• Title/Summary/Keyword: 이규보

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Variations in The Size of The Ischemic Myocardium Due to Differences in The Normal File (Normal File의 차이에 따른 심근 관류결손 크기의 변화)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Heo Jae-Kyeong;Iskandrian Abdulmasshi S.
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.49-57
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    • 1992
  • 혈관확장제 투여에 의한 약물부하 심근스캔시는 운동부하 심근스캔시와 비교하여 심박출량과 관상 동백 혈류의 증가정도가 달라서 심근내 T1-201의 농도가 달라진다. 그러므로 부하 심근관류스캔의 정량적 판독시에 각각의 부하에 특이적인 Normal file을 사용하지 않으면 이러한 심근내 T1-201 농도의 차이로 인하여 관류 결손의 크기가 다르게 나타날 수 있으리라 추측할 수 있다. 본 연구는 좌전하행지의 유의한 협착이 있는 34명의 단일 혈관 관상동맥 환자에서 이러한 가정이 실제적으로 어떻게 나타나는가를 조사하였다. 환자들은 adenosine 140ug/kg/min을 정맥주사하고 T1-201 SPECT를 실시하였다. 관류결손의 크기는 답차운동부하 T1-201 스캔을 실시한 정상인에서 구한 Normal File (File-ex)과 adenosine T1-201 스캔의 Normal File (File-ad)을 각각 이용하여 만든 극성지도에서 구한 adenosine 심근스캔의 관류결손의 범위지수(extent score)와 중증도지수(severity score)로 표시하였고, 이들의 값을 비교하여 아래의 결과를 얻었다. File-ex로 구한 관류결손의 범위지수는 $19{\pm}13%$였고 File-ad로 구한 범위는 $11{\pm}10%$였다(차이 $8.1{\pm}1.6%$, p=0.0001), 중증도지수는 File-ex를 사용하였을 때 $582{\pm}479$였고 File-ad를 사용하였을때는 $310{\pm}309$였다(차이 $272{\pm}49$, p<0.0001). $50\sim70%$의 중등도의 내경 협착이 있었던 20명의 환자에서는 범위지수는 File-ex와 File-ad에서 각각 $17{\pm}10$$7{\pm}7%$(p=0.001)였고, 70% 이상의 내경 협착이 있었던 14명에서의 범위 지수는 각각 $24{\pm}16$$18{\pm}10%$ (p=0.03)로 모두에서 File-ex를 사용하였을때의 값이 컸다. 이와 같은 성적으로 보아 T1-201 스핀에서 관류결손의 정도를 정량적으로 첨가할 시에는 부하에 특이적인 Normal File을 사용하여야 관류 결손의 정도를 정확하게 추출할 수 있다는 사실을 알 수가 있다. 즉 dipyridamole이나 adenosine부하경사에서 운동부하의 Normal File을 사용하면 관류결손의 정도가 과대평가 된다는 것이다.

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Adenosine $^{99m}Tc-MIBI$ Scintigraphy in the Diagnosis of Coronary Artery Disease: Comparison with Exercise $^{99m}Tc-MIBI$ Scintigraphy (관상동맥 질환에서의 Adenosine 부하 $^{99m}Tc-MIBI$ 심근 스캔의 진단적 가치 : 운동 부하 $^{99m}Tc-MIBI$ 심근 스캔과의 비교)

  • Kang, Seung-Wan;Woo, Eon-Jo;Chae, Sung-Chull;Jun, Jae-Eun;Park, Wee-Hyun;Chung, Byung-Cheon;Choi, Chung-Il;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.72-81
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    • 1992
  • Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine $^{99m}Tc-MIBI$ myocardial scintigraphy were evaluated and comparison with exercise $^{99m}Tc-MIBI$ was performed. Twenty-eight subjects underwent $^{99m}Tc-MIBI$ imaging after adenosine infusion and exercise $^{99m}Tc-MIBI$ imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate ($64{\pm}12$ at baseline versus $74{\pm}16$ beats/min at peak effect, p<0.001), a mild decrease in systolic and diastolic blood pressure and a slightly increase in PR interval(p; NS). Side effects were reported in 92% of patients and were mostly mild in nature and promptly resolved within 1 or 2 minutes of termination of adenosine infusion. Facial flushing (53%), chest pain (36%), mild dyspnea (39%), headache (21%), throat discomfort (21%) were frequent symptoms. ST segment depression (> 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, $^{99m}Tc-MIBI$ myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise $^{99m}Tc-MIBI$ scintigraphy.

