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Predictive Values of Early Rest/24 Hour Delay T1-201 Perfusion SPECT for Wall Motion Improvement in Patients with Acute Myocardial Infarction After Reperfusion (급성 심근 경색 환자에서 재관류 후 조기에 시행한 휴식/24시간 지연 T1-201 심근 SPECT의 심근벽 운동 호전 예측능)

  • Hyun, In-Young;Kwan, June
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.259-265
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    • 1998
  • Purpose: We studied early rest/24 hour delay T1-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Materials and Methods: Among 17 patients (male/female= 11/6, age: 59±13) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay: 11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct-related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest T1-201 perfusion SPECT less then 6 hours after reperfusion and delay T1-201 perfusion SPECT next day. T1-201 uptake was visually graded as 4 point score from normal (0) to severe defect (3). Rest T1-201 uptake 2 or combination of rest T1-201 uptake 2 or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement 1 grade in follow up echo compared with the baseline values. Results: Among 98 segments with wall motion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 51/98 (52%), dyskinesia: 1/98 (1%). The wall motion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest T1-201 uptake were 99%, and 54%. PPV and NPV of rest T1-201 uptake were 100% and 52% respectively. Predictive values of combination of rest T1-201 uptake and late reversibility were not significantly different compared with predictive values of rest T1-201 uptake only. Conclusion: We conclude that early T1-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative predictive values in patients with acute myocardial infarction after reperfusion.

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Quality of Life among Family Caregivers of Terminal Cancer Patient (말기 암 환자 가족 간병인의 삶의 질)

  • Jung, Jin-Gyu;Kim, Sung-Soo;Kang, Dong-Soo;Kim, Sung-Min;Lee, Dong-Hoon;Han, Kyung-Hee;Kim, Jong-Sung
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.1-10
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    • 2006
  • Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (±SD) SF-36 score was 47.9 (±20.7). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall R2=0.639, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

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Relationship between Blood Pressure and Impairment of Cognitive Function In Some Rural Residents Aged 60-64 (일부 60-64세 농촌 거주자에서 혈압과 인지기능 장애와의 관계)

  • Lee, Moo-Sik;Chun, Jong-Chan;Lee, Choong-Won
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.208-214
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    • 2000
  • Objectives : Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 Methods : Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Results : By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95% confidence interval CI; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95% CI; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% CI; 0.37-0.89). Conclusions : These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.

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Bending Creep Performances of Hybrid Laminated Woods Composed of Wood-Wood Based Boards (목재와 목질보드 복합적층재의 휨 크리프 성능)

  • Park, Han-Min;Kang, Dong-Hyun;Choi, Yoon-Eun;Ahn, Sang-Yeol;Ryu, Hyun-Su;Byeon, Hee-Seop
    • Journal of the Korean Wood Science and Technology
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    • v.38 no.1
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    • pp.1-10
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    • 2010
  • In this study, to study an effective use and improve strength performances of woods and wood-based materials, three-ply hybrid laminated woods which are composed of spruce in the face and three kinds of wood-based boards (MDF, PB, OSB) in the core were manufactured, and the effect of constitution elements used for the core laminae on bending creep performances was investigated. The shape of creep curves showed exponential function plots which the upper right side was increased, and differed among the kinds of wood-based boards used for the core laminae of hybrid laminated wood. The creep deformation perpendicular to the grain of faces of hybrid laminated woods was in order C(P) > C(M) > C(O) with PB, MDF and OSB in the core, respectively. It was found that the creep deformation arranged with OSB in the core had 2 times smaller than those arranged with MDF and PB in the core. By hybrid laminating, the creep deformation of spruce perpendicular to the grain was markedly decreased. On the other hand, the creep deformation parallel to the grain of the faces (C type) of hybrid laminated woods was in order C(P) > C(O) > C(M) with PB, OSB and MDF in the core. The ratios among three hybrid laminated woods were considerably decreased, especially the difference between C(P) and C(O) hybrid laminated woods arranged with PB and OSB in the core was very small. These values showed 0.108~0.464 times smaller than creep deformation of three wood-based boards and it was found that creep deformation of three wood-based boards was considerably decreased by hybrid laminating. Creep anisotropy of hybrid laminated woods was greater in creep deformation than in initial deformation, whereas it was found that the values was much smaller than that of spruce parallel laminated woods.

