• Title/Summary/Keyword: radial pulse

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A Brachial Artery Pseudoaneurysm Treated with a Bifurcated Y-Shaped Artificial Vessel Graft

  • Joon seok Oh;Seokchan Eun
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.755-759
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    • 2022
  • Brachial artery aneurysms are rare diseases that may be caused by infection or trauma. We report a case of a 71-year-old man who presented with a mass in his right antecubital fossa that increased in size slowly over time. Three years ago, the patient underwent ascending and total-arch replacement with artificial vessel graft to treat aortic root and ascending aorta aneurysm. Preoperative physical examination of right upper extremity showed a nonpulsatile mass with normal pulse of axillary, brachial, and radial arteries. The mass was removed and brachial artery reconstruction was done initially using saphenous vein graft. Two months later, the patient revisited with recurrent pseudoaneurysm, involving the bifurcation point of brachial artery. Aneurysm was totally resected and the brachial artery was reconstructed by interposition graft using a bifurcated GORE-TEX artificial vessel graft. The patient healed without complication and no recurrence was observed. Artificial vessel graft is an available option for reconstruction, and revascularization of vessel defect after excision of brachial artery aneurysm may involve bifurcation point.

Case of the Anti-Type 2 Diabetes Effects on the Prescription of Red Onion (한약과 자색양파 제재로 호전된 제2형 당뇨병 42례 보고)

  • Lee, Jeong Won;Kim, Yi Soon;Kim, Chang Tae;Kwak, Yi Sub;Lee, Hai Woong;Han, Cho Ryang;Oh, Mi Jung;Kim, Gyeong Cheol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.4
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    • pp.465-470
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    • 2013
  • The purpose of this study is to observe clinically the effects of red onion prescription on type 2 diabetes. The subject of this study were middle-aged people. We measured clinically physiological index, body composition, radial arterial pulse wave before taking medicine and after taking medicine for 4 month (the prescription of red onion). The study results were as follows. In physiological Index, diastolic blood pressure(mmHg)(p<0.001), Fasting blood glucose(mg/dL)(p=0.001), and HbA1c(%)(p<0.001) were decreased significantly after taking medicine. In body Composition, waist-hip ratio(p=0.031), body fat percentage(p=0.006), fat mass(kg)(p=0.005), and muscle mass(kg)(p=0.001) were decreased significantly after taking medicine. Blood Circulation Index, ECO(L/min)(p=0.038) and ECI($L/min/m^2$)(p=0.007) were increased significantly after taking medicine, ECR($dyne^*sec^*cm^{-5}$)(p=0.002), and ECRI($dyne^*sec/cm$)(p=0.001) were decreased significantly after taking medicine for 4 month. The prescription of red onion was showed significant change in physiological index, character of body composition, blood circulation index. Based on this result, it is considered that red onion prescription has the positive effects on type 2 diabetes and blood circulation clinically. In the future, diversified studies on the effects of red onion prescription are needed.

Content and Educational Needs for Fundamental Nursing Practice (기본간호실습 교육 현황 및 실습교육 필요도)

  • Kim, Kyung-Hee;Chang, Sung-Ok;Kang, Hyun-Sook;Kim, Keum-Soon;Kim, Jong-Im;Kim, Hwa-Soon;Park, Jin-Hee;Eom, Mi-Ran;Youn, Mi-Sun;Lee, Og-Cheol;Won, Jong-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.4
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    • pp.506-519
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    • 2011
  • Purpose: The purpose of this study was to identify content of Fundamental Nursing Practice (FNP) and the educational needs for nursing practice items in schools of nursing. Methods: Participants were 81 professors who were teaching FNP and 166 clinical nurses. The research questionnaire included 148 practice items, which were selected by content analysis of 7 FNP textbooks. Data were collected from May 20 to July 27, 2011 and analyzed using descriptive statistics and t-test with SPSS 17.0. Results: The research findings showed that : 1) the seven items included in the education content of all schools of nursing were putting on sterile gloves, checking radial pulse, checking blood pressure in the arm, Foley catheterization, injection preparation with ampule, intramuscular injection in the buttocks, and mixing intravenous fluid. Fifty items were included in the content in more than 80% of the schools. 2) Educational domains needing emphasis were medication, infection control, health assessment, oxygenation, urinary elimination, activity/positioning, and nutrition. There were significant differences in reported educational needs between professors and clinical nurses for 62.8% of practice items. Conclusions: Results indicated that standardization of FNP education contents using the findings of this study should lead to improvement in quality of FNP education.

