1.Steroid therapy.
Journal of the Korean Academy of Family Medicine 1998;19(10):776-786
No abstract available.
2.Left Ventricular Ejection Fraetion Determmed by Cated Tl-201 Perfusion SPECT and Quantitative Software.
In Young HYUN ; Sung Eun KIM ; Jeong Kee SEO ; Eui Soo HONG ; Jun KWAN ; Keum Soo PARK ; Woo Hyung LEE
Korean Journal of Nuclear Medicine 2000;34(3):222-227
PURPOSE: We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-TI-SPECT) with those by gated blood pool (GBP) scan. MATERIALS AND METHODS: Eighteen subjects underwent g-TI-SPECT and GBP scan. After reconstruction of g-TI-SPECT, we measured EF with Cedars software. The comparison of the EF with g-TI-SPECT and GHP scan was assessed by correlation analysis and Bland Altman plot. RESULTS: The estimates of EF were significantly different (p<0.05) with g-TI-SPECT (40%+/-14%) and GBP scan (43%+/-14%). There was an excellent correlation of EF between e-TI-SPECT and GBP scan (r=0.94, p<0.001). The mean difference of EF between GRP scan and g-TI- SPECT was +3.2%, Ninety-five percent limits of agreement were +9,8%. EF between g-TI-SPECT and GBP scan were in poor agreement. CONCLUSION: The estimates of EF by g-TI-SPECT was well correlated with those by GBP scan. However, EF of g-TI-SPECT doesn't agree with EF of GBP scan. EF of g-TI-SPECT cant be used interchangeably with EF of GBP scan.
Perfusion*
;
Tomography, Emission-Computed, Single-Photon*
3.Comparison of Myocardial Fractional and Coronary Flow Reserve after Revascularization in Acute Myocardial Infarction.
Gyeong A KIM ; Jeong Kee SEO ; Eui Soo HONG ; June KWAN ; Seong Wook CHO ; Keum Soo PARK ; Woo Hyung LEE
Korean Circulation Journal 1998;28(9):1435-1442
BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure
;
Arteries
;
Catheters
;
Constriction, Pathologic
;
Humans
;
Myocardial Infarction*
;
Phenobarbital
4.Long-erm Follow-p of Patients Treated with Interferon Alfa for Chronic Hepatitis B.
Jong Eun YEON ; Yeon Seok SEO ; Yoon Hong KIM ; Sang Hoon PARK ; Oh Sang KWON ; Kwan Soo BYUN ; Chang Hong LEE
The Korean Journal of Hepatology 1999;5(1):12-21
BACKGROUND/AIMS: Several randomized controlled studies have shown that responders who had treated with interferon alpha for chronic hepatitis B had better rate of sustained loss of HBeAg and HBV DNA than non-esponders. These studies also showed that non-esponders had higher rates of liver related complication and mortality. But there is very little data on how well sustained responders are and whether the responders eventually lose HBsAg in Korea. The aims of this study were to better define the long term remission of chronic hepatitis B induced by interferon alfa therapy and compare the clinical outcome among the interferon responders and non-esponders in Korea. METHODS: Sixty-ight patients with chronic hepatitis B who were treated with interferon alfa between 1987 and 1998 were followed up for serologic status (HBsAg, HBeAg, HBV DNA), biochemical tests and liver related complication or mortality. RESULTS: Among 68 patients with chronic hepatitis B who were treated with interferon alfa, 28 (41%) responded to treatment with loss of HBeAg within 1 year of starting treatment. Up to 129 months (mean 58 months) after therapy, responders had higher rate of cumulative clearance of HBeAg at five years than non-esponders (100% vs 35.1%, p<0.05). Responders had maintained the normal serum ALT than nonresponders at five years (94% vs 55.6%, p<0.05). Loss of HBsAg was not different between responders and non-esponders (5% vs 4%, NS). The rates of liver related complication and mortality did not differ between both groups. Delayed clearance of HBeAg occured in twelve out of forty non-esponders (30%). There were no differences in age, baseline ALT, histologic finding of liver biopsy, HBV DNA at the end of first year after study with IFN therapy between the non-esponders with and without delayed clearance of HBeAg. CONCLUSION: Remission in chronic hepatitis B induced by alfa interferon maintained in long duration. But clinical outcomes such as liver related complication, mortality and the elimination of HBV infection have no differences between responders and non-esponders. Further studies are needed for the role of interferon therapy in long-erm clinical outcome for chronic hepatitis B.