Clinic Analysis of Heart Surgery -110 cases- (심장수술 110례 임상고찰)

  • Chang, Hoon;Shin, Sung-Aia;No, Joong-Kee;Rho, Jun-Ryang
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.597-603
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    • 2001
  • Background: The purpose of writing this article is to get better clinical results and further clinical improvement based on subject to 110 cases of cardiac surgery which were performed and clinically analyzed. Material and Method: Since January 1995, the patent ductus arteriosus surgery had started in our hospital. In February 1999, an open heart surgery had started and up to September 2000, total of 110 cases were performed as of double ligation of patent ductus arteriosus(10 cases) and open heart surgery(100 cases). Result: Among the patients, Korean-Chines was 74(67.3%) and Han-Chinese was 35(31.8%). Congenital heart disease was 95 cases and acquired valvular heart disease was 15 cases. 83 cases of acyanotic congenital heart disease consisted of ventricular septal defect(VSD) with associated anomaly(45 cases), atrial septal defect(ASD) with associated anomaly(20 cases), patent ductus arteriosus(PDA) with associated anomaly(11 cases), cogenital aortic stenosis(5 cases), double chamber right ventrical(1 case) and Ebstein's anomaly(1 case). Among the 12 cases of cyanotic congenital heart disease, 11 cases of tetralogy of Fallot underwent total correction. Among the 15 cases of acquired valvular heart disease, valvular replacement(7 cases), double valve replacement (3 cases), mitral valve replacement(3 cases) and aortic valve replacement(1 case) were performed. And 8 cases of valvuloplasty were performed by using of commissurotomy, chordal plasty, plasty of papillary muscle, ring type annuloplasty, repair of leaflet. Conclusion: on cogenital heart disease, short term results of surgery for acyanotic cogenital heart disease was good. Among the cyanotic congenital heart disease, tetralogy of Fallot showed a little difference of recovery according to the surgery method so that further follow up observation was needed for long term result. On acquired valvular heart disease, especially, in terms of short term result of valvuloplasty, was relatively good, but further follow up observation was also needed for long term result. There wasn's any operative mortality.

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Crustal Characteristics and Structure of the Ulleung Basin, the East Sea (Japan Sea), Inferred from Seismic, Gravity and Magnetic Data (탄성파 및 중자력자료에 의한 울릉분지의 지각특성 및 구조 연구)

  • Huh, Sik;Kim, Han-Jun;Yoo, Hai-Soo;Park, Chan-Hong
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.5 no.2
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    • pp.95-104
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    • 2000
  • Depths to four seismic sequence boundaries and the thickness of each sequence were estimated and mapped based on multi-channel seismic data in the Ulleung Basin. These depth-structure and isopach maps were incorporated into the interpretation of gravity and magnetic anomaly maps. The sediment thickness ranges from 3,000 m to 4,000 m in the central basin, while it reaches 6,000 m locally along the southwestern, western, and southeastern margins. The acoustic basement forms a northeast-southwest elongated depression deeper than 5000 m, and locally deepens up to 7,500 m in the southwestern and western margins. Low gravity anomalies along the western and southern margins are associated with basement depressions with thick sediment as well as the transitional crust between the continental and oceanic crusts. Higher gravity anomalies, dominant in the central Ulleung basin, broaden from southwest toward northeast, are likely due to the shallow mantle and a dense crust. A pair of magnetic elongations in the southeastern and northwestern margins appear to separate the central Ulleung basin from its margin. These magnetic elongations are largely dominated by intrusive or extrusive volcanics which occurred along the rifted margin of the Ulleung basin formed during the basin opening. The crust in the central Ulleung Basin, surrounded by the magnetic elongations, is possibly oceanic as inferred from the seismic velocity. The oceanic crust can be mapped in the central zone where it widens to 120 km from the southwest toward northeast. Bending of the crustal boundary in the southern part of the Ulleung Basin suggests that the Ulleung Basin has been deformed by a collision of the Phillipine plate into the Japan arc.

