• Journal of Chest Surgery
• /
• v.43 no.3
• /
• pp.266-272
• /
• 2010

Background: Deep vein thrombosis (DVT) is a serious disease that causes life-threatening pulmonary embolism and chronic venous insufficiency. Anticoagulation is the standard therapy for DVT. However, the results of standard anticoagulation for treating DVT have been disappointing, so endovascular treatment is commonly performed nowadays. The aim of this study was to evaluate the efficacy of an endovascular procedure for treating patients with DVT. Material and Method: We retrospectively evaluated the clinical data of 29 DVT patients who underwent an endovascular procedure between December 2006 and July 2008. We compared the results of the 29 patients with the results of another 45 patients who were treated with only aspirin and heparin. Result: The patient’s mean age was 55.4 years in the intervention group and 53.7 years in the control group. DVT occurred more frequently in the females. Catheter-directed thrombolysis was performed in 22 patients (75.8%). Aspiration thrombectomy was performed in 18 patients (62%) and a endovascular stent was placed in 25 patients (86.2%). Fifteen patients (51.7%) underwent percutaneous insertion of a retrievable IVC filter for the prevention of pulmonary embolism. In the control group, thirty nine patients (86.7%) were treated with low-molecular heparin, and seven patients (15.6%) who were contraindicated for warfarin were treated with aspirin. No bleeding complications occurred during thrombolysis or anticoagulation. We analyzed the statistical data according to recurrence of DVT and the incidence of post-thrombotic syndrome (PTS) during the follow-up period. The intervention group had a significantly lower incidence of PTS (p-value=0.008), but they had the same result as the control group for the recurrence of DVT. In addition, death from the DVT did not occur in the intervention group. Thus, we obtained better clinical outcomes in the intervention group as compared to those in the anticoagulation only group. Conclusion: Endovascular procedures are effective alternative modalities, as compared to systemic anticoagulation, for the treatment of DVT. But more studies are needed to determine the specific indications and to validate the long-term efficacy of endovascular procedures for the treatment of DVT.

• Journal of Chest Surgery
• /
• v.31 no.12
• /
• pp.1172-1182
• /
• 1998

Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

• The Journal of the Korean bone and joint tumor society
• /
• v.6 no.1
• /
• pp.17-21
• /
• 2000

Purpose : Dermatofibrosarcoma protuberans(DFSP) is a rare tumor of the skin with a strong tendency of infiltration to surrounding tissues. Inadequate surgical intervention brings about frequent recurrence and poor prognosis. We attempted to find a guideline for adequate treatment for DFSP. Materials and Methods : Fourteen cases who had been treated in our department since Mar. 1993 and followed up for more than 12 months postoperatively were reviewed. Including nine cases who were transferred from other hospital after recurrence, thirteen cases underwent wide resection. One case was treated by intralesional resection followed by chemotherapy (CYVADIC) due to neurovascular abutment to the mass in the inguinal area. Results : The nine cases who were transferred due to recurrences experienced recurrence in average 1.3(1-2) times and the average period until first local recurrence from primary operation was 11.8(2-24) months. The thirteen cases with wide surgical margin showed no recurrence at the final follow up. One case treated by intralesional resection and chemotherapy showed multiple recurrence and died of the disease due to lung metastasis. Conclusions : From these data, we could find that primary wide resection can be the way of reducing recurrence and metastasis, and the follow up period for the detection of recurrence should be at least two years.

• Proceedings of the Korean Information Science Society Conference
• /
• 1999.10c
• /
• pp.466-468
• /
• 1999

현재 인터넷 프로토콜인 IPv4의 주소 부족 등의 문제를 해결하기 위해 차세대 인터넷 프로토콜 IPv6에 대한 연구가 활발히 진행되고 있다. 그러나 새로운 프로토콜 IPv6 상에서 기존의 다른 상위 프로토콜 및 응용이 어떠한 영향을 받게 될지는 의문이다. 한편, IPv6 상에서 새로운 프로토콜 및 응용을 개발할 때에 많은 시험이 요구된다. 이와 같은 이유로 인해 새로운 통신 프로토콜에 있어서 모니터링은 필수적이다. 그러나 지금까지의 많은 모니터링 라이브러리들은 텍스트에 기반하고 있으며, 그래픽 데이터를 제공하는 도구들도 대부분 통계정보의 제공에 초점을 두고 있다. 이를 두고 프로토콜이 그 표준에 따라 정확한 원리에 맞게 동작하는 지를 파악하는 데는 큰 도움이 되지 않고 있다. 이에 본 연구에서는 대상 프로토콜의 실제적인 동작 과정이나 원리를 알 수 있도록 그래픽 기반의 사용자 친화적 모니터링 도구를 제작한다. 이를 위해, 먼저 IPv6가 다른 프로토콜에 영향을 미칠 수 있는 사항들을 분석한다. 다음으로 본 교에 구축되어 있는 IPv6 호스트에 모니터링에 필요한 환경을 구축하고, Java Applet을 이용한 모니터 프로그램을 제작한다. 현재 개발하는 모니터 프로그램은 TCP의 슬라이딩 윈도우(Sliding Window) 기법에 관련된 사항을 모니터링 해주는 것으로 그 범위를 한정한다. 개발된 도구를 이용하여 IPv6 상에서 FTP가 TCP를 이용하여 파일을 전송하는 경우의 모니터링을 실시하고, 그 결과를 분석 제시한다. 이로써, 개발된사용자 친화적 모니터링 도구가 얼마나 쉽게 슬라이딩 윈도우 기법을 이해시켜 주고, 내포된 의미를 파악할 수 있게 해주는지를 알 수 있다.한 것으로 연구되었다. 정상조 직에 비해 산소가 부족하여 염기성대사(anaerobic metabolism)를 많이 함으로 그 부산물인 유산 (lactic acid)이 많이 생성됨으로 정상조직보다 pH가 낮아 암 조직이 정상조직에 비해 고온온열치료에 더 잘 듣는 원인이 된다. 3) 영양이 부족한 상태의 세포는 고온온열치료에 훨씬 예민하다. 4) 암조직은 혈관상태가 정상조직에 비해 좋지 않음으로 정상조직보다 쉽게 가온이 되며, 일단 가온된 온도는 잘 식지 않음으로 정상조직에 비해 훨씬 효율적이다. 5)고 온온열치료는 4$0^{\circ}C$~43.5 $^{\circ}C$정도에서만 이 작용이 일어남으로 정상인체에서 43$^{\circ}C$이상의 가온 은 쉽지 않음으로 이 효과는 암조직에서 주고 일어나게 된다. 6)고온온열치료는 방사선치료 후에 생기는 손상의 재생을 억제함으로 방사선의 치료효과를 높인다. 7)38.5$^{\circ}C$~41.5$^{\circ}C$의 낮 은 온도에서도 암조직의 산소 상태를 호전시켜 방사선 치료효과를 증대시키는 역할을 한다.alization)가 나타난다. 그러나 무의식에 대칭화만 있는 것은 아니며, 의식의 사고양식인 비대칭도 어느 정도 나타나며, 대칭화의 정도에 따라, 대상들이 잘 구분되어 있는 단계, 의식수준의 감정단계, 집단 내에서의 대칭화 단계, 집단간에서의 대칭화 단계, 구분이 없어지는 단계로 구분하였다.systems. We believe that this taxonomy is a significant contribution because it ad

