• Title/Summary/Keyword: anatomical

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Usefulness of a Functional Tracheobronchial Phantom for Interventional Procedure (중재 시술용 기능성 기관-기관지 팬텀의 유용성)

  • Kim, Tae-Hyung;Lim, Cheong-Hwan;Kim, Jeong-Koo;Kim, Myeong-Soo;Choi, Won-Chan;Lim, Jin-Oh;Lee, Kwang-Jong;Park, In-Ae;Kim, Mi-Ok;Jung, Eun-Mi;Shin, Ryung-Mi;Jung, Seung-Ki;Youn, Sun-Hee
    • Journal of radiological science and technology
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    • v.26 no.4
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    • pp.27-32
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    • 2003
  • To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were 0.76(${\pm}0.011$) in human, 0.97(${\pm}0.015$) in animal, 0.45(${\pm}0.016$) in phantom. The tracheobronchial bifurcation part measured 0.51(${\pm}0.006$) in human, 0.65(${\pm}0.005$) in animal, 0.65(${\pm}0.008$) in phantom. The right bronchus part measured 0.14(${\pm}0.008$) in human, 0.59(${\pm}0.014$) in animal and 0.04(${\pm}0.007$) in phantom. The left bronchus were 0.54(${\pm}0.004$) in human, 0.54(${\pm}0.008$) in animal and 0.08(${\pm}0.008$) in phantom. At the stent part were 0.54(${\pm}0.004$) in human, 0.59(${\pm}0.011$) in animal and 0.04(${\pm}0.007$) in phantom, respectively. The tracheobronchial angle of the left bronchus site were $42.6({\pm}2.07)^{\circ}$ in human, $43.4({\pm}2.40)^{\circ}$ in animal and $35({\pm}2.00)^{\circ}$ in phantom, respectively. The right bronchus site were $32.8({\pm}2.77)^{\circ}$ in human, $34.6({\pm}1.94)^{\circ}$ in animal and $50.2({\pm}1.30)^{\circ}$ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.

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Usefuless of Multi-functional Gastroduodenal Coil Catheter with Phantom (팬텀을 이용한 다기능 위.십이지장관 코일 카테타의 유용성 평가)

  • Lim, Jin-Oh;Kim, Tae-Hyung;Jung, Yang-Hwa;Choi, Won-Chan;Shin, Ji-Hoon;Song, Ho-Young
    • Journal of radiological science and technology
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    • v.26 no.4
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    • pp.21-26
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    • 2003
  • To evaluate the newly designed gastroduodenal coil catheter:in-vitro test. The coil catheter that we made in our laboratory was 150 cm. The coil that is made of stainless steel wire was composed 1.3 mm inner diameter and this coil spring was covered with heat-shrinkable polyethylene tube. To measure the length under fluorocopy, 8 radiopaque marks were attached at 5 cm, 10 cm, 11 cm, 12 cm, 13 cm, 14 cm, 15 cm, 20 cm apart from distal end of the catheter and 6, 2, 1 pores were made at 7 cm, 13 cm, 19 cm apart from the distal end. Radio-opacity and the amount of injected contrast was investigated in formerly used 5 Fr. vessel catheter, which is possible in measuring length, and newly designed coil catheter. Film density was tested for radio-opacity with autodensitometer. For measuring the volume of injected salin, the catheter was located in the acryl box(26 cm, 3 cm, 16 cm) that divided into 4 chambers. After injection 50 cc of contrast with autoinjector, the contrast's quantity in each chamber was measured with and without over the guide wire. Radio-opacity was 0.51 in 5 Fr. vessel catheter, 0.31 in newly made catheter. The amount of injected contrast was measured. In case of 5 Fr. vessel catheter, the amount was 99.5% from the distal part, there was no difference between with and without the guide wire. Otherwise, using a coil catheter, the pacentage the ejected saline was 1.17%, 18.8%, 41.8%, 38.2% from the distal part with the guide wire, 19.5%, 32.6%, 27.7%, 20.3% without the guide wire. Compare with formerly established catheter, this new coil catheter is easy to measure the length thanks to easy confirming under fluoroscopy and excellent in injecting contrast. Therefore, newly designed gastrointestinal catheter seems to be useful in gastrointestinal intervention procedure.

