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CT영상에 기반한 복부대동맥과 장골동맥 분기관 모델의 혈류유동 해석
홍이송,김민철,강현민,이종선,김찬중,이종민,김대수,이건,Hong Y. S.,Kim M. C.,Kang H. M.,Lee C. S.,Kim C. J.,Lee J. M.,Kim D. S.,Lee K. 대한의용생체공학회 2004 의공학회지 Vol.25 No.6
건강한 정상인의 복부대동맥과 장골동맥 분기관의 다이콤 의료 영상으로부터 구성된 혈관 모델을 대상으로 전산혈류해석을 수행하였다. 본 연구에서는 CT로 촬영한 혈관영상으로부터 단면영상을 읽고 각 단면의 경계 좌표를 매끄럽게 추출하는 프로그램을 개발하여 적응하였다. 해석용 3차원 메쉬 생성과 혈류해석은 상용프로그램을 사용하였다. 해석을 통해 얻어진 압력, 속도 및 유량 분포는 정상인의 생리학적 범위 내에 있었다. 초음파로 측정된 장골동맥 중심부의 심장 수축기 속도는 해석에 비해 20% 정도 작은 값을 보였으며 한 주기 동안 속도 변화의 경향은 유사하였다. 본 연구의 접근방법은 환자 개인의 실제 혈관 형상에 기반한 혈류해석으로서 좁아진 동맥 또는 시술 될 동맥에서의 압력, 속도값, 속도분포에 대한 정보를 제공한다. 이 결과는 의사로 하여금 환자의 혈류역학적 변수의 변화를 파악하게 하여 환자의 상태를 더 잘 이해하고 수술의 필요성을 판단하도록 도움을 줄 수 있으며 나아가 혈관 수술의 기초자료로 사용될 수 있을 것이다. 이 연구는 향후 동맥경화와 밀접히 연관된 혈류역학적 변수의 분포를 혈관 내에 보여줌으로서 동맥경화를 조기 진단하는 프로그램으로 발전할 것으로 기대된다. Numerical simulation of blood flow has been conducted based on real vessel geometries generated front DICOM medical images of abdominal and iliac bifurcated arteries of a healthy man. A program was developed to read cross sectional images of the three dimensional arteries and smoothly extract boundary coordinates of vessels. Commercial programs were employed for mesh generation and flow simulation. Pressures, velocities, and flow distributions were found to lie within normal physiological ranges. Peak velocity measured in the iliac artery by ultrasound was 20% smaller than that obtained by simulation. The trend of velocity variation in a cardiac cycle was fairly similar between the simulation and the ultrasonic measurements. Simulation based on real vessel geometry of individual patient provides information on pressure, velocity, and its distribution in the diseased arteries or arteries to be surgically treated. The results of simulation may help surgeons to better understand hemodynamic status and surgical need of the patient by revealing variation of the hemodynamic parameters. Futhermore, they may serve as basic data for surgical treatment of arteries. This research is expected to develop to a program in the future that early diagnose atherosclerosis by showing distribution of a hemodynamic index closely related to atherosclerosis in arteries.
뇌압 펄스에 의한 션트밸브의 압력-유량제어 특성의 변화
홍이송,이종선,장종윤 대한의용생체공학회 2002 의공학회지 Vol.23 No.5
수두증 환자를 치료하기 위해 머리에 시술 되는 션트밸브가 받는 뇌압 펄스가 밸브의 유량조절 특성에 미치는 영향을 수치적으로 해석하였다. 션트밸브를 통한 유량을 계산하기 위하여 밸브 다이아프램이 형성하는 유량 오리피스를 모델링 하여 맥동압력과 변동하는 압력에 의한 다이아프램의 움직임을 고려하였다. 연구 결과, 압력 펄스와 이에 따른 다이아프램의 움직임에 의하여 유량이 40% 이상 증가함을 보였다. 이 결과는, 뇌실에 시술 되는 션트밸브의 압력-유량 조절특성이 제조 직후 맥동이 없는 유량을 공급하는 시린지 펌프를 사용하여 구한 실험 결과와 상당히 다르다는 사실을 보여주었다. Shunt valves used to treat patient with hydrocephalus were numerically simulated to investigate influence of pressure pulsation on their flow control characteristics. We modeled flow orifice through the shunt valve and imposed pulsating pressure and valve diaphragm movement to compute flow through the valve. The results of our study indicated that flow rates increased more than 40% by introducing pressure pulsation and diaphragm movement on the shunt valve. Our results demonstrate the pressure-flow control characteristics of shunt valves implanted above human brain may be quite different from those obtained by syringe pump test just after manufacture that induces uniform pressure.
