• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.153-161
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• 2003

Purpose: Recently the occurrence of dipyridamole stress-induced short term stunning was proven and it is reported that Bland Altman analysis by repeated acquisition Tl-201 gated myocardial SPECT (gSPECT) revealed the 95% limit of agreement for LVEF was 10.3 %. The purpose of this study was to investigate the clinical value of dipyridamole induced transient LV dysfunction on Tl-201 gSPECT. Materials and Methods: Total 93 patients were included and coronary angiography was peformed in all patients less than 2 month from gSPECT. The patients with myocardial infarction were excluded. All patients underwent both dipyridamole stress and 4-h redistribution Tl-201 gSPECT. Forty nine patients of total 93 showed normal coronary arteries (Group 1) and the remaining 44 patients had coronary artery disease (Group 2). We compared LV EF, EDV and ESV during post-stress and 4-h redistribution period calculated by gSPECT using quantitative gated SPECT software and the incidence of dipyridamole induced transient LV dysfunction between group 1 and 2. The criteria for transient LV dysfunction was defined more decrease ${\geq}11%$ of LVEF during post-stress than 4-h redistribution according to previous reported Bland Altman analysis. Results: During post-stress and 4-h redistribution average of 3.1% increment in LVEF, 6.6% increment in LVEDV and 0.7% decrement in LVESV were shown after stress in Group 1, whereas 4.1% decrement, 9.7% increment and 7.2% increment in Group 2 respectively. Dipyridamole induced transient LV dysfunction was only detected in group 2 (18.2%) and not in group 1. It was more frequently observed in triple vessel disease and left main disease (31.8%, N=22) than one and two vessel disease (4.5%, N=22). Conclusion: As with Tc-99m myocardial agent post-stress LV dysfunction was observed in dipyridamole Tl-201 gSPECT. It was only detected in CAD and more frequently occurred in multivessel disease. Thus this finding seems to provide additional information in the diagnosis of coronary artery disease and prediction of prognosis.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.359-369
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• 2019

To evaluate the effect of simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and catheter assisted thrombus aspiration in the treatment of coronary stent thrombosis. 267 patients ($64.6{\pm}12.1years$, 187 men) with stent thrombosis on coronary angiography at Chonnam National University Hospital from July 2008 to July 2017 were enrolled. We devided two groups based on treatment modalities: Group I (N=32, platelet glycoprotein IIb / IIIa receptor blocker and thrombo-aspiration), Group II (N =235, either platelet glycoprotein IIb /IIIa receptor blocker or thrombo-aspiration, or none of both), and the major cardiac events including death, revascularization and stent thrombosis were followed up for 1 year. There were no significant differences in clinical characteristics between the two groups including age (Group I: $60.8{\pm}12.9$ vs. Group II: $65.1{\pm}11.9$, p= 0.603), male (Group I: 75.0% vs. Group II: 69.4%, p=0.681), and left ventricular ejection fraction (Group I: $58.1{\pm}9.0%$ vs. Group II: $59.5{\pm}11.9%$, p= 0.127). The major cardiac events did not differ between the two groups (Group I: 12.5% vs. Group II: 23.8%, p=0.180). The secondary endopoints were as followings: The mortality rate (Group I: 0% vs. 13.2%, Group II: p=0.034), target lesion revascularization (Group I: 9.4% vs Group II: 6.4%, p=0.461) and stent thrombosis (Group I: 3.1% vs. Group II: 4.7%, p=1.000). In conclusion, in the treatment of coronary artery stent thrombosis, simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and thrombus aspiration was associated with better clinical outcomes regarding 1 year mortality.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.220-227
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• 2004

The number of patients with coronary artery disease and peripheral vascular disease are increasing, and the need of small diameter vessel is also increasing. We developed small diameter artificial vessel and experimented in vivo. We got allogenic valve from mongrel dogs, and removed all cells from the allogenic valve. Then, we seeded autologous bone marrow cells onto the decellularized scaffold. After implantation of artificial vessel into the canine carotid artery, we performed angiography regularly. In case of vessel occlusion or at 8 weeks after operation, we euthanized dogs, and retrieved the implanted artificial vessels. Control vessels were all occluded except one (which developed aneurysmal dilatation). But autologous cell seeded vascular graft were patent by 4 weeks in one, by 6 in one and by 8 weeks in two. Histologic examination of patent vessel revealed similar structure to native artery. Tissue-engineered vascular graft manufactured with decellularized allogenic matrix and autologous bone marrow cells showed that tissue engineered graft had similar structure to native artery.

