• Title/Summary/Keyword: 혈관촬영실

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Noninvasive Evaluation of Coronary Artery Bypass Graft Patency by Electron Beam Tomography (전자선 단층 촬영을 이용한 관상동맥 우회로 개존의 비침습적 평가)

  • 최규옥;김호석;조범구
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.693-701
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    • 1999
  • Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.

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A Case of Advanced Gastric Cancer with Deep Vein Thrombosis Treated with Low Molecular Weighted Heparin (전이성 위암환자의 심부정맥혈전증에 대한 저분자량 헤파린 투여 사례)

  • Su Jin Heo;Chan Hyuk Park;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.108-110
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    • 2013
  • The relationship between malignancy and venous thromboembolism(VTE) has been well established. About 20% of all VTE cases are associated with cancer and thrombotic events are the second leading cause of death in cancer patients after death from cancer itself. Effective prophylaxis and treatment will reduce morbidity and may decrease overall mortality. We report a case of VTE in a patient with advanced gastric cancer who treated with low-molecular weighted heparin (LMWH). A 49-year-old man with heartburn was admitted to our hospital. On the endoscopic and radiologic imaging, the patient was diagnosed as an advanced gastric cancer with perigastric infiltration and liver metastasis. During the combination chemotherapy, he had pain and swelling of left lower leg. Doppler ultrasonography showed left posterior tibial venous thrombosis and pulmonary embolism CT showed thromboembolism in subsegmental pulmonary artery branch in right lower lobe. He was treated with LMWH, Dalteparin once daily via subcutaneous injection, and his symptoms was subsided.

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Surgical Treatment of Traumatic Ventricular Septal Defect by Penetrating Chest Injury (흉부관통상으로 인한 심실중격결손의 치료)

  • 김시욱;한종희;강민웅;나명훈;임승평;이영;최시완;유재현
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.999-1002
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    • 2004
  • Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.

The Effects of Nursing Work Environment, Job Stress and Knowledge Sharing on Nursing Performance of Nurses in a Tertiary Hospital (일개 상급종합병원 간호사의 간호근무환경, 직무스트레스, 지식공유가 간호업무성과에 미치는 영향)

  • Shin, Yang Mi;Cho, Hun Ha
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.32-42
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    • 2021
  • Purpose: The purpose of this study was to identify factors influencing nursing performance of clinical nurses. Methods: This was a descriptive study involving 172 nurses who worked for 6 months or longer at one general hospital in B City. The data analysis was conducted with t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression. Results: Nursing performance of participants positively correlated with job stress (r=.16, p=.033). The factors affecting nursing performance were total clinical experience (β=.37 p<.001), salary (β=.19, p=.028), and job stress (β=.13, p=.045). These variables had a 27.2% variance to explain nursing performance. Conclusion: Based on these results, administrative and financial support are required for the development of a clinical career program, including the differentiation of salary systems of clinical nurses. There is also a need to develop and implement job stress management and coping programs.

Laceration of Left Main Bronchus and Azygos Vein Following Stab Wound - 1 case report - (자상에 의한 기정맥 및 좌측 주 기관지 열상 - 치험 1례 -)

  • 이신영;신원선;곽영태;배철영;김동원;윤영철;이경호
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1243-1246
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    • 1998
  • Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.

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Distribution and Management of Spatial Dose Rate in Neuro Angio Room (두개부 혈관조영실에서 공간산란선량의 분포와 관리)

  • Lee, Mi-Hwa;Jung, Hong-Ryang;Lim, Cheong-Hwan;Hong, Dong-Hee;Kim, Ki-Jeong;Kim, Sang-Hyun
    • Journal of Digital Convergence
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    • v.12 no.4
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    • pp.427-435
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    • 2014
  • This study is performed in the intervention unit, during interventional procedures and in accordance with the direction and distance during the exposure indoor space is to measure the dose. I was classified at an angle of $45^{\circ}$ counterclockwise from the phantom. Seven(A, B, C, D, E, F, G) were classified as direction. Length was measured from the center of the phantom. Each direction 50cm, 100cm, 150cm, 200cm were classified. I was analyzed by measuring of frontal, lateral, Bi-plan fluoroscopic Spatial dose rate in all 28 points. Measured dose was the highest at 50cm and over 200cm, dose was rapidly decreasing as increased distance. Dose was different more than nine times depending on the distance and direction, Installation of shielding wall can reduce exposure about 84.52% to 93.54%.

Reducing Radiation Exposure Dose on Operator by Using Lateral Protection in Neuro-Intervention (뇌혈관 중재적시술에 있어 측방향 차폐체를 이용한 시술자 피폭 선량 저감화 방법 연구)

  • Kim, Jongdeok;Ahn, ByeoungJu;Lee, Junhaeng
    • Journal of the Korean Society of Radiology
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    • v.8 no.1
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    • pp.1-10
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    • 2014
  • The bi-plane cerebrovascular angiography radiation is done the radiation exposure at the forward and lateral direction as opposed to the one of the source. So, the exposure dose of radiation workers increases further. Therefore, the medical diagnostic radiation workers as well as patients is interested to ways to reduce the dose. The exposure dose of cerebral angiography and interventional radiology must be considered the primary radiation of X-ray tube directly, scattered primary radiation between lateral tube and lateral detector and relatively small secondary scatter radiation in the walls of room. The aim of study is that the exposure dose of primary and scatter radiation reduce as much as possible to install protection device of lateral protection than common shielding of table and ceiling. As a result, the dose of fluoroscopy was reduced approximately 3.64 times the gonads, thyroid approximately 3.13 times, 4.42 times around eyes. And the dose of DSA was reduced approximately 4.98 times the gonads, thyroid approximately 3.00 times, 1.67 times around eyes. Consequently, medical practitioners can be helpful for radiation dose-exposure for the lateral protection of bi-plane cerebrovascular angiography more than the common shield method in cerebrovascular angiography and interventional radiological procedures.

The Analysis of Radiation Exposure of Hospital Radiation Workers (병원 방사선 작업 종사자의 방사선 피폭 분석 현황)

  • Jeong Tae Sik;Shin Byung Chul;Moon Chang Woo;Cho Yeong Duk;Lee Yong Hwan;Yum Ha Yong
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.157-166
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    • 2000
  • Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

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Spontaneous Chylothorax Associated with Primary Lymphedema (림프 부종과 동반된 특발성 유미흉)

  • Lee, Sung-Ho;Kim, Kwang-Taik;Gweon, Woo-Seog;Lee, Song-Am;Cho, Seong-Joon;Son, Ho-Sung;Sun, Kyung;Cho, Jong-Ho;Park, Sung-Min
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.718-721
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    • 2004
  • Chylothorax is defined as an extravasation of chylous fluid to the pleural cavity due to various causes, and a spontaneous chylothorax associated with primary lymphedema is an exceedingly rare condition. We report a case of the chylothorax associated with lymphedema. A 14-year-old boy was admitted to our hospital for chest pain and dyspnea. He had been on medical treatment for lymphedema and his chest roentgenogram on admission revealed left pleural effusion. The diagnosis of chylothorax was confirmed by chemical analysis of the pleural fluid. The patient was treated successfully by ligation of the thoracic duct using video assisted thoracoscopic technique.