• The Korean Journal of Nuclear Medicine
• /
• v.31 no.1
• /
• pp.67-72
• /
• 1997

Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age $53{\pm}12$ years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% Per Year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary artery disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of. cardiac event rates between patients with normal and abnormal coronary angiograms.

• Journal of Chest Surgery
• /
• v.38 no.7 s.252
• /
• pp.468-475
• /
• 2005

Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. Material and Method: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. Result: The heart rates after ligation and after cannula insertion were $239.1\pm61.7,\;235.8\pm58.0bpm$ respectively, and they were statistically significantly slower than that of before ligation, $277.6\pm40.3bpm\;(p=0.017,\;p=0.007\;respectively)$. QRS sizes before ligation, after ligation, and after cannula insertion were $3.6\pm3.3mm,\;2.8\pm3.3 mm,\;and\;2.4\pm2.2mm,$respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from $2.11\pm0.17kHz,\;1.25\pm0.22kHz\;to\;0.83\pm0.15kHz,\;0.38\pm0.11kHz$(p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were $0.61\pm0.05kHz\;and\;0.33\pm0.05 kHz$ respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. Conclusion: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.6
• /
• pp.513-518
• /
• 2009

Purpose: Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. Materials and Methods: Forty-eight patients (M:F=26:22, Age: $63.3{\pm}10.4$ years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. Results: Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. Conclusion: Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.

• Annual Conference of KIPS
• /
• 2006.05a
• /
• pp.39-42
• /
• 2006

심전도는 각종심장질환 들을 예측하는데 널리 사용되고 있다. 이러한 심전도에서 ST-분절은 허혈성 심장 질환, 확장성 심근성, 비후성 심근증 등을 예측하는데 이용되고 있다. 이 논문에서는 환자들의 임상 정보와 심전도로부터 심장 질환 예측을 위한 중요 파라미터인 ST-부절을 추출하였다. 그리고 이러한 추출된 데이터 분석을 위해서 데이터마이닝 기법을 적용한다. 데이터마이닝의 분류 알고리즘인 베이지안 네트워크를 적용 심장 질환을 효율적으로 분류하기 위한 방법을 제시 하였다.

• Journal of Chest Surgery
• /
• v.43 no.3
• /
• pp.246-253
• /
• 2010

Background: Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. Material and Method: We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation. Result: Average follow-up was $66{\pm}22$ months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients ($39.6{\pm}11.8%$ vs $76.7{\pm}2.2$, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients ($53.12{\pm}12%$ vs $77{\pm}2%$, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR: 2.31), especially congestive heart failure and recurrent myocardial infarction. Conclusion: In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.

• 대한핵의학회:학술대회논문집
• /
• 1996.05a
• /
• pp.203-203
• /
• 1996

• 대한임상약리학회:학술대회논문집
• /
• 1992.11a
• /
• pp.29-29
• /
• 1992

• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.3
• /
• pp.155-162
• /
• 2006

Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

• Journal of the korean Society of Automotive Engineers
• /
• v.24 no.5
• /
• pp.98-103
• /
• 2002

