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Intraoperative Measurement and Analysis of Coronary Artery Bypass Graft Flow (수술중 측정한 관상동맥 우회도관 혈류량의 분석)

  • Park, Kye-Hyun;Chae, Hurn;Yun, Yang-Ku;Lee, Jae-Woong;Kim, Kwhan-Mien;Jun, Tae-Gook;Kim, Jhin-Gook;Shim, Young-Mog;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.760-769
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    • 1997
  • This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.

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The Findings of $^{99m}Tc$-MDP Bone Scan in Primary Malignant Bone Tumors (원발성 악성 골종양의 $^{99m}Tc$-MDP 골스캔 소견)

  • Hyun, In-Young;Lee, Kung-Han;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kang, Heung-Sik;Lee, Sang-Hoon;Lee, Han-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.73-78
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    • 1995
  • [ $^{99m}Tc$ ]-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were cor related with scan findings in 22 patients with osteogenic sarcoma. The results were as follows 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope Intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients.. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and $^{99m}Tc$-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

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Effects of Potassium-Channel Opener on Thallium-201 Kinetics: In-vitro Study in Rat Myocyte Preparations and In-vivo Mice Biodistribution Study (K-통로개방제가 배양심근세포와 생쥐 체내의 Thallium-201역동학에 미치는 영향)

  • Lee, Jae-Tae;Kim, Eun-Ji;Ahn, Byeong-Cheol;Sohn, Kang-Kyun;Lee, Kyu-Bo;Ha, Jeoung-Hee;Kim, Chun-K.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.507-515
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    • 1996
  • Background : Potassium channel opener (K-opener) opens ATP-sensitive K'-channel located at cell membrane and induces potassium efflux from cytosol, resulting in intracellular hyperpolarization. Newly synthesized K-opener is currently examined for pharmacologic potency by means of rubidium release test from smooth muscle strip pre-incubated with Rb-86. Since in-vivo behavior of thallium is similar to that of rubidium, we hypothesized that K-opener can alter T1-201 kinetics in vivo. Purpose : This study was prepared to investigate the effects of pinacidil (one of potent K-openers) on the T1-201 uptake and clearance in cultured myocyte, and in-vivo biodistribution in mice. Methods : Spontaneous contracting myocytes were prepared to imitate in-vivo condition from 20 hearts of 3-5 days old Sprague-Dawley rat and cultured for 3-5 days before use ($5{\times}10^5$ cells/ml). Pinacidil was dissolved in 10% DMSO solution at a final concentration of 100nM or l0uM and was co-incubated with T1-201 in HBSS buffer for 20-min to evaluate its effect on cellular T1-uptake, or challenged to cell preparation pre-incubated with T1-201 for washout study. Two, 40 or $100{\mu}g$ of pinacidil was injected intravenously into ICR mice at 10 min after $5{\mu}Ci$ T1-201 injection, and organ uptake and whole body retention rate were measured at different time points. Results : Co-incubation of pinacidil with T1-201 resulted in a decrease in T1-201 uptake into cultured myocyte by 1.6 to 2.5 times, depending on pinacidil concentration and activity of T1-201 used. Pinacidil enhanced T1-201 washout by 1.6-3.1 times from myocyte preparations pre-incubated with T1-201. Pinacidil treatment appears to be resulted in mild decreases in blood and liver activity in normal mice, in contrast, renal and cardiac uptake were mildly decreased in a dose dependent manner. Whole body retention ratios of T1-201 were lower at 24 hour after injection with $100{\mu}g$ of pinacidil than control. Conclusion : These results suggest that treatment with K-opener may affect the interpretation of T1-201 myocardial images, due to decreasing thallium accumulation and enhancing washout from myocardium.

