• Title/Summary/Keyword: 혈관내 치료

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Three Dimensional Target Volume Reconstruction from Multiple Projection Images (다중투사영상을 이용한 표적체적의 3차원 재구성)

  • 정광호;진호상;이형구;최보영;서태석
    • Progress in Medical Physics
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    • v.14 no.3
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    • pp.167-174
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    • 2003
  • In the radiation treatment planning (RTP) process, especially for stereotactic radiosurgery (SRS), knowing the exact volume and shape and the precise position of a lesion is very important. Sometimes X-ray projection images, such as angiograms, become the best choice for lesion identification. However, while the exact target position can be acquired by bi-projection images, 3D target reconstruction from bi-projection images is considered to be impossible. The aim of this study was to reconstruct the 3D target volume from multiple projection images. It was assumed that we knew the exact target position in advance, and all processes were performed in Target Coordinates, where the origin was the center of the target. We used six projections: two projections were used to make a Reconstruction Box and four projections were for image acquisition. The Reconstruction Box was made up of voxels of 3D matrices. Projection images were transformed into 3D in this virtual box using a geometric back-projection method. The resolution and the accuracy of the reconstructed target volume were dependent on the target size. An algorithm was applied to an ellipsoid model and a horseshoe-shaped model. Projection images were created geometrically using C program language, and reconstruction was also performed using C program language and Matlab ver. 6(The Mathwork Inc., USA). For the ellipsoid model, the reconstructed volume was slightly overestimated, but the target shape and position proved to be correct. For the horseshoe-shaped model, reconstructed volume was somewhat different from the original target model, but there was a considerable improvement in determining the target volume.

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Results of Segmental Resection and Reconstruction of the Trachea for Obstructive Tracheal Lesions (기관 폐쇄 병변에서 시행된 기관 절제 및 재건술에 대한 결과)

  • 김명천;박주철;조규석;유세영;김범식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.792-798
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    • 1998
  • Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

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The efficacy of computerized tomographic scan for chest trauma (흉부외상 환자에 대한 전산화 단층촬영의 효용성)

  • Roh, Hwan-Kyu;Choi, Ho;Kim, Young-Jin;Kim, Jung-Tae;Soh, Dong-Moon;Ryu, Han-Young;Lee, Cheol-Joo
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.298-303
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    • 1998
  • Computerized tomography(CT) is an effective technique in the initial evaluation of the abdomen and head following blunt trauma. To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram (CXR) was carried out on 134 patients with blunt trauma on the chest. Among 134 patients, 45 patients had normal initial chest roentgenogram and 24 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (46.2 and 62.9% respectively), whereas 71.4%(45/63) of patients had thoracostomy only by CXR. Although sometimes abused, CT of the thorax is effective in the initial diagnosis.

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Repair of Ruptured Papillary Muscle of the Tricuspid Valve as a Cause of Tricuspid Insufficiency Following Blunt Chest Trauma (흉부 둔상후 삼첨판막 폐쇄부전을 유발한 삼첨판막 유두근 파열의 치료)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Lee, Jung-Hoon
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.413-416
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    • 2010
  • A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.

KAPOSI'S SARCOMA OF MAXILLARAY GINGIVA IN SYSTEMIC LUPUS ERYTHEMATOSUS (전신성 홍반성 낭창 환자에서 상악 치은에 발생한 Kaposi's Sarcoma)

  • Kim, Il-Kyu;Cho, Hyun-Young;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won;Sasikala, Balaraman;Kim, Joon-Mee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.343-348
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    • 2009
  • Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Immunosuppressive type. Epidemic categories is found approximately 20% of all AIDS patients and has strong predilection for head and neck region. The first case of immunosuppresive type Kaposi's sarcoma in patients with kidney transplants was reported in 1969. Kaposi's sarcoma accounts for 5% of all tumors associated with transplanted patients. The most common site of Kaposi's sarcoma in immunosuppressed patients are extremities, but rare in head and neck area. A 42 years old woman who had systemic lupus erythematosus visited to our clinic because of gingival hyperplasia, and excisional biopsy revealed Kaposi's sarcoma. We experienced a case of favorable results using excision and chemotherapy, so we report with review of literatures.

