• Title/Summary/Keyword: 시술 각도

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A Comparison of Clinical Efficacy of Weaning Method Between the Mode of Intermittent Mandatory Ventilation and Intermittent Mandatory Ventilation Plus Pressure Support (기계적 호흡 치료로부터의 이탈방법으로서 Intermittent Mandatory Ventilation 단독 사용과 Pressure Support를 병용한 Intermittent Mandatory Ventilation의 비교)

  • Choi, Jeong-Eun;Koh, Youn-Suck;Cho, Won-Kyoung;Lim, Chae-Man;Kim, Woo-Sung;Park, Pyung-Hwan;Choi, Jong-Moo;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.372-378
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    • 1994
  • Background: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiraory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by an endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object: The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation(IMV) in facilitating weaning precess compaired to IMV mode alone. Method: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant throught the weaning period. For the patients who required mechanical ventilation for less than 72 hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning trial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. Results: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. Conclusion: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm $H_2O$ did not induce significant physiologic changes during weaning process.

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New maxillary anterior ridge classification according to ideal implant restorative position determined by CAT (전산화단층영상을 이용한 이상적 임플란트 수복 위치에 따른 상악 전치부 치조제의 새로운 분류)

  • Park, Young-Sang;Cho, Sang-Choon;Kim, Kyoung-Nam;Kim, Kwang-Mahn;Choi, Seong-Ho;Moon, Hong-Seok;Lee, Yong-Keun
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.385-396
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    • 2007
  • This study proposed a new classification system for maxillary anterior alveolar ridge deformities based on CAT-scan implant simulation as a useful concept in order to more precisely predict treatment outcomes and the necessity for ridge augmentation prior to implant placement. The results indicate that a high number of cases in the maxillary anterior area would require augmentation procedures in order to achieve ideal implant placement and restoration.

Comparison of Reconstruction Methods after Distal Gsstrectomy for Gastric Carcinoma in Terms of the Long Term Physiologic Function and Nutritional Status; Billroth I Gastroduodenostomy versus Roux-en Y Gastrojejunostomy (수술 후 장기적인 생리적 기능과 영양적 측면에서 본 원위부위절제술 후 재건술식의 비교; Billroth I 위십이지장문합술과 Roux-en Y 위공장문합술의 비교)

  • Jeong, Oh;Oh, Sung-Tae;Yuk, Jung-Hwan;Choi, Ji-Eun;Kim, Kab-Jung;Lim, Jung-Taek;Park, Gun-Chun;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.88-96
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    • 2007
  • Purpose: The only curative treatment for gastric carcinoma is surgery and it is still under debate which reconstruction method is better after performing gastrectomy for gastric carcinoma. The typical reconstruction methods after distal gastrectomy are Billroth I, Billroth II and Roux-en Y reconstruction. Yet it is difficult to compare these methods and not so much is known about which reconstruction is better in terms of the physiologic and nutritional function. With this background, we compared two reconstruction methods after distal gastrectomy (Billroth I versus Roux-en Y reconstruction) in terms of the long term physiologic function and nutritional status to create a reference for selecting reconstruction methods after distal gastrectomy. Materials and Methods: Between 1999 and 2002, 663 patients who underwent distal gastrectomy for early gastric carcinoma filled out questionnaires every six months after operation, and these questionnaires evaluated the physiologic function. To evaluate their nutritional status, blood tests were performed every six months to check their albumin, protein and hemoglobin levels, and we checked the body weight every 6 months as well. Results: The total score of the 15 questions on the questionnaire concerned with the physiologic function showed no difference between the two groups at every evaluation time, and both groups showed very low total scores, indicating tolerable physiologic function after operation. When comparing each question between two the groups, only symptoms of regurgitation and food passage showed a difference between the two groups, showing that the Roux-en Y group had better function in terms of these two symptoms. The Billroth I group showed a better nutrition status, indicating that the level of albumin, protein and hemoglobin were higher in the Billroth I group, with statistical significance. Body weight loss was severe in the Roux-en Y group. Conclusion: The physiologic function is slightly better in the Roux-en Y group in terms of some symptoms such as regurgitation and food passage. However, the nutritional status is better in the Billroth I group. In conclusion, because we cannot definitely ascertain which reconstruction is better when we consider both the physiologic and nutritional functions, it is reasonable that surgeon should choose reconstruction methods according to their experience and preference.

