• Title/Summary/Keyword: Gamma camera imaging

Search Result 120, Processing Time 0.041 seconds

Detection of Atherosclerotic Lesion with $^{99m}Tc-LDL$ Scintigraphy ($^{99m}Tc-LDL$ (Low Density Lipoprotein)신티그라피를 이용한 동맥경화병소 진단)

  • Kim, Deog-Yoon;Koh, Eun-Mi;Woo, Jeong-Taek;Kim, Sung-Woon;Yang, In-Myung;Kim, Jin-Woo;Kim, Young-Seol;Kim, Kwang-Won;Choi, Young-Kil
    • The Korean Journal of Nuclear Medicine
    • /
    • v.26 no.2
    • /
    • pp.257-264
    • /
    • 1992
  • Diagnostic approaches such as angiography, ultrasound, computed tomography and nuclear magnetic resonance have limitation for contributing to the early clinical diagnosis of atherosclerosis. Recently, $^{99m}Tc-labelled$ low density lipoprotein was developed to detect early atherosclerotic lesion by external imaging with gamma camera. To determine whether $^{99m}Tc-LDL$ scintigraphy can visualize the active atherosclerotic lesion, rabbits were injected with $^{99m}Tc-LDL$, 3 months after feeding dietary fat (lanolin) and we obtained following results. 1) Labelling efficiency of $^{99m}Tc-LDL$ was $79\sim88%$. 2) Biodistribution study of normal rabbits with $^{99m}Tc-LDL$ revealed the high activities in spleen, adrenal gland, liver, kidney which are major organs of high metabolic rate of LDL. 3) Three months after feeding lanolin, serum cholesterol was markedly increased from $74{\pm}17mg/dl$ to $979{\pm}153mg/dl$ and histologic study of aorta after sacrificing the rabbit demonstrated marked atherosclerotic changes. 4) Atherosclerotic lesion of abdominal aorta which was confirmed with histologic study could be demonstrated in $^{99m}Tc-LDL$ scintigraphy after feeding lanolin for 3 months. In conclusion, the results of this preliminary investigation suggest that it may be possible to image active atheromatous lesion with $^{99m}Tc-LDL$. It is anticipated that this promising agent may allow the in vivo monitoring of preclinical atherosclerotic lesions and may be useful to evaluate the metabolic pathway of LDL in humans.

  • PDF

A study on the Effectivness of Hand-made Paraffin Thyroid Phantom (Paraffin을 이용한 Thyroid Phantom제작에 따른 유용성에 관한 연구)

  • Park, Soung-Ock;Lee, In-Ja
    • Journal of radiological science and technology
    • /
    • v.30 no.3
    • /
    • pp.237-243
    • /
    • 2007
  • Phantoms are very necessary for quality assurance of radio nuclides imaging systems to maintain standards and to ensure reproducibility of test. General quality assurance and instrument quality control are essential in every hospital. The human tissue equivalent materials are aluminum, areryl, water and epoxy..etc. It is very important to select optimum equivalant materials for a phantoms in QC. Especially, paraffin is very similar with human soft tissue in X or Gamma-ray physical characteristics and easy to buy with economically. We made a paraffin thyroid phantom and compare with thyroid areryl phantom, also used commercially in practice. Two small size cold spots(3 and 6 mm diameter) and a hot spot(3 mm diameter) embeded in paraffin phantom. And imaged with $^{99m}TcO_4$ by camera for analysis about spatial resolution and noise at the hot and cold spots. We got some results as below : 1. No difference in counting rate and noise between both arcryl and paraffin thyroid phantoms. 2. The best spatial resolution can be seen 6 cm distance between pinhole collimator and thyroid phantoms(arcryl and paraffin). 3. More optimal spatial resolution could acquired in paraffin thyroid phantom. Paraffin is very similar with human soft tissue in atomic number, density and relative absorbtion function, and can be shaped easily what we wanted. So we can recommendation paraffin as quality assurance phantom because its usefulness, economical benefit and purchasability.

