• The Monthly Diabetes
• /
• s.253
• /
• pp.34-35
• /
• 2010

50대 중반인 회사원 김 모 씨는 10년 전 당뇨병을 진단받았다. 요즘 그에게 말 못 할 고민이 생겼다. 아내와의 잠자리가 예전 같지 않다는 것. 어느 날부턴가 발기가 잘 되지 않더니 어렵사리 발기가 되도 오랫동안 유지되지 못했다. 처음에는 피곤해서 그러려니 하고 넘겼지만 그러기를 몇 번, 이제는 아내 볼 면목도 서지 않는다. 어딘가 털어놓을 곳도 마땅치 않고 남자로서 자존심 상하는 게 이만 저만이 아니다. 몇날 며칠 고민을 거듭하던 끝에 용기를 내 비뇨기과를 찾았다. 병원에서 찾은 김 씨는 발기부전에 대한 여러 가지 검사를 받았다. 기본적인 소변검사 및 혈액검사를 통해 남성호르몬 검사와 시청각 발기유발검사, 복합 초음파 검사 등이 실시되었다. 검사 결과 김 씨는 당뇨합병증으로 인해 음경의 신경과 말초 혈관에 이상이 생긴 것이 발견됐다. 바쁘게 생활하다 보니 식사조절이나 운동을 꾸준하게 실천하지 못해 혈당관리에도 신경을 쓰지 못하고 있었다.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.725-728
• /
• 2010

Rhabdomyoma is the most common benign cardiac neoplasm in neonates. Most patients with rhabdomyoma experienced spontaneous regression. Yet some of them need surgical therapy because of hemodynamic problems of the heart such as arrhythmia, outflow tract obstruction and valvular dysfunction. We found multiple masses in both ventricles on the patient's fetal echocardiogram. Heart failure caused by severe left ventricular outflow tract obstruction quickly presented after birth. The mass interfering with the outflow tract was resected via the transaortic approach at the first day of birth. Postoperative echocardiography showed complete release of the outflow tract obstruction. He was discharged on the postoperative day 8. During the 3 years of follow up, we found that the sizes of the remnant masses had gradually decreased.

• Journal of Veterinary Clinics
• /
• v.28 no.6
• /
• pp.613-616
• /
• 2011

A 5-year-old male German shepherd dog was presented with a 4 day-history of anorexia and depression. Abdominal radiographs showed a large soft tissue mass and loss of serosal detail. Ultrasonographs revealed splenomegaly with the lacy pattern parenchyma, perivenous hyperechoic region at the splenic hilum, and loss of splenic venous flow. Computed tomographic findings included the enlarged non-enhanced spleen except perivenous region at the splenic hilum and a whirled soft tissue mass at the splenic hilum. Exploratory laparotomy confirmed the diagnosis of splenic torsion. Ultrasonographic findings including lacy appearance, hyperechoic perivenous echogenicity and absence of splenic blood flow and CT findings including no or minimal enhancement of the spleen and a whirled appearance of splenic pedicle could be useful for diagnosing isolated splenic torsion in the dog.

• Journal of Chest Surgery
• /
• v.40 no.3 s.272
• /
• pp.180-192
• /
• 2007

Background: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. Material and Method: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at $-70^{\circ}C$ without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. Result: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. Conclusion: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.2
• /
• pp.235-239
• /
• 2019

High-grade liver injury is associated with high morbidity and mortality rates. We report successful emergency angioembolization and early interventional radiology support to manage a high-grade liver injury in a 29-year-old man who presented following a fall during parachute training. Upon arrival, his blood pressure was 80/40 mmHg, and emergency ultrasonography showed a liver injury with perihepatic fluid collection. The patient's blood pressure reduced to 60/40 mmHg, and emergency angiography was performed without computed tomography (CT) (door to puncture time 36 min). After angioembolization, his blood pressure returned to 120/77 mmHg. Subsequent CT revealed no additional bleeding or hollow viscus injury. He was admitted to the Intensive Care Unit and discharged without complications 30 days after admission. In this case, emergency angioembolization (without performing CT) could successfully and safely treat a hemodynamically unstable patient with a high-grade liver injury.

• Journal of Chest Surgery
• /
• v.34 no.12
• /
• pp.937-943
• /
• 2001

Background: The aims of this study are to determine the predicting factors related with cardiovascular injuries in sternal fractures and to suggest the indication of emergency echocardiography. Material and Method: A retrospective review of the Ewha Womans University Mok-Dong Hospital trauma registry revealed 40 patients, that visited the hospital with a sternal fracture a over 5-year period. We analyzed 4 factors as predicting factors; 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, and 4) Revised Trauma Score(RTS). We, also, assessed the utility of conventional study methods involving cardiovascular injuries, such as ECG, chest X-ray, and enzyme level. Based on the methods, we inferred an indication for emergency echocardiography in sternal fractures. Result: Statistically significant predicting factors were the presence of a past medical history involving cardiovascular system and abnormal RTS on admission. Usage of emergency echocardiography depended upon the predicting factors and the results from conventional evaluations. We can now suggest the indications of emergency echocardiography in sternal fractures as 1) if more than two studies reveal abnormality without any significant predicting factors, and 2) if more than one study reveals abnormality with any significant predicting factors. Conclusion: The past medical history involving cardiovascular system and initial vital signs imply the presence of cardiovascular injuries in sternal fractures. And if needed, emergency echocardiography should be performed.

