• Title/Summary/Keyword: 좌측연결로

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Application of the Total Artificial Heart as an Implantable Biventricular Assist Device by Left Thoracotomy in an Ovine Model (양에서 좌측 개흉술 하에 완전인공심장의 체내이식형 양심실 보조장치로 사용에 관한 연구)

  • 원태희;민병구;김원곤
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.296-304
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    • 2001
  • 배경: 이번 연구의 목적은 체내이식형 양심실 보조장치의 개발을 위한 안전하고 간편한 동물실험 모델을 확립하는 것이며 이동작동형 완전 인공심장의 양심실 보조장치로의 사용 가능성을 알아보는 것이다. 대상 및 방법: 7마리의 Corridale 양을 대상으로 실험하였다. 5번째 늑간극을 통하여 좌측 개흉술을 시행하고 좌측 유출로 캐뉼라는 하행 대동맥에 Dacron graft을 사용하여 연결하였고 유입로 캐뉼라는 좌심방에 삽입하였다. 우측 유출로 캐뉼라는 하행 대동맥과 같은 방법으로 주폐동맥에 연결하였으며 유입로 캐뉼라는 혜동맥을 하방으로 젖혀 우심방이를 노출시킨 다음 우심방이에 삽입하였다. 4마리에 있어서는 양심실 보조장치를 전복막강(preperitoneal space)에 위치시켰으며 2마리에 촤측흉강 내에, 1마리에서는 외부에 위치시켰다. aPTT는 수술전 aPTT의 2∼2.5배로 맞추어 주었다 결과: 수술중 또는 수술직후 사망한 경우는 없었으며 7마리 모두 인공호흡기 이탈이 가능하였고 스스로 기립하고 음식물 섭취도 가능하였다. 1마리는 술후 2일째 혈전 색전증 및 인공호흡기 작동 잘못으로 사망하였으며 2마리의 겨우는 술후 2일째 각각 양심실 보조장치의 작동 잘못 및 호흡부전으로 사망하였고, 3마리의 경우는 술후 4일째 혈전색전증으로 인한 급성신부전 및 호흡부전 등으로 사망하였다. 1마리에 있어서는 28일간 생존하였으며 양심실 보조장치의 구동 장치에 연결된 라인의 마로로 인해 양심실 보조장치의 작동이 정지되었으나 바로 양심실 보조장치를 제거하고 살릴 수 있었다. 모든 경우에 있는 캐뉼라를 삽입하고 양심실 보조장치를 작동시키는데 큰 어려움이 없었다. 7마리 중 4마리에서 혈전이 발견되었으며 특히 판막을 연결한 부위에 혈전생성이 많았다. 그러나 캐뉼라에는 혈전생성이 없었다. 결론: 양에 있어서 좌측 개흉술 및 전복막강 공간에 양심실 보조장치를 위치시키는 이번 동물실험 모델은 체내 이식형 양심실 보조장치 개발을 위한 좋은 동물실험 모델이라고 생각된다. 또한 디동 작동기형 완전 인공심장의 혈전생성을 억제할수 있는 방법들의 연구개발이 지속된다면 장기간의 체내 이식형 양심실 보조장치로 사용할 수 있을 것으로 생각된다.

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Science Teachers' Brain activation and functional connectivity during scientific observation on the biological phenomena (생명현상에 대한 과학적 관찰에서 나타나는 과학 교사들의 두뇌 활성 및 기능적 연결)

