• Title/Summary/Keyword: 유두근

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Short-axis cine MR 영상을 이용한 심박출량 측정 : Threshold segmentation 기법의 적용

  • 강원석;최병욱;최규옥;정해조;이상호;유선국;김희중
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.79-79
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    • 2003
  • 심실의 내부는 유두근이나 trabecular와 같은 해부학적 구조물들로 인해 복잡한 형태를 띄고 있다. 그러한 복잡한 구조는 MR 영상을 이용한 심박출량 측정시 오차를 유발시킬 수 있으며, 만약 오차를 줄이기 위해 수작업을 하게 된다면 많은 수고와 시간이 필요하게 될 것이다. 본 연구에서는 threshold 기법을 이용하여 짧은 시간동안에 정확하게 복잡한 구조를 가진 심실의 심박출량을 측정하고자 하였다. 7 명의 환자에 대해 l.5T 급 MR 장치 (INTERA, Philips, Netherlands)를 이용하여 short-axis cardiac MR 영상을 획득하였다. 한 환자에 대해서 8개에서 10개의 슬라이스 영상을 8-10 mm의 두께로, 하나의 심장주기(cardiac cycle)동안 일정한 시간간격으로 25 개의 영상을 획득하였으며, 펄스시퀀스로는 ECG-gated segmented balanced fast field echo (TR/TE = 3ms/1.56ms)를 사용하였다. 획득된 영상은 PC(threshold 기법)와 workstation (기존의 수동 및 자동 segmentation 기법)로 DICOM 형태로 전송되었다. 측정은 IDL을 이용하여 자체 제작된 소프트웨어와 상용화된 소프트웨어 (MASS 5.0, MEDIS, Netherlands)를 이용하여 분석되었다. MR 영상에서 심내벽 부위를 추출하기 위하여 자체제작된 소프트웨어로는 threshold 기법을, 상용 소프트웨어로는 기존의 수동 및 자동 기법을 이용하였다. 심박출량은 최대수축기와 이완기 사이의 용적 차이로써 계산되었으며, 좌심실 및 우심실 모두에 대해 수행되었다. 또한, 해부학적 구조의 복잡도에 따른 측정방법의 정확도를 확인하기 위해 유두근 및 trabecular의 hypertrophy의 정도를 3 단계로 구분하고 측정된 값들을 통계적으로 분석하였다. Hypertrophy가 약한 그룹에서는 기존의 수동방식과 threshold 기법간의 의미있는 차이가 없었으며 (p=0.372), 기존의 수동 및 자동방식 간에도 큰 차이가 없었다 (p=0.298). 그러나, hypertrophy가 심한 그룹에서는 수동방식 및 자동방식 측정치 사이에 통계적으로 유의한 차이를 보임을 알 수 있었다 (p=0.044). 그러나, threshold 기법과 수동방식 사이에는 유의한 차이가 없었다 (p=0.l94). 분석시간은 threshold 기법이 기존의 수동방식에 비해서 두배정도 빠르다는 것을 알 수 있었다, Threshold 기법은 심박출량 측정에 있어서 정확하면서도 빠른 결과의 도출이 가능했으며, 특히 심내벽의 구조가 복잡한 경우에 그 효과가 증대됨을 알 수 있었다.

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Prevention and Adjuvant Therapy of Recurrent Respiratory Papillomatosis (재발성 호흡기 유두종증의 예방과 보조 요법)

  • Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.7-12
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    • 2020
  • Recurrent respiratory papillomatosis (RRP) is characterized by repeated recurrence in the respiratory system, such as the pharynx, larynx, and trachea, caused by the human papilloma virus. The main treatment is surgical removal of the papilloma. However repeated recurrence of RRP in multiple areas is burdened for the surgeon. In addition to the surgery, various adjuvant therapies have been studied to reduce the recurrence. Literature review was conducted with a focus on the adjuvant treatments for RRP.

