• Title/Summary/Keyword: reversibility

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High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report (중증 빈혈과 관련된 가역적 뇌혈관 수축 증후군의 고해상도 자기공명영상 소견: 증례 보고)

  • Yongsang Kim;Ra Gyoung Yoon;Ji Ye Lee;Jong-Moo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.261-266
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    • 2021
  • Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.

Prediction of Improvement of Myocardial Wall Motion after Coronary Artery Bypass Surgery Using Rest T1-201/Dipyridamole Stress Gated Tc-99m-MIBI/24 Hour Delay T1-201 SPECT (휴식기 T1-201/디피리다몰 부하 게이트 Tc-99m-MIBI/24시간 지연 T1-201 SPECT를 이용한 관상동맥 우회로 수술 후 심근벽 운동 호전의 예측)

  • Lee, Dong-Soo;Lee, Won-Woo;Yeo, Jeong-Seok;Kim, Seok-Ki;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.497-508
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    • 1998
  • Purpose: Using rest T1-201/dipyridamole stress gated Tc-99m-MIBI/ 24 hour delay T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. Materials and Methods: In 39 patients (M;F= 34:5, age $58{\pm}8$), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0: normal to 3: defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. Results: After bypass surgery, ejection fraction increased from $37.8{\pm}9.0%$ to $45.5{\pm}12.3%$ in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Conclusion: Among independent predictors obtained by rest T1-201/ stress gated Tc-99m-MIBI/ delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.

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The Correlation Analysis of Stress/Rest Ejection Fraction of $^{201}Tl$ Gated Myocardial Perfusion SPECT ($^{201}Tl$ 게이트 심근관류 스펙트에서의 휴식기와 부하기 좌심실 구혈률 상관관계 분석)

  • Kim, Dong-Seok;Yoo, Hee-Jae;Shim, Dong-Oh
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.3-9
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    • 2009
  • Purpose: It is well-known that stress-induced stunning and reversible perfusion defect have impact on ejection fraction (EF) when performing myocardial perfusion SPECT. Due to these reasons, gated SPECT is recommended at stress and rest studies. And there was many experiments to analyze between Stress and Rest EF by using $^{99m}Tc$-MIBI. The aim of this study is to analyze between stress EF and rest EF at myocardial perfusion SPECT by using $^{201}Tl$ and define possible predictors of EF variability. Materials and Methods: From 2008 June to 2009 February, we analyzed 144 patients undergoing $^{201}Tl$ gated myocardial perfusion SPECT in ASAN medical center. To analyze the data, we use QGS (Quantitative gated SPECT) software, and derived End-systolic volume (ESV), End-diastolic volume (EDV), EF from the result. In this study, we comparatively analyzed stress/rest EF correlation based on stress/rest EF, EDV, ESV and reversibility of myocardial perfusion defect by using paired t-test, Bland-Altman analysis. Results: Mached pairs of stress EF and rest EF demonstrated excellent correlation (r=0.92) with no statistically significant difference (p=0.11). Bland-Altman analysis demonstrated a mean ${\Delta}EF$ was 0.52% (95% confidential interval[CI], -1.17~0.12%). No statistically significant difference between a mean ${\Delta}EF$ and hypothetic mean of 0 (${\Delta}EF$=0) (p=0.10). In the correlation of ${\Delta}EF$ according to stress/rest EDV and ESV, except rest ESV of <28mL (p<0.05), there was no statistically significant difference. In the correlation of ${\Delta}EF$ according to reversibility of perfusion defect, patients with reversible perfusion defect has statistically significant difference of ${\Delta}EF$ (p<0.05). ${\Delta}EF$ of stress/rest EF showed no statistically significant difference except 55% of rest EF (p<0.05). Conclusion: Like studies with $^{99m}Tc$-MIBI, there was generally no statistically significant difference between stress and rest EF in this study results. However a stress EF of <55%, a rest ESV of <28mL and patients with reversible perfusion defect showed statistically significant difference in ${\Delta}EF$. If performing $^{201}T$ myocardial perfusion SPECT to patients with abnormal cardiac function or reversible perfusion defect, consider this study results and apply it. We expect this study results could be useful predictors of ${\Delta}EF$ variability.

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Comparison of Clinical Usefulness between N-13 Ammonia PET/CT and Tc-99m Sestamibi SPET in Coronary Artery Disease (관상동맥질환에서 N-13 암모니아 PET/CT와 Tc-99m 세스타미비 SPECT의 임상 유용성 비교)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Park, Jeong-Sun;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.354-361
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    • 2008
  • Purpose: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. Materials and Methods: Seventeen patients (male 13 : $63{\pm}11$ years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). Results: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/89% vs MPS: 65%/82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p < 0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. Conclusion: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.

