• Title/Summary/Keyword: Small Vessels

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Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular Embolization (Folded-Loop Guidewire Remodeling Technique: 색전술 시 급격한 분지 각도를 가지는 혈관의 선택적 진입 방법)

  • Dong Hyun Kim;Ung Rae Kang;Young Hwan Kim;Jung Guen Cha
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.418-426
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    • 2023
  • Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization. Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery. Results Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.

Initial Experience of Robotic Cardiac Surgery (수술로봇을 이용한 심장수술 첫 체험)

  • Cho Sung Woo;Chung Cheol Hyun;Kim Kyoung Sun;Choo Suk Jung;Song Hyung;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.366-370
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    • 2005
  • Background: In general, cardiac surgery has been performed via median sternotomy. During the past decade, improvements in endoscopic equipment and operative techniques have resulted in development of minimally invasive cardiac operation using small incisions. With the advent of a voice controlled camera-holding robotic arm (AESOP 3000, Automated Endoscope System for Optimal Positioning), cardiac surgery entered the robotic age. Material and Method: Between April 2004 and December 2004, a total of seventy eight patients underwent robotic cardiac surgery, of whom sixty four patients underwent robot-assisted minimally invasive cardiac surgery via 5cm right lateral minithoracotomy using voice controlled robotic arm, femoral vessels cannulation, percutaneous internal jugular cannulation, transthoracic aortic cross clamp. Other fourteen patients underwent MIDCAB via internal mammary artery harvesting using AESOP. Result: Robotic cardiac surgery were mitral valve repair in 37 cases, mitral valve replacement in 10 cases, aortic valve replacement in 1 case, MIDCAB in 14 cases, ASD operation in 9 cases, and isolated Maze procedure in 1 case. In mitral operation, mean CPB time was $165.3\pm43.1$ minutes and mean ACC time was $110.4\pm48.2$ minutes. Median length of hospital stay was 6 days (range 3 to 30) in mitral operation, 4 days (range 2 to 7) in MIDCAB, and 4 days (range 2 to 6) in ASD operation. For complications, 3 patients were required by reoperation for bleeding. There was no hospital mortality. Conclusion: Our experience of robot cardiac surgery suggests that many cardiovascular surgeons will be able to perform minimally invasive cardiac operations through small incisions with robot-assisted video-direction. Well-designed studies and close long-term follow-up will be required to analyze the benefits of robot-assisted operation.

A Study on Evaluating the Possibility of Monitoring Ships of CAS500-1 Images Based on YOLO Algorithm: A Case Study of a Busan New Port and an Oakland Port in California (YOLO 알고리즘 기반 국토위성영상의 선박 모니터링 가능성 평가 연구: 부산 신항과 캘리포니아 오클랜드항을 대상으로)

  • Park, Sangchul;Park, Yeongbin;Jang, Soyeong;Kim, Tae-Ho
    • Korean Journal of Remote Sensing
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    • v.38 no.6_1
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    • pp.1463-1478
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    • 2022
  • Maritime transport accounts for 99.7% of the exports and imports of the Republic of Korea; therefore, developing a vessel monitoring system for efficient operation is of significant interest. Several studies have focused on tracking and monitoring vessel movements based on automatic identification system (AIS) data; however, ships without AIS have limited monitoring and tracking ability. High-resolution optical satellite images can provide the missing layer of information in AIS-based monitoring systems because they can identify non-AIS vessels and small ships over a wide range. Therefore, it is necessary to investigate vessel monitoring and small vessel classification systems using high-resolution optical satellite images. This study examined the possibility of developing ship monitoring systems using Compact Advanced Satellite 500-1 (CAS500-1) satellite images by first training a deep learning model using satellite image data and then performing detection in other images. To determine the effectiveness of the proposed method, the learning data was acquired from ships in the Yellow Sea and its major ports, and the detection model was established using the You Only Look Once (YOLO) algorithm. The ship detection performance was evaluated for a domestic and an international port. The results obtained using the detection model in ships in the anchorage and berth areas were compared with the ship classification information obtained using AIS, and an accuracy of 85.5% and 70% was achieved using domestic and international classification models, respectively. The results indicate that high-resolution satellite images can be used in mooring ships for vessel monitoring. The developed approach can potentially be used in vessel tracking and monitoring systems at major ports around the world if the accuracy of the detection model is improved through continuous learning data construction.

