• Title/Summary/Keyword: 정맥류

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Effect of Propranolol on Portal Vein Pressure in Patients with Chronic Liver Disease: Evaluation by Perrectal Portal Scintigraphy (만성 간질환에서 Propranolol의 문맥압 감소 효과: 경직장 문맥 신티그라피를 이용한 평가)

  • Rho, Young-Ho;Han, Shin;Kim, Hak-Su;Yoon, Su-Jin;Kim, Yun-Kwon;Kim, So-Yon;Kim, Yeong-Jung;Cho, Min-Koo;Park, Byong-Yik;Lee, Gwon-Jun
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.388-397
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    • 1999
  • Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

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A Case of Multiple Giant Coronary Aneurysms with Large Mural Thrombus due to Kawasaki Disease in a Young Infant (가와사끼병 영아에서 발생한 혈전을 동반한 거대관상동맥류 1례)

  • Choi, Eun Na;Kim, Jeoung Tae;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kye;Kim, Dong Soo;Park, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.321-326
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    • 2005
  • Kawasaki disease is an acute systemic vasculitis of unknown origin. Giant coronary aneurysm is one of the most serious complications, although peripheral artery vasculitis can produce life-threatening events. Myocardial ischemia and infarction can be caused by coronary artery stenosis, aneurysm, and stagnation of blood flow in coronary arteries which triggers thromboembolism. Atypical presentation in young infants often interferes with prompt diagnosis and timely treatment, resulting in poor outcomes. We describe a 3-month-old infant with multiple giant coronary aneurysms with flow stagnation, stenosis and large mural thrombus due to Kawasaki disease. He presented with a prolonged course of severe coronary involvement in spite of all measures to reduce coronary complications. Finally, surgical intervention was tried because of the worsening coronary artery abnormalities. The patient died of acute cardiorespiratory failure shortly after weaning from cardiopulmonary bypass.

Anticoagulant Therapy for Left Ventricular Thrombosis after Dor Procedure (Dor 술식 후 좌심실 혈전증에서의 항응고제의 역할)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kang, Ho-Kyong;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.518-522
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    • 2003
  • Left ventricular thrombosis is a frequent and potentially dangerous complication in acute myocardiac infarction, but its occurrence and adequate therapy has not been known in patients with Dor procedure for the ischemic cardiomyopathy. We report a patient, 45 year-old male, who had a new left ventricular thrombus developed after coronary arterial bypass graft, Dor procedure, and removal of the left ventricular thrombus for ischemic car-diomyopathy. Left ventricular thrombus was disappeared on the follow-up cardiac MRI following intravenous heparin injection and oral coumadin therapy. This case suggest that anticoagulation therapy may prevent patients with the severe left ventricular dysfunction and apical aneurysm and dyskinesia from developing the left ventricular thrombus, and that thrombi will resolve without clinical evidence of systemic embolism.

The Bacterial Contamination in Glasses for Vision Correction (시력 교정용 안경의 세균 오염)

  • Kim, Heung-Soo;Hwang, Seock-Yeon;Yun, Chi-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.1
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    • pp.67-73
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    • 2013
  • Purpose: Recently, bacterial contamination of equipment and accessories required for vision correction has become a main causal factor in ophthalmic diseases. Thus, We investigated on both the actual condition of bacterial contamination from glasses of vision correction. Methods: Investigation of microorganisms was carried out with a group of 145 glasses wearers, composed of 36 elementary school students, 37 middle school students, 38 high school students, 10 college students, and 32 aged men. Results: Seventeen species of bacteria are detected from glasses of vision correction: B. cereus, B. licheniformis, Bacillus sp., CNS, Enterococcus sp., Escherichia coli, Proteus sp., Pseudomonas sp., Serretia sp., Streptococcus sp., Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus hemolyticus,, Acinetobacter sp., Enterobacter cloacae, GNR, and Pseudomonas aeruginosa. Among 17 species of bacteria, there are some potential causative agents for keratitis, corneal ulcer, Acute dacryocystitis, Orbital cellulitis, Periphlebitis retinae, Marginal blepharitis, and Acute conjunctivitis. Enterobacter cloacae, Pseudomonas aeruginosa and Staphylococcus epidermidis cause keratitis. Pseudomonas sp., and Staphylococcus aureus cause corneal ulcer. Staphylococcus aureus causes acute dacryocystitis, orbital cellulitis, periphlebitis retinae, marginal belpharitis. Streptococcus hemolyticus causes acute conjunctivitis. Conclusions: In summation, it is verified that hazardous, opportunistic and infectious microorganisms exist in glasses for vision correction. Ophthalmic diseases are predicted. Therefore, supplementary research on the development of a cleaning solution to cleanse the infection and of an effective method to remove microorganisms is required.

Minimally Invasive Marsupialization for Treating Odontogenic Cysts: Case Reports (최소 침습적 조대술을 이용한 치성낭종의 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Youngjae;Kim, Jungwook;Kim, Chong-Chul;Jang, Ki-Taeg;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.235-242
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    • 2017
  • Marsupialization and decompression constitute a well-established procedure for treating cavitary bone lesions of the jaw. The technique can be a primary treatment option, especially for pediatric patients with large cysts or lesions involving vital anatomical structures, such as a developing tooth germ. In this procedure, a decompression stent, such as a customized acrylic obturator or space-maintaining appliance, silicone tