• Title/Summary/Keyword: clinical device

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Postcardiotomy Ventricular Support with Biomedicus Pump (Biomedicus pump를 이용한 개심술후 심실보조)

  • Kim, Won-Gon;Lee, Chang-Ha;Kim, Ki-Bong;Ahn, Hyuk;Rho, Ryang-Joon
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1218-1222
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    • 1996
  • The reported incidence of postcardiotomy cardiogenic shock not responding to conventional therapy is still 0.1 to 0.8%. For this group of patients, more aggressive form of circulatory support must be employed. Centrifugal pumps are a ventricular assist device most commonly used on this purpose, due to low cost and easy availability. Currently, however, clinical experience of centrifugal pumps as a ventricular assist device is rarely reported in Korea. From January 1992 to January 1996, 2986 patients underwent cardiac operations on cardiopulmonary bypass at Seoul National University Hospital. Refractory postcardiotomy cardiac failure requring ventricular support with a Biomedicus centrifugal pump developed in ten of these patients. There were eight men and two women, ranged in age from nine years to 77 years with a mean of 50$\pm$20 years. The primary surgical procedures consisted of isolated coronary revascularization in four patients, combined coronary revascularization and aortic valve replacement in two, aortic dissection repair in two, pulmonary embolectomy in one, and heart transplantation in one. Of the ten patients, five had left ventricular assistance, one had right ventricular assistance, and four had biventricular assistance. Duration of ventricular assistance ranged from 24 to 175 hours, with a mean of 76$\pm$51 hours. Seven patients were weaned from ventricular assistance, and four of them discharged. The causes of death for nonsurvivors were progressive cardiac failure in two patients and multiorgan failure, intractable ventricular fibrillation, irreversible brain injury, and mechanical problem, respectively, in the other four. Survival was not predicted by time on cardiopulmonary bypass, aortic cross-clamp time, or duration of ventricular support. Major complications included bleeding(7), renal failure(6), infection(3) and neurologic complication(2). These results indicate that a centrifugal pump can provide reasonably satisfactory short-term circulatory support.

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Clinical Application of Dose Reconstruction Based on Full-Scope Monte Carlo Calculations: Composite Dose Reconstruction on a Deformed Phantom (몬테칼로 계산을 통한 흡수선량 재구성의 임상적 응용: 변형된 팬텀에서의 총제적 선량재구성)

  • Yeo, Inhwan;Xu, Qianyi;Chen, Yan;Jung, Jae Won;Kim, Jong Oh
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.139-142
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    • 2014
  • The purpose of this study was to develop a system of clinical application of reconstructed dose that includes dose reconstruction, reconstructed dose registration between fractions of treatment, and dose-volume-histogram generation and to demonstrate the system on a deformable prostate phantom. To achieve this purpose, a deformable prostate phantom was embedded into a 20 cm-deep and 40 cm-wide water phantom. The phantom was CT scanned and the anatomical models of prostate, seminal vesicles, and rectum were contoured. A coplanar 4-field intensity modulated radiation therapy (IMRT) plan was used for this study. Organ deformation was simulated by inserting a "transrectal" balloon containing 20 ml of water. A new CT scan was obtained and the deformed structures were contoured. Dose responses in phantoms and electronic portal imaging device (EPID) were calculated by using the XVMC Monte Carlo code. The IMRT plan was delivered to the two phantoms and integrated EPID images were respectively acquired. Dose reconstruction was performed on these images using the calculated responses. The deformed phantom was registered to the original phantom using an in-house developed software based on the Demons algorithm. The transfer matrix for each voxel was obtained and used to correlate the two sets of the reconstructed dose to generate a cumulative reconstructed dose on the original phantom. Forwardly calculated planning dose in the original phantom was compared to the cumulative reconstructed dose from EPID in the original phantom. The prescribed 200 cGy isodose lines showed little difference with respect to the "prostate" and "seminal vesicles", but appreciable difference (3%) was observed at the dose level greater than 210 cGy. In the rectum, the reconstructed dose showed lower volume coverage by a few percent than the plan dose in the dose range of 150 to 200 cGy. Through this study, the system of clinical application of reconstructed dose was successfully developed and demonstrated. The organ deformation simulated in this study resulted in small but observable dose changes in the target and critical structure.

HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.404-416
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    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

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Blood Pressure of Healthy Newborns in the First Week of Life (분당 차병원에서 출생한 신생아 혈압치 비교)

  • Lee Jung-Sun;Park Shin-I;Park Hye-Won;Kim Se-Hyun;Hah Tae-Sun;Lee Jun-Ho
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.8-14
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    • 2005
  • Purpose : This study was peformed to study normative blood pressure data in full-term neonates that may be used to facilitate Identification of neonatal hypertension.Methods : 383 newborns born in our hospital from May 2003 to January 2004 were enrolled in this study Using an oscillometric device(BP-88 NEXT, COLIN Corp.), their blood pressures were measured more than one time within a week after birth. According to each clinical variable such as sex, delivery mode, birth weight, gestational age and presence of maternal disease or perinatal problems, we divided the population into groups and calculated the mean blood pressures of each group. We compared mean blood pressures between the divided groups according to each clinical variable statistically.Results : Mean systolic and diastolic blood pressure of the Population was 70.8$\pm$ 10.9 mmHg and 43.4 $\pm$ 8.0 mmHg, respectively. There was no satistically significant difference in blood pressure according to clinical variables. Mean systolic pressure showed positive correlation with birth weight and gestational age(r=0.1420, 0.03130).Conclusion : Our results are almost in agreement with Zubrow's data from 695 newborns in U.S.A, 1995. Our data may be helpful for early detection and management of neonatal hypertension, thereby maintaining renal function ,and preventing possible complications of renal disease.

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Evaluation of Bone Change by Digital Subtraction Radiography after Implantation of Tooth Ash-plaster Mixture (치아회분과 석고혼합제제 매식후 Digital Subtraction Radiography에 의한 골량 변화의 평가)

  • Kim Jae-Duk;Kim Kwang-Won;Cho Yaung-Gon;Kim Dong-Kie;Choi Eui-Hwan
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.423-433
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    • 1999
  • Purpose : To assess the methods for the clinical evaluation of the longitudinal bone changes after implantation of tooth ash-plaster mixture into the defect area of human jaws. Materials and methods : Tooth ash-plaster mixtures were implanted into the defects of 8 human jaws. 48 intraoral radiograms taken with copper step wedge as reference at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture were used. X-ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner were digitized and analyzed by NIH image program. Cu­equivalent values were measured at the implanted sites from the periodic digital images. Analysis was performed by the bidirectional subtraction with color enhancement and the surface plot of resliced contiguous image. The obtained results by the two methods were compared with Cu­equivalent value changes. Results : The average determination coefficient of Cu-equivalent equations was 0.9988 and the coefficient of variation of measured Cu values ranged from 0.08~0.10. The coefficient of variation of Cu-equivalent values measured at the areas of the mixture and the bone by the conversion equation ranged from 0.06 ~0.09. The analyzed results by the bidirectional subtraction with color enhancement were coincident with the changes of Cu-equivalent values. The surface plot of the resliced contiguous image showed the three dimensional view of the longitudinal bone changes on one image and also coincident with Cu-equivalent value changes after implantation. Conclusion : The bidirectional subtraction with color enhancement and the surface plot of the resliced contiguous image was very effective and reasonable to analyze clinically and qualitatively the longitudinal bone change. These methods are expected to be applicable to the non-destructive test in other fields.

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Effect of Post Insemination Progesterone Supplement on Pregnancy Rates of Repeat Breeder Friesian Cows

  • Ababneh, Mohammed M.;Alnimer, Mufeed A.;Husein, Mustafa Q.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.11
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    • pp.1670-1676
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    • 2007
  • Fifty repeat breeder (RB) Friesian cows were allocated to five groups of 10 cows each, to determine the effect of progesterone (P4) supplement on P4 concentrations and pregnancy rates during the periods of corpus luteum (CL) formation and development between days 2-7 and 7-12 following a spontaneous or $PGF_{2{\alpha}}$-induced estrus. Cows were artificially inseminated during $PGF_{2{\alpha}}$-induced (PGF-P4-d2 and PGF-P4-d7 groups) or spontaneous (S-P4-d2, S-P4-d7, and control groups) estrus. Progesterone-releasing intravaginal device (PRID) devoid of estrogen capsule were inserted either on d 2 (PGF-P4-d2 and S-P4-d2 groups) or d 7 (PGF-P4-d7 and S-P4-d7 groups) post-insemination and left in place for 5 days. Control cows did not receive any treatment. Blood samples were collected for progesterone analysis from all cows once daily for 4 days starting on the day of estrus (d 0) and once every 3 days thereafter until d 22. Progesterone treatment by day interaction accounted for higher plasma P4 in treated than non-treated control cows. Progesterone concentrations differed significantly (p<0.05) during metestrus (d 2 to d 7) but not during diestrus (d 7 to d 12). $PGF_{2{\alpha}}$ treatment, lactation number, service number or their interactions did not affect progesterone concentrations and pregnancy rates. Therefore, cows were grouped according to the day of P4 supplement irrespective of the $PGF_{2{\alpha}}$ treatment. Progesterone supplement on d 7 but not d 2 significantly increased (p<0.03) pregnancy rates in repeat breeding cows with four or more previous services but not in cows in their third service. In conclusion, post-insemination P4 supplement to repeat breeding cows with four or more previous services improved pregnancy rates and should be advocated when no specific reason for infertility is diagnosed. Further studies with larger numbers of repeat breeding cows under field conditions are needed to ascertain the findings of this study.

CLINICAL STUDY OF SENSORY ALTERATIONS AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상분할 절단술 후 감각 변화에 관한 연구)

  • Choi, Jun-Young;Yoo, Jun-Yeol;Yoon, Bo-Keun;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.141-148
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    • 2010
  • The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

The effects of salivary contamination on tensile bond strength of resin modified glass ionomer cements in bonding brackets (브라켓 접착시 타액 오염이 레진 강화형 글래스 아이오노머 시멘트의 인장 접착 강도에 미치는 영향)

  • Lee, Kyoung-A;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.83-89
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    • 2000
  • The purposes of this study were to evaluate clinical applicability of resin modified glass ionomer cements and to determine the effect of salivary contamination on the tensile bond strength. Fourty extracted human permanent premolars were prepared lot bonding and standard edgewise brackets were bonded with Ortho-One, Fuji Ortho LC, Vitremer and Advance. Fourty extracted human permanent premolars were contaminated with saliva, dried and bonded with same materials above. The tensile bond strength was tested by Instron testing device aster storage in normal saline at ,$37^{\circ}C$ for 24 hours from bonding. The results were as follows : 1. The tensile bond strength of Ortho-One group was $7.68\pm1.76$, Advance group was $7.87\pm2.80$, Fuji Ortho LC group was $4.99\pm2.53$, Vitremer group was $2.80\pm0.88$ MPa. The tensile bond strength in contaminated condition of Ortho-One group was $4.12\pm1.67$, Advance group was $5.37\pm0.68$, Fuji Ortho LC group was $4.41\pm1.61$, Vitremer group was $2.60\pm1.10$ Mpa. 2. Salivary contamination did not affect the tensile bond strength when compared with the uncontaminated enamel group in Fuji Ortho LC and Vitremer (p>0.05) and there was great significant difference in the tensile bond strength of Ortho-One and Advance. 3. Advance, Ortho-One and Fuji Ortho LC seemed to have clinically a proper bond strength.

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Frontal Cephalogram Study on The Natural Head Position of Facial Asymmetry Patients (안면비대칭 환자의 natural head position에 대한 정모두부방사선사진 연구)

  • Kim, Hyun;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.535-542
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    • 2000
  • The purpose of this study was to find the characteristics of the frontal natural head position(NHP) of patients with facial asymmetry, and to contribute to the diagnosis of facial asymmetry in the clinical examination of orthodontic patients. Twenty adult patients who had apparent facial asymmetry and no severe sagittal skeletal discrepancy were selected as the asymmetry group, and 21 young adults who had symmetric faces were selected as the symmetry group. Frontal cephalograms were obtained in the state of NHP using a pivot-mounted fluid level device. The degree of the menton deviation was defined as the angle between the line drawn through crista galli and anterior nasal spine and the line drawn through crista galli and menton. The following angles were measured and each of them was compared with the degree of the menton deviation one is the angle between the true vertical line and the supra-orbital line which is a tangent line to the extreme cranial point on the supra-orbital margin, and the other is the angle between the true vertical line and the cervical line drawn through the midpoint of atlas and the 4th cervical vertebra. Through the statistical analysis, following results were obtained. 1. The angle between the supra-orbital line and the true vertical line was much mote deviated from the right angle in the asymmetry group than in the symmetry group. 2. The angle between the cervical line and the true vertical line in the asymmetry group showed greater tendency than in the symmetry group, but the difference was not statistically significant. 3. In the asymmetry group, the degree of the menton deviation was positively correlated with the angle between the supraorbital line and the true vertical line. The above results suggest that racial asymmetry patients show the tendency to have the tilted NHP to compensate the deviation of menton position.

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Diagnosis of Diabetes Using Voltage Analysis Based on EIS (Electro Interstitial Scan) (EIS 기반 전압신호 분석을 통한 당뇨병 진단 가능성 평가)

  • Bae, Jang-Han;Kim, Soochan;Kaewkannate, Kanitthika;Jun, Min-Ho;Kim, Jaeuk U.
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.11
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    • pp.114-122
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    • 2016
  • EIS (Electro interstitial scan) is a non-invasive and simple method to find the physio-pathological information inferred by electric current response with respect to low direct current applied between remote sites of the body. Although a few EIS-based devices for diagnosing diabetes were commercialized, they were not successful in offering clinical validity nor in confirming diagnostic principle. In this study, we measured the voltage responses of diabetic patients and normal subjects with a commercialized EIS device to test the usefulness of EIS in screening diabetes. For this purpose, voltage was measured between pairs of electrodes contacted at both palm, both soles of the feet and left and right forehead above both eyes. After feature extraction of voltage signals, the AUC (area under the curve) between the two groups was calculated and we found that seven variables were appropriately shown above 60% of accuracy. In addition, we applied the k-NN (k-nearest neighbors) method and found that the accuracy of classification between the two groups reached the accuracy of 76.2%. This result implies that the voltage response analysis based on EIS has potential as a diabetics screening method.