Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.
Cho, Jeong Nam;Suh, In Suck;Chung, Chan Min;Tak, Kyoung Seok;Sin, Mi Kyoung
Archives of Craniofacial Surgery
/
v.9
no.2
/
pp.93-96
/
2008
Purpose: Sudoriferous cyst usually occurs on the face, and especially on the ear and scalp as a solitary cystic mass. It is derived from the sweat glands of Moll and results from the obstruction of excretory ducts with the retention of fluid. In the eyelid, it is usually seen as small and firm vesicle arising at the eyelid margin. If it rarely occurs on the orbit, it develops from orbital ectopic epithelial cells predetermined to form glands of Moll. We experienced a case of sudoriferous cyst on eyelid which was adhered to levator aponeurosis and it disappeared when patient closed eyes. Methods: A 55-year-old women suffered palpable mass on left upper eyelid without pain that had been present for 25 years. Orbital computed tomographic finding showed a oval mass($2.1{\times}0.6{\times}0.6cm$ size) inside upper eyelid and it invaded the orbit. The mass was completely excised under general anesthesia and histopathological examination was followed. Results: Cystic mass was purple color and it was located in superiorly to tarsal plate. The mass was adhered to levator aponeurosis and levator palpabrae superioris muscle between the fat layer of post-orbital septum and the Whitnall ligament. The mass was completely excised without injury of aponeurosis and muscle. Microscopically, the lesion was a solitary cyst lined by two layers of cuboidal epithelial cells and innermost cells displaying eosinophilic cytoplasm with apical expansions. Conclusion: Sudoriferous cyst usually occurs on eyelid margin. But in this case, cystic mass occurred on upper eyelid and disappeared when patient closed the eyes because it was partially adhered to levator aponeurosis and levator palpebrae superioris muscle. Therefore, if sudoriferous cyst occurs on eyelid, it is necessary to excised the mass carefully.
Human circulatory system between heart and tissue is not directly connected in normal condition but mandatory to go through the capillary system in order to fulfill its physiologic aim to deliver oxygen and nutrients, etc. to the tissue and retrieve used blood together with waste products from the tissue properly. When abnormal connection between arterial and venous system (AV fistula), these two circulatory systems respond differently to the hemodynamic impact of this abnormal connection between high pressure (artery) and low pressure (vein) system. Depending upon the location and/or degree (e.g. size and flow) of fistulous condition, each circulatory system exerts different compensatory hemodynamic response to this newly developed abnormal inter-relationship between two systems in order to minimize its hemodynamic impact to own system of different hemodynamic characteristics. Pump action of the heart can assist the failing arterial system directly to maintain arterial circulation against newly established low peripheral resistance by the AV fistula during the compensation period, while it affects venous system in negative way with increased venous loading. However, the negative impact of increased heart action to the venous system is partly compensated by the lymphatic system which is the third circulatory system to assist venous system independently with different hemodynamics. The lymphatic system with own unique Iymphodynamics based on peristaltic circulation from low resistance to high resistance condition, also increases its circulation to assist the compensation of overloaded venous system. Once these compensation mechanisms should fail to fight to newly established hemodynamic condition due to this abnormal AV connection, each system start to show different physiologic ${\underline{de}compensation}$ including heart and lymphatic system. The vicious cycle of decompensation between arterial and vein, two circulatory system affecting each other by mutually negative way steadily progresses to show series of hemodynamic change throughout entire circulation system altogether including heart. Clinical outcome of AV fistula from the compensated status to decompensated status is closely affected by various biological and mechanical factors to make the hemodynmic status more complicated. Proper understanding of these crucial biomechanical factors iii particular on hemodyanmic point of view is mandatory for the advanced assessment of biomechanical impact of AV fistula, since this new advanced concept of AY fistula based on blomechanical information will be able to improve clinical control of the complicated AV fistula, either congenital or acquired.
