• Title/Summary/Keyword: analysis of correlation

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A Study and Investigation for the Attitude about Smoking of Boys' and Girls' High School in Seoul (서울시내 남녀고교생의 흡연에 관한 태도 조사연구)

  • Sim Young Ae
    • Journal of Korean Public Health Nursing
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    • v.3 no.1
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    • pp.74-100
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    • 1989
  • Inspite of the lots of studies on the harmfulness of cigarette smoking to the body published by many researchers since 1950, cigarette smoking people are increasing in number especially, cigarette smoking by young and women causes a serious problem. Examining the physiological motives of youth shows that, impulse which the youth want to immitate the adults, alluring curiousity, and defiant physiology of escaping from the norm of traditional groups which has been banned are cooperated well compoundly. As the period of the youth is the one which they accumulate knowledge and charactor by learning as well as the period of growth mentally, and physically they should be rightly educated about smoking before they addicted to smoking and it is desirable for us to make the youth to understand how harmfully the smoking is to effect to their growth and mental soundness simply not as a social norm which they should not smoke. The main motive of this study on the attitude of smoking by the youth is to give basic materials related on this field. For this study, 647 questionnaires were used as studying material which were able to analyze among 720 questionnaires of 2 classes of each grade of 3 high schools among the high schools of boys, girls and co-educated in Seoul from Oct. 21, 1988 through Oct. 26, 1988. Study Instrument are graded in Likert's 5 point from 40 questions which are 20 questions m affirmations and 20 questions in negations after analyzing the factors on 60 simple sentence questions which the students showed in preliminary studies. And these are systemized to be measured from 1 point which means they think smoking IS very bad to 5points which means they think smoking is really good. In these collected materials, technical statistics of frequency. percentage, average, standard deviation are used for general character and smoking attitude, $X^2-test$ for examinning Independant variables of physical. emotional, ethical and other areas pearson's coefficient of correlation for related direction and degree" and step­regression analysis for the degree of relative contribution of all variables which effect smoking attitude. The results of this study are as follows; 1. The smoking attitude of high school boys and girls showed average of 1.78 in physical area, 2.63 in emotional area, 2.61 in ethical area, 2.29 in other area respectively in a negative attitude generally also the negative attitude are expressed most strongly in physical area. I've can also say by this results that smoking is harmful to their health and further more it can be judged that this proves the youth in the period of preparation be adults have a strong curiousity in the emotional, ethical and other areas. 2. The most influential variables in each field as related factors effecting smoking attitude of the student can be explained from 13.2 in physical area the lowest experienced variables to 25.2 in emotional area the highest of degree of smoking experience. The fact that the more the smoking experienced students are increasing in number the higher tendency which accept the' smoking tells as the importance of health education about the population of latest student's smoking as important variables shown equally in each area. Those of grade, age, numbers of smoking people in house are showed meaningful in pure interrelation. Those related to the acceptance of teacher's smoking, sex, mothors education are shown meaningful in opposite interrelations. This means that the' increasing number' of smoking people in grade age, the number of smoker in family have a affirmative attitude. And people who are not interested in teacher's smoking wants to quit it, and whose mother's education is higher have a negative attitude. 3. The most negatively answered questions of the smoking attitude In physical, emotional, ethical and other areas are as belows; Firstly too much smoking is harmful to our health is 1.12 point. Secondly smoking have a ill-effect on pregnancy and embryo is 1.13 point. Thirdly smoking is harmful· to our health is 1.27 point. Fourthly smoking in crowed area with the people such as In a bus or subway should be prohibited is 1.27point. Fifthly smoking can ruin lungs is 1.31 point. And the most affirmatively answered questions are also as below; Firstly we showed smoke depending on time and place is 3.96 points. Secondly smoking is just habit is 3.83 points. Thirdly smoking people seem to be unable and deplorable is 3.69 point. Fourthly smoking should be prohibited by law is 3.56 points. Fifthly high school student's smoking is immitation of adults is 3.52 points.

