• The Korean Journal of Nuclear Medicine
• /
• v.33 no.3
• /
• pp.247-261
• /
• 1999

Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO, Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age $40.3{\pm}24.9$ years, range 4 to 82 years) were underwent rost/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in (rental, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018, rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was $29.9{\pm}12.9%$. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.1
• /
• pp.625-636
• /
• 2017

Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardio-cerebrovascular disease (CVD). Although the prevalence of dyslipidemia among Korean adults is very high, its management is known to be poor. The aim of this study was to assess the prevalence, awareness, treatment, and control rates of dyslipidemia among adults aged 30 years and older in Gangwon-do, Korea. Analysis included 58,121 adults (29,123 males and 28,998 females) participating in the 2013-2014 Korea National Health Screening Program (KNHSP). Dyslipidemia was defined according to the treatment criteria rather than the diagnostic criteria in Korea. Therefore, high-low-density lipoprotein cholesterol (LDL)-cholesterolemia was deemed present in individuals with LDL-cholesterol levels that exceeded the appropriate risk-based threshold. The age-standardized prevalence was highest in dyslipidemia (32.5%), followed by hypertension (25.1%), and diabetes (9.4%). The awareness rate was 76.7% for hypertension and 74.7% for diabetes, but only 10.6% for dyslipidemia. The lowest patient treatment was found for dyslipidemia (9.4%). The control rate among those undergoing treatment was highest for hypertension (75.8), followed by dyslipidemia (63.3%), and diabetes (43.9%). The higher CVD-risk categories showed lower control rates of hyper-LDL-cholesterolemia. The prevalence of dyslipidemia was higher than hypertension and diabetes, but awareness and treatment rates were lower. Our findings indicate there is a wide gap between the prevalence of dyslipidemia and subsequent treatment, which suggests that effective strategies are required to improve dyslipidemia management. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the KNHSP, especially for the high risk group of CVD.

• The Korean Journal of Nuclear Medicine
• /
• v.37 no.2
• /
• pp.94-102
• /
• 2003

Purpose : Cerebral blood flow (CBF) reactivity to acetazolamide (ACZ) is useful to select patients with hemodynamic failure. However, it is still a matter of speculation that varying degrees of regional CBF increases after ACZ administration represent the severity or stage of regional hemodynamic failure as assessed by positron emission tomography (PET). We studied to elucidate whether ACZ challenge $^{123}I-IMP$ brain single photon emission tomography (SPECT) can accurately grade the seventy of regional hemodynamic failure. Materials and Methods: Eighteen patients (M: 16, F: 2, average age: 61 years) with unilateral occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA). Patients undewent $^{123}I-IMP$ brain SPECT study with acetazolamide challenge and PET study was carried out within 2 weeks before and after SPECT study. Five healthy volunteers with a mean age of 48 years (range: 28-73 yr, M: 3, F: 2) underwent PET studies to determine normal values. In SPECT study, an asymmetry index (Al)-the percentage of radioactivity of region of interest (ROI) in the occlusive cerebrovascular lesion to the contralateral homologous ROI-was used for numerical evaluation of relative $^{123}I-IMP$ distribution. In PET study, regional CBF, oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen ($CMRO_2$) and cerebral blood volume (CBV) values were measured with $^{15}O-labeled$ gas inhalation method and the values were used for comparison with Al (Al during acetazolamide challenge-Al of basal study) on the SPECT study. ROls were classified by severity into three groups (normal, stage I and stage II). Results: Mean values of Al in areas with normal, stage I and stage II hemodynamic failure were $6.25{\pm}7.77%\;(n=107),\;-10.38{\pm}10.41%\:(n=117)\;and\;13.30{\pm}10.51%\;(n=140)$, respectively. Al significantly differed with each groups (p<0.05). Correlation between Al and CBF, OEF and CBV/CBF in hemisphere with occlusive cerebrovascular lesion was 0.20 (p<0.01), -0.28 (p<0.01) and -0.28 (p<0.01), respectively. Conclusion: We concluded that $^{123}I-IMP$ brain SPECT with acetazolamide challenge could determine the severity ad stage of regional hemodynamic failure as assessed by PET.

• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.6
• /
• pp.293-301
• /
• 2006

Purpose: The aim of the study was to evaluate the hemodynamic changes after successful bypass surgery in patients with atherosclerotic stenosis in ICA using $^{99m}Tc-ECD$ SPECT. Materials and Methods: Fourteen patients (M:F=8:6, mean age; $60{\pm}9$ years) who underwent STA-MCA anastomosis for unilateral atherosclerotic cerebrovascular disease were enrolled. $^{99m}Tc-ECD$ basal/acetazolamide perfusion SPECT studies were performed before, 10 days and 6 months after bypass surgery. Perfusion reserve was defined as the % changes after acetazolamide over rest image. Regional cerebral blood flow and perfusion reserve were compared preoperative, early-postoperative and late-postoperative scans. Results: The mean resting perfusion and decrease in perfusion reserve in affected ICA territory on preoperative scan was $52.4{\pm}3.5\;and\;-7.9{\pm}4.7%$, respectively. The resting perfusion was significantly improved after surgery on early-postoperative scan (mean $53.7{\pm}2.7$) and late-postoperative scan (mean $53.3{\pm}2.5$) compared with preoperative images (p<0.05, respectively). Resting perfusion did not showed further improvement on late-postoperative scan compared with early-postoperative scan. The perfusion reserve was $-3.7{\pm}2.6%$ on early-postoperative scan, and $-1.6{\pm}2.3%$ on late-postoperative scan, which was significantly improved after surgery. Additionally, further improvement of perfusion reserved as observed on late-postoperative scan (p<0.05). While, in the unaffected ICA territory, no significant changes in the resting perfusion and perfusion reserve was observed. Conclusion: The improvement of resting perfusion and perfusion reserve in early-postoperative scan reflects the immediate restoration of the cerebral blood flow by bypass surgery. In contrasts, further improvement of perfusion reserve showing on late-postoperative scan may indicate a good collateral development after surgery, which may indicate good surgical outcome after surgery.

• Journal of Korean Academy of Nursing
• /
• v.16 no.3
• /
• pp.38-66
• /
• 1986

Based on the statistical data of FKMIS during five years from 1981 to 1985, the major findings of studying on the treatments of employee's modical insurance covered people were made as follows. 1. During five years, the total number of trratment case was increased 25.14% annually, and so doubled. The consultation rate was increased from 2.086 to 2.856, showng annual increase of 8.17% and total increase of 36.91%. In the cafe, of in-patient, the rate was from 0.056 to 0.602, . showing annual increase of 2.58%. And in out-patient, the rate was from, 2.030 to 2.794, showing annual increase of 8.31%. The male: female ratio of treatment case was changed from 1 : 1.1 to 1 : 1.2. 2. Case of chronic disease was on the increase .every year. The ratio of medical expenditure of that disease to the total medical expenditure was increased from 22.99% in 1984 to 25.0% in 1985. 3. As a whole, the consultation rate of circulatory disease was increased from 26.10 in 1981 to 46.53 in 1985, showing an nual increase of 15.55 %. The rate of in-patient was increased from 2.06 to 2.94, showing annual increase of 9.30%. The rate of out-patient wag from. 24.04 to 43.59, showing annual increase of 16.04%. 4. The duration (days) of circulatory disease in 1985 by types is as follows. In the case of in-patient, rheumatic fever rheumatic heart disease, (22. 67), ischaemic disease (17.39), cerebrovascular disease (17.18), disease of pulmonary circulation and other from of heart disease (15.82), hypertensive disease (13.18), other disease of circulatory disease(11.55). In the case of out-patient, visiting day (11.57 day) and medical expenditure per case (7,853 won) is lower than that of other diseases (4.39 day, 4,361 won). 5. Cases of circulatory chronic disease were two times as many as those of non-chronic disease. Incidence of the out-patient was shown higher than that of in-patient. In the case of duration per case, the chronic disease(12.92 days) was longer that of non-chronic disease (9.8 day). 6. The male: female ratio of chronic rheumatic heart disease is 34.56 : 65.44 (in-patient) and 34. 67 : 65.33 (out-patient). The consultation rate(case per 1,000 persons) was increased from 1.11 in 1983 to 1.30 in 1985, showing annual increase of 8.22 %. The duration, visiting day, was decreased slightly, but medication day wasincreased from 13.93 in 1983 to 16.72 in 1985, showing annual increase of 9.56%. 7. The male: female ratio of hypertensive disease (case) was 39.36 : 60.64(in-patient) and 40.67 : 59.33 (out-patient). The consultation rate was increased from 19.59 in 1983 to 25.36 in 1985, showing annual increase of 13.78%. Duration, visting day was decreased slightly, but medication day was increased from 11.82 in 1983 to 12.77 in 1985, showing annual increase of 3.94%. 8. The male： female ratio of chronic pulmonary-ischaemic heart disease (case) was 48.90 : 51.10 (in-patient) and 43.66 : 56.34 (out-patient). The consultation rate of chronic pulmonary-ischaemic heart disease was increase from 0.69 in 1983 to 1. 12 in 1985, showing annual increase of 27.40％. Duration, visiting day, was decreased from 2.67 in 1983 to 2.36 in 1985, and medication day was decreased from 0.69 in 1983 to 1.12 in 1985, showing annual decrease of 2.09%. 9. The male: female ratio of cerebrovascular disease (case) was 47.90 : 52.10 (in-patient) and 52.28 : 47.72 (out: patient). The consulatation rate was increased from 2.12 in 1983 to 2.89 in 1985, showing annual increase of 16.76%, Duration, visiting day, was decreased slightly, but medication day was increased from 12. 67 in 1983 to 13.85 in 1985, showing annual increase of 4.55%. 10. In case of artery and capillary disease, the male: female ratio of case was 61.80 : 38.20 (in-patient) and 51.77 : 48.23 (out-patient). But durntion, visiting day, was increased from 3.45 in 1983 to 3.60 in 1985, showing annual increase of 2.15 % and the medication day was increased from 10. 06 to 10.18, showing annual increase of 0.59%.

