• Title/Summary/Keyword: PAI-1

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Role of Redistribution and 24 Hour Reinjection Images to assess Myocardial Viability in Patients with Acute Myocardial Infarction (급성심근경색환자의 심근생존능 평가에 있어서 T1-201 재분포영상과 24시간 재주사영상의 역할)

  • Yoon, Seok-Nam;Pai, Moon-Sun;Park, Chan-H.;Yoo Myung-Ho;Choi, Byung-Il William
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.325-331
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    • 1998
  • Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.

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F-18-FDG Whole Body Scan using Gamma Camera equipped with Ultra High Energy Collimator in Cancer Patients: Comparison with FDG Coincidence PET (종양 환자에서 초고에너지(511 keV) 조준기를 이용한 전신 F-18-FDG 평면 영상: Coincidence 감마카메라 단층 촬영 영상과의 비교)

  • Pai, Moon-Sun;Park, Chan-H.;Joh, Chul-Woo;Yoon, Seok-Nam;Yang, Seung-Dae;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.65-75
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    • 1999
  • Purpose: The aim of this study is to demonstrate the feasibility of 2-[fluorine-18] fluoro-2-deoxy-D-glucose (F-18-FDG) whole body scan (FDG W/B Scan) using dual-head gamma camera equipped with ultra high energy collimator in patients with various cancers, and compare the results with those of coincidence imaging. Materials and Methods: Phantom studies of planar imaging with ultra high energy and coincidence tomography (FDG CoDe PET) were performed. Fourteen patients with known or suspected malignancy were examined. F-18-FDG whole body scan was performed using dual-head gamma camera with high energy (511 keV) collimators and regional FDG CoDe PET immediately followed it Radiological, clinical follow up and histologic results were correlated with F-18-FDG findings. Results: Planar phantom study showed 13.1 mm spatial resolution at 10 cm with a sensitivity of 2638 cpm/MBq/ml. In coincidence PET, spatial resolution was 7.49 mm and sensitivity was 5351 cpm/MBq/ml. Eight out of 14 patients showed hypermetabolic sites in primary or metastatic tumors in FDG CoDe PET. The lesions showing no hypermetabolic uptake of FDG in both methods were all less than 1 cm except one lesion of 2 cm sized metastatic lymph node. The metastatic lymph nodes of positive FDG uptake were more than 1.5 cm in size or conglomerated lesions of lymph nodes less than 1cm in size. FDG W/B scan showed similar results but had additional false positive and false negative cases. FDG W/B scan could not visualize liver metastasis in one case that showed multiple metastatic sites in FDG CoDe PET. Conclusion: FDG W/B scan with specially designed collimators depicted some cancers and their metastatic sites, although it had a limitation in image quality compared to that of FDG CoDe PET. This study suggests that F-18-FDG positron imaging using dual-head gamma camera is feasible in oncology and helpful if it should be more available by regional distribution of FDG.

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Self-Efficacy, Self-Care Behavior, Posttraumatic Growth, and Quality of Life in Patients with Cancer according to Disease Characteristics (질병관련 특성에 따른 암환자의 자기효능감, 자가간호행위, 외상 후 성장, 삶의 질)

  • Choi, Jinho;Lee, Sunyoung;An, Byungduck
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.170-179
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    • 2016
  • Purpose: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. Methods: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. Results: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. Conclusion: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.

Nontuberculous Mycobacterial pulmonary Infection in Immunocompetent Patients (면역적격자에서 비결핵마이코박테리아의 폐감염)