Biopsy
;
DNA
;
Hepatitis B e Antigens
;
Hepatitis B Surface Antigens
;
Hepatitis B, Chronic*
;
Hepatitis, Chronic*
;
Humans
;
Interferon-alpha*
;
Interferons*
;
Korea
;
Liver
;
Mortality
5.Memory lateralizing values of different stimulus types in Wada test.
Ki Young JUNG ; Yeonwook KANG ; Jin Woon PARK ; Dae Won SEO ; Seung Bong HONG ; Seung Chyul HONG
Journal of the Korean Neurological Association 1998;16(6):844-850
BACKGROUND: We studied the accuracy, lateralization criteria of Wada test in patients with temporal lobe epilepsy(TLE). We also evaluated material specific memory and determined the stimulus which can classify best between right and left TLE among four different types of stimuli. METHODS: We examined Wada memory performance in 33 patients(15 left, 18 right) with TLE who underwent surgery and who were good seizure outcome at least 1 year follow-up. Twelve stimuli consited of figures, written words, geometric designs and real objects were presented after Amytal injection. The recognition memory test was performed at 10 minutes after the injection and hemisphere memory performance of each stimulus and total stimuli were obtained by(number of stimuli recognized / number of stimuli presented x 100%). Classification rate, best stimulus for lateralization, and suitable lateralization criteria were determined by discriminant analysis and Chi-square test. Hemispheric memory difference of each stimulus was analyzed by paired-sample Student's t-test in left temporal lobectomy(LTL) and right temporal lobectomy(RTL) groups. RESULTS: No significant difference was observed in pre-Wada memory score and in IQ between LTL and RTL group. The classification rate of Wada test in terms of lateralization by discriminant analysis was 81.82%. The accuracy was 75.8% at 10% and 15% lateralization criteria and was 63.6% and 45.5% at 20% and 25% lateraliza.
Amobarbital
;
Classification
;
Follow-Up Studies
;
Humans
;
Memory*
;
Seizures
;
Temporal Lobe
6.A Case of Stent Migration into Right Ventricle after Percutaneous Transluminal Angioplasty for Budd-Chiari Syndrome.
Mi Ran SIM ; Wha Sook KIM ; Won Kyung PARK ; Gae Hyuk MOON ; Eui Soo HONG ; Jeong Kee SEO ; Seong CHO ; June KWAN ; Keum Soo PARK ; Woo Hyung LEE
Korean Circulation Journal 2000;30(7):885-889
No abstract available.
Angioplasty*
;
Budd-Chiari Syndrome*
;
Heart Ventricles*
;
Stents*
7.Ethical problems of family physicians.
Il Soo KIM ; Chul Hwan KIM ; Hong Kwan SEO ; Kang Suk PAE
Journal of the Korean Academy of Family Medicine 2000;21(12):1568-1580
BACKGROUND: Recently ethical problems such as sex discrimination, euthanasia, trade in organ transplantation, medical certificate, and doctors' prescription are in issue. Doctors believe that their ethical level is high, but their social reputation is not. The objective of this study was to find out how family physicians responded to ethical problems in a primary care field. METHODS: Information was obtained by questionnaire survey from 613 family physicians in Seoul & Kyunggi Province from Aug. to Sep. 1997. Overall respondents were 149 (24.3%). RESULTS: The rate of the family physicians who never performed defensive medical practice was 9.4%, seldom was 56.4%, sometimes was 26.8%, and frequently was 7.4%. The rate of the family physicians who never performed excessive medical practice was 38.3%, seldom was 31.5%, sometimes was 22.1%, and frequently was 8.1% respectively. The rate of those who received premium in purchasing medicine was 90.6%. They regarded registered nurses, aid nurses and other technicians as companions who had the same rights to doctors. 58.3% of the respondents answered that ethical level of themselves was above average compared to other people. 51.6% of the respondents answered that their ethical level was above average to other medical specialists. They agreed to artificial abortion in 57.7%, euthanasia in 65.1%, brain death in 87.9%, and in vitro fertilization in 74.5%. They disagreed to homosexuality in 79.2%, sex exchange surgery in 72.5%. CONCLUSION: Most family physicians answered that their ethical level was high, but they had difficulties in problems concerning excessive practice and the premium purchasing medicine.
