• Korean Journal of Radiology
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• 제20권5호
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• pp.759-772
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• 2019

Objective: To investigate the value of ultrasound (US) microflow assessment in distinguishing malignant from benign solid breast masses as well as the association between US parameters and histologic microvessel density (MVD). Materials and Methods: Ninety-eight breast masses (57 benign and 41 malignant) were examined using Superb Microvascular Imaging (SMI) and contrast-enhanced US (CEUS) before biopsy. Two radiologists evaluated the quantitative and qualitative vascular parameters on SMI (vascular index, morphology, distribution, and penetration) and CEUS (time-intensity curve analysis and enhancement characteristics). US parameters were compared between benign and malignant masses and the diagnostic performance was compared between SMI and CEUS. Subgroup analysis was performed according to lesion size. The effect of vascular parameters on downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4A masses was evaluated. The association between histologic MVD and US parameters was analyzed. Results: Malignant masses were associated with a higher vascular index (15.1 ± 7.3 vs. 5.9 ± 5.6), complex vessel morphology (82.9% vs. 42.1%), central vascularity (95.1% vs. 59.6%), penetrating vessels (80.5% vs. 31.6%) on SMI (all, p < 0.001), as well as higher peak intensity (37.1 ± 25.7 vs. 17.0 ± 15.8, p < 0.001), slope (10.6 ± 11.2 vs. 3.9 ± 4.2, p = 0.001), area (1035.7 ± 726.9 vs. 458.2 ± 410.2, p < 0.001), hyperenhancement (95.1% vs. 70.2%, p = 0.005), centripetal enhancement (70.7% vs. 45.6%, p = 0.023), penetrating vessels (65.9% vs. 22.8%, p < 0.001), and perfusion defects (31.7% vs. 3.5%, p < 0.001) on CEUS (p ≤ 0.023). The areas under the receiver operating characteristic curve (AUCs) of SMI and CEUS were 0.853 and 0.841, respectively (p = 0.803). In 19 masses measuring < 10 mm, central vascularity on SMI was associated with malignancy (100% vs. 38.5%, p = 0.018). Considering all benign SMI parameters on the BI-RADS assessment, unnecessary biopsies could be avoided in 12 category 4A masses with improved AUCs (0.500 vs. 0.605, p < 0.001). US vascular parameters associated with malignancy showed higher MVD (p ≤ 0.016). MVD was higher in malignant masses than in benign masses, and malignant masses negative for estrogen receptor or positive for Ki67 had higher MVD (p < 0.05). Conclusion: US microflow assessment using SMI and CEUS is valuable in distinguishing malignant from benign solid breast masses, and US vascular parameters are associated with histologic MVD.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.432-435
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• 2007

Purpose: The jejunal free flap has the shorter ischemic time than other flap and requires a laparotomy to harvest it. As the evaluation of the perfusion the buried flap is very important, the perfusion of the buried jejunal free flap requires monitoring for its salvage. We tried to improve the monitoring flap method in the jejunal free flap and examined its usefulness. Methods: From March 2002 to March 2006, the monitoring flap method was applied to 4 cases in 8 jejunal free flaps for the pharyngeal and cervical esophageal reconstructions. The distal part of the jejunal flap was exposed without suture fixation through cervical wound for monitoring its perfusion. The status of perfusion was judged by the color change of jejunal mucosa and mesentery. If necessary, pin prick test was performed. Doppler sonography was applied to mesenteric pedicle of the monitoring flap in case of suspicious abnormal circulation. Results: The monitoring flap shows no change in 3 cases, but the congestion happened in one case at the 12 hours after the operation. This congestion was caused by the twisting or kinking of the mesenteric pedicle of the monitoring flap. So, we fixed up the monitoring flap close to adjacent cervical skin for prevention of rotation. Finally, the main part of transferred jejunal flap was intact. Conclusion: The success of a jejunal free flap depends on close postoperative monitoring and early detection of vascular compromise. So, various monitoring methods have been tried, for instance, direct visualization using a fiberoptic pharyngoscope, through a Silastic window placed in the neck flap, or external surface monitoring with an Doppler sonography, use of a buried monitoring probe. But, all of the above have their own shortcomings of simplicity, non-invasiveness, reliability and etc. In our experience, monitoring flap can be a accurate and reliable method.

