• Title/Summary/Keyword: 요골동맥

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A study for measurement of radial artery oxygen saturation system using photoelectric plenthysmography (광전용적맥파를 이용한 요골동맥 산소포화도 측정 시스템의 연구)

  • Kim, Kyung-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.15 no.3
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    • pp.11-18
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    • 2010
  • In this study, the pulse of radial artery and oxygen saturation are detected using photoelectric plethysmograph method. Using our device designed reflection type, we can detect the reflected light by radial artery and by switching circuit, we can also separate to 625nm band signal and 940nm band signals. The separated signals are converted as a pulse data by the pulse signal processing circuit. In this study, the reflection type of oxygen saturation calculation method is applied instead of the transmission type because of the reflection type sensor is used to measure the radial artery. As a result, we can detect about 97% accuracy of the oxygen saturation compare with the conventional method. For the accurate signals, the wrist band with sensor was designed and fixed on the radial artery. As a result, this wrist band type sensor was applicable to prevent position errors from motion artifact and could increase the accuracy during the measuring.

Multivessel Coronary Revascularization with Composite LITA-RA Y Graft (좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술)

  • Lee Sub;Ko Mgo-Sung;Park Ki-Sung;Ryu Jae-Kean;Jang Jae-Suk;Kwon Oh-Choon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.359-365
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    • 2006
  • Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

Arterial blood pressure measurement using pulse transit time (맥파전달시간을 이용한 동맥혈 혈압측정)

  • Hwang, Dae-Seok;Lee, Young-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2007.10a
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    • pp.265-267
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    • 2007
  • 고혈압을 진단하고 치료함에 있어 정기적인 혈압의 측정 및 관리는 매우 중요하다. 본 논문에서는 요골 동맥혈에서 혈압 측정을 하기 위한 심전도 측정기와 광용적맥파 측정기를 설계하여 구성하였으며, 이를 이용한 맥파 전달 시간 측정을 LA(Left Arm), RA(Right Arm)에서 심전도와 요골동맥에서 광 용적맥파 신호를 측정하였다.

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A Study on Hemodynamic Characteristics at the Occlusion on Radial Artery (Radial artery occlusion 시 혈류역학적 특성변화)

  • Lee, Yu-Jung;Lee, Jeon;Ryu, Hyun-Hee;Kim, Jong-Yeol
    • Proceedings of the KIEE Conference
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    • 2008.07a
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    • pp.1989-1990
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    • 2008
  • 한의학에서 맥진은 한의사가 손가락으로 환자의 손목의 요골동맥을 짚어 맥박이 손가락에 닿는 느낌에 근거하여 병세를 감별하는 진찰방법으로 인체의 건강상태를 살피고, 정상인의 평맥(平脈)으로부터 환자의 병맥(病脈)을 분석하는 진단법이다. 손목에 있는 요골 경상돌기(styloid preocess) 부근의 볼록한 지점을 고골(高骨)이라하는데 이 돌기를 기준으로 맥이 느껴지는 위치를 검지, 중지, 약지를 이용해 진맥위치를 잡는다. 맥진 시 한의사는 맥진위치에 압력을 서서히 가하면서 손끝에 느껴지는 감각을 이용해 진단한다. 이 과정에서 맥진위치 요골동맥의 혈관이 서서히 occlusion 된다. 본 논문에서는 맥진과정 시 요골동맥의 혈류역학적인 변화를 초음파를 이용해 분석해보고자 한다. 건강한 남자 피험자(34세)를 대상으로 초음파 장비(Voluson 730Pro, GE Medical, U.S.)를 이용해 맥진 위치의 혈관특성을 관찰한다. 혈압계를 이용해 혈관에 압력을 0에서 130mmHg까지 10mmHg씩 단계별로 가압한 후 초음파를 측정한다. 그 결과, 요골동맥에 압력을 가할수록 혈류속도가 서서히 감소함을 알 수 있었으며, 회귀식을 분석할 수 있었다(y = -0.3509x +44.323, $R^2$ = 0.9547). 또한, 가압 단계를 0$\sim$10mmHg, 20$\sim$40mmHg, 50$\sim$70mmHg, 80$\sim$100mmHg 110$\sim$130mmHg으로 가압단계를 나누어 보면, 각 단계별로는 42.32cm/sec, 33.08cm/sec, 24.8cm/sec, 14.3cm/sec, 0cm/sec로 혈류속도가 변화를 보였다. 각 단계별로 혈류속도가 평균 10.58cm/sec의 차이를 보임을 알 수 있다. 본 연구를 통해 가압력에 대한 맥진위치의 혈류변화를 관찰하였다. 그러나 직접 맥진위치를 가압하면서 초음파를 통해 혈류속도를 측정할 수 있는 방법이 없어, 맥진 위치 바로 위쪽을 가압하고 초음파 측정을 하였다. 직접 혈관을 가압하고 그때의 혈류속도를 측정하면 보다 정확히 맥진시의 혈류역학적 특성을 분석할 수 있을 것으로 판단된다. 장비의 고안을 통해 다음 연구에서는 직접적인 가압 후 혈슈속도를 측정해 봄으로써 본 결과와 비교 분석해 보고자 한다.

