• Title/Summary/Keyword: wall defect

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Tuberculous Empyema Necessitatis with Osteomyelitis, a Rare Case in the 21st Century (늑골 골수염에 동반된 흉벽 천공성 농흉 1례)

  • Kim, Han Wool;Lim, Goh-Woon;Cho, Hye Kyung;Lee, Hyunju;Won, Tae Hee;Park, Kyoung Un;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.80-84
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    • 2011
  • Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right $7^{th}$ rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right $7^{th}$ rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.

Definitive Surgical Management for Deep-Seated Mediastinitis and Sternal Osteomyelitis Following Tracheal Reconstruction -Sternectomy, Free or In-Situ Omental Transfer, Myocutaneous Flap- (기관재건술 후 발생한 심부 종격염 -흉골 절제, 위망 이식, 근피성형을 병합한 근치술-)

  • Lee, Seo-Won;Kim, Jung-Taek;Kim, Kwang-Ho;Lee, Choong-Jae;Kim, Young-Mo;Lim, Hyun-Kyoung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.206-210
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    • 1999
  • We report here 2 cases of deep-seated mediastinitis combined with sternal osteomyelitis after tracheal reconstruction which were successfully treated with sternectomy, in-situ or free omental transfer, and pectoralis major myocutaneous flap. In case I, an 8 year-old boy with deep seated mediastinitis and sternal osteomyelitis that developed after anterior tracheoplasty through a standard midline sternotomy. In case II, a 50 year-old female patient with mediastinal abcess and sternal osteomyelitis that developed after resection and end-to-end anastomosis of the trachea through an upper midline sternotomy. Treatments consisted of drainage and irrigation followed by wide resection of the infected sternum, placement of the viable omentum into the anterior mediastinal space, and chest wall reconstruction with a pectoralis major myocutaneous flap. The omentum was transferred as an in-situ pedicled graft in case I and a free graft in case II. Both patients have recovered smoothly wit out any events and have been doing well postoperatively.

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Copper Filling to TSV (Through-Si-Via) and Simplification of Bumping Process (비아 홀(TSV)의 Cu 충전 및 범핑 공정 단순화)

  • Hong, Sung-Jun;Hong, Sung-Chul;Kim, Won-Joong;Jung, Jae-Pil
    • Journal of the Microelectronics and Packaging Society
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    • v.17 no.3
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    • pp.79-84
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    • 2010
  • Formation of TSV (Through-Si-Via) with an Au seed layer and Cu filling to the via, simplification of bumping process for three dimensional stacking of Si dice were investigated. In order to produce the via holes, the Si wafer was etched by a DRIE (Deep Reactive Ion Etching) process using $SF_6$ and $C_4F_8$ plasmas alternately. The vias were 40 ${\mu}m$ in diameter, 80 ${\mu}m$ in depth, and were produced by etching for 1.92 ks. On the via side wall, a dielectric layer of $SiO_2$ was formed by thermal oxidation, and an adhesion layer of Ti, and a seed layer of Au were applied by sputtering. Electroplating with pulsed DC was applied to fill the via holes with Cu. The plating condition was at a forward pulse current density of 1000 mA/$dm^2$ for 5 s and a reverse pulse current density of 190 mA/$dm^2$ for 25 s. By using these parameters, sound Cu filling was obtained in the vias with a total plating time of 57.6 ks. Sn bumping was performed on the Cu plugs without lithography process. The bumps were produced on the Si die successfully by the simplified process without serious defect.

