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Diagnostic Ability of Tc-99m MIBI SPECT in Coronary Artery Diseases is not Affected by the Degree of Exercise (운동 정도와 무관한 Tc-99m Methoxyisobutyl Isonitrile 심근관류 스캔의 진단능)

  • Lee, Jae-Tae;Kim, Jong-Soo;Chun, Kyung-Ah;Lee, Sang-Woo;Kang, Do-Young;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.40-48
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    • 1999
  • Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

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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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Retrospective Cohort Study on the Administration of Sedative for Delirium in Terminally Ill Cancer Patients and Survival Time (말기암환자의 섬망으로 인한 진정제 투약과 생존기간에 관한 후향적 코호트 연구)

  • Park, Hyoung Sook;Kim, Dae Sook;Bae, Eun Hee;Kim, Jung Rim;Seo, Jung Hwa;Yun, Jung Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.119-126
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    • 2016
  • Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

Effects of Steam Flaking of Corns imported from USA and India on the in vitro Fermentation Characteristic and the Mycotixin Contents of Logistic Processing Line (미국산과 인도산 옥수수의 steam flaking 처리가 공정라인별 mycotoxin 함량의 변화와 in vitro 발효 특성에 미치는 영향)

  • Lee, Shin-Ja;Lee, Ji-Hun;Shin, Nyeon-Hak;Han, Jung-Hun;Hyun, Jong-Hwan;Moon, Yea-Hwang;Lee, Sung-Sill
    • Journal of Life Science
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    • v.19 no.1
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    • pp.65-74
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    • 2009
  • The objective of this study was to examine the effects of steam flaking treatment of corn grains imported from USA and India on in vitro gas production, microbial growth and contents of aflatoxin $B_1$ and ochratoxin A. Each treatment was composed of total 4 treatments including (1) USCW (US com-whole type), (2) USCF (US corn-flaked type), (3) IDCW (India corn-whole type) and (4) IDCF (India orn-flaked type) with 4 replications $\times$ 6 incubation times (3, 6, 9, 12, 18 and 24 hr). Mycotoxin (aflatoxin $B_1$ & ochratoxin A) contents in test corns tended to increase gradually with increasing logistics periods from the harbor, hopper, silo to processing line. The contents of aflatoxin $B_1$ in India corn (IDCW) and US corn (USCW) were 11.71 and 1.78 ppb, respectively when measured at the hopper. After steam flaking, both contents of aflatoxin $B_1$ in USCW and IDCW were 0.00 ppb. It means that Aspergillus flavus could be decreased by steam flaking. However, this trend was not observed in ochratoxin content. The gas production rate of USA corns (USCW & USCF) was significantly (p<0.05) higher than India corns (IDCW & IDCF), and that of steam flaked corns (USCF & IDCF) was higher $1.5{\sim}2%$ than whole corns (USCW & IDCW) after 3 hr incubation in in vitro experiment. pH value was optimally maintained for microbial growth during whole incubation times with the value of 6.05 to 6.54, and was not significantly different between treatments, but USCF was somewhat lower than other treatments. pH value decreased following 12 hr of incubation but gas production increased rapidly during the same period. In addition, in vitro microbial growth rates also increased with up to 18 hr of incubation period, thereafter experienced a decrease with extended incubation time. In conclusion, US corn was superior to India corn by origin based on the results of in vitro and mycotoxin contents. And steam flaking process of imported corns tended to decrease mycotoxin contents such as aflatoxin $B_1$ and ochratoxin A as well as improve in vitro gas production and microbial growth rates.

An Analysis on the Understanding of High School Students about the Concept of a Differential Coefficient Based on Integrated Understanding (통합적 이해의 관점에서 본 고등학교 학생들의 미분계수 개념 이해 분석)

