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관상동맥 질환에서 우회로 수술 전 Tl - 201 휴식 - 24시간 지연 심근 관류 SPECT를 이용한 심근생존능의 평가
이명철(Myung Chul Lee),정준기(June Key Chung),서정돈(Jung Don Seo),이동수(Dong Soo Lee),고창순,이원우(Won Woo Lee),윤석남(Seok Nam Yoon),김기봉(Ki Bong Kim) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4
N/A To assess contribution of T1-201 rest-24 hour delay redistribution in detection of viable myocardium, we studied the predictive value of this redistribution in 17 patients who performed rest-24 hour delay perfusion SPECT before bypass surgery. Regional wall motion was compared with gated SPECT in 10 patients and echocardiography in 7 patients before and after bypass surgery. Rest and 24 hour delayed uptakes were scored from 0 (normal perfusion) to 3 (defect). In rest SPECT, 56 segments showed perfusion decrease. Thirty four segments(61%) improved after surgery and were defined as viable. Nineteen(34%) segments had more uptake of T1-201 at 24 hour delay, and the other 37 segments did not. In 81%(25/31) of segments with mildly decreased perfusion, wall motion after bypass surgery improved, 57% (8/14) of segments with severely decreased perfusion improved, and 9%(1/11) of segments with defects improved. In 14 among 19 segments which had more T1-201 uptakes at 24 hour delay, wall motion was improved (positive predictive value of redistribution: 74%). 20 among 37 segments which had persistent decreases in rest-24 hour redistribution improved and 17 did not(negative predictive value: 46%). Segments having severe perfusion decrease or defects showed improved wall motion after surgery in 64%(7/11), if it had redistribution at delay. Segments with either mildly decreased uptake in resting or rest-delayed redistribution showed improved wall motion in 76%(32/42). Among the 14 segments which showed improvement in wall motion, 10 had partial reversibility in stress-rest images and the other 4 had persistent perfusion defects in stress-rest images. These 4 segments were found viable only with rest-24 hour delayed perfusion SPECT. We concluded that rest T1-201 uptake or redistribution at 24 hour delay should be referred as an evidence to warrant postoperative improvement of abnormal wall motion and we could predict mycardial viability with preoperative rest-24 hour delay perfusion SPECT in the segments with rest perfusion decreases
이명철(Myung Chul Lee),정준기(June Key Chung),이영우(Young Woo Lee),서정돈(Jung Don Seo),박영배(Young Bae Park),이동수(Dong Soo Lee),김상은(Sang Eun Kim),최창운(Chang Woon Choi),이명묵(Myoung Mook Lee),고창순(Chang Soon Ko),배상균(Sa 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2
N/A Rest gated blood pool scan (Rest GBP scan) and dipyridamole Tc-99m-MIBI SPECT were performed in 34 patients with or suspected coronary artery disease. Both studies were performed within 2∼32 days (mean 8.1 days). A significant correlation was present between left ventricular ejection fraction (r=-0.7356, p〈0.001) and peak ejection rate and peak filling rate in rest GBP scan and perfusion defect in MIBI SPECT. And there were acceptable correlations (0.05〈p〈0.001) between regional ejection fractions and perfusion defects corresponding to the regions. There were 39 segments of fixed (rest) perfusion defects in MIBI SPECT and there was a significant difference in perfusion defect according to the regional wall motion (normal or mild hypokinesia in 23 regions: 26.2±10.8%, severe hypokinesia, akinesia or dyskinesia in 16 regions: 78.2±23.7, p〈0.001). These data indicate there is a significant coupling between the degree of myocardial perfusion and the myocardial functional change in coronary artery disease.