• International Journal of Vascular Biomedical Engineering
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• 제1권1호
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• pp.3-12
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• 2003

Ultrasonic pulsed Doppler velocimetry has become a standard international method of classifying carotid disease. Because the measured angle adjusted velocity increases as the Doppler angle increases, examinations should be performed at a convenient standard Doppler examination angle. An angle of 60 degrees is achievable throughout most examinations. Multiple Doppler viewing angles allow the acquisition of velocity vectors during the cardiac cycle, revealing the complex velocity patterns. Ultrasonic velocimetry (whether Doppler or time domain) is based on changes in the phase of the ultrasound echo. Other examinations can be done based on the echo phase. Slow motions of organs such as the brain can be used to monitor changes in edema. Measurements of tissue strain due to the pulsatile filling of the arterioles. This plethysmographic imaging method can display differences in tissue perfusion because of different tissue types and changes in autonomic activity.

• 대한의용생체공학회:의공학회지
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• 제11권1호
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• pp.131-140
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• 1990

To improve antithrombogenicity of polymer that used in vascular graft and artificial organs, seeding of human endothelial cells on the polyurethane was studied. Human endothelial cells were ismlated from human umbilical veins, using type I collagenase, and identified with goat anti vWF antibodies. Human endothilial cell seeding was tried upon the polyurethane which has good mechanical property and resists stresses. The hydrophobic polyurethane surface was changed hydrophilic by corona discharf:e treatment. Surface hydrophilicity was measured with Wilhemly plate method and the goniometer. To evaluate matrix protein adsorption, fibronectin adsorption test was done. To eveluate cell adhesion, human endothelial cell attachment forces were measured rising a perfusion chamber of , ism diamter. Less cells were detached from the hydrophilically treated polyurethane. This showed that corona discharge on the polyurethane could improve matrix adsorption and endothelial cell attachment.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.150-152
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• 2022

Complications related to the vascular anastomosis of the placental vessels in monochorionic twins are fatal. The clinical syndromes of feto-fetal transfusion include twin anemia polycythemia sequence (TAPS), twin-twin transfusion syndrome, and twin reversed arterial perfusion sequence. We present an extremely rare case of TAPS in a dichorionic diamniotic pregnancy. A 36-year-old woman, gravida 0, para 0, was referred to our hospital with suspected preterm premature membrane rupture. Although her pelvic examination did not reveal specific findings, the non-stress test result showed minimal variability in the first fetus and late deceleration in the second one. An emergency cesarean section was performed. The placenta was fused, and one portion of the placenta was pale, while the other portion was dark red. The hemoglobin level of the first fetus was 7.8 g/dL and that of the second one was 22.2 g/dL.

• 대한치과교정학회지
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• 제18권2호
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• pp.311-327
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• 1988

Vascular changes in the periodontal ligament of the rat incisors following application of experimental orthodontic forces were examined by the India ink perfusion method. 57 rats were used for this experiment. The rats were divided into experimental group (54 rats) and control group (3 rats). 54 experimental rats were divided into group I (27 rats) and group II (27 rats). The right and left upper incisors of group. I and group II rats were separated distally with forces of 20gm, 70gm respectively. The vascular changes of periodontal ligament were observed histologically by means of light microscope after 1, 2 and 3 days of tooth movement and 1,3,5,8,14, and 21 days after removal of orthodontic force. The results were as follows; 1. After one day of tooth movement, occlusion of blood vessels, hyalinization of periodontal ligament and resorption of alveolar bone adjacent to the alveolar crest on pressure side were observed. Above the tissue changes on the pressure side of group II were more severe than those of group I. Especially, septal bone of group II was separated after 2 days of tooth movement. 2. In tension zones, periodontal space was widened and periodontal fibers were orientated in the direction of puil. The blood vessels of periodontal ligament were distended. New bone deposition was seen along the inner surface of the alveolus after 2 days of tooth movement. 3. After 3 days of tooth movement, deposition of new bone was seen along the periosteal surface of alveolar bone on pressure side, progressing with increasing after removal of orthodontic force. Remodelling of the new bone was occurred 5 days after removal of orthodontic force. 4. 3 days after removal of orthodontic force, invasion of blood vessels into the marginal periodontal ligament on pressure side was observed clearly and the vessels below the epithelial attachment were increased. 5. After removal of orthodontic force, hyalinized structures disappeared concomittantly with an invasion of blood vessels from the neighboring periodontal ligament. 14 days after removal of orthodontic force, the vessels in the periodontal ligament of group I were finished the vascular rearrangement. 21 days after removal of orthodontic force, the vessels in the periodontal ligament of group II were finished the vascular rearrangement.