  • Lee, Hyun Ju;Ryu, Jung Hyeon;Cho, Wan Young
    • Communications of Mathematical Education
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    • v.29 no.1
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    • pp.131-155
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    • 2015
  • The purpose of this study is to investigate if top-ranked high school students do integrated understanding about the concept of a differential coefficient. For here, the meaning of integrated understanding about the concept of a differential coefficient is whether students understand tangent and velocity problems, which are occurrence contexts of a differential coefficient, by connecting with the concept of a differential coefficient and organically understand the concept, algebraic and geometrical expression of a differential coefficient and applied situations about a differential coefficient. For this, 38 top-ranked high school students, who are attending S high school, located in Cheongju, were selected as subjects of this analysis. The test was developed with high-school math II textbooks and various other books and revised and supplemented by practising teachers and experts. It is composed of 11 questions. Question 1 and 2-(1) are about the connection between the concept of a differential coefficient and algebraic and geometrical expression, question 2-(2) and 4 are about the connection between occurrence context of the concept and the concept itself, question 3 and 10 are about the connection between the expression with algebra and geometry. Question 5 to 9 are about applied situations. Question 6 is about the connection between the concept and application of a differential coefficient, question 8 is about the connection between application of a differential coefficient and expression with algebra, question 5 and 7 are about the connection between application of a differential coefficient, used besides math, and expression with geometry and question 9 is about the connection between application of a differential coefficient, used within math, and expression with geometry. The research shows the high rate of students, who organizationally understand the concept of a differential coefficient and algebraic and geometrical expression. However, for other connections, the rates of students are nearly half of it or lower than half.

Effect of Panax ginseng on the Graft-versus-Host Reaction, Production of Leucocyte Migration Inhibitory Factor and Expulsion of Adult Trichinella spiralis in Mice (인삼이 이식편대숙주반응, 대식세포유주저지반응 및 Trichinella spiralis의 expulsion에 미치는 영향)

  • Ha, Tai-You;Lee, Jeong-Ho;Kim, Sang-Hyung
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.1
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    • pp.133-144
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    • 1986
  • This study was undertaken to assess the effect of ginseng administration on T lymphocyte induced local xenogenic graft-versus-host(GVM) reactions which were induced with thymocyte, spleen cell and lymph node cell of ICR mice. Mice received daily 10mg of 70% alcohol ginseng extract oral1y for 100days and control mice remained untreated for the same period of time. The cells from donor mice were injected intradermally into the closely shaven abdominal skin of Sprague-Dawley rats for GVH tests. The thymocyte from control(ginseng-untreated) mice showed a negative local GVH reaction, whereas thymocyte from experimental(ginseng-treated) mice showed a positive reaction with the rate of 17.4%. When spleen cells were injected, the incidence of positive local GVH reaction was 66.7% among ginseng-treated mice, as opposed to incidence of 45.5% of positive local GVH reaction among control mice. The incidence of positive local GVH reaction of the lymph node cells when injected into a recipient was 71.4% among ginseng-treated mice as compared with that of 18.9% among control mice. The relationship between spleen cell inoculum and intensity of the local GVH reaction was assessed in ginseng-untreated mice. The intensity of GVH reaction clearly appears to be dose related. In ginseng-treated mice, a minimum of $1{\times}10^7$ spleen cell was required for production of positive local GVH reaction with almost linear relationship up to an inoculum of $5{\times}10^8$ cells. In control mice, however, a minimum of $1{\times}10^8$ spleen cells was required for positive GVH reaction. These results strongly suggest that the ginseng administration augments significantly the local xenogenic GVH reaction which was used to assess T lymphocyte function and immunocompetence of mice and in addition to this, these results appear to support previous suggestions that the local GVH reaction consitutes a qualitative test of the functional activity of T lymphocytes. These results may be the first to induce local GVH reaction, employing rats as recipient and mice as donor. This study was also desingned to investigate some of the effects of ginseng extract on lymphocyte-macrophage interactions. This was accomplished by in vitro quantification of 1) migratory inhibitory factor(MIF) synthetic capacity of splenic lymphocytes in mice previously primed with ginseng 2) MIF responsiveness of mouse peritoneal macrophages or chicken peripheral leucocytes under the presence of ginseng extract 3) migration ability of chicken peripheral leucocytes by direct stimulation of ginseng extract or ginseng saponin and 4) immunosuppressive effects of immunosuppressants such as cyclophosphamide, cyclosporin A or dexamethasone. Mice divided equally into the ginseng and the saline groups, which received intraperitoneally daily 0.2ml of ginseng absolute alcohol-extract(5mg/ml) and same amount of saline for 15 days, respectively. The cellular immune responsiveness of these mice was assayed 15 days after ginseng pretreatment. Splenic lymphocytes of mice treated with ginseng, when stimulated with sensitized specific-antigen such as sheep red blood cells or toxoplasmin, or with polyclonal activator concanavalin A, produced significantly more MIF than those of control saline group. MIF responsiveness of normal mouse macrophages was significantly augmented when assayed under the presence of ginseng extract (1mg/ml). The migratory ability of normal chicken leucocytes in the absence of MIF was significantly decreased by the stimulation of ginseng extract alone. MIF response was significantly decreased by immunosuppressants and this impaired response was not restored by ginseng pretreatment. This study was additionally performed to evaluate the effect of ginseng on the expulsion of adult Trichinella spiralis in mice. ICR mice were infected experimentally by esophageal incubation of 300 T. spiralis infective muscle larvae prepared by acid-pepsin digestion of infected mice. and received oral administration of 70% alcohol ginseng extract(10mg/mouse/day) for the indicated days plus 4 days before infection. At various times after infection, the number of adult T. spiralis worms in small intestines was determined. Interestingly, ginseng-treatment was accompanied by accelerated expulson of T. spiralis. These results led to the conclusion that Panax ginseng caused some enhancing effect on GVH reaction, macrophage migration inhibition reaction and expulsion of T. spiralis. In addition these results suggested that the mechanisms responsible for this enhancement of ginseng may be chiefly or partially due to nonspecific stimulation of cell-mediated immune response.