• Journal of dental hygiene science
• /
• v.9 no.4
• /
• pp.475-483
• /
• 2009

Subjects of the research were 668 elderly people aged over 65 from Gangneung city. OHIP 14 went through a first translation from English to Korean, discussion among experts, a second translation from Korean to English, and then the translation was approved. After the primary and main research were carried out, validity and correlation coefficient with the outcome of oral and mental health examination were studied. OHIP 14 in terms of the perception of oral health was relevant to the perception of overall health and oral health, the necessity of dental treatment, the satisfaction about oral health, the level of pain from observation, and the satisfaction about artificial tooth. OHIP 14 on account of oral health state was related to the number of present natural teeth, the necessity of dental treatment, and the status of no teeth. OHIP 14 according to overall health was correlated to the number of ailments, the state of mind, nerve systems, bones and sinews, digestive systems, urogenital systems, cerebrovascular systems, respiratory systems, eyes, ears, and dementia. OHIP 14 according to the perception of oral health showed a significant difference in the perception of overall health and oral health, the level of pain in terms of observation, and the satisfaction on artificial tooth. OHIP 14 on account of oral health state demonstrated a meaningful difference in the number of present natural teeth, the necessity of dental treatment, and status of no teeth. OHIP 14 in terms of overall health exhibited considerable difference in the state of mind, nerve systems, bones and sinews, digestive systems, cerebrovascular systems, respiratory systems, ears, and dementia. From the study, it was proven that there was relevance between the validity of OHIP 14 and the perception of oral health, the state of oral health, and the state of overall health in the experiment on some Korean elderly people.

• Journal of agricultural medicine and community health
• /
• v.40 no.3
• /
• pp.126-136
• /
• 2015

Objectives: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. Methods: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. Results: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). Conclusions: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

• Journal of Chest Surgery
• /
• v.32 no.9
• /
• pp.790-798
• /
• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.4 s.55
• /
• pp.765-783
• /
• 1996

This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of e cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Once, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,118 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer (14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance (p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.l% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was $1.0\sim1.9$ in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.

• Journal of Acupuncture Research
• /
• v.18 no.4
• /
• pp.46-54
• /
• 2001

Objective : To study correlation of the brain areas with acupoints used in the treatment of cerebrovascular diseases to evaluate the hypothesis that selecting acupoints on the left side to treat disorders on the right side and vice versa is known as the crossing combination of acupoints. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 5 normal male volunteers (age range from 27 to 30 years) using acupuncture at acupoint, LI4 located in the left hand. In the control study, needle location was chosen on a non-meridian focus 1cm posterior to the right fibular head. All images were spatially normalized and the differences between rest and acupuncture stimulation were statistically analyzed using SPM(R) for Windows(R). Results : Acupuncture applied at LI4 located in the left hand increased rCBF in the right hemisphere, that is, the right parietal lobe(angular gyrus) and a part of the right middle posterior temporal gyrus and the right inferior occipital lobe. In the control stimulation, no significant rCBF increase was observed. Conclusion : The results demonstrated a correlation between stimulation at acupoint with increase in rCBF to the controlateral hemisphere.