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High Definition Road Map Object usability Verification for High Definition Road Map improvement (정밀도로지도 개선을 위한 정밀도로지도 객체 활용성 검증)

  • Oh, Jong Min;Song, Yong Hyun;Hong, Song Pyo;Shin, Young Min;Ko, Young Chin
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.4
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    • pp.375-382
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    • 2020
  • As the 4th Industrial Revolution era in worldwide, interest in autonomous vehicles is increasing. but due to recent safety issues such as pedestrian accidents and car accidents, as a technical model for this, the demand for 3D HD maps (High Definition maps) is increasing in including lanes, road markings, road information, traffic lights and traffic signs etc. However, since some complementary points have been continuously raised according to demand, It is necessary to collect the opinions of institutions and companies utilizing HD maps and to improve HD maps. This study was conducted by utilizing the results of the contest for usability verification of HD Maps hosted by the National Geographic Information Institute and organized by the Spatial Information Industry Promotion Institute. For this study, we researched HD maps' layers and codes for HD maps object usability to improve HD maps, constructed HD maps object usability items accordingly, and contested usability verification of HD maps according to the items The contestants conducted verification and analyzed the results. As a result, the most frequently used code for each layer was the flat intersection, and the code showing the highest usage rate was a safety sign. In addition, the use rate of the sub-section and height obstacles was 16.67% and 8.88%, respectively, showing a low ratio. In order to utilize HD maps in the future, this study is expected to require research to continuously collect opinions from customers and improve data objects and data models that are actually needed by customers.

Clinical Features of Symptomatic Meckel's Diverticulum (증후성 멕켈 게실의 임상적 고찰)

  • Lee, Young Ah;Seo, Ji Hyun;Youn, Hee Sang;Lee, Gyeong Hun;Kim, Jae Young;Choi, Gwang Hae;Choi, Byung Ho;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.193-199
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    • 2006
  • Purpose: The proper diagnosis of Meckel's diverticulum (MD) is difficult and delayed because of the variety of clinical manifestations. We reviewed clinical characteristics of symptomatic MD to facilitate early detection. Methods: We analyzed retrospectively the clinical manifestations, diagnostic tools, histopathological findings, and operative findings in 58 patients with symptomatic MD. Results: The male to female ratio was 2.8 : 1. The most common symptom of MD was bleeding. Others symptoms included: vomiting, abdominal pain, irritability, abdominal distension and fever in the order of frequency. The clinical manifestations of symptomatic MD were lower gastrointestinal bleeding, intestinal obstruction, perforation, diverticulitis and hemoperitoneum, in the order of frequency. The causes of intestinal obstruction were intussusception, internal hernia, band, volvulus, invagination, in the order of frequency. Seventy five percent of patient with MD were diagnosed prior to 5 years of age. The most frequently used diagnostic tool was the Meckel's scan. The diverticulum was located 2 cm to 120 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 1 cm to 10 cm and 94% were less than 5 cm. The most common ectopic tissue found in the MD was gastric mucosa. Ileal resection was more frequently performed than diverticulectomy. Conclusion: In cases of unexplained gastrointestinal bleeding, obstruction and repeated intussusception, the meckel's scan, ultrasound and computed tomography shoud be considered to rule out MD, and if clinically necessary, an exploratory laparotomy when needed.