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Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.299-306
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    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

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Quantitative Assessment of the Radiation Exposure during Pathologic Process in the Sentinel Iymph Node Biopsy using Radioactive Colloid (방사성 콜로이드를 이용한 감시림프절 생검 병리처리과정에서 방사선 피폭의 정량적 평가)

  • Song, Yoo-Sung;Lee, Jeong-Won;Lee, Ho-Young;Kim, Seok-Ki;Kang, Keon-Wook;Kook, Myeong-Cherl;Park, Weon-Seo;Lee, Geon-Kook;Hong, Eun-Kyung;Lee, Eun-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.309-316
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    • 2007
  • Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)

Effect of Ledebouriella seseloides Extracts on Lipid Parameters in Ovariectomized Rats (방풍나물 추출물이 난소절제 흰쥐의 혈중 지질 변화에 미치는 영향)

  • Jeon, Myeong-Jeong;Kim, Mihyang
    • Journal of Life Science
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    • v.26 no.1
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    • pp.83-90
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    • 2016
  • This study was investigated the improvement effects of Ledebouriella seseloides (LS) ethanol extracts on lipid parameters in an ovariectomized animal model. Sixty, nine-week old female Sprague Dawley rats were randomly assigned to four groups as follows: sham-operated rats (SHAM), ovariectomized rats (OVX-CON) and ovariectomized rats that were treated with LS ethanol extracts (50 mg/kg/day and 200 mg/kg/day, respectively). The diets were fed to the rats for six weeks after their operation. The total-cholesterol and triglyceride contents on serum increased in the OVX-CON group compared to the SHAM group, but supplementation with the LS extract caused these factors to decrease. Notably, the serum LDL-cholesterol concentration in the supplemented 200 mg/kg/day LS ethanol extract group was significantly more reduced than the OVX-CON group. In addition, the platelet aggregation ability was lower in groups treated with LS than in the OVX-CON group. The alkaline phosphatase (ALP) activity was lower in the LS extract group compared to the OVX-CON group. Collagen content, in bone and cartilage, were reduced by ovariectomy, but the supplemented LS extract groups exhibited higher concentrations in their bones. According to these results, the improvement effects of LS extract on serum lipid parameters and osteogenesis in ovariectomized rats were illuminated.

The Microleakage in Class V Cavity Based on Different Kinds of Several Dentin Adhesive and Composite Resin (5급 와동에서 수종의 상아질 접착제와 복합레진의 종류에 따른 미세누출)

  • Choi, Yoo-Seok;Jeong, Soon-Jeong;Jeong, Moon-Jin;Ahn, Yong-Soon;Park, Seon-Nyeo;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.330-338
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    • 2013
  • In order to explore microleakage in class V cavity based on different kinds of several dentin adhesive and composite resin, 2 kinds of composite resin was restored and exposed after applying 4 kinds of dentin adhesives. Deposited in methylene blue solution for 4 hours and cut in parallel with tooth longitudinal axis. By observing dye penetration level of enamel and dentin margins of each restored resin following conclusion was obtained. 1. In composite resin Filtek Z350XT Universal (3M/ESPE Dental Products, USA) in enamel margin, Easy Bond (3M/ESPE Dental Products) showed the lowest microleakage and this leakage was represented to be high in the order of Single Bond 2 (3M/ESPE Dental Products), Scotchbond Multi-Purpose (3M/ESPE Dental Products) and Cearfil SE Bond (Kuraray Medical Inc., Japan). In case of Filtek Z350XT Flowable (3M/ESPE Dental Products), Scotchbond Multi-Purpose showed the lowest microleakage and this leakage was represented to be high in the order of Single Bond 2, Clearfil SE Bond and Easy Bond. 2. In case of Filtek Z350XT Universal in dentin margin, Easy Bond showed the lowest microleakage and this leakage was represented to be high in the order of Scotchbond Multi-Purpose, Single Bond 2 and Clearfil SE Bond. In case of Filtek Z350XT Flowable, Scotchbond Multi-Purpose and Single Bond showed the lowest microleakage and this leakage was represented to be high in the order of Clearfil SE Bond and Easy Bond. 3. In all the groups excepting S-U group (Single Bond 2+Filtek Z350XT Universal), enamel margin showed more higher microleakage than that of dentin margin. 4. There was a difference between enamel and dentin margin among each group but it was not significant statistically (p>0.05). When summarizing this result, it is considered that composite resin and dentin adhesive could be applied selectively and particularly in case of applying 1-step self-etching dentin adhesive, this method would be advantageous for manipulation convenience and shortening of operation time.

DIRECT PULP CAPPING WITH BONDING RESIN (접착용 레진을 이용한 유치의 직접 치수복조술에 관한 연구)

