20%$), and $1.13{\pm}0.89$ mmHg/ml for severely dysfunctional regions (<20%). $E_{max}$ was improved after CABG in both the viable (from $1.27{\pm}1.07\;to\;1.79{\pm}1.48$ mmHg/ml) and non-viable segments (from $0.97 {\pm}0.59\;to\;1.22{\pm}0.71$ mmHg/ml), but there was no correlation between $E_{max}$ and thickening improvements (r=0.007). Conclusions: Preoperative regional $E_{max}$ was relatively concordant with regional perfusion and systolic thickening on gated myocardial SPECT. In dysfunctional but viable segments, $E_{max}$ was improved after CABG, but showed no correlation with thickening improvement. As a load-independent contractility index of dysfunctional myocardial segments, we suggest that the regional $E_{max}$ could be an independent parameter in the assessment of myocardial function.

INFLUENCES OF DRY METHODS OF RETROCAVITY ON THE APICAL SEAL (치근단 역충전와동의 건조방법이 폐쇄성에 미치는 영향)

  • Lee, Jung-Tae;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.166-179
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    • 1999
  • Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.

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The Health Behavior Patterns of Some Rural Residents in Korea and Their Association with Health Status and Health Management Practice (일부 농촌주민의 건강행위유형과 건강상태 및 건강관련실태와의 관련성)

  • Kim, Young-Gab;Kang, Myung-Guen;Ryu, So-Yeon;Kim, Ki-Soon;Kang, Sung-Deuk
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.43-63
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    • 2004
  • Objectives: The purpose of this study was to classify the patterns of health behaviors of some rural residents in Korea by sub-grouping them into populations with similar patterns of diet quality, physical activity, alcohol consumption and cigarette smoking, and then to investigate the relationship between these health behavior patterns and health status or health management of them. Methods: The study subjects were 722 rural residents above 20 years old on a typical rural district in Korea, and the data used in this study was from the survey data for health planning of a health center. Study questionnaire for this survey was developed from modifying the questionnaire for 'National Nutrition and Health Study' conducted in 1998. To classify health behavior patterns, cluster analysis was conducted. And to test the association of health behavior patterns with health status or health management, multiple logistic regression analysis were conducted. Results: The results and their implications of this study were as follows: 1. We identified six health behavior typologies : 67.8% of the sample had a good diet quality but showed sedentary activity level(good diet lifestyle) and 10.9% had heavy smoking behavior(smoking lifestyle). Individuals included in fitness lifestyle cluster(6.2%) had high physical activity level and those in drinking life style(2.6%) had had mainly large amount of alcohol. Zero point six percent of sample were included in hedonic lifestyle cluster, who showed poor health behaviors in all. Those included in passive lifestyle(11.9%) had no active health promoting activities but tended to avoid risk taking health behavior such as cigarette smoking and alcohol drinking. 2. As a result of logistic regression analysis, to compare with the individuals in good diet lifestyle, the prevalence of chronic diseases of those in fitness lifestyle showed higher and that of those in smoking lifestyle, drinking lifestyle, hedonic lifestyle, passive lifestyle showed lower than them, retrospectively. 3. Adjusting with general characteristics and health status, to compare with the individuals in good diet lifestyle, the proportion of those who had good health management practices in fitness lifestyle was higher, and the proportion of those who had health check in past 2 years was lower than them, retrospectively. Conclusions: There were some differences in health behavior patterns between rural population and national population, which influenced significantly on health status and health management practice of them. We suggested that the health promotion program for them be developed with considering these points.

