• Title/Summary/Keyword: Stress Function

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Lung Uptake of $^{99m}Tc-sestamibi$ during Routine Gated Exercise SPECT Imaging : Comparison with Left Ventricular Ejection Fraction and Severity of Perfusion Defect (일상적인 운동 부하 게이트 심근 관류 SPECT에서 $^{99m}Tc-sestamibi$ 폐섭취 : 좌심실 구혈률과 관류 결손 정도와의 비교)

  • Jeong, Shin-Young;Lee, Jae-Tae;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.83-93
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    • 2003
  • Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

Difference of the Heart Rate Variability According to the Social Support Level in a County (일 군 주민에서 사회적 지지의 수준에 따른 심박변이도의 차이)

  • Shin, Yoo-Shup;Byun, Ji-Sang;Kim, Seok-Hyeon;Shin, Jin-Ho;Choi, Bo-Youl;Nam, Jung-Hyun;Oh, Dong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.59-65
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    • 2012
  • Objectives : The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. Methods : We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. Results : The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). Conclusion : According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.

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Effects of the Exercise Training on Aging Heart in Rat I. Long Term Endurance Exercise (운동훈련이 흰쥐 노화심근에 미치는 영향 I. 장기간 지구력 운동 훈련)

  • 박원학;이상선;이용덕
    • Biomedical Science Letters
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    • v.2 no.1
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    • pp.71-90
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    • 1996
  • There is considerable current interest in the effect of regular vigorous exercise and in particular endurance-running as a possible measure in improving myocardial function. Some data indicate that the aging heart may actually suffer from vigorous endurance exercise. On the contrary appropriate exercise in aged animals improves myocardial function and aerobic energy metabolism. So far there is relatively little data to indicate that endurance exercise is in fact beneficial in improving myocardial function or damaging to heart of aged animals. The present investigation aimed to study the possible effect of a long range treadmill training program on the heart in aging rats. Male rats aged 3, 10, and 20 months were divided at random into a control (sedentary) and an exercise group. The training group was exercised for 5 days a week on an automated treadmill for 20minutes at 18m/min over a period of 5 months. The exercise regimen of our experiments did not cause any significant changes in the tissues and ultrastructural as com-pared with sedentary age-matched control. Tissues and ultrastructures of myocardial cells in trained group aged 8 months are intact and well organized as well as sedentary control group. Age associated tissue and ultrastructural changes of trained group aged 15 months included : an increase in transformed mitochondria, vacuoles, lysosomes, lipid droplets and early lipofuscin. But the trained heart did not show significant difference in tissue and ultrastructural properties from those of sedentary controls. Endurance-trained group aged 25 months showed significant qualitative tissue and ultrastructural difference as compared with age-matched controls. In addition to those found in 25 months control group, focal necrosis, myofibril fraying, hypercontraction band, seperation of intercalated discs, degenerating nucleus and infiltration of collagenous fiber into myocyte were noted in trained 25 months group. The stereological examination of the mi-crographs disclosed no significant difference in the myoflbril, mitochondrion, sarcotubule and in-terstitium volume density and surface density of mitochondrial cristae and numerical density of mitochondria between trained and control group aged 8 and 15 months. In the trained 25 months group, significant increase in volume density of interstitium, lipofucsin granule were shown as compared to untrained age-matched control. On the other hand, significant decrease in mitochondrion volume density was shown. The myofibril volume density did not differ between trained and control group although trained group showed slight increase. From the data obtained a reduced mitochondria/myofibrils ratio was found in trained rat heart aged 25 months and there was no difference between trained and control rat aged 15 months. But a slight but not significant increase was found in the trained group aged 8 months as compared with same age control group. Such increase in the ratio in young animals is considered to be of great importance to cardiac pumping and adaptability. Whereas such adaptations don't seem to occur in aged heart muscle. This study proposed that repeated endurance exercise do not cause any significant qualitative and quantitative ultrastructural change of heart muscle in young(3months) and adult (10months) suggesting that the heart is able to adapt to the exercise. On the contrary, the repeated endurance exercise stress may actually induce degenerative changes in the aged heart muscle(20months).