  • PDF

Development of Stream Cover Classification Model Using SVM Algorithm based on Drone Remote Sensing (드론원격탐사 기반 SVM 알고리즘을 활용한 하천 피복 분류 모델 개발)

  • Jeong, Kyeong-So;Go, Seong-Hwan;Lee, Kyeong-Kyu;Park, Jong-Hwa
    • Journal of Korean Society of Rural Planning
    • /
    • v.30 no.1
    • /
    • pp.57-66
    • /
    • 2024
  • This study aimed to develop a precise vegetation cover classification model for small streams using the combination of drone remote sensing and support vector machine (SVM) techniques. The chosen study area was the Idong stream, nestled within Geosan-gun, Chunbuk, South Korea. The initial stage involved image acquisition through a fixed-wing drone named ebee. This drone carried two sensors: the S.O.D.A visible camera for capturing detailed visuals and the Sequoia+ multispectral sensor for gathering rich spectral data. The survey meticulously captured the stream's features on August 18, 2023. Leveraging the multispectral images, a range of vegetation indices were calculated. These included the widely used normalized difference vegetation index (NDVI), the soil-adjusted vegetation index (SAVI) that factors in soil background, and the normalized difference water index (NDWI) for identifying water bodies. The third stage saw the development of an SVM model based on the calculated vegetation indices. The RBF kernel was chosen as the SVM algorithm, and optimal values for the cost (C) and gamma hyperparameters were determined. The results are as follows: (a) High-Resolution Imaging: The drone-based image acquisition delivered results, providing high-resolution images (1 cm/pixel) of the Idong stream. These detailed visuals effectively captured the stream's morphology, including its width, variations in the streambed, and the intricate vegetation cover patterns adorning the stream banks and bed. (b) Vegetation Insights through Indices: The calculated vegetation indices revealed distinct spatial patterns in vegetation cover and moisture content. NDVI emerged as the strongest indicator of vegetation cover, while SAVI and NDWI provided insights into moisture variations. (c) Accurate Classification with SVM: The SVM model, fueled by the combination of NDVI, SAVI, and NDWI, achieved an outstanding accuracy of 0.903, which was calculated based on the confusion matrix. This performance translated to precise classification of vegetation, soil, and water within the stream area. The study's findings demonstrate the effectiveness of drone remote sensing and SVM techniques in developing accurate vegetation cover classification models for small streams. These models hold immense potential for various applications, including stream monitoring, informed management practices, and effective stream restoration efforts. By incorporating images and additional details about the specific drone and sensors technology, we can gain a deeper understanding of small streams and develop effective strategies for stream protection and management.

Development and Performance Evaluation of an Animal SPECT System Using Philips ARGUS Gamma Camera and Pinhole Collimator (Philips ARGUS 감마카메라와 바늘구멍조준기를 이용한 소동물 SPECT 시스템의 개발 및 성능 평가)

  • Kim, Joong-Hyun;Lee, Jae-Sung;Kim, Jin-Su;Lee, Byeong-Il;Kim, Soo-Mee;Choung, In-Soon;Kim, Yu-Kyeong;Lee, Won-Woo;Kim, Sang-Eun;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
    • /
    • v.39 no.6
    • /
    • pp.445-455
    • /
    • 2005
  • Purpose: We developed an animal SPECT system using clinical Philips ARGUS scintillation camera and pinhole collimator with specially manufactured small apertures. In this study, we evaluated the physical characteristics of this system and biological feasibility for animal experiments. Materials and Methods: Rotating station for small animals using a step motor and operating software were developed. Pinhole inserts with small apertures (diameter of 0.5, 1.0, and 2.0 mm) were manufactured and physical parameters including planar spatial resolution and sensitivity and reconstructed resolution were measured for some apertures. In order to measure the size of the usable field of view according to the distance from the focal point, manufactured multiple line sources separated with the same distance were scanned and numbers of lines within the field of view were counted. Using a Tc-99m line source with 0.5 mm diameter and 12 mm length placed in the exact center of field of view, planar spatial resolution according to the distance was measured. Calibration factor to obtain FWHM values in 'mm' unit was calculated from the planar image of two separated line sources. Te-99m point source with i mm diameter was used for the measurement of system sensitivity. In addition, SPECT data of micro phantom with cold and hot line inserts and rat brain after intravenous injection of [I-123]FP-CIT were acquired and reconstructed using filtered back protection reconstruction algorithm for pinhole collimator. Results: Size of usable field of view was proportional to the distance from the focal point and their relationship could be fitted into a linear equation (y=1.4x+0.5, x: distance). System sensitivity and planar spatial resolution at 3 cm measured using 1.0 mm aperture was 71 cps/MBq and 1.24 mm, respectively. In the SPECT image of rat brain with [I-123]FP-CIT acquired using 1.0 mm aperture, the distribution of dopamine transporter in the striatum was well identified in each hemisphere. Conclusion: We verified that this new animal SPECT system with the Phlilps ARGUS scanner and small apertures had sufficient performance for small animal imaging.

