• Title/Summary/Keyword: 동맥간

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One-stage Repair of Truncus Arteriosus with Interrupted Arch (대동맥궁 차단증를 동반한 동맥간의 일차 완전교정 - 1예 보고-)

  • 성시찬;박준호;이형두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.759-765
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    • 2003
  • Truncus arteriosus with interrupted aortic arch is a very rare congenital cardiac anomaly that has an unfavorable natural course. We report a successful one-stage repair of truncus arteriosus with interrupted aortic arch through median sternotomy in a 25-day-old neonate weighing 3.1 kg. We reconstructed the aortic arch with direct side-to-end anastomosis between ascending and descending aortas. The right ventricular outflow reconstruction was performed with untreated autologous pericardial conduit without valve following Lecompte maneuver. The patient has been grown-up in good condition (25 ∼ 50 percentile of body weight) and shows the right ventricular outflow tract wide 1 year after the operation.

Surgical Repair of Truncus Arteriosus in an Low-Birth Weight Premature Baby: Right Ventricular Outflow Reconstruction with Valveless Autologous Pericardial Conduit and the Result of 20-Month′s Follow-up (저체중조산아에서 동맥간의 교정 1예: 무판막 자가심낭도관의 이용과 20개월간의 추적결과)

  • 성시찬;양승인;이헝두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.766-771
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    • 2003
  • It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. Truncus arteriosus is a rare congenital anomaly that has an unfavorable natural course. We report a successful surgical correction of truncus arteriosus in an 13-day-old premature infant with body weight of 1.5 kg and gestational age of 32 weeks. We used autologous untreated pericardial conduit without valve in right ventricular outflow reconstruction. The patients remains in good condition with normal body weight (50 percentile) and wide right ventricular outflow tract 20 months after the operation.

The in Vivo Distribution of $^{99m}Tc-Phytate$ IL-2 Complex on Selective Splenic Arterial Injection (비장동맥에 선택적으로 투여한 Interleukin-2와 $^{99m}Tc-Phytate$ 혼합물의 생체내 분포)

  • Zeon, Seok-Kil;Lee, Hee-Jung;Sohn, Soo-Sang
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.124-126
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    • 1992
  • Interleukin-2 (IL-2)는 많은 immunoenhancing lymphokine의 한 종류로서 lymphokine activiated killer (LAK) cell의 생성을 자극시켜 흑종의 종양세포를 죽인다고 알려져 있다. 최근 간종양에서 비장동맥 또는 간동맥으로 투여한 IL-2가 비장의 임파계를 자극하여 LAK cell을 생성하여 어느정도효과가 있음이 밝혀지면서, 여러가지의 투여 방법이 시도되고 있다. 그러나 각종의 투여 방법에서 실제로 투여한 IL-2의 인체내 분포에 관한 연구는 없다. 저자들은 비정맥과 간문맥에 이상이 없는 증례의 비동맥에 IL-2와 $^{99m}Tc-phytate$ 혼합물을 투여하고, IL-2의 생체에서의 비장과 간에 어떻게 분포하는지 알아보기 위하여 $^{99m}Tc$의 radioactivity를 계측하여 보았다. 6예의 간세포암과 3예의 위암으로부터의 전이성간암에서 동맥조영술적방법을 이용하여 초선택적 비장동맥에 투여한 IL-2와 $^{99m}Tc-phytate$ 혼합물이 비장 27%, 간73%의 분포를 보여 비장을 거쳐온 $^{99m}Tc$의 방사능이 간에 많이 침착함을 확인하였고 간과 비장이외의 부위 즉 골수, 복수 또는 폐장이나 늑막에는 전혀 방사능 분포가 없음을 알 수 있었다. 따라서 비정맥이나 간문백에 이상이 없는 증례에서 IL-2의 비장동맥 투여는 목적하는 바 IL-2의 생체내 분포를 이룩할 수 있을 것으로 사료된다.

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Aberrant Right Subclavian Artery with Dysphagia and Recurrent Pneumonia -A case report - (연하곤란 및 반복괵인 폐렴를 동반한 이상우쇄골하동맥 - 1예 보고 -)

  • 장원채;임영혁;임성철;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.282-285
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    • 2004
  • Aberrant right subclavian artery (ARSA) is an anomaly with a reported incidence of 0.5% to 2%. Most patients with an ARSA remain asymptomatic; however about to% of adult patients have compressive symptoms. A case is reported of a 64-year old female patient who had a few years of history of dysphagia and recurrent pneumonia. Angiography was performed, which demonstrated an ARSA with common origin of the right and left carotid arteries. Surgical correction was performed via right thoracotomy. The proximal aberrant artery was mobilized behind the esophagus. The distal, right subclavian artery was exposed, transected, and transposed with reimplantation into the aortic root by graft bypass.