  • Cho, Hae-Sung;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.165-172
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    • 2006
  • A direct pulp capping with different medicaments has been attempted for a long time. The most commonly used among those is the calcium hydroxide. In primary teeth, however, a success rate of direct pulp capping with calcium hydroxide has been reported to be lower than that of pulpotomy. The disappointing results of calcium hydroxide have prompted the search for other capping materials. Lately, several researchers suggested an application of adhesive resin-based composite systems as a capping material. They claimed that when an exposed vital pulp is capped directly with bonding resin, the pulp tissue is free of inflammation or necrosis without clinical symptoms. The aim of this study was to compare short-term effects of the bonding resin which was applied on the mechanically exposed vital pulp tissue and those of direct pulp capping with calcium hydroxide. The second objective was to compare success rates of the primary teeth which already underwent physiologic root resorption and those of the teeth which had not undergone physiologic root resorption yet, in each capping material groups. The vital, healthy pulp of forty-one primary teeth were exposed mechanically during a cavity preparation. They were divided into two groups: Group 1(n=21) underwent capping with bonding resin, and group 2(n=20) underwent capping with calcium hydroxide. Then these two groups were subdivided into two groups in each : the teeth which show physiologic root resorption and the teeth without root resorption. All of the sample teeth were restored with composite resin. Clinical evaluations such as percussion test, ice test, EPT, were recorded and also before- and after- standard x-ray films were compared and evaluated to decide whether the case was successful or not. Evaluation was performed at least 3 months after the capping materials. The results were as follows 1. There was no difference in success rate between group 1 and group 2. 2. Success rate of the teeth with physiologic root resorption was higher than that of the teeth without physiologic root resorption in group 1 and group 2. 3. There was no difference in success rate between anterior teeth and posterior teeth.

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Utility Evaluation of Supportive Devices for Interventional Lower Extremity Angiography (인터벤션 하지 혈관조영검사를 위한 보조기구의 유용성 평가)

  • Kong, Chang gi;Song, Jong Nam;Jeong, Moon Taek;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.613-621
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    • 2019
  • The purpose of this study is to evaluate the effectiveness of supportive devices which are for minimizing the patient's movement during lower extremity angiography and to verify image quality of phantom by analyzing of Mask image, DSA image and Roadmap image into SNR and CNR. As a result of comparing SNR with CNR of mask image obtained by DSA technique using the phantom alone and phantom placed on the supportive devices, there was no significant difference between about 0~0.06 for SNR and about 0~0.003 for CNR. The study showed about 0.11~0.35 for SNR and 0.016~0.031 for CNR of DSA imaging by DSA technique about only water phantom of the blood vessel model and the water phantom placed on the device. Analyzing SNR and CNR of Roadmap technique about water phantom on the auxiliary device (hardboard paper, pomax, polycarbonate, acrylic) and water phantom alone, there was no significant difference between 0.02~0.05 for SNR and 0.002~0.004 for CNR. In conclusion, there was no significant difference on image quality by using supportive devices made by hardboard paper, pomax, polycarbonate or acryl regardless of whether using supportive devices or not. Supportive devices to minimize of the patient's movement may reduce the total amount of contrast, exam-time, radiation exposure and eliminate risk factors during angiogram. Supportive devices made by hardboard paper can be applied easily during angiogram due to advantages of reasonable price and simple processing. It is considered that will be useful to consider cost efficiency and types of materials and their properties in accordance with purpose and method of the study when the operator makes and uses supportive devices.

Effects of Supplementation of Spent Mushroom(Flammulina velutipes) Substrates on the in vitro Ruminal Fermentation Characteristics and Dry Matter Digestibility of Rye Silage (호밀 사일리지 제조 시 팽이버섯 수확 후 배지 첨가수준이 in vitro 반추위 발효특성 및 건물소화율에 미치는 영향)

  • Kang, Han-Byeol;Cho, Woong-Ki;Cho, Soo-Jeong;Lee, Shin-Ja;Lee, Sung-Sill;Moon, Yea-Hwang
    • Journal of agriculture & life science
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    • v.51 no.5
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    • pp.91-101
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    • 2017
  • The in vitro experiment was conducted to ensure the supplemental level of spent Flammulina velutipes mushroom substrates(SMS) as an energy source in manufacturing of rye silage. Rye harvested at heading stage was ensiled with spent mushroom substrates of 0%(Control), 20%(R-20), 40%(R-40) and 60%(R-60) as fresh matter basis for 6week. The rumen fluid for preparation of in vitro solution was collected from two cannulated Holstein bulls fed a 40:60 concentrate:timothy diet. The experiment was conducted by 3, 6, 9, 12, 24, and 48 hrs of ncubation time with 3 replications. The silages were evaluated fermentation characteristics and dry matter digestibility(DMD) in vitro. The pH of in vitro solution was inclined to decrease with elapsing the incubation time, and that of the R-60 was significantly(p<0.05) lower than the other treatment at 48 hr of incubation. The microbial growth in vitro was inclined to increase with elapsing the incubation time, and that of the R-20 was significantly(p<0.05) greater than the Control at 48 hr of incubation. Gas production was greater(p<0.05) in the Control than the other treatments at 48 hr of incubation. In vitro dry matter digestibility(IVDMD) was higher with increasing the supplemental level of SMS, and was significantly(p<0.05) lower in the Control compared with other treatments throughout whole incubation time. The IVDMD for R-60 was the highest(p<0.05) among treatments at 24 hr and 48 hr of incubation. Considering of above results and the availability of SMS, SMS could be supplemented by 60% in fresh matter basis for rye silage fermentation.