포스터 전시 발표 : 순환기, 호흡기 ; 심인성 쇽으로 발현된 우심방내 혈전(RA thrombi)

조상건,강상구,배종호,이은영,임성민,최현종,류제영,문용 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

Radiation Safety in Nuclear Medicine Procedures

조상건,김자혜,송호천 대한핵의학회 2017 핵의학 분자영상 Vol.51 No.1

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Evaluation of Non-infarct-Related Arteries Using C-11 Acetate PET in STEMI With Multivessel Disease

조상건,Min Chul Kim,Seung Hun Lee,Ki Seong Park,Ja-Hae Kim,Jang Bae Moon,Ho-Chun Song 한국심초음파학회 2022 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.30 No.3

BACKGROUND: We analyzed whether C-11 acetate positron emission tomography (PET) can be used for the evaluation of non-infarct-related artery (NIRA) in patients with ST-elevation myocardial infarction (STEMI) and multivessel disease. METHODS: We prospectively enrolled 31 patients with STEMI and at least one NIRA stenosis (diameter stenosis [DS] ≥ 50%). C-11 acetate PET was performed after successful revascularization for the infarct-related artery (IRA). Myocardial blood flow (MBF) and oxidative metabolism (kmono) were measured and compared between NIRA vs. IRA, stenotic (DS ≥ 50%) vs. non-stenotic (DS < 50%) NIRAs, and NIRAs with significant stenosis (DS ≥ 70% or fractional flow reserve [FFR] ≤ 0.80) vs. those without (neither DS ≥ 70% nor FFR ≤ 0.80). The correlations between PET and angiographic parameters were also analyzed. RESULTS: MBF and kmono were significantly higher in NIRAs than those in IRAs. Stenotic NIRAs showed significantly reduced stress MBF, myocardial flow reserve (MFR), relative flow reserve (RFR) (0.72 ± 0.12 vs. 0.82 ± 0.14; p = 0.001), and stress kmono, as compared to those in non-stenotic NIRAs. NIRAs with significant stenosis had significantly lower stress MBF, MFR, and RFR (0.70 ± 0.10 vs. 0.80 ± 0.14; p = 0.001). RFR showed the best, but modest linear correlation with DS of NIRA stenosis (r = −0.429, p = 0.001). RFR > 0.81 could effectively exclude the presence of significant NIRA stenosis. CONCLUSIONS: C-11 acetate PET could be a feasible alternative noninvasive modality in patients with STEMI and multivessel disease, by excluding the presence of significant NIRA stenosis.

KSNM60 in Cardiology: Regrowth After a Long Pause

조상건,공은정,강원준,팽진철,범희승,조인호 대한핵의학회 2021 핵의학 분자영상 Vol.55 No.4

The Korean Society of Nuclear Medicine (KSNM) is celebrating its 60th anniversary in honor of the nuclear medicine professionals who have dedicated their efforts towards research, academics, and the more comprehensive clinical applications and uses of nuclear imaging modalities. Nuclear cardiology in Korea was at its prime time in the 1990s, but its growth was interrupted by a long pause. Despite the academic and practical challenges, nuclear cardiology in Korea now meets the second leap, attributed to the growth in molecular imaging tailored for many non-coronary diseases and the genuine values of nuclear myocardial perfusion imaging. In this review, we describe the trends, achievements, challenges, and perspectives of nuclear cardiology throughout the 60-year history of the KSNM.

Debates over NICE Guideline Update: What Are the Roles of Nuclear Cardiology in the Initial Evaluation of Stable Chest Pain?

조상건,김자혜,송호천 대한핵의학회 2019 핵의학 분자영상 Vol.53 No.5

Recent clinical trials have demonstrated the values of cardiac computed tomography (CT) in the initial evaluation of stable chest pain which led to drastic changes in the National Institute for Health and Care Excellence (NICE) guidelines in 2016. According to the updated NICE guidelines, cardiac CT should be performed as the initial cardiac testing in stable chest pain regardless of pre-test probability (PTP) of coronary artery disease (CAD). As a result, cardiac CT is now considered as a validated gatekeeper for assessing stable chest pain, which precedes all the functional studies including nuclear myocardial perfusion imaging (MPI). Nuclear MPI, in contrast, has been assigned as one of the second-line studies, which is inevitably dependent on the results of cardiac CT. However, nuclear MPI has genuine values in the diagnosis, treatment decision, and prognostic stratification of stable chest pain, which cannot be replaced by cardiac CT. In this review, the updated NICE guidelines and related cardiac CT trials will be critically reviewed from the view of nuclear physicians and the exceptional values of nuclear MPI will be described along with the future perspectives.

구연 : 신장 ; 수술후 발생한 급성 신부전의 임상적 연구

조상건,배종오,임성민,이은영,강상구,이진규,전성희,김정화,이광영 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-

Myocardial Blood Flow and Flow Reserve in Proximal and Mid-to-Distal Lesions of Left Anterior Descending Artery Measured By N-13 Ammonia PET/CT

