• 제목/요약/키워드: Compression injury

검색결과 171건 처리시간 0.024초

고주파에너지를 이용한 미로술식의 성적향상을 위한 새로운 기구의 개발 (Development of New Device to Improve Sucess Rate of Maze Procedure with Radiofrequency Energy)

  • 박남희;유양기;이재원
    • Journal of Chest Surgery
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    • 제37권6호
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    • pp.467-473
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    • 2004
  • 배경: 심방세동의 수술적 치료 방법인 미로술식에 있어 고주파에너지를 이용한 절제술은 전통적인 절개 및 봉합술 (cut and saw) 또는 냉동절제술(cyroablation)에 비해 술 후 동율동의로의 전환율이 낮은 것으로 알려져 있다. 이는 절제술 시 심방벽 (atrial wall)과 도자 간의 접촉이 원활하지 않아 심방의 전층에 걸쳐 고주파 에너지가 전달되지 않기 때문인 것으로 생각된다. 이에 고주파 절제시 심방과 도자간의 접촉을 원활하게 하기 위한 기구를 개발하였으며 동물실험을 통하여 그 임상적인 효과를 관찰하고자 하였다. 대상 및 방법: 60 kg 내외의 돼지 10 마리를 대상으로 하였다. 우심방이 첨부로부터 3∼4 cm 하방의 심방외벽에 고주파에너지를 가하여 우심방이가 우심방에서 완전히 분리되도록 원형의 병변 (circumferential lesions)을 만들었다. 이때 실험군(n=5)에서는 새로 고안한 기구를 이용하여 도자를 심방벽에 완전히 밀착시킨 후 고주파 에너지를 가하였으며, 대조군(n=5)에서는 이러한 기구의 사용 없이 통상적인 방법으로 에너지를 가하였다. 고주파절제술이 끝난 후 우심방이 첨부에 인공심장박동 전극을 설치하고 심박동을 유발하여 고주파 절제부위 이하로 심박동이 전달되는지를 관찰하여 절제술의 성공 여부를 판단하였다. 또한 심방조직에 대해 조직학적 검사를 시행하여 심외막, 심근, 그리고 심내막층에 고주파에너지에 의한 열손상의 생성 유무를 관찰하였다. 결과: 실험군에서 5예, 대조군에서 3예 등 총 8예에서 심박동의 전달 차단 (conduction block)이 관찰되었으며 조직학적 검사 소견상 심내막(endocardium)에서 탄성섬유(elastic fiber)의 소실과 급성 염증세포의 축적 등 급성 열손상의 소견이 관찰되었다. 한편 심박동의 전달 차단이 관찰되지 않았던 대조군의 2예에서는 심내막이 정상으로 나타났다. 또한 기관 및 식도에 대한 조직학적 검사에서 열손상에 의한 병변은 관찰되지않았다. 결론: 고주파에너지에 의한 절제술 시 심방의 전층에 병변을 만들기 위해서는 심장과 도자간의 접촉이 가장 중요한 인자로 생각된다. 본 연구에서 새로 개발한 기구는 고주파에너지를 이용한 도자절제술 시 심장과 도자 간의 확고한 접촉을 유도하여 심방 전층에 병변을 만드는 데 매우 효과적이었으며 이러한 기구의 사용은 향후 고주파에너지를 이용한 미로술식의 성적향상에 도움이 될 것으로 사료된다.

동반이환된 특발성 수근관증후군과 족근관증후군의 전기생리학적 특징 (Electrophysiologic Characteristics of Combined Idiopathic Carpal Tunnel Syndrome and Tarsal Tunnel Syndrome)

  • 김성혁;양지원;성영희;박기형;박현미;신동진;이영배
    • Annals of Clinical Neurophysiology
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    • 제13권1호
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    • pp.31-37
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    • 2011
  • Background: Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology, compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationship between idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze the electrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS. Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 to February 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantar nerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control group of each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS group and CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve action potential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTS group. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTS control group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degree of nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.