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Effectiveness of MDCT for the Followup of CABG Patients with LIMA to LAD and Saphenous Veins to Others (좌내흉동맥과 복재정맥편을 사용한 관상동맥우회로술 환자에서의 추적조사에서 MDCT의 유용성)

  • Kang Joon Kyu;Kim Hyung Tai;Park In Duk;Chung Young Mi;Lee Cheol Joo
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.410-414
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    • 2005
  • There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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The Influence of AH-26 and Zinc Oxide-Eugenol Root Canal Sealer on the Shear Bond Strength of Composite Resin to Dentin (AH-26 및 산화아연유지놀 근관실러가 상아질에 대한 복합레진의 전단결합강도에 미치는 영향)

  • Cho, Ju-Yeon;Jin, Myoung-Uk;Kim, Young-Kyung;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.31 no.3
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    • pp.147-152
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    • 2006
  • The purpose of this study was to evaluate the influence of the AH-26 root canal sealer on the shear bond strength of composite resin to dentin. One hundred and forty four (144) extracted, sound human molars were used. After embedding in a cylindrical mold, the occlusal part of the anatomical crown was cut away and trimmed in order to create a flat dentin surface. The teeth were randomly divided into three groups; the AH-26 sealer was applied to the AH-26 group, and zinc-oxide eugenol (ZOE) paste was applied to the ZOE group. The dentin surface of the control group did not receive any sealer. A mount jig was placed against the surface of the teeth and the One-step dentin bonding agent was applied after acid etching. Charisma composite resin was packed into the mold and light cured. After polymerization, the alignment tube and mold were removed and the specimens were placed in distilled water at $37^{\circ}C$ for twenty four hours. The shear bond strength was measured by an Instron testing machine. The data for each group were subjected to one-way ANOVA and Tukey's studentized rank test so as to make comparisons between the groups. The AH-26 group and the control group showed significantly higher shear bond strength than the ZOE group (p<0.05). There were no significant differences between the AH-26 group and the control one (p>0.05). Under the conditions of this study, the AH-26 root canal sealer did not seem to affect the shear bond strength of the composite resin to dentin while the ZOE sealer did. Therefore, there may be no decrease in bond strength when the composite resin core is built up immediately after a canal filling with AH-26 as a root canal sealer.

Comparison of Success Rates after Silicone Tube Intubation with or without Lacrimal Endoscopy for Epiphora (눈물흘림 환자에서 눈물길미세내시경의 사용 여부에 따른 실리콘관삽입술의 성공률 비교)

  • Choi, Min Gyu;Lee, Jeong Kyu
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1001-1008
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    • 2018
  • Purpose: To compare the success rates between silicone tube intubation using a lacrimal endoscope and using a conventional nasal endoscope alone in adult patients suffering from epiphora. Methods: We conducted a retrospective chart review of 80 eyes of 55 patients who underwent silicone tube intubation from January 2014 to June 2017. Patients were preoperatively diagnosed with syringing and dacryocystography. The silicone tube was removed 3 months after surgery and success rates were evaluated at 4 and 12 months. Success rates were analyzed by dividing the patients into two groups, according to lacrimal endoscope use. Results: A lacrimal endoscope was used in 40 eyes. In the group using a lacrimal endoscope, preoperative diagnoses were partial obstruction in 26 eyes and complete obstruction in 14 eyes. In the group without lacrimal endoscope use, preoperative diagnoses were partial obstruction in 35 eyes and complete obstruction in 5 eyes (p = 0.018). The success rates at 4 and 12 months after surgery in the two groups (with and without lacrimal endoscope use) were 87.5% and 80.0% and 72.0% and 62.1% (p = 0.546 and p = 0.565), respectively. The success rates of patients with partial obstruction in the two groups were 92.3% and 82.9% at 4 months and 71.4% and 69.2% at 12 months (p = 0.448 and p = 1.000), respectively. The success rates of patients with complete obstruction in the two groups were 78.6% and 60.0% at 4 months and 72.7% and 33.3% at 12 months (p = 0.570 and p = 0.505), respectively. Site differences, the degree of obstruction, and lacrimal endoscope use had a significant impact on the success rate at 4 and 12 months (p = 0.001 and p = 0.022, respectively). Conclusions: Although silicone tube intubation using a lacrimal endoscope cannot guarantee a significant success rate, it is possible to observe the anatomical structure of the nasolacrimal pathway in real time, such that the appropriate diagnosis and treatment can be performed simultaneously. Because patients diagnosed as having a complete obstruction had a good success rate, we can extend indication of silicone tube intubation as a less invasive approach.

Intravitreal Anti-vascular Endothelial Growth Factor Injections to Treat Neovascular Age-related Macular Degeneration: Long-term Treatment Outcomes (삼출 나이관련황반변성에 대한 항혈관내피성장인자 유리체내주사 치료의 장기 임상 결과)

  • Park, Yu Jeong;Son, Gi Sung;Kim, Yoon Jeon;Kim, June-Gone;Yoon, Young Hee;Lee, Joo Yong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1142-1151
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    • 2018
  • Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.

