• Title/Summary/Keyword: Motion Technique

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Mitral Valvuloplasty using New Mitral Strip (Mitracon^{(R)}$) (새로운 Strip (Mitracon^{(R)}$)을 이용한 승모판막 성형술)

  • Kang, Seong-Sik;Kim, Sang-Pil;Song, Meong-Gum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.320-328
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    • 2008
  • Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.

Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Left Ventricular Systolic Function Improvement after Surgical Revascularization in Postinfarction Angina (급성 심근 경색 후 협심증 환자에서의 관상동맥 우회술 후 좌심실 수축 기능의 호전)

  • Yi Gi-Jong;Park Seong-Yong;Hong You-Sun;Yoo Kyung-Jong;Chang Byung-Chul;Lim Sang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.674-680
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    • 2006
  • Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.

Effects of Arc Number or Rotation Range upon Dose Distribution at RapidArc Planning for Liver Cancer (간암환자를 대상으로 한 래피드아크 치료계획에서 아크수 및 회전범위가 선량분포에 미치는 영향)

  • Park, Hae-Jin;Kim, Mi-Hwa;Chun, Mi-Son;Oh, Yeong-Teak;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.165-173
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    • 2010
  • In this paper, we evaluated the performance of 3D CRT, IMRT and three kind of RA plannings to investigate the clinical effect of RA with liver cancer case. The patient undergoing liver cancer of small volume and somewhat constant motion were selected. We performed 3D CRT, IMRT and RA plannings such as 2RA, limited triple arcs (3RA) and 3MRA with Eclipse version 8.6.15. The same dose volume objectives were defined for only CTV, PTV and body except heart, liver and partial body in IMRT and RA plannings. The steepness of dose gradient around tumor was determined by the Normal Tissue Objective function with the same parameters in place of respective definitions of dose volume objectives for the normal organs. The approach between the defined dose constraints and the practical DVH of CTV, PTV and Body was the best in 3MRA and the worst in IMRT. The DVHs were almost the same among RAs. Plans were evaluated using Conformity Index (CI), Homogeneity Index (HI) and Quality of coverage (QoC) by RTOG after prescription with dose level surrounding 98% of PTV in the respective plans. As a result, 3MRA planning showed the better favorable indices than that of the others and achieved the lowest MUs. In this study, RA planning is a technique that is possible to obtain the faster and better dose distribution than 3D CRT or IMRT techniques. Our result suggest that 3MRA planning is able to reduce the MUs further, keeping a similar or better targer dose homogeneity, conformity and sparing normal tissue than 2RA or 3RA.

A Study of the Japanese Colonial Era Rock-Carved Seated Avalokiteśvara Statue at Ganghwa Bomunsa Temple (일제강점기 강화 보문사 마애관음보살좌상 연구)

  • Lee, Jumin
    • Korean Journal of Heritage: History & Science
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    • v.53 no.3
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    • pp.62-79
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    • 2020
  • The rock-carved seated Avalokiteśvara statue at Ganghwa Bomunsa Temple is a giant rock-carved Buddhist statue that was built in 1928 during the Japanese colonial era. Although it is a year-recorded Buddhist statue that occupies a prominent place in modern Korean Buddhist sculpture history, it has not been the subject of in-depth discussion due to weak research on modern Buddhist sculptures. In this study, to examine the various significant aspects of the rock-carved Seated Avalokiteśvara statue at Bomunsa Temple as a modern Buddhist sculpture, I have managed to determine its construction year, artificers, and patrons by deciphering the inscription around the rock-carved statue; in addition I have researched the effects of the rock shapes and landforms on the formation of the Buddhist statue by comparing and analyzing the points of view of both artificers and worshipers. I have also identified the specific circumstances of the time of construction from interviews with the descendants of artificers. A monk from Geumgangsan Mountain, Lee Hwaeung, took the role of sponsor and chief painter to construct the rock-carved seated Avalokiteśvara statue at Bomunsa temple. In the beginning of its construction in 1928, more than 100 donators jointly sponsored the construction of the statue. Gansong Jeon Hyoungphil sponsored alone at the time of the place of worship's expansion in 1938. Bomunsa Temple has been regarded as one of the top-three sacred places of Avalokiteśvara Bodhisattva together with Naksansa Temple in Yang Yang and Boriam in Nam Hae, due to the construction of the rock-carved statue. It took about three months to construct the statue. Lee Hwaeung drew a rough sketch and then Un Songhag and five masons from Ganghwa Island took part in the carving process. We can observe the line drawing technique around the rock-carved statue because the statue was carved based on the rough sketch of the monk painter. The aspect of Lee Hwaeung as a painter is revealed; therefore, we can identify the clue of painting pattern leading to Seogongchulyou- Hwaunghyoungjin- Ilonghyegag. The rock-carved seated Avalokiteśvara statue at Bomunsa Temple is a typical Avalokiteśvara that wears a jeweled crown and holds Kundica. It makes a strong impression as it has a big square-shaped face and a short neck and is unsophisticated in general. The artificers solved the issue of visual distortion of the rock-carved statue caused by carving on a 10-meter high and 40-degree sloping rock by controlling motion to its maximum, omitting detailed expression by emphasizing symmetry, and adjusting the head-to-body proportion to be almost one-to-one. In this study, especially, I presume the unified form of sacred sculptures and Buddhist altars, without making a Buddhist altar like the rock-carved seated Avalokiteśvara statue at Bomunsa Temple, to be a key characteristic of modern Buddhist sculptures. Furthermore, I make newly clear that the six letters of Sanskrit carved on nimbus, which had been interpreted as a Six-Syllable Mantra, are a combination with Jeongbeopgye and Sabang Mantras. In addition, three iron rings driven on eaves rock were used as a reference point, and after construction they were used as a decoration for the Bodhisattva with hanging wind chimes.

