• Title/Summary/Keyword: 이식편

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Early Result of Coronary Artery Bypass Surgery (관상동맥 우회술의 조기성적)

  • Park, Jae-Hyeong;Lee, Won-Yong;Kim, Eung-Jung;Hong, Gi-U
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.158-163
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    • 1997
  • From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years (range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction hi tory. Five patients had preoperative left ventricular ejection fraction of 40% or less, The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases.21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery,)1, radial artery; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).

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Aortic Valve Replacement with Pulmonary Autograft in Patient with Congenital Aortic Stenosis : Ross Procedure without Homograft -one case report - (선천성 대동맥판 협착증에서 폐동맥판 자가이식편을 이용한 대동맥판 교체술:동종판막을 쓰지 않는 Ross술식)

  • 이은상;윤태진;서동만
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.303-306
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    • 1999
  • This is a genuine case report of the Ross operation without the use of homografts or heterografts in reconstruction of the right ventricular outflow tract. A 8-year-old boy with congenital aortic stenosis underwent aortic valve replacement with a pulmonary autograft and right ventricular outflow tract reconstruction with a pericardial conduit bearing autologous aortic monocusp. The postoperative echocardiography and cardiac angiography revealed good ventricular function and competent neoaortic valve. He has been followed up for 19 months.

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Recanalization of Portal Vein Graft Occlusion via a Percutaneous Transmesenteric Approach: A Case Report (간문맥 이식편 폐색증에서 경피적 장간막 경유 접근 방법을 통한 혈관 내 재개통 시술: 증례 보고)

  • Min-Hyuk Yu;Dong-Ho Hyun;Shin-Seok Yang
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.230-234
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    • 2024
  • Interventional recanalization is an effective treatment option for postoperative portal vein occlusion. A transhepatic or transsplenic approach is preferred, whereas a percutaneous transmesenteric route enables antegrade cannulation. Here, we present a case of successful percutaneous transmesenteric recanalization in a patient with a postoperative portal vein graft occlusion.

Total Body Irradiation in Leukemia - Preliminary Report - (방사선 전신조사)

  • Jang Hong Seok;Chung Su Mi;Choi Ihl Bohng;Kim Choon Yul;Bahk Yong Whee;Kim Choon Choo;Kim Dong Jip;Lee Jae Soo
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.247-251
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    • 1988
  • Total body irradiation has been applied to treat acute leukemia and chronic granulocytic leukemia.20 patients with acute leukemia or chronic granulocytic leukemia were treated with total body irradiation using 6 MV linear accelerator before bone marrow transplantation at the Division of Therapeutic Radiology, Department of Radiology, St. Mary's Hospital, Catholic University Medical College from August 1987 to September 1988. Among 20 patients, 8 patients received 6 fractions of 200 cGy (total 1200 cGy),10 patients received a single 850 cGy radiation,1 patient received 4 fractions totalling 850 cGy (200, 200, 200, 250), and 1 patient received 1100 cGy in 2 fractions (850, 250).17 patients received allogenic grafts, 2 patients received autologous grafts, and only one patient received one locus mismatched graft. 13 patients are still alive and 7 patients died. The complications induced by total body irradiation were nausea and vomiting, diarrhea, skin erruption, mucositis, and pneumonitis.

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Time-related Histopathologic Changes of Fresh Frozen Vascular Xenograft in Pig-to-goat Model (돼지-염소 모델에서 신선 동결된 이종 경동맥 이식편의 시간 경과에 따른 조직병리학적 변화)

  • Chang, Ji-Min;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.180-192
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    • 2007
  • Background: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. Material and Method: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at $-70^{\circ}C$ without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. Result: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. Conclusion: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.

Mixed Chimerism to Achieve Donor-Specific Transplantation Tolerance for Lung Allografts in Rats (혼합형 동종이인자형 키메라쥐에서 특정공여군의 동종 폐이식펀에대한 관용)

  • Youm, Wook
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.713-722
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    • 1996
  • Poor long term patient survival (60% at 2 years) in lung allograft recipients are mainly due to rejection and complications associated with the use of nonspecific immunosuppressants. Better means to achieve waft acceptance is desperately needed. 1 have investigated whether mixed allogeneic chimerism in the form of bone marrow stem cell engraftment would induce donor-specific tolerance for lung allografts. Fisher (F344) and Wistar Forth (WF)rats were lethally irradiated (1100c0y) and reconstituted with a mixture of T-cell depleted syngeneic and allogeneic bone marrow (F344+WFIWF, ACI +F344- F344). After Mixed chimerism was documented by peripheral blood Ipnphocyte typing at 28 days, orthotopic left single lung transplantation was performed, using donor-s ecific or third party allografts. No immunosuppressants were administered. Graft rejection was monitored by chest rentgenography, and con- firmed by histology Mixed chimeric rats accepted lung allografts permanently, and it was not strain specific effect. Tolerance was all or none phenomenon which had nothing to do with the percentage of chimerlsm. Mixed chimeras rejected third party allografts in less than 10 days, a time course similar to that of unmanipulated controls. No acute or chronic rejection was observed in donor specific grafts more than 150 days posttransplant. These data suggest that mixed chimerism in the form of bone marrow stem cell engraftment results in stable, systemic donor-specific transplantation tolerance for lung allografts.

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Bypass of Superior Vena Cava with Spiral Vein Graft (Spiral Vein Graft를 이용한 상대정맥 우회로 조성술-치험 1례-)

  • Hwang, Su-Hui;Kim, Byeong-Jun;Jeong, Seong-Un
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.344-347
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    • 1997
  • A 49-year-old female patient who had obstruction of superior vents cave(SVC) with SVC syndrome was successfully managed by bypass operation of superior vents cava with spiral vein graft. A composite spiral vein graft was placed between the right innominate vein and the right atrium to bypass the occluded SVC. The graft was constructed from the patient's own saphenous vein, which was split longitudinally and wrapped around a stent in spiral fashion and the edges of the vein were sutured together to form a large autogenous conduit. The patient was relieved o SVC obstructive symtoms and signs and discharged 21 days postoperatively without any complication.

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