• Title/Summary/Keyword: therapeutic space

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Development and in Vivo Test of an Electrohydraulic Total Artificial Heart at the National Cardiovascular Center in Japan (일본 국립 순환기 센타형 전기유압식 인공심장의 개발과 동물실험)

  • 손영상
    • Journal of Biomedical Engineering Research
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    • v.19 no.2
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    • pp.163-170
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    • 1998
  • The ultimate goal of total artificial heart is permanent substitute for a failed heart in a patient without any other therapeutic modality. Until now, infection has been the main problem related to the mechanical circulatory support system. The best way to solve this catastrophic complication and to improve the quality of life of TAH patients in terms of tethering must be implantation of TAH totally. The EH-TAH has been developed in NCVC from 1987 for this purpose. The system consists of an energy converter and pumps, which are designed to be placed in abdomen and pericardial space separately for a good anatomical fit. To evaluate the anatomical fit and hemodynamic performance of the EH-TAH, in vivo test was done. General condition of the animal and hemodynamic status had been stable until the TAH stopped on the 11th pumping day. The estimated cardiac output was about 7.7L/min. The values of mean aortic pressure, left and right atrial pressure were 93$\pm$10, 19$\pm$3 and 15$\pm$4 mmHg, respectively. The correlation coefficient between left and right atrial pressure was 0.96, which represents the dynamic function of the interatrial shunt in controlling left-right imbalance of cardiac output. During pumping days, the temperature on the surface of actuator had been maintained at 39.7$\pm$0.4$^{\circ}C$, less than 1$^{\circ}C$ higher than the rectal temperature. The TAH stopped on the 11th day due to mechanical problems. We concluded that the EH-TAH possessed satisfactory basic performance including anatomic fit and hemodynamic adequacy, although there were several mechanical problems to be solved yet.

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Dose Distribution Comparison between Arc Radiation Therapy and Tomotherapy (아크치료기법과 토모테라피치료의 선량분포 비교)

  • Kim, Ji-Yoon;Lee, Seung-Chul;Cheon, Geum-Seong;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.723-730
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    • 2021
  • This study tries to compare dose distribution between arc radiation therapy and Tomotherapy, which are main radiation therapy modalities. The subjects of this study are lung cancer patients. For planning target volume (PTV), a dose of 60.0 Gy was set as a basis. The PTVmean of Arc was 61.04 Gy, and that of Tomotherapy was 58.50 Gy. The total lung capacities of Arc and Tomotherapy were 3.0 Gy and 4.24 Gy, respectively. The mean heart doses of Arc and Tomotherapy were 0.13 and 0.34, respectively; the mean trachea dose of Arc and Tomotherapy were 1.35 and 2.58, respectively; the mean esophagus dose of Arc and Tomotherapy were 0.41 and 0.86, respectively; the mean spinal cord dose of Arc and Tomotherapy were 3.65 and 4.68, respectively. With regard to the appropriateness of therapeutic effect in DHV, both modalities seemed appropriate. Tomotherapy protected normal tissues better than Arc radiation therapy. In Tomotherapy, patients need to have treatment long in a limited space. If such a point is overcome, Tomotherapy is better. Otherwise, Arc radiation therapy can be applied. This study was conducted with treatment planning images. Therefore, the results of this study are different from actual treatment results. If more research is conducted to overcome the limitation, the effects of radiation therapy are expected to increase further.

Visualization and Localization of Fusion Image Using VRML for Three-dimensional Modeling of Epileptic Seizure Focus (VRML을 이용한 융합 영상에서 간질환자 발작 진원지의 3차원적 가시화와 위치 측정 구현)

