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Cadmium Concentrations in Environmental Tobacco Smoke of Indoor Environments (실내환경의 환경성담배연기(ETS) 중 카드뮴에 관한 연구)

  • Ha, Kwon Chul;Park, Dong-Uk;Yoon, Chung Sik
    • Analytical Science and Technology
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    • v.16 no.4
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    • pp.299-308
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    • 2003
  • The purpose of this study is to investigate cadmium concentrations among metals in ETS (Environmental Tobacco Smoke) of indoor environments and to evaluate the cadmium as a marker of ETS. The correlations of cadmium concentrations and nicotine, 3-EP, RSP, SD (Smoking Density), and SI (Smoking Index). Air samples of metals, nicotine, 3-EP, and RSP were taken in smoking room, smoking allowed office, corridor outside smoking room, and non-smoking office respectively. The SD, ACH, and SI were investigated during sampling. Airborne concentration of cadmium known as human carcinogen were qualified and quantified. The SD was 0.2 to $2.6cig/m^2{\cdot}hr$, and the mean value of SD in smoking rooms was $1.2cig/m^2{\cdot}hr$ that is higher than other researches. The mean of ACH in smoking rooms was 11.1. The concentrations of cadmium showed log-normal distributions and the geometric mean concentrations of cadmium in smoking rooms, corridor outside smoking rooms, smoking allowed offices, and non-smoking offices were $0.045{\mu}g/m^3$, $0.018{\mu}g/m^3$, $0.021{\mu}g/m^3$, and $0.017{\mu}g/m^3$ respectively. The concentrations of cadmium in smoking room showed significant difference according to category of indoor office environments (p<0.05) and showed compliance with occupational exposure limits. The correlation coefficients between cadmium and nicotine, 3-EP, and RSP were 0.53, 0.41, 0.43 respectively. The cadmium among metals showed the highest correlations (r=0.63) with SI. It was recommended cadmium among metals is a good indicator for ETS.

A Multimodal Profile Ensemble Approach to Development of Recommender Systems Using Big Data (빅데이터 기반 추천시스템 구현을 위한 다중 프로파일 앙상블 기법)

  • Kim, Minjeong;Cho, Yoonho
    • Journal of Intelligence and Information Systems
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    • v.21 no.4
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    • pp.93-110
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    • 2015
  • The recommender system is a system which recommends products to the customers who are likely to be interested in. Based on automated information filtering technology, various recommender systems have been developed. Collaborative filtering (CF), one of the most successful recommendation algorithms, has been applied in a number of different domains such as recommending Web pages, books, movies, music and products. But, it has been known that CF has a critical shortcoming. CF finds neighbors whose preferences are like those of the target customer and recommends products those customers have most liked. Thus, CF works properly only when there's a sufficient number of ratings on common product from customers. When there's a shortage of customer ratings, CF makes the formation of a neighborhood inaccurate, thereby resulting in poor recommendations. To improve the performance of CF based recommender systems, most of the related studies have been focused on the development of novel algorithms under the assumption of using a single profile, which is created from user's rating information for items, purchase transactions, or Web access logs. With the advent of big data, companies got to collect more data and to use a variety of information with big size. So, many companies recognize it very importantly to utilize big data because it makes companies to improve their competitiveness and to create new value. In particular, on the rise is the issue of utilizing personal big data in the recommender system. It is why personal big data facilitate more accurate identification of the preferences or behaviors of users. The proposed recommendation methodology is as follows: First, multimodal user profiles are created from personal big data in order to grasp the preferences and behavior of users from various viewpoints. We derive five user profiles based on the personal information such as rating, site preference, demographic, Internet usage, and topic in text. Next, the similarity between users is calculated based on the profiles and then neighbors of users are found from the results. One of three ensemble approaches is applied to calculate the similarity. Each ensemble approach uses the similarity of combined profile, the average similarity of each profile, and the weighted average similarity of each profile, respectively. Finally, the products that people among the neighborhood prefer most to are recommended to the target users. For the experiments, we used the demographic data and a very large volume of Web log transaction for 5,000 panel users of a company that is specialized to analyzing ranks of Web sites. R and SAS E-miner was used to implement the proposed recommender system and to conduct the topic analysis using the keyword search, respectively. To evaluate the recommendation performance, we used 60% of data for training and 40% of data for test. The 5-fold cross validation was also conducted to enhance the reliability of our experiments. A widely used combination metric called F1 metric that gives equal weight to both recall and precision was employed for our evaluation. As the results of evaluation, the proposed methodology achieved the significant improvement over the single profile based CF algorithm. In particular, the ensemble approach using weighted average similarity shows the highest performance. That is, the rate of improvement in F1 is 16.9 percent for the ensemble approach using weighted average similarity and 8.1 percent for the ensemble approach using average similarity of each profile. From these results, we conclude that the multimodal profile ensemble approach is a viable solution to the problems encountered when there's a shortage of customer ratings. This study has significance in suggesting what kind of information could we use to create profile in the environment of big data and how could we combine and utilize them effectively. However, our methodology should be further studied to consider for its real-world application. We need to compare the differences in recommendation accuracy by applying the proposed method to different recommendation algorithms and then to identify which combination of them would show the best performance.