염색체 17p11.2 유전자 결손을 동반한 유전성 압박마비 편향 신경병증의 임상적, 전기생리학적 특성 (Clinical and Electrophysiological Features of HNPP Patients with 17p11.2 Deletion)

  • 홍윤호;김만호;성정준;김성훈;이광우
    • Annals of Clinical Neurophysiology
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    • 제4권2호
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    • pp.125-132
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    • 2002
  • Objectives : Although the diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP) is important for correct prognostic evaluation and genetic counseling, the diagnosis is frequently missed or delayed. Our main aim on undertaking this study was to characterize the electrodiagnostic features of HNPP. Material and Methods : Clinical, electrophysiologic and molecular studies were performed on Korean HNPP patients with 17p11.2 deletion. The results of electrophysiologic studies were compared with those of Charcot-Marie-Tooth disease type 1A (CMT1A) patients carrying 17p11.2 duplication. Results : Eight HNPP (50 motor, 39 sensory nerves) and six CMT1A (28 motor, 16 sensory nerves) patients were included. The slowing of sensory conduction in nearly all nerves and the distal accentuation of motor conduction abnormalities are the main features of background polyneuropathy in HNPP. In contrast to CMT1A, where severity of nerve conduction slowing was not different among nerve groups, HNPP sensory nerve conduction was more slowed in the median and ulnar nerves than in the sural nerve (p<0.01), and DML was more prolonged in the median nerve than in the other motor nerves (p<0.01). TLIs were significantly lower in HNPP than in the normal control and CMT1A patients for the median and ulnar nerves (p<0.01), and were also significantly reduced for the peroneal nerve (p<0.05) compared with those of the normal controls. Conclusion : The distribution and severity of the background electrophysiologic abnormalities are closely related to the topography of common entrapment or compression sites, which suggests the possible pathogenetic role of subclinical pressure injury at these sites in the development of the distinct background polyneuropathy in HNPP.

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3.5 mm T형 잠김 금속판을 이용한 원위 쇄골 골절의 치료 결과 (3.5 mm T-shaped LCP (Locking Compression Plate) Fixation for Unstable Distal Clavicular Fractures)

  • 이철우;김희천;노재영;박영수
    • Clinics in Shoulder and Elbow
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    • 제11권1호
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    • pp.41-45
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    • 2008
  • 목적: 쇄골 원위부 불안정성 골절에 대하여 3.5 mm T형 잠김 금속판을 이용한 내고정을 시행한 후 임상적 결과를 보고하고자 한다. 대상 및 방법: 2005년 2월부터 2006년6월까지 3.5 mm T형 잠김 금속판을 이용하여 수술적 치료를 시행한 Neer 2형 원위 쇄골 골절 환자 중 1년 이상 추시가 가능하였던 10예를 대상으로 후향적 연구를 시행하였다. 남자가 6예 여자가 4예였으며, 평균 연령은 45.7세($32{\sim}62$)였다. 동반 손상은 다발성 골절이 1예가 있었으며, 비수술적 치료의 실패로 불유합이 발생하여 자가골 이식술을 동반한 수술적 치료를 시행한 예가 2예 있었다. 평균 추시 기간은 14.8개월($12{\sim}22$)이었으며, 골유합은 단순 방사선검사 소견으로 판정하였고, 임상적 결과는 UCLA점수와 관절 운동 범위 등으로 평가 하였다. 결과: 방사선학적 골유합은 평균 9주($6{\sim}12$주)에 얻을 수 있었으며, 최종 추시 시 UCLA 점수는 평균 33.4점($30{\sim}35$)으로 전예에서 양호 이상의 결과를 얻었고, 관절 운동 범위도 전예에서 정상으로 회복되었다. 합병증으로 1예에서 나사못의 이완소견이 관찰 되었고, 1예에서 견봉-쇄골 관절의 경도의 아탈구가 발생하였으나, 결과에 영향을 미치지는 않았다. 결론: 불안정성 원위 쇄골 골절에 사용한 3.5 mm T형 잠김 금속판을 이용한 내고정은 견봉 쇄골 관절에 영향을 주지 않으며, 견고한 고정을 얻을 수 있었고, 분쇄의 정도가 아주 심하지 않은 원위쇄골 골절의 치료 시 고려 할 수 있는 유용한 술기로 사료된다.