Brain Death
;
Surveys and Questionnaires
;
Ethics, Medical
;
Euthanasia
;
Fertilization in Vitro
;
Friends
;
Gyeonggi-do
;
Homosexuality
;
Human Rights
;
Humans
;
Organ Transplantation
;
Physicians, Family*
;
Prescriptions
;
Primary Health Care
;
Seoul
;
Sexism
;
Specialization
;
Transplants
8.The Evaluation of Diagnostic Validity of ECG for the Subendocardial Infarction by Myocardial Contrast Echocardiography.
Jeong Kee SEO ; Keum Soo PARK ; Jun KWAN ; Mee Young KWON ; Don LEE ; Eui Soo HONG ; Hyo Jung LEE ; Dea Hyeok KIM ; Seong Wook CHO ; Woo Hyung LEE
Korean Circulation Journal 2000;30(8):958-964
BACKGROUND AND OBJECTIVES: The pathological findings of Non-Q wave myocardial infarction(NQMI) on ECG did not always correspond to subendocardial infarction(SEMI). The purpose of this study was to evaluate the diagnostic validity of ECG for SEMI by myocardial contrast echocardiography (MCE) in the patients with acute myocardial infarction(AMI). MATERIALS AND METHODS: The study population was 84 patients who underwent MCE under the diagnosis of AMI. MCE was performed by intracoronary injection of sonicated Hexabrix into the infarct related artery and SEMI was diagnosed by inspecting endocardial defect with epicardial enhancement on MCE. RESULTS: (1) Among 19 NQMI cases, 7 cases showed SEMI with MCE score 0.5, 11 cases with score 1, and 1 case with score 0. Among 65 Q-wave MI(QMI) cases, only 5 cases showed SEMI. (2) 7 cases who had NQMI with SEMI showed LV wall motion recovery at follow-up echocardiography except 1 case. Whereas, of 5 QMI cases who had SEMI, only 1 case improve LV wall motion. CONCLUSION: NQMI on ECG does not always imply SEMI on MCE, but the absence of pathologic Q wave in the patients with SEMI is thought to be a predictive factor of the recovery of LV wall motion.
Arteries
;
Diagnosis
;
Echocardiography*
;
Electrocardiography*
;
Follow-Up Studies
;
Humans
;
Infarction*
;
Ioxaglic Acid
9.The Evaluation of Diagnostic Validity of ECG for the Subendocardial Infarction by Myocardial Contrast Echocardiography.
Jeong Kee SEO ; Keum Soo PARK ; Jun KWAN ; Mee Young KWON ; Don LEE ; Eui Soo HONG ; Hyo Jung LEE ; Dea Hyeok KIM ; Seong Wook CHO ; Woo Hyung LEE
Korean Circulation Journal 2000;30(8):958-964
BACKGROUND AND OBJECTIVES: The pathological findings of Non-Q wave myocardial infarction(NQMI) on ECG did not always correspond to subendocardial infarction(SEMI). The purpose of this study was to evaluate the diagnostic validity of ECG for SEMI by myocardial contrast echocardiography (MCE) in the patients with acute myocardial infarction(AMI). MATERIALS AND METHODS: The study population was 84 patients who underwent MCE under the diagnosis of AMI. MCE was performed by intracoronary injection of sonicated Hexabrix into the infarct related artery and SEMI was diagnosed by inspecting endocardial defect with epicardial enhancement on MCE. RESULTS: (1) Among 19 NQMI cases, 7 cases showed SEMI with MCE score 0.5, 11 cases with score 1, and 1 case with score 0. Among 65 Q-wave MI(QMI) cases, only 5 cases showed SEMI. (2) 7 cases who had NQMI with SEMI showed LV wall motion recovery at follow-up echocardiography except 1 case. Whereas, of 5 QMI cases who had SEMI, only 1 case improve LV wall motion. CONCLUSION: NQMI on ECG does not always imply SEMI on MCE, but the absence of pathologic Q wave in the patients with SEMI is thought to be a predictive factor of the recovery of LV wall motion.