• Archives of Plastic Surgery
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• 제42권2호
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• pp.207-213
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• 2015

Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group ($14.0^{\circ}{\pm}3.6^{\circ}$) than in the control group ($7.9^{\circ}{\pm}3.0^{\circ}$) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity.

• 대한방사성의약품학회지
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• 제5권2호
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• pp.71-78
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• 2019

Nuclear imaging is one of the most powerful measures for non-invasive diagnosis of myocardial vascular disease. Radionuclide such as ¹³N, ¹⁵O, ²⁰¹Tl and ⁸²Rb is used for the measurement of cardiac blood flow. ¹³N, ¹⁵O and ²⁰¹Tl are produced in cyclotrons while ⁸²Rb is obtained from generator. Rubidium (Rb), an alkali ion, behaves biologically like potassium, and accumulates in myocardial tissue. Rb has rapid blood clearance profile which allows the use of ⁸²Rb with a short physical half-life of 75 s for non-invasive evaluation of regional myocardial perfusion. There are several advantages of ⁸²Rb over other radioisotopes. An ultra-short half-life significantly reduces the exposure of patients to radiation and allows to repeat injections for studying the effects of medical intervention. As a positron emitter, ⁸²Rb allows positron emission tomography (PET) imaging which have shown superior diagnostic performances. ⁸²Rb can be produced from generator by decay of its parent ⁸²Sr. However, the preparation of ⁸²Sr is difficult, because appropriate purity is required to meet the specification of the product. Recently reported procedure from ARRONAX research institute showed that a Chelex-100 resin is sufficient for this purpose and additional column is not necessary. Whereas Brookhaven National Laboratory (BNL) procedure contains three ion exchange resin separation, including Chelex-100 resin. Currently, since ⁸²Sr production site is non-existent in Korea, Korea Atomic Energy Research Institute (KAERI) has plan to produce ⁸²Sr within specifications. We compared ⁸²Sr purification procedures reported from ARRONAX and BNL to investigate the most suitable procedure for our conditions.

• Journal of Yeungnam Medical Science
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• 제10권1호
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• pp.253-259
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• 1993

본원에서는 출산 후 지속되는 호흡곤란, 전신부종을 주소로 내원한 환자에서 임신과 관계된 De Bakey유형II의 대동맥해리를 진단하고 성공적으로 수술을 시행한 1례를 경험하였기에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6565-6570
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• 2014

Objective: To observe the curative effects of rh-endostatin combined with DP regimen in treating patients with advanced esophageal cancer and analyze the correlation of CT perfusion (CTP) parameters and the expression of vascular endothelial growth factor (VEGF). Methods: Twenty patients with esophageal cancer confirmed pathologically were randomly divided into combined treatment (rh-endostatin+DP regimen) group and single chemotherapy group, 10 patients in each group, respectively. All patients were given conventional CT examination and CTP imaging for primary tumor. The level of VEGF, the size of tumor and CTP parameters (BF, BV, PS and MTT) before treatment and after 2 cycles of treatment were determined for the comparison and the correlation between CTP parameters and VEGF expression was analyzed. Results: the therapeutic effect of rh-endostatin+DP regimen group was superior to single chemotherapy group. VEGF level after treatment in rh-endostatin+DP regimen group was obviously lower than single chemotherapy group (P<0.01). The expression of VEGF had positive correlation with BF and BV but negative correlation with MTT. Compared with treatment before for rh-endostatin+DP regimen group, BF, BV and PS decreased while MTT increased after treatment (P<0.05). However, there were no significant differences between treatment before and after treatment in single chemotherapy (P>0.05). Conclusions: Rh-endostatin can down-regulate the expression of VEGF in esophageal cancer, change the state of hypertransfusion and high permeability of tumor vessels and had the better curative effect and slighter adverse reactions when combined with chemotherapy.