No abstract available.
Abruptio Placentae* ; Female ; Pregnancy

No abstract available.
Abruptio Placentae* ; Female ; Pregnancy

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.

BACKGROUND: Familial hypercholesterolemia(FH) is an autosomal dominant metabolic disorder caused by the mutation in low density lipoprotein receptor(LDLR) gene. However, direct genetic diagnosis of LDLR gene mutation is not easily available because more than 300 mutations have been described in LDLR gene of FH patients. Therefore indirect genetic diagnosis using the genetic markers can be used to follow the inheritance of defective gene in FH families. The purpose of this study was to evaluate the usefulness of indirect genetic markers for detecting identical-by-descent LDLR gene abnormalities in FH families. METHODS: We examined the allele frequency, heterozygosity, polymorphism information content(PIC) of each genetic markers(D19S394, Taq I, Hinc II, Ava II, ATn, D19S221) in 94 unrelated healthy subjects. The genetic polymorphic haplotypes in 3 FH families were also determined. RESULTS: The heterozygosity and PIC values of RFLP's(Taq I, Hinc II, Ava II) were 0.51/0.344, 0.25/0.223, 0.28/0.233 and microsatellite markers(D19S394, ATn, D19S221) were 0.64/0.558, 0.56/0.455, 0.60/0.475. Hinc II and Ava II were significantly linked(|D|=0.72, p< 0.05). The cumulative PIC values of Taq I+Hinc II, Taq I+Hinc II+ATn, D19S394+ATn were 0.520, 0.814, 0.813, respectively. When applied in the FH pedigree, the genetic diagnosis using only one marker was not available in most cases. However, combination of two or more genetic markers could successfully discriminate the affected and unaffected members in FH families. Among the several combinations of the genetic markers, the combination of D19S394 and ATn was supposed to be the most effective and informative. Because one case of recombination was suspected in D19S221 allele, it was thought to be carefully used for genetic diagnosis of FH. CONCLUSION: We concluded that indirect genetic diagnosis using intragenic or extragenic genetic markers was useful for detecting identical-by-descent LDLR gene abnormalities in FH families and the most effective and informative combination of genetic marker seemed to be D19S394 and ATn.
Alleles ; Diagnosis* ; Gene Frequency ; Genetic Markers* ; Haplotypes ; Humans ; Hyperlipoproteinemia Type II* ; Lipoproteins* ; Microsatellite Repeats ; Pedigree ; Receptors, Lipoprotein* ; Recombination, Genetic ; Wills

The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree and site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.
Academic Medical Centers ; Dentistry* ; Diagnosis ; Humans ; Obesity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders ; Standard of Care

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.
Cardiology ; Chest Pain ; Coronary Artery Disease ; Diagnosis ; Myocardial Perfusion Imaging ; Thorax

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.
Ammonia ; Chimera ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Evaluation Studies as Topic ; Humans ; Imidazoles ; Nitro Compounds ; Positron-Emission Tomography

Recently the incidence of inflammatory and infiltrative heart diseases is increasing in Korea. Cardiac PET/CT is a useful technology evaluating inflammatory and infiltrative heart diseases. This study analyzed trends in the use of cardiac PET/CT for evaluating inflammatory and infiltrative heart diseases in the Chonnam National University Hospital and Chonnam National University Hwasun Hospital. The general trend in Korea was also assessed based on the domestic nuclear medicine database.There was a common increasing trend in the number of F-18 FDG PET/CT for the evaluation of inflammatory and infiltrative heart diseases. A representative case with cardiac sarcoidosis is illustrated.

Recently the incidence of inflammatory and infiltrative heart diseases is increasing in Korea. Cardiac PET/CT is a useful technology evaluating inflammatory and infiltrative heart diseases. This study analyzed trends in the use of cardiac PET/CT for evaluating inflammatory and infiltrative heart diseases in the Chonnam National University Hospital and Chonnam National University Hwasun Hospital. The general trend in Korea was also assessed based on the domestic nuclear medicine database.There was a common increasing trend in the number of F-18 FDG PET/CT for the evaluation of inflammatory and infiltrative heart diseases. A representative case with cardiac sarcoidosis is illustrated.

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.