In Vivo Image and Biodistribution of $^{123}I$-15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP) in Liposarcoma Bearing Nude Mice (지방육종형성 동물모델에서 $^{123}I$-15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP)의 생체분포와 생체영상)

  • Lee, Tae-Sup;Suh, Yong-Sup;Choi, Chang-Woon;Woo, Kwang-Sun;Chung, Wee-Sup;Lim, Soo-Jung;Lim, Sang-Moo;Awh, Ok-Doo
    • The Korean Journal of Nuclear Medicine
    • /
    • v.35 no.5
    • /
    • pp.324-333
    • /
    • 2001
  • Purpose: $^{123}I$-labeled fatty acids have been used in the evaluation of regional myocardial energy metabolism. This study aimed to evaluate the usefulness of $^{123}I$-BMIPP as a liposarcoma-imaging agent. Materials and Methods: We compared in vitro uptakes between liposarcoma(SW872) and glioma(9L) cell lines, and examined biodistribution and in vivo images of $^{123}I$-BMIPP in liposarcoma-bearing nude mice. Cold-BMIPP was labeled with $^{123}I\;using\;Cu^{2+}$ as catalyst. After purification by Sep-pak, radiochemical purity was determined by TLC. We compared cellular uptake between glioma and liposarcoma after incubation of 5, 10, 15, 30, 60, 120, and 180 mins with culture medium containing $^{123}I$-BMIPP. The difference in biodistribution was determined between non-feeding (water only) group for 18 hr and feeding group in normal mice (n=6/group) at 0.5, 2, and 24 hr. In liposarcoma-hearing nude mice model, liposarcoma, SW872, ceil lines were injected subcutaneously into the felt thigh of nude mice. The biodistribution of $^{123}I$-BMIPP was evaluated at 0.5, 2, and 24 hr (n:5 / group) and in vivo Image of $^{123}I$-BMIPP was obtained with gamma camera at 2 and 24 hr in liposarcoma-hearing nude mice. Results: Radiolabeling yield and radiochemical purity were 95% and above 99%, respectively. SW872 cell line showed more increased uptake than 9L with 1.5 times at 180 mins. The clearance of $^{123}I$-BMIPP in various tissues was more delayed in the non-feeding group than in the feeding group, especially at delayed time (24 hr) in normal mice, and the major excreting organ was the gastrointestinal tract. In liposarcoma-bearing nude mice, tumor/blood ratio of $^{123}I$-BMIPP was 0.94, 0.75, and 1.38 and tumor/muscle ratio was 0.66, 1.53, and 1.11 at 0.5, 2, and 24hr, respectively. $^{123}I$-BMIPP was selectively localized in liposarcoma at 24 hr image. Conclusions: These results suggest that $^{123}I$-BMIPP can be used as a liposarcoma-imaging agent.