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Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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Perfusion Impairment in Infantile Autism on Brain SPECT Using Tc-99m ECD : Comparison with MR Findings (유아 자폐증 환아에서의 Tc-99m ECD를 이용한 뇌 단일 광전자 방출 전산화 단층 촬영술상의 관류 저하: 자기 공명 영상과의 비교 분석)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Yoon, Pyeong-Ho;Kim, Dong-Ik;Oh, Young-Taik;Lee, Sun-Ah;Lee, Ho-Bun;Shin, Yee-Jin;Lee, Byung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.320-329
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    • 1997
  • Neuroanatomic substrate of autism has been the subjects of continuing investigation. Because previous studies had not demonstrated consistent and specific neuroimaging findings in autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and anatomical abnormalities with brain SPECT using Tc-99m ECD and correlative MRI The patient population was composed of 18 children aged 28 to 89 months(mean age : 55 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPECT was performed after intravenous injection of 185-370MBq of Tc-99m ECD using brain dedicated annular crystal gamma camera. MRI was performed in all patients including T1, T2 axial and T1 sagittal sequences. SPECT data were visually assessed. Thirteen patients had abnormal SPECT scan revealing focal areas of decreased perfusion. Decreased perfusion of cerebellar vermis(12/18), cerebellar hemisphere(11/18), thalami(13/18), basal ganglia(4/18), posterior parietal(7/18), and temporal(4/18) area were noted on brain SPECT. Whereas, only 3 patients had abnormal MR findings which were subtle volume loss of parieto-occipital white matter in 3 and mild thinning of posterior body of corpus callosum in 2 and slightly decreased volume of cerebellar vermis in 1. Comparison of the numbers of abnormal findings revealed that regional cerebral blood flow (rCBF) abnormalities seen on SPECT were more numerous than anatomical abnormalities seen on MRI. In conclusion, extensive perfusion impairment involving cerebellum, thalami and parietal lobe were found in this study. SPECT may be more sensitive in reflecting pathophysiology of autism than MRI. However, further studies are mandatory to determine the significance of thalamic and parietal perfusion impairment in autism.

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A Convenient Radiolabeling of [$^{11}$C](R)-PK11195 Using Loop Method in Automatic Synthesis Module ($^{11}$C 표지 자동합성장치에서 루프법을 이용한 ($^{11}$C)(R)-PK11195의 간편한 합성법)

  • Lee, Hak-Jeong;Jeong, Jae-Min;Lee, Yun-Sang;Kim, Hyung-Woo;Choi, Jae-Yeon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.337-343
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    • 2009
  • Purpose: ((R)-1-(2-chlorophenyl)-N-1-[$^{11}$C]methyl-N(1-propyl)-3-isoquinoline carboxamide ((R)-PK11195) is a specific ligand for the peripheral type benzodiazepine receptor and a marker of activated microglia, used to measure inflammation in neurologic disorders. We report here that a direct and simple radiosynthesis of [$^{11}$C](R)-PK11195 in mild condition using NaH suspension in DMF and one-step loop method. Materials and Methods: (R)-N-Desmethyl-PK11195 (1 mg) in DMSO (0.1 mL) and NaH suspension in DMF (0.1 mL) were injected into a semi-prep HPLC loop. [$^{11}$C]methyl iodide was passed through HPLC loop at room temperature. Purification was performed using semi-preparative HPLC. Aliquots eluted at 11.3 min were collected and analyzed by analytical HPLC and mass spectrometer. Results: The labeling efficiency of [$^{11}$C](R)-PK11195 was 71.8$\pm$8.5%. The specific activity was 11.8:$\pm$6.4 GBq/$\mu$mol and radiochemical purity was higher than 99.2%. The mass spectrum of the product eluted at 11.3 min showed m/z peaks at 353.1 (M+1), indicating the mass and structure of (R)-PK11195. Conclusion: By the one-step loop method with the [$^{11}$C]CH3l automated synthesis module, [$^{11}C$](R)-PK11195 could be easily prepared in high radiochemical yield using NaH suspension in DMF.

Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy (유방암 절제술 후 방사선치료를 시행한 환자의 골스캔에서 보이는 방사전 유발 늑골골절)

  • Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Kim, Jin-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.287-293
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    • 2009
  • Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

Estimation of Agronomic Characteristics of Domestic Aromatic Rice Germplasm and Foreign Aromatic Rice Germplasm in RDA Genebank, Korea (국내육성 향미 유전자원과 도입 향미 유전자원의 농업적 형질 평가)

