• Title/Summary/Keyword: 심초

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Prediction of Improvement of Hibernating Myocardium after Coronary Artery Bypass Grafting -The role of dobutamine stress echocardiography- (동면심근을 가진 관상동맥 환자의 수술 후 기능회복의 예측에 대한 임상적 고찰 - Dobutamine 심초음파의 역할 -)

  • 유경종;강면식;이교준;김대준;임세중;정남식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.776-780
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    • 1998
  • Background: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular(LV) function after surgical revascularization. Materials and methods: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography(DSE) (dobutamine: baseline, 5, 10, 20$\mu$g/kg/min) before coronary artery bypass grafting(CABG) and underwent echocardiography at least 2 months after CABG. Results: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8(50%) of 16 patients in DSE. Among them, 6 patients(75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients(38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments(74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments(23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.

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A Study on the Simcho of Wooden Pagodas in Baekjae (백제의 심초 및 사리봉안)

  • Jung, Ja Young
    • Korean Journal of Heritage: History & Science
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    • v.41 no.1
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    • pp.109-125
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    • 2008
  • Recently, there has been an increase in excavation studies of wood pagodas from the Three Kingdoms and Unified Shilla periods and new data related to wood pagoda erection are being found bringing about progress in research on this field. In other words, studies on wooden pagodas in Korea were composed mainly of flat, axis construction techniques and sarijangeomgu, but by acquiring new data, it has now become possible to study not only the stylobate construction procedure and transition, but also studies on restoring wooden pagodas. Furthermore, pagoda sites similar to this were found in China and Japan as well, making it possible to make comparative studies among ancient wooden pagodas possible. In this paper, the main remains were set as Baekjae wooden pagodas, which were the most frequently studied and among the wooden pagodas, the simcho (central base stone) and sarira housing locations. In result, simcho can be found changing its position from underground ${\rightarrow}$ halfway underground ${\rightarrow}$ above ground. Baekjae wooden pagodas up until the mid sixth century located at Neungsan-ri saji (AD 567) and Wangheungsaji (AD 577) had its simcho located underground and later it was constructed halfway underground and then above ground. It was confirmed that in the 7th century, it became customary to place above ground as seen in the Jaeseoksaji (AD639) and Hwangnyongsaji (AD645) wooden pagoda sites. The sarira was usually located on the south side of the simcho, but gradually changed to the center. In particular, sarira were combined in the simcho in the mid sixth century at the Wangheungsaji. This is approximately 11 years earlier than the Bijosa (AD 588) simcho found in Japan and this was not found even in the simcho of wooden pagodas in Yeongnyeongsa (AD 516) and Jopaengseong temple (AD 535~561) of China showing that the Wangheungsaji simcho was the earliest of its kind.

Diagnostic Performance of Cardiac CT and Transthoracic Echocardiography for Detection of Surgically Confirmed Bicuspid Aortic Valve: Effect of Calcium Extent and Valve Subtypes (외과적으로 확진된 이첨 대동맥 판막의 진단을 위한 심장 CT 및 경흉부 심초음파의 진단적 성능: 판막 아형 및 칼슘의 양이 미치는 효과)

  • Jeongju Kim;Sung Mok Kim;Joonghyun Ahn;Jihoon Kim;Yeon Hyeon Choe
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1324-1336
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    • 2023
  • Purpose This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype. Materials and Methods This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium. The aortic valves were classified into fused and two-sinus types. The diagnostic accuracy of cardiac CT and TTE was calculated using a reference standard for intraoperative inspection. Results CT demonstrated significantly higher sensitivity, negative predictive value, and accuracy than TTE in detecting BAV (p < 0.001, p < 0.001, and p = 0.003, respectively). The TTE sensitivity tended to decrease as valvular calcification increased. The error rate of TTE for CT was 10.9% for the twosinus type of BAV and 28.3% for the fused type (p = 0.044). Conclusion Cardiac CT had a higher diagnostic performance in detecting BAV than TTE and may help diagnose BAV, particularly in patients with severe valvular calcification.

Comparison of the Ejection Fraction Between Gated Blood Pool, Gated Blood Pool SPECT and Echocardiography (게이트심장혈액풀스캔과 게이트심장혈액풀 SPECT로 측정한 심박출계수의 심초음파와의 비교 연구)

  • Jeong, Ji-Uk;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Moo-Seok;Song, Hyeon-Seok;Park, Se-Yun;Kim, Jae-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.150-154
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    • 2010
  • Purpose: Ejection fraction (EF) is one of the most important factors that evaluate heart function. Recently, according to echocardiography and myocardial perfusion SPECT, the number of gated blood pool scan (planar GBP) is declining. Measurement of left ventricular ejection fraction using gated blood pool SPECT (GBPS) is known as relatively correspond with echocardiography. We compared EF derived from plnar GBP, GBPS and echocadiography using modified simpson method to determine the accuracy. Materials and Methods: From January 2007 to June 2010, planar GBP and GBPS were performed on 34 patients who admitted to Pusan National University Hospital (men 23, women 11, mean age $52.6{\pm}27.2$). Each patient was injected with $^{99m}{TcO_4}^-$ of 20 mCi after pyrophosphate injection and then scanned using both planar GBP and GBPS techniques. For image analysis, we use ADAC Laboratories, Ver. 4.20 software. The result analyzed was processed by SPSS 17.0 Win statistic program and statistical method applied in data analysis is one-way anova, Tukey's post hoc test, pearson correlation test. Results: One-way anova test show no significant difference (planar GBP $56.3{\pm}13.9%$; GBPS $60.4{\pm}16.0%$; echocardiography $59.1{\pm}14.4%$, p=0.486, p>0.05). Tukey's post hoc test show no significant difference (planar GBP-echocardiography p=0.697; GBPS-echocardiography p=0.928; planar GBP-GBPS p=0.469, p>0.05). Values for EF obtained with planar GBP and GBPS correlated well with those obtained with echocardiography (planar-echocardiography r=0.697; GBPS-echocardiography r=0.928; planar GBP-GBPS r=0.469). Conclusion: The problems of accuracy and reproducibility for planar GBP still remain. But planar GBP is a safe and non-invasive method. In addition, planar GBP is useful to evaluate patient with low resolution echocardiography images. GBPS is not appicated clinically. but GBPS can be obtain various left ventricular functional parameters. planar GBP, GBPS and echocardiography show a good correlation between each other. Therefore, planar GBP and GBPS are useful for evaluating left ventricular ejection fraction.