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Analysis of Antibodies Cross-reactive with Pressate Extract Antigen from Mycobacterium tuberculosis and Other 3 Species Mycobacteria in Sera of Patients with Pulmonary Tuberculosis (결핵균 및 기타 3종 Mycobacteria의 파쇄추출항원과 교차반응하는 폐결핵환자의 항체분석)

  • Cho, Myung-Je;Hwang, Eung-Soo;Kook, Yoon-Hoh;Kim, Ik-Sang;Lee, Seoung-Hoon;Cha, Chang-Yong;Shim, Young-Soo;Han, Yong-Chol;Bae, Gill-Han;Kim, Sang-Jae
    • The Journal of the Korean Society for Microbiology
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    • v.20 no.1
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    • pp.79-89
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    • 1985
  • It is important to discriminate between tuberculosis and tuberculosis-like disease by Mycobacteria other than tuberculosis in the serodiagnosis of tuberculosis. But because common antigens share among Mycobacteria, their antigenicities to human are similar. Therefore degree of cross-reactivity of antibody in the sera of patients with tuberculosis between M. tuberculosis and Mycobacteria other than tuberculosis should be checked to increase the specificity in the serodiagnosis of tuberculosis. The activity levels of IgG antibody in the sera of 106 patients confirmed as active pulmonary tuberculosis and 30 normal healthy control person to the pressate extract antigen (TE, BE, AE, and FE antigen) from M. tuberculosis, M. bovis, M. avium, and M. fortuitum were measured by enzyme-linked immunosorbent assay and the crossreactivity of IgG antibody with mycobacterial species was analysed. The results were as follows; 1. The activity level(O.D. at 492nm) of IgG to TE antigen in sera of patients with pulmonary tuberculosis was $0.228{\pm}0.167$ in minimal tuberculosis; moderately advanced, $0.556{\pm}0.616$; far advanced, $1.116{\pm}0.651$ and $0.315{\pm}0.245$ in miliary tuberculosis. 2. The activity level (O.D. at 492nm) of IgG to BE antigen in sera of patients with pulmonary tuberculosis was $0.190{\pm}0.162$ in minimal tuberculosis; moderately advanced, $0.337{\pm}0.361$; far advanced, $0.713[\pm}0.460$ and $0.204{\pm}0.162$ in miliary tuberculosis. 3. The activity level (O.D. at 492nm) of IgG to AE antigen in sera of patients with pulmonary tuberculosis was $0.165{\pm}0.114$ in minimal tuberculosis; moderately advanced, $0.392{\pm}0.494$; far advenced, $0.751{\pm}0.512$ and $0.233{\pm}0.191$ in miliary tuberculosis. 4. The activity level (O.D. at 492nm) of IgG to FE antigen in sera of patients with pulmonary tuberculosis was $0.280{\pm}0.227$ in minimal tuberculosis; moderately advanced, $0.460{\pm}0.564$ ; far advanced, $0.845{\pm}0.573$ and $0.257{\pm}0.103$ in miliary tuberculosis. 5. The activity level (O.D. at 492nm) of IgG in sera of healthy control person was $0.126{\pm}0.084$ to TE antigen. $0.105{\pm}0.041$ to BE antigen, $0.103{\pm}0.052$ to AE antigen, and $0.095{\pm}0.061$ to FE antigen. 6. Degree of correlation(r) in activity level of IgG between TE antigen and BE antigen was 0.905 ; between TE antigen and AE antigen, 0.760; between TE antigen and FE antigen, 0.790, and between AE antigen and FE antigen, 0.945. 7. As O.D. above 0.200 was determined positive for the serodiagnosis of pulmonary tuberculosis, the sensitivity and specificity in ELISA using TE antigen were 80% and 87% respectively, whereas in the case of using BE antigen, 66% and 100%; in the case of using AE antigen, 62% and 100%, and in the case of using FE antigen, 72% and 93%, respecitively.

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The Characteristics of Heavy Metal Contamination in Tailings and Soils in the Vicinity of the Palbong Mine, Korea (팔봉광산 선광광미와 주변토양의 중금속 오염 특성)