조상건,김주한,조재영,김현식,범희승 대한핵의학회 2013 핵의학 분자영상 Vol.47 No.3

Purpose The purpose of this study is to compare the myocardial blood flow (MBF) and flow reserve (MFR) between proximal and mid-to-distal lesions of the left anterior descending artery (pLAD and mdLAD, respectively) using N-13ammonia positron emission tomography/computed tomography (PET/CT). Methods Subjects were 11 patients (six men and five women,mean age 64.5 years) with known coronary artery disease (CAD) involving LAD studied by N-13 ammonia PET/CT. They were divided into two groups by the location of stenotic lesions, i.e. pLAD versus mdLAD. Global and regional MBF and MFR were measured and compared. Characteristics of perfusion defects including the number of involved segments, basal area involvement, location, size, and shape were also compared between the two groups. Results The regional MFR in mid-anterior segment was significantly lower in pLAD group (1.80±0.35 vs 2.76±1.13 for pLAD and mdLAD groups, respectively, p=0.034), while global MFR was not different (2.10±1.10 vs 2.34±0.84). Both stress and restMBF in LAD territories were not different in both groups. The size of the perfusion defects were significantly larger in pLAD group (44.0±11.5 % vs 21.1±15.8 %,p=0.041). Other characteristics such as location, basal area involvement, and shape were not significantly different between two groups. Conclusions The proximal lesion makes lower MFR in the mid-anterior segment and larger perfusion defect in the LAD territory but comparable MBF compared with mdLAD lesion.

증예(症例) : 통풍환자에서 allopurinol 투여에 의한 호중구 감소성 열이 동반된 범혈구감소증 1예

조상건 ( Sang Gun Cho ),강상구 ( Sang Ku Kang ),임성민 ( Seong Min Lim ),배종오 ( Jong O Bae ),이신은 ( Shin Eun Lee ),이영재 ( Yeong Jae Lee ),이용웅 ( Yong Ung Lee ),황민호 ( Min Ho Hwang ) 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.1

고요산혈증을 동반한 통풍, 신부전 환자 또는 백혈병, 악성 림프종 등의 조혈계종양의 화학요법 시에 allopurinol을 이용하는 빈도는 증가하고 있다. 이 약제는 강력한 xanthine 산화억제 작용을 통해 혈청요산수치를 떨어뜨림으로써 통풍 환자의 치료에 쓰이며 백혈병 및 악성 림프종 등의 악성질환 치료에 따르는 요산 신장병 예방에 널리 사용되고 있다. 혈청학적 부작용으로 과립구 감소증과 무과립증, 드물게는 재생불량성 빈혈까지 일으킨 수 있지만 호중 구 감소성 열이 동반된 범혈구 감소증도 일으킬 수 있다는 사실을 관찰할 수 있었다. 그러므로 이 약물 투여 중에는 매우 드물기는 하지만 조혈장해의 부작용에 관하여 충분히 유의해야 하며 만약 조혈장해가 발생하면 조기에 투여량을 감량하거나 중지하고 정기적인 검사 및 적극적인 치료가 필요하다 하겠다. 저자들은 allopurinol 복용 후에 발생된 호중구 감소성 열이 동반된 범혈구 감소증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Allopurinol is an urate-lowering agent to prevent attack of gouty arthritis and nephropathy. It is also used to treat secondary hyperuricemia which may occur during treatment of tumors and to prevent recurrent renal stones. Allopurinol inhibits xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid. It is metabolized to oxypurinol which is also an inhibitor of xanthine oxidase. It acts on purine metabolism, by reducing the production of uric acid without disrupting the biosynthesis of vital purines. Hematologic toxicity is one of the most important side effects of allopurinol, including agranulocytosis, and rarely aplastic anemia. We report a case of allopurinol-induced pancytopenia, accompanying neutropenic fever. A 72-year old man was admitted because of painful swelling on the left ankle. He presented pancytopenia with neutropenic fever. After the withdrawal of allopurinol, he has recovered.

역T형 옹벽에서 저판뒷굽 정사에 의한 재료절감

임철오,조상건,윤여원 대한토목학회 2000 대한토목학회 학술발표회 논문집 Vol.2000 No.2

Indirect Radionuclide Coronary Angiography to Evaluate Gradients of Myocardial Blood Flow and Flow Reserve Through Coronary Stenosis Using N-13 Ammonia PET/CT

김현식,조상건,김주한,범희승 전남대학교 의과학연구소 2013 전남의대학술지 Vol.49 No.2

Although quantitative evaluation of myocardial blood flow (MBF) and myocardial flow reserve (MFR) has been perceived as an attractive advantage of positron emission tomography (PET) over other cardiac imaging technologies, application of the information to specific coronary lesions is a difficult task for nuclear cardiologists. We hypothesized that changes in MBF and MFR over a coronary lesion could be identified by use of a hybrid technology of CT coronary angiography (CTCA) and N-13 ammonia PET. To evaluate this hypothesis, we measured the gradient of MBF and MFR through coronary stenosis in seven patients (M:F=3:4, median age 56 years) with coronary artery disease who underwent N-13 ammonia PET, CTCA, and interventional coronary angiography. Two patients had proximal left anterior descending (LAD) coronary artery disease and five patients had mid to distal LAD disease. Mean global stress and rest MBF were 2.62±0.58 and 1.03±0.19 ml/min/g, respectively. Mean global MFR was 2.6±0.73. Regional stress and rest MBF in the LAD territory were 2.36±0.75 and 0.96±0.21 ml/min/g, respectively. Regional MFR in the LAD territory was 2.55±0.83 ml/min/g. Stress MBF changed dramatically according to the location of coronary stenosis. It dropped acutely in proximal lesions, whereas it diminished gradually in mid to distal lesions. In conclusion, by use of a hybrid technology of CTCA and PET, it was feasible to make a direct correlation of coronary lesions with the gradient of MFR and CFR through coronary stenosis, which indicated the severity of the coronary lesion. We named this technique indirect radionuclide coronary angiography.