Effects of Perfusion Defect on the Measurement of Left Ventricular Mass, Ventricular Volume and Post-stress Left Ventricular Ejection Fraction in Gated Myocardial Perfusion SPECT (정량적 게이트 심근관류 스펙트 검사에서 관류결손이 좌심근질량 측정과 부하 후 좌심실 용적 및 구혈률에 미치는 영향)

  • Ahn, Byeong-Cheol;Bae, Sun-Keun;Lee, Sang-Woo;Jeong, Sin-Young;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.6
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    • pp.381-391
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    • 2002
  • Purpose: The presence of perfusion defect may influence the left ventricular mass (LVM) measurement by quantitative gated myocardial perfusion SPECT (QGS), and ischemic myocardium, usually showing perfusion defect may produce post-stress LV dysfunction. This study was aimed to evaluate the effects of extent and reversibility of perfusion defect on the automatic measurement of LVM by QGS and to investigate the effect of reversibility of perfusion defect on post-stress LV dysfunction. Subjects and Methods: Forty-six patients (male/female=34:12, mean age=64years) with perfusion defect on myocardial perfusion SPECT underwent rest and post-stress QGS. Forty patients (87%) showed reversible defect. End-diastolic volume (EDV), end-systolic volume (ESV), LV ejection fraction (EF), and LV myocardial volume were obtained from QGS by AutoQUANT program, and LVM was calculated by multiplying the LV myocardial volume by the specific gravity of myocardium. Results: LVMs measured at rest and post-stress QGS showed good correlation, and higher correlation was founded in the subjects with fixed perfusion defect and with small defect (smaller than 20%). There were no significant differences in EDVs, ESVs and EFs between obtained by rest and post-stress QGS un patients with fixed myocardial defect. Whereas, EF obtained by post-stress QGS was lower than that by rest QGS in patients with reversible defect and 10 (25%) of them showed decreases in EF more than 5% in post-stress QGS, as compared to that of rest QGS. Excellent correlations of EDVs, ESVs, EFs between rest and post-stress QGS were noted. Patients with fixed defect had higher correlation between EDVs, ESVs, EFs than patients with reversible defect. Conclusion: These results suggest that perfusion defect can affect LVM measurement by QGS and patients with reversible defect shows post-stress LV dysfunction more frequently than patients with fixed perfusion defect.

Unchosen Cohabitation of Hannah Arendt and Precarity Politics of Judith Butler: Based on Body Politic and Ethical Obligation (한나 아렌트의 비선택적 공거와 주디스 버틀러의 프레카리티 정치학: 몸의 정치학과 윤리적 의무)

  • Cho, Hyun June
    • Cross-Cultural Studies
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    • v.48
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    • pp.361-389
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    • 2017
  • This essay examines 'precarity politics' by Judith Butler, a well-known gender theorist and queer philosopher, in Notes Towards a Performative Theory of Assembly (2015) focused on concepts as unchosen cohabitation of Hannah Arendt and unwilled proximity of Emmanuel Levinas. Butler's precarity politics is the condition of our dispossessed political beings with fundamental vulnerability and interdependency that cannot choose with whom we will live on this Earth. Butler's political ethics is twofold: on one hand, she examines significance of 'action'' the most significant vita activa in the public area, and 'plurality'' the condition-not only the necessary condition but the possible condition-for a political life suggested by Hannah Arendt in Human Condition; on the other hand, Butler reflects upon global precarity based on a diasporic precarious life in the social world towards freedom and equality. Unchosen cohabitation of plural humans on Earth, and global pervasion of precarity, that indicates "politically induced condition in which certain populations suffer from failing social and economic networks of support and become differentially exposed to injury, violence, and death," so called "differential distribution of precariousness," are practical possibilities of ethical and equal cohabitation of different ethnic groups in the social world. Ethical obligations or ethical demand to respond to others' suffering in distance and proximity originated from precarity politics, mentioned in Precarious Life, Parting Ways, and Frames of War, could be non-foundational joint of plural people living together globally. We should presume the 'reversibility' of distance and proximity in others' suffering, based on responsiveness and responsibility of others, if we want to stay attuned to the pain of others we never chose to live together. That is the significance of Butler's 'precarity politics' with 'ethical obligation' to accept 'unchosen plurality' of living population on Earth, and 'reversibility between of distance and proximity,' in her 'new plural and embodied body politics' or 'new corporeal ontology', through human primary vulnerability, fundamental interdependency, being exposed and responsive to suffering of others.

Effect of Heavy Metal Ions on the Oocyte Maturation of Frog, Rana dybowskii in vitro (중금속 이온이 산개구리 난자성숙에 미치는 영향에 관한 연구)