A Quantitative Method for the Assessment of Myocardial Function using the Polar Analysis of Tc-99m-MIBI Myocardial SPECT (Tc-99m-MIBI 심근 SPECT 극성지도 분석에 의한 심근 기능의 정량적 평가)

  • Kwark, Cheol-Eun;Lee, Dong-Soo;Yeo, Jung-Suk;Lee, Kyung-Han;Chung, June-Key;Lee, Myung-Chul;Seo, Joung-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.172-176
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    • 1994
  • As the Tc-99m-MIBI myocardial SPECT demonstrated wide application in the diagnosis of myocardial function, the quantitative and severity-dependent information is currently re quired. In this study, we proposed a computerized method for scoring the fixed defects in terms of extent-weighted severity and for identifying the reversibility in ischemic regions. At the first stage of this method, the transverse slices were reconstructed with 0.4 Nyquist freq. and order 5 Butterworth filter. From the oblique/sagittal slices, maximal count per pixel circumferential profiles were extracted for each sector, and then stress/redist. polar maps were normalized and plotted. For reversibility, the stress polar map was subtracted from the de-layed image and positive-valued pixels were categorized into three grades. The extent-weight-ed severity scores were calculated using the assigned grades and their number of pixels. This procedure was done automatically and the reversibility and severity scores were produced for each of the coronary territories (LAD, RCA, LCX) or any combination of these. Clinical ap-plication has shown that the changes In reversibility scores after PTCA were correlated linearly with the pre PTCA scores(r>0.8) in postinfarct cases as well as in angina, and severity scores of persistent defects in stress/rest SPECT study matched to the regional ejection fraction and visual analysis of regional wall motion of gated blood pool scan(r>0.6). We conclude that the computerized severity scoring method for the analysis of myocardial SPECT could be useful in the assessment of the myocardial ischemia and fixed defect.

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A Study on the Cobalt Electrodeposition of High Aspect Ratio Through-Silicon-Via (TSV) with Single Additive (단일 첨가제를 이용한 고종횡비 TSV의 코발트 전해증착에 관한 연구)

  • Kim, Yu-Jeong;Lee, Jin-Hyeon;Park, Gi-Mun;Yu, Bong-Yeong
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2018.06a
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    • pp.140-140
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    • 2018
  • The 3D interconnect technologies have been appeared, as the density of Integrated Circuit (IC) devices increases. Through Silicon Via (TSV) process is an important technology in the 3D interconnect technologies. And the process is used to form a vertically electrical connection through silicon dies. This TSV process has some advantages that short length of interconnection, high interconnection density, low electrical resistance, and low power consumption. Because of these advantages, TSVs could improve the device performance higher. The fabrication process of TSV has several steps such as TSV etching, insulator deposition, seed layer deposition, metallization, planarization, and assembly. Among them, TSV metallization (i.e. TSV filling) was core process in the fabrication process of TSV because TSV metallization determines the performance and reliability of the TSV interconnect. TSVs were commonly filled with metals by using the simple electrochemical deposition method. However, since the aspect ratio of TSVs was become a higher, it was easy to occur voids and copper filling of TSVs became more difficult. Using some additives like an accelerator, suppressor and leveler for the void-free filling of TSVs, deposition rate of bottom could be fast whereas deposition of side walls could be inhibited. The suppressor was adsorbed surface of via easily because of its higher molecular weight than the accelerator. However, for high aspect ratio TSV fillers, the growth of the top of via can be accelerated because the suppressor is replaced by an accelerator. The substitution of the accelerator and the suppressor caused the side wall growth and defect generation. The suppressor was used as Single additive electrodeposition of TSV to overcome the constraints. At the electrochemical deposition of high aspect ratio of TSVs, the suppressor as single additive could effectively suppress the growth of the top surface and the void-free bottom-up filling became possible. Generally, copper was used to fill TSVs since its low resistivity could reduce the RC delay of the interconnection. However, because of the large Coefficients of Thermal Expansion (CTE) mismatch between silicon and copper, stress was induced to the silicon around the TSVs at the annealing process. The Keep Out Zone (KOZ), the stressed area in the silicon, could affect carrier mobility and could cause degradation of the device performance. Cobalt can be used as an alternative material because the CTE of cobalt was lower than that of copper. Therefore, using cobalt could reduce KOZ and improve device performance. In this study, high-aspect ratio TSVs were filled with cobalt using the electrochemical deposition. And the filling performance was enhanced by using the suppressor as single additive. Electrochemical analysis explains the effect of suppressor in the cobalt filling bath and the effect of filling behavior at condition such as current type was investigated.