Comparison of Image Quality and Dose between Intra-Venous and Intra-Arterial Liver Dynamic CT using MDCT (MDCT를 이용한 역동적 간 컴퓨터단층촬영 검사에서 정맥과 동맥 주입법에 따른 영상의 화질 및 선량 비교)

  • Ji-Young, Kim;Ye-Jin, Cho;Hui-Hyeon, Im;Ju-Hyung, Lee;Yeong-Cheol, Heo
    • Journal of the Korean Society of Radiology
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    • v.17 no.1
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    • pp.123-129
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    • 2023
  • The purpose of this study was to analyze differences in imaging quality and dose difference between intra-venous (IV) and intra-arterial (IA) liver dynamic computed tomography (CT). Herein, retrospective, blinded analysis was conducted to analyze signal-to-noise and contrast-to-noise ratios in cases of patients who underwent IV or IA liver dynamic CT for transarterial chemoembolization (TACE), an interventional procedure for hepatocellular carcinoma. The dose length product (DLP) value stored in Picture Archive and Communication System (PACS) was used to calculate the effective dose and thereby compare differences in the dose between the two methods. The mean liver and spleen signal to noise ratio (SNR) was greater in IV-liver dynamic CT than in IA-liver dynamic CT; however, contrast to noise ratio (CNR) was higher in IA-liver dynamic CT than in IV-liver dynamic CT. However, there were no differences in DLP and effective dose between the two methods. In conclusion, our findings showed that IA-liver dynamic CT showed a similar effective dose and superior CNR compared with IV-liver dynamic CT. Further studies must analyze 3D angiography CT of the hepatic artery to clearly distinguish the feeding artery, which is the essential step in interventional procedures for hepatocellular carcinoma.

윌리엄하비, 현대 생리학의 시작

  • Cheon, Myeong-Seon
    • Journal of the korean veterinary medical association
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    • v.41 no.12
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    • pp.1142-1147
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    • 2005
  • 생명체 안에는 정맥혈과 동맥혈이라는 두 가지 종류의 혈액이 흐른다. 여기에는 신체 내 세 가지 기관이 관여하는데, 간은 영양과 성장의 임무를 심장은 생명의 원동력을 뇌는 인지와 이성을 담당한다. 영양과 성장은 간에서 형성되는 '정맥혈'을 통해 형성되고 생명의 원동력은 심장에서 형성되는 '동맥혈'을 통해 전신으로 퍼진다. 이 혈액들은 심장으로 다시 돌아오지 않고 온 몸에 퍼져 소비된다. 혈액은 심장이 이완될 때 심장 안으로 빨아들여진다. 심장은 혈액을 펌프질하는 기능이 없으며 동맥이 그 스스로가 '박동성'을 가지고 혈액을 밀어낸다. 좌심실에서 정맥혈과 프네우마(Pneuma)가 섞이게 되는데 심장 오른쪽 심실과 심방의 정맥혈은 좌심실과 우심실 사이 중격(심실중격, interventricularseptum)의 작은 구멍을 통해 좌심실로 이동한다.

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Bronchial Artery Embolization(BAE) for Hemoptysis of Small Amount : A Comparative Study with Conservative Management (소량객혈 환자에서 동맥색전술과 보존적치료의 비교연구)

  • Ryu, Jeong-Seon;Song, Kwang-Seon;Yong, Suk-Joong;Lee, Hong-Lyeol;Chang, Joon;Shin, Kye-Chul;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.629-638
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    • 1997
  • Background : Surgical intervention is known as the principle management for hemoptysis of significant amount. But surgical procedure is applicable to only small number of patients because of increased mortality in emergency surgery and various functional and structural problems after lung resection. Bronchial artery embolization(BAE) has been used as an alternative interventional technique for immediate control of patients with increased risk for surgery due to recurrent or massive hemoptysis. BAE also has limitations such as recurrent bleeding after procedure and its role for the application to small amount of hemoptysis is still not established. Method : To evaluate immediate and long term effectiveness of BAE, we analysed 65 patients with hemoptysis according to therapeutic modalities they received ; BAE versus conservative management. Results : The success rate for immediate control of hemoptysis was significantly higher in BAE group with 43 cases(100%) among 43 cases compared with 17 cases(77%) among 22 cases in conservative group (p < 0.001). The disease control duration was $19.5{\pm}8.06$ months in BAE group and $18.8{\pm}6.06$ months in conservative group(p > 0.05). The therapeutic response in BAE group was 82%(36/43 cases) and 95%(21/22 cases) in conservative group (p > 0.05). According to the amount of hemoptysis, the therapeutic response were seen in 91%(29/32 cases) in less than 100ml and 85%(28/33 cases) in 100~400ml (p > 0.05). According to the manifestation of hemoptysis, the therapeutic response in groups of recurrent and nonrecurent were 87%(20/23 cases) and 88%(37/42 cases)(p > 0.05). Conclusion : The difference of therapeutic response between BAE and conservative group in patients with small amounts of hemoptysis was not found except for immediate control of hemoptysis.