Arteries
;
Diagnosis
;
Echocardiography*
;
Electrocardiography*
;
Follow-Up Studies
;
Humans
;
Infarction*
;
Ioxaglic Acid
10.Comparison of Coronary Flow Reserve According to The Degree of Hypokinesia in Dilated Cardiomyopathy With Regional Asynergy.
Jeong Kee SEO ; Jun KWAN ; Dea Hyeok KIM ; Eui Soo HONG ; Hyo Jung LEE ; Sung Wook CHO ; Keum Soo PARK ; Woo Hyung LEE
Korean Circulation Journal 2000;30(10):1238-1244
BACKGROUND AND OBJECTIVES: Dilated cardiomyopathy(DCMP) is a primary myocardial disease of unknown cause characterized by left ventricular or biventricular dilatation and impaired myocardial contractility. In 1973, Kreulen et al. classified DCMP into two groups-one with generalized hypokinesia and the other with regional asynergy in addition to generalized hypokinesia. Diminished coronary flow reserve has been reported in DCMP with generalized hypokinesia but its mechanism remains obscure. The aim of this study was to investigate the relationship between the degree of microvascular dysfunction and the difference of regional wall motion abnormality in DCMP with regional asynergy. METHODS: The subjects of this study were 11 patients (M:F=:5, mean age:60 15yrs) a diagnosis of DCMP with regional asynergy, normal sinus rhythm without left bundle branch block and normal coronary angiogram who underwent Doppler wire from September 1997 to December 1999. Left ventricle was divided into three territories according to the coronary arterial distribution by echocardiography(A: coronary artery territory showing regional asynergy, I: coronary artery territory showing intermediate wall motion, P: coronary artery territory showing relatively preserved wall motion). Coronary flow reserve(CFR) was measured at the mid portion of left anterior descending artery(LAD), left circumflex artery(LCX) and right coronary artery(RCA) with 0.014 inch Doppler guide wire before and during intracoronary injection of 12-18 of adenosine. Relative coronary flow reserve(rCFR) was obtained by the ratio of the CFR in coronary artery of the territory showing regional asynergy and relatively preserved wall motion to the CFR in coronary artery of the territory showing intermediate wall motion (CFRA/CFRI, CFRP/CFRI). RESULTS: Regional asynergy was observed in LAD territory in 4(36%) patients, LCX territory in 4(36%) patients, RCA territory in 3(28%) patients (p=s). The mean CFR was 2.5 0.6 in LAD, 2.4 0.5 in LCX, 2.4 0.6 in RCA(p=s). The mean CFR and rCFR in coronary arteries showing regional asynergy were significantly lower than those in coronary arteries showing relatively preserved wall motion(2.1 0.5 vs 2.7 0.6, p<0.05, 0.84 0.12 vs 1.11 0.11, p<0.001). CONCLUSION: Degree of regional hypokinesia in DCMP with regional asynergy seems to be associated with that of microvascular dysfunction.
Adenosine
;
Bundle-Branch Block
;
Cardiomyopathies
;
Cardiomyopathy, Dilated*
;
Coronary Vessels
;
Deoxycytidine Monophosphate
;
Diagnosis
;
Dilatation
;
Heart Ventricles
;
Humans
;
Hypokinesia*