• Proceedings of the Acoustical Society of Korea Conference
• /
• spring
• /
• pp.353-356
• /
• 2002

심근 경색 및 뇌졸중 등 혈관과 관련된 질환들의 진단 및 치료의 목적으로 미세 크기의 원형 배열 초음파 트랜스듀서가 사용되고 있다. 원형 배열 초음파 트랜스듀서는 종래의 선형 배열 트랜스듀서에 비해 반경 방향의 입체적 진단을 가능케 하고 높은 감도 및 해상도를 구현할 수 있는 장점을 가진다. 본 연구에서는 이러한 원형 배열 초음파 트랜스듀서의 개발을 위하여, 유한요소법 및 이론적인 해석으로 트랜스 eb서의 방사특성을 분석함으로써 무지향성을 이루기 위한 트랜스듀서 내 진동자의 최적 규격을 설정하였다. 나아가 해석 결과에 따라 직경이 약 10mm정도가 되는 알루미나 $Al_2O_3$ 튜브에 32개의 진동자가 원형으로 배열된 트랜스 듀서 시작품의 제작 및 방사특성 측정 실험을 수행함으로써 설계 결과의 타당성을 검증하였다.

• Journal of Biomedical Engineering Research
• /
• v.19 no.6
• /
• pp.617-622
• /
• 1998

A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

• Transactions of the Korean Society of Mechanical Engineers B
• /
• v.35 no.11
• /
• pp.1219-1227
• /
• 2011

Due to recent changes in living conditions, people who suffer from vascular disease have been increasing. As a result, several kinds of procedures to treat diseases of the blood vessels are being carried out and the epidemiological analysis and interpretation is needed. In this paper, the mechanical behavior of blood vessels based on hyperelastic model were evaluated. The stress distributions in the arterial walls subjected to both normal blood pressure and high blood pressure are studied along with different opening angles representing as the effect of the residual stress. As a result, when applied to residual stress effects in blood vessels to act maximum stress compared to as the absence of residual stress effect about 50% stresses can be reduced. When high blood pressure was the normal blood pressure acting on the blood vessel wall that twice stress can be confirmed.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.1
• /
• pp.39-45
• /
• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• Journal of Chest Surgery
• /
• v.43 no.2
• /
• pp.194-198
• /
• 2010

Intramural hematoma of the aorta (IMH) is the precursor or a variant of a classic aortic dissection where hemorrhage occurs within the aorta wall in the absence of an initial intimal tear. IMH has a high rate of mortality and morbidity. The optimal therapy for IMH is uncertain, yet the involvement of the ascending aorta is usually considered as an indication for surgery due to the associated risk of rupture or cardiac tamponade. We report here on a case of a 71-year-old man who presented with syncope. Because of misdiagnosis, he underwent computed tomography (CT) after 5 hrs from arriving to the ER. Computed tomography of the aorta revealed intramural hematoma of the ascending aorta with cardiac tamponade. He also had vascular complications such as acute renal failure and visceral ischemia. We performed emergency graft replacement of the total arch and ascending aorta. He was discharged without complication on postoperative day 14.

• Journal of Chest Surgery
• /
• v.35 no.6
• /
• pp.449-453
• /
• 2002

Intra-aortic balloon pump (IABP) is well known for its hemodynamic benefit but still has its own complications. Proper use of IABP is the best way to obtain maximum benefit with low complication rate. Material and Method： Twenty one(men 10, female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital. Eighteen(85.7%) were ischemic heart disease patients. They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications. Their preoperative conditions, intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. Result： Nineteen patients(90.5%) were successfully weaned from IABP. There were 2 patients of operative death and the mortality rate was 9.5%. Duration of IABP use was 40.7$\pm$24.3 hours. There were 2 cases(9.5 %) of IABP-related vascular complications that required surgical intervention. Conclusion： We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.