• Title/Summary/Keyword: 비정상 전도

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Abnormal Perfusion on Myocardial Perfusion SPECT in Patients with Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군 환자의 심근 관류 이상)

  • Kang, Do-Young;Cha, Kwang-Soo;Han, Seung-Ho;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.9-14
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    • 2005
  • Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome. Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients (mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent ($11.0{\pm}8.5%$, range:$3{\sim}35%$) and mild to moderate severity ($-71{\pm}42.7%$, range:$-2l7{\sim}-39%$) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

The Effect of Nitric Oxide, Isosorbide Dinitrate and Sodium Nitroprusside on Ischemic Myocardium of Rat (Nitric oxide, Isosorbide dinitrate 및 Sodium nitroprusside가 쥐의 허혈성 심근에 미치는 영향)

  • Jeong, Jong-Hwa;Kim, Su-Hyeon;Kim, Song-Myeong
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1055-1065
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    • 1996
  • This experiment was undertaken to assess the effect of nitric oxide, isosorbide dinitrate, and sodium nitroprusside, which are known to increase coronary flow by vasodilation and to improve the cardiac function of an ischemic heart The experiment was carried out to investigate the effect of nitric oxide on the coronary artery of an ischemic rat myocardium using isolated constant pressure Langendorfr system. The experimental parameters were lactate and CK-MB for the frozen myocardium and coronary flow. the quantity of coyonary flow, left ventricular developed pressure (LVDP), and dp/dt. The experimental groups were decided as control group (Group I), nitric oxide group (Group II), Iso orbide dinitrate group (Group III) and sodium nitroprusside group (Group IV). Statistical analysis was performed using repeated measured analysis of variance and 2tudent t-test The results were as follows: 1 . The lactic acid contents of group II and IV were less than other groups for the frozen myocardium at preischemic state (p< 0.0025), whereas the determined coronary flows were higher. 2. In the ratio of produced lactic acid between the preischemia and reperfusion for the coronary flow, group II and IV exhibitrod less value than others (p< 0.005). 3. Group II and III were less than others in the coronary flow for the quantity of CK-MB, but or the frozen myocardium, group II and IV were less. 4. Group II and IV showed higher coronary flow compared to others throughout entire experimental period (p< 0.005). 5. Group II was highest at the preischemic state for the left ventricular developed pressure. 6. The +maximal dp/dt of group II was highest compared to others. 7. Group I exhibi ed the highest recovery rate of coronary flow between prelschemla and reperfusion. 8. The(-dp/dt)1(+dp/dt) ratio was 116%, 100%, 100%, and 55% for the 4 groups, respectively And the recovery rate of total dp/dt was 34%, 67%, 51%, and 76% for the four groups, respectively.

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Parasympathetic Modulation Plays a Key Role in Initiation of Paroxysmal Atrial Fibrillation

  • Lee, Won-Jae;Shin, Dong-Gu;Hong, Geu-Ru;Park, Jong-Sun;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.216-231
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    • 2007
  • Background : An acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. Materials and Methods : From 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, $58{\pm}12$ years) of PAF (>5 min), preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. Results : A significant linear decrease in the mean R-R interval was observed in group A ($924{\pm}30$ to $835{\pm}28ms$, $P$=0.001) and an increase from $831{\pm}32$ to $866{\pm}31ms$ in group B PAF episodes ($P$=0.046). In the frequency-domain analyses, the LF/HF ratio exhibited a progressive linear increase before the PAF in group A ($P$=0.005). The HF normalized units (HFnu) and natural logarithm-transformed HF ($In$HF) values decreased from $30.8{\pm}4.0$ to $16.1{\pm}1.8$ ($P$=0.003) and $4.49{\pm}0.25$ to $4.07{\pm}0.22$ ($P$=0.001), respectively. Contrary to the results in group A, a significant increase in the HF components (HFnu and $In$HF) (from $22.6{\pm}3.2$ to $30.2{\pm}4.0$, $P$=0.005, and $4.27{\pm}0.27$ to 4.75 0.33, $P$=0.001, respectively) and a resultant decrease in the LF/HF ratio were observed in group B PAF episodes. No significant changes were observed in the LF components in either PAF group. Conclusion : Autonomic stimuli leading to an acceleration or deceleration of the HR before the onset of AF are due to parasympathetic modulation. Parasympathetic modulation plays a key role in the initiation of PAF.