The new explore of the animated content using OculusVR - Focusing on the VR platform and killer content - (오큘러스 VR (Oculus VR)를 이용한 애니메이션 콘텐츠의 새로운 모색 - VR 플랫폼과 킬러콘텐츠를 중심으로 -)

  • Lee, Jong-Han
    • Cartoon and Animation Studies
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    • s.45
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    • pp.197-214
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    • 2016
  • Augmented Reality, virtual reality in recently attracted attention throughout the world. and Mix them mixed reality etc., it has had a significant impact on the overall pop culture beyond the scope of science and technology. The world's leading IT company : Google, Apple, Samsung, Microsoft, Sony, LG is focusing on development of AR, VR technology for the public. The many large and small companies developed VR hardware, VR software, VR content. It does not look that makes a human a human operation in the cognitive experience of certain places or situations or invisible through Specific platforms or program is Encompass a common technique that a realization of the virtual space. In particular, out of the three-dimensional image reveals the limitations of the conventional two-dimensional structure - 180, 360 degree images provided by the subjective and objective symptoms such as vision and sense of time and got participants to select it. VR technology that can significantly induce the commitment and participation is Industry as well as to the general public which leads to the attention of colostrum. It was introduced more than 10 related VR works Year 2015 Sundance Film Festival New Frontier program. The appearance VR content : medical, architecture, shopping, movies, animations. Also, 360 individuals can be produced by the camera / video sharing VR is becoming an interactive tunnel between two possible users. Nevertheless, This confusion of values, moral degeneration and the realization of a virtual space that has been pointed out that the inherent. 4K or HUD, location tracking, motion sensors, processing power, and superior 3D graphics, touch, smell, 4D technology, 3D audio technology - It developed more than ever and possible approaches to reality. Thereafter, This is because the moral degeneration, identity, generational conflict, and escapism concerns. Animation is also seeking costs in this category Reality. Despite the similarities rather it has that image, and may be the reason that the animation is pushed back to the VR content creation. However, it is focused on the game and VR technology and the platform that is entertaining, but also seek new points within the animation staying in the flat Given that eventually consist of visual images is clear that VR sought. Finally, What is the reality created in the virtual space using VR technology could be applied to the animation? So it can be seen that the common interest is research on what methods and means applied.

Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder - A Minimum Three-Year Follow-up Study - (심한 회전근 개 부전을 동반한 환자에 대한 역형 견관절 전치환술 - 최소 3년 추시 결과 -)

  • Kim, Myung-Sun;Yeo, Je-Hyoung
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.73-83
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    • 2013
  • Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency. Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications. Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from $42.7(10{\sim}100)^{\circ}$ to $129.1(110{\sim}180)^{\circ}$. In addition, ASES score improved from preoperative 32.9 (11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery was performed in two cases for treatment of delayed postoperative deep infection. Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to delayed deep infection or surgeon's technique, RTSA should be judiciously and carefully indicated by expert surgeons.

A Biomechanical Study on a New Surgical Procedure for the Treatment of Intertrochanteric Fractures in relation to Osteoporosis of Varying Degrees (대퇴골 전자간 골절의 새로운 수술기법에 관한 생체역학적 분석)

