• Title/Summary/Keyword: 식도협착

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A Case of Coronary Vasospasm in a Patient with Esophageal Cancer Receiving Chemotherapy with 5-fluorouracil (5-fluorouracil 사용 중인 식도암 환자에서 발생한 관상동맥연축)

  • Jin Wook Lee;Moo In Park;Seun Ja Park;Won Moon;Sung Eun Kim;Jae Hyun Kim;Kyoungwon Jung
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.58-61
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    • 2017
  • 5-Fluorouracil (5-FU) has been widely used in the treatment of various solid tumors. However, 5-FU cardiotoxicity is being reported with increasing frequency. The main symptom of cardiotoxicity is chest pain at rest with ischemic electrocardiographic changes. Up until now, the underlying mechanism has been suspected to be coronary artery spasm. However, this chest pain associated with 5-FU has several characteristics that are incompatible with coronary artery spasm; eg, inefficacy of calcium-channel blocker and a slow increase in cardiac enzyme levels. We experienced a case of 5-FU-induced cardiotoxicity which showed clinical findings consistent with acute myocardial infarction. Based on the clinical findings, coronary angiography, and no stenosis was noted. However, we concluded that the cardiotoxicity in this case was due to ischemia caused by coronary artery spasm. Because vasodilatator was effective and secondary attack was followed.

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Gastrointestinal Complications after Lung Transplantation (폐이식 후 발생한 소화기계 합병증)

  • Haam, Seok-Jin;Paik, Hyo-Chae;Kim, Ji-Hyun;Lee, Doo-Yun;Kim, Chang-Wan;Kim, Jung-Hwan
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.280-284
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    • 2010
  • Background: The postoperative management following lung transplantation has dramatically improved in the recent decade. However, some complications still remain as troublesome problems. We retrospectively reviewed the gastrointestinal complications and their management after lung transplantation. Material and Method: We performed a retrospective review of the medical records of 25 cases in 23 patients who underwent lung and heart-lung transplantations from July 1996 to March 2009. The definition of gastrointestinal complication was the gastrointestinal tract-related disease that occurred after lung transplantation. There were eight postoperative deaths (within postoperative 30 days) that were excluded from the analysis. Result: Twenty three gastrointestinal complications occurred in 11 (64.7%) of the 17 cases. The median follow-up period was 6.9 months (range: 2 months to 111 months), and chronic gastritis (23.5%, 4 of 17 cases) was the most common complication. Severe, prolonged (more than 2 weeks) diarrhea occurred in 3 cases. Three patients had gastric ulcer with one case requiring gastric primary closure for gastric ulcer perforation. This patient had gastric bleeding due to recurrent gastric ulcer 2 months after laparotomy. Cytomegalovirus gastritis and esophagitis occurred in 2 cases and 1 case, respectively, and esophageal ulcer occurred in 2 cases. There were esophageal strictures in 2 patients who underwent esophageal stent insertion. Other complications were one case each of ileus, early gastric cancer requiring endoscopic mucosal resection, gall bladder stone accompanied with jaundice, and pseudomembranous colitis. Conclusion: The incidence of gastrointestinal complication is relatively high in patients after they undergo lung transplantation. Since gastrointestinal complications can induce malnutrition, which might be related to considerable morbidity and mortality, close follow-up is necessary for the early detection and proper management of gastrointestinal complications.

A Clinical Analysis of Neonatal Surgical Gastrointestinal Diseases in Daegu·Busan Area (대구·부산 지역에서 수술을 요하는 신생아 소화기 질환의 임상적 고찰)

  • Son, Seung Kook;Park, Jae Hong;Choi, Byung Ho;Choi, Kwang Hae;Lee, Kyoung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.179-185
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    • 2004
  • Purpose: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. Methods: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. Results: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8 : 1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. Conclusion: The current status of neonatal surgical gastrointestinal diseases in Daegu Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.

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Clinicostatistical Analysis for 53 Cases which were performed Microlaryngeal Surgery under Suspension Laryngoscope (Suspension Laryngoscope 하에 후두미세 수술을 시행한 53명에 대한 임상통계학적 고찰)

  • 전하동;최인환;추광철;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.6.3-7
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    • 1979
  • During last two. decades, microlaryngeal surgery opened now era in the laryngeal surgery. In 1960, using Lynch's suspension laryngoscope, Seal co et al performed the first successful microsurgery in the treatment of polyp and other laryngeal diseases. In 1968, Kleinsasser reported a new technique of microlaryngeal surgery with a self retaining laryngoscope. Authors studied the statistic analysis of 53 cases (75 times) of the suspension laryngoscopic microsurgery at E.N.T. department of Han Yang University Hospital from May 1972 to April 1979 an reported this result. 1) sex distribution was male 1.3 : female 1. 2) age distribution was 3rd decade 14 cases (26.4%), 2nd decade 10 cases (18.7%) and 5th decade 9 cases (17%) in order. 3) chief compliant was hoarseness 48 cases (90.6%), dyspnea 16 cases (30.5%) and sore throat 8 cases (15.1%) in order. 4) diagnostic impression was polyp 18 cases (34%), nodule 12 cases (22.6%), papilloma 9 cases (17%), tumor 7 cases (13.2%), intubation granuloma 3 cases (5.7%) in order and other kinds were laryngeal stenosis with decannulation difficulty, laryngeal paralysis and hematoma. 5) histopathologic result of 48 cases was polyp 17 cases (35.4%), papilloma 11 cases (23%), nodule 9 cases (18.9%), malignancy 3 cases (6.3%), chronic inflammation 2 cases (4.2%) in order and others were hyperkeratosis, mucous retension cyst, nodule associated abscess, granuloma, hematoma and unconfirmed case. 6) in involved site, both sides 15 cases (60%), Lt.side 5 cases (19%), Rt side 3 cases (12%), anterior commissure 3 cases (12%) on the nodule and polyp (26 cases) and whole laryngeal involvement 7 cases (63.6%), one side cord involement 3 cases (23.7%), extralaryngeal involvement 1 cases (9.1%) on the papilloma (11 cases).