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Effects of Korean diet control nutrition education on cardiovascular disease risk factors in patients who underwent cardiovascular disease surgery (심혈관질환 수술을 받은 환자에서 한식식이조절 영양교육이 심혈관질환 위험요인에 미치는 영향)

  • Jung, Su-Jin;Chae, Soo-Wan
    • Journal of Nutrition and Health
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    • v.51 no.3
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    • pp.215-227
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    • 2018
  • Purpose: This study was conducted to verify the effects of increases in consuming Korean food in patients who underwent cardiovascular disease (CVD) surgery based on a Korean diet control education program and to investigate the effects of Korean diet control nutrition education on risk factors of CVD, changes in amounts of medication, and nutritional intakes. Methods: The subjects consisted of 15 patients who have undergone CVD surgery within three years and continuously taken cardiovascular drugs. The Korean traditional diet (KTD) emphasizes intake of vegetables and fermented foods to lower saturated fat and cholesterol intake. We applied a KTD education program that included a modified DASH (The dietary approaches to stop hypertension) diet for cardiovascular disease patients. Korean diet control education was then applied to the patients for 12 weeks to evaluate the risk factors of CVD and the state of nutritional intakes. Results: The Korean diet control compliance score increased significantly (p < 0.001) as Korean diet control education was implemented. Additionally, the obesity indexes, waist circumference (WC) (p = 0.002) and waist-to-hip ratio (WHR) decreased significantly (p < 0.001) after subjects received the education. Moreover, the glycemic control index, HbA1c, was significantly decreased (p < 0.05) from $7.3{\pm}1.0%$ before the education to $7.0{\pm}1.1%$ after the education. Changes in the amounts of Korean diet intake consisted of significant increases in cooked rice with whole grains, narmuls (vegetables either raw or cooked), kimchi, and traditional fermented foods following the education. Moreover, the nutritional intake after the education showed significant decreases (p < 0.05) in animal protein, animal lipids, and cholesterol. However, the intakes of Na, K, dietary fiber, vitamin A, vitamin $B_6$, vitamin C, and folic acid were significantly increased. Conclusion: The active encouragement of consuming Korean food and the intervention of implementing diet control education positively affected nutritional intake, the obesity index and glycemic control of patients who have undergone CVD surgery.

Changes of C-Reactive Protein and Erythrocyte Sedimentation Rate Level from Infection and Non-Infection after the Artificial Joint Surgery (인공관절 수술 후 감염과 비 감염에 따른 C-반응성단백과 적혈구침강속도의 변화 추이)

  • Kim, Min-Ju;Kim, Hye-Jeong
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.321-326
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    • 2016
  • This study aimed to analyze the changes of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measured in acute infection within four weeks post artificial joint surgery to predict potential infection in early stages, provide rapid treatment, and prevent the abuse of antibiotics. This study included 50 patients with acute infection and 50 patients without any symptoms of infection, among patients who received artificial joint replacement surgery on the lower limbs in a four-week period. CRP was the highest two-to-three days after surgery. with $5.77{\pm}3.69$ and $5.17{\pm}3.48$, respectively, in those with infection and without infection. Thereafter, the value rapidly reduced in those without infection. However, it increased again to $3.16{\pm}2.87$ in the group with infection according to the bimodal curve (p<0.001). ESR was the highest two-to-three days after surgery, with $58.8{\pm}24.63$ and $44.08{\pm}21.48$, respectively. Thereafter, the value slowly reduced in those without infection. However, it was increased again to $47.62{\pm}26.26$ in those with infection according to the bimodal curve p<0.001). As this study shows, if there is an increasing trend for CRP and ESR after artificial joint replacement surgery, it may be possible to question whether patients are acutely infected post surgery. In particular, this result is expected and regarded as a useful factor for diagnosing infection due to the high level of sensitivity and uniqueness for CRP.

Effect of treadmill exercise on autophagy related protein expression in the cardiac muscle of high-fat diet fed rats (트레드밀 운동이 고지방 식이 쥐 심근세포의 자가포식 관련 단백질 발현에 미치는 영향)