  • Lee, Jun-Ki;Byeon, Jung-Ho;Kwon, Yong-Ju
    • Journal of The Korean Association For Science Education
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    • v.29 no.6
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    • pp.730-740
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    • 2009
  • The purpose of this study was to investigate secondary science teachers' brain activation and functional connectivity during scientific observation on the biological phenomena. Twenty six right-handed healthy science teachers volunteered to be in the present study. To investigate science teachers' brain activities during the tasks, 3.0T fMRI system with block design was used to measure BOLD signals in their brains. The SPM2 software package was applied to analyze the acquired initial image data from the fMRI system. The results have shown that the left inferior frontal gyrus, the bilateral superior parietal lobule, the left inferior parietal lobule, the left precuneus, the left superior occipital gyrus, the right middle occipital gyrus, the right precuneus, the left inferior occipital gyrus and bilateral fusiform gyrus were significantly activated during participants' scientific observation. The network model consisted of eleven nodes (ROIs) and its ten connections. These results suggested the notion that scientific observation needs a connective cooperation among several brain regions associated with observing over just a sensory receiving process.

Three Dimensional Comparative Study On The Accuracy Of Impression Technique Using New Impression Coping (새로운 인상용 코핑을 이용한 임플란트 인상법의 정확성에 대한 3차원적 비교 연구)

  • Kim, Se-Ra;Kim, In-Soo;Park, Sung-Jae;Lee, Byung-Ok;Ko, Sok-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.323-337
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    • 2010
  • The objective of this study was to examine the availability of the new impression coping by comparing with conventional coping in implant pick-up impression technique. Five implant fixtures were installed on #14, 21, 23, 25, 27 in acrylic resin model. That model with 5 fixtures was standard model, which was divided 3 groups; using new flag type impression coping, conventional impression coping splinted with self-curing resin, conventional impression coping without splinting. We made metal circular cones for calculation 3-dimensional coordinates by attaching to implant fixtures or analogs. Three-dimensional relationships of each model were calculated. Data was analyzed by multiple ANOVA and Bonferroni. The accuracy of impression between using new flag type impression coping and conventional impression coping did not show differences in 3 - dimensional analysis.Within limitations of this study, the new flag type impression coping is available in implant pick-up impression technique.

Hybrid Operation of a Kommerell’s Diverticulum with Left Aberrant Subclavian Artery (비정상 좌측 쇄골하동맥을 동반한 Kommerell 게실의 하이브리드 수술법)

  • Kim, Hye-Won;Lee, Jae-Won;Jung, Sung-Ho;Jung, Jae-Seung;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.458-461
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    • 2010
  • A 53-year-old woman had right aortic arch, Kommerell’s diverticulum and aberrant left subclavian artery (LSA) without any compressive symptoms. Hybrid operation was performed. This consisted of LSA bypass using a 6 mm ringed Gore-Tex graft between the left common carotid artery and aberrant LSA via a left supraclavicular incision, and stent graft insertion into the aortic arch via the right femoral artery. Postoperative computed tomography as well as intraoperative angiography demonstrated successful occlusion of Kommerell’s diverticulum and bypass of the aberrant LSA. There were no complications related to the operation or the intervention.

Analysis on Propagation of Highway Traffic Flow Turbulence at Entrance-Ramp Junctions (교통류 난류현상을 이용한 고속도로 합류부의 영향권 분석)

  • Lee, Ki Yoon;Roh, Chang Gyun;Son, BongSoo;Chung, Jin-Hyuk
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.29 no.2D
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    • pp.167-173
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    • 2009
  • In general, an influenced area of merging section is defined as 500 m including 100 m upstream and 400 m downstream. However, from an observation of the actual traffic flow, it is found that merging effect influences more on downstream than upstream. In this study, an influenced area of merging section on freeway is analyzed by using turbulence which is defined as conflicts between vehicles. In order to overcome the limits of existing traffic flow detection system established with intervals of about 500 m, this study uses raw data collected from the detectors which are established in entrance ramps with similar road conditions. To divide data of each point into similar road conditions, the data of total 72 hours is sorted by Level of Service. An influenced area analyzed by standard deviation of speed is 700 m section of highway, including 300 m upstream and 400 m downstream, for both right and left ramps. It is the result including upstream 200 m more than previous studies.

Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report- (관상동맥질환을 동반한 대동맥류 수술치험 1례)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.724-728
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    • 1997
  • We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

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Anomalous Systemic Arterial Supply to the Left Basal Segments without Sequestration from Descending Thoracic Aorta - A case report - (폐분획증이 없이 하행 흉부 대동맥에서 분지된 좌측 바닥 구역의 이상 기시 체혈관 - 1예 보고 -)

  • Kim, Hyuck;Chung, Won-Sang;Jang, Hyo-Jun;Kang, Jeong-Ho;Kim, Young-Hak;Kim, Ji-Hoon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.512-515
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    • 2008
  • An anomalous systemic arterial supply to the left basal segments without sequestration is a rare congenital abnormality within the spectrum of pulmonary sequestration. But this is rather different from the definition of pulmonary sequestration in that it has normal bronchial connections. We describe here our experience with surgical treatments for an anomalous systemic arterial supply to the left basal segments without sequestration, and this condition was confirmed preoperatively.

The Results of Extracardiac Fontan Operation in the Patients with Heterotaxy Syndrome (이소성증후군에서의 심장외도관 폰탄 수술의 결과)

  • Lim Hong Gook;Kim Soo-Jin;Lee Chang-Ha;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Oh Sam-Sae;Baek Man-Jong;Na Chan-Young;Kim Jae Hyun;Seo Hong Joo;Jung Sung Chol;Kim Chong Whan
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.529-537
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    • 2005
  • Background: Historically the Fontan operation in patients with single ventricle and heterotaxy syndrome has been associated with high mortality because of systemic or pulmonary anomalous venous drainage, incompetent common atrioventricular valve, right ventricle type univentricular heart, and arrhythmia. Material and Method: A retrospective review of 62 patients $(age:\;54.79\pm33.97\;months)$ with heterotaxy syndrome who underwent a extracadiac Fontan operation between 1996 and 2005 was performed. Twenty one patients had left atrial isomerism, and 41 had right isomerism. The Fontan procedure was staged in all but 2 patients, and a fenestration was less placed in left isomerism. Result: Left isomerism was associated more with interrupted inferior vena cava and pulmonary arteriovenous fistula, and right isomerism was associated more with anomalous pulmonary venous drainage, common atrioventricular valve and morphologic right ventricle. There were 3 hospital deaths$(4.8\%)$ and 3 late deaths $(5.2\%)$ with a follow-up duration of $48.8\pm31.0$ months. Eight-year survivals were $90.5\pm6.4\%$ in left isomerism and $88.6\pm5.4\%$ in right isomerism (p=0.94). At 8 years, freedom from reoperation was $73.9\pm11.3\%$ in left isomerism, and $82.3\pm6.7\%$ in right isomerism (p=0.87). Atrioventricular valve regurgitation progressed after Fontan operation in heterotaxy syndrome, and reoperation for pulmonary arteriovenous fistula and permanent pacemaker implantation for sinus node dysfunction were required more in left isomerism. Conclusion: The extracardiac Fontan operation can now be performed in patients with heterotaxy syndrome with excellent survival. However, morbidity in terms of postoperative atrioventricular valve regurgitation, arrhythmia, and pulmonary arteriovenous fistula remains significant.

Localization of Sensory Neurons Innervating the Rat Intestine Using the Cholera Toxin B Subunit(CTB) and Wheat Germ Agglutinin-Horseradish Peroxidase(WGA-HRP) (표지방식을 이용한 흰 쥐 복강 내장을 지배하는 감각신경세포체와 신경섬유의 표지부위)

