• Title/Summary/Keyword: CT practice

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Surgical Correction of Left Ventricular Assist Device Outflow Graft Obstruction Caused by a Wrapped Expanded Polytetrafluoroethylene Graft: A Case Report

  • Sung Min Kim;Ilkun Park;Siwon Oh;Hyo Won Seo;Ga Hee Jeong;Jun Ho Lee;Su Ryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.413-417
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    • 2024
  • A 70-year-old man with dilated cardiomyopathy underwent left ventricular assist device (LVAD) implantation, using a HeartWare ventricular assist device, as a bridge to candidacy. After 26 months, computed tomography (CT) angiography indicated stenosis in the LVAD outflow graft; however, the patient was asymptomatic, prompting a decision to manage his condition with close monitoring. Ten months later, the patient presented with dizziness and low-flow alerts. Subsequent CT angiography revealed a critical obstruction involving the entire LVAD outflow graft. The patient underwent emergency surgery, during which an organized seroma causing the graft obstruction was found between a wrapped expanded polytetrafluoroethylene (ePTFE) graft and a Dacron outflow graft. The covering of the outflow graft was removed, along with the organized seroma. Following removal of the ePTFE wrap and decompression of the outflow graft, normal LVAD flow was reestablished. The practice of wrapping the outflow graft with synthetic material, commonly done to facilitate later redo sternotomy, may pose a risk for outflow graft obstruction.

VR, AR Simulation and 3D Printing for Shoulder and Elbow Practice (VR, AR 시뮬레이션 및 3D Printing을 활용한 어깨와 팔꿈치 수술실습)

  • Lim, Wonbong;Moon, Young Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.175-179
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    • 2016
  • Recent advances in technology of medical image have made surgical simulation that is helpful to diagnosis, operation plan, or education. Improving and enhancing the medical imaging have led to the availability of high definition images and three-dimensional (3D) visualization, it allows a better understanding in the surgical and educational field. The Real human field of view is stereoscopic. Therefore, with just 2D images, stereoscopic reconstruction process through the surgeon's head, is necessary. To reduce these process, 3D images have been used. 3D images enhanced 3D visualization, it provides significantly shorter time for surgeon for judgment in complex situations. Based on 3D image data set, virtual medical simulations, such as virtual endoscopy, surgical planning, and real-time interaction, have become possible. This article describes principles and recent applications of newer imaging techniques and special attention is directed towards medical 3D reconstruction techniques. Recent advances in technology of CT, MR and other imaging modalities has resulted in exciting new solutions and possibilities of shoulder imaging. Especially, three-dimensional (3D) images derived from medical devices provides advanced information. This presentation describes the principles and potential applications of 3D imaging techniques, simulation and printing in shoulder and elbow practice.

Application of Simulated Three Dimensional CT Image in Orthognathic Surgery (악교정 수술에서 모의 조종된 3차원 전산화 단층촬영상의 응용)

  • Kim Hyung-Don;Yoo Sun-Kook;Lee Kyoung-Sang;Park Chang-Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.2
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    • pp.363-385
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    • 1998
  • In orthodontics and orthognathic surgery. cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery. too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation. limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram. pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. and for validation of new method. in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery. computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced. range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94% in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer­simulated three dimensional images and actual postoperative three dimensional images in coordinates values was from -6.7 mm to 7.7 mm and 90% in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively. computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore. potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.

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Effect of SRI Water Management on the Reduction of Greenhouse-gas Emissions and Irrigation Water Supply in Paddy (논에서 SRI 물관리 방법에 의한 온실가스와 관개용수 저감효과 분석)

  • Seo, Jiyeon;Park, Baekyung;Park, Woonji;Lee, Suin;Choi, Yonghun;Shin, Minhwan;Choi, Joongdae
    • Journal of The Korean Society of Agricultural Engineers
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    • v.60 no.1
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    • pp.79-87
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    • 2018
  • Water management impacts both methane ($CH_4$) and nitrous oxide ($N_2O$) emissions from rice paddy fields. Although irrigation is one of the most important methods for reducing $CH_4$ emission in rice production systems it can also $N_2O$ emissions and reduce crop yields. A feasibility study on the system of rice intensification (SRI) methods with respect to irrigation requirements, greenhouse gas (GHG) emissions was conducted for either 2 or 3 years depending on the treatment in Korea. The SRI methods (i.e. SRI and midsummer drainage (MD) with conventional practice (CT)) reduced the irrigation requirement by 49.0 and 22.0 %, respectively. Global warming contribution of GHG to different depending on the type of GHG. Therefore, the emission of $CH_4$ and $N_2O$ shall be converted to Global Warming Potential (GWP). The GHG emission from the conventional practice with midsummer drainage (MD) and the SRI plots, in GWP were reduced by 49.1 and 77.1 %, respectively. Application of SRI water management method could help to improve Korea's water resources and could thus contribute to mitigation of the negative effects of global warming.