Kim, Tae-Young;Choi, Soo-Joong;Kwon, Bong-Cheol;Lee, Yong-Beom;Kim, Ki-Bok
Archives of Reconstructive Microsurgery
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v.19
no.1
/
pp.61-67
/
2010
Emergency free flap has been advocated to cover the severely injured extremity for more than two decades, due to its numerous advantages such as low incidence of flap failure and infection rate and early recovery of function. But there are very few reports about these. The authors report their experience in using the emergency free flap for reconstruction of extremities. For last 10 years, 4 patients ranging from 3 to 27 years old with severely traumatized extremities were treated with emergency free flap transfers. Three were males and the other was a female. Flap size ranged from $2{\times}5\;cm^2$ to $7{\times}22\;cm^2$. The locations of the recipient site were the dorsum of the foot, the cubital fossa, the popliteal fossa and the upper arm. The number of the donor sites used was as follows: one scapular flap, two parascapular flaps, and one radial forearm flap with the radial bone. All of the flaps survived without need of re-exploration. There was no infection or flap loss. Involved joints have recovered a normal range of motion. Therefore, we consider that the emergency free flap is a very safe and reliable method to cover the severely injured extremities.
Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.
Ryu, Ah-Jin;Lee, Kyung Eun;Kwon, Soon-Sung;Shin, Eun-Seok;Shim, Eun Bo
The Korean Journal of Physiology and Pharmacology
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v.23
no.1
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pp.71-79
/
2019
Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.
Purpose: Tumor ablation and traumatic intractable ulceration of the plantar surface of the foot results in skin and soft tissue defects of the weight-bearing sole. Simple skin grafting is not sufficient for reconstruction of the weight-bearing areas. Instead, the island medial plantar flap (instep flap) and distally-based island medial plantar flap was used for proper reconstruction of the weight bearing area. However, there are some disadvantages. In particular, an island medial plantar flap has a short pedicle limiting the mobility of the flap and the distally-based island medial plantar flap is based on a very small vessel. We investigated whether good results could be obtained using a reverse island medial plantar flap based on the lateral plantar vessel as a solution to the above limitations. Methods: Three patients with malignant melanoma were cared for in our tertiary hospital. The tumors involved the lateral forefoot, the postero-lateral heel, and the medial forefoot area. We designed and harvested the flap from the medial plantar area, dissected the lateral and medial plantar artery and vena comitans, and clamped and cut the vessel 1 cm proximal to the branch from the posterior tibial artery and vena comitans. The medial plantar nerve fascicles of these flaps anastomosed to the sural nerve, the 5th interdigital nerve, and the 1st interdigital nerve of each lesion. The donor sites were covered with skin grafting. Results: The mean age of the 3 subjects was 64.7 years (range, 57 - 70 years). Histologically, all cases were lentiginous malignant melanomas. The average size of the lesion was $5.3\;cm^2$. The average size of the flap was $33.1\;cm^2$. The flap color and circulation were intact during the early postoperative period. There was no evidence of flap necrosis, hematomas or infection. All patients had a normal gait after the surgery. Sensory return progressively improved. Conclusion: Use of an island medial plantar flap based on the lateral plantar vessel to the variable weight-bearing sole is a simple but useful procedure for the reconstruction of any difficult lesion of the weight-bearing sole.