  • Lee, Dong-Hyup;Lee, Chang-Hyun;Lee, Moo-Sam
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.75-96
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    • 1998
  • The local arrangement of sensory nerve cell bodies and nerve fibers in the brain stem, spinal ganglia and nodose ganglia were observed following injection of cholera toxin B subunit(CTB) and wheat germ agglutinin-horseradish peroxidase(WGA-HRP) into the rat intestine. The tracers were injected in the stomach(anterior and posterior portion), duodenum, jejunum, ileum, cecum, ascending colon or descending colon. After survival times of 48-96 hours, the rats were perfused and their brain, spinal and nodose ganglia were frozen sectioned ($40{\mu}m$). These sectiones were stained by CTB immunohistochemical and HRP histochemical staining methods and observed by dark and light microscopy. The results were as follows: 1. WGA-HRP labeled afferent terminal fields in the brain stem were seen in the stomach and cecum, and CTB labeled afferent terminal fields in the brain stem were seen in all parts of the intestine. 2. Afferent terminal fields innervating the intestine were heavily labeled bilaterally gelalinous part of nucleus of tractus solitarius(gelNTS), dorsomedial part of gelNTS, commissural part of NTS(comNTS), medial part of NTS(medNTS), wall of the fourth ventricle, ventral border of area postrema and comNTS in midline dorsal to the central canal. 3. WGA-HRP labeled sensory neurons were observed bilaterally within the spinal ganglia, and labeled sensory neurons innervating the stomach were observed in spinal ganglia $T_2-L_1$ and the most numerous in spinal ganglia $T_{8-9}$. 4. Labeled sensory neurons innervating the duodenum were observed in spinal ganglia $T_6-L_2$ and labeled cell number were fewer than the other parts of the intestines. 5. Labeled sensory neurons innervating the jejunum were observed in spinal ganglia $T_6-L_2$ and the most numerous area in the spinal ganglia were $T_{12}$ in left and $T_{13}$ in right. 6. Labeled sensory neurons innervating the ileum were observed in spinal ganglia $T_6-L_2$ and the most numerous area in the spinal ganglia were $T_{11}$ in left and $L_1$ in right. 7. Labeled sensory neurons innervating the cecum were observed in spinal ganglia $T_7-L_2$ and the most numerous area in the spinal ganglia were $T_{11}$ in left and $T_{11-12}$ in right. 8. Labeled sensory neurons innervating the ascending colon were observed in spinal ganglia $T_7-L_2$ in left, and $T_9-L_4$ in right. The most numerous area in the spinal ganglia were $T_9$ in left and $T_{11}$ in right. 9. Labeled sensory neurons innervating the descending colon were observed in spinal ganglia $T_9-L_2$ in left, and $T_6-L_2$ in right. The most numerous area in the spinal ganglia were $T_{13}$ in left and $L_1$ in right. 10. WGA-HRP labeled sensory neurons were observed bilaterally within the nodose ganglia, and the most numerous labeled sensory neurons innervating the abdominal organs were observed in the stomach. 11. The number of labeled sensory neurons within the nodose ganglia innervating small and large intestines were fewer than that of labeled sensory neurons innervating stomach These results indicated that area of sensory neurons innervated all parts of intestines were bilaterally gelatinous part of nucleus tractus solitarius(gelNTS), dorsomedial part of gelNTS, commissural part of NTS (comNTS), medial part of NTS, wall of the fourth ventricle, ventral border of area postrema and com NTS in midline dorsal to the central canal within brain stem, spinal ganglia $T_2-L_4$ and nodose ganglia. Labeled sensory neurons innervating the intestines except the stomach were observed in spinal ganglia $T_6-L_4$. The most labeled sensory neurons from the small intestine to large intestine came from middle thoracic spinal ganglia to upper lumbar spinal ganglia.

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Decreased White Matter Structural Connectivity in Psychotropic Drug-Naïve Adolescent Patients with First Onset Major Depressive Disorder (정신과적 투약력이 없는 초발 주요 우울장애 청소년 환아들에서의 백질 구조적 연결성 감소)

  • Suh, Eunsoo;Kim, Jihyun;Suh, Sangil;Park, Soyoung;Lee, Jeonho;Lee, Jongha;Kim, In-Seong;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.153-165
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    • 2017
  • Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.