저당질고지방-경장영양액이 뇌손상 후 환자의 혈당 조절에 미치는 영향: A Pilot Study
이송미 ( Song Mi Lee ),김선정 ( Sun Jeong Kim ),정혜경 ( Hye Kyung Chung ),전주혜 ( Joo Hye Jeon ),이보담 ( Bo Dam Lee ),홍창기 ( Chang Ki Hong ),박종숙 ( Jong Sook Park ),장철호 ( Chul Ho Chang ) 한국정맥경장영양학회 2011 한국정맥경장영양학회지 Vol.4 No.1
Purpose: Hyperlycemia after brain injury is known to be a risk factor that is correlated with hospital infection, mortality and the length of the hospital stay. There have been some reports about the use of a reduced-carbohydrate, modified high fat enteral formula for improving the blood glucose control and clinical outcomes of patients with type 2 diabetes. This pilot study evaluated the glucose control of brain-injured patients who were admitted into the neurointensive care unit (NCU) and they received either standard formula or high fat formula. Methods: Fourteen subjects were collected and they were divided into the experimental (high fat formula) and the control (standard formula) groups. We investigated the blood glucose levels, the total dose of insulin used, the number of patients who received insulin, the rate of hospital infection, the number of hospital days, the number of NCU days, the days of mechanical ventilation, the body mass index and the mental status of the subjects. Results: The hospital infection rate of the control group was higher than that of the experimental group, but the daily blood glucose level, the number of patients who received insulin and the total dose of insulin used were not statistically different between the two groups. The number of hospital days, the number of NCU days and the days on mechanical ventilation or the number of patients on mechanical ventilation were lower in the experimental group than that in the control group, but there were no statistically significant differences. Conclusion: These results suggest that the use of high fat enteral formula as compared to standard formula may decrease the hospital infection rate in critically ill patients after brain injury. But high fat formula did not have beneficial effects on the blood sugar level and insulin dosage. (JKSPEN 2011;4(1):21-26)
임병훈 ( Byung-hun Lim ),이송이 ( Song-i Lee ),임재홍 ( Jae-hong Lim ),오수진 ( Su-jin Oh ),주민수 ( Min-su Chu ),안선호 ( Seon-ho Ahn ),변승재 ( Seung-jae Byun ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1
Primary dissection of the renal artery is rare. Spontaneous renal artery dissection can be associated with diseases such as medial degeneration, neurofibromatosis, syphilitic arteritis, tuberculosis, polyarteritis nodosa, Marfan syndrome, fibromuscular dysplasia, or Ehlers-Danlos syndrome (EDS). Among these causes, EDS related renal artery dissection is very rare worldwide and has not been previously reported in Korea. EDS are a group of heritable connective tissue disorders characterized by fragility of the skin and hypermobility of the joints. We describe the case history of a young man who presented with left side flank pain, hypermobility of the hand joints and showed left renal artery dissection on computed tomography and angiography that turned out to be the first complication of vascular type EDS.
실제 형상을 통한 복부대동맥의 혈류 유동에 대한 수치적 연구
강한영(Han-Young Kang),김민철(Min Cheol Kim),홍이송(Yi Song Hong),이종선(Chong-Sun Lee),이종민(Jong-Min Lee),김찬중(Charn-Jung Kim) 대한기계학회 2003 대한기계학회 춘추학술대회 Vol.2003 No.11
Many clinical studies have suggested that the blood flow in ideal geometry is involved in the development of<br/> atherosclerosis. This study simulated blood flow in the abdominal artery with real geometry to investigate MWSS(mean<br/> wall shear stress), AWSS(amplitude of wall shear stress) and OSI(oscillator shear index). The calculation grid for the<br/> real geometry was constructed by extracting the surface of arterial wall from CT(Computed Tomography) or<br/> MRI(Magnetic Resonance Imaging) sheets called as DICOM (Digital Imaging and Communications in Medicines). The<br/> calculated MWSS, AWSS and OSI are much different from those of ideal geometry calculation. The MWSS increased<br/> while the AWSS decreased. Many shear forces are related to shapes of gradient. This paper will give clinical datum<br/> where the MWSS, AWSS and OSI are strong or weak. The hemodynamic analysis based on real geometry can provide<br/> surgeons with more reliable information about the effect of blood flow.