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Antioxidant activity and quality characteristics of black sesame gruel added with glutinous rice, glutinous brown rice and, glutinous black rice powder (찹쌀, 찹쌀현미, 찰흑미 가루를 첨가한 흑임자죽의 항산화활성 및 품질특성)

  • Park, Jung-Lee
    • Korean journal of food and cookery science
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    • v.29 no.5
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    • pp.581-590
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    • 2013
  • This study investigated the quality characteristics and antioxidant effects of black sesame gruel made with different concentrations of 15 minutes of treatment at $100^{\circ}C$ roasted black sesame. Total lignans showed the highest levels with 15 minutes of treatment at $100^{\circ}C$ roasted black sesame. With regard to lecithin's antioxidant effects, 15 minutes of treatment at $100^{\circ}C$ roasted black sesame showed a higher oxidation restriction rate. Hydroxyl radical scavenging, a similar scavenging activity to tocopherol, and a comparatively higher scavenging activity than sesamol, was shown with 15 minutes of treatment at $100^{\circ}C$ roasted black sesame and showed scavenging abilities of 90% and higher. For black sesame gruels, roasting can be used in a variety of ways in cooking in order to enhance functionality and preference. The most appropriate ratios of $100^{\circ}C$, 15minutes roasted black sesame in black sesame gruels, with regard to the overall quality characteristics, are as follows: The results of the sensory test showed that the overall preference was highest for glutinous rice-black sesame gruel, glutinous brown rice-black sesame gruel, and glutinous black rice-black sesame gruel, which were deemed best with 50% black sesame. From the above results, it could be seen that glutinous rice, glutinous brown rice, and glutinous black rice black sesame gruels, which are made by adding 50% roasted black sesame, contributed to enhancing the function of antioxidant activation and development quality.

Studies on the Desalinization and Improvement of Physical-chemical Characteristics of Saline and Alkali Soils by CHP Treatment (CHP에 의(依)한 간척지(干拓地) 토양(土壤)의 제염(除鹽) 및 이화학성질개량(理化學性質改良)에 관(關)한 시험연구(試驗硏究))

  • Lee, S.H.;Oh, J.S.;Im, C.N.
    • Applied Biological Chemistry
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    • v.8
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    • pp.65-73
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    • 1967
  • For the study of method for salt elimination aimed at reforming tidal land into normal paddy fields in a short period with reduction of periods requiring for elimination of saline, CHP (a kind of Ca-hum ate), a soil conditioner made of peat as a main material was tried. In the pot experiment, effect on elimination of salt, improvement of physical-chemical characteristics and rice cultivation test were studied. The results of these tests are as follows: 1, CHP treatment somewhat improves aggregation state with some effect on aggregation. 2. CHP treatment is remarkably effective in permeability which increases with 1.0 percent treatment by three times in percolation rate, and by 4.5 times in volume of leached water respectively. 3. With the increase of CHP amounts, salt was eliminated in short period. When 80% of the total Na was leached in 1.0% CHP-A treated pot, control pot begins permeable. 4. CEC and phosphorous absorption capacity are not influenced by CHP treatment. 5. Growing state of rice is greatly influenced by rainfalls. Growth of rice in tidal land however are almost similar to those in normal paddy fields with layer amounts of CHP treatment. With salt content in the soils, saline hazard and numbers of ineffective stems, amounts of unmatured grain are increased. 6. With the treatment of CHP yields of rough rice were increased. With 0.5% CHP treatment the yields were similar to those of the normal paddy fields. With 1.0% CHP-A treatment, the yields were increased by 15 times more than those of none treated soil and by 25 percent more than normal paddy soils.