선천성 담도폐쇄증에서 99mTc DISIDA 신티그라피의 진단정확성 ( Diagnostic Accuracy of 99mTc-DISIDA 신티그라피의 진단정확성
현인영,이동수,이경한,김종호,정준기,서정기,이명철,고창순 ( In Young Hyun,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,June Key Chung,Jung Key Suh,Myung Chul Lee,Chang Soon Koh ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
We evaluated the diagnostic accuracy of 99mTc-DISIDA scintigraphy as a mean of differentianting biliary tresia from neonatal hepatitis. Tc-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepat,ic retention index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake index was graded visually with 5 minute images using the following scoring scheme :grade 0(normal hepatic uptake), grade 1(decreased hepatic up take), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent int,estinal radioactivity. The results were as follows : l) None of the 30 hiliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity, The sensitivity, specificity, and accuracy of the presence of inlestinal radioactivity .or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patienis with absent intestinal radioactivity the mean hepatic retention index was 1.5+0.6 in the 16 biliary atresia patient,s, and 1.1+0.2 in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary at,resia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake index between biliary atresia and neonatal hepatit.is patients. However t.here were differences in age, total bilirubin, and hepatic uptake index bet.ween neonatal hepatitis patients with and without intestinal radioactivity. The hepatic upt,ake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioact,ivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake index and the hepatic retention index. Thus, we conclude that Tc DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patients age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.
신혈관성 고혈압의 진단에 있어서 캅토프릴 신스캔의 의의
김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),배상균(Sang Kyun Bae),양형인(Hyung In Yang),김승철(Sung Chul Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2
N/A To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of Tc-99m-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.
통상적 99mTc - DTPA 신장스캔을 이용한 GFR측정
한진석(Jin Suk Han),이정상(Jung Sang Lee),고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이강욱(Gang Wook Yi) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.1
N/A Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintigraphy. We measured Tc- 99m-DTPA renal clearance with Jackson's method during the routine Tc-99m-DTPA renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of ClDPDA was from 19.9 ml/min to 170 mi/min and the correlation of ClDPDA and creatinine clearance was discribed by Y=16.2570+0.7852X(X=C1DPDA, Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that Tc-99m-DTPA renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine Tc-99m-DTPA renal scintigraphy simultaneously.
소형 계수용 및 영상용 감마프로브 시스템의 설계와 성능평가
양묘근,곽철은,심용걸,김희중,최용,정준기,이명철,고창순,Yang, Myo-Geun,Kwark, Cheol-Eun,Sim, yong-Geol,Kim, Hee-Joung,Choi, Yong,Chung, Jung-Key,Lee, Myung-Chul,Koh, Chang-Soon 대한의용생체공학회 1997 의공학회지 Vol.18 No.3
As a microimaging device detecting gamma rays emitted from small lesions or tumors during operation, the intraoperative surgical probe has been proposed and is now under development. We have designed a multipurpose portable gamma prove system and evaluated the performance both for the absolute counting purpose of residual radioactivities and for the localizing capability of gamma events using the NaI(Tl) crystal and two types of photomultiplier tubes(PMTs). Counting efficiencies in the range of routine clinical use of radiation dose were measured using the assembly of single channel PMTs and 0.5 inch thick NaI(Tl) crystal of 1 inch diameter. The positioning of gamma events for imaging purpose requires the multiple channel PMTs with appropriate positioning electronics. We have designed a simple and reliable positioning circuit based on the concept of modified Anger. In preliminary experiments using the multiple channel PMT of 3 inch diameter and the dim lighth source, we were able to trace and localize the correct position with reduced positioning error by the use of two multiplier/divider chipset and simplified peripherals. The energy resolutions for the counting gamma probe measured as full width at half maximum(FWHM) for Cs-137, F-18, Tc-99m were 12%, 13%, and 36%, respectively. The spatial resolution for the imaging gamma probe measured as FWHM for green LED was 2.9 mm. The results indicate that the currently developing probe is very promising and could be very useful for many applications in nuclear medicine. Future studies will include developing collimators, improving interface hardwares, and evaluating the system with clinical data.