반전성 유두종의 악성변화

  • Cha Chang-Il;Yeo Seung-Geun;Seok Sang-Ryeol;Hong Nam-Pyo;Jo Jung-Saeng;An Hoi-Yeong
    • 대한두경부종양학회:학술대회논문집
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    • 1993.11a
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    • pp.253.3-253.3
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    • 1993
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Papillary Muscle Rupture of The Left Ventricle - 3 Cases - (좌심실 유두근 파열;3례 보고)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.9
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    • pp.936-942
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    • 1992
  • There are three types of papillary muscle of the left ventricle[finger, tethered and mixed type] according to the morphology of the attachment to the ventricular wall. Especially finger type of the papillary muscle is more vulnerable to the injury than tethered or mixed type, because their blood supply is dependent upon the central artery whose diameter is less than 1mm and the papillary muscle itself is the end organ of the heart anatomically. There are several causes of papillary muscle rupture but few cases have been reported. Recently we have experienced 3 cases of papillary muscle rupture of the left ventricle with successful mitral valve replacement and the causes are postmyocardial infarction, percutaneous mitral valvulotomy and non-penetrating chest trauma. The common finding is the morphology of papillary muscle, that is the finger type and their rupture type is the complete type.

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$K^{+}$ channel openers가 기니픽 심근의 수축력, 막전위 및 세포내 $Na^{+}$ 이온 활성도에 미치는 영향

  • 채수완
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.36-36
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    • 1992
  • 기니픽심장에서 유두근을 적출하여 valve 쪽은 silver wire에 연결하여 수축력을 측정하고 mural end는 sylgard floor에 pin으로 고정하여 1Hz로 자극하였다. 이때 사용된 영양액은 Tyrode Ringer로 bath내 은도는 36$^{\circ}C$이고 97% 0$_2$, 3% $CO_2$로 포화시켜 사용하였다. 수축력이 일정해진 후 막전위는 conventional electrode를 이용해서 기록하고, 세포내 $Na^{+}$ 이온 활성도( $a_{Na}$ $^{i}$ )는 $Na^{+}$ 선택적 전극을 이용해서 기록하였다. 적출 기니픽 심근에서 pinacidil, cromakalim, RP49356 둥의 $K^{+}$ channel opener는 활동전위 기간(APD)과 수축력 감소을 일으켰고, pinacidil과 cromakalim에 의한 APD 감소는 glibenclamide (10 $\mu$M)에 의해 거의 억제되었다. Pinacidil, RP49356 및 cromakalim에 의한 수축력 감소시 세포내 $Na^{+}$ 이온농도( $a_{Na}$ $^{i}$ )의 감소가 나타났으며 glibenclamide(10 $\mu$M)에 의한 APD의 감소는 거의 차단되었으나 $a_{Na}$ $^{i}$ 감소는 일부 나타났으며 이때 수축력의 감소도 나타났다.

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Intravascular Papillary Endothelial Hyperplasia (Masson's hemangioma) Presenting as a Forearm Mass (전완부에 발생한 내혈관 유두내피 증식증(Masson 혈관종))

  • Chun, Young-Soo;Rhyu, Kee-Hyung;Kim, Sang-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.59-64
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    • 2009
  • Intravascular papillary endothelial hyperplasia (IPEH, Masson's hemangioma) is a non neoplastic reactive endothelial proliferation most commonly located in the skin or subcutaneous tissues although it has been reported in multiple locations throughout the body. This lesion may arise from malformed or normal vessels primarily, and may develop with hemangioma, pyogenic granuloma, or lymphangioma. This lesion, though benign, is clinically important since it may present as a mass and be confused histologically with angiosarcoma. The authors report a 27 years old patient with a mass in his forearm which results in intravascular papillary endothelial hyperplasia.

