• 제목/요약/키워드: Mechanical obstruction

검색결과 88건 처리시간 0.032초

도플러 초음파를 이용한 인공판막 상하의 압력차 측정에 관한 연구 -승모판막 치환에 사용한 Duromedics 인공판막과 정사인의 승모판막과의 비교연구- (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-)

  • 진성훈;서경필
    • Journal of Chest Surgery
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    • 제20권2호
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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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    • 제72권6호
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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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    • 제2권1호
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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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기어형 높이 조절식 맨홀 개발 (Development of a Gear-shaped Manhole with Height Adjustment)

  • 김창호;박준홍;최정일
    • 한국산업융합학회 논문집
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    • 제7권1호
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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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높이 조절식 맨홀 개발에 관한 연구 (A Study on Development of a Manhole with Height Adjustment)

  • 김창호;박준홍
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2004년도 춘계학술대회
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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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수막을 가지는 선형 젖음성 패턴 표면에서의 액적 거동 특성 (The Behavioral Characteristics of a Droplet on the Line Patterned Surface Including Water Film)

  • 이창우;박진영;조한동;황운봉
    • 한국정밀공학회지
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    • 제30권12호
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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.

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

  • 안영준;이승현;김효빈;박성종;고태성;홍수종
    • Clinical and Experimental Pediatrics
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    • 제48권4호
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    • pp.401-405
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    • 2005
  • 목 적 : 급성 호흡부전증, 호흡중추장애, 신경근 질환 등으로 인한 만성 호흡부전 환자들이 가정용 인공 호흡기의 도입으로 가정에서 기계 환기를 받을 수 있게 되어 생명을 연장시키고, 삶의 질을 향상시킬 수 있어 그 사용하는 예가 증가하고 있다. 그러나 이에 대한 임상자료가 거의 없어 저자들은 인공 호흡기를 장착한 환아들을 대상으로 임상실태를 조사하였다. 방 법 : 1997년부터 2003년까지 서울아산병원 소아 중환자실에 입원 후 가정용 인공 호흡기를 장착한 21명의 환아들을 대상으로 하여 후향적으로 의무기록을 분석하고 전화면담을 시행하였다. 결 과 : 대상 환아들은 21명으로 남아 15명, 여아 6명이었다. 인공 호흡기를 장착하였을 때 중간 연령은 31개월(범위 : 2-150개월)이었으며, 호흡기를 장착한 중간 기간은 25개월(범위 : 2-68개월)이었다. 환아들의 원인 질환으로는 호흡중추장애를 포함한 신경근 질환이 16례, 급성 호흡곤란을 포함한 폐질환이 4례, 유전성 대사질환이 1례였다. 인공 호흡기 양식은 압력 조절 양식이 16례(76%), 용적 조절 양식이 5례(24%), 산소가 필요한 경우는 13례(62%)였고, 인공 호흡기를 조금이라도 이탈할 수 있었던 경우는 3례(14%)였다. 기계고장은 19개월마다 1회 발생하였고, 인공 호흡기 장착 후 평균 입원 횟수는 매년 1.7회, 그 원인으로는 폐렴(68%)이 가장 많았다. 추적 관찰한 결과 사망한 환아는 9명(43%)이었고, 사망원인은 기관지 튜브 폐쇄가 4례였다. 인공 호흡기 대여, 산소발생기, 영양식, 진찰 및 치료비용 등을 포함한 모든 의료비용은 월간 평균 111만원이었다. 결 론 : 최근 가정용 인공 호흡기 사용이 증가하고 있으며, 사망원인으로 기관지 튜브 폐쇄가 많아 주의 및 관리를 필요로 하고 인공 호흡기를 장착한 가정에 경제적 어려움이 있어 사회적 관심과 제도적 지원이 필요할 것으로 사료된다.

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

  • 전수민;이문규;최범규
    • 한국정밀공학회지
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    • 제29권5호
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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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    • 제77권4호
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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.

구치부 개교 (POSTERIOR OPEN BITE)

  • 손영화;장영일
    • 대한치과교정학회지
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    • 제25권5호
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    • pp.641-654
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    • 1995
  • 수직적인 문제는 심한 과개 교합에서 심한 정도의 개교에 이르기까지 다양하다. 구치와 전치의 맹출, 하악지와 하악체의 성장, 기저골과 치조골의 성장, 근육및 습관 활동의 동시적인 상호 작용이 궁극적인 수직 관계를 결정한다. '개교'라 함은 다른 치아가 최대 감합위에 있을 때, 어떤 대합치가 교합되지 않는 것이라 정의할 수 있다. 구치부 개교는 종종 치조골과 치아 맹출과 관련되어 있으며, 대부분 습관과 같은 연조직 장애나 유착등 맹출 과정중의 기계적 장애에 기인한다고 생각되어 왔으나, 때로 맹출 기전 자체의 이상에 의할 수도 있다. 몇 개의 증례 제시와 함께 구치부 개교의 원인과 치료에 대해 생각해 보고자 한다.

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