  • 고선근;이두표
    • Korean Journal of Environment and Ecology
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    • v.11 no.3
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    • pp.310-315
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    • 1997
  • In oreder to know the effect of the oocyte maturation with several heavy metal ions(Cd$^{2+}$, Hg$^{2+}$, Cu$^{2+}$, Pb$^{2+}$) on frog(Rana dybowskii) by FPH(Frog pituitary homogenate: 0.1 p.e./ml) in vitro, oocytes were cultured for 20 hours and exanimed the maturation rates with exposure of various comcentrations of those ions. The results showed that Cd$^{2+}$ at concentration of 0.1 ppm suppressed the maturation of the oocytes, while Hg$^{2+}$, Cu$^{2+}$ and Pb$^{2+}$ suppressed them significantly at 1 and 5 ppm respectively. To examine the reversibility of the inhibitory effects, the oocutes were exposed to the metal ions only for 3 hours and transferred to plain medium and cultured further for 17 hours. The oocytes were recovered from the toxic effect of the ions when they were exposed to 1 ppm of Cd$^{2+}$ for 3 hours and not available to 2.5 ppm. The effect of 2.5 ppm of Hg$^{2+}$, Cu$^{2+}$, Pb$^{2+}$ were also reversible and not available to 5 ppm for 3 hours exposure. From the abave results, it reveal that heavy metal ions in this study suppressed the maturation of oocytes at relatively low concentration. Therefore the oocyte culture system can be used as a useful tool to evaluate the toxicity of the pollutants in envirment.

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Spirometry and Bronchodilator Test

  • Sim, Yun Su;Lee, Ji-Hyun;Lee, Won-Yeon;Suh, Dong In;Oh, Yeon-Mok;Yoon, Jong-seo;Lee, Jin Hwa;Cho, Jae Hwa;Kwon, Cheol Seok;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.105-112
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    • 2017
  • Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

Study on the Toxicity of Jihwangbakhotang in Rats (지황백호탕(地黃白虎楊)의 독성효과(毒性效果)에 관(關)한 연구(硏究))

  • Na, Dal-Rye;Kim, Kyung-Yo;Lee, Jong-Duck
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.2
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    • pp.203-225
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    • 1997
  • Jihwangbakhotang(地黃白虎楊) is made by Li Je Ma, the creator of the Four Constitutional Medicine. Single and 13 weeks oral repeated dose toxicity studies were conducted in Sprague Dawley rats of both sexes to elucidate the potential acute and subchronic toxicity of JBT extract and reversibility of any effects. In the single dose study, JBT extract was administered orally to rats with the dose of 2 g/kg and 8 g/kg. In the long term administration of 13 weeks, the JBT extract of 125 mg/kg/day, 500 mg/kg/day, 2000 mg/kg/day was administered to rats. The change of blood weight, urine volume, electrolyte in urine, hematological change, the change of blood chemistry, autopsy finding, and histological observation were researched, the results were as follows; 1. The lethal dose of JBT extract seems to be over 10 g/kg, the single administration of JBT extract 8 g/kg showed no toxical signs except little increase of urine volume. 2. The change of body weight had the trend of decrease in the group of, but has no significance, and also the consumption of food and water had no changes. 3. The hematological changes induced by the 13 weeks administration of JBT extract showed the significance in the item of Hb, MCH, MCV, WBC in the group of 125 mg/kg/day. 4. In the test of blood chemistry, total cholesterol showed little decrease and A/G ratio showed little increase, but the change was not clear, and the standard error was large. So the result was obtained insignificantly and the toxicity of JBT extract was not observed. 5. In the male group after recovery period, the level of cholesterol and triglyceride decreased slightly, but the result was not significant. 6. In the urine test, the little change of electrolyte was appeared, but it seemed not to be the result induced by the toxicity of JBT extract. 7. In each group of male and female rats, the weight change of organ and the serum histological changes was observed, but the result did not showed the dose dependent toxicity. So the toxicity of JBT extract was not regarded. In the conclusion, the toxicity of JBT extract was not observed in the single dose treatment and long term repetitive administration of JBT extract.

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Electrochemical Behavior of Lithium-Iron Oxide Electrode and Measurement of Chemical Diffusion Coefficient of Lithium (리튬-철계 산화물 전극의 전기화학 거동 및 리튬의 화학확산 계수 측정)

  • Lee Joung-Jun;Chong Won-Jung;Ju Jeh-Beck;Sohn Tai-Won;Cho Won-Il;Cho Byung-Won;Kim Hyung-Sun
    • Journal of the Korean Electrochemical Society
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    • v.4 no.4
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    • pp.139-145
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    • 2001
  • Various compositions of iron oxide based materials as a cathode of lithium secondary battery have been fabricated and tested with electrochemical method. A layered form of $LiFeO_2$ was synthesized by mixing and heating the initial materials of $FeCl_3\;6H_2O,\;LiOH$ and NaOH at low temperature. The effect of changing the precursors composition was investigated. As a result, when increasing the additive amount of NaOH, the capacity of the electrode is decreased but the performance and declining rate of capacity became smaller. $LiFeO_2$ synthesized with the weight ratio of $NaOH/FeCl_3/LiOH,\;2/1/7$ showed the largest capacity, but the discharging efficiency was sharply decreased after 30 cycles. Charge-discharge tests of lithium cells with $LiFeO_2$ cathode having the layer structure were performed. This cell showed the reversibility in the range of 1.5-4.5V of cell voltage. By using CPR method, chemical diffusion coefficients were measured in 1M $LiPF_6/EC/DEC$ solution. The value of chemical diffusion coefficient decreased with increasing the lithium content x, In 0.5$10^{-11}^cm^2/s$.