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Difference of Time Course of Functional Recovery after Revascularization According to Preoperative Reversibility of Perfusion Impairment in Ischemic Myocardial Dysfunction (허혈성 심근 기능장애에서 술전 관류결손의 가역성에 따른 재관류 시술 이후 심근 기능회복 양상의 시간적 차이)

  • Paeng, Jin-Chul;Lee, Dong-Soo;Kim, Ki-Bong;Kim, Yu-Kyeong;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.364-370
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    • 2001
  • Purpose: In the revascuarization of ischemic dysfunctional myocardium, stunned myocardium was reported to recover function earlier than hibernating myocardium. It was also suggested that stunning and hibernation could be discriminated by reversibility of perfusion impairment on myocardial SPECT. In this study, we investigated the time course of functional recover after CABG according to reversibility of perfusion impairment. Materials and Methods: In 92 patients with coronary artery disease, Tl-201 rest/dipyridamole stress Tc-99m-MIBI gated SPECT was performed before, 3 months after, and 17 months after CABG. Using a 20-segment model, segmental perfusion and systolic thickening were automatically quantified. Perfusion-impaired segments with abnormal thickening were classified by reversibility into reversible (REV) and irreversible (IRREV) groups. The proportions of function-recovered segments were compared between groups and also between 3 months and 17 months in each group. Results: A total of 129 segments were Included In the analysis, and 76 were REV and 53 were IRREV. At 3 months after CABG, 61 segments (80%) in REV group showed functional recovery while 28 segments (53%) in IRREV group did (p<0.001). However, at 17 months after CABG, 60 segments (79%) in REV group and 37 segments (70%) un IRREV group showed functional recovery (p=n.s.). When comparing 3 months and 17 months in each group, REV group showed no difference, while IRREV group showed significant further improvement (p<0.05). Conclusion: In viable myocardium with ischemic myocardial dysfunction, the segments with reversible perfusion impairment recover function earlier after revascularization than irreversible segments.

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A study about art theory of Yeoncheon Hong Seok-joo - Focused on difference with Jeong Yak-yong丁若鏞 (연천 홍석주의 예술론(藝術論)에 대한 일고찰 - 정약용(丁若鏞)과의 차이점을 중심으로 -)

  • Yoon, Jong-il
    • (The)Study of the Eastern Classic
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    • no.55
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    • pp.223-264
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    • 2014
  • Yeoncheon Hong Seok-joo(淵泉 洪奭周: 1774-1842) faithfully followed a policy of restoration of literary style of king Jeongjo. He was an young vassal after 1794 and influenced by Jeongjo because Yeoncheon was around the king. Furthermore, he had comparatively favorable working period as a vassal(仕宦期, 1795-1836) after death of Jeongjo(1800) while establishing his own academic viewpoint. Therefore, a study about art theory of Yeoncheon Hong Seok-joo is one about logical system to accept various desires for change of then while not getting rid of scope of Neo-Confucianism after Jeongjo. It is catched that exchange of Hong Seok-joo and Jeong Yak-yong was made relating to study of Sangseo. Hong Seok-joo and Jeong Yak-yong absorbed in study of Sangseo, which is come from putting importance on 6 scriptures (經) among studies of scriptures by both of them. Through this, they aimed to re-discover ideology of original Confucian studies as one for cultivating oneself and governing people (修己治人之學). Dasan and Yeoncheon have something in common that they were young vassals who were cultivated as a guarding power for Jeongjo centered on Gyujanggak. They were largely fit to view of literature(文體觀) of Jeongjo. Hong Seok-joo distinguished function of prose(文) and poetry(詩) into teaching moral(明敎) and moving people(感人) in the category of Mun-yi-jae-do(文以載道) based on thoughts of 'literature is linguistic device for Taoism '(道本文末)' which is a core concept of literature theory based on Neo-Confucianism. He gave a careful attention on instructional and social function in prose while on emotional understanding that puts importance on temper and the secrets of nature in poetry. Hong Seok-joo regarded moral impression and edification through this as a core of artistic creation based on Segyoseol(世敎說). Furthermore, expressions such as 'Heunggwangunwon(興觀群怨)' or 'Yeohangguyo(閭巷謳謠) which are mentioned as important elements in his artistic works put importance on actual existence of objective things in artistic activity and this is connected to an attitude to require description fit to fact. So, it is assumed that such expression style aimed for features of genre painting in painting arts. Understanding of the study of ancient documents by Yeoncheon developed from critical perspective. He criticized the study of ancient documents, saying it as first, Pasoijisul(破碎之術), second, Dotaekjisul(塗澤之術), third, Hoimojisul(毁侮之術). Jeong Yak-yong criticized ' theory on the Odes' from viewpoint of theory of Mun-yi-jae-do(文以載道) based on Neo-Confucianism. He stressed political and social function of Sipeon and general poetry in "the Odes" and reinterprets discourses about poetry of Zhu Xi based on his own opinion. He says that poems of national fashion do political and social criticism. The theory of national fashion by Jeong Yak-yong clearly discloses his thoughts that stress practical role of noblemen in the social and political context.

A Study on the Function of Oral Medicine as the Secondary Clinic Based on Analysis on Admissive Channel and Case Features (내원경위 분석과 환자 특성 평가에 따른 2차 진료기관으로서 구강내과 역할에 대한 연구)

  • Lee, You-Mee;Lee, Jung-Hyun;Lim, Hyun-Dae
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.199-210
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    • 2006
  • The epidemiological researches on the inpatients hospitalized at the oral medicine ward have been continuously carried out since 1970, and most researches have been performed by centering around the oral medicine wards of college hospitals. Numerous specialists have been produced after the establishment of oral medicine, and they have been active in various fields. As dental clinics have gotten bigger, the function of oral medicine in the secondary clinics is being brought out. As admissive channel, case features, case composition and otherwise have not been researched for a long time, the related researches should be carried out from now on. Hereupon, this study was carried out by targeting the 100 inpatients hospitalized at the oral medicine ward of Sun Hospital located in Daejeon Korea, through questionnaire. As the result, the following results were derived. 1. The ages of the inpatients in Sun Hospital were $29.21{\pm}11.31$ on the average; 71 females' mean average was $29.63{\pm}11.29$ and 29 males' mean average was $28.17{\pm}11.48$. In regard of school career, the patients who finished high-school course or higher accounted for 78%; the patients' school career seemed to be relatively high. The patients who complained of temporomandibular pain accounted for the highest proportion with 65%. In motivation to visit this hospital, internet surfing was 11%, mass media was 10%, acquaintance's introduction was 38%. The patients, who were hospitalized at another hospital due to the same symptom, accounted for 56%. The dental clinics, which made the patients visit this hospital, accounted for 20%. The patients, who were previously aware that the present symptom should be treated by oral medicine, accounted for 38%. The patients, who were not aware of the fact in advance, were 62%. The respondents of 51% answered that they were aware of the fact one month or below before hospitalization. 2. The patients, who complained of craniocervical ache, accounted for 58%; the patients, whose ache aches affect dailylife, were 22%. Continuous ache was 14% and intermittent ache was 68%, and dull pain was 23%. 3. Life variations were compared with each other by using SRRS (Social Readjustment Rating Scale). In consequence, the variation within 3 years indicated a significant difference in the both groups but the variation within 6 months did not indicate any differences. 4. In regard of the questionnaire on the incidents happened for a week, the ache-group was compared with the group free from the ache. As the result, the number of strain arisen for a week, the decrease of favorite works and sudden fear indicated a significant difference. Pleasant feeling and the decrease of interests in looks did not indicate a significant difference, but came close to the significance. 5. In the questionnaire on impatience, the ache-group indicated higher value but there was not a significant difference. 6. In the questionnaire on the symptoms caused by stress, the two groups indicated significant differences in the item of 'the teethridge itches and feels a tooth rising' and 'the occiput or the nape is stiff.' In the item 'the inside of the cheek or the teethridge are widely peeled off, accompanied with ache and hemorrhage', 'the face has acne or pimple' and 'headache frequently attacks', a significant difference was not observed but the two groups came close to the significance.

Optimum Design of Steel-Deck System for Two-Story Roads (2층도로용 강구조 덱 시스템의 최적설계)

  • Cho, Hyo Nam;Min, Dae Hong;Kim, Hyun Woo
    • Journal of Korean Society of Steel Construction
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    • v.10 no.3 s.36
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    • pp.553-564
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    • 1998
  • Recently, more and more steel-deck structural system for two story roads has been adopted as a solution against traffic congestion in urban area, mainly because of fast construction, reduced self-weight, higher stiffness and efficient erection compared to that of concrete decks. The main objective is to study on the unit-elective optimal type and proportioning of a rational steel-deck system for two story roads using an optimum design program specifically developed for steel-deck systems. The objective function for the optimization is formulated as a minimum cost design problem. The behavior and design constraints are formulated based on the ASD(Allowable Stress Design) criteria of the Korean Bridge Design Code. The optimum design program developed in this study consists of two steps - the first step for the optimization of the steel box or plate girder viaducts, and the second step for the optimum design of the steel-decks with closed or open ribs. A grid model is used as a structural analysis model for the optimization of the main girder system, while the analysis of the deck system is based on the Pelican-Esslinger method. The SQP(Sequential Quadratic Programming) is used as the optimization technique for the constrained optimization problem. By using a set of application examples, the rational type related to the optimized steel-deck system designs is investigated by comparing the cost effectiveness of each type. Based on the results of the investigation it may be concluded that the optimal linear box girder and deck system with closed ribs may be utilized as one of the most rational and economical viaducts in the construction of two-story roads.

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Effect of Galacto-mannan-oligosaccharides or Chitosan Supplementation on Cytoimmunity and Humoral Immunity in Early-weaned Piglets

  • Yin, Y.-L.;Tang, Z.R.;Sun, Z.H.;Liu, Z.Q.;Li, T.J.;Huang, R.L.;Ruan, Z.;Deng, Z.Y.;Gao, B.;Chen, L.X.;Wu, G.Y.;Kim, S.W.
    • Asian-Australasian Journal of Animal Sciences
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    • v.21 no.5
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    • pp.723-731
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    • 2008
  • Immunomodulatory feed additives might offer alternatives to antimicrobial growth promoters in pig production. This experiment was designed to determine the effects of dietary galacto-mannan-oligosaccharide (GMOS) and chitosan oligosaccharide (COS) supplementation on the immune response in early-weaned piglets. Forty 15-day-old piglets (Duroc$\times$Landrace$\times$Yorkshire) with an average live body weight of $5.6{\pm}0.51kg$ were weaned and randomly assigned to 4 treatment groups that were fed maize-soybean meal diets containing either basal, 110 mg/kg of lincomycin, 250 mg/kg of COS or 0.2% GMOS, respectively, over a 2-week period. Another six piglets of the same age were sacrificed on the same day at the beginning of the study for sampling, in order to obtain baseline values. Interleukin (IL)-1${\beta}$gene expression in peripheral blood monocytes, jejunal mucosa and lymph nodes, as well as serum levels of IL-1${\beta}$ IL-2 and IL-6, IgA, IgG, and IgM, were evaluated for 5 pigs from each group at 15 and 28 days of age. The results indicate that weaning stress resulted in decreases in serum antibody and cytokine levels. Dietary supplementation with GMOS or COS enhanced (p<0.05) IL-1${\beta}$gene expression in jejunal mucosa and lymph nodes, as well as serum levels of IL-1${\beta}$ IL-2, IL-6, IgA, IgG and IgM compared to supplementation with lincomycin. These findings suggest that GMOS or COS may enhance the cell-mediated immune response in early-weaned piglets by modulating the production of cytokines and antibodies, which shows that GMOS or COS have different effects than the antibiotic on animal growth and health.

The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Pre-Exercise Protective Effects Against Renal Ischemic Reperfusion Injury in Hsp 70.1 Knockout Mice (Hsp70.1유전자결핍된 마우스에서 허혈 재관류 신장손상에 대한 전처치 운동의 보호효과)

  • Lee, Jin;Kim, Won-Kyu
    • Journal of Life Science
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    • v.20 no.4
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    • pp.555-560
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    • 2010
  • The objective of this study was to investigate levels of serum creatinine, CuSOD and MnSOD protein expression in the kidney after renal ischemic reperfusion with pre-exercise using heat shock protein 70.1 in knock-out mice (KO). The C57/BL6 strain (Wild type: WT) and KO were divided into 4 groups as follows: Sham control group (Sham), pre-exercise group (Ex), pre-exercise +ischemia group (Ex+IR), and ischemia group (IR). CuSOD and MnSOD expression were significantly decreased (p<0.01, p<0.05) and blood creatinine concentration was significantly increased (p<0.01) in the IR group of KO. In contrast, CuSOD and MnSOD expression in the Ex+IR group of KO were higher than the IR group, while creatinine concentration was significantly lower. These results suggest that Hsp70 is directly correlated to renal ischemic reperfusion injury. Pre-exercise in renal ischemia might prevent or inhibit positive oxidative stress inhibitory effects by increasing anti-oxidative enzymes (CuSOD, MnSOD) within the kidney and improve to prevent renal function. Thus, pre-exercise may have a protective role against renal injury after renal ischemia.