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Dipyridamole Thallium - 201 심근주사
우연미(Youn Mee Woo),백영건(Young Keun Baik),김은식(Eun Sik Kim),이홍순(Hong Soon Lee),김종순(Jong Soon Kim),이학중(Hak Choong Lee),정준기(June Key Chung) 대한내과학회 1986 대한내과학회지 Vol.31 No.1
N/A Exercise Tl-20I myocardial imaging is an important technique in the evaluation of coronary disease. However, a standard maximal exercise stress test is not always possible for various reasons, including therapy with β-blockers, unstable anginal symptoms, poor physical condition and peripheral vascular disease. Previous studies have shown that dipyridamole could lead to coronary vasodilatation in nomral vessels, but fixed coronary stenoses prevented or attenuated this response. The coronary flow response to dipyridamole was similar to that during exercise. So we performed dipyridamole T1-201 myocardial scintigraphy on 21 subjects who have angina or myocardial infarction instead of exercise Tl- 201 scan which bas several disadvantages in actual clinical use. The results obtained are as follows: 1) During dipyridamole infusion the mean systolic and diastolic blood pressure decreased from 126±4.3/75±4.9 to 119±4.2/77±3.0mmHg. Immediately after tilt up, both pressure decreased more dramatically to 115±4.3/76±2.8mmHg, and then slowly returned to baseline values. The heart rate increased from 74±2.4/min to 82±2.7/ min during dipyridamole infusion and 86±2.4/ min after tilting up, Double product also increased from 93±4.0 to 99±4.5. 2) Adverse effects of dipyridamole were noted in 10(47.6%) of the subjects, but in 8 of these, the symptoms were mild in severity and subsided spontaneously. 3) Tl-201 scintigraphic findings in 14 patients with angina were as follows; abnormal redistribution was seen in 7cases, perfusion defect with abnormalredistribution in 3 cases and perfusiondefect in 1 case. 4) Tl-201 scintigraphic findings in 6 patients with AMI were as follows; perfusion defect was seen in all cases and in 3 cases of them abnormal redistribution was accompanied. Myocardial portions exhibiting perfusion defect were comparatively consistent with the area of infarction indicated by ECC. 5) In 8 patients who had undergone coronary angiography, perfusion defect or abnormal redistribution were noted in 12 segments and these segments were consistent with coronary artery narrowing of more than 50%. In conclusion, serial tballium-201 myocardial imaging after dipyridamole is a useful test for coronary artery disease that dose not require exercise or patient effort.
간경변에 합병된 원발성 세균성 복막염에 있어서 복수의 세균배양검사의 의의
이학중(Hak Choong Lee),백영건(Yeong Keon Baek),우연미(Yeon Mi Woo),권영근(Yeong Keun Kwon),민경업(Kyung Up Min) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1
N/A The spontaneous bacterial peritonitis (SBP) is very grave complication in cirrhotics, and early diagnosis and treatment is crucial for good management. Authors studied clinical features and diagnostic value of laboratory findings in SBP, which was confirmed by bacteriological culture of ascites. The results obtained were summarized as follows: 1) The incidences of abdominal pain, tenderness and rebound tenderness in SBP were significantly higher than those of controls. 2) The levels of serum protein, bilirubin, and WBC counts in ascitic fluid were different significantly between SBP and controls. 3) In spite of the differences between SPB and controls, it was unsuitable to apply these findings in the diffential diagnosis of bacterial infection because there were significantly high risks of false positive and false negative. On the bases of these findings, it is suggested that culture of ascitic fluid is mandatory to detect bacterial infection early, even though clinical findings are not suggestive of bacterial infection