  • Jeong, Jae-Hoon;Kang, Eun-Bum
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.1
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    • pp.91-101
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    • 2020
  • The purpose of this study was to investigate the influence of obesity on the expression of autophagy-related proteins in cardiac muscle. To this end, obesity was induced in rats through 20 weeks of high-fat diet, and the animals were then subjected to 8 weeks of treadmill exercise. Subsequently, the expression of proteins that regulate the induction of autophagy, formation of autophagosome, and fusion of autophagosome and lysosome was confirmed. Obesity was induced in the experimental animals (SD rats) through 20 weeks of high-fat diet (carbohydrate: 20%, fat: 60%, and protein: 20%), and they were subsequently subjected to 8 weeks of treadmill exercise (5 days/week, 30 min/day, 5 minutes; 8m/min, 5 minutes; 11m/min, 20 minutes; 14m/min). The experimental groups comprised the normal diet control group (ND-CON, n=10), high-fat diet comparison group (HFD-CON, n=10), and high-fat exercise group (HFD-TE, n=10). Oral glucose tolerance test was conducted before and after 8 weeks of treadmill exercise, and the area under the curve (AUC) was calculated. Through fasting insulin and fasting glucose levels, HOMA-IR, which is an index of insulin resistance, and abdominal visceral fat/body weight (AVF/BW) were calculated for comparison. Moreover, autophagy-related proteins were analyzed from cardiac tissue to investigate the effects of exercise training. Obesity was successfully induced in the HFD-CON group through long-term high-fat diet, and the HFD-CON group had higher body weight, AUC, HOMA-IR, and AVF/BW compared to the ND-CON group. The HFD-TE group, which underwent 8 weeks of treadmill exercise, showed improvements in AUC, HOMA-IR, and AVF/BW. Although the body weight tended to decrease as well, there was no statistically significant difference. mTOR and AMPK, which are involved in the induction of autophagy, both decreased in obesity but increased upon exercise. Beclin-1, BNIP3, ATG-7, p62, and LC3, which are related to the formation of autophagosomes, all increased in obesity and decreased after exercise. Cathepsin L and LAMP2, which regulate the fusion of autophagosome and lysosome, both decreased in obesity and increased upon exercise. Physical activity, including treadmill exercise, was found to induce normal autophagy and improve pathological phenomena observed in metabolic diseases. Therefore, the findings suggest the need to consider treadmill exercise as a primary means to achieve effective prevention and treatment of cardiac diseases.

Usefulness and Comparison of $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA Single Photon Emission Computed Tomography in Distinguishing Lung Cancer from Benign Lesion (폐암과 양성질환의 감별에 $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA 단일광자전산화단층촬영술의 비교 및 가치)

  • Kim, Chang Ho;Chae, Sang Cheol;Park, Jae Yong;Jung, Tae Hoon;Ahn, Byeong Cheol;Lee, Jae Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.720-727
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    • 1996
  • Objectives: $^{201}TI$ - chloride, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we perfonned three consecutive SPECT using $^{201}TI$, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods: SPECT was carried out at 10min and 3hr for $^{201}TI$ after injection of 20mCi, and 2hr for $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - background(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for $^{201}TI$. Results: The diagnostic sensitivity of $^{201}TI$, $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer. Conclusion : $^{201}TI$ and $^{99m}Tc$ - MIBI showed higher sensitivity than $^{99m}Tc$(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.

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Assessment of Ovarian Volume and Hormonal Changes after Ovarian Cystectomy in the Different Ovarian Tumor (난소 낭종 제거술후 난소 용적 및 호르몬의 변화)

  • Park, Joon-Cheol;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.155-162
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    • 2008
  • Objectives: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, $E_2$, clomiphene citrate challenge test and ovarian volume. Methods: Twenty two patients with unilateral ovarian tumor, ${\leq}35$ years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, $E_2$ and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. Results: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma ${\geq}10\;cm$ group ($4.79{\pm}2.57\;cm^3$ and $5.21{\pm}1.33\;cm^3$, respectively), but not in the non-endometrioma <10 cm group ($6.18{\pm}2.85\;cm^3$). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were $4.25{\pm}0.20\;mIU/ml$ and $3.79{\pm}0.80\;mIU/ml$, $4.24{\pm}0.85\;mIU/ml$ and $4.28{\pm}0.92\;mIU/ml$, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. Conclusions: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.