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Preservation of Subvalvular Apparatus During Mitral Valve Replacement (판막하부 구조물을 보존하는 인공 승모판막 치환술)

  • 임창영;임정철
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1329-1336
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    • 1996
  • From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.

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Subannular Procedures in Mitral Valve Reconstruction (승모판 재건술의 승모판막하술식)

  • 이재원;정종필
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.146-151
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    • 1997
  • Between December 1993 and March 1996, 75 patients had undergone ubannular procedures in mitral valve reconstruction. Their mean age was 45 years and they consisted of 28 males and 47 females. The cause of mitral disease in 75 patients were classified as follow : 29 cases were degenerative, 40 cases were rheumatic, 3 cases were congenital, 2 cases were infectious and 1 case was ischemic. Average number of mitral anatomical lesion per patient was 3.1 and we used average 1.5 procedures on subannular structure in mitral valve per patient. Subannular procedures were chordae shortening 21, chordae transfer 22, new chordae formation 20, papillary muscle splitting 33, shortening of papillary muscle 2. Intraoperative transesophageal echocardiography was carried out for providing an immediate and accurate assessment of the adequacy of the reconstruction. There was no operative death. Patients have been followed up from 2 to 29months, mean 12.5. There were two failures that necessitated reoperation. The mean functional class (NYHA) was 3.19 preoperative and improved to 1.12 postoperatively. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data. In conclusion, subannular procedure in mitral valve repair when feasible is stable and safe with a low prevalence of reoperation.

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Tricespid Regurgitation Due to Rupture of a Chordae in Newborn -A Report of One Case (신생아에서의 건삭 파열에 의한 삼첨판 폐쇄 부전 -1례 보고-)

  • 김태이;이장훈
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.927-931
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    • 1997
  • Tricuspid regurgitation due to rupture of a chorda is a rare disease in newborns. Recently, we experienced one day old male with tricuspid regurgitation due to rupture of a chorda of anterior papillary muscle, and who had suffered from severe hypoxemia, acidosis, cyanosis, and bradycardia. Preoperative diagnosis was pulmonary atresia with intact ventricular s ptum, massive tricuspid regurgitation, and patent ductus arteriosus by echocardiogram, which demonstrated no flow through the pulmonic valve. At operation, the pulmonic valve was intact and a chorda of anterior papillary muscle was ruptured. Tricuspid regurgitation was corrected successfully with reconstruction of the chords. Postoperative course was complicated by pneumonia and sepsis, but the infant recovered and discharged at postoperative 20 days.

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EFFECT OF D-PROPRANOLOL ON TRANSMEMBRANE ACTION POTENTIAL OF CARDIAC PAPILLARY MUSCLE OF CAT (고양이 유두근의 활동전압에 미치는 d-propranolol의 영향)

  • Lee, Jong-Heun;Kim, Joong-Soo
    • The Journal of the Korean dental association
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    • v.16 no.7 s.110
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    • pp.531-536
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    • 1978
  • Adult cats were light anesthetized with ethyl ether and heart was removed fastly. cardiac papillary muscle was dissected from heart in organ bath con taining Tyrode solution saturated with 95% O₂+5% CO₂, and prepared papillary muscles were placed in Tyrode solution that was continuously circulated and gassed with 95% O₂+5% CO₂at 32℃. The isolated papillary muscle was stimulated continuously with platinum pin electrode at frequency of 15/min and 90/min by means of electric stimulator and transmembrane action potentials were recorded with microelectrdes on the oscilloscope. The drug used was d-propranolol and its concentration was 0.5, 1.5 and 5.0 mg/L. The results obtained were as follows: 1. D-propranolol increased the threshold voltage of papillary muscle and raised by average of 213.6% of control. 2. D-propranolol had no effect on duration of action potential. 3. Conduction time of isolated papillary muscle was increased by d-propranolol and its effect was prominent at frequency of 90/min. 4. the maximum upstroke velocity was decreased by d-propranolol and its effect was dose-depndent decrease.

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