  • PDF

Effect of GB 34-GB 39 Electro-acupuncture on Regional Cerebral Blood Flow in Stroke Patients and Normal Volunteers Evaluated by $^{99m}Tc-ECD$ SPECT (양릉천-현종 전침치료가 뇌경색환자 및 정상인의 뇌혈류에 미치는 영향 - SPECT와 SPM을 이용한 연구 -)

  • Han, Jin-An;Jeong, Dong-Won;Bae, Hyung-Sup;Park, Sung-Uk;Jung, Woo-Sang;Park, Jung-Mee;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
    • /
    • v.27 no.3 s.67
    • /
    • pp.187-200
    • /
    • 2006
  • Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

  • PDF

Image-Based Assessment and Clinical Significance of Absorbed Radiation Dose to Tumor in Repeated High-Dose $^{131}I$ Anti-CD20 Monoclonal Antibody (Rituximab) Radioimmunotherapy for Non-Hodgkin's Lymphoma (반복적인 $^{131}I$ rituximab 방사면역치료를 시행 받은 비호지킨 림프종 환자 군에서 종양 부위의 영상기반 방사선 흡수선량 평가와 임상적 의의)

  • Byun, Byung-Hyun;Kim, Kyeong-Min;Woo, Sang-Keun;Choi, Tae-Hyun;Kang, Hye-Jin;Oh, Dong-Hyun;Kim, Byeong-Il;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.43 no.1
    • /
    • pp.60-71
    • /
    • 2009
  • Purpose: We assessed the absorbed dose to the tumor ($Dose_{tumor}$) by using pretreatment FDG-PET and whole-body (WB) planar images in repeated radioimmunotherapy (RIT) with $^{131}I$ rituximab for NHL. Materials and Methods: Patients with NHL (n=4) were administered a therapeutic dose of $^{131}I$ rituximab. Serial WB planar images alter RIT were acquired and overlaid to the coronal maximum intensity projection (MIP) PET image before RIT. On registered MIP PET and WB planar images, 2D-ROls were drawn on the region of tumor (n=7) and left medial thigh as background, and $Dose_{tumor}$ was calculated. The correlation between $Dose_{tumor}$ and the CT-based tumor volume change alter RIT was analyzed. The differences of $Dose_{tumor}$ and the tumor volume change according to the number of RIT were also assessed. Results: The values of absorbed dose were $397.7{\pm}646.2cGy$ ($53.0{\sim}2853.0cGy$). The values of CT-based tumor volume were $11.3{\pm}9.1\;cc$ ($2.9{\sim}34.2cc$), and the % changes of tumor volume before and alter RIT were $-29.8{\pm}44.3%$ ($-100.0%{\sim}+42.5%$), respectively. $Dose_{tumor}$ and the tumor volume change did not show the linear relationship (p>0.05). $Dose_{tumor}$ and the tumor volume change did not correlate with the number of repeated administration (p>0.05). Conclusion: We could determine the position and contour of viable tumor by MIP PET image. And, registration of PET and gamma camera images was possible to estimate the quantitative values of absorbed dose to tumor.

Comparison of Clinical Usefulness between N-13 Ammonia PET/CT and Tc-99m Sestamibi SPET in Coronary Artery Disease (관상동맥질환에서 N-13 암모니아 PET/CT와 Tc-99m 세스타미비 SPECT의 임상 유용성 비교)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Park, Jeong-Sun;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seop
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.42 no.5
    • /
    • pp.354-361
    • /
    • 2008
  • Purpose: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. Materials and Methods: Seventeen patients (male 13 : $63{\pm}11$ years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). Results: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/89% vs MPS: 65%/82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p < 0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. Conclusion: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.

Migration of $^{99m}Tc$-Hexamethylpropylene Amino Oxime (HMPAO) Labeled Immature and Mature Dendritic Cells in the Mouse (마우스에서 Tc-99m HMPAO 표지 미성숙 및 성숙 수지상세포의 이동에 관한 연구)