  • Kim, Jeong-Soon;Ahn, Sang-Nag;Cho, Yang-Hee;Gwag, Jae-Gyun;Kim, Tae-San;Lee, Jung-Ro;Lee, Sok-Young
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.53 no.3
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    • pp.261-272
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    • 2008
  • This study was conducted to provide the fundamental data based on the agronomic characteristics of domestic aroma rice, widely cultivated domestic rice and foreign aroma rice for breeding of functional aromatic rice. Among the 104 varieties, all of domestic aroma rice and widely cultivated rice varieties were headed, 24 of 84 varieties of foreign aroma rice were not headed. The average heading date of domestic aroma rice Japonica types of domestic rice was later as 136 day, and Tongil types of domestic aroma rice were faster as 122 day. The average culm length of Indica types of foreign aroma rice was longer as 130 cm, and Tongil types of were shorter as 74 cm. The average panicle length of domestic aroma rice and traditional rice were about 21 cm, and Indica types of foreign aroma rice were longer as 29.5 cm. The average 1,000 grain weight of Tongil types of domestic aroma rice and was not a difference with the domestic aroma rice and was more 2.5 g than the Indica types of foreign aroma rice. The average ratio of grain width and length of Indica types of foreign aroma rice were highest as 3.29 (W/L), and the domestic traditional rice was lowest as 1.7 (W/L). The average fertility rate of the domestic aroma rice, the widely cultivated domestic rice, and the Japonica types of foreign aroma rice were above 89.7%, but the Indica types of foreign and the Tongil types of domestic aroma rice were below 65.4%. The average germination rate of foreign aroma rice were above 83.7%, and domestic aroma rice were above 90.4%. The non-glutinous rice were 64 varieties (84.2%) of total 104 accessions of material rice and the waxy rice were 7 varieties (1%). In the domestic aroma rice, Hyangmi2ho and Aranghyangchalbyeo has a mild aroma grade. In the foreign aroma rice, 22 of 40 varieties of Indica types and 9 of 16 varieties of Japonica types has a lightly aroma grade. And 13 varieties of widely cultivated domestic rice has a non-aroma grade.

Preliminary Study on the Relationship between Self-Induced Mental Imagery and GSR - Comparison among Mental Imageries Inducing Pleasantness or Unpleasantness and Mental Arithmetic (심상자극과 GSR의 관계에 대한 예비연구 - 쾌.불쾌를 유발하는 심상자극과 암산과제에 대한 SCL 반응비교)

  • 이봉건;정인원;김재진;신철진
    • Science of Emotion and Sensibility
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    • v.5 no.2
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    • pp.11-22
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    • 2002
  • This study investigated the effects of mild mental imagery inducing pleasantness or unpleasantness and cognitive mental arithmetic task on skin conductance level. Subjects were f undergraduates(male 5, female 4). They were given the list of the words and asked to write down the liked objects and the disliked ones freely associated with these words. Among these objects the most-liked one and the most disliked one were selected as the self-induced mental imageries. Data-collection procedures were as follows ; first baseline, pleasant imagery, 2nd baseline, unpleasant imagery, finally 3rd baseline, and mental arithmetic task subtracting continuously 7 from the number 500. During these trials, the SCLs were recorded every 10 seconds. The results indicated that there were nonsignificant differences between the 3 trial-baselines ot each condition. This suggested that unlike the procedures used in the previous studies, our procedures would give the stability of the baseline level necessary for the comparison of the effects of several stimuli. Also, the level of skin conductance in mental arithmetic condition was significantly higher than that of the emotional mental imagery. This suggested the possibility that mental arithmetic task would gave rise to the higher physiological arousal in comparison to mental imageries. Overall, it was suggested that the procedures and the stimulus presentation methods used in this preliminary study could be useful for the data-collection techniques for The future study. Implications for the future study were presented.

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A Case of Citrullinemia Type 1 in ASS 1 Mutation (ASS 1 유전자 돌연변이로 확진된 시트룰린혈증 1형 1례)

  • Yim, Dae kyoon;Huh, Rimm;Kwun, Younghee;Lee, Jieun;Cho, Sung Yoon;Park, Hyung Doo;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.29-34
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    • 2015
  • Citrullinemia type1 is an autosomal recessive disorder of the urea cycle characterized by neonatal or late onset of hyperammonemia caused by a deficiency of the enzyme argininosuccinate synthetase (ASS). An ASS1 deficiency demonstrates fatal clinical manifestations that are characterized by the neonatal metabolic coma and early death when untreated. It causes a broad spectrum of effects, ranging from a mild disorder to a severe mental retardation, epilepsy, neurologic deficits. An acute neonatal form is the most common. Infants are normal at birth followed by an acute illness characterized by vomiting, lethargy, seizures and coma. These medical problems are life-threatening in many cases. A later onset form is less frequent and may be milder than the neonatal form. This later-onset form is associated with severe headaches, visual dysfunction, motor dysfunction, and lack of energy. Citrullinemia type1 is caused by mutations in the ASS1 gene located on chromosome 9q34.1 that encodes argininosuccinate synthetase, the third enzyme of the urea cycle catalyzing the formation of argininosuccinic acid from citrulline and aspartic acid. The enzyme is distributed in tissues including liver and fibroblasts. This mutation leads to hyperammonemia, arginine deficiency and elevated citrulline level. In the urea cycle, argininosuccinate synthetase catalyses the conversion of citrulline and aspartate to argininosuccinate.. Here, we describe a female newborn patient with lethargy, rigidity and hyperammonemia who was diagnosed as citrullinemia type1 with a c.[421-2A>G], c.[1128-6_1188dup] mutation.