• Title/Summary/Keyword: 폐색

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The Effect of Left Subclavian Artery Coverage During Endovascular Repair of the Thoracic Aortic Aneurysm on Cerebral Hemodynamics: Two Cases of Flow Measurement by using 2D Phase Contrast Magnetic Resonance Imaging (흉부대동맥류의 혈관내치료 도중 좌측 쇄골하동맥 폐색이 뇌혈류역동에 미치는 효과: 2차원 위상차 대조 자기공명영상을 이용한 혈류 측정 2례 보고)

  • Baek, Seung-Hoon;Youn, Sung-Won;Kim, Ho-Kyun;Kwon, Oh-Choon;Lee, Sub;Lee, Jong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.159-168
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    • 2012
  • The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

Clogging Potential in Constructed Vertical Flow Wetlands Employing Different Filter Materials for First-flush Urban Stormwater Runoff Treatment (도시 초기 강우유출수 처리를 위한 수직흐름습지에서 여재별 폐색 잠재성 분석)

  • Chen, Yaoping;Guerra, Heidi B.;Kim, Youngchul
    • Journal of Wetlands Research
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    • v.20 no.3
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    • pp.235-242
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    • 2018
  • The function of vertical subsurface flow wetlands can potentially be reduced with time due to clogging and are often assumed to be occurring when ponding and overflow is observed during rainfall. To investigate their clogging potential, three pilot-scale vertical subsurface flow (VSF) wetland systems were constructed employing woodchip, pumice, and volcanic gravel as main media. The systems received stormwater runoff from a highway bridge for seven months, after which the media were taken out and divided into layers to determine the amount and characteristics of the accumulated clogging matters. Findings revealed that the main clogging mechanism was the deposition of suspended solids. This is followed by the growth of biofilm in the media which is more evident in the wetland employing woodchip. Up to more than 30% of the clogging matter were found in the upper 20 cm of the media suggesting that this layer will need replacement once clogging occurs. Moreover, no signs of clogging were observed in all the wetlands during the operation period even though an estimation of at least 2 months without clogging was calculated. This was attributed to the intermittent loading mode of operation that gave way for the decomposition of organic matters during the resting period and potentially restored the pore volume.

The Effects of Vero Cells Coculturing on the Motility of Human Testicular Spermatozoa in an Intracytoplasmic Sperm Injection Program (정자직접주입술에 있어 Vero Cells 공배양이 인간 정소정자의 운동성에 미치는 영향에 관한 연구)

  • Kim, Hyun-Kyoo;Oum, Ki-Boong;Kim, Hyun-Joo;Ko, Jung-Jae;Lee, Sook-Hwan;Yoon, Tae-Ki;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.225-232
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    • 1997
  • 폐색성 혹은 비폐색성 무정자증에서 부정소 정자채취법 등이 부적절하다고 여겨질때는 정소 조직을 일부 절제하여 그 조직으로부터 정자를 직접 채취하게 되는데 일반적으로 이렇게 정소로부터 추출한 정소정자는 운동성이 전혀 없거나 매우 약한 운동성을 보이는 경우가 많다. 본 연구의 목적은 이러한 정소정자를 Vero cell과 공배양을 시킴으로써 운동성을 획득시키거나 향상시키고 이를 수정시키는 시기까지 지속시킴으로써 정소정자추출술 (TESE)을 시행하는 환자나 의료진들에게 보다 편안하고 융통성있는 시간대를 부여하고, 아울러 정자직접주입술 (ICSI)을 보다 용이하게 하여 성공적인 수정률과 임신율을 얻음에 있다. 또한 ICSI를 시행한 후, 운동성이 향상된 잉여의 정소정자를 냉동보존함으로써 차후에 TESE을 다시 시행치않고도 시험관 아기 시술을 시도할 수 있는 부가적인 잇점도 있다고 할 수 있다. 대상환자군은 정관폐색증(n=11) 혹은 비정관폐색증(n=2)을 보이는 13명의 무정자증의 남성불임환자였으며 난자회수예정일 3일전에 TESE를 시행하여 정소정자를 얻은 후 이를 정자직접주입술이 시행되는 당일까지 Vero cell과 공배양을 실시하였다. Vero cell과의 공배양에 의하여 운동성이 있는 정소정자의 수는 공배양전과 비교하여 평균 3.3배가 증가하였으며, 특히 공배양전에 운동성이 있는 정소정자의 수가 50,000/ml이하의 미약한 운동성만을 보였던 경우 (n=5)에는 공배양 후에 운동성이 있는 정소정자 수의 평균증가율이 7.7배였다. 공배양전 정자운동성이 전혀 없었던 2례의 비정관폐색증환자중 3일간의 공배양을 통하여 1례에서 운동성을 획득한 정소정자를 얻을 수 있었으며 (14,300/ml), 정자직접주입술을 통하여 성공적인 수정 및 임신에 도달할 수 있었다. Vero cell과 공배양을 하고 ICSI했던 결과, 평균 수정률은 75.0% 이었으며 임신율은 61.5%였다.