• Anxiety and mood
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• v.2 no.1
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• pp.28-32
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• 2006

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.31-35
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• 2013

Hematoma is quite a common complication of femoral arterial catheterization. However, to the best of our knowledge, there have been no previous studies regarding deep vein thrombosis (DVT) caused by compression of a vein due to a hematoma. We report a case of a hematoma developing after femoral arterial catheterization and causing extensive symptomatic DVT. A 59-year-old male was seen in our Emergency Department with right lower leg swelling 15 days after coronary stent implantation performed using right femoral artery access. Computed tomographic (CT) scanning revealed a large hematoma (45 mm in its longest diameter) compressing the common femoral vein and with DVT from the right external iliac vein to the popliteal vein. Due to the extensive DVT involvement, we decided to release the compressed common femoral vein by surgical evacuation of the large hematoma. However, even following evacuation of the hematoma, as the DVT did not resolve soon, further mechanical thrombectomy and catheter-directed thrombolysis were performed. Angiography then showed nearly resolved DVT, and the leg swelling was improved. The patient was discharged with the anticoagulation medication, warfarin.

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.94-99
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• 2005

Electrocardiogram-gated single photon omission computed tomography (SPECT) provides valuable information in the assessment of both myocardial perfusion and ventricular function. Tl-201 is a suboptimal isotope for gating. Tl-201 images are more blurred compared with Tc-99m tracers due to the increased amount of scattered photons and use of a smooth filter. The average myocardial count densities are approximately one-half those of conventional technetium tracers. However, Tl-201 is still widely used because of its well-established utility for assessing myocardial perfusion, viability and risk stratification. Gated SPECT with Tl-201 enables us to assess both post-stress and rest left ventricular volume and function. Previous studies with gated Tl-201 SPECT measurements of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) have shown high correlation with first-pass radionuclide angiography, gated blood pool scan, Tc-99m-MIBI gated SPECT, contrast ventriculography, echocardiography, and 3-dimensional magnetic resonance imaging. However, problems related to these studies include few agreement data of EDV and ESV, use of a reference method that is likely to have the same systemic errors (gated Tc-99m-MIBI SPECT), and other technical factors related to the count density of gated SPECT. With optimization of gated imaging protocols and more validation studies, gated Tl-201 SPECT would be an accurate method to provide perfusion and function information in patients with coronary artery disease.

• Journal of East-West Nursing Research
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• v.8 no.1
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• pp.89-102
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• 2003

This study attempted to analyze the trend of studies related to IHD(Ischemic Heart Disease). This article reviewed 102 researches on IHD conducted from 1980 to 2003, by examining them according to their characteristics, such as sources by publication period, research design, nursing intervention, outcome of experimental research, and theme of qualitative research. The results were as follows : 1. The number of studies related to IHD has steadily increased year by year since 1985, and that of the articles was the highest during the post-2000 period. Especially, the majority of researches has published since 1995. 2. The 69 studies were degree of all 102 studies related to IHD, and the majority of articles' authors belonged to graduate school. Thirty three studies were non-degree articles. As for study design, the number of quantitative studies were 99 and that of qualitative studies were 3. Non-experimental research design were largely survey and correlational study. 3. Non-experimental study makes up a high proportion of the quantitative study. The most of experimental studies were accomplished after 2000. The main subjects were patients, chart records and general subjects. The majority number of subjects was like this : while the number of non-experimental study was between 51 and 100, that of experimental study was below 50. The number of subject of qualitative study is like this : the number of phenomenology study was 21 and 11, and that of case study is 14. 4. Nursing interventions used in the experimental study comprised teaching program, cardiac rehabilitation program, massage, relaxation, music therapy and providing of sense information. And the most nursing intervention effects included physiological effect, increased self-efficacy, relieved pain and increased quality of life. Most studies proved to have the affirmative effects. 5. The number of qualitative studies related to IHD is like this : the number of degree articles was 2 and that of non-degree articles was 1. Its themes included resources of hope, the experience of coronary artery angiography and the experience of admission at ICU(Intensive Care Unit).