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Independent Prognostic Value of the Fascin Expression in Patients with Esophageal Cancer (식도암에 있어서 Fascin의 발현과 예후와의 상관관계에 대한 연구)

  • Choi, Pill-Jo;Jeong, Sang-Seok;Bang, Jung-Heui;Cho, Kwang-Jo;Woo, Jong-Soo;Roh, Mee-Sook
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.74-81
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    • 2008
  • Background: Fascin is an actin-bundling protein that induces membrane protrusions and it increases cell motility in various transformed cells. Esophageal cancer is one of the most lethal malignancies, and it exhibits extensive local invasion or frequent regional lymph node metastasis even after curative surgery. We investigate the expression of fascin by performing immunohistochemistry to evaluate the clinical characteristics and prognostic significance of its expression in esophageal cancer patients. Material and Method: Immunochemistry for fascin was performed on 76 tumor samples from 76 patients who underwent esophageal cancer operations. The expression levels of fascin in the 76 esophageal cancer tissues were compared with those in the corresponding normal esophageal epithelium. The fascin-positive samples were defined as those showing more than 75% of fascin-positive cells. Result: Overall, a fascin positive expression was detected in 39 (51.3%) out of the total 76 cases. The tumors with positive fascin expression tended to more frequently show a higher stage (p=0.030), and a higher T-factor (p=0.031). The prognosis of the fascin negative group was significantly better than that of the fascin positive group (p=0.004). Multivariate analysis revealed that lymphovascular invasion and the fascin expression were independent prognostic factors. Conclusion: Fascin was expressed in 513% of the esophageal cancer tissues and a positive expression of fascin was associated with more advanced tumor progression and recurrence. Our study suggests that the fascin expression may be an independent prognostic factor for an unfavorable clinical course few those patients suffering with esophageal cancer.

Replacement of Obstructed Extracardiac Conduits with Autologous Tissue Reconstructions (Peel operation); Early and Midterm Results (심외도관 협착 환자에서 자가조직을 이용한 재수술(Peel 수술); 조기 및 중기성적)

  • Sung, Si-Chan;Chang, Yoon-Hee;Lee, Choong-Won;Park, Chin-Su;Lee, Hyoung-Doo;Ban, Ji-Eun;Choo, Ki-Seok
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.193-199
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    • 2007
  • Background: Reoperation is usually required for a right ventricle to pulmonary artery conduit obstruction caused by valve degeneration, conduit peel formation or somatic growth of the patient. An autologous tissue reconstruction (peel operation), where a prosthetic roof is placed over the fibrotic tissue bed of the explanted conduit, has been used to manage conduit obstructions at our institute since May 2002. Herein, the early and midterm results are evaluated. Material and Method: Between May 2002 and July 2006, 9 patients underwent obstructed extracardiac conduit replacement with an autologous tissue reconstruction, at a mean of 5.1 years after a Rastelli operation. The mean age at reoperation was 7.5±2.4 years, ranging from 2.9 to 10.1 years. The diagnoses included 6 pulmonary atresia with VSD, 2 truncus arteriosus and 1 transposition of the great arteries. The preoperative mean systolic gradient was 88.3±22.2mmHg, ranging from 58 to 125 mmHg. The explanted conduits were all Polystan valved pulmonary conduit (Polystan, Denmark). A bioprosthetic valve was inserted in 8 patients, and a monocusp ventricular outflow patch (MVOP) was used in 1 patient. The anterior wall was constructed with a Gore-Tex patch (n=7), MVOP (n=1) and bovine pericardium (n=1). Pulmonary artery angioplasty was required in 5 patients and anterior aortopexy in 2. The mean cardiopulmonary bypass time . was 154 minutes, ranging from 133 to 181 minutes; an aortic crossclamp was not performed in all patients. The mean follow-up duration was 20 months, ranging from 1 to 51 months. All patients were evaluated for their right ventricular outflow pathway using a 3-D CT scan. Resuit: There was no operative mortality or late death. The mean pressure gradient, assessed by echocardiography through the right ventricular outflow tract, was 20.4 mmHg, ranging from 0 to 29.6 mmMg, at discharge and 26 mmHg, ranging from 13 to 36 mmHg, at the latest follow-up (n=7, follow-up duration >1 year). There were no pseudoaneurysms, strictures or thrombotic occlusions. Conclusion: A peel operation was concluded to be a safe and effective re-operative option for an obstructed extracardiac conduit following a Rastelli operation.