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EFFECTS OF LOCAL IRRIGATION AND/OR INTRAVENOUS ADMINISTRATION OF ARGATROBAN ON THROMBOSIS IN MICROVASCULAR ANASTOMOSES OF FEMORAL VEIN OF RABBIT (가토대퇴정맥에서 미세혈관문합시 Argatroban의 국소세척 및 전신투여가 혈전형성에 미치는 영향)

  • Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.4
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    • pp.300-305
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    • 2005
  • Purpose: For the reconstruction of maxillofacial defect created by trauma, infection, or tumor etc, the role of microvascular anastomosis or vessel graft has been increased. Many methods has been tried to increase the success rate of microvascular anastomosis. Various anticoagulants and thrombolytic agents have been used to reduce the failure rate of microvascular anastomosis and avoid re-operation. Many drugs, however, have been used in the limited cases because most of these drugs may cause complications, such as allergy, fever or systemic bleeding. This study was performed to evaluate the influence of the Argatroban on patency and thrombosis in microvascular anastomosis when it is used for local irrigation or general administration. Materials & methods: Eight mature rabbits, weighing 2kg, were used. After exposing both femoral veins, the artificial thrombotic model was made by crushing injury using a smooth needle holder, and the transverse incision were made on femoral vein. The animals were divided into 4 groups according to Argatroban administration methods; control group (n=4), topical irrigation of lumen with saline solution; experimental group 1 (n=4), topical irrigation of lumen with Argatroban saline solution; experimental group 2 (n=4), topical irrigation of lumen with heparin followed by intravenous injection of Argatroban; experimental group 3 (n=4), topical irrigation of lumen with Argatroban followed by IV of Argatroban. Microvascular anastomosis was done with 10-0 Ethilon. The patency was evaluated by empty-and-refill test 30 minutes and 3 days after microanastomosis. The thrombus formation was examined 3 days after microanastomosis by surgical microscope. The histologic findings were also examined. Results: 1. Thirty minutes after microvascular anastomosis, the patency of all experimental groups was better than that of control group, but there was no significant difference among groups. 2. Three days after microvascular anastomosis, the patency of all experimental groups was more improved than that of control group (p<0.05). There was no significant difference among experimental groups. 3. Three days after microvascular anastomosis, the amount of thrombus in all experimental groups was less than that of control group (p<0.05). There was no significant difference among experimental groups. 4. Histologically, a lot of luminal thrombus was observed around sutured area in control group. Few luminal thrombus was observed in all experimental groups. The necrotic changes were observed on the sutured vein wall in all specimens. Conclusion: These results indicate that topical irrigation and/or intravenous administration of Argatroban is effective in improving patency and preventing thrombus formation after microvascular anastomosis.

