• Title/Summary/Keyword: 맥 주소

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Right coronary artery atresia in Marfan's syndrome: A case report (Marfan 증후군에 동반된 우관상동맥 폐쇄증 - 1 례 보고 -)

  • 이재원
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.720-723
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    • 2001
  • A case of Marfan’s syndrome with atresia of right coronary artery is reported. A 45-year-old woman, who was diagnosed as Marfan’s syndrome 1 year ago, came to the hospital complaining of acute chest pain. The patient showed arachynodactyly, pectus carinatum, and long and slender extremities. In echocardiography there were severe aortic regurgitation measured grade IV and aortic dilatation of ascending aorta maximally 5.9 cm in diameter. Mitral regurgitation was mild, but there were also moderate left ventricular dilation and moderately decreased ejection fraction of left ventricle. At operation, atresia of right coronary artery was found. We performed Bentall type operation with SJM 27mm valved conduit for left coronary artery, and Piehler’s modification for right coronary artery bypass using 6mm PTFE graft. The atretic portion of right coronary artery from the suspected right coronary ostium to distal coronary flow was about 4 cm in length. The combination of right coronary artery atresia and Marfan’s syndrome is very rare. The author describes the rare case, which is treated with combined technique of Bentall and Piehler modification for reconstruction of coronary circulation.

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A Case of Dissection in Marfan Syndrome with Ascending Aortic Aneurysm (상행 대동맥 동맥류를 동반한 Marfan씨증후군 환자에서 생긴 대동맥 박리(Aortic Dissection) 1례)

  • Yoon, Bong-Young;Yang, Chang-Heon;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo;Ryu, Han-Young;Jung, Tae-Eun;Park, Yee-Tae;Han, Sung-Sae
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.179-184
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    • 1989
  • The Marfans syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aoritc aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.

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Gender Difference of Accuracy in Detecting Coronary Artery Disease by Myocardial Perfusion SPECT (디피리다몰 심근관류 SPECT를 이용한 관동맥질환 진단에 있어 남녀간의 진단율 비교)

  • Min, Jung-Jun;Bom, Hee-Seung;Song, Ho-Cheon;Jeong, Hwan-Jeong;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.129-136
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    • 1998
  • Purpose: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. Materials and Methods: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTS were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of ${\geq}$ 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). Results: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (p<0.01), respectively. Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). Conclusion: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.

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The Role of Rest Image in Patients Showing Normal Stress Image on Tc-99m Myocardial Perfusion Scan (심근 관류스캔 중 정상 부하영상 소견을 보인 환자에서 휴식기 영상의 필요성에 대한 평가)

  • Bom, Hee-Seung;Song, Ho-Chun;Min, Jung-Jun;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.502-506
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    • 1996
  • Tc-99m myocardial perfusion agents such as Tc-99m sestamibi or Tc-99m tetrofosmin has advantages over T1-201 for myocardial perfusion scan fuck as low attenuation and easy availability. However, Tc-99m agents do not redistribute so they need to be given T times, namely after stress and at rest. To evaluate whether rest image is needed in patients showing normal stress image, 43 patients who underwent both myocardial perfusion scan and coronary angiography and showed normal stress images were evaluated. Findings of rest images of them were evaluated whether they change the diagnosis or treatment plans. Among 43 patients who showed normal stress myocardial perfusion imaging, 31 (72.1%) showed no additional informations. However, among 5 patients with vasospastic angina 4 (80%) showed abnormal rest images in spite of normal stress images. So, when vasospastic angina is suspected clinically, rest image could be helpful in identifying patients with coronary vasospasm. In conclusion, rest myocardial perfusion images were not helpful in 72.1 % of patients with angina when stress images were normal. In only exception was those with vasospastic angina.

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Prognostic Implication of Normal Myocardial Perfusion Scintigraphy in Patients with Chest Pain (정상 심근관류신티그라피 소견을 보인 흉통환자의 예후)

  • Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.67-72
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    • 1997
  • Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age $53{\pm}12$ years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% Per Year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary artery disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of. cardiac event rates between patients with normal and abnormal coronary angiograms.

