• Title/Summary/Keyword: Mechanical obstruction

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Noninvasive assessment of pressure gradients across prosthetic heart valve by doppler ultrasound -A comparative studyof the duromedics bileaflet valves in mitral position and normal mitral valves- (도플러 초음파를 이용한 인공판막 상하의 압력차 측정에 관한 연구 -승모판막 치환에 사용한 Duromedics 인공판막과 정사인의 승모판막과의 비교연구-)

  • Jin, Seong-Hun;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.223-229
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    • 1987
  • Doppler echocardiography provides valuable information regarding prosthetic heart valve function rather than structure. There are three methods of expressing the severity of mitral valve obstruction: the transvalvular pressure gradient, effective valve area, and pressure half-time. Of these, the transvalvular pressure gradient [~p] can be determined by the measurement of maximum transvalvular blood flow velocity [V] according to the modified Bernoulli`s equation [gp=4V*]. Eleven patients, who underwent mitral valve replacement with Duromedics mechanical prostheses, and 17 normal persons were investigated. There were significantly higher calculated pressure gradients in prosthetic than normal mitral valves [9.*10*2.22mmHg-vs-3.26*0.99mmHg:p<0,01], and there was a inverse relationship between pressure gradient and prosthetic valve size [11.17*0.%mmHg in size 27mm and 29mm -v- 7.38*1.12mmHg in size 31mm and 33mm; r=0.85, p<0.01] The noninvasive Doppler technique should be useful in the diagnosis of prosthetic valve obstruction.

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Clinical Experience of Rigid Bronchoscopy in Single Center

  • Kim, Hyun-Jin;Kim, Sei-Won;Lee, Hye-Yeon;Kang, Hyeon-Hui;Kang, Ji-Young;Kim, Ju-Sang;Kim, Myung-Sook;Kim, Seung-Soo;Kim, Jin-Woo;Yun, Hyeong-Gyu;Kim, Chi-Hong;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Cho, Kwang-Jae;Moon, Seok-Hwan;Lee, Sang-Haak
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.486-492
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    • 2012
  • Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

Changes of Blood Flow Characteristics due to Catheter Obstruction during the Coronary Angioplasty

  • Suh, Sang-Ho;Roh, Hyung-Woon;Kwon, Hyuck-Moon;Lee, Byoung-Kwon
    • International Journal of Vascular Biomedical Engineering
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    • v.2 no.1
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    • pp.25-30
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    • 2004
  • Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Uses of catheters during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. Catheters in blood vessels cause pressure gradient rise and blood flow drop during the measurements. In this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter obstructions during the coronary angioplasty. The computer simulation models are generated by the data, which are measured by coronary angiogram, and the blood is treated as non-Newtonian fluid. The velocity, pressure, and wall shear stress variations are observed for the estimate of damages of blood vessel. This study is also extended to investigate the effects of stenotic vessel size, and shape and catheter size and location.

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Development of a Gear-shaped Manhole with Height Adjustment (기어형 높이 조절식 맨홀 개발)

  • Kim, Chang-Ho;Park, Joon-Hong;Choi, Jung-il
    • Journal of the Korean Society of Industry Convergence
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    • v.7 no.1
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    • pp.63-68
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    • 2004
  • There are a lot of manholes such as for water supply, sewage, telecommunication cable, traffic sign, electricity supply, and rainwater, etc. Conventional manholes installed on a road are impossible to adjust height, so that they should be entirely excavated to reinstall or repair. This entire excavation of a manhole causes too much time-consuming work, waste of resources, and obstruction of traffic. In this study, in order to solve the above mentioned problems, a cover, outer and inner parts of a manhole are integrated by gear-shaped parts located between outer and inner parts of a manhole. Mechanical design is performed to determine dimension of gear-shaped parts by Taguchi orthogonal array table. Cast molds for a gear-shaped manhole are also manufactured.

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A Study on Development of a Manhole with Height Adjustment (높이 조절식 맨홀 개발에 관한 연구)

  • Kim, Chang-Ho;Park, Joon-Hong
    • Proceedings of the KSME Conference
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    • 2004.04a
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    • pp.710-715
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    • 2004
  • There are a lot of manholes such as for water supply, sewage, telecommunication cable, traffic sign, electricity supply, and rainwater, etc. Conventional manholes installed on a road are impossible to adjust height, so that they should be entirely excavated to reinstall or repair. This entire excavation of a manhole causes too much time-consuming work, waste of resources, and obstruction of traffic. In this study, in order to solve the above mentioned problems, a cover, outer and inner parts of a manhole are integrated by gear-shaped parts located between outer and inner parts of a manhole. Mechanical design is performed to determine dimension of gear-shaped parts by Taguchi orthogonal array table. Cast molds for a gear-shaped manhole are also manufactured.