Treatment of Benign Bone Lesions with Autologous Bone Marrow Stromal Cell Transplantation (자가 골수 기질 세포 이식을 이용한 장관골 양성 골 병변의 치료)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Kim, Yong-Sik;Bahk, Won-Jong;Chung, Yang-Guk;Kim, Hyoung-Jun;Ok, Ji-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.13-21
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    • 2004
  • Purpose: We analyzed the result of autologous bone marrow stromal cell transplantation with or without cancellous chip bone allograft for benign long bone lesions. Materials and methods: Since July 1996, eight benign bone lesions treated by curettage, cancellous chip bone allograft and bone marrow or marrow stromal cell transplantation were observed for resolution of clinical symptoms, new bone formation and consolidation. There were 6 males and 2 females. Average age was 24 (range 8 to 47) years old. Histologic diagnoses were 5 fibrous dysplasia, 2 simple bone cysts and one chondroblastoma and fibrous cortical defect each. Mean follow-up period was 16.3 (range 3 to 84) months. Results: In all four symptomatic patients, the pain was subsided in two weeks after surgery. New bone formation in the lesion was observed at 4 weeks, which incorporated into surrounding normal bone around 8 weeks. There were one pathologic fracture through the lesion at 3 weeks and one recurrence of simple bone cyst at 5 months postoperatively. Conclusion: Bone marrow or marrow stromal cell transplantation for bone defects from curettage of benign bone lesions, with or without cancellous chip bone allograft revealed rapid healing. Though it was the result of short-term follow up, it supports that bone marrow stromal cell transplantation will be very useful for the treatment of benign long bone cysts or other lesions. The complete curettage of inner cystic wall is important to prevent later recurrence, and the rigid internal fixation is also needed in selected high risk lesions of fracture.

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Prenatal Deaths and External Malformations Caused by X-Irradiation during the Preimplantation Period of ddy Mice (임신 ddy Mice에서 착상전기 방사선 조사에 따른 산전 사망 및 외부 기형 발현)

  • Ro, Hee-Jeong;Choi, Ihl-Bhong;Gu, Yeun-Wh
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.233-243
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    • 1998
  • Purpose : To evaluate the effects of X-irradiation on prenatal deaths, i.e., preimplantation deaths, embryonic deaths and fetal deaths, and on external malformations in precompacted preimplantation ddy mice Materials and Methods : Pregnant mice (n=85) obtained by limiting the mating time to from 6 to 9 A.M., were segregated into 11 groups. The first five groups (n=26) were irradiated with X-ray doses of 0.1 0.5, 0.75, 1.5, and 3 Gy, respectively, at 24 h post conception (p.c.) of the preimplantation Period. The second five (n=27) groups were irradiated at the same X-ray doses, respectively, but at 48 h p.c. of the preimplantation period. The last group (n=32) was the control group. The uterine contents were examined on the 18th day of gestation for prenatal deaths and external malformations. Results : 1) A statistically significant increase in preimplantation deaths with increasing dose was observed in the experimental groups irradiated at 24 h p.c. and in the groups irradiated at 48 h p.c., as compared to the control group. The threshold dose was close to 0.05 Gy and 0.075 Gy for the irradiations at 24 h p.c. and 48 h p.c. respectively. 2) A statistically significant increase in embryonic deaths with increasing dose was observed in all irradiation groups, except the group irradiated with a dose of 0.1 Gy at 48 h p.c.. 3) No fetal deaths were found in any experimental group. 4) In the experimental groups irradiated at 24 h p.c. anomalies increased with statistical significance, as compared with the control group : 2 exencephalies, 2 open eyelids, 3 anophthalmias, 2 cleft Palates, 2 gastroschisis, 1 abdominal wall defect. 1 leg defect, and 2 short tail anomalies: the threshold dose for external malformations was close to 0.2 Gy at 24 h p.c.. In the groups irradiated at 48 h p.c., 1 open eyelid and 2 short tail anomalies were observed, but there was no statistical significance in those malformations. Conclusion : The results of this study reveal that X-irradiation of precompacted preimplantation ddy mice causes not only preimplantation deaths and embryonic deaths but also external malformations. In addition, external malformations were observed in our experiments at diagnostic doses, including 0.1 and 0.5 Gy. For this reason, we recommend that irradiation should be avoided during the preimplantation period by applying Rugh's 10-day rule.

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The Usefulness of Bone Scan in Electric Burns (전기화상에서 골스캔의 유용성)

  • Kim, Tae-Hyung;So, Yong-Seon;Kweon, Ki-Hyeon;Han, Sang-Woong;Kim, Seok-Hwan;Kim, Jong-Soon;Han, Seung-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.130-138
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    • 1996
  • Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

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Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.