1.The Usefulness of Myocardial SPECT for the Preoperative Cardiac Risk Evaluation in Noncardiac Surgery.
Myung Chul LEE ; Dong Soo LEE ; Won Jun KANG ; June Key CHUNG ; Seok Tae LIM
Korean Journal of Nuclear Medicine 1999;33(3):273-281
PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death
;
Electrocardiography
;
Heart Failure
;
Humans
;
Multivariate Analysis
;
Myocardial Infarction
;
Myocardial Ischemia
;
Perfusion
;
Perioperative Period
;
Retrospective Studies
;
Risk Factors
;
Tomography, Emission-Computed, Single-Photon*
2.Prognostic Value of Rest Tl-201/Dipyridamole Stress Tc-99m-MIBI Myocardial Single Photon Emission Computed Tomography (SPECT).
Won Jun KANG ; Dong Soo LEE ; June Key CHUNG ; Myoung Mook LEE ; Myung Chul LEE
Korean Circulation Journal 1998;28(8):1260-1271
BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain
;
Coronary Angiography
;
Coronary Artery Disease
;
Dipyridamole
;
Humans
;
Interviews as Topic
;
Medical Records
;
Multivariate Analysis
;
Myocardial Infarction
;
Perfusion
;
Prognosis
;
Proportional Hazards Models
;
Smoke
;
Smoking
;
Tomography, Emission-Computed, Single-Photon*
3.Establishment of I-131, Tc-99m labeling methods to in-house anti-CEA antibodies and evaluation of the immunological characteristics.
June Key CHUNG ; Dong Soo LEE ; Myung Chul LEE ; Hong Keun CHUNG ; Chang Soon KOH ; Mee Kyoung HONG ; Seok Rye CHOI ; Il Taek SEO ; Jun Ho CHUNG
Korean Journal of Nuclear Medicine 1992;26(2):346-354
No abstract available.
Antibodies*
4.Nine Case of Congenital Variants of the Pancreatic Duct Diagnosed by ERCP.
Jin Kyung KANG ; In Suh PARK ; Jae Bock CHUNG ; Si Young SONG ; Key Joon HAN ; Jun Pyo JUNG
Korean Journal of Gastrointestinal Endoscopy 1994;14(3):343-348
Although variation is the rule with pancreatic duct morphology, certain variants occur as a result of altered embroological development. These ductal configurations, most striking deviations from the normal configuration, may be classfied according to alterations of embryological development. These congenital variants of pancreatic duct may be important for several reasons. First, the pseudomass effect of ductal anomalies can be mistaken for carcinoma by the inexperienced radiologists. Second, whether or not the anomaly is important, it is present in many patients with recurrent pacreatitis. Original descriptions were based on small sampling of postmortem studies and surgical specimen, but more recently the advent of endoscopic retrograde cholangiopancreatography(ERCP) has confirmed of the work of early anastomists and increased awareness of these variants. To evalute of frequency, characteristics of associated disease and clinical significance of pancreatic anomalies, we have reviewed of 5330 case of ERCP filmes which were undertaken between July, 1973 and August, 1993. Having reviewed of ERCP filmes, we found out 9 case of pancreatic duct variants. Among them, 7 cases were classified as ductal duplication anomalies, 4 cases of number variation, most, bifuricaiton and 3 cases of form variation, which were composed of loop, spiral and terminal N. Three cases of fusion anomalies were also noted, which were 2 cases of panceratic divisum and 1 case of incomplete pancreatic divisum. The associated diseases were 6 cases of bile duct and galbladder stones and 3 cases of pancreatic cancer. We could not find out the case of congenital anomalies as cause of obstructive pain and pseudomass effect.
Bile Ducts
;
Cholangiopancreatography, Endoscopic Retrograde*
;
Humans
;
Pancreatic Ducts*
;
Pancreatic Neoplasms
;
Pancrelipase
;
Strikes, Employee
5.Performance of Gated Myocardial Perfusion SPECT to Diagnose Coronary Artery Disease.