Clinicopathological Effects of Waterpepper (Persicaria hydropiper) on Ruminants (여뀌섭취가 반추수에 비치는 임상병리학적 영향)

  • Cho Myoung-Rae;Han Hong-Ryul
    • Journal of Veterinary Clinics
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    • v.6 no.2
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    • pp.227-259
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    • 1989
  • Waterpepper is a weed which grows on damp soil. especially near swamps, and in shallow water of ponds and ditches. It Is widespread throughout the country In abundant colonies. In the present experiments, possible toxic effects of waterpepper were investigated in ruminants. Pour cows were fed waterpepper ad libitum or by force in the from of green forage, hay and/or powder, 8 goats were administered in the form of methanol extract, and 4 goats, crude juice, into the lumen. Clinical signs were examined as well as urinalysis, hematology, serum chemical analysis, pH/blood gas analysis and chclinesterase activities following administration of waterpepper. Six goats which were administered the methanol extract or crude juice were sacrificed for pathological examinations., In addition to the clini copathological examinations, the chemical constituents of waterpepper were qualitively analyzed from the methanol extract and the Effects of the waterpepper crude juice were examined on the motility of rabbit duodenum and uterus. It is revealed that waterpepper contains steroids, terpenoids, flavonoids, tannin and essential oils in the methanol extract and nitrates in the crude juice. The crude juice of waterpepper relaxed the rabbit uterine and duodenal smooth muscles. The constraction of duodenum by acetylcholine or BaCl$_2$ were partially inhibited by pretreatment of the crude juice. However, the relaxation of duodenum by the crude juice was not blocked by the pretreatments of phenoxybenzamlne, propranolol, cocaine, reserpine and tetrodotoxin. The constituents of waterpepper to evoke elaxation of duodenal smooth muscle were stable to heat. The cows administered waterpepper showed common clinical symptoms such as acrid expression, restlessness, dullness, inappetence, anorexia, severe diarrhea, mild bloat and left displacement of abomasum, while bloody feces was shown in a cow. The goats administered the mothanol extract showed common clinical signs such as acrid expression, restlessness, dullness, inappetence and soft feces, while bloody feces was shown in a goat, A goat adminstered the crude juice showde bloody feces and diarrhea. Respiratory rates and heart beats were increased along with diarrhea in the experimental cows. The erythrocyte counts and MCHC were decreased whereas PCV, MCV and neutrophils were increased in the cows administered waterpepper. In goats administered methanol extract, there were decreases in erythrocytes, PCV and hemoglobin content, and an increase in MCHC. The goats ingester with the crude juice showed negligible changes in hematologic values compared with control group which was administered the same amount of water instead of the crude juice. The contents of serum calcium, Inorganic phosphorus, magnesium, Iron, glucose, cholesterol, total protein, triglycerides and phospholipids were tended to decrease in cows. In goats serum iron, glucose, triglycerides, cholesterol, BUN and phospholipids content were decreased while the content of sodium and chloride were increased after administration of the methamol extract The goats ingested with the crude juice did not show significant changes in serum chemical analysis. Even though there were some pathological findings such as hyperemia in the small intestines and kidneys and swelling of liver parenchymal cells, the values of serum AST, ALT, LDH, alkaline phosphatase, total bilirubin and creatinine did not change significantly. While proteins, hemoglobin and blood were detected in the urine of cows, urine pH, ketone bodies, glucose, bilirubin and urobilinogen content were normal or undetected. There were no significant changes in pH/bolld gas analysis data of cows and cholinesterase activities of plasma and erythrocytes of cows and goats ingested with waterpepper or the methanol extract. It is concluded that waterpepper irritates the gatrointestinal system, causes abdominal pain, relaxes the gastrointestinal smooth muscle and dilatates blood vessels supplied to the system. The irritation and relaxation may lead to abnormal fermentation, maldigestion and malabsorption of nutrients and result in diarrhea, body feces, mild bloat and left displacement of abomasum.