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Aorto-bicarotid-biaxillary Bypass in Takayasu′s Arteritis -One case report- (Takayasu 동맥염에서 Aorto-bicarotid-biaxillary Bypass -1예 보고 -)

  • 김대현;이인호;윤호철;김수철;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.176-179
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    • 2004
  • A 30 year-old female patient was admitted for dizziness and palpitation. Pulsation of the both upper extremities and both common carotid arteries were absent. Innominate artery and both common carotid arteries were severely narrowed and both subclavian arteries were completely obstructed on aortogram. The patient was diagnosed as tvue Ⅰ Takayasu's arteritis, and operation was peformed to increase blood flow to the brain and both upper extremities. Ascending aorta, both carotid arteries, both subclavian arteries, and both axillary arteries were exposed by four separate incision, and we performed an aorto-bicarotid-biaxillary bypass with Hemashield graft. Previous dizziness and palpation were disappeared after the operation.

Histomorphological Comparison of the Coronary Artery and Available Graft Conduits (관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교)

  • Kim, Yong-Ho;Lee, Seok-Ki;Yu, Jeong-Hwan;Kim, Si-Wook;Kang, Shin-Kwang;Lim, Seung-Pyung;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.563-567
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    • 2008
  • Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

Significance of Ligation of Patent Ductus Arteriosus in Premature Infant (미숙아 동맥관 개존증에서 동맥관 결찰술의 의의)

  • 조성래;이충석;백용운
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.35-40
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    • 2001
  • 배경: 혈역학적으로 문제가 되며 인도메타신 치료가 불가능한 미숙아 동맥관 개존증에서 동맥관 결찰술은 비교적 안전하고 효과적인 치료법으로 알려져 있다. 대상 및 방법: 1995년 1월부터 2000년 5월까지 동맥관 개존증을 가진 50명의 미숙아를 대상으로 인도메타신 치료와 동맥관 결찰술의 치료성적을 검토하였다. 결과: 50례의 미숙아 동맥관 개존증 중 28례에서 혈역학적으로 문제가 되어 치료가 요구되었고 그 중 5례에서는 인도메타신 치료를, 나머지 23례는 인도메타신 치료의 금기가 되어 동맥관 결찰술을 시행하였다. 제태기간과 출생시 체중은 치료를 시행하지 않았던 군(32.1$\pm$2.1주, 1731$\pm$450.9g)과 인도메타신 치료군(32.0$\pm$2.1주, 1830$\pm$165.5g)보다 동맥관 결찰술군(29.6$\pm$2.1주, 1435$\pm$431.0g)이 가장 짧았다(p<0.05). 치료를 시행한 28례에서 치료시 나이(8.6$\pm$5.5일, 7,3$\pm$4.4일)는 인도메타신 치료군과 동맥관 결찰술군 간에 차이가 없었으나, 체중(1670$\pm$43.6g, 1211$\pm$22.4g)은 동맥관 결찰술군에서 의의있게 적었다(p<0.05). 치료후 생존율은 100%와 73.9%로 인도메타신 치료군에서 높았고 술후 사망은 23.7$\pm$22.4일(6-68일)째 발생하였으며 사망원인은 패혈증 5례, 뇌실질내 출혈과 기관지폐이형성증이 각각 2례, 패혈증 쇼크와 기흉이 각각 1례로 수술과는 직접적인 관련이 없었다. 결론: 미숙아 동맥관 개존증에서 조기에 동맥관 결찰술을 시행하는 것은 비교적 안전하고 효과적이며, 특히 인도메타신 치료를 시행할 수 없는 경우와 초저체중의 미숙아에서도 안전하게 적용 될 수 있을 것으로 사료된다.

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