Chang Soon KOH ; Myung Chul LEE ; June Key CHUNG ; Dong Soo LEE ; Myoung Mook LEE ; Won Jun KANG
Korean Journal of Nuclear Medicine 1997;31(1):50-56
We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We performed rest T1-20l/stress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, a kinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickenining 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening, Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening. However, 16(84%) segments out of 19 having severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.
Coronary Artery Disease*
;
Coronary Vessels*
;
Dobutamine
;
Dyskinesias
;
Echocardiography
;
Humans
;
Hypokinesia
;
Myocardium
;
Perfusion*
;
Tomography, Emission-Computed, Single-Photon*
6.A Case of Leiomyoblastoma of Stomach.
Sang Pal LEE ; Duk Key JANG ; Yong Jun HUR ; Young Ki CHUNG ; Dae Sik WON ; Dong Ryong SEO ; Doo Bok PAK
Korean Journal of Gastrointestinal Endoscopy 1988;8(2):141-144
In 1960 Martin and his associates described another type of tumor of the stomach derived from the smooth muscle, which they named myoid tumor in a study of six patients. In 1962 Stout applied the term "lelomyoblastoma" to this interesting entity in a report of a collected series of 69 patients. Tumor cells are round or polygonal epithelioid cells, which contain perinuclear vacuole or clear zone. A 58 year-old female was admitted to this hospital because of epigastric discomfort for three months. At Upper gastrointestinal series and gastrofiberscope, a round hemispherical submucosal tumor was noted at posterior wall near the lesser curvature of gastric antrum. After subtotal gastrectomy, the submucosal tumor was diagnosed as leiomyoblastoma. Because leiomyoblastoma are rare and easily misdiagnosed as leiomyoma or leiomyosarcoma, careful histologic study is recommended.
Epithelioid Cells
;
Female
;
Gastrectomy
;
Humans
;
Leiomyoma
;
Leiomyoma, Epithelioid*
;
Leiomyosarcoma
;
Middle Aged
;
Muscle, Smooth
;
Pyloric Antrum
;
Stomach*
;
Vacuoles
7.Comparison of the Neural Substrates Mediating the Semantic Processing of Korean and English Words Using Positron Emission Tomography.
Jae Jin KIM ; Myung Sun KIM ; Sang Soo CHO ; Jun Soo KWON ; Jae Sung LEE ; Dong Soo LEE ; June Key CHUNG ; Myung Chul LEE
Korean Journal of Nuclear Medicine 2001;35(3):142-151
No abstract available.
Electrons*
;
Negotiating*
;
Positron-Emission Tomography*
;
Semantics*
8.Clinical features of autonomously functioning thyroid nodules.
Min Ho SHONG ; Jun Key CHUNG ; Seong Yeon KIM ; Myung Chul LEE ; Bo Youn CHO ; Hong Kyu LEE ; Chang Soon KOH ; Hun Ki MIN
Journal of Korean Society of Endocrinology 1992;7(2):115-120
No abstract available.
Thyroid Gland*
;
Thyroid Nodule*
9.Long-term Prognostic Value of Dipyridamole Stress Myocardial SPECT.
Dong Soo LEE ; Gi Jeong CHEON ; Myung Jin JANG ; Won Jun KANG ; June Key CHUNG ; Myoung Mook LEE ; Myung Chul LEE ; Wee Chang KANG ; Young Jo LEE
Korean Journal of Nuclear Medicine 2000;34(1):39-54
PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.
Coronary Angiography
;
Coronary Artery Disease
;
Dipyridamole*
;
Follow-Up Studies
;
Humans
;
Perfusion
;
Prognosis
;
Proportional Hazards Models
;
Tomography, Emission-Computed, Single-Photon*
10.Detection of Osteomylitis Using a Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy.
Won Jun KANG ; June Key CHUNG ; Jeong Seok YEO ; Mee Kyoung HONG ; Jae Min JEONG ; Dong Soo LEE ; Sang Hoon LEE ; In Ho CHOI ; Myung Chul LEE
Korean Journal of Nuclear Medicine 1998;32(4):344-353
PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. MATERIALS AND METHODS: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. RESULTS: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. CONCLUSION: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.
Biopsy
;
Diagnosis
;
Follow-Up Studies
;
Humans
;
Male
;
Orthopedics
;
Osteomyelitis
;
Sensitivity and Specificity