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A Study on the assignment of vicera of the pulsation examination method of the KiGu (기구맥진법(氣口脈診法)의 장부배속(藏府配屬)에 관한 연구(硏究))

  • Hwang, Won-Deok;Kim, Jung-Han
    • Journal of Korean Medical classics
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    • v.12 no.1
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    • pp.226-254
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    • 1999
  • For the first time, the theory of ChonKwanChuk(寸關尺) and the examination method of KyungJung(輕重法) of KiGu(氣口) were formed in "NanKyung(難經)". After that, the vicera assignment theory at left and right hands(左右守藏府記屬理論) was established in "MaekKyung(脈經)" After Reserching the theoretical relevance of the two books, theories between the doctors who understood the examination method of ChukBu(尺部診法) of "Somun MaekYoJungMiRon(素問 脈要精微論)" as the examination method of KyungJung(輕重法) and the doctors who understood that method as the method of ChonKwanChuk(寸關尺) were compared and researched. The results were as follows : 1. The posit ion of ChonKwanChuk(寸關尺) of the examination method of ChonKwanChuk(寸關尺法) is explained at 2nd Nan(二難) of "NanKyung" as follows. Chuk(尺) is the position which is 1Chon(1寸, unit) distant from Kwan(關) to the direction of ChukTaek acupuncture point(尺澤穴) and Chon(寸) is the position which is 9Pun(9分, unit) distant from Kwan(關) to the direction of EoJe acupuncture point(魚際穴). And the six vessels(六經) were assined to ChonKwanChuk(寸關尺) on the basis of OHangJaMoSnagSaeng(五行子母相生) at 18th Nan(18難) of NanKyung. After that Yang Hyun-Jo(楊玄操) at Dang Dynasty, Jung Deok-Yong(丁德用), Woo Seo(廬庶) at Song dynasty explaind the examination method of ChonKwanChuk(寸關尺法) of NanKyung as the method of ChonKwanChuk of two hands(兩手寸關尺法) from the viewpoint of "MaekKyung(脈經)". 2. From the viewpoint of MaeKyung, the vicera assignment of the two hand ChonKwanChuk method is as follows. At Chuk of left hand, the Heart and Small intestine are assigned. At Kwan of left hand, the Liver and Gall Bladder are assigned. At Chuk of left hand, the Kidney and Bladder are assigned. At Chuk of right hand, the Lung and Large in testine are assigned. At Kwan of right hand, the Spleen and Stomach are assigned. At Chuk of Right hand, the Vital Gate(命門) and Bladder are assigned. 3. For the first time, HwalSu(滑壽) at Won dynasty said that the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" is the first of the examination method of KiGu(氣口診脈法). After that Ma Shi(馬蒔), Jang Gae-Bin(張介賓) of Myung Dynasty, Jang Ji-Chong(張志聰), Seo Dae-Chun(徐大椿) of Chung Dynasty who were influenced by him explained that paragraph as the method of KiGuChonKwanChuk(氣口寸關尺法). 4. Lee Kyu-Jun(李圭晙) explained the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" as the method of KyungJung(輕重法) and explained Chok(尺) as the paragraph 'Chuk is low position of Kigu, and it means the depth(氣口之下位也, 言其深也)' and explained that 'the Left and the Right is layers(左右者層數). And he revised that the Jang(臟) must be examined at the inner part and the Bu(府) must be examined at the outer part. By this, he settled the theoratical basis of the method of KyungJung(輕重法). 5. The doctors who used the examination method of ChonKwanChok(寸關尺診法) settled their logical justification of the two hand examination method of ChonKwanChuk(兩手寸關尺診法) by connecting with "Somon MaekYoJungMi-Ron" from the viewpoint of 2nd Nan(難) and 18th Nan(難) of NanKyung and MaekKyung. On the contrary, the doctors who used the examination method of KyungJung(輕重診法) settled their logical justification of the examination method of KyungJung(輕重診法) by connecting with "Somun MaekYoJungMiRon" from the viewpoint of 4th Nan(四難) and 5th Nan(五難).