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A Design of Real-Time QRS Detection in Physio-Module for Echocardiography (심초음파용 실시간 심전도 QRS 검출 모듈에 관한 연구)

  • Jang, Won-Seuk;Kim, Nam-Hyun;Kim, Eong-Sok;Jeon, Dae-Keun
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.47 no.3
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    • pp.40-47
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    • 2010
  • In this study, we investigated the performance of real-time QRS complex detection algorithm in physio-module for echocardiography. The performance of QRS detection module in echocardiography was evaluated according to international standard, EC-13 and we compared with commercialized physio-module with QRS complex detection. In this study, we can get performance of QRS complex detection, pacer pulse detection, Tall t-wave rejection and arrhythmia detection within EC-13's criteria and we can get improved QRS trigger delay time and baseline wondering rejection times in compared with commercialized physio-module.

A Study on Tracking and Quantitative Analysis of Regional Left Ventricular Wall Motion in Echocardiography (심초음파에서 국소 좌심실벽 운동 추적 및 정량적 분석에 관한 연구)

  • 신동규;김동윤;최경훈;박광훈
    • Progress in Medical Physics
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    • v.10 no.3
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    • pp.115-123
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    • 1999
  • The two dimensional echocardiography is widely used to evaluate regional wall motion abnormality, because of its abilities to depict left ventricular wall motion. A number of researches have been processed for evaluation and quantitative analysis of left ventricular wall motion functions. In this paper, we proposed an algorithm which detects automatically and analyze quantitatively endocardial wall motion during systole. The echocardiograms were obtained in the short-axis views in normal subjects. Automated edge detection and endocardial contour tracking algorithm was applied to each frames, quantitative analysis based on segmentation was performed, pre-defined color overlays superimposed on the gray scale images, and the images was animated. The proposed algorithm provided automated, quantitative diagnosis of regional wall motion abnormality.

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The Correlation Analysis of Ejection Fraction: Comparison of $^{201}Tl$ gated Myocardial Perfusion SPECT and Echocardiography ($^{201}Tl$ 게이트 심근관류 SPECT 및 심초음파의 좌심실 구혈률 상관관계 비교)

  • Yoon, Soon Sang;Ryu, Jae Kwang;Cha, Min Kyung;Lee, Jong Hun;Kim, Sung Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.49-56
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    • 2012
  • Purpose : Gated myocardial perfusion SPECT provides not only myocardial perfusion status, but various functional parameters of left ventricle (LV). The purpose of this study was to analyze ejection fraction (EF) for correlation and difference between $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography depending on extent of perfusion defect, gender and LV volumes. Materials and Methods : From April 2011 to May 2012, we analyzed 291 patients (male:female =165:126; mean: $64.6{\pm}10.8$ years) who were examined both $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography at less than 7 days apart in our hospital. 101 patients showed perfusion defect and the rest of the people without any defect. We applied automatic analysis (Quantitative gated SPECT, QGS), and calculated EF, End-diastolic volume (EDV) and End-systolic volume (ESV) from Stress (G-Stress) and Rest (G-Rest) studies. And we analyzed the correlation and difference for EF between $^{201}Tl$ gated SPECT and echocardiography. Results : The correlation of LVEF among G-Stress, G-Rest and echocardiography was quite a good (G-Stress vs. G-Rest: r=0.909, G-Stress vs. echocardiography: r=0.833, G-Rest vs. echocardiography: r=0.825). And there were significant differences in EDV, ESV and EF in total patients (p<0.01). The normal group showed significant difference in EF (p<0.01) and the group with perfusion defect also demonstrated significant difference (a group with reversible defect: p<0.01, fixed defect: p<0.01) depending on extent of perfusion defect. We analyzed difference in normal group by gender. In normal group, there was no significant difference (p>0.05) in EF from men. However, there was a significant difference (p<0.01) from women. When we classified two groups by average size of EDV in Korean women, there was no significant difference in a group of above average size of EDV (p>0.05). Conclusion : When compared among Stress and Rest of $^{201}Tl$ gated SPECT and echocardiography, we confirmed that there was a good correlation for LVEF. But there were significant differences among three studies. And extent of perfusion defect, gender and LV volumes are independent determinants of the accuracy of LVEF. So, it is hard to compare and interchange quantitative indices among modalities. We should take additional researches to prove results of our study.

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