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.189-193
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• 2018

A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.669-675
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• 2018

This study aimed to investigate the difference of X-ray exposure by comparing and analyzing entrance surface dose and absorbed dose according to the frame change in coronary angiography using an X-ray machine. Moreover, appropriate frame selection measures for examination, including the effect of frame change on the image quality, were sought by measuring and analyzing the SNR and CNR of the image through image J. The study was conducted on 30 patients (19 males and 11 females) who underwent CAG at this hospital from June 2017 to October 2017. In regard to the patients, their age range was 49-82 years (mean of $65{\pm}9$ years), body weight was 45-91 kg (mean of $67{\pm}8.9kg$), height was 150-179cm (mean of $165.1{\pm}8.9kg$), and BMI was 19.5-30.5(mean of $24.5{\pm}2.9$). For the entrance surface dose and absorbed dose, air kerma value and DAP were obtained and analyzed retrospectively. The SNR and CNR were measured and analyzed through imageJ, and the result values were derived by applying the values to the formula. As for the statistical analyses, the correlations between the entrance surface dose and absorbed dose, and between the SNR and CNR were analyzed by using the SPSS statistical program. The relationship between the entrance surface dose and absorbed dose was not statistically significant for both 10 f/s and 15 f/s (p>0.05). In terms of the relationship between the SNR and CNR, the SNR ($3.374{\pm}2.1297$) and CNR ($0.234{\pm}0.2249$) in 10 f/s were $1.43{\pm}0.4861$ and $0.132{\pm}0.0555$ lower, respectively, than the SNR ($4.929{\pm}2.8532$) and CNR ($0.391{\pm}0.3025$) in 15 f/s, which were not statistically significant (p>0.05). In the correlation analysis, statistically significant results were obtained among the BMI, air kerma, and DAP; between air kerma and DAP; and between SNR and CNR (p<0.001, p<0.001). In conclusion, there was no significant difference between the entrance surface dose and absorbed dose even when the images were taken by changing the frame from 10 f/s to 15 f/s at the time of the coronary angiography. SNR and CNR increased at 15 f/s than at 10 f/s, but they were not statistically significant. Therefore, this study suggests that the concern of the patient and practitioner regarding image quality degradation, as well as the problem of X-ray exposure caused by imaging at 10 f/s and 15 f/s, may be reduced.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.38-42
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• 2019

Purpose Although computed tomography (CT) is used for coronary artery calcification, it is difficult to differentiate between high risk microcalcifications. Studies have shown that $^{18}F$-sodium fluoride ($^{18}F-NaF$) is very useful for the diagnosis of microcalcifications. In this study, we aimed to evaluate the usefulness of $^{18}F-NaF$ PET imaging in quantitative evaluation of calcification. Materials and Methods A total of 45 patients ($67.1{\pm}6.9years\;old$) were injected with 250 MBq of $^{18}F-NaF$ for 1 hour and images were acquired for 30 minutes. All patients underwent CT angiography (CTAngiography, CTA) before the PET scan. The SUVmax of calcification was measured and the background radioactivity of the left atrium was measured to determine Target to Background (TBR) and quantitatively analyzed. High risk group was classified through ROC curve (Receiver Operating Characteristic Curve). Results There were 226 coronary artery calcifications in the cohort and SUVmax was $1.15{\pm}0.39$. Of the 28 patients (62%), 58 were classified as high risk (TBR > 1.25). The remaining 168 were $TBR{\leq}1.25$. Conclusion $^{18}F-NaF$ PET images were available for quantitative assessment of microcalcifications and could be classified into high-risk groups. The combination of angiographic CT and $^{18}F-NaF$ PET may be a new method for early diagnosis of high-risk microcalcifications.