척추 경막외 출혈에 대한 수술적 치료성적 분석 (Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas)

  • 조영현;박진훈;김지훈;노성우;김창진;전상룡
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

원위경비인대결합 손상 선수의 경·비간 압박테이핑 적용이 통증, 관절가동범위, 근력에 미치는 영향 (Effect of Pressure Taping between Tibia and Fibula on Pain, ROM and Strength in Athletes diagnosed with High Ankle Sprain)

  • 장원봉;오재근;윤진호
    • 한국융합학회논문지
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    • 제12권4호
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    • pp.303-310
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    • 2021
  • 본 연구는 원위경비인대결합이 손상된(High Ankle Sprain) 운동선수들의 경·비간 압박테이핑 적용이 통증, 관절가동범위, 근력에 미치는 영향을 규명하는데 있다. High Ankle Sprain 또는 발목 염좌를 진단받은 선수 중 이학적 검사결과 양성인 운동선수 14명을 대상으로 중도 포기 4명을 제와한 10명을 대상으로 진행하였다. 3주간 아급성기재활 전, 중, 후로 경비간 압박테이핑 처치군(TG)과 적용하지 않는 대조군(NTG)으로 나누어 통증, 관절가동범위, 등척성근력을 측정 하였다. 통계는 반복측정에 의한 변량분석을 실시하였으며 사후검증은 t-test를 실시하였다. 연구 결과 통증(VAS)은 유의한 차이가 발생하지 않았으며, 관절가동범위는 두 그룹 모두 내번과 외번 가동범위가 시기간 유의한 증가를 보였고, 등척성근력은 테이핑 처치군 에서만 내번(0°, 7°, 14°)과 외번(0°)에서 시기간 유의한 향상이 나타났다. 결론적으로 원위경비인대결합 손상 운동선수의 경·비간 압박 테이핑 적용이 아급성기 재활프로그램에서 동일한 통증수준에서도 관절가동범위와 근력의 조기 향상에 효과가 있는 것으로 나타났다.

위증에 대한 동서의학적(東西醫學的) 고찰(考察) (The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine)

  • 김용성;김철중
    • 혜화의학회지
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    • 제8권2호
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    • pp.211-243
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    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

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자궁경부암의 3D-CRT와 IMRT시 소장전위장치의 소장 선량에 대한 영향 (Small Bowel Sparing Effect of Small Bowel Displacement System in 3D-CRT and IMRT for Cervix Cancer)

  • 강민규;허승재;한영이;박 원;주상규;김경주;이정은;박영제;남희림;임도훈;안용찬
    • Radiation Oncology Journal
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    • 제22권2호
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    • pp.130-137
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    • 2004
  • 목적 : 자궁경부암의 방사선치료 시 3차원입체조형방사선치료(3D-CRT)와 세기조절방사선치료(IMRT)는 소장의 방사선 조사선량을 감소시킬 수 있으며, 소장전위장치(SBDS)는 골반강 내의 소장 용적을 감소시킬 수 있다고 알려져 있다. 본 연구는 SBDS를 사용한 3D-CRT와 IMRT 계획을 SBDS를 사용하지 않은 계획과 비교하여, SBDS의 소장 조사선량에 대한 영향을 평가하였다 대상 및 방법 : 자궁경부암으로 근치적 방사선치료를 받은 10명의 환자를 대상으로 하였다. 각 환자에 대하여 스티로폼 압박기구와 환자에게 개별적으로 제작되는 고정기구로 구성된 SBDS를 제작하였고, SBDS가 있는 상태와 없는 상태로 복와위에서 전산화단층촬영(CT)을 시행하였다 3D-CRT는 4-field box technique을, IMRT는 15 MV X-선 7 조사문을 이용하여 계획하였으며, 회전중심점에 50 Gy (25회 분할)를 처방하였다. 비교 분석은 SBDS의 사용에 따른 소장 용적의 변화와 네 가지 계획의 소장의 선량체적히스토그람의 차이를 10 Gy 단위로 paired f-test를 이용하여 분석하였다. 결과 : 소장의 용적은 SBDS를 사용하였을 때 평균 522 cm$^{3}$에서 262 cm$^{3}$로 49.8$\%$ 감소되었다. 10 Gy부터 50 Gy까지 10 Gy 간격으로 일정한 조사선량을 받는 소장의 용적은 SBDS를 사용하였을 때 3D-CRT에서65$\~$80$\%$, IMRT에서 54$\~$67$\%$ 감소하였다. 3D-CRT와 IMRT를 서로 비교하면, 20 Gy부터 50 Gy까지 10 Gy간격으로 일정한 조사선량을 받는 소장 용적은 SBDS를 사용하지 않은 경우에는 IMRT가 6$\~$7$\%$ 정도 유의하게 적었으나 SBDS를 사용한 경우에는 1$\%$ 이내로 차이가 없었다. 결론 : 3D-CRT와 IMRT에서 SBDS를 사용할 때 소장의 조사선량을 더 감소시킬 수 있었으므로, SBDS를 치료에 이용하면 소장의 부작용을 더 감소시킬 수 있을 것이다.

