• Title/Summary/Keyword: 수정체수술

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Evaluation of the Fetal Dose during Prophylactic Placement of Internal Iliac Artery Balloon Occlusion Catheters in Placenta Accreta (유착태반환자의 예방적 내장골동맥 풍선카테터 설치술 시행 시 태아선량 평가)

  • Kim, Dong-Sik;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.313-321
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    • 2016
  • Placenta accrete patients whose mother mortality rates are rather high due to massive bleeding during childbirth need to have Prophylactic placement of Internal Iliac Artery Balloon Occlusion Catheters procedure to reduce amount of blood loss and inoperative transfusion. Nevertheless, studies for mothers inevitably exposed to dose during PIIABOCs procedure have not been published many yet. Therefore, this study is to investigate exact information on radiation dose exposed to fetus during PIIABOCs procedure. Average effective dose of fetus per organ is 2.38~8.83 mGy, measured highest at beam center and followed by eyeball, stomach and bladder. The result showed that the longer fluoroscopy time is used, the closer beam center is and the thicker abdominal thickness is, the more effective dose on fetus is increasing. When using the collimator and protection shown to decrease the effective dose and when using higher the patient table shown to decrease the effective dose. It has been reported that the threshold of deterministic effect is about 100mGy. Deterministic effect was regarded as a factor that would influence on fetus exposed by medical radiation than stochastic effect. Consequently, it concluded that dose exposed on fetus in PIIABOCs procedure was approximately 10% of threshold of deterministic effect with effective dose of 0.49~18.27 mGy.

Surgical Results for Treating Postpneumonectomy Empyema with BPF by Using an Omental Pedicled Flap and Thoracoplasty (전폐절제술 후 기관지 흉막루를 동반한 농흉에서 유경성 대망 이식편과 흉곽성형술을 이용한 수술적 치료에 대한 임상 고찰)

  • Jeong, Seong-Cheol;Kim, Mi-Jung;Song, Chang-Min;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.420-427
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    • 2007
  • Background: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy. Material and Mehod: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: $45.9{\pm}9$ years). The patients were followed up for a mean of 58 months (median: 28 months, range: $6{\sim}169$). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema, Result: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8). Conclusion: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to 75-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.

The Correlation of Refractive Error and Ocular Dimensions in Older Age (고령의 연령에서 굴절이상과 안광학 성분들의 연관성 분석)

  • Lim, Byung Kwan;Jeon, Soon-Woo;Jeong, Youn Hong
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.3
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    • pp.293-297
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    • 2011
  • Purpose: This study was to know the correlation among refractive error and the dimensions of ocular components on older adults. Methods: The subjects were 95 older age who had no eye diseases. The refractive error, corneal radius, corneal diopter, axial length, anterior chamber depth and lens thickness were measured and analysed. Results: The axial length(AL)/corneal radius(CR) ratio was positively correlated with the corneal diopter, axial length, the anterior chamber depth. Then it was negatively correlated with corneal radius. It was shown that the highest correlation was between the corneal diopter and axial length (r = -0.545, p = 0.000). The spherical equivalent of the refractive error was negatively correlated with the AL/CR ratio. Conclusions: It was shown that the AL/CR ratio was a very important indicator for diagnosing the refractive error of the old age.

The Study on Accommodation for eyes with pseudo-crystalline lenses (인공수정체안의 조절반응에 관한 연구)

  • Lee, Seok-Ju;Sung, A-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.203-209
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    • 2004
  • Physiological accommodation in aphakia has been reported 0.50D. Also, accommodation appears in pseudo-crystalline lens. However accommodation was not clear how to works in the eyes. Therefore, the purpose of this study is that accommodation has been affected to changes of axial length and corneal refractive power when the accommodative stimulus was taken 10 diopters to person who has pseudo-crystalline lens. To determine of the accommodative response of pseudo-phakic patients who had no side effects over 2 months, we have measured the axial length, corneal refractive power in 48 patients(96 eyes). When the accommodative stimulus was taken about 10 diopters, the axial length increased by $0.05{\pm}0.06mm$ and corneal refractive power increased $0.04{\pm}0.24$ diopter. The changes of axial length in the myopia was increased by $0.19{\pm}0.18D$, emmetropia was increased by $0.12{\pm}0.16D$ and hyperopia was $0.10{\pm}0.19D$. The results of measurement revealed that the mean value was increased $0.03{\pm}0.13D$ in the myopia, and increased $0.21{\pm}0.13D$ in the emmetropia, and decreased $0.02{\pm}0.34D$ in the hyperopia.