• Journal of the Korean Society of Radiology
• /
• v.13 no.3
• /
• pp.349-357
• /
• 2019

The purpose of this study was to evaluate the clinical significance of ultrasonographic classification of fatty liver in three grades. From June 2018 to April 2019, 1047 patients (818 males and 229 females) diagnosed as fatty liver among 3607 patients who underwent abdominal ultrasonography at Busan screening center. Ultrasonography was classified into three grades: Grade I (mild fatty liver), Grade II (moderate fatty liver), and Grade III (severe fatty liver) according to the degree of parenchyma texture, acoustic attenuation, Obesity index, hematological test, and metabolic syndrome. The average age of men in each sex increased with the increase of the fatty liver. Body mass index (BMI) and waist circumference were significantly increased in both men and women (p=.000). hematological analysis showed that AST, ALT, ${\gamma}-GTP$, TG, fasting blood sugar, and glycated hemoglobin were significantly different from each other (p<.05). In women, ALT, ${\gamma}-GTP$ and TG showed a significant difference with increasing fatty liver (p<.05). The prevalence of metabolic syndrome was significantly increased in both sexes as the grade of fatty liver increased (p=.000). Based on the results of this study, it is suggested that the use of ultrasound - guided fatty liver according to severity may be useful for the treatment and follow - up of fatty liver if the liver grade is divided in consideration of hematological variables and metabolic syndrome.

• Journal of Chest Surgery
• /
• v.40 no.2 s.271
• /
• pp.97-102
• /
• 2007

Background: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported, A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. Material and Method: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. Conclusion: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.

• Journal of the Institute of Electronics Engineers of Korea SC
• /
• v.43 no.5 s.311
• /
• pp.89-100
• /
• 2006

The carotid intima-media thickness (IMT) is very important, because the severity of it is an independent predictor of transient cerebral ischemia, stroke, and coronary events such as myocardial infarction. The conventional image processing to measure the IMT has not been satisfactory, because the methods have relied on the manual section drawing and a regional segmentation by differential estimation. We propose a new image processing technology effective to extract features from the carotid artery image whose pixels have the directional vector properties with composed color distribution. The technique we presented here is not by differential variation but by verification of the layer properties of carotid artery image. Iterated vertical and horizontal analysis and segmentation of the IMT image show the vector characteristics. This new technique makes it possible to cluster the layers statistically, and to classify mathematical correlation between regions and resulting in correct measurements of thickness and its variation. The advantages and effectiveness of this approach are applicable to region process and character extraction of such a vector image.

• Science of Emotion and Sensibility
• /
• v.27 no.3
• /
• pp.61-70
• /
• 2024

This study aimed to investigate the effects of voluntary intrathoracic pressure adjustment during the Valsalva maneuver (VM) on changes in prefrontal brain function and cerebral blood flow dynamics using diagnostic ultrasound and near-infrared spectroscopy (NIRS). Sixteen healthy adults performed VM by adjusting their expiratory pressure. Their regional oxygen saturation (rSO2) and oxidized hemoglobin (HbO) levels were measured to confirm changes in prefrontal lobe function. To confirm hemodynamic changes in cerebral blood vessels, this study measured peak systolic velocity (PSV), heart rate (HR), vascular stiffness (STIFF), and pulse wave velocity (PWV) in the common carotid artery before and after the VM. Results showed significant cerebrovascular physiological changes after 30mmHg VM. In particular, PSV increased significantly following VM, whereas PWV and STIFF significantly decreased. A similar trend was observed in 40mmHg VM to 30mmHg, but no significant change was observed except for HR, which showed a significant decrease. Furthermore, rSO2 tended to increase in the prefrontal region after preforming 30 and 40mmHg VM, but it did not show a significant difference. In contrast, HbO significantly decreased after performing 30 and 40mmHg VM. This trend did not show any difference depending on intrathoracic pressure. In conclusion, VM performance at both intrathoracic pressure levels has the same effect on brain function, but induces difference changes in cerebrovascular vessels' physiological function. Thus, at 40mmHg VM, it interferes with effective vascular relaxation due to high intrathoracic pressure. However, 30mmHg VM has an effective effect on cerebrovascular function by causing a significant increase in the elasticity of arterial blood vessels. Such VM performance can effectively improve cerebrovascular function.