• Title/Summary/Keyword: Dilation

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Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone (하부 요관결석 환자에서 Dormia Stone Dislodger를 이용한 경뇨도적 요관배석술의 의의)

  • Kim, Eun-Gill;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.81-85
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    • 1985
  • Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial Herem we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 4-6 mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained In the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And In the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

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Evaluation of cytotoxicity of electroplated stainless steel orthodontic wire (전기도금한 교정용 스테인레스스틸 선재의 세포독성에 관한 연구)

  • Lee, Gye-Hyeong;Cho, Jin-Hyoung;Lee, Ki-Heon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.127-136
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    • 2005
  • The purpose of this study was to examine the cytotoxicity of orthodontic wire which had an increased diameter through electroplating, and to evaluate its possible clinical applications, First. nickel plating was carried out on the commercially available stainless steel wire using an electroplating technique For the comparison of the electroplated wire with ready made stainless steel wire and titanium or copper. each wire was incubated for 72 hours in a medium. The release of the metal ion was measured using ICP-AES (Inductively Coupled Plasma Atomic Emission Spectrophotometer). Balb/c 3T3 mouse fibroblast was put on a microplate and placed in an incubated medium of 75%, 50%, and 20% dilation. An MTT analysis was used to compare with the medium only. The change in absorbency value of each wire group and the difference of absorbency value according to the change of dilution was measured The results of ICP-AES analysis showed that great amount nickel iou was isolated from electroplated orthodontic wires and great amount copper ion was isolated from copper. The results of the MTT analysis showed that there was no difference in the absorbency value of titanium at any dilution. However, the electroplated wires (p<0.001) the stainless steel wires (p<0.05) and the copper (P<0.001) were statistically significantly lower than those of medium only at all dilutions. Assessment as per ISO 10993, part 5, showed that electroplated wire was alloted to 'moderate cytotoxic' the titanium and stainless steel wire were 'non-cytotoxic' The results of this study indicate that the electroplated orthodontic wires need additional efforts to decrease cytotoxicity for their clinical applications.

MRI of Hydrosyringomyelia Combined to Hydrocephalus and Occipital Dysplasia in a Dog (개에서 뇌수두증과 후두골 이형성증을 동반한 척수공동증의 자기공명영상학적 평가 1례)

  • Choi Chi-Bong;Bae Chun-Sik;Kim Hwi-Yool
    • Journal of Life Science
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    • v.15 no.4 s.71
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    • pp.664-667
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    • 2005
  • Hydrosyringomyelia is a dilation of the spinal cord central canal. In human it may be caused by congenital malformations such as Dandy-Walker syndrome and Chiari malformations or may be acquired as a result of infection, trauma or neoplasia. Hydrocephalus is an excessive accumulation of cerebrospinal fluid within the ventricles and occipital dysplasia is the dorsal extension of the foramen magnum. Hydrosyringomyelia and hydrocephalus can be confirmed by computed tomography or magnetic resonance imaging (MRI). A 3-year-old male maltese was presented with a history of long-term seizure. Blood examination was all unremarkable. On rostrodorsal-caudoventral oblique radiograph of the skull showed severe occipital dysplasia. On brain sonography through the persistent fontanelle, severe lateral ventriculomegaly was revealed. MRI examination revealed hydrocephalus and hydrosyringomyelia. Diuretic therapy didn't reduce clinical symptoms and surgical decompression was conducted. The dog responded well with ventriculo-peritoneal shunting. MRI is the most superior modality to diagnose hydrocephalus and hydrosyringomyelia, to plan therapy and to determine the prognosis.

Blood Gas Analysis and Lung Histopathology in Waterston Operation (Waterston 수술이 Gas 값과 폐조직에 미치는 영향)

  • 김세화;이홍균
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.87-96
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    • 1972
  • Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.

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Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic Hyperplasia (전립선비대증의 진료지침 개발을 위한 한국문헌의 메타분석)

  • Yu, Seung-Hum;Kim, Chun-Bae;Kang, Myung-Geun;Song, Jae-Mann
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.643-664
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    • 1997
  • This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

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Effects of Exercise on Endothelial Progenitor Cells in Cardiovascular Disease Patients: A Systematic Review (운동중재가 심혈관질환자의 혈관내피전구세포에 미치는 영향: 체계적 문헌고찰)

  • Kim, Ahrin;Yang, In-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.366-379
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    • 2017
  • In this study, we performed a systematic review and meta-analysis to identify the effects of exercise on endothelial progenitor cells (EPCs) in patients with cardiovascular disease (CVD). We conducted database searches (Cochrane Library, PubMed, EMBASE, ScienceDirect, CINAHL, Scopus, KoreaMed, KISS, RISS, KMBASE) for the effect of exercise on cardiovascular disease, using heart disease, coronary artery disease, heart failure, cardiovascular disease, exercise, motor activity, rehabilitation, and endothelial progenitor cells as the keywords. Of the 539 studies identified, 9 met the inclusion and exclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze the effect size and the publication bias was checked with a funnel plot. Exercise was found to improve the VEGF (vascular endothelial growth factor), CD34+KDR+, and endothelial function, assessed via FMD (flow-mediated dilation), in the exercise vs. control groups, viz. 2.008 (95% CI 0.204-3.812), 1.399 (95% CI 0.310-2.489), and 1.881 (95% CI 0.848-2.914), respectively. Exercise improved the VEGF, number of EPCs, and endothelial function in the CVD patients. Considering the increasing prevalence and mortality rates for cardiovascular disease in Korea, the findings of this study that analyzed the effects of exercise on EPCs might provide guidelines for planning exercise interventions for patients with CVD.