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A Systematic Study on the Amphipods in Korea, II. On the Geographical Distribution and Variation of Species of Fresch-Water Gammarus(Crustacea : Amphipoda, Gammaridae) (韓國山 端脚類의 系統分類學的 硏究: II. 淡水産 Gammarus 屬의 種의 地理學分布 및 變異에 관하여)

  • Kim, Hoon Soo;Lee, Kyung Sook
    • The Korean Journal of Zoology
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    • v.20 no.1
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    • pp.29-40
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    • 1977
  • The authors examined fresh-water gammarid materials which were collected from streams in 20 localities of South Korea during the period from 1965 to 1977. As the results of the observation, the authors have concluded as follows: 1. These fresh-water gammarids belong to Gammarus pulex-group and are distributed widely in mountain-streams of mainland and surrounding islands of South Korea. 2. The present specimens are different from the subspecies, G. pulex koreanus Ueno, 1940 which was described originally from North Korea. In the latter, the pulmose setae of third uropod are limited only to the outer margin of both rami. The peduncle and flagellum of second antenna are fringed with a few short setae and the flagellum is provided with calceoli. In the former, both margins of inner ramus and outer margin of outer ramus of third uropod are fringed with long pulmose setae. The peduncle and flagellum of second antenna have abundant relatively long setase and the flagellum is not provided with calceoli. 3. The present specimens are different from the subspecies, G. pulex sobaegensis Ueno, 1966 which was described originally from South Korea. The latter dwells in cave, while the former dwells in mountain-stream. In the former, the arrangements of pulmose setae of third uropod and the setation of second antenna are similar to those of the latter. But they are quite different from each other in several characters such as shape of upper lip, shape of fifth article of second gnathopod and numbers of incisions on front distal margins of coxal plates 1-3. The former has spines on surface of coxal plates 1-3, but the latter has not. In females, the former has four pairs of marsupial plates, while the latter has three pairs. 4. The present materials show local variations. Therefore, they could be divided into 3 local groups. The first group (specimens from Mt. Odae and Mt. Sogeumgang) has pulmose setae on the both margins of both rami of third uropod and second article of outer ramus is relatively long. In general, this group has setae sparsely on the both rami and especially a few setae on the outer margin of outer ramus. The second group, which are widely distributed in South Korea, has pulmose setae on the both margins of inner ramus and on the outer margin of outer ramus of third uropod. In the third group (specimens from Mt. Soyo), the pulmose setation of third uropod is similar to that of the first group, but the second article of outer ramus is very small.

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Biocompatibility and Histopathologic Change of the Acellular Xenogenic Pulmonary Valved Conduit Grafted in the Right Ventricular Outflow Tract (우심실 유출로에 이식한 무세포화 이종 폐동맥 판막도관의 생체 적합성 및 조직병리학적 변화양상에 대한 연구)

  • 허재학;김용진;박현정;김원곤
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.482-491
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    • 2004
  • Background: The xenogenic or allogenic valves after in Vitro repopulation with autologous cells or in vivo repo-pulation after acellularization treatment to remove the antigenicity could used as an alternative to synthetic polymer scaffold. In the present study, we evaluated the process of repopulation by recipient cell to the acellu-larized xenograft treated with NaCl-SDS solution and grafted in the right ventricular outflow tract. Material and Method: Porcine pulmonary valved conduit were treated with. NaCl-SDS solution to make the grafts acellularized and implanted in the right ventricular outflow tract of the goats under cardiopulmonary bypass. After evaluating the functions of pulmonary valves by echocardiography, goats were sacrificed at 1 week, 1 month, 3 months, 6 months, and 12 months after implantation, respectively. After retrieving the implanted valved conduits, histopathologic examination with Hematoxylin-Eosin, Masson' trichrome staining and immunohistochemical staining was performed. Result: Among the six goats, which had been implanted with acellularized pulmonary valved conduits, five survived the expected time period. Echocardiographic examinations for pulmonary valves revealed good function except mild regurgitation and stenosis. Microscopic analysis of the leaflets showed progressive cellular in-growth, composed of fibroblasts, myofibroblasts, and endothelial cells, into the acellularized leaflets over time. Severe inflammatory respon-se was detected in early phase, though it gradually decreased afterwards. The extracellular matrices were regenerated by repopulated cells on the recellularized portion of the acellularized leaflet. Conclusion: The acellularized xenogenic pulmonary valved conuits were repopulated with fibroblasts, myofibroblasts, and endothelial cells of the recipient and extracellullar matrices were regenerated by repopulted cells 12 months after the implantation. The functional integrity of pulmonary valves was well preserved. This study showed that the acellularized porcine xenogenic valved conduits could be used as an ideal valve prosthesis with long term durability.