Automated patient set-up using intensity based image registration in proton therapy (양성자 치료 시 Intensity 기반의 영상 정합을 이용한 환자 자동화 Set up 적용 방법)

  • Jang, Hoon;Kim, Ho Sik;Choe, Seung Oh;Kim, Eun Suk;Jeong, Jong Hyi;Ahn, Sang Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.97-105
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    • 2018
  • Purpose : Proton Therapy using Bragg-peak, because it has distinct characteristics in providing maximum dosage for tumor and minimal dosage for normal tissue, a medical imaging system that can quantify changes in patient position or treatment area is of paramount importance to the treatment of protons. The purpose of this research is to evaluate the usefulness of the algorithm by comparing the image matching through the set-up and in-house code through the existing dips program by producing a Matlab-based in-house registration code to determine the error value between dips and DRR to evaluate the accuracy of the existing treatment. Materials and Methods : Thirteen patients with brain tumors and head and neck cancer who received proton therapy were included in this study and used the DIPS Program System (Version 2.4.3, IBA, Belgium) for image comparison and the Eclipse Proton Planning System (Version 13.7, Varian, USA) for patient treatment planning. For Validation of the Registration method, a test image was artificially rotated and moved to match the existing image, and the initial set up image of DIPS program of existing set up process was image-matched with plan DRR, and the error value was obtained, and the usefulness of the algorithm was evaluated. Results : When the test image was moved 0.5, 1, and 10 cm in the left and right directions, the average error was 0.018 cm. When the test image was rotated counterclockwise by 1 and $10^{\circ}$, the error was $0.0011^{\circ}$. When the initial images of four patients were imaged, the mean error was 0.056, 0.044, and 0.053 cm in the order of x, y, and z, and 0.190 and $0.206^{\circ}$ in the order of rotation and pitch. When the final images of 13 patients were imaged, the mean differences were 0.062, 0.085, and 0.074 cm in the order of x, y, and z, and 0.120 cm as the vector value. Rotation and pitch were 0.171 and $0.174^{\circ}$, respectively. Conclusion : The Matlab-based In-house Registration code produced through this study showed accurate Image matching based on Intensity as well as the simple image as well as anatomical structure. Also, the Set-up error through the DIPS program of the existing treatment method showed a very slight difference, confirming the accuracy of the proton therapy. Future development of additional programs and future Intensity-based Matlab In-house code research will be necessary for future clinical applications.

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Study of silk lousiness (I) (견사 Lousiness에 대한 연구 (I))

  • 최병희;김낙정;박광의;남중희
    • Journal of Sericultural and Entomological Science
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    • v.3
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    • pp.1-11
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    • 1963
  • This treatise is to set up a fundamental condition of checking silk lousiness and to set up a new improving method of cocoon bave lousiness after super refining treatment. It is also studied whether silk lousiness can be eliminated through the observation of the silk gland, or the lousiness can be able to improve through such a study. The conclusions obtained in this paper are as follows. 1. Silk lousiness is able to be observed most properly when the light direction and the fiber direction are parallel in plan view of the silk cloth and the greater the angle between them is, the less the lousiness is observed. When, however, the angle is greater than some specific angle(30$^{\circ}$), no more lousiness is observed. This specific angle is named by the author as Lousiness Horizontal Critical Angle. 2. Silk lousiness can be observed when the angle of light incidence against the silk cloth is six degrees, while the larger the angle is, the less the lousiness is observed. When, however, the angle is greater than same specific angle(45$^{\circ}$) the lousiness disappears. Such a specific angle is named by the author as Lousiness Vertical Critical Angle. 3. The best textile composition to decrease lousiness defect is plan weave, while twill and satin weave show more lousiness with the same silk fiber. 4. Lousiness was classified as Lousiness A, B, ana C of which A was the general lousiness, B was the group type, and C was the glucose type and the standard photographs for the lousiness grading of these types were prepared. 5. The proper soap-refining hours of silk for lousiness test was eight hours. 6. The greater the difference of fiber diameter between the cocoon single bave and the splitend was, the more lousiness was composed. The normal splitends were measured as 1/4-1/5 of the main fiber. 7. The lousiness was found at the cocoon shape ends more than other parts, and found at the middle cocoon layer than other layer which was imagined to be as a result of poor uniform bave spinning of silk worm. 8. Female cocoon had more lousiness than the male cocoon. 9. It was found that there was a great possibility to have the splitends through the observation of the anatomical silkgland, and the author reached a conclusion that the lousiness can be improved to a certain degree only by the elimination of abnormal silk gland from the breeding aspects. 10. The cocoon bave of the offspring after super refining lousiness test and selection showed more improved lousiness defect than that of the parents.

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