  • 이상호;김동현;유선국;정해조;윤미진;손혜경;강원석;이종두;김희중
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.34-42
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    • 2003
  • In medical imaging, three-dimensional (3D) display using Virtual Reality Modeling Language (VRML) as a portable file format can give intuitive information more efficiently on the World Wide Web (WWW). The web-based 3D visualization of functional images combined with anatomical images has not studied much in systematic ways. The goal of this study was to achieve a simultaneous observation of 3D anatomic and functional models with planar images on the WWW, providing their locational information in 3D space with a measuring implement using VRML. MRI and ictal-interictal SPECT images were obtained from one epileptic patient. Subtraction ictal SPECT co-registered to MRI (SISCOM) was performed to improve identification of a seizure focus. SISCOM image volumes were held by thresholds above one standard deviation (1-SD) and two standard deviations (2-SD). SISCOM foci and boundaries of gray matter, white matter, and cerebrospinal fluid (CSF) in the MRI volume were segmented and rendered to VRML polygonal surfaces by marching cube algorithm. Line profiles of x and y-axis that represent real lengths on an image were acquired and their maximum lengths were the same as 211.67 mm. The real size vs. the rendered VRML surface size was approximately the ratio of 1 to 605.9. A VRML measuring tool was made and merged with previous VRML surfaces. User interface tools were embedded with Java Script routines to display MRI planar images as cross sections of 3D surface models and to set transparencies of 3D surface models. When transparencies of 3D surface models were properly controlled, a fused display of the brain geometry with 3D distributions of focal activated regions provided intuitively spatial correlations among three 3D surface models. The epileptic seizure focus was in the right temporal lobe of the brain. The real position of the seizure focus could be verified by the VRML measuring tool and the anatomy corresponding to the seizure focus could be confirmed by MRI planar images crossing 3D surface models. The VRML application developed in this study may have several advantages. Firstly, 3D fused display and control of anatomic and functional image were achieved on the m. Secondly, the vector analysis of a 3D surface model was defined by the VRML measuring tool based on the real size. Finally, the anatomy corresponding to the seizure focus was intuitively detected by correlations with MRI images. Our web based visualization of 3-D fusion image and its localization will be a help to online research and education in diagnostic radiology, therapeutic radiology, and surgery applications.

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A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Resorbability and histological reaction of bioabsorbable membranes (수종의 흡수성 차단막의 생체 분해도와 조직학적 반응)

  • Suk, Hun-Joo;Kwon, Suk-Hoon;Kim, Chang-Sung;Choi, Seong-Ho;Jeon, Dong-Won;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.32 no.4
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    • pp.781-800
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    • 2002
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mm ${\times}$ 4mm) on dorsal side of Sprague Dawley rat, and sacrified them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76${\pm}$2.37$mm^2$, 4.90${\pm}$l.06$mm^2$, 4.90${\pm}$0.98$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6${\pm}$4.5%, 52.8${\pm}$9.4%, 56.4${\pm}$5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62${\pm}$0.82$mm^2$, 3.63${\pm}$0.76$mm^2$, 4.07${\pm}$1.14$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1${\pm}$5.8%, 30.9${\pm}$3.4%, 29.2${\pm}$3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96${\pm}$1.05$mm^2$, 4.77${\pm}$10.76$mm^2$, 3.86${\pm}$0.84$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7${\pm}$5.1%, 53.3${\pm}$4.4%, 69.5${\pm}$3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resorption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01${\pm}$2.01$mm^2$, 5.49${\pm}$1.3$mm^2$, 5.06${\pm}$1.38$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3${\pm}$3.6%, 38.4${\pm}$3.80%, 39.7${\pm}$5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.

List-event Data Resampling for Quantitative Improvement of PET Image (PET 영상의 정량적 개선을 위한 리스트-이벤트 데이터 재추출)

  • Woo, Sang-Keun;Ju, Jung Woo;Kim, Ji Min;Kang, Joo Hyun;Lim, Sang Moo;Kim, Kyeong Min
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.309-316
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    • 2012
  • Multimodal-imaging technique has been rapidly developed for improvement of diagnosis and evaluation of therapeutic effects. In despite of integrated hardware, registration accuracy was decreased due to a discrepancy between multimodal image and insufficiency of count in accordance with different acquisition method of each modality. The purpose of this study was to improve the PET image by event data resampling through analysis of data format, noise and statistical properties of small animal PET list data. Inveon PET listmode data was acquired as static data for 10 min after 60 min of 37 MBq/0.1 ml $^{18}F$-FDG injection via tail vein. Listmode data format was consist of packet containing 48 bit in which divided 8 bit header and 40 bit payload space. Realigned sinogram was generated from resampled event data of original listmode by using adjustment of LOR location, simple event magnification and nonparametric bootstrap. Sinogram was reconstructed for imaging using OSEM 2D algorithm with 16 subset and 4 iterations. Prompt coincidence was 13,940,707 count measured from PET data header and 13,936,687 count measured from analysis of list-event data. In simple event magnification of PET data, maximum was improved from 1.336 to 1.743, but noise was also increased. Resampling efficiency of PET data was assessed from de-noised and improved image by shift operation of payload value of sequential packet. Bootstrap resampling technique provides the PET image which noise and statistical properties was improved. List-event data resampling method would be aid to improve registration accuracy and early diagnosis efficiency.