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Cerebrovascular Reservoir and Arterial Transit Time Changes Assessed by Acetazolamide-Challenged Multi-Phase Arterial Spin Labeling Perfusion MRI in Chronic Cerebrovascular Steno-Occlusive Disease (만성 뇌혈관 협착폐색증에서 아세타졸아미드 부하 다상 동맥스핀표지 자기공명관류영상으로 평가한 뇌혈류 예비능과 동맥 통과 시간의 변화)

  • Inpyeong Hwang;Chul-Ho Sohn;Keun-Hwa Jung;Eung Koo Yeon;Ji Ye Lee;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Seung Hong Choi;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.626-637
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    • 2021
  • Purpose To explore cerebrovascular reservoir (CVR) and arterial transit time (ATT) changes using acetazolamide-challenged multi-phase arterial spin labeling (MP-ASL) perfusion-weighted MRI in chronic cerebrovascular steno-occlusive disease. Materials and Methods This retrospective study enrolled patients with chronic steno-occlusion who underwent acetazolamide-challenged MP-ASL between June 2019 and October 2020. Cerebral blood flow, CVR, basal ATT, and ATT changes associated with severe stenosis, total occlusion, and chronic infarction lesions were compared. Results There were 32 patients (5 with bilateral steno-occlusion) in our study sample. The CVR was significantly reduced during total occlusion compared with severe stenosis (26.2% ± 28.8% vs. 41.4% ± 34.1%, respectively, p = 0.004). The ATT changes were not significantly different (p = 0.717). The CVR was marginally lower in patients with chronic infarction (29.6% ± 39.1% vs. 38.9% ± 28.7%, respectively, p = 0.076). However, the ATT was less shortened in patients with chronic infarction (-54 ± 135 vs. -117 ± 128 ms, respectively, p = 0.013). Conclusion Acetazolamide-challenged MP-ASL provides an MRI-based CVR evaluation tool for chronic steno-occlusive disease.

A case of cystic fibrosis presented with meconium ileus in a female neonate (신생아에서 발생한 태변장폐색증에 동반된 낭성섬유증 1례)

  • Hwang, In-Ok;Lee, Eun-Sil
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1252-1256
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    • 2007
  • Meconium ileus (MI) is the earliest clinical manifestation of cystic fibrosis (CF) in infants. It arises from the intraluminal accumulation of highly viscid, protein-rich meconium, typically present in the terminal ileum as a neonatal intestinal obstruction. Therefore, the clinical symptoms include abdominal distension, bilious vomiting and delayed passage of meconium. CF is caused by mutations in the transmembrane conductance regulator gene (CFTR) located in the long arm of chromosome 7. CF is common in Caucacians, but is a rare disorder in Asian countries, including Korea. We experienced a case of CF combined with MI. Compared with the previous reports of CF in Korea which presented respiratory problems, this is the first case genetically diagnosed as CF with MI during the newborn period.

Budd-Chiari Syndrome Complicating Behcet's Disease -Report of one case- (Behcet's 병을 동반한 Budd-Chiari 증후군 -1례 보고-)

  • O, Bong-Seok;Kim, Bo-Yeong;Kim, In-Gwang
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.219-222
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    • 1996
  • A 34-year-old man was admitted to the hospital because of ascites, abdominal fullness. computed tomography and cavography revealed inferior vena cavil occlusion just above the hepatic vein and diagnosed as Budd-Chiari syndrome. conservative medical therapy failed to control the symptoms produced from both portal hypertension and versa caval stasis. Therefore, under extracorporeal circulation with moderate hypothermia and normal cardiac contraction, membranoto y and inferior vena casa venoplasty with Gore-tex (10mm) was performed. Postoperatively, physical examination revealed oral ulceration, subcutaneous thrombophlebitis, folliculitic lesions. uveitis And increased reactivity of the skin to needle punctures. 10 month later, superior vena ciiva obstruction symptom was found. Hehcet's disease was diagnosed.