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Clinical Observation on Hyperthyroidism (갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 관찰(觀察))

  • Lee, Kyu-Bo;Kang, Bann;Song, Suk-Ho;Park, Hi-Myung;Whang, Kee-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.2
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    • pp.39-47
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    • 1969
  • A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).

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Evaluation of Coronary Artery Disease with Gated Blood Pool Scan Using Dipyridamole (Dipyridamole 부하 심장 풀 스캔을 이용한 관동맥질환의 평가)

  • Kim, Gwang-Weon;Choi, Chung-Il;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Chae, Shung-Chull;Jun, Jae-Eun;Park, Wee-Hyun;Park, Hee-Myung
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.27-36
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    • 1991
  • Thirty-one patients with coronary artery disease and twenty-sir normal subjects underwent $^{99m}Tc-GBPS$ before and after coronary vasodilatation was induced by dipyridamle 0.54 mg/kg given IV over 4 min. LVEF, ${\Delta}EF$ and regional wall motion by phase analysis were measured during rest and dipyridamole infusion. The results were as follows: 1) Mean LVEF of normal subjects was significantly higher than that of MI group (p=0.001), but similar to that of angina group during rest. Among MI group, mean LVEF of anterior MI group was significantly lower than that of inferior MI group during rest (p=0.024). 2) The normal subjects had a significaat increase in mean LVEF during dipyridamole infusion $(+12{\pm}3.8)$, while the CAD group had no increase $(+2{\pm}5.0)$ (p<0.001). If an increase of LVEF during stress is less than 5%, it suggests an abnormality. The sensitivity and specificity of LVEF changes after dipyridamole infusion were 81%, 96%, respectively. 3) With phase analysis, LV mean phase angle of normal subjects and CAD patients was $143{\pm}20.5^{\circ},\;132{\pm}20.6^{\circ}$ respectively, durign rest (p=0.049). But an ncrease of LV mean phase angle during dipyridamole infusion in these two groups was not significantly different. Dipyridamole infusion did not affect standard deviation and FWHM of phase angle. 4) Regional wall motion was abnormal in 5 patients (16%) during dipyridamole infusion. 5) Side effects with dipyridamole infusion include; headache, angina pain, chest discomfirt, nausea, weakness sense. In conclusion, dipyridamole GBPS might be useful in detection and follow up of CAD.

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Hepatosplenic Scanning with $^{198}Au$ Colloidal Gold in Chronic Myelogenous Leukemia (만성골수성백혈병(慢性骨髓性白血病)에 있어서 $^{198}Au$교질(膠質)을 사용(使用)한 간비주사소견(肝脾走査所見))

  • Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.15-21
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    • 1979
  • From January 1975 to March 1978, 18 cases of chronic myelogenous leukemia diagnosed at Kyungpook National University Hospital were tested by hepatosplenic scanning with $^{198}Au$ colloidal gold. The photo scanning findings in relation to clinical and laboratory findings are following. 1) Male to female ratio was 2:1 and 2nd and 3rd decades were predominant. 2) No focal space-occupying lesion was noticed both in the liver and spleen. 3) 4 cases revealed well visualization of spleen, 7 cases poor visualization, and 7 cases nonvisualization. 4) No significant difference between well visualization group and poor visualization group was noted in clinical findings, liver function test and hematologic findings. 5) Cases with nonvisualization of the spleen tended to be associated with thrombocytopenia, decreased megakaryocytes in the marrow and longer duration of the illness.