Environmental Geochemistry and Contamination Assessment of the Tohyun Mine Creek, Korea (토현광산 수계의 환경지구화학적 특성과 오염도 평가)

  • 이찬희;이현구;이종창;전서령
    • Economic and Environmental Geology
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    • v.34 no.5
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    • pp.471-483
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    • 2001
  • The pH values of the mine and surface water from the Tohyun mine creek were higher compared with those of groundwater, and 2nd round samples in same sites were even alkaline. The stream and mine waters belong to the characteristics of (Ca+Mg)-(SO$_4$) and (Ca+Mg)-(HCO$_3$) types, and groundwaters have to the (Ca+Mg+Na+K)-(HCO$_3$+SO$_4$) type. As the 2nd samples. concentrations of mostly anions are increasing compared with the forder samples. However, the mostly cation concentrations are decreasing. The hydrogeochemistry indicate that water quality is different chemical characteristics and evolution trends. The range of $\delta$D and $\delta$$^{18}$ valutes (relative to SMOW) in the waters are shown in -62.2 to -70.1$\textperthousand$, and -8.1 to -9.4$\textperthousand$. The values are plowed parallel to $\delta$D=8$\delta$$^{18}$ O+ (6$\pm$4). The d values of groundwater show 2.4, which is lower than the surface (5.2) and mine (7.6) waters. Strontium concentra titans range from 0.025 to 11.844 mg/$\ell$ in all kinds of water samples, but the groundwater has the highest contents The $^{87}$ Sr/$^{86}$ Sr ratios (0.7115 to 0.7129) show more lightened to the groundwater. The $\delta$$^{18}$ O value, Ca and Sr contents are decreased with $^{87}$ Sr/$^{86}$ Sr increasing, because it is support to the altitude effects of the sampling sites rather than a water-rock interaction of environmental isotope. Using computer code of WATEQ4F, saturation indices of albite, Quartz, gibssite and gypsum are calculated to be soluble. The calcite and dolomite show super saturation state, however, clay mineral species are plotted boundary between undersaturation and supersaturation. In the Tohyun mine creek, reaction materials with ore wastes arid precipitation have influence upon increasing EC and TDS of the waters independent of pH. The SO$_4$ concentrations in the mine water is 181.845 mg/$\ell$. This is abruptly increase in surface water and then detected 249.727 mg/$\ell$ in the groundwater. As a results of the calculated sulfate mineral solubilities, the sulfate ions became saturation states an above 150 mg/$\ell$ concentrations.

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A study on knowledge, self-efficacy and compliance in Reumatic arthritis Patients (류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구)

  • Kim, Soon-Bong
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.238-252
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    • 1998
  • Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

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A Study on Chemical Composition of Fine Particles in the Sungdong Area, Seoul, Korea (서울 성동구 지역 미세먼지의 화학적 조성에 관한 연구)

  • 조용성;이홍석;김윤신;이종태;박진수
    • Journal of Environmental Science International
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    • v.12 no.6
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    • pp.665-676
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    • 2003
  • To investigate the chemical characteristics of PM$\_$2.5/ in Seoul, Korea, atmospheric particulate matters were collected using a PM$\_$10/ dichotomous sampler including PM$\_$10/ and PM$\_$2.5/ inlet during the period of October 2000 to September 2001. The Inductively Coupled Plasma-Mass Spectromety (ICP-MS), ion Chromatography (IC) methods were used to determine the concentration of both metal and ionic species. A statistical analysis was performed for the heavy metals data set using a principal component analysis (PCA) to derived important factors inherent in the interactions among the variables. The mean concentrations of ambient PM$\_$2.5/ and PM/sub10/ were 24.47 and 45.27 $\mu\textrm{g}$/㎥, respectively. PM$\_$2.5/ masses also showed temporal variations both yearly and seasonally. The ratios of PM$\_$2.5/PM$\_$10/ was 0.54, which similar to the value of 0.60 in North America. Soil-related chemical components (such as Al, Ca, Fe, Si, and Mn) were abundant in PM$\_$10/, while anthropogenic components (such as As, Cd, Cr, V, Zn and Pb) were abundant in PM2s. Total water soluble ions constituted 30∼50 % of PM$\_$2.5/ mass, and sulfate, nitrate and ammonium were main components in water soluble ions. Reactive farms of NH$_4$$\^$+/were considered as NH$_4$NO$_3$ and (NH$_4$)$_2$SO$_4$ during the sampling periods. In the results of PCA for PM$\_$2.5/, we identified three principal components. Major contribution to PM$\_$2.5/ seemed to be soil, oil combustion, unidentified source. Further study, the detailed interpretation of these data will need efforts in order to identify emission sources.