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Clinical Implementation of an Eye Fixing and Monitoring System with Head Mount Display (Head Mount Display (HMD)를 이용한 안구의 고정 및 감시장치의 임상사용 가능성 확인)

  • Ko, Young-Eun;Park, Seoung-HO;Yi, Byong-Yong;Ahn, Seung-Do;Lim, Sang-Wook;Lee, Sang-Wook;Shin, Seong-Soo;Kim, Jong-Hoon;Choi, Eun-Kyung;Noh, Young-Ju
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.1-6
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    • 2007
  • A system to non-invasively fix and monitor eye by a head mounted display (HMD) with a CCD camera for stereotactic radiotherapy (SRS) of uveal melanoma has been developed and implemented clinically. The eye fixing and monitoring system consists of a HMD showing patient a screen for fixing eyeball, a CCD camera monitoring patient's eyeball, and an immobilization mask. At flrst, patient's head was immobilized with a mask. Then, patient was Instructed to wear HMD, to which CCD camera was attached, on the mask and see the given reference point on its screen. While patient stared at the given point in order to fix eyeball, the camera monitored Its motion. Four volunteers and one patient of uveal melanoma for SRS came into this study. For the volunteers, setup errors and the motion of eyeball were analyzed. For the patient, CT scans were peformed, with patient's wearing HMD and fixing the eye to the given point. To treat patient under the same condition, daily CT scans were also peformed before every treatment and the motion of lens was compared to the planning CT Setup errors for four volunteers were within 1mm and the motion of eyeball was fixed within the clinically acceptable ranges. For the patient with uveal melanoma, the motion of lens was fixed within 2mm from daily CT scans. An eye fixing and monitoring system allowed Immobilizing patient as well as monitoring eyeball and was successfully implemented in the treatment of uveal melanoma for SRS.

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The Change of Medical Care Pattern and Cost of Cataract Surgery by the DRG Payment System in a General Hospital (한 종합병원의 포괄수가제 실시 전후 수정체수술환자의 의료서비스 및 진료비 비교분석)

  • Lee, Mi-Rim;Lee, Yong-Hwan;Koh, Kwang-Wook
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.48-70
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    • 2005
  • The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

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The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children (소아청소년 개방안구손상 환자에서의 시력예후와 안외상 점수와의 연관성)

  • Park, Su Jin;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1062-1070
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    • 2018
  • Purpose: We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS). Methods: We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity. Results: By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (${\geq}20/32$). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems. Conclusions: Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.

The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

Flower and Microspore Development in 'Campbell Early' (Vitis labruscana) and 'Tamnara' (V. spp.) Grapes ('캠벨얼리'와 '탐나라' 포도의 꽃과 소포자 발달)

  • Yim, Bomi;Mun, Jeong-Hwan;Jeong, Young-Min;Hur, Youn Young;Yu, Hee-Ju
    • Horticultural Science & Technology
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    • v.33 no.3
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    • pp.420-428
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    • 2015
  • The majority of cultivated varieties of grape have perfect flowers that are clustered in an individual inflorescence. Grape flower has a single pistil, five stamens, a protective flower cap (calyptra), and a calyx. After fertilization, an individual flower develops into a single berry. Although there are a number of reported studies focusing on berry formation, berry enlargement, and sugar accumulation in grape, the morphological studies of flower, including gametophyte morphogenesis and structural change in floral organs, have not yet been studied in detail. In this study, we investigated the flower structure and development characteristics of grape using microscopy and defined the floral development stages 9 to 13 based on microspore or male gametophyte development stage from tetrad to mature pollen. We used seeded diploid table grapes 'Campbell Early' (Vitis labruscana) and 'Tamnara' (V. spp.) as plant materials. At floral development stage 9, pollen mother cells develop to tetrads. During floral development stages 10 to 11, unicellular microspore develop to mid bicellular pollen. At the end of floral stage 12, male gametophyte develops to mature tricelluar pollen. In floral stage 13, the flower cap falls off and flower bud opens. During floral development stages 9 to 12, there were no major changes in calyx length, whereas the length of the flower cap continuously increased. The flower cap-to-calyx length ratio was 2.0, 3.0, 4.5, and 6.5 at floral stages 9, 10, 11, and 12, respectively. The flower cap-to-calyx length ratio was consistent in the two grape cultivars, suggesting that the ratio is a morphological character representing floral development stage. This study provides a reference for determining floral development stage of the two grape cultivars. It will be useful for the determination of optimum time for microspore culture needed to generate doubled haploid lines and appropriate gibberellic acid treatment needed to induce parthenocarpic fruit development in 'Tamnara' grape.