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Automatic Detection of Pulmonary Embolism in Spiral CT Angiography (나선형 CT 혈관촬영의 폐색전증 자동 검출)

  • Han, Jae-Bok;Hong, Sung-Hoon;Kim, Soo-Hyung;Lee, Guee-Sang
    • Proceedings of the Korea Information Processing Society Conference
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    • 2004.05a
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    • pp.703-706
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    • 2004
  • 나선형 CT 혈관촬영에서 획득한 영상의 분석를 통해서 폐색전증이 의심되는 부위를 자동으로 검출하는 방법으로, 연구 대상은 20명의 환자를 대상으로 분석하였으며 CT 검사 후 방사선과 의사가 정상소견을 받은 환자 5명과 폐색전증이 있는 판독소견을 가진 15명을 대상으로 비교 분석하였다. CT 검사하는 동안에 조영제를 투입하면, 폐색전증이 발생한 부위는 조영제 양과 분포가 불균등하여 명암값이 낮게 검출된다. 검출방법으로는 전처리 작업으로 폐영역만을 분할하고, 분할된 폐영역에서 혈관을 찾기 위해 모폴로지기법를 적용하여 세선화(thinning) 작업을 진행한다. 다음 공정으로는 경계선을 찾아 local watershed를 적용하여 혈관을 검출하고, 검출된 혈관내에서 원형모델을 적용하여 모폴로지(morphology)을 통해 국소 부위의 미세한 농도변화를 인지하여 색전이 발생한 영역을 자동검출하였다. 본 논문의 자동검출시스템에서는 색전증이 있는 경우에 true positive의 발생빈도는 case 당 4.5개가 검출되었다. 정상인의 경우에도 혈류의 흐름, 혈류의 분기점, 노이즈로 인한 false positive의 빈도는 case 당 2.6개가 발생하여 전체적으로 false positive는 5.2개가 검출되었다. 본 논문은 false positive의 비율이 높게 검출되었지만 폐영역 CT 검사의 컴퓨터지원진단시스템(computer aided diagnosis)의 향후 연구과제에 방향을 제시할 수 있을 것이라 사료된다.

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Deep learning-based assistance software implementation for pulmonary embolism diagnosis (딥러닝 기반 폐색전증 진단 보조 소프트웨어 구현)

  • Roh, Tae seong;Kim, Sea Jung;Shin, Jin Woo;Kim, Jun Hyung;Kim, Kou Gyeom;Ryu, Jong Hyun;Jeong, Kil Hwan;Kim, Dae Won;Jun, Hong Young
    • Proceedings of the Korea Information Processing Society Conference
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    • 2021.05a
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    • pp.393-396
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    • 2021
  • 폐색전증(Pulmonary Embolism : PE)은 사망률이 높은 질환중 하나이다. 초기에 정확한 진단 및 치료를 시행하는 경우 사망과 재발의 경우가 흔치 않으나 지연 진단이 일어나는 경우 사망률은 높기 때문에 보다 정확하고 빠른 검사법이 필요하다. 본 연구에서는 폐색전증 환자의 흉부 CT 데이터를 가지고 딥러닝 알고리즘을 생성하여 소프트웨어를 구현하고자 한다. 개발된 딥러닝 기반의 폐색전증 진단 보조 소프트웨어는 CT 촬영 후 즉각적인 질환 예측으로 판독 시간의 단축과 효율성을 제공할 것으로 기대된다.

The $Outback^{(R)}$ $LTD^{TM}$ Catheter: The Novel Re-Entry Technique in Recanalization of Chronic Inflow Occlusion of the Superficial Femoral Arteries in 3 Cases ($Outback^{(R)}$ $LTD^{TM}$ Catheter를 이용한 표재성 대퇴동맥의 만성동맥폐색증의 성공적인 재개통술: 3예 보고)

  • Kong, Joon-Hyuk;Hur, Jin;Kim, Duk-Sil;Kim, Sung-Wan
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.785-789
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    • 2010
  • The acute technical failure of endovascular treatment of chronic total occlusions is most often due to the inability to re-enter the true lumen after occlusion is crossed in a subintimal plane. True lumen re-entry catheters are very effective at gaining wire passage back to the true lumen and facilitating successful endovascular treatment of chronic total occlusions that would otherwise require open bypass. These case reports describe our initial experiences with a new catheter system (the $Outback^{(R)}$ $LTD^{TM}$ catheter) that is designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions.

Use of artificial palate for improving facial support in the fabrication of a maxillary obturator: A case report (상악골 부분 절제술 시행한 환자에서 Artificial Palate로 안모지지를 재현한 폐색장치를 이용한 수복 증례)

  • Yoon, Hee-Kyoung;Hwang, Hee-Seong;Kim, Chul-Hoon;Kim, Jung-Han;Kim, Bok-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.319-324
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    • 2017
  • Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.