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The Clinical Aspects of Regional Lymphadenitis following BCG Vaccination (BCG 접종 후 국소 림프절염의 임상양상)

  • Bae, Sun Young;Park, Yang Joon;Kim, Jong-Hyun;Oh, Jin Hee;Koh, Dae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.137-146
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    • 2006
  • Purpose : A regional lymphadenitis is the most frequent adverse reaction of BCG. In order to find out developmental factors and establish a strategy of management, we investigated the clinical courses of children with lymphadenitis following BCG on the aspect of BCG strains, suppurative rates according to the sizes of lymph node and the clinical difference with or without treatment. Methods : From January 1997 to June 2004, 52 children less than 24 month-age-old diagnosed as BCG lymphadenitis in Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea were enrolled. The type of BCG strain, place of vaccination, location and size of lymphadenitis were assessed with medical records, retrospectively. Finally, we analysed the correlations between BCG strains or the sizes of lymph node and natural remission or suppuration. Results : The first detected mean age of BCG lymphadenitis was 5.5 month-age. The larger of the measurement was at the first visiting, the younger of age that was first presented. The most frequent location was the same sided axillary region of BCG injection. Among 52 subjects, 46 cases(88.5%) were vaccinated with intradermal Pastuer strain, and only 5 cases(9.6%) were done with percutaneous multipunctured Tokyo strain. Twenty eight cases(53.8%) were regressed naturally, otherwise 24 cases(46.2%) were suppurated. The larger those were sized, the higher freqeuncies those were suppurated on, significantly. Treatment with medications could not prevent the suppuration and could not shorten the healing periods. Conclusion : We predict that there are differences between the occurrent rate of BCG lymphadenitis and BCG strains or methods. Treatment with medication is not recommended owing to its ineffectiveness. Especially, in case of non-suppurative lymphadenitis should be onlyless influence on the tuberculin skin test, cause less adverse reactions, and is inexpensive. observed without treatment, because it could be regressed naturally. An ideal BCG makes a scar, We should make an effort to choose the best BCG strain that can fulfill such requirements.

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Health Assessment of Shift Workers in a Automobile Manufacturing Plant (자동차공장 교대작업 근로자들의 건강상태평가)

  • Lee, Jung-Jeung;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.103-121
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    • 1995
  • An investigation on psychophysiological health and social well-being of shift workers been carried out on workers of a automobile manufacturing plant in Ulsan, for 1 month from April, 1993. This cross-sectional survey compared shift workers(n=544) with day workers(n=115). Each subject completed a questionnaire about his personal habit, background, shift schedule, sleep and eating patterns, subjective digestive symptom and psychological well-being and distress using the General Well-Being Schedule(GWB) by self administrated questionnaire that was developed for the U.S. Health and Nutrition Examination Surveys (HANES I). Chi-square analysis was used for discontinuous data and the t-test was used for continous data to determine whether differences noted between the two groups. In terms of sleep quality, a greater percentage of shift workers frequently had trouble getting back to sleep once awakend(p<0.01), and a greater percentage of shift workers awakend tired or sleepy frequently more often than day workers(p<0.05). In rating the quality of their sleep, more shift workers rated their sleep fair to poor than day workers, and greater percentage of shift workers felt tired or sleepy at work two or more times per week(p<0.01) and a much higher percentage of shift workers felt tired or sleepy after work every days(p<0.01). In terms of sleep patterns, a much higher percentage of day workers reported uninterrupted sleep per 24hours than shift workers. The shift workers reported different eating patterns from day workers but there were no statistically significant and rate of their appetite. Thirteen percent of day workers reported the best appetite but only 6.6% of shift workers had the best appetite. The gastric complaints is more frequent in shift workers than day workers(p<0.01). Among subscores in General Well-Being Schedule, anxiety, depression, positive well-being and vitality subscale of shift workers were lower than those of day workers(p<0.05) and general health and self control subscale of shift workers were lower than .those of day workers but there were no statistical significant difference. Based on these study result, it could be concluded that the shift work has significant effects on some psychophysiological conditions of the workers.

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