Critical Analyses of '2nd Science Inquiry Experiment Contest' (과학탐구 실험대회의 문제점 분석)

  • Paik, Seoung-Hey
    • Journal of The Korean Association For Science Education
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    • v.15 no.2
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    • pp.173-184
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    • 1995
  • The purpose of this study was to analyse the problems of 'Science Inquiry Experiment Contest(SIEC)' which was one of 8 programs of 'The 2nd Student Science Inquiry Olympic Meet(SSIOM)'. The results and conclusions of this study were as follows: 1. It needs to reconsider the role of practical work within science experiment because practical work skills form one of the mainstays in current science. But the assessment of students' laboratory skills in the contest was made little account of. It is necessary to remind of what it means to be 'good at science'. There are two aspects: knowing and doing. Both are important and, in certain respects, quite distinct. Doing science is more of a craft activity, relying more on craft skill and tacit knowledge than on the conscious application of explicit knowledge. Doing science is also divided into two aspects, 'process' and 'skill' by many science educators. 2. The report's and checklist's assessment items were overlapped. Therefore it was suggested that the checklist assessment items were set limit to the students' acts which can't be found in reports. It is important to identify those activities which produce a permanent assessable product, and those which do not. Skills connected with recording and reporting are likely to produce permanent evidence which can be evaluated after the experiment. Those connected with manipulative skills involving processes are more ephemeral and need to be assessed as they occur. The division of student's experimental skills will contribute to the accurate assess of student's scientific inquiry experimental ability. 3. There was a wide difference among the scores of one participant recorded by three evaluators. This means that there was no concrete discussion among the evaluators before the contest. Despite the items of the checklists were set by preparers of the contest experiments, the concrete discussions before the contest were necessary because students' experimental acts were very diverse. There is a variety of scientific skills. So it is necessary to assess the performance of individual students in a range of skills. But the most of the difficulties in the assessment of skills arise from the interaction between measurement and the use. To overcome the difficulties, not only must the mark needed for each skill be recorded, something which all examination groups obviously need, but also a description of the work that the student did when the skill was assessed must also be given, and not all groups need this. Fuller details must also be available for the purposes of moderation. This is a requirement for all students that there must be provision for samples of any end-product or other tangible form of evidence of candidates' work to be submitted for inspection. This is rather important if one is to be as fair as possible to students because, not only can this work be made available to moderators if necessary, but also it can be used to help in arriving at common standards among several evaluators, and in ensuring consistent standards from one evaluator over the assessment period. This need arises because there are problems associated with assessing different students on the same skill in different activities. 4. Most of the students' reports were assessed intuitively by the evaluators despite the assessment items were established concretely by preparers of the experiment. This result means that the evaluators were new to grasp the essence of the established assessment items of the experiment report and that the students' assessment scores were short of objectivity. Lastly, there are suggestions from the results and the conclusions. The students' experimental acts which were difficult to observe because they occur in a flash and which can be easily imitated should be excluded from the assessment items. Evaluators are likely to miss the time to observe the acts, and the students who are assessed later have more opportunity to practise the skill which is being assessed. It is necessary to be aware of these problems and try to reduce their influence or remove them. The skills and processes analysis has made a very useful checklist for scientific inquiry experiment assessment. But in itself it is of little value. It must be seen alongside the other vital attributes needed in the making of a good scientist, the affective aspects of commitment and confidence, the personal insights which come both through formal and informal learning, and the tacit knowledge that comes through experience, both structured and acquired in play. These four aspects must be continually interacting, in a flexible and individualistic way, throughout the scientific education of students. An increasing ability to be good at science, to be good at doing investigational practical work, will be gained through continually, successively, but often unpredictably, developing more experience, developing more insights, developing more skills, and producing more confidence and commitment.