  • Lee, Hyo-Won;Kim, Mi-Na;Shim, Tae-Sun;Bai, Gill-Han;Pai, Chik-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.173-182
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    • 2002
  • Background : Nontuberculous mycobacteria (NTM) have usually been considered to be contaminants of colonizers when isolated from respiratory specimens in Korea, where there is a high prevalence of tuberculosis and a low rate of HIV infections. Therefore, there has been few studies on the clinical significance of NTM species in immunocompetent patients were investigated. Methods : Thirty-five NTM isolates, for which species identification was requested by the treating physicians during 1999 at the Asan Medical Center, were retrospectively analyzed. They were identified to the species level by mycolic acid analysis using high-performance liquid chromatography. The medical records of the patients with the NTM isolates were reviewed to identify those patients who met the American Thoracic Society (ATS)'s criteria for mycobacterial pulmonary infection. Their antimicrobial susceptibility data were compared with the clinical outcomes. Results : The NTM were identified as M. intracellulare (6 isolates), M. avium (5), M. abscessus (5), M. gordonae (5), M. terrae complex (4), M. szulgai (2), M. kansasii (2), M. fortuitum (2), M. peregrinum (1), M. mucogenicum (1), M. celatum (1), and M. chelonae (1). All 35 patients showed clinical symptoms and signs of chronic lung disease, but none had a HIV infections; 16 (45.7%) patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria, 5 and 4 cases were affected with M. intracellulare and M. abscessus, respectively; 8 patients had a history of pulmonary tuberculosis. 13 patients received antimycobacterial therapy for an average of 21 months and 9 patients were treated with second-line drugs. Only 4 patients had improved radiologically. Conclusion : A NTM should be considered a potential pathogen of pulmonary infections in immunocompetent patients with chronic pulmonary diseases. Most NTM infections were left untreated for a prolonged period and showed a poor outcome as a result, M. intracellulare and M. abscessus were the two most frequent causes of NTM pulmonary infections in this study. Species identification and antimycobacterial susceptibility tests based on the species are needed for the optimum management of a NTM pulmonary infection in patients.

Effects of Long Term Fertilizations on Growth, Yield and Grain Development of Rice (비료의 장기연용이 벼의 생육ㆍ수량 및 미립발달에 미치는 영향)

  • Han, Hee-Suk;Lee, Moon-Hee;Shim, Jai-Sung
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.1
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    • pp.41-51
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    • 1991
  • This study was conducted to determine the effect of 20 years long term fertilizations on the physical and chemical properties of paddy soil and the growth, yield, yield components and grain development of rice. Non-fertilized, PK, NK, NP, NPK, NPK + compost, NPK+straw and NPK+lime have been applied since 1968 after surface paddy soil was removed. NPK+compost and NPK+straw applications increased the content of organic matter, available P and CEC, and lime increased soil acidity and SiO$_2$ content. While chemical contents in non-fertilized treatment were low as compared with other treatments. Soil porosity was higher in NPK+straw (51.4%) and NPK+lime(53.1%) than in NPK application (49.8%). Soil hardness was highest in the NPK application and was lowest in the NPK + lime. Continuous application of straw with NPK markedly increased the content of aggregate with over 1mm(19.6%) as compared with NPK application (7.1%). Plant height, tiller number, root number, leaf area index and total dry weight were higher in the applications of compost, straw and lime with NPK than in any other treatments. Brown rice yield in non-fertilized, PK and NP applications was decreased 45, 55, 15 and 5% of that in NPK application, respectively, while application of compost, straw and lime with NPK increased the yield by 11, 14 and 4%, respectively, during 20 years. The number of differentiated rachis branchs in the application of compost, straw and lime was 17 to 21 and that in the other application was 13 to 15, whereas the degenerated rachis branchs was low in the application of compost, straw and lime with NPK. The applications having higher level of perfect rice grain such as non-fertilized, NPK+compost, NPK+straw and NPK+lime had high grain weight and had low level of white core rice, white belly rice. The white core and belly rice was highest in the NP application and notched belly rice kernel was markedly increased in NK and NP applications. The period of grain filling was 30 DAH at NP and NPK applications, 35 DAH at NK and NPK+lime, 40DAH at NPK+compost and NPK+ straw, and 45DAH at non-fertilized, respectively.

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Efficacy and Safety during the Combination Therapy of Imipramine and Desmopressin in Primary Monosymptomatic Nocturnal Enuresis (어린이의 일차성 단일 증상성 야뇨증에서 Imipramine과 Desmopressin 복합 약물치료의 효과 및 안전성)

  • Yeo Ji-Hyun;Choi Jung-Youn;Chung Hyo-Seok;Lee Kyung-Soo;Ko Cheol-Woo;Kim Kyo-Sun;Kim Kee-Hyuk;Kim Jung-Soe;NamGoong Mee-Kyung;Park Young-Seo;Pai Ki-Soo;Yoo Kee-Hwan;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.129-137
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    • 2004
  • Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.