이제 카트 정렬과 휠 셋업에 필요한 최적의 변수들을 알아보았다. 실제 세팅은 위에서 언급한 내용 이외에도 많은 것들을 고려하여야 한다. 타이어 접지력의 세팅은 경기장, 날씨, 제품의 불 균일성 등을 고려하여 야 한다. 즉, 어떤 경기장은 코너의 반경이 다른 경기 장 보다 크며 어떤 경기장은 코너가 매우 많기도 하여 세팅을 상황에 맞게 하여야 하는 것이다. 각각의 변수를 세팅할 경우는 중간 값을 취하는 것이 바람직하여 이 중간 값을 취하는 것이 바람직하며 이 중간 값을 각각의 경기장의 특성에 맞추어 변화시키면 되는 것이다. 예를 들면, 접지력이 작게 발생되는 경기장(혹은 매우 추운날씨) 에서는 캐스터를 코기 하여 초기 회전 발생이 용이하게 할 수도 있다. 또한 토우인 값을 크게 하여 타이어가 마찰을 더욱 많이 발생하여 타이어의 온도가 급격히 상승하여 원하는 접지력의 수준에 용이하게 도달할 수 있게 하는 것이다. 그러나 이러한 세팅은 다른 핸들링 문제를 야기할 수 있다는 것을 이해하여야 하며 이러한 문제를 해결하는 또 다른 노력이 필요하게 되는 것이다. 가장 중요한 것은 후륜 내측으로부터는 조종 성능을 향상시키는데 필요한 접지력을 거의 기대하지 못한다는 것이며 마찰이 적게 발생하여 손쉽게 동력 손실을 초래하고 있다는 것이다. 그러므로 회전을 할 경우에도 속도를 낮추어서는 안되며 이렇게 하이야 핸들링이 매우 용이하게 되는 것이다. 그러나 위의 설명에서도 보았듯이 일부 세팅을 변경하면 여러 곳이 그 효과가 나타난다. 예를 들어 후륜의 간격을 변화시키면 카트에서 무게이동 뿐만 아니라 회전 시에 가속이나 감속에 의한 회전 토크의 효과도 달라지게 된다. 특정한 세팅의 변화가 어떻게 작용할 것이라는 확신을 가지고 있다고 할지라도 세팅에서 가장 중요한 것은 주행 기록이다. 여기서 설명되어진 많은 내용이 주행 기록을 향상시키기를 바라는 바이다.간이 육색과 총육색소 함량에는 영향을 미치지 않는 것으로 나타났다. 관능적 특성평가 중 육색과 육즙참출은 대조구와 비교하여 CLA급여 처리구가 유의적인 차이가 없었으나, 근내지방 축적 정도와 전체적인 기호성은 대조구에 비하여 CLA 급여 처리구가 유의적으로 높은 평가를 받았다(p<0.05). 간격은 술 후 1년 후까지도 지속적으로 감소하는 경향을 보였다. 따라서 이 기간동안에는 추적관찰이 필요한 것으로 생각된다.경미하게 나타났으며, 이는 2% 흥국 첨가식이의 섭취로 인한 bromobenzene 대사 및 유해산소 해독의 촉진에 기인되기 때문일 것으로 생각된다.다.과 및 지질과산화억제효과의 순과 일치하였다. 총 flavonoid 함량은 DPPH 라디칼 제거효과에 대한 $IC_{50}$/ 값과 높은 상관관계(r=-0.9924, p<0.01)를 나타내었다.이 우수한 심근보호 효과를 나타내나, 허혈시간이 2시간을 초과하면 심근의 혈역학적 기능과 미세구조의 변화는 중등도의 저온(22∼24$^{\circ}C$)에서 유의하게 악화되었다. 이 같은 결과로 볼 때 심근 허혈시간이 2시간을 초과한다면 심근 온도를 낮추어야 할 것으로 판단된다. 7.2, with 64.0% of office workers having an average level between 6- and 9. The degree of stress was higher for females than males, for unmarried salaried and hot-tempered persons. Those not doing exercise were subject to the highest levels of stress, and those a having sufficient sleep were found to be subject to less stress.

• Journal of Life Science
• /
• v.33 no.1
• /
• pp.64-72
• /
• 2023

Despite several advances in identification of cardiac transcription factors, there are still needs to find new bioactive molecules that promote cardiomyogenesis from stem cells to highly efficient myocardial differentiation. We analyzed Illumina expression microarray data of mouse embryonic stem cells (mESCs)-derived cardiomyocytes. 276 genes were upregulated (≥ 4fold) in mESCs-derived cardiomyocytes compared undifferentiated ESCs. Secreted phosphoprotein 2 (Spp2) is one of candidates and is known to inhibit bone morphogenetic protein 2 (BMP2) signal transduction as a pseudoreceptor for BMP2. However, its function in cardiomyogenesis is unknown. We confirmed that Spp2 expression increased during the differentiation into functional cardiomyocytes using mESCs, TC-1/Kh2 and E14. Interestingly, Spp2 secretion transiently increased 3 days after formation of embryoid bodies (EBs), indicating that the extracellular secretion of Spp2 is involved in the differentiation of ESCs into cardiomyocytes. To characterize Spp2, we performed experiments using the C2C12 mouse myoblast cell line, which has the property of shifting the differentiation pathway from myoblastic to osteoblastic by treatment with BMP2. Similar to the differentiation of ESCs, transcription of Spp2 increased as C2C12 myoblasts differentiated into myotubes. In particular, Spp2 secretion increased dramatically in the early stage of differentiation. Furthermore, treatment with Spp2-Flag recombinant protein promoted the differentiation of C2C12 myoblasts into myotubes. Taken together, we suggest a novel bioactive protein Spp2 that differentiates ESCs into cardiomyocytes. This may be useful for understanding the molecular pathways of cardiomyogenesis and for experimental or clinical promotion of stem cell therapy for ischemic heart diseases.