This study aimed to develop a modular smart clothing system for heart rate monitoring that reduces the inconvenience caused by battery charging and the large size of measurement devices. The heart rate monitoring system was modularized into a temporary device and a continuous device to enable heart rate monitoring depending on the requirement. The temporary device with near-field communication (NFC) and heart rate sensors was developed as a clothing attachment type that enables heart rate monitoring via smart phone tagging when required. The continuous device is based on Bluetooth Low Energy (BLE) communication and batteries and was developed to enable continuous heart rate measurement via a direct connection to the temporary device. Furthermore, the temporary device was configured to connect with a textile electrode made of a silver-based knitted fabric designed to be located below the pectoralis major muscle for heart rate measurement. Considering the user-experience factors, key functions, and the ease of use, we developed an application to automatically log through smart phone tagging to improve usability. To evaluate the accuracy of the heart rate measurement, we recorded the heart rate of 10 healthy male subjects with a modular smart clothing system and compared the results with the heart rate values measured by the Polar RS800. Consequently, the average heart rate value measured by the temporary system was 85.37, while that measured by the reference device was 87.03, corresponding to an accuracy of 96.73%. No significant difference was found in comparison with the reference device (T value = -1.892, p = .091). Similarly, the average heart rate measured by the continuous system was 86.00, while that measured by the reference device was 86.97, corresponding to an accuracy of 97.16%. No significant difference was found in terms of the heart rate value between the two signals (T value = 1.089, p = .304). The significance of this study is to develop and validate a modular clothing system that can measure heart rates according to the purpose of the user. The developed modular smart clothing system for heart rate monitoring enables dual product planning by reducing the price increase due to unnecessary functions.
Objective: The first aim of this study is to determine the effects of acupuncture on the autonomic nervous system (ANS) via Heart Rate (HR) and Pupil Size (PS), and to compare the effects of acupuncture on the subjects' ANS when they are in a sitting position with the effects when they are in a supine position. Methods: Ten healthy male subjects were randomized to receive either verum acupuncture stimulation in a sitting position (SitV), verum acupuncture stimulation in a supine position (SupV), sham acupuncture stimulation in a sitting position (SitS), and sham acupuncture stimulation in a supine position (SupS). Acupuncture stimulation was applied to Neguan point (PC6) on the forearm. The subject's electrocardiogram (ECG) and pupil size were recorded continuously from 5 min before stimulation to 12 min after stimulation. Results: Verum and sham acupuncture stimulation were found to have reduced heart rate (p<0.01) and to have increased pupil size (p<0.01) in all the subjects. But when the reduction in HR and the increment in PS after verum acupuncture stimulation (both sitting and supine position) were compared with those after sham acupuncture stimulation, it was found that the reduction in HR (74.48 and 73.47 bpm, p<0.063) and the increment of PS (7.32 and, 6.10 mm, p<0.001) after verum acupuncture stimulation were greater than those after sham acupuncture stimulation, and that the corresponding values were statistically significant. In addition, at the baseline, it was found that the subjects had a larger PS and a faster HR in a sitting position than when they did so in a supine position. And then the reduction and increment ratio in the subject's HR and PS when they underwent acupuncture stimulation in a sitting position was significantly different from the reduction and increment in their HR and PS when they underwent the procedure in a supine position-i.e., the reduction ratio in HR was greater when they underwent the procedure in a sitting position, and such reduction ratio was statistically significant (p<0.05). As for the increment in PS, it was greater when the subjects underwent the procedure in a supine position, and such increment was significant (p<0.05). Conclusion: Manual acupuncture stimulation on Neguan point (PC6) has more significant influence on the autonomic nervous system rather than sham acupuncture (tactile stimulation). And the position-induced different states of ANS have different influence on the acupuncture effect.
As the new large buildings are continuously being built with the advanced technology and skills, an adequate size of electric room needs to be obtained so that engineers establish an efficient and reliable system in the electric room. Considering the current capacity, its expansion and its connecting system, the final size of it should be determined in order to bring an effective use of the building. Usually the extension of electricity capacity is on the increase after construction and it comes from the lack of scientific evaluation on the electric room. Later when the expansion of computer and important electric equipment that needs much capacity is impossible, it will cause a great deal of damage to the renting business of the building as well as becomes the unstable factors of the whole system. Therefore, it is important to have the exact method of calculating the effective size of electric room, the heart of the building, especially when the value of land price is very high. In addition, it should be calculated in an accurate way due to the diversification of the system and the compact size of the electricity equipment. However, the research on this area and the comparison and evaluation of the size after construction have not been made enough and the results of them have not been applied when calculating a new size of electric room. Accordingly, this study examines three methods prescribed in the standards of electricity installation technology through case analysis and suggests substantial data by system, capacity, and purpose.
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