대퇴골 간부 골절시 사용한 금속물의 금속부전(Metal failure)의 기전에 대한 연구 (A study of the cause of metal failure in treatment of femur shaft fracture - Fractographical and clinical analysis of metal failure-)

  • 전춘배;서재성;안면환;안종철;인주철
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.81-93
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    • 1990
  • 1983년 5월부터 1989년 9월까지 본 영남의료원 정형외과에 대퇴골 간부골절시 사용한 금속 내 고정물의 금속 부전으로 입원한 경우 중 부전된 금속의 표면관찰이 가능한 8례에 대한 임상적 고찰 및 부전된 금속 파손 표면의 관찰을 통해 확인한 파손 원인을 요약하면 다음과 같다. 1. 금속 부전이 발생 내고정물의 종류는 압박금속판 5례, Jewett nail 1례, Rowe plate screw 1례, interlocking nail 1례였다. 2. 금속 부전의 임상적 추정에 의한 원인으로는 반대편 피질골 결손 5례, 부적절한 위치선정 1례 및 부적절한 금속선택 1례였다. 3. 금속 내고정후 금속 부전이 되기까지의 기간을 보면, 4개월이 1례, 6개월에서 12개월 사이가 6례, 3년이 1례였다. 4. 부전된 내고정물의 파손면 관찰을 통해 확인한 금속부전의 원인을 보면, 첫째, impact failure 1례 둘째, fatigue failure 6례 machining mark가 있어 이것이 stress riser로서 역할을 한 것으로 보이는 경우가 4례였으며, 이의 형태는 low consistent cyclic fatigue failure와 irregular cyclic fatigue failure의 형태를 관찰할 수 있었다. 셋째, Stress corrosion crack 1례를 관찰할 수 있었다. 5. 316L Stainless Steel은 내부식성이 좋은 금속이지만 fretting에 의해 특유의 부동태 피막이 손상되면 pitting corrosion을 일으키며 경우에 따라서는 파손의 기점으로 작용되어 failure의 주요 원인이 되기도 한다. 6. screw hole의 가공시 기계에 의한 손상 및 기구(implant) 제조 과정중 손상이 plate의 failure를 유발하는 중요한 원인이 될 수도 있다. 기계에 의한 손상은 응력을 집중시키므로 plate가 파손되기 쉽게 한다. 이상의 결과 임상적 추정에 의한 원인 이외에도 부전된 금속파손면 관찰을 통해 중요한 다른 원인을 찾을 수 있었으므로, 금속부전의 예방을 위해 앞으로 이 방향으로의 계속적인 연구가 필요할 것으로 사료된다.

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Sensory Information Processing

  • Yoshimoto, Chiyoshi
    • 대한의용생체공학회:의공학회지
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    • 제6권2호
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    • pp.1-8
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    • 1985
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70$\pm$1.32mmHg/min)compared to CF dialyzers(4.32$\pm$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500, 550, 570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500, 550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100, 300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3, 000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.SpO2 with Plethysmograph.

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