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The Behavioral Characteristics of a Droplet on the Line Patterned Surface Including Water Film (수막을 가지는 선형 젖음성 패턴 표면에서의 액적 거동 특성)

  • Lee, Changwoo;Park, Jinyoung;Cho, Handong;Hwang, Woonbong
    • Journal of the Korean Society for Precision Engineering
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    • v.30 no.12
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    • pp.1335-1340
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    • 2013
  • Herein the water film was introduced to the hydrophilic area on the line patterned surface to solve the contradiction caused by surface roughness (high different wettability has advantage to control the droplet but high roughness for that high wettability difference causes obstruction of droplet moving). Thus the droplet on the water film could not be hindered to line direction but restricted to orthogonal direction, effectively. In addition, droplet behaviors according to droplet volume and line thickness were studied. Droplet fell off the line with narrowing the interface between the droplet and the water film on the line. When the droplet fell off the line, the plate angle was designated as a critical plate angle and it used as an indicator of surface capability to control the droplet. As a result critical plate angle increases as droplet volume decreases and line thickness increases.

Clinical Study of Children Using Home Mechanical Ventilation (가정용 인공 호흡기를 사용하는 소아의 임상적 고찰)

  • Ahn, Young Joon;Lee, Seung Hyeon;Kim, Hyo-Bin;Park, Seong Jong;Ko, Tae Sung;Hong, Soo Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.401-405
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    • 2005
  • Purpose : The use of mechanically-assisted ventilators at home reduces morbidity and improves the quality of life in children with chronic respiratory failure. But in Korea there is no clinical data of children with home mechanical ventilation. We investigated ventilator types, duration, the causes of failure or death, and the cost needed for care. Methods : We retrospectively analyzed the medical records of 21 children who were admitted and who applied for home mechanical ventilation at the Pediatric Intensive Care Unit in Asan Medical Center. Phone interviews took place after discharge. and interviewed by phone after discharge. Results : The median age was 31 months; the median duration with ventilator was 25 months. Underlying diseases were 16 neuromuscular diseases, one metabolic disease and four chronic respiratory diseases. The types of ventilator were pressure and volume type(16 and five patients, respectively). The frequency of ventilation failure was once per 19 months. Weaning could be performed in three cases. Frequencies of admission after receiving ventilators were 1.7 times per year; the most common cause was pneumonia. Nine patients(43%) died; four of them died because of endotracheal tube obstruction. The costs for medical care were about 1,110,000 won per month. Conclusion : There is an increment in the numbers of individuals who need mechanical ventilation support. The most common cause of death was endotracheal tube obstruction. The most important problem for the patients was medical cost. There needs to be more interest in patients with ventilator and social welfare systems to support their families need to be prepared.

Effect of Bladder Wall Thickness Through Change of Bladder Volume and Material Properties on Detrusor activity Study (체적의 변화를 통한 방광벽 두께와 기계적 재료상수 변화가 배뇨근 활동에 미치는 영향)

  • Jun, Su-Min;Lee, Moon-Kyu;Choi, Bum-Kyoo
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.5
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    • pp.584-590
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    • 2012
  • The structural and functional disorder of a detrusor induces a bladder hypertrophy and degenerates a bladder muscle gradually by preventing normal urination. Thus, the thickness of the bladder wall has been increased in proportion to the degree of bladder outlet obstruction. In this study, the mechanical characteristics of the detrusor is analyzed for the physical properties and the thickness changes of the bladder muscle using a mathematically analytic method. In order to obtain the mechanical property of the bladder muscle, the tensile test of porcine bladder tissue is performed because its property is similar to that of human. The result of tensile test is applied to the mathematically model as Mooney Rivlin coefficients which represent the hyperelastic material. The model of the bladder is defined as the spherical shape with the initial volume of 50ml. The principal stress and strain according to the thickness are analyzed. Also, computer simulations for three types of the material property for the model of the bladder are performed based on the fact that the stiffness of the bladder is weakened as the progress of the benign prostatic hyperplasia. As a result, the principal stress is 341kPa at the initial thickness of 2.2mm, and is 249kPa at 6.5mm. As the bladder wall thickness increases, the principal stress decreases. The principal stress and strain decrease as the stiffness of the bladder decreases under the same thinkness.

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

  • Lee, Hongyeul;Leem, Cho Sun;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.193-196
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    • 2014
  • Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

POSTERIOR OPEN BITE (구치부 개교)

  • Sohn, Young-Hwa;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.641-654
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    • 1995
  • The purpose of this report is to present the cause and treatment of posterior open bite. Posterior open bite is the open bite limited to posterior teeth. These problem usually are attributed to a mechanical interference with the eruption process, either ankylosis or some soft tissue interference. But, in some patient, lateral open bite is due to a disturbance of the eruptive mechanism itself and other disease or side effect following other treatment. Distinguising cause of posterior open bite, lack of eruption due to some external interference with eruption or primary failure of eruption mechanism, is important clinically because this determines the prognosis for orthodontic treatments. The characteristics, differential diagnosis with posterior open bite due to other etiologies and the treatment of these problems are presented and discussed,.

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