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Total Arterial 011-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts (다중 복합 Y 동맥 이식편(Multiple Y Composite Craft)을 이용한 완저너 동맥 무인공 심폐바이패스 관상동맥우회술)

  • Kim Do-kyun;Lee Kyo Jgon;Joo Hyun Chul;Li Gyjong;Ahn Jiyoung;shim Yungee;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.551-556
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    • 2005
  • Background: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypopefusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method. Material and Method: Between February 2003 and October 2004, If patients underwent total arterial OPCAB using multiple arterial V composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 6f patients by multi-slice computed tomegraphy. Result: An average of $2.5\pm0.6$ arteries and $3.7pm0.7$ distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was $17.4pm29.7\;IU/L.$Overall graft patency was $99.1\%\;(214/216)(LIMA:\;100\%,\;RA:\;98.4\%,\;RIMA:\;100\%).$ Conclusion: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.

Histomorphological Comparison of the Coronary Artery and Available Graft Conduits (관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교)

  • Kim, Yong-Ho;Lee, Seok-Ki;Yu, Jeong-Hwan;Kim, Si-Wook;Kang, Shin-Kwang;Lim, Seung-Pyung;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.563-567
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    • 2008
  • Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

Surgical Treatment of a True Radial Artery Aneurysm in the Palm, and This Was Caused by Handclapping and Repetitive - A case report - (박수 및 반복되는 직업적 가위질로 인하여 손바닥에 발생한 요골 동맥 진성 동맥류의 수술적 치험 - 1예 보고 -)

  • Lee, Woo-Surng;Kim, Yo-Han;Chee, Hyun-Keun;Hwang, Jae-Joon;Kim, Jun-Seok;Lee, Song-Am
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.384-387
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    • 2009
  • Radial artery aneurysm is an extremely rare disease and this is usually caused by iatrogenic trauma such as arterial cannulation. Most traumatic aneurysms in the extremities are false aneurysms and most cases have occurred at the level of the wrist. Very few true aneurysms of the radial artery have been reported, with most of them being iatrogenic. A right handed 38-year-old female had a true aneurysm of the distal radial artery in the thenar groove of the palm. The patient had a history of excessive handclapping and the injury was suggestive of repetitive occupational injury due to scissoring. She underwent surgical treatment for the aneurysm of the radial artery in the thenar groove of the palm of her hand.

Development of a Test Jig for Examination of Radial Pulse Waveform Variations at Different Hold-down Pressures (가압에 따른 요골동맥 맥파 변동 측정을 위한 테스트 지그 개발)

  • Lee, Jeon;Woo, Young-Jae;Jeon, Young-Ju;Lee, Yu-Jung;Kim, Jong-Yeol
    • Proceedings of the KIEE Conference
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    • 2008.10b
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    • pp.203-204
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    • 2008
  • 한의학 진단의 중요 요소인 맥진을 자동화한 맥진기에서뿐만 아니라 비관혈적 심혈관 기능 평가를 위해서 요골동맥 맥파 측정이 널리 활용되고 있다. 요골동맥 맥파는 피험자의 생리적, 병리적 원인을 통제하더라도 가압력이 변함에 따라 형태가 달라지며, 어느 시점 맥파를 피험자의 상태를 대표하는 맥파로 해야 할지에 대한 명확한 기준이 없어 맥압이 최대가 되는 시점의 맥파를 사용하고 있다. 그러나, 맥파가 측정되는 가압력 범위뿐만 아니라 맥압이 최대가 되는 시점이 피험자마다 다르기 때문에 정확한 대표 맥파를 획득하기 위해서는 보다 가압력 단계를 늘려야 하며, 결과적으로 측정시간이 보다 길어지게 될 것이다. 본 논문에서는 최소한의 가압단계로도 보다 정확히 대표 맥파를 획득할 수 있는 방법을 개발할 수 있도록, 정밀 제어가 가능한 가압 로봇 축, 가압에 의해 눌리는 피부이동 거리 측정을 위한 레이저 센서, 가압에 따른 피부 반발력과 맥파를 측정할 수 있는 압력 센서로 구성된 테스트 지그를 개발하였다. 이를 통해 모터 이동 스텝 수에 따른 피부 이동 거리 특성, 피부 이동 거리에 따른 맥파 변화 특성 등을 관찰할 수 있었으며, 향후 효과적인 대표 맥파 획득 방법을 개발할 수 있을 것으로 기대한다.

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