According to Extent of Sympathectomy, Compensatory Hyperhidrosis in Essential Hyperhidrosis (다한증환자에서 수술 방법에 따른 보상성 다한증의 비교)

  • 이두연;윤용한;김해균;강정신;이교준;신화균
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.175-180
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    • 1999
  • Background: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. Material and Method: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. Result: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. Conclusion: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.

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TRAUMATIC BONE CYST : A CASE REPORT (외상성 골낭의 치험례)

  • Oh, Min-Hyung;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.18-25
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    • 2005
  • Traumatic bone cyst is a nonodontogenic cyst without epithelial-linig which contains fluid in it's cavity, and it is limited by bone walls with no evidence of infection. Traumatic bone cyst is asymptomatic and appears more frequently in the second decade. Gender distribution is approximately equal, although males are affected slightly often than females. Radiographically the lesion shows a well demarcated radiolucent lesion of variable size and the lesion may have scalloped margins. The adjacent teeth to traumatic bone cyst remains vital. Traumatic bone cyst is usually treated by surgical exploration and currettage of the lesion. In the first case of this case report, the patient was refered from the local dental clinic for the radiolucent area under the left mandibular first molar. From the panorama radiograph at the first visit, the radiolucent area of the left mandible showed a well defined scalloped margin and identified as traumatic bone cyst. In the second case, the patient have visited for the chief complaint of swelling and abcess of right maxillary second premolar. In the radiographic check up with panorama radiograph, the radiolucent lesion with well demarcated scalloped margin was found in the right mandible body, and identified as traumatic bone cyst. In the first case, overinstrumentation was done through the mesial root canal to irrigate the lesion. In the second case, not any treatment was done, and watched the progression of the lesion. And in both cases, after two month, the radiolucency and the size of the lesion has decreased to show healing in progress.

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Clinical Study of Composite Valve Graft Replacement of the Aortic Root (대동맥 근부 복합 인공 판막 도관 치환술에 관한 임상적 고찰)

  • Park, Kwon-Jae;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Jeong, Sang-Seok
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.260-265
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    • 2010
  • Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

EARLY DETECTION OF BEHCET'S DISEASE (베체트병의 조기 진단)

  • Kim, Seung-Hye;Song, Je-Seon;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.575-579
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    • 2009
  • Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

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Thrombin Inhibition Activity of Fructus Extract of Crataggus pinnatifida Bunge (산사자 추출물의 트롬빈 저해활성)

  • Ryu, Hee-Young;Kim, Yung-Kwan;Kwun, In-Sook;Kwon, Chong-Suk;Jin, Ing-Nyol;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.17 no.4 s.84
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    • pp.535-539
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    • 2007
  • The fructus of Crataegus pinnatifida Bunge has been used as medicinal and food source in worldwide. In this study, a strong direct thrombin inhibition and antithrombosis activity were identified from the methanol extract of C. pinnatifida Bunge fructus. The solvent fractionation of fructus extract using hexane, ethylacetate, butanol revealed that the butanol fraction has a prominent antithrombin activity. Thrombin time(blood-clot formation time) and activated partial thromboplastin time(aPTT) extended to 835% and 315% by addition of the butanol fraction at concentration of 1.25 mg/mL, whereas thrombin time extended to 287% by addition of aspirin at concentration of 1,25 mg/mL. The butanol fraction showed anthrone-positive and weak ninhydrine-postive reaction. The thrombin inhibitory activity was not related to previously reported flavonoids or polyphenols. The activity was maintained against acid treatment(0.5 N HCl for 120 min), but rapidly lost by heat-treatment($100^{\circ}C$ for 30 min). Our results suggested that fructus of C. pinnatifida Bunge with non-heat treatment process could be developed as a natural source of antithrombosis.