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The Effects of Several Halophytes on Insulin Resistance in Otsuka Long-evans Tokushima Fatty Rats (OLETF 쥐에서 칠면초와 세발나물의 인슐린 저항성 개선 효과)

  • Cho, Jeong-Yong;Huang, Zhangjun;Park, Sun-Young;Park, Kyung-Hee;Pai, Tong-Kun;Kim, So-Young;Kim, Haeng-Ran;Ham, Kyung-Sik
    • Korean Journal of Food Science and Technology
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    • v.46 no.1
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    • pp.100-107
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    • 2014
  • We evaluated preventive effects of Suaeda japonica (SJ) and Spergularia marina Griseb (SMG) on the insulin resistance in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. The 10-week old OLETF rats were fed diets containing 3% (w/w) SJ and SMG for 18 weeks. Fasting blood glucose levels in SJ and SMG groups, measured using the oral glucose tolerance test, were lower than that of the control rats. The SMG group showed significantly lower levels of insulin, glycated hemoglobin, triglyceride, and total cholesterol than the control group. In addition, these levels were relatively lower in the SJ group than those in the control rats. The SJ and SMG groups had relatively lower protein levels of nuclear factor-kappa B (NF-${\kappa}B$) p65 in adipose tissue and serine phosphorylated insulin receptor substrate 1 (IRS-1) in skeletal muscle than the control group. These results suggest that SJ and SMG prevent insulin resistance and SMG in particular reduces blood triglyceride and total cholesterol levels.

Prevalence of Antibodies to Hepatitis A in the Healthy Children in Inchon-Kyunggi Prefecture (경인 지역 소아의 A형 간염 항체 보유율)

  • Kwon, Young Se;Hong, Young Jin;Choe, Yon Ho;Kim, Soon Ki;Son, Byong Kwan;Kang, Moon Su;Pai, Soo Hwan;Hong, Kwang Sun
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.239-244
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    • 1998
  • Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

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Clinical Characteristics and Renal Outcomes of Acute Focal Bacterial Nephritis in Children (소아 급성 세균성 신엽염의 임상상 및 신장 예후)

  • Lee Dong-Ki;Kwon Duck-Geun;Lim Yun-Ju;Shin Yun-Hye;Yun Suk-Nam;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.229-238
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    • 2004
  • Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

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Administrative Legislation Procedures, Pre-Notices, Listening to Opinions under the Administrative Law of the United States - Focusing on the Analysis of the 2019 Ruling, Federal Supreme Court Azar v. Allina Health Service, 587 U.S. 1804 - (미국 행정법상 행정입법절차와 사전통지, 의견청취 - Azar v. Allina Health Service, 587 U.S. 1804 2019 판결에 대한 분석을 중심으로 -)

  • Kim, Yong-Min
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.187-220
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    • 2020
  • Today, administrative legislation is becoming more and more important in that it not only sets the legal life relationship of the people in great detail and detail, but is closely related to the occurrence, extinction, and alteration of rights and obligations held by prisoners. In the United States, the types of administrative legislation are divided into substantive and interpretative regulations, so-called substantive regulations, which give prior notice and opportunity to comment on interested parties through formal or informal administrative procedures in accordance with Article 553 of the Federal Administrative Procedures Act. On the other hand, the interpretation regulation, which is "the regulation established by the Administration for the simple interpretation of statutes," does not require prior notice or comment because it does not affect the people's rights obligations. The Azar v. Allina Health Service, 587 U.S. 1804, 2019 ruling by the U.S. Constitutional Court, subject to this research paper, is about a dispute over a new decision to require Medicare to determine the amount of compensation for care providers that provide medical services for the poor, and should the regulations be regarded as substantive under the Administrative Procedures Act and should not be given a hearing or a simple internal process for processing. Given that the current administrative procedure law of our country stipulates the procedures for administrative pre-announcement through Articles 42.1 and 44.1, but that our courts have not judged violations of legislative pre-announcement procedures under the Administrative Procedures Act so far as to judge the illegality of administrative legislation, the dispute of the U.S. Constitutional Court will provide new implications for controlling legal orders beyond simple legal interpretation and has great significance in terms of readjustment of relevant regulations under future administrative procedures.