[en] The purpose was to evaluate cardiac sympathetic reinnervation and hemodynamic changes after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and rest 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 patients (M:F=10:5;mean ages=34.5±13.0 yr; idiopathic:rheumatic=14:1; one heart lung TPL)(10.80 ±11.88 (1-48) mo) after TPL 123I-MIBG imagings were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR) Compared to HMR on 15 min images (1.48 ± 0.28), neither four nor 24 hour delayed images (1.26 ± 0.23 vs. 1.06 ± 0.26: p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. 12 subjects with <13 (4.9 ±3.7) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.6±12.8) months had visible cardiac 123I-MIBG uptake (HMR: 1.65±0.21 vs. 1.32±0.26; p=0.002). One-year followup 123I-MIBG scintigraphy in nine pts showed significantly increased HMR(1.40±0.31 to 1.61±0.16, p<0.05) but a plateau was reached at HMR value of 2.0, which was still lower than 3.0 in normal controls. Plasma NE was increased according to I-123 MIBG myocardial uptake. Annual G-MPS detected an allograft atherosclerosis in one pt and showed progressive normalization of tachycardia and significant deterioration of LVEF and cardiac indices according to severity of rejection. To dipyridamole stress, transplant heats showed significant subnormal hemodynamic responses. Partial sympathetic late reinnervation can occur <1 year after TPL, and reached a plateau of two-third of normal value. G-MPS seems to be a useful screening test for the detection of allograft atherosclerosis and rejection

[en] Iodine-123 metaiodobenzylguanidine (123I-MIBG) is a norepinephrine (NE) analogue and taken up by myocardial sympathetic nerves. To determine whether cardiac sympathetic reinnervation occurs after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and 201T1/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 pts(M : F =10 : 5; mean ages = 34.67±12.92 yr; idiopathic: rheumatic=14:1) (10.80±11.88 (1-48) mo) after TPL. 123I-MIBG imagins were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of heart to mediastinal MIBG uptake (HMR). 12 subjects with < 13 (4.91±3.67) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.58±12.77) months had visible cardiac 123I-MIBG uptake (HMR: 1.65 ±0.21 vs. 1.32±0.26 p=0.002). Correlation was found between plasma NE concentration and HMR ( r=0.80: p<0.05). Compared to HMR on 15 min images (1.48±0.28), neither four nor 24 hour delayed images (1.26±0.23 vs. 1.06±0.10 : p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. To dipyridamole stress, transplant hearts showed significant subnormal hemodynamic responses of HR, s-BP, d-BP, and rate pressure product (90.9±14.9 to 102.2±15.3, 136.5±17.3 to 124.9±13.3, 83.3±12.5 to 74.7±15.6, 123.2±19.4 to 127.4±21.8 p<0.05, respectively). One-year followup 123I-MIBG scintigraphy in nine pts showed increased HMR (1.50±0,37 to 1.61±0.15, p=ns) but couldnt reach the statistical significance. Out of nine followup patients, five showed increased HMR but four didnt. gMPS performed at post-TPL 48 months in one patient complaining vague chest pain whose HMR value 1.73 to 1.62 showed an apicoanterior wall reversible perfusion defect which confirmed as 90% distal left anterior descending artery stenosis by coronary angiography. In conclusion, partial sympathetic late reinnervation of the transplant human hearts can occur > 1 year after TPL whereas reinnervation is less likely to occur in pts with a pretransplantation diagnosis idiopathic cardiomyopathy

[en] Selection of diagnosis data, troubleshooting table(symptom/diagnosis/remedy) - visiting Uljin 2 times, Yeonggwang once, examination of monitoring system, data collection of piping system, analysis of operation parameter for Pielstic DMDS, analysis of DMDS trial data for Uljin 5/6 EDG, embodiment of diagnosis knowledge for diesel engine(class/method/member), framing roubleshooting for Pielstic PC2-5V. Development of display module for monitoring and diagnosis - system classification of EDGS, design of system GUI based on in-touch, development of interface to diagnosis module. Development of diagnosis module - expression of EDG object using Java language, development of inference engine based on ILOG Jrules, development of interface to in-touch