• Title/Summary/Keyword: Dynamic Stress

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Relationship Between Adenosine-Induced ST Segment Depression During $^{99m}Tc$-MIBI Scintigraphy and The Severity of Coronary Artery Disease (Adenosine 부하 $^{99m}Tc$-MIBI 심근 관류스캔도중 나타나는 ST절 하강과 관상동맥 질환의 중증도와의 관계)

  • Cho, Jung-Ah;Choi, Chung-Il;Kwak, Dong-Suk;Kim, Jeong-Gyun;Bae, Sun-Kun;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Kang, Seung-Wan;Woo, Eon-Jo;Kim, Sin-Woo;Sohn, Sang-Kyun;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.177-185
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    • 1994
  • Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

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The Effect of Surface Defects on the Cyclic Fatigue Fracture of HEROShaper Ni-Ti rotary files in a Dynamic Model: A Fractographic Analysis (Fractographic 분석을 통한 HEROShaper 니켈티타늄 전동 파일의 피로파절에 미치는 표면결함의 역할)

  • Lee, Jung-Kyu;Kim, Eui-Sung;Kang, Myoung-Whai;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.130-137
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    • 2007
  • This in vitro study examined the effect of surface defects on cutting blades on the extent of the cyclic fatigue fracture of HEROShaper Ni-Ti rotary files using fractographic analysis of the fractured surfaces. A total of 45 HEROShaper (MicroMega) Ni-Ti rotary flies with a #30/.04 taper were divided into three groups of 15 each. Group 1 contained new HEROShapers without any surface defects. Group 2 contained HEROShapers with manufacturing defects such as metal rollover and machining marks. Croup 3 contained HEROShapers that had been clinically used for the canal preparation of 4-6 molars A fatigue-testing device was designed to allow cyclic tension and compressive stress on the tip of the instrument whilst maintaining similar conditions to those experienced in a clinic. The level of fatigue fracture time was measured using a computer connected the system. Statistical analysis was performed using a Tukey's test. Scanning electron microscopy (SEM) was used for fractographic analysis of the fractured surfaces. The fatigue fracture time between groups 1 and 2, and between groups 1 and 3 was significantly different (p<0.05) but there was no significant difference between groups 2 and 3 (p>0.05). A low magnification SEM views show brittle fracture as the main initial failure mode At higher magnification, the brittle fracture region showed clusters of fatigue striations and a large number of secondary cracks. These fractures typically led to a central region of catastrophic ductile failure. Qualitatively, the ductile fracture region was characterized by the formation of microvoids and dimpling. The fractured surfaces of the HEROShapers in groups 2 and 3 were always associated with pre-existing surface defects. Typically, the fractured surface in the brittle fracture region showed evidence of cleavage (transgranular) facets across the grains, as well as intergranular facets along the grain boundaries. These results show that surface defects on cutting blades of Ni-Ti rotary files might be the preferred sites for the origin of fatigue fracture under experimental conditions. Furthermore this work demonstrates the utility of fractography in evaluating the failure of Ni-Ti rotary flies.

A Study on the Behaviour of Prebored and Precast Steel Pipe Piles from Full-Scale Field Tests and Class-A and C1 Type Numerical Analyses (현장시험과 Class-A 및 C1 type 수치해석을 통한 강관매입말뚝의 거동에 대한 연구)

  • Kim, Sung-Hee;Jung, Gyoung-Ja;Jeong, Sang-Seom;Jeon, Young-Jin;Kim, Jeong-Sub;Lee, Cheol-Ju
    • Journal of the Korean GEO-environmental Society
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    • v.18 no.7
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    • pp.37-47
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    • 2017
  • In this study, a series of full-scale field tests on prebored and precast steel pipe piles and the corresponding numerical analysis have been conducted in order to study the characteristics of pile load-settlement relations and shear stress transfer at the pile-soil interface. Dynamic pile load tests (EOID and restrike) have been performed on the piles and the estimated design pile loads from EOID and restrike tests were analysed. Class-A type numerical analyses conducted prior to the pile loading tests were 56~105%, 65~121% and 38~142% respectively of those obtained from static load tests. In addition, design loads estimated from the restrike tests indicate increases of 12~60% compared to those estimated in the EOID tests. The EOID tests show large end bearing capacity while the restrike tests demonstrate increased skin friction. When impact energy is insufficient during the restrike tests, the end bearing capacity may be underestimated. It has been found that total pile capacity would be reasonably estimated if skin friction from the restrike tests and end bearing capacity from the EOID are combined. The load-settlement relation measured from the static pile load tests and estimated from the numerical modelling is in general agreement until yielding occurs, after which results from the numerical analyses substantially deviated away from those obtained from the static load tests. The measured pile behaviour from the static load tests shows somewhat similar behaviour of perfectly-elastic plastic materials after yielding with a small increase in the pile load, while the numerical analyses demonstrates a gradual increase in the pile load associated with strain hardening approaching ultimate pile load. It has been discussed that the load-settlement relation mainly depends upon the stiffness of the ground, whilst the shear transfer mechanism depends on shear strength parameters.