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Coronary Artery Transfer for Anomalous Origin of Left Coronary Artery from Right Coronary Sinus (좌 관상동맥 이상기시의 수술적 치료)

  • 이준완;이재원;김종우
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.514-517
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    • 2003
  • Anomalous aortic origin of left coronary artery is a rare congenital coronary anomaly that can cause clinical manifestations such as ischemic chest pain, arrhythmic syncope or even sudden cardiac death. We describe a case of anomalous aortic origin of left main coronary artery presented as a cardiogenic shock which was successfully treated by coronary artery transfer.

A System Unauthorized Access using MAC Address and OTP (MAC Address와 OTP를 이용한 비인가 접근 거부 시스템)

  • Shin, Seung-Soo;Jeong, Yoon-Su
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.127-135
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    • 2012
  • This study improves the existing user identification method using user ID and password. The new protocol protecting unauthorized access is designed and developed using user's ID, password, and OTP for user certification as well as MAC address for computer identification on networks. The safety on trials of unauthorized certification is tested and analyzed for four types following the criterion of information acquisition.

Efficient Token-Update scheme for Site Authentication (효율적인 토큰 업데이트를 이용한 인증 기술에 관한 연구)

  • ;Lee, Joung-Ho;Jang, Injoo;Yoo, Hyeong-Seon
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.07a
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    • pp.217-219
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    • 2005
  • 본 논문에서는 사이트 인증을 위해 효율적으로 토큰을 업데이트하여 등록된 사용자만을 대상으로 인증하는 것을 목적으로 하고 있다. 일반적인 OTP(one-time password)와 스마트카드를 이용한 인증은 다양한 공격에서 서버와 클라이언트를 보호하는데 사용이 되고 있으며, KIC(key information center)를 통해 서버와 클라이언트를 상호 인증을 한다. 제안하고 있는 기법에서 KIC를 거치지 않고 대체 사용이 가능한 컴퓨터 안에 있는 랜 카드의 고유한 값인 맥(media access control) 주소와 난수를 사용하여 토큰을 업데이트하는 방법은 사이트 인증에 매우 효율적인 알고리즘이다.

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Surgical Treatment of the Pseudoaneurysm of the Ascending Aorta Following the Repair of Congenital VSD -1 case report- (선천성 심실중격결손증 교정술 후 발생한 가성 상행대동맥류 수술 치험 -1례 보고-)

  • An, Byeong-Hui;Kim, Gwang-Hyu;Na, Guk-Ju;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.564-568
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    • 1996
  • Pseudoaneurysm of the ascending aorta following cardiac surgery is very unusual and it is poten- tially fatal. We report here a fourteen year-old female patient with pseudoaneurysm of the ascending aorta following a repair of a congenital ventricular septal defect at other hospital 50 months ago. Although she had a mild superficial wound infection postoperatively, she enjoyed uneventful. life until she visited our hospital for a generalized weakness and exertional dyspnea which developed a month ago. Chest CT and echocardiogram showed partially calcified pseudoaneurysm of the ascending aorta. Two aortic defects were located on the anterolateral ascending aortic wall wkere it was suspected as a previous sites of aortic and cardioplegic cannulation. The internal wall of the pseudoaneurysm was covered with neoendothelium and intervened by septal tissue. Two defects on he aortic wall were oval in shape and about 1.5cm in the greatest diameter The defects were trimmed to make a one large de- fect and it was reconstructed with patch designed from 22mm collagen impregnated double velour Dacron graft. The postoperative course was uneventful.

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Coronary Artery Compression after an Arterial Switch Operation for Transposition of the Great Arteries - A case report- (대혈관전위로 동맥치환술을 시행했던 환자에서 발생한 관상동맥 압박 -1예 보고-)

  • Yoo, Jae-Suk;Koak, Jae-Gun;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.360-362
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    • 2008
  • An adequate location of the reimplanted coronary arteries is one of the most important prognostic factors for an arterial switch operation for treating TGA (transposition of great arteries). We report here on a case of malposition of the reimplanted coronary artery in a 14-year-old boy who had undergone an arterial switch operation. He had chest pain and dyspnea on exertion. The imaging study showed that the ostium of the left main coronary artery, which was between the neo-pulmonary artery and the neo-aorta, was compressed by the great arteries. We excised the left main coronary artery with a button incision from the aorta and reimplanted it on the left lateral side of the aorta. The patency of the left main coronary artery os after the operation was good and it was not compressed by the surrounding arteries.