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Potential Benefits of Intercropping Corn with Runner Bean for Small-sized Farming System

  • Bildirici, N.;Aldemir, R.;Karsli, M.A.;Dogan, Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.6
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    • pp.836-842
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    • 2009
  • The objectives of this study were to evaluate potential benefits of intercropping of corn with runner bean for a smallsized farming system, based on land equivalent ratio (LER) and silage yield and quality of corn intercropped with runner bean (Phaseolus vulgaris L.), in arid conditions of Turkey under an irrigation system. This experiment was established as a split-plot design in a randomized complete block, with three replications and carried out over two (consecutive) years in 2006 and 2007. Seven different mixtures (runner bean, B and silage corn sole crop, C, 10% B+90% C, 20% B+80% C, 30% B+70% C, 40% B+60%C, and 50% B+50%C) of silage corn-runner bean were intercropped. All of the mixtures were grown under irrigation. The corn-runner bean fields were planted in the second week of May and harvested in the first week of September in both years. Green beans were harvested three times each year and green bean yields were recorded each time. After the 3rd harvest of green bean, residues of bean and corn together were randomly harvested from a 1 $m^{2}$ area by hand using a clipper when the bean started to dry and corn was at the dough stage. Green mass yields of each plot were recorded. Silages were prepared from each plot (triplicate) in 1 L mini-silos. After 60 d ensiling, subsamples were taken from this material for determination of dry matter (DM), pH, organic acids, chemical composition, and in vitro DM digestibility of silages. The LER index was also calculated to evaluate intercrop efficiencies with respect to sole crops. Average pH, acetic, propionic and butyric acid concentrations were similar but lactic acid and ammonia-N levels were significantly different (p<0.05) among different mixtures of bean intercropped with corn. Ammonia-N levels linearly increased from 0.90% to 2.218 as the percentage of bean increased in the mixtures up to a 50:50 seeding ratio. While average CP content increased linearly from 6.47 to 12.45%, and average NDF and ADF contents decreased linearly from 56.17 to 44.88 and from 34.92 to 33.51%, respectively, (p<0.05) as the percentage of bean increased in the mixtures up to a 50:50 seeding ratio, but DM and OM contents did not differ among different mixtures of bean intercropped with corn (p>0.05). In vitro OM digestibility values differed significantly among bean-corn mixture silages (p<0.05). Fresh bean, herbage DM, IVOMD, ME yields, and LER index were significantly influenced by percentage of bean in the mixtures (p<0.01). As the percentage of bean increased in the mixtures up to a 50:50 seeding ratio, yields of fresh bean (from 0 to 24,380 kg/ha) and CP (from 1,258.0 to 1,563.0 kg/ha) and LER values (from 1.0 to 1.775) linearly increased, but yields of herbage DM (from 19,670 to 12,550 kg/ha), IVOMD (from 12,790 to 8,020 kg/ha) and ME (46,230 to 29,000 Mcal/ha) yields decreased (p<0.05). In conclusion, all of the bean-corn mixtures provided a good silage and better CP concentrations. Even though forage yields decreased, the LER index linearly increased as the percentage of bean increased in the mixture up to a 50:50 seeding ratio, which indicates a greater utilization of land. Therefore, a 50:50 seeding ratio seemed to be best for optimal utilization of land in this study and to provide greater financial stability for labor-intensive, small farmers.

Analyses of the Efficiency in Hospital Management (병원 단위비용 결정요인에 관한 연구)

  • Ro, Kong-Kyun;Lee, Seon
    • Korea Journal of Hospital Management
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    • v.9 no.1
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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Applying the Theory of Planned Behavior to Understand Milk Consumption among WIC Preagnant Women (저소득층 임신부들의 우유 소비 행동을 이해하기 위한예측이론(Theory of Planned Behavior)의 적용)

  • Kyungwon Kim;John R. Ureda
    • Korean Journal of Community Nutrition
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    • v.1 no.2
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    • pp.239-249
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    • 1996
  • Despite the importance of prenatal nutrition, many studies find inadequate calcium intake among pregnant women. The purpose of this study was to investigate the value of the Theory of Planned Behavior in explaining the intentions and the actual consumption of milk among pregnant women participating in or eligible for WIC. A cross-sectional survey was conducted to collect information regarding attitudes, subjective norms, perceived control, milk allocation within the family, intentions and consumption of milk. The survey questionnaire was developed using open-ended questions and interviews with 112 pregnant women. One-hundred-eighty women recruited from prenatal clinics completed the survey questionnaire. Multiple regression was used separately to investigate the association of factors to intentions and to the consu-mption of milk, as proposed in the theory. Milk allocation within the family was used as an exploratory variable to explain milk consumption. Study findings revealed that all three factors, attitudes, subjective norms and perceived control contributed to the model in explaining intentions (explained variance : 36.2%), with perceived control being most important. For milk consumption, intentions and perceived control were related significantly to actual consumption, while milk allocation within the family was not (explained variance : 44.6%). These findings suggest that perceived control is important in understanding both intentions and milk consumption, providing empirical evidence for the Theory of Planned Behavior. With respect to the role of perceived control, more strong evidence was provided in explaining intentions. Findings suggest that educational interventions to increase milk consumption among pregnant women should incorporate strategies to enhance the perception of control, and to strengthen positive attitudes and to elicit social support from significant other. (Korean J Community Nutrition 1(2) 239-249, 1996)

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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.