  • Li, Ming-Hao;Lee, Je-Jung;Min, Jung-Joon;Heo, Young-Jun;Song, Ho-Chun;Park, Young-Kyu;Park, An-Na;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
    • /
    • v.39 no.1
    • /
    • pp.26-33
    • /
    • 2005
  • Purpose: The purpose of this study is to evaluate migration of technetium-99m hexamethylpropylene amine oxime ($^{99m}Tc$-HMPAO) labeled immature and mature dendritic cells (DC) in the mouse. Methods: DC were collected from bone marrow (BM) of tibiae and femurs of mice. Immature and mature DC from BM cells were radiolabeled with $^{99m}Tc$-HMPAO. To evaluate the functional and phenotypic changes of DC from radiolabeling, the allogeneic mixed lymphocyte reaction (MLR) and fluorescence-activated cell sorting (FACS) analysis were performed before and after labeling with $^{99m}Tc$-HMPAO. Migration of intravenously injected DC (iv-DC) was assessed by serial gamma camera images of mice with or without subcutaneous tumor. Percent injected dose per gram (%ID/g) was calculated in lungs, liver, spleen, kidneys, and tumor through dissection of each mice after 24 hours of injection. Results: Labeling efficiency of immature and mature DC were $60.4{\pm}5.4%\;and\;61.8{\pm}6.7%$, respectively. Iv-DC initially appeared in the lungs, then redistributed mainly to liver and spleen. Migration of mature DC to spleen was significantly higher than that of immature DC ($38.3{\pm}4.0%\;vs.\;32.2{\pm}4.1%$ in control group, $40.4{\pm}4.1%\;vs.\;35.9{\pm}3.8%$ in tumor group; p<0.05). Migration to tumor was also significantly higher in mature DC than in immature DC ($2.4{\pm}0.3%\;vs\;1.7{\pm}0.2%$; p=0.034). Conclusion: Assessment of migration pattern of DC in mice was possible using $^{99m}Tc$-HMPAO labeled immature and mature DC. Migration of mature DC to spleen and tumor was higher than that of immature DC when they were i.v. injected.

Optimization of GFR value according to Kidney Depth Measurement Methods (신장 Depth 측정 방법에 따른 GFR 값의 최적화)

  • Kwon, Hyeong-Jin;Moon, Il-Sang;Noh, Gyeong Woon;Kang, Keon Wook
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.23 no.2
    • /
    • pp.25-28
    • /
    • 2019
  • Purpose In patients with unusual kidney position after $^{99m}Tc-DTPA$ renal dynamic imaging study, the GFR(Glomerular Filtration Rate) values are significantly different according to the depth of the kidney. Thus, we tried to compare the difference of the GFR values between the depth measurement methods and in-vitro test. 30 adult patients who were subjected to renal study. 27 patients were in usual position and 3 patients were in unusual. $555{\pm}37MBq$ of $^{99m}Tc-DTPA$ was administrated to all patients. GE infinia gamma camera was used. GFR values were obtained in-vivo(gates method) and in-vitro(blood). The kidney depth in-vivo was calculated by three methods(tonnensen, manual, taylor). In-vitro, GFR was performed by blood test. Differences in the mean values of GFR and correlation between depth and GFR values were evaluated using the SPSS 12.0 statistical program. The GFR values for 27 patients with kidney in the usual position are as follows(1.tonnensen 2.manual 3.taylor 4.invitro); $69.3{\pm}4.2$, $88.2{\pm}5.6$, $77.8{\pm}4.3$, $82.2{\pm}5.8ml/min$. The three unusual cases are as follows, first(congenital renal anomaly): 66.4, 101.24, 69.07, 94.8 ml/min. second(transplantation kidney): 12.22, 29.99, 19.36, 23.5 ml/min. third(horseshoe kidney): 37.37, 93.54, 35.9, 92.5 ml/min. There was a difference between tonnensen and manual in the usual position of the kidney(p<0.05). There was no significant difference between the other methods. However, there was a significant difference in case of the unusual position of the kidneys. Correlation analysis between both kidney depth and GFR value shows person correlation as follows; Rt kidney: 0.298, Lt kidney: 0.322. When compared with the GFR values in-vitro test, it was useful to calculate the GFR value by measuring the kidney depth using a manual formula in the unusual position of the kidneys. GFR values and kidney depth were significantly related.