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Experimental Studies on Heat Conductivity of Human Bone and Torsional Strength of Pasteurized Porcine Tibia (생체골의 열전도성 및 열처리된 골의 염전력 변화에 대한 실험적 연구)

  • Park, Il-Hyung;Kim, Sin-Gun;Shin, Dong-Kyu;Ihn, Joo-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.7-16
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    • 1995
  • In countries where confucianism is popular, it is extremely hard to get fresh cadaver bone for allograft. Therefore in Korea, the reimplantation of resected autoclaved autogenous bone segments has been increasingly performed for limb reconstruction of extremities with malignancies. To preserve the bone morphogenetic protein and mechanical strength of heated bone, many studies have reported that pasteurization of bone is far better than autoclaving over $100^{\circ}C$. Based on this assumption, replacement with a pasteurized autogenous bone graft after resection of a malignant bone tumor was deemed feasible for reconstruction. However, little is known about how high a temperature and how much time for pasteurization is needed to make tumors completely necrotic and to maintain the mechanical strength of bone. Consequantly, experimental studies were carried out to test heat conductivity of human bone and torsional strength of porcine tibia after pasteurization. First, two pairs of human proximal tibia and distal femur were used. We used T-type thermocoples to check core temperature of the bone and a computerized data acquisition system to record results. Without reaming of the medullary cavity, in a $60^{\circ}C$-thermostatic saline tub, it took 32 minutes and 50 seconds to raise the core temperature of human proximal tibia from $20^{\circ}C$ to $58^{\circ}C$, and 30 minutes for distal femur. In a $80^{\circ}C$ saline tub, it took 12 minutes and 50 seconds for proximal tibia, and 11 minutes and 10 seconds for distal femur. In contrast, using porcine tibia whose cortical thickness is similar to that of human tibia, after reaming of the medullary canal, it took less than 3 minutes and 30 seconds in a $60^{\circ}C$ saline tub, less than 1 minute and 45 seconds in a $70^{\circ}C$ tub, and less than 1 minute in a $80^{\circ}C$ tub to elevate core temperature from $20^{\circ}C$ to $58^{\circ}C$. Second, based on data of the heat conductivity test, we compared the torsional strength before and after pasteurization. Twenty matched pairs of porcine tibia were used, The left one was used as a non-heated control group and the right one as a pasteurized experimental group. Wighout reaming of the medullary cavity, there was no statistical difference in torsional strength between the pasteurization of the $60^{\circ}C$-35minute and of $80^{\circ}C$-15minute. With reaming, we also found no statistical difference among pasteurization of $60^{\circ}C$-15 minute, of $70^{\circ}C$-15 minute, and of $80^{\circ}C$-15 minute groups. In conclusion, reaming of the medullary canal is very helpful in saving pasteurization time. And, in a $60^{\circ}C$ saline tub, no significant weakness in torsional strength occurs with pasteurization of the bone for up to 35 minutes. Also no significant weakness in torsional strength occurs with an exposure of 15 minutes to the $80^{\circ}C$ saline tub.

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Open Skies Policy : A Study on the Alliance Performance and International Competition of FFP (항공자유화정책상 상용고객우대제도의 제휴성과와 국제경쟁에 관한 연구)

  • Suh, Myung-Sun;Cho, Ju-Eun
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.139-162
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    • 2010
  • In terms of the international air transport, the open skies policy implies freedom in the sky or opening the sky. In the normative respect, the open skies policy is a kind of open-door policy which gives various forms of traffic right to other countries, but on the other hand it is a policy of free competition in the international air transport. Since the Airline Deregulation Act of 1978, the United States has signed an open skies agreement with many countries, starting with the Netherlands, so that competitive large airlines can compete in the international air transport market where there exist a lot of business opportunities. South Korea now has an open skies agreement with more than 20 countries. The frequent flyer program (FFP) is part of a broad-based marketing alliance which has been used as an airfare strategy since the U.S. government's airline deregulation. The membership-based program is an incentive plan that provides mileage points to customers for using airline services and rewards customer loyalty in tangible forms based on their accumulated points. In its early stages, the frequent flyer program was focused on marketing efforts to attract customers, but now in the environment of intense competition among airlines, the program is used as an important strategic marketing tool for enhancing business performance. Therefore, airline companies agree that they need to identify customer needs in order to secure loyal customers more effectively. The outcomes from an airline's frequent flyer program can have a variety of effects on international competition. First, the airline can obtain a more dominant position in the air flight market by expanding its air route networks. Second, the availability of flight products for customers can be improved with an increase in flight frequency. Third, the airline can preferentially expand into new markets and thus gain advantages over its competitors. However, there are few empirical studies on the airline frequent flyer program. Accordingly, this study aims to explore the effects of the program on international competition, after reviewing the types of strategic alliance between airlines. Making strategic airline alliances is a worldwide trend resulting from the open skies policy. South Korea also needs to be making open skies agreements more realistic to promote the growth and competition of domestic airlines. The present study is about the performance of the airline frequent flyer program and international competition under the open skies policy. With a sample of five global alliance groups (Star, Oneworld, Wings, Qualiflyer and Skyteam), the study was attempted as an empirical study of the effects that the resource structures and levels of information technology held by airlines in each group have on the type of alliance, and one-way analysis of variance and regression analysis were used to test hypotheses. The findings of this study suggest that both large airline companies and small/medium-size airlines in an alliance group with global networks and organizations are able to achieve high performance and secure international competitiveness. Airline passengers earn mileage points by using non-flight services through an alliance network with hotels, car-rental services, duty-free shops, travel agents and more and show high interests in and preferences for related service benefits. Therefore, Korean airline companies should develop more aggressive marketing programs based on multilateral alliances with other services including hotels, as well as with other airlines.