  • 김봉주;이성재;권순용;탁계래;이권용
    • Journal of Biomedical Engineering Research
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    • v.24 no.5
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    • pp.401-410
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    • 2003
  • This study investigates the biomechanical efficacies of various cement augmentation techniques with or without pressurization for varying degrees of osteoporotic femur. For this study, a biomechanical analysis using a finite element method (FEM) was undertaken to evaluate surgical procedures, Simulated models include the non-cemented(i.e., hip screw only, Type I), the cement-augmented(Type II), and the cemented augmented with pressurization(Type III) models. To simulate the fracture plane and other interfacial regions, 3-D contact elements were used with appropriate friction coefficients. Material properties of the cancellous bone were varied to accommodate varying degrees of osteoporosis(Singh indices, II∼V). For each model. the following items were analyzed to investigate the effect surgical procedures in relation to osteoporosis of varying degrees : (a) von Mises stress distribution within the femoral head in terms of volumetric percentages. (b) Peak von Mises stress(PVMS) within the femoral head and the surgical constructs. (c) Maximum von Mises strain(MVMS) within the femoral head, (d) micromotions at the fracture plane and at the interfacial region between surgical construct and surrounding bone. Type III showed the lowest PVMS and MVMS at the cancellous bone near the bone-construct interface regardless of bone densities. an indication of its least likelihood of construct loosening due to failure of the host bone. Particularly, its efficacy was more prominent when the bone density level was low. Micromotions at the interfacial surgical construct was lowest in Type III. followed by Type I and Type II. They were about 15-20% of other types. which suggested that pressurization was most effective in limiting the interfacial motion. Our results demonstrated the cement augmentation with hip screw could be more effective when used with pressurization technique for the treatment of intertrochanteric fractures. For patients with low bone density. its effectiveness can be more pronounced in limiting construct loosening and promoting bone union.

Computer Aided Diagnosis System for Evaluation of Mechanical Artificial Valve (기계식 인공판막 상태 평가를 위한 컴퓨터 보조진단 시스템)

  • 이혁수
    • Journal of Biomedical Engineering Research
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    • v.25 no.5
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    • pp.421-430
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    • 2004
  • Clinically, it is almost impossible for a physician to distinguish subtle changes of frequency spectrum by using a stethoscope alone especially in the early stage of thrombus formation. Considering that reliability of mechanical valve is paramount because the failure might end up with patient death, early detection of valve thrombus using noninvasive technique is important. Thus the study was designed to provide a tool for early noninvasive detection of valve thrombus by observing shift of frequency spectrum of acoustic signals with computer aid diagnosis system. A thrombus model was constructed on commercialized mechanical valves using polyurethane or silicon. Polyurethane coating was made on the valve surface, and silicon coating on the sewing ring of the valve. To simulate pannus formation, which is fibrous tissue overgrowth obstructing the valve orifice, the degree of silicone coating on the sewing ring varied from 20%, 40%, 60% of orifice obstruction. In experiment system, acoustic signals from the valve were measured using microphone and amplifier. The microphone was attached to a coupler to remove environmental noise. Acoustic signals were sampled by an AID converter, frequency spectrum was obtained by the algorithm of spectral analysis. To quantitatively distinguish the frequency peak of the normal valve from that of the thrombosed valves, analysis using a neural network was employed. A return map was applied to evaluate continuous monitoring of valve motion cycle. The in-vivo data also obtained from animals with mechanical valves in circulatory devices as well as patients with mechanical valve replacement for 1 year or longer before. Each spectrum wave showed a primary and secondary peak. The secondary peak showed changes according to the thrombus model. In the mock as well as the animal study, both spectral analysis and 3-layer neural network could differentiate the normal valves from thrombosed valves. In the human study, one of 10 patients showed shift of frequency spectrum, however the presence of valve thrombus was yet to be determined. Conclusively, acoustic signal measurement can be of suggestive as a noninvasive diagnostic tool in early detection of mechanical valve thrombosis.

Evaluation of Image Quality for 2D TSE(RT) and 3D GRASE in MRCP Study: Fast MRCP Method (췌담관자기공명영상에서 2D TSE(RT)와 3D GRASE(BH) 기법에 대한 영상의 질 평가 : Fast MRCP 기법)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.983-989
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    • 2021
  • In this study, we intend to evaluate image quality and provide to clinical basic data by applying to 2D TSE (RT) and 3D GRASE (BH) techniques using Fast MRCP testing methods for application to patients in poor patient condition. Data were analyzed for 30 patients (15 males, 15 females, and 64±4.26 average age) who underwent MRCP tests. The equipment used was Ingenia CX 3.0 T equipment and Ds anterior coil was used for data acquisition. SNR and CNR of each image were measured through quantitative analysis, and the quality of the image was evaluated by dividing it into 5 grades for qualitative evaluation. The image evaluation was performed on the paired t-test and the Wilcoxon test, and when the p value was 0.05 or less, it was considered to be significant. As a result of quantitative analysis of SNR and CNR, 3D GRASE (BH) was measured high when comparing the two techniques, 2D TSE (RT) MRCP and 3D GRASE (BH) (p<0.05). The qualitative analysis result is a sharpness of the bile duct: 3D GRASE(BH): 4.12±0.03, Overall image quality: 3D GRASE(BH): 4.21±0.91 was high (p=0.001). The motion artifact of the bile duct showed no significant difference with two techniques(2D TSE(RT): 4.41±0.04, 3D GRASE(BH): 4.53±0.14(p=0.067). However, the background suppression obtained significant results with 2D TSE(RT) of 4.14±0.55(p=0.001). In conclusion, as a result of using the Fast MRCP testing method, MRCP images obtained by 3D GRASE (BH) had an advantage over MRCP images using 2D TSE (RT). However, there will be useful results of 2D TSE(RT) MRCP technique in patients who have difficulty holding their breath.