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Identification and Assessment of Paradoxical Ventricular Wall Motion Using ECG Gated Blood Pool Scan - Comparison of Cine Loop, Phase Analysis and Paradox Image - (ECG Gated Blood Pool Scan을 이용한 심실벽 역행성 운동의 평가 - Cine Loop, Phase Analysis, Paradox Image의 비교 -)

  • Lee, Jae-Tae;Kim, Gwang-Weon;Jeong, Byeong-Cheon;Lee, Kyu-Bo;Whang, Kee-Suk;Chae, Sung-Chul;Jeon, Jae-Eun;Park, Wee-Hyun;Lee, Hyong-Woo;Chung, Jin-Hong
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.244-253
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    • 1990
  • Sixty-four patients with paradoxical ventricular wall motion noticed both in angiocardiography or 2-dimensional echocardiography were assessed by ECG gated blood pool scan (GBPS). Endless cine loop image, phase and amplitude images and paradox image obtained by visual inspection of each cardiac beat or Fourier transformation of acquired raw data were investigated to determine the incremental value of GBPS with these processing methods for identification of paradoxical ventricular wall motion. The results were as follows: 1) Paradoxical wall motions were observed on interventricular septum in 34 cases, left ventricular free wall in 26 and right ventricular wall in 24. Underlying heart diseases were ischemic (23 cases) valvular(9), congenital heart disease (12), cardiomyopathy (5). pericardial effusion(5), post cardiac surgery(3), col pulmonale (2), endocarditis(1) and right ventricular tumor(1). 2) Left ventricular ejection fractions of patients with paradoxical left ventricular wall motion were significantly lower than those with paradoxical septal motion(p<0.005). 3) The sensitivity of each processing methods for detecting paradoxical wall motion was 76.9% by phase analysis, 74.6% by endless cine loop mapping and 68.4% by paradox image manipultion respectively. Paradoxial motions visualized only in phase, paradox or both images were appeared as hypokinesia or akinesia in cine loop image. 4) All events could be identified by at least one of above three processing methods, however only 34 cases (48.4%) showed the paradoxical molies in all of the three images. By these findings, we concluded that simultaneous inspection of all above three processing methods-endless cine loop, phase analysis and paradox image-is necessary for accurate identification and assessment of paradoxical ventricular wall motion when performing GBPS.

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The Clinical Role of $^{99m}Tc$-(V)-DMSA Imaging in Patients with Head and Neck Cancer (두경부 종양에서 $^{99m}Tc$-(V)-DMSA 영상술의 진단적 유용성)

  • Bae, Sun-Kun;Lee, Jae-Tae;Park, June-Sik;Park, In-Kyu;Hyun, Dong-Woo;Lee, Young-Hak;Kim, Jeong-Gyun;Ahn, Byeong-Cheal;Choi, Ji-Yong;Sohn, Sang-Gyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.526-532
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    • 1995
  • Introduction : $^{99m}Tc$-(V)-DMSA is a tumor seeking agent that has been used to image medullary carcinoma of thyroid, soft tissue sarcoma and lung cancer. This study was designed to assess the clinical role of $^{99m}Tc$-(V)-DMSA in the diagnosis of head and neck cancers. We has evaluated the diagnostic efficacy of planar and SPECT imaging using $^{99m}Tc$-(V)-DMSA. Patients and Method : Sixty-eight patients with head and neck mass were included in this study. All subjects were diagnosed by biopsy or surgery. Planar and SPECT images were obtained at 2 or 3 hour after intravenous injection of 740 MBq(20 mCi) $^{99m}Tc$-(V)-DMSA. Seventeen patients also underwent SPECT in aging using dual head camera. Result : The diagnostic sensitivity of $^{99m}Tc$-(V)-DMSA planar and SPECT imaging was 65% and 90%, and specificity was 80% and 66%, respectively. The sensitivity of planar imaging in squamous cell carcinoma was similar to overall sensitivity Six metastatic lesion were first diagnosed by scintigraphy. But benign lesions such as Kikuchi syndrome, tuberculous lymphadenitis also revealed increased uptake. Conclusion : $^{99m}Tc$-(V)-DMSA imaging seems to be a promising method in the evaluation of patients with head and neck mass. We recommend SPECT imaging to delineate anatomic localization of the lesion.