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Analysis of Quantitative Indices in Tl-201 Myocardial Perfusion SPECT: Comparison of 4DM, QPS, and ECT Program (Tl-201 심근 관류 SPECT에서 4DM, QPS, ECT 프로그램의 정량적 지표 비교 분석)

  • Lee, Dong-Hun;Shim, Dong-Oh;Yoo, Hee-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.67-75
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    • 2009
  • Purpose: As to the analytical method of data, the various programs in which it is used for the quantitative rating of the Tl-201 myocardial perfusion SPECT are reported that there is a difference. Therefore, the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made against data of the same patient. Using quantitative index that able to represent myocardial perfusion defect level, we aimed to determine correlation among three myocardial perfusion analysis programs 4DM (4DMSPECT), QPS (Quantitative Perfusion SPECT), ECT (Emory Cardiac Toolbox) that be used generally in most departments of Nuclear Medicine. Materials and Methods: We analyzed the 145 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Mediacal Center from December 1th 2008 to February 14th 2008. We sorted as normal group and abnormal group. Normal group consist of 80 patients (Male/Female=38/42, age:$65.1{\pm}9.9$) who have low possibility of cardiovascular disease. And abnormal group consist of 65 patients (Male/Female=45/20, age:$63.0{\pm}8.7$) who were diagnosed cardiovascular disease with reversible perfusion defect or fixed perfusion defect through myocardial perfusion SPECT results. Using the 4DM, QPS, and ECT programs, the total defect extent (TDE) such as LAD, LCX, RCA and the summed stress score (SSS) have been analysed for their correlations and statistical comparison with the paried t-test for the quantitative indices analysed from each group. Results: The correlation of 4DM:QPS, QPS:ECT, ECT:4DM each group result from 145 patients is 0.84, 0.86, 0.82 at SSS, 0.87, 0.84, 0.87 at TDE, and both index showed good correlation. In paired t-test and Bland-Altman analysis results showed no statistically significant difference in the comparison of QPS:ECT at the mean SSS and TDE, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index. The correlation of 4DM:QPS, QPS:ECT, ECT:4DM program results from abnormal group (65 patients) is 0.72, 0.72, 0.70 at SSS and 0.77, 0.70, 0.77 at TDE and TDE and SSS has a good correlation. In abnormal group, paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.89) and TDE (p=0.23) comparison, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). In normal group (80 patients), paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.95) and TDE (p=0.73) comparison. And 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). Conclusions: The perfusion defect of the Tl-201 myocardial perfusion SPECT was analyzed in not only the patient in whom it has the cardiovascular disease but also the patient in whom the possibility of the cardiovascular disease is few. In the comparison of the all group research, the mean of the TDE and SSS, 4DM was lower than QPS and ECT progrms. Each program showed good correlation and the results showed statistically significant difference. However, in this way, it is determined to be compatible about the analysis value in which the large-scale side between the programs uses each program a difference in a clinical in the Bland-Altman analyzed result in spite of the good correlation and cannot use. but, this analyzed result will be able to be usefully used as the reference material for the clinical read and is expected.

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