Surgical Treatment of Left Subclavian Aneurysm -A case report- (Subclavian artery 의 동맥류 -1예 수술 경험-)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Khil Rho;Kim, Song Myung
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.245-250
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    • 1976
  • A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

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Stability of the growth process at pulling large alkali halide single crystals

  • V.I. Goriletsky;S.K. Bondarenko;M.M. Smirnov;V.I. Sumin;K.V. Shakhova;V.S. Suzdal;V.A. Kuznetzov
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.13 no.1
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    • pp.5-14
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    • 2003
  • Principles of a novel pulse growing method are described. The method realized in the crystal growing on a seed from melts under raw melt feeding provided a more reliable control of the crystallization process when producing large alkali halide crystals. The slow natural convection of the melt in the crucible at a constant melt level is intensified by rotating the crucible, while the crystal rotation favors a more symmetrical distribution of thermal stresses over the crystal cross-section. Optimum rotation parameters for the crucible and crystal have been determined. The spatial position oi the solid/liquid phase interface relatively to the melt surface, heaters and the crucible elements are considered. Basing on that consideration, a novel criterion is stated, that is, the immersion extent of the crystallization front (CF) convex toward the melt. When the crystal grows at a <> CF immersion, the raised CF may tear off from the melt partially or completely due to its weight. This results in avoid formation in the crystal. Experimental data on the radial crystal growth speed are discussed. This speed defines the formation of a gas phase layer at the crystal surface. The layer thickness il a function of time a temperature at specific values of pressure in the furnace and the free melt surface dimensions in the gap between the crystal and crucible wall. Analytical expressions have been derived for the impurity component mass transfer at the steady-state growth stage describing two independent processes, the impurity mass transfer along the <> path and its transit along the <> one. The heater (and thus the melt) temperature variation is inherent in any control system. It has been shown that when random temperature changes occur causing its lowering at a rate exceeding $0.5^{\circ}C/min$, a kind of the CF decoration by foreign impurities or by gas bubbles takes place. Short-term temperature changes at one heater or both result in local (i.e., at the front) redistribution of the preset axial growth speed.

Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

Development of Automatic Sorting System for Black Plastics Using Laser Induced Breakdown Spectroscopy (LIBS) (LIBS를 이용한 흑색 플라스틱의 자동선별 시스템 개발)

  • Park, Eun Kyu;Jung, Bam Bit;Choi, Woo Zin;Oh, Sung Kwun
    • Resources Recycling
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    • v.26 no.6
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    • pp.73-83
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    • 2017
  • Used small household appliances have a wide variety of product types and component materials, and contain high percentage of black plastics. However, they are not being recycled efficiently as conventional sensors such as near-infrared ray (NIR), etc. are not able to detect black plastic by types. In the present study, an automatic sorting system was developed based on laser-induced breakdown spectroscopy (LIBS) to promote the recycling of waste plastics. The system we developed mainly consists of sample feeder, automatic position recognition system, LIBS device, separator and control unit. By applying laser pulse on the target sample, characteristic spectral data can be obtained and analyzed by using CCD detectors. The obtained data was then treated by using a classifier, which was developed based on artificial intelligent algorithm. The separation tests on waste plastics also were carried out by using a lab-scale automatic sorting system and the test results will be discussed. The classification rate of the radial basis neural network (RBFNNs) classifier developed in this study was about > 97%. The recognition rate of the black plastic by types with the automatic sorting system was more than 94.0% and the sorting efficiency was more than 80.0%. Automatic sorting system based on LIBS technology is in its infant stage and it has a high potential for utilization in and outside Korea due to its excellent economic efficiency.

THE CURRENT STATUS OF BIOMEDICAL ENGINEERING IN THE USA

  • Webster, John G.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.27-47
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    • 1992
  • Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

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Projection-type Fast Spin Echo Imaging (프로젝션 타입 고속 스핀 에코 영상)

  • 김휴정;김치영;김상묵;안창범
    • Investigative Magnetic Resonance Imaging
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    • v.4 no.1
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    • pp.42-51
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    • 2000
  • Purpose: Projection-type Fast Spin Echo (PFSE) imaging is robust to patient motion or flow related artifact compared to conventional Fast Spin Echo (FSE) imaging, however, it has difficulty in controlling $T_2$ contrast. In this paper, Tz contrast in the PFSE method is analyzed and compared with those of the FSE method with various effective echo times by computer simulation. The contrasts in the FSE and PFSE methods are also compared by experiments with volunteers. From the analysis and simulation, it is shown that ${T_2}-weighted$ images can well be obtained by the PFSE method proposed. Materials and methods: Pulse sequence for the PFSE method is implemented at a 1.0 Tesla whole body MRI system and $T_2$ contrasts in the PFSE and FSE methods are analyzed by computer simulation and experiment with volunteers. For the simulation, a mathematical phantom composed of various $T_2$ values is devised and $T_2$ contrast in the reconstructed image by the PFSE is compared to those by the FSE method with various effective echo times. Multi-slice ${T_2}-weighted$ head images of the volunteers obtained by the PFSE method are also shown in comparison with those by the FSE method at a 1.0 Tesla whole body MRI system. Results: From the analysis, $T_2$ contrast by the PFSE method appears similar to those by the FSE method with the effective echo time in a range of SO-lOOms. Using a mathematical phantom, contrast in the PFSE image appears close to that by the FSE method with the effective echo time of 96ms. From experiment with volunteers, multi-slice $T_2-weighted$ images are obtained by the PFSE method having contrast similar to that of the FSE method with the effective echo time of 96ms. Reconstructed images by the PFSE method show less motion related artifact compared to those by the FSE method. Conclusion: The projection-type FSE imaging acquires multiple radial lines with different angles in polar coordinate in k space using multiple spin echoes. The PFSE method is robust to patient motion or flow, however, it has difficulty in controlling $T_2$ contrast compared to the FSE method. In this paper, it is shown that the PFSE method provides good $T_2$ contrast (${T_2}-weighted$ images) similar to the FSE method by both computer simulation and experiments with volunteers.

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