송인성(In Sung Song),김정룡(Chung Yong Kim),김용일(Yong Il Kim),정현채(Hyun Chae Jung),정준기(June Key Chung),김윤준(Yoon Jun Kim),임영석(Young Seok Lim),이대희(Dae Hee Lee),우광훈(Gwang Hoon Woo),이국래(Kook Lae Lee),한준구(Joon Koo 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3
Protein-losing enteropathy is a mamfestation of various disorders associated with an excess loss of serum proteins into the gastrointestinal tract, thereby leading to hypoproteinemia and other sequelae. We present here a case of protein-losing enteropathy with unknown etiology. In spite of explorative laparotomy for multiple stricture of the small bowel, we were unable to uncover the etiology of protein-losmg entetopathy. After the resection of most severe stricture site, serum protein level was normalized, (Korean J Gsstroenterol 1997; 29: 416-421)
관상동맥질환에서 휴식기 심전도게이트혈액풀스캔을 이용한 각종 심기능 지표들의 평가 및 ROC 분석
고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이영우(Young Woo Lee),서정돈(Jung Don Seo),박영배(Young Bae Park),이동수(Dong Soo Lee),김상은(Sang Eun Kim),최창운(Chang Woon Choi) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1
N/A Gated blood pool scan is frequently used for evaluating the change in cardiac function in various cardiac diseases. But resting gated blood pool scan using only LVEF as a cardiac index has been consitently shown to have a low sensitivity, which is about 50%, in detecting coronary artery disease. So it is recommended to compare exercise gated blood pool scan to resting gated blood pool scan. Exercise tests, however, are not always possible, especially in patients with musculoskeletal diseases, recent myocardial infarction and in elderly persons. We studied the usefulness of resting gated blood pool scan using multiple indices in evaluating the patients with coronary artery disease. Studied cases were 185 patients with coronary artery disease (angina pectoris 31, myocardial infarction 154) and 25 normals with low likelihood of coronary artery disease. We used Tc-90m-labeled RBC, 740 MBq labeled by in vivo method. The data were evaluated by Micro DELTA computer program. The results were as following: 1) The ejection rates (PER, AER) and filling rates (PFR, AFR) were different in normals and patients with angina pectoris or myocardial infarction. 2) Mean phase angie, ejection rates and filling rates could separate normals from coronary artery disease patients with normal LVEF. 3) Regional ejection fraction was decreased at the site of the infarct in patients with myocardial infarction. 4) Peak filling rate was the most detectable index in evaluation of cardiac function in patients with coronary artery disease. 5) The threshold at 1.5 standard deviation of normal range was considered as the most reliable cut-off value from ROC analysis. These data suggest that the resting gated blood pool scan has an important role in the evaluation of cardiac functional changes using various cardiac indices in patients with coronary artery disease.
국내 합성한 HMPAO 이용 99mTc 표지 백혈구를 이용한 실험적 농양 스캔
고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(Jung Key Chung),안규리(Cu Rie Ahn),이동수(Dong Soo Lee),신형식(Hyung Sik Shin),최강원(Kang Won Choi),정재민(Jae Min Jung),정은주(Eun Ju Chung) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.2
N/A With HMPAO we have synthesized in our laboratory, we labelled 99mTc to canine leukocytes. Experimental abscess made by subcutaneous injection with Staphylococcus aureus was imaged with these 99mTc 1abelled leukocytes. Labelling efficiency of HMPAO with 99mTc was 66.2%.+- 14.6% (N=9). Labelling efficieney of leukocytes with 99mTc-HMPAO was 54% +- 7.79 (N=7). CelI bound radio activity in 99mTc-HMPAO labelled leukocytes was around 80%. when these cells were incubated in plasma in vitro at 37`C for 5 hours. In vivo cell bound activity was over 80% at 24 hours after injection. One day and four days after inoculation, uptake at the inflammatory focus was found with 99mTc labelted leukocytes. Uptake showed up in 4 hour image, and the uptake at the lesion was most prominent in 24 hour image. These findings show that in-house-synthesized HMPAO could be used for labelling leukocytes with 99mTc, and that 99mTc-HMPAO-labelled leukocytes were so stable and viable that inflammatory focus could be visualized with these 99mTc-labelled leukocytes.