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Myocardial Uptake and Clearance of Thallium-201 in Normal Subjects: A Comparison Between Pharmacologic Stress with Intravenous Adenosine, Dipyridamole and Dobutamine, and Exercise Stress Testing (정상인 심근의 Thallium-201 섭취 및 제거 : Adenosine, Dipyridamole Dobutamine 정맥주사와 운동부하시의 비교)

  • Lee, Jae-Tae;Chung, Byung-Chun;Choi, Jung-Il;Kwak, Dong-Suk;Lee, Kyu-Bo;Chae, Shung-Chull;Chung, Chin-Hong
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.35-50
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    • 1993
  • 심근관류 스캔에서 약제부하 검사에 많이 이용되는 것으로는 adenosine, dipyridamole, dobutamine등이 있다. 이 약제들이 혈역학 및 thallium의 약동학에 미치는 효과를 검사하기 위하여 저자들은 15명의 건강인을 대상으로 이들 약제를 정맥주사한 후에와 그리고 운동부하를 시행한 후에 thallium-201 신근관류 스캔을 시행하여 thallium의 약동학에 미치는 영향에 대하여 서로 비교하였다. 부작용은 adenosine (87%), dipyridamole(80%), dobutamine (73%)을 정맥주사할 시에 흔히 나타났으나 경미하였다. 1예에서는 dobutamine을 주사할때의 부작용으로 인하여 최대용량을 투여하지는 못한바 있었다. 대상들은 dipyridamole (13%)이나 dobutamine (27%)보다 adenosine (60%)을 선호하였다 (P<0.05). Thallium의 절대 적인 심근섭취는 운동부하 검사보다 adenosine (1.3배), dipyridamole(1.2배), dobutamine(1.4배) 부하시에 더 많았고, 이들 약제 사이에는 유의한 차이는 없었다. Thallium의 심근제거율(%/hr)는 운동부하 검사보다 약제부하한 후에가 더 늦었다. 폐, 간, 비장, 및 내장지역에서 thallium의 섭취 및 제거는 운동부하 검사보다 약제부하시에 더 많았으나, 이들 약제 사이에는 유의한 차이가 없었다. Dobutamine 투여시의 thallium의 섭취 및 제거는 adenosine 또는 dipyridamole을 투여시의 결과와 상응하였다. 저자들은 adenosine, dipyridamole 및 dobutamine을 이용한 약제부하 thallium-201 심근관류 검사를 시행하는데 코든 대상들에서 어려움 없이 쉽게 시행할 수 있었다. Thallium의 심근내 섭취 및 제거는 각 약제부하에 따라서 다를 수가 있으므로 심근관류 스캔의 정량적인 분석을 시행할 때는 각각 약제에 대한 특별한 진단기준이 마련되어야 할 것으로 생각된다.

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Scintigraphic Features of Choledochal Cyst Using Technetium-99m-DISIDA Hepatobiliary Scan (총담관낭종의 $^{99m}Tc$-DISIDA 간담도 스캔)

  • Choi, Chung-Il;Kim, Jeong-Gyun;Bae, Sun-Kun;Kwak, Dong-Suk;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Zeon, Seok-Kil;Lee, Hyung-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.71-80
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    • 1993
  • In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.

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A Study on the Sudeok Choi-Ja's Study Viewpoint (수덕(樹德) 최자(崔滋)의 학문관)

  • Jeong, Seong-sik
    • (The)Study of the Eastern Classic
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    • no.67
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    • pp.237-258
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    • 2017
  • This study aims is consider the life and study viewpoint of Choi-Ja who lived in during the Musin regime of Koryo Dynasty. During this period, knowledge of the Confucian scriptures gradually generalized among scholars and writers. Therefore, it was possible to create an atmosphere that criticized sajanghak(詞章學). Choi-Ja regrets that people' reading style is not correct at the time. People are only trying to learn to participate in social exams and learn to read and write articles related to the Civil servant examination. Nevertheless, if he passed the Civil servant examination he criticized the government for failing to study harder, even though he had to work harder. Choi-Ja lamented that the intellectuals basically did not read about the Kyeongsabaekka(經史百家) and on the outward appearance. His scholarly attitude implies that he can be recognized as a genuine learningexperience when he forms the moral character of his inner self rather than his outward form. Choi-Ja' emphasis on six Confucian writings indicates that his virtues ere based on the Confucian spirit of Confucius. He pointed out the abuses of intellectuals at the time of his poems to build poems based on these Confucian traditions. He emphasized that the government ought to reflect on the Confucian scriptures and histories of the Confucian scriptures and reflect the politics of the people and improve the mood of the people.