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Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy (스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료)

  • Yang, Hye Ran;Choi, Won Jung;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.784-789
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    • 2006
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

Development of Acquisition and Analysis System of Radar Information for Small Inshore and Coastal Fishing Vessels - Suppression of Radar Clutter by CFAR - (연근해 소형 어선의 레이더 정보 수록 및 해석 시스템 개발 - CFAR에 의한 레이더 잡음 억제 -)

  • 이대재;김광식;신형일;변덕수
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.39 no.4
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    • pp.347-357
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    • 2003
  • This paper describes on the suppression of sea clutter on marine radar display using a cell-averaging CFAR(constant false alarm rate) technique, and on the analysis of radar echo signal data in relation to the estimation of ARPA functions and the detection of the shadow effect in clutter returns. The echo signal was measured using a X -band radar, that is located on the Pukyong National University, with a horizontal beamwidth of $$3.9^{\circ}$$, a vertical beamwidth of $20^{\circ}$, pulsewidth of $0.8 {\mu}s$ and a transmitted peak power of 4 ㎾ The suppression performance of sea clutter was investigated for the probability of false alarm between $l0-^0.25;and; 10^-1.0$. Also the performance of cell averaging CFAR was compared with that of ideal fixed threshold. The motion vectors and trajectory of ships was extracted and the shadow effect in clutter returns was analyzed. The results obtained are summarized as follows;1. The ARPA plotting results and motion vectors for acquired targets extracted by analyzing the echo signal data were displayed on the PC based radar system and the continuous trajectory of ships was tracked in real time. 2. To suppress the sea clutter under noisy environment, a cell averaging CFAR processor having total CFAR window of 47 samples(20+20 reference cells, 3+3 guard cells and the cell under test) was designed. On a particular data set acquired at Suyong Man, Busan, Korea, when the probability of false alarm applied to the designed cell averaging CFAR processor was 10$^{-0}$.75/ the suppression performance of radar clutter was significantly improved. The results obtained suggest that the designed cell averaging CFAR processor was very effective in uniform clutter environments. 3. It is concluded that the cell averaging CF AR may be able to give a considerable improvement in suppression performance of uniform sea clutter compared to the ideal fixed threshold. 4. The effective height of target, that was estimated by analyzing the shadow effect in clutter returns for a number of range bins behind the target as seen from the radar antenna, was approximately 1.2 m and the information for this height can be used to extract the shape parameter of tracked target..

Early Surgical Revascularization for Acute Myocardial Infarction (급성 심근 경색후 관상 동맥 우회술의 조기 적용)

  • 지현근;이원용
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1077-1082
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    • 1997
  • To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

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The Research to Correct Overestimation in TOF-MRA for Severity of Cerebrovascular Stenosis (3D-SPACE T2 기법에 의한 TOF-MRA검사 시 발생하는 혈관 내 협착 정도의 측정 오류 개선에 관한 연구)

  • Han, Yong Su;Kim, Ho Chul;Lee, Dong Young;Lee, Su Cheol;Ha, Seung Han;Kim, Min Gi
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.12
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    • pp.180-188
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    • 2014
  • It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

The Study on the Factors for Detection of Renal Stone on Ultrasound (초음파 검사에서 신장 결석의 검출 요인에 관한 연구)

  • Sim, Hyun-Sun;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.29 no.1
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    • pp.1-6
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    • 2006
  • Purpose: Renal stones are common and typically arise within the collecting system. The renal sinus are contains the collection system, the renal vessels, lymphatcs, fat, and fibrous tissue. Because of the compression of all the large echoes in signal processing, the echo from the renal stone generally cannot be distinguished from large echoes emanating from normal structures of the renal sinus. Use of ultrasonography has been difficult for detecting small renal stone without posterior shadowing and chemical composition of stone. The aim of study was measuring for posterior acoustic shadowing to a stone for various scan parameter and it examines a help in renal stone diagnosis. Material & Methods: The stone was place on sponge examined in a water bath with a 3.5MHz or 7.5MHz transducer(LOGIQ 400, USA). First, tested a variety of gain. Second, tested a variety of dynamic range. Third, tested a variety of focal zone. Fourth, measuring of the echo level for low and high frequency for depth. Results: 1) Average echo level was 98 for low total gain(10 dB) and was 142 for high total gain(40 dB). Posterior acoustic shadowing of renal stone was clear for low gain. 2) Average echo level was 129 for low dynamic range(42 dB) and was 101 for high dynamic range(72 dB). Posterior acoustic shadowing of renal stone was clear for high dynamic range. 3) When stone is in focal zone of transducer, definite posterior acoustic shadow is identified. 4) Stone was clear appeared for high frequency(7.5 MHz) than low frequency(3.5 MHz) and it is not distorted. Conclusion: The demonstration of an posterior acoustic shadow of renal stone dependents on several technical factors such as gain, dynamic range, focus, and frequency. This various factors are a help in renal stone diagnosis.

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