Utilization of desktop 3D printer-fabricated "Cost-Effective" 3D models in orthognathic surgery

  • Narita, Masato;Takaki, Takashi;Shibahara, Takahiko;Iwamoto, Masashi;Yakushiji, Takashi;Kamio, Takashi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.24.1-24.7
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    • 2020
  • Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

Using Ultrasonography in Korean Medicine to Observe Organs and Diseases, and Evidence of its Use (한의학에서 초음파 진단기기를 활용한 장부 및 질병 관찰과 그 활용 근거)

  • Baik, Tai-Hyeun
    • The Journal of Korean Medicine
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    • v.35 no.3
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    • pp.70-92
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    • 2014
  • Objectives: Due to advance of science and IT technology, high tech imaging equipment like ultrasonography, CT, MRI and PET scan is constantly being developed and progressed; use of these techniques is needed for Korean medicine. Methods: Historical study was undertaken on the evidence of using ultrasonography. Normal organs and various sorts of diseases were also observed by ultrasonography. Results: Korean medicine judges disease of internal organs and condition of health by symptoms of functional disease and organic disease based on anatomical theory. Ultrasonography based on anatomical theory is non-invasive and free from radiation exposure and can be performed directly from clinical practice in real-time. Ultrasonography can be a big help for securing the stability of the internal organs in inserting needles in the thorax and abdomen as well as diagnosing functional and organic diseases based on anatomical theory. Conclusion: We look forward to a great development of scientification and objectification of Korean medicine by using and researching imaging equipment based on anatomical theory as well as ultrasonography.

Three-Dimensional Visualization of Medical Image using Image Segmentation Algorithm based on Deep Learning (딥 러닝 기반의 영상분할 알고리즘을 이용한 의료영상 3차원 시각화에 관한 연구)

  • Lim, SangHeon;Kim, YoungJae;Kim, Kwang Gi
    • Journal of Korea Multimedia Society
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    • v.23 no.3
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    • pp.468-475
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    • 2020
  • In this paper, we proposed a three-dimensional visualization system for medical images in augmented reality based on deep learning. In the proposed system, the artificial neural network model performed fully automatic segmentation of the region of lung and pulmonary nodule from chest CT images. After applying the three-dimensional volume rendering method to the segmented images, it was visualized in augmented reality devices. As a result of the experiment, when nodules were present in the region of lung, it could be easily distinguished with the naked eye. Also, the location and shape of the lesions were intuitively confirmed. The evaluation was accomplished by comparing automated segmentation results of the test dataset to the manual segmented image. Through the evaluation of the segmentation model, we obtained the region of lung DSC (Dice Similarity Coefficient) of 98.77%, precision of 98.45%, recall of 99.10%. And the region of pulmonary nodule DSC of 91.88%, precision of 93.05%, recall of 90.94%. If this proposed system will be applied in medical fields such as medical practice and medical education, it is expected that it can contribute to custom organ modeling, lesion analysis, and surgical education and training of patients.

The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage

  • Han, Ju-Hee;Lee, Jong-Myong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.303-309
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    • 2014
  • Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

Two Cases of Disc Internal Disruption Syndrome (추간판 내부 파열 증후군(Internal disc disruption) 2례)

  • Lee, Jong-Hyeung;Ahn, Myun-Whan;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.238-245
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    • 1991
  • The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggrevated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus We present these cases with a brief review of the concerned literature.

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Congenital Heart Disease: a Pictorial Illustration of Putting Segmental Approach into Practice

  • Yeung, Tse Hang;Park, Eun-Ah;Lee, Ying Cheong;Yoo, Jin Young;Lui, Choi Yu
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.205-211
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    • 2015
  • The human heart is a complex organ in which many complicated congenital defects may happen and some of them require surgical intervention. Due to the vast complexity of varied anatomical presentations, establishing an accurate and consistent nomenclature system is utmost important to facilitate effective communication among pediatric cardiologists, cardiothoracic surgeons and radiologists. The Van Praagh segmental approach to the complex congenital heart disease (CHD) was developed in the 1960s and has been used widely as the language for describing complex anatomy of CHD over the decades. It utilizes a systematic and sequential method to describe the cardiac segments and connections which in turn allows accurate, comprehensive and unambiguous description of CHD. It can also be applied to multiple imaging modalities such as echocardiogram, cardiac CT and MRI. The Van Praagh notation demonstrates a group of three letters, with each letter representative for a key embryologic region of cardiac anatomy: the atria, ventricles and great vessels. By using a 3-steps approach, we can evaluate complex CHD precisely and have no difficulties in communicating with other medial colleague. This pictorial essay revisits the logical steps of segmental approach, followed by a pictorial illustration of its application.