• Tuberculosis and Respiratory Diseases
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• v.54 no.6
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• pp.596-603
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• 2003

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.207-221
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• 2000

Purpose: Cost-effectiveness of myocardial SPECT for the diagnosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Materials and Methods: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (${\Delta}QALY$) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases. $Cost/{\Delta}QALY$ was calculated and compared between four different tactics according to pre-test probability. Results: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective. Conclusion: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.

• Journal of radiological science and technology
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• v.32 no.1
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• pp.69-78
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• 2009

The cardiovascular disease has been known as a common cause of death for a long time in the west. The eating habits of Asia, including Korea, have changed recently, so that this disease is also a problem in Asia now. Annual Report on the Cause of Death Statistics from 1996 to 2006 reported that the cardiovascular disease would become the number one cause of death in the next $5{\sim}10$ years. Therefore we realize that more accurate examination is required. The aim of this study was to investigate the accuracy of Calcium-scoring CT and the relationship between risk factor and quantitative scores of Calcium-scoring CT. Through this study we expect that the national public health will be improved. Seventy patients with chest pain were chosen at random. The patients were undergone both coronary CT antigraphy and Calcium - scoring CT at G hospital in Incheon from February 1 to June 30, 2008. The result of the Calcium-scoring CT showed its usefulness for Ischemic cardiovascular disease, with an accuracy similar to that of exercise/pharmacologic stress or ECG when it is difficult for a patient to exercise due to joint problems, aging or for other reasons.

• Tuberculosis and Respiratory Diseases
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• v.54 no.6
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• pp.589-595
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• 2003

• Tuberculosis and Respiratory Diseases
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• v.54 no.6
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• pp.604-609
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• 2003

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.495-501
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• 2000

Background : Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate ($VO_2$) compared to non~obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. Methods : Maximal exercise capacity was represented by maximam maximum oxygen uptake and $VO_2$ max in the cardiopulmonary test. Obesity, total fat content and abdomina1 obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers (male 22, fema1e 20) were evaluated. Results : 1) Weight to height ratio (mean$\pm$SD) was 110$\pm$14.9% in men and 100$\pm$11.1% in women. 2) Fat ratio (mean$\pm$SD) was 23.3$\pm$5.2% in men and 27.55$\pm$3.9% in woman. 3) Waist to hip ratio (mean$\pm$SD) was 0.85$\pm$0.04 in men and 0.8$\pm$0.03 in woman. 4) In men, $VO_2$ max/min/Kg was negatively correlated with obesity, fat ratio, and abdominal fat distribution. 5) In woman, $VO_2$ max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. Conclusion : Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.1-10
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• 1994

Background: Patients with mitral stenosis(MS) have been demonstrated to have a variable degree of pulmonary dysfunction and exercise impairment. The hemodynamic changes of MS can be reversed after percutaneous mitral balloon valvuloplasty(PMV), but the extent and time course of the imporvement in pulmonary function and exercise capacity are not defined. Methods: In order to investigate the early(3 weeks or less)and late(3 months or more) effects of PMV on pulmonary function and determine if the pulmonary dysfunction is reversible even in patients with moderate to severe pulmonary hypertension, we performed the spirometry, measurements of diffusing capacity and lung volumes, and incremental exercise tests in patients with MS before and after PMV. Results: In 46 patients with MS(age: $40{\pm}12$years, male to female ratio: 1:2, mitral valve area: $0.8{\pm}0.2cm^2$) there was a significant increase in FVC(P<0.0025), $FEV_1$(P<0.001), $FEF_{25-75%}$(P<0.001, $FEF_{50%}$(P<0.001), PEF(P<0.0005), MVV(P<0.005), $\dot{V}O_2$max (P<0.0001), and AT(P<0.0001) after average 10 days of PMV. Also there was a significant decrease in DLco(P<0.0001) and DL/VA(P<0.0001). At later($5{\pm}2$months) follow-up in 11 patients, there was no further improvement in any parameters of pulmonary function and exercise test. Twenty nine patients with sinus rhythm were divided into 16 patients with pulmonary arterial pressure(PAP) more than 35mmHg and/or tricuspid regurgitation grade n or more(group A) and 13 patients with PAP less than 35mmHg(group B). Group A Patients had significantly lower FVC(P<0.001), $FEV_1$(P<0.001), DLco(P<0.05), $\dot{V}O_2$ max(P<0.025) and mitral valve area(P<0.025) than group B patients. Group A patients after PMV, showed significant increase in FVC(P<0.001), maximum $O_2$ pulse(P<0.00001) and $\dot{V}O_2$ max(P<0.00025). Both group showed an increase in AT(P<0.0001, P<0.005), but group A showed greater decrease in $\dot{V}E/\dot{V}O_2$ and $\dot{V}E/\dot{V}CO_2$ both at AT(P<0.001, P<0.001) and $\dot{V}O_2$ max(P<0.0001, P<0.0001) after PMV compared with group B. Conclusion: These data suggest that patients with MS can show increased pulmonary function and exercise performance within 1 month after PMV. Patients with moderate to severe pulmonary hypertension had a significant increase in exercise performance compared with those with mild to no pulmonary hypertension and it is thought to be related to a significat decrease of ventilation for a given oxygen consumption at maximum exercise.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.231-238
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• 1999

Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

• Physical Therapy Korea
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• v.2 no.2
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• pp.1-8
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• 1995

이 논문의 주목적은 정상인을 대상으로 각기 다른 3가지의 (체중의 1.5 %, 3.0 %, 9.0 %) 부하를 통해서 자세의 불균형을 유발시켰을 때 나타나는 postural movement patterns을 기술하기 위한 연구이다. 연구대상의 허리중심에 체중부하를 주어 균형이 뒤로 이동하게 하여, surface EMG(표면 근전도)를 통하여 Tibialis anterior(Ta), Gastrocnernius(Gc), Quadriceps femoris(Qc), Hamstring(Ha), Rectus abdominalis(Ab)와 Paraspinalis(Pa) 근육들의 motor recruitment pattern(운동회집형태)를 측정하였다. 그리고 비디오 촬영은 고관절, 슬관절, 족관절의 움직임을 보기 위해 사용하였다. 특히 근전도 (EMG)는 자세반응 검사에 있어 첫 근반응(근수축) 경과시간(FR)과 분절간격간의 (ID)시간을 조사하는데 사용되었다. 이 연구의 결과는 4가지 중요한 사실을 전해주고 있다. 첫 번째로서, 연구대상자에게 체중의 1.5 %의 부하를 적용하였을 때 Ta가 가장 먼저 수축을 시작하였고(FR:$88{\pm}19.4$ ms) 발목과 대퇴사이의 분절 간격간(ID)의 평균은 +9.3 ms였다. 또한 족관절의 변화가 가장 뚜렷하여 Nashner(1985)의 족기전을 뒷받침하고 있다. 둘째로는 연구대상자에게 체중의 3.0 %의 부하를 주었을 때 Qc와 Ab근육이 원위부에서 근위부 순서로 수축하였고, 첫 번째 근육수축시간은 ($82{\pm}39.2$ ms)였다. 그리고 이때 분절간격의 평균은 +8.3ms 이였고 Ta는 거의 반응하지 않았다. 족관절과 슬관절에 비해 고관절의 변화가 가장 현저하게 나타났고, 이 또한 Nashner의 고관절 기전과 같은 현상을 보였다. 셋째로 연구 대상자에게 체중의 9.0 % 부하를 허리에 적용하였을 때 근수축은 근위부에서 원위부 순서를 이루어졌다. 즉 Ab,Qc, Ta, Ps순으로 근수축 되었다. Ab가 처음으로 수축하여 첫 반응(FR)은 $73{\pm}3.2$ ms 이였고 슬관절과 고관절의 변화가 가장 뚜렷하였다. 넷째로 연구 대상자에게 체중의 9.0 %부하를 적용하였을 때, 균형을 잡기 위해 뒷걸음치는 것이 관찰되었고 이때 근수축 순서는 Ta,Ab.Ps,Qc,Hs였다. 이 결과는 Nasher의 결과와 불일치하였다. 이상과 같은 결과에서 연구대상자의 자세운동형태(postural movement patterns)는 각기 다른 부하 정도와 시간에 따라 합성적으로 이루어지는 것으로 보여졌다. 특히, 자세운동형태는 부하의 적용위치와 연구대상자의 최근의 경험에 영향을 받은 것으로 밝혀졌다. 결론적으로 말하면 자세운동형태는 중앙신경계의 제한적(한정적) 명령 시스템에 의해서 움직임(movement)이 발생하기 전에 조직된다는 Nashner의 가설을 뒷받침하였다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.9-14
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• 2002

SLAP 병변의 진단시에는 정상 meniscoid 상부 관절와순과 구분이 중요하다. 병변의 기전은대부분 외 회전손상에 의해 발생하게 되며 불안정한 견관절에서 이차적 안정화 구조물로 작용하게된다. 대부분 이두박근 부하검사법으로 진단할 수 있으며, 봉합나사를 이용한 관절경적 봉합술을 시행하였을 때 투구 동작을 하는 운동 선수를 제외한 대부분의 환자에서 만족스러운 결과를 나타낸다