• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.94-102
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• 1997

Purpose: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compares the results of high resolution, fast speed slice interpolation MRA and DSA thereby examing the potentiality of primary non-invasive screening test. Materials and Methods: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine (Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. The settings include TR/TE/FA=30/6.4/25, matrix $160{\times}512$, FOV $150{\times}200$, 7minutes 42 seconds of scan time, effective thickness of 0.7 mm and an entire thickness of 102. 2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction (MPR) technique was used in cases of intracranial aneurysm. Results: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than IOmm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitivity. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. Conclusion: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary non-invasive screening test in the future.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.168-179
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• 2007

Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

• Journal of Biomedical Engineering Research
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• v.19 no.2
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• pp.183-188
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• 1998

Von Mises stress and compliance distribution was evaluated using a finite element analysis on the end-to-side anastomosis of an artery with length of 20-24mm, inner diameter of 4mm, thickness of 0.5mm and a PTFE graft with length of 10mm, inner diameter of 2mm, thickness of 0.2mm when the anastomotic angle was taken from 30$^{\circ}$~90$^{\circ}$ in every 10$^{\circ}$ and the diameter ratio from 0.1-1 in every 0.1. The inner pressure of 1330 dyne/$\textrm{mm}^2$ was applied inside the 2 conduits. It was found that the compliance whose magnitude is larger on the acute angle anastomotic side than on the abtuse angle side became larger as the anastomotic angle became smaller and the diameter ratio larger and that the equivalent stress on the acute angle anastomotic side was larger than that on the abtuse angle side and became larger as the anastomotic angle and the diameter ratio became larger.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.165-169
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• 2001

Apatient, 51 years old woman, had suffered form headache and decrease of visual acuity. She had $3{\times}3cm$ sized giant aneurysm originated in cavernous and clinoid portion of left ICA(C4,C5) in the cerebral angiography. Before craniotomy, left CCA was exposed and 6F double lumen catheter was inserted in left ICA through the sheath. Pre-operative angiography was done. balloon catheter was positioned at the petrous portion of ICA. Eyebrow approach was done and giant aneurysm was exposed. The proximal blood flow was controlled with balloon dilatation and suction and decompression was tried, then multiple clips were applied. The loss of distal blood flow under intra-operative angiography was notified after clipping. The position of clips were repositioned to preserve blood flow & the rich flow was confirmed at distal part of clipping. In the post-operative cerebral angiography, the same finding was shown.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.302-307
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• 2003

The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.101-107
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• 1999

We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients. all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more than 50% of coronary artery narrowing was considered significant, the overall sensitivity and specificity of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%. respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity for CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.205-208
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• 2000

소에서 경정맥, 경동맥 및 갑상선의 초으파상에 관한 기초자료를 확립하기 위하여 본 연구를 실시하였다. 한우 9두에서 6개월경으로부터 12개월령에 도달할 때까지 1개월 간격으로 성장에 따른 경정맥, 경동맥 및 갑상선의 초음파상을 측정하였다. 경정맥, 경도맥 및 갑상선은 경부의 양측에서 관찰하였다. 경정맥의 내경은 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 8.5, 8.7, 8.8, 9.5, 10.0, 10.5, 11.5 및 12.2mm를 나타내었다. 경동맥의 내경은, 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 7.4, 7.5, 8.6, 9.1, 9.4, 9.7, 10.1 및 10.3mm 이었다. 갑상선엽의 길이는 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 28.0, 32.1, 36.4, 42.2, 51.7, 53.2, 55.1 and 58.8mm이었다. 갑상선엽의 높이는 6, 7, 8, 9. 10, 11, 12 및 13개월령에서, 각각 13.6, 15.3, 16.1, 20.7, 22.9, 25.6, 28.9 and 29.4mm를 나타내었다. 본 연구에서는 초음파측정 결과는 한우에서의 경정맥, 경동맥 및 갑상선에서의 형태학적 변화의 진단을 위한 참고자료가 될 수 있을 것으로 사료된다.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.187-193
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• 2000

Fifteen adult Korea Jin-do dogs were studied by echocardiography to obtain the basic data of the imaging planes and normal references ranges to the aorta and pulmonary artery internal dimension. Measurements of aortic root internal dimension(AOID) and right pulmonary artery internal dimension (RPAID) were made at modified pulmonary arteries level short-axis view and left ventricular outflow tract long-axis view. The aortic root internal dimension and right pulmonary artery internal dimension at modified pulmonary arteries level short-axis view were 18.7$\pm$1.3mm (mean$\pm$SD) and 10.1$\pm$0.8mm, respectively. And RPAID/AOID was 0.5$\pm$0.1mm. The aortic root internal dimension and right pulmonary artery internal dimension at left ventricular outflow tract long-axis view were 19.3$\pm$1.6 mm and 10.7$\pm$1.3mm, respectively. And RPAID/AOID was 0.5$\pm$0.1mm. These results indicate that modified pulmonary arteries level short-axis view is useful planes to examine the aortic root and pulmonary arteries, and aortic root internal dimension is significantly higher(40~50%)than the right pulmonary artery internal dimension. Therefore measurements of aortic root internal and right pulmonary artery internal dimension can be used for monitoring dilation of pulmonary artery.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1657-1663
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• 2000

The authors report a case of a 72-year-old woman who presented with intraventricular and subarachnoid hemorrhage of Hunt and Hess grade IV after the rupture of a giant aneurysm arising from the right internal carotid artery. The aneurysm was clipped successfully with the aid of cardiopulmonary bypass(closed chest method), deep hypothermic circulatory arrest, and cerebral protection with barbiturate resulting in moderate disability. We discuss the usefulness and problems related to technique of circulatory arrest and cardiopulmonary bypass using closed chest method, and suggest the possible benefits of open chest method in elderly people and the importance of preoperative plan to coordinate anesthesia and operation.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.143-147
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• 2007

Background: The safety of cervical transforaminal epidural block has been the subject of debate, therefore, this study was conducted to measure the angle of the cervical transforaminal axis and to investigate its relationship to the internal jugular vein, internal carotid artery and vertebral artery. Methods: One hundred cases of cervical MRI were reviewed. The angle between a line passing through the center of the vertebral body and spinous process and a line passing through the center of the lamina in C3-4, C4-5 and C5-6 was measured and designated as A-degree. Additionally, we drew a line at the back of the vertebral artery that ran parallel to a line passing through the center of the lamina, which was presented as A-line. We then examined the distribution of the area in which the internal jugular vein and the internal carotid artery were located. Results: The mean values of the A-degree in C3-4, C4-5 and C5-6 were $53.5{\pm}4.3$, $54.2{\pm}4.6$ and $54.3{\pm}4.8$, respectively. There were no statistically significant differences among age groups or vertebral levels (ANOVA test, P > 0.05). The A-line was distributed primarily throughout zone 3, 4, and 5 in C3-4 and zone 5 in C4-5 and C5-6. Conclusions: The results of this study indicate that the mean values of A-degree were not statistically different among each age group and each vertebral level. However, the A-line may be located in the zone in which the internal jugular vein and the internal carotid artery lie and individual differences in the A-degree remain.