Cyberknife Dosimetric Planning Using a Dose-Limiting Shell Method for Brain Metastases

  • Yoon, Kyoung Jun;Cho, Byungchul;Kwak, Jung Won;Lee, Doheui;Kwon, Do Hoon;Ahn, Seung Do;Lee, Sang-Wook;Kim, Chang Jin;Roh, Sung Woo;Cho, Young Hyun
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.753-760
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    • 2018
  • Objective : We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs). Methods : We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans ($CK_{original}$) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at low-isodose levels (10-30% of prescription dose) for dose spillage. In each case, a modified CK plan ($CK_{modified}$) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared. Results : There were no differences in the conformity indices among the $CK_{original}$, $CK_{modified}$, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the $CK_{modified}$ plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the $CK_{original}$ plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345). Conclusion : These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.

A Novel Method for Automated Honeycomb Segmentation in HRCT Using Pathology-specific Morphological Analysis (병리특이적 형태분석 기법을 이용한 HRCT 영상에서의 새로운 봉와양폐 자동 분할 방법)

  • Kim, Young Jae;Kim, Tae Yun;Lee, Seung Hyun;Kim, Kwang Gi;Kim, Jong Hyo
    • KIPS Transactions on Software and Data Engineering
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    • v.1 no.2
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    • pp.109-114
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    • 2012
  • Honeycombs are dense structures that small cysts, which generally have about 2~10 mm in diameter, are surrounded by the wall of fibrosis. When honeycomb is found in the patients, the incidence of acute exacerbation is generally very high. Thus, the observation and quantitative measurement of honeycomb are considered as a significant marker for clinical diagnosis. In this point of view, we propose an automatic segmentation method using morphological image processing and assessment of the degree of clustering techniques. Firstly, image noises were removed by the Gaussian filtering and then a morphological dilation method was applied to segment lung regions. Secondly, honeycomb cyst candidates were detected through the 8-neighborhood pixel exploration, and then non-cyst regions were removed using the region growing method and wall pattern testing. Lastly, final honeycomb regions were segmented through the extraction of dense regions which are consisted of two or more cysts using cluster analysis. The proposed method applied to 80 High resolution computed tomography (HRCT) images and achieved a sensitivity of 89.4% and PPV (Positive Predictive Value) of 72.2%.

A Numerical Study for Stability of Tunnel in Jointed Rock Using Barton-Bandis Model (BB절리모델을 활용한 절리암반속 터널안정성의 수치해석적 연구)

  • Lee, Sung-Ki;Chung, Hyung-Sik
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.3 no.3
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    • pp.15-29
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    • 2001
  • For the pertinent use of NMT method, both characteristics of joints (JRC, JCS and ${\phi}_r$) and characteristics of rock mass (Q-Value) must be investigated carefully. The main objective of the study presented is to investigate how sensitive the predicted behaviour of an underground excavation is to various realistic assumptions about some input parameter for the jointed rock mass. Joint pattern in the tunnel is predicted by statistical approach (chi-square test). In this paper, sensitivity studies involving in joint characteristics were carried out. The parametric studies involving change in Barton-Bandis joint model have shown that JCS is relatively insensitive to JRC and ${\phi}_r$. An increase in JRC value may not, according to the Barton-Bandis model, necessarily lead to a decrease in displacement. The importance of dilation in predicting the behaviour of a rock mass around an excavation is emphasized from a comparison of the Barton-Bandis joint behaviour model with the Mohr-Coulomb model. The Barton-Bandis model predicted higher stress, which allow for the build-up of stress caused by dilatant behaviour.

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Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy (유리체절제술과 수정체유화술 동시 수술 시 백내장수술 후 앞방내 에피네프린 주입과 동공 확대)

  • Kim, Sangbum;Park, Jongyeop;Shin, Jaeryung;Lee, Seungwoo
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1137-1141
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    • 2018
  • Purpose: We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR). Methods: We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes). Results: The PCA ratios of the study group were $0.52{\pm}0.11$ before PE, $0.43{\pm}0.12$ after PE, and $0.51{\pm}0.11$ after PPV, respectively. Changes in pupil size were significant (p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were $0.52{\pm}0.10$ before PE, $0.39{\pm}0.15$ after PE, and $0.43{\pm}0.15$ after PPV, respectively. Changes in pupil size after PE were significant (p = 0.011) but the change after PPV was not (p = 0.056). Conclusions: Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.