BGK 수치기법을 이용한 로켓 노즐 내의 유동장 해석

  • 신동신;이재성
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2000.04a
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    • pp.16-16
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    • 2000
  • 충격파를 포함하는 초음속 유동을 해석하는 수치해법 중에서 많이 사용되어진 것은 엄밀 및 근사 리만 해법과 플럭스 분할 기법들로서 이들은 Euler 방정식에 기반을 두고 선형 또는 비선형파의 상호작용을 풍상 차분법으로 기술하는 방법들이다. 이러한 수치기법들은 과거 광범위하게 사용되어 왔으나 최근 여러 가지 단점이 발견되었다. 이와 같은 문제점을 극복하고자 입자의 통계적인 운동을 기술하는 기체 운동론에 근거하여 BGK 수치기법이 제시되었다. 이는 비충돌 볼츠만 방정식으로부터 입자의 수준에서 플럭스 분할 기법 형태의 풍상차분법을 구현하는 것으로 볼츠만 방정식의 충돌항을 BGK 모델로 대치하고 이것의 적분해로부터 수치 플럭스를 구한다. 이 수치기법은 기존의 리만해법에 비하여 수치적으로나 물리적으로 매우 타당한 성질인 강건성, 정확성, 엔트로피 조건, 양수보존성 등을 가지고 있음이 밝혀졌다. 이와 같은 수치기법을 사용하여 로켓 노즐 내의 아음속, 천이음속, 초음속에서의 유동장 해석을 위한 프로그램을 작성하였다. 시간 적분에 대하여는 정상 상태의 계산을 위하여 내재적 시간 적분 방법을 사용하였으며, 공간 이산화 방법으로는 임의의 제어체적에 대하여 적분형 보존 방정식을 적용하는 유한 체적법을 사용하였다. 초음속 입구 유동과 출구에서 초음속과 저음속 유동의 두가지 경우를 고려하여 얻은 결과를 기존의 연구 결과와 비교하여 본 결과 잘 일치하였다. 입구 유동이 저음속이고 출구 유동이 초음속인 경우에 대하여도 해석결과가 실험결과와 잘 일치하였다. 상대적으로 낮은 온도, 압력 조건과 높은 온도, 압력 조건을 가지는 고체 로켓 모터 노즐 내의 유동을 해석하였다. 이들 해석 결과를 전압, 전온도로 표준화시킨 결과 서로 일치하였으며, 파라서 저온, 저압에서 얻은 결과도 표준화시킬 경우, 고온, 고압에서도 사용될 수 있음을 알 수 있었다.의 영향에 초점을 맞추었다.다고 판단되며 배기 가스 자체에 대기 공기중에 함유되어 있던 습기가 얼어붙는(Icing화) 문제가 발생하기 때문에 배기가스의 Icing을 방지하기 위하여 압축기 끝단에서 공기를 추출하여 배기부분에 송출할 필요성이 있는 것으로 판단되었다. 출구가스의 기체 유동속도가 매우 빠르므로 (100-l10m.sec) 이를 완화하기 위한 디퓨저의 설계가 요구된다고 판단된다. 또 연소기 후방에 물을 주입하는 경우 열교환기 및 기타 부분품에 발생할 수 있는 부식 및 열교환 효율 저하도 간과할 수 없는 문제로 파악되었다. 이러한 기술적 문제가 적절히 해결되는 경우 비활성 가스 제너레이터는 민수용으로는 대형 빌딩, 산림, 유조선 등의 화재에 매우 적절히 사용되어 질 수 있을 뿐 아니라 군사적으로도 군사작전 중 및 공군 기지의 화재 그리고 지하벙커에 설치되어 있는 고급 첨단 군사 장비 등의 화재 뿐 아니라 대간첩작전 등에 효과적으로 활용될 수 있을 것으로 판단된다.가 작으며, 본 연소관에 충전된 RDX/AP계 추진제의 경우 추진제의 습기투과에 의한 추진제 물성 변화는 미미한 것으로 나타났다.의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다..7%), 혈액투석, 식도부분절제술 및 위루술·위회장문합술을 시행한 경우가 각 1례(2.9%)씩이었다. 13) 심각한 합병증은 9례(26.5%)에서 보였는데 그중 식도협착증이 6례(17.6%), 급성신부전증 1례(2.9%), 종격동기흉과 폐염이 병발한 경우와 폐염이 각 1례(2.9%)였다. 14) 식도경 시행회수는 1회가 17례(54.8%), 2회가 9례(29.0%), 3회 이상이 5례(16.1%)였다.EX>$IC_{50}$/ 값이 210 $\mu\textrm{g}$<

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Correlation of $^{137}Cs/^{60}Co$ Activity Ratio in Radwaste with Primary Coolant (원자로 냉각재와 방사성폐기물 내 $^{137}Cs/^{60}Co$ 핵종비)

  • Jee, Kwang-Yong;Park, Yeong-Jae;Pyo, Hyung-Yeol;Ahn, Hong-Joo;Kim, Won-Ho
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.5 no.1
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    • pp.9-17
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    • 2007
  • In order to compare the correlation of radioactivity ratio between the radwaste streams and the primary coolant of PWR NPPs, A RCS sampling kit was installed to primary coolant system for the collection of the radionuclides during the normal operation of NPPs. RCS samples were collected from PWR type of domestic NPPs through 2004 to 2005, and pretreated with acid microwave digestion or leaching method to assay quantitatively of several interesting radionuclides. The radioactivity ratios of $^{137}Cs\;to\;^{60}Co$ in a filter cartridge and a resin cartridge were 2.3E-2 and 7.3E-1, respectively. At a same period of the reactor operating cycle, the radioactivity ratios of $^{137}Cs\;to\;^{60}Co$ were 6.3E-1 for a evaporator bottom, 6.7E-1 for a spent resin, and 5.6E-2 for a dry active waste, so that these radwaste streams were identified as having similar characteristics with the corresponding RCS samples.

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