  • 이영엽;정재일;권영호
    • Economic and Environmental Geology
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    • v.34 no.3
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    • pp.271-281
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    • 2001
  • The characteristics of the heavy metal contamination in the soils affected by the tailings of the Palbong mine have been studied. The soils in the studied area consist mostly of loam by the particle size analysis, but a little of it, located near the stream, consist of loamy sand to sandy loam, finally to loam downward. The organic contents of soils are significantly low aoom 2 percent and the pH is in acidic ranging 6.0 $\pm$ 0.1. The samples of the parent rocks, the normal soils, the tailings and the channel deposits from the studied area were chemically analysed. From the result, the heavy metal concenlration of the soils is a little Jow compared with that of the parent rocks, shows the hydrologic process of the surface and the groundwater. The contamination of the tailings from the ore mining are high in lead, copper and arsenic. In the channel deposits the concenlrations of lead and copper are abnormally high but that of arsenic is uniquely low. And most of heavy metal contamination are decreased with the distance from the mine. It is caused by the properties of the surface and the ground water during the process of the heavy metal migration. The correlation-coefficient between sand and silt contents and the concentrations of Cd, Cu and Pb are significant but the amounts of As and Hg are increased with the clay contents. The dispersion of the heavy metals with the distance shows that the concentrations of them in the soils sampled at distance of 100 m to 200 m along the stream started near the Palbong mine are extremely high compared with those from other distances. These discrepancies are significant in Cd, Cu, Pb and Hg, but low in As. All the samples contain below detection limit of Cr+6 In the present stream water the concentrations of the heavy metals are not detected. So, it is interpreted that the concentrations in the soils are caused by the activities of the mining during the operation and have been continued by the dispersion from the tailings since after the closure of the mining, especially by the surface and ground water. The concentrations are diminished with the distance from the mining site, but in the interval of 800-2000 m increases abruptly. In the soil samples counted on the dispersion direction by wind, the lowering of the concentration is relatively uniform with the distance from the mining site. So, the rapid increase of the heavy metal concentrations is presumed to have been caused by the ground-water movement. In the migration of the heavy metals, the groundwater conditions, such as pH, Eh, the contents of colloidal particles, and Mn and Fe oxides are closely involveo. Integrating with these factors, it is interpreted that the groundwater conditions which have caused the heavy metal contamination of the studied area are those that the pH is about 3 in oxidized conditions, the contents of the colloidal particles are low, and Mn and Fe oxides are not involved in the migration of the heavy metals. Meanwhile, the vegetables growing on the soils in the studied area are not affected by the contamination of the heavy metals.

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Comparative Study on Acoustic Characteristics of Vocal Fold Paralysis and Benign Mucosal Disorders of Vocal Fold (성대마비와 양성 성대점막질환의 음향학적 특성비교)

  • Kong, Il-Seung;Cho, Young-Ju;Lee, Myung-Hee;Kim, Jong-Seung;Yang, Yun-Su;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.122-128
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    • 2007
  • This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

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The Associated Factors with Xerostomia in Adults Aged 30 Years and Over (일부 만 30세 이상 성인에서 구강건조증 관련요인 분석)

  • Han, Hae-Seong;Kwon, Da-Ae;Kim, Ri-Na;Kim, Yu-Na;Lee, Gyeol-Hui;Lee, Na-Ram;Lee, Da-Jeong;Lee, Seung-Hui;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.62-70
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    • 2013
  • The aim of this study was to analyze factors related to xerostomia in adults aged 30 years and over. The data were analyzed using the t-test, one-way ANOVA and multiple linear regression analysis in the SPSS version 12.0 program. The results were as follow. 1. The respondents who were older than 51 years old, unemployed and had less than 3 million won of average monthly income were more aware of xerostomia (p<0.05). 2. The respondents who answered poor and moderate for their general and oral health and the group with duplicate medication and comorbidity were more aware of xerostomia (p<0.05). 3. The respondents that had problems in chewing, communication, ordinary activities and complained of pain discomfort and suffered from anxiety depression were more aware of xerostomia (p<0.001). 4. The respondents that answered frequent dryness on their skin, eyes, lips, and nasal mucosa were more aware of xerostomia (p<0.001). 5. Xerostomia showed highest correlation with quality of life ($\beta$=0.436) followed by the number of medications ($\beta$=0.239), sense of entire body dryness ($\beta$=0.200), feeling of hopelessness ($\beta$=0.160) and number of oral mucosa disease symptoms ($\beta$=0.099) (p<0.05). According to the results of the study, xerostomia may cause deterioration in quality of life. Thus, it is advised to improve the patient management system among dental professions to prevent various complications caused by xerostomia and conduct regular health education on the cause and management method of xerostomia.

Evaluation of Neoadjuvant Chemotherapy Effect in Osteosarcoma (골육종에서 술전 항암화학요법의 효과 판정)

  • Joo, Min Wook;Kang, Yong-Koo;Yoo, Ie Ryung;Choi, Woo Hee;Chung, Yang-Guk;Kim, Dong-Hyun;Kang, Jin-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.66-73
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    • 2014
  • Purpose: Various diagnostic imaging modalities have been used to evaluate the effect of neoadjuvant chemotherapy for osteosarcoma early and noninvasively. We evaluated the effectiveness of imaging studies of plain radiographs and positron-emission tomography/computed tomography (PET/CT) in predicting neoadjuvant chemotherapy effect for osteosarcoma and tried to establish a general principle in interpretation of PET/CT parameters. Materials and Methods: Eighteen patients who underwent two cycles of neoadjuvant chemotherapy and surgical excision for osteosarcoma were enrolled. There were 13 males and 5 females, with a median age of 19 (11-63) years. Fifteen patients of 18 had the American Joint Committe on Cancer (AJCC) stage IIB. They had plain radiographs and PET/CT before and after neoadjuvant chemotherapy. The resected tumor specimens were pathologically examined to determine histological response grade using a conventional mapping method. Statistical analysis was performed to evaluate the correlation between histopathological necrosis rate, and radiographic finding category, post-chemotherapy maximum standardized uptake value (SUVmax), average standardized uptake value and metabolic tumor volume (MTV) as well as reduction rates of them. Results: Eight patients were good responders to neoadjuvant chemotherapy based on histological evaluation. Median SUVmax reduction rate was 73 (23-77) % in good responders and 42 (-32-76) % in poor responders. Median MTV reduction rate was 93.5 (62-99) % in good responders and 46 (-81-100) % in poor responders. While radiographic finding category was not different according to histological response (p=1.0), SUVmax reduction rate was significantly different (p=0.041). Difference in MTV reduction rates approached statistical significance as well (p=0.071). Conclusion: While radiographic finding category was not reliable to assess neoadjuvant chemotherapy effect for osteosarcoma, reduction rate of SUVmax was a useful indicator in this study. As parameters of PET/CT can be influenced by various factors of settings, different centers have to make an effort to establish their own standard of judgement with reference of previous studies.

FAMILY DYNAMICS OF INCEST PERCEIVED BY ADOLESECENTS (청소년이 지각한 근친상간의 가족역동)

  • Kim, Hun-Soo;Shin, Hwa-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.56-64
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    • 1995
  • Family is a primary unit of the major socialization processing for children. Parents among the family members are one of the most important figures from whom the child and adolescent acquire a wide variety of behavior patterns, attitudes, values and norms. An organization of family members product family structural functioning. Abnormal family structure is one of the most important reference models in the learning of antisocial patterns of behavior. Therefore incest and child sexual abuse including spouse abuse, elderly abuse, and neglect occurs in the abnormal family structural setting. In particular, incest, a specific form of sexual abuse, was once thought to be a phenomenon of great rarity, but our clinical experiences, especially over the past decade, have made us aware that incest and child sexual abuse is not rare case and on the increasing trend. Therefore, the aim of this study was to determine the family problem and dynamics of incest family, and character pattern of post-incest adolescent victim in Korea. A total of 1,838 adolescents from middle and high school(1,237) and juvenile correctional institute(601) were studied, sampled from Korean student population and adolescent delinquent population confined in juvenile correctional institutes, using proportional stratified random sampling method. The subjects' ages ranged from 12 to 21 years. Data were collected through questionnaire survey. Data analysis was done by IBM PC of Behavior Science Center at the Korea university, using SAS program. Statistical methods employed were Chi-square, principal component analysis and t-test etc. The results of this study were as follows ; 1) Of 1,071 subjects, 40(3.7%) reported incest experiences(sibling incest : 1.6% ; another type of incest : 2.1%) in their family setting. 2) The character pattern of post-incest adolescent victim was more socially maladjusted, immature, impulsive, rigid, anxious and dependent than non-incest adolescent. Also they showed some problem in academic performance and their assertiveness. 3) The other family members of incest family revealed more psychological and behavioral problem such as depression, alcoholism, psychotic disorder and criminal act than the non-incest family, even though there is no evidence of the context between them. 4) The family dynamics of incest family tended to be dysfunctional trend, as compared with non-incest family. It showed that the psychological instability of family member, parental rejection toward their children, coldness and indifference among family member and marital discordance between the parents had significant correlation with incest.

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Polysomnographic Characteristics and Prescription Status of Restless Legs Syndrome Patients in Naturalistic Setting (임상현장에서 하지불안증후군 환자의 수면다원검사결과의 특징과 약물처방현황)

  • Kang, Seung-Gul;Nam, Ji-Hye;Kim, Hana;Shin, Hong Beom
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.35-40
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    • 2013
  • Objectives: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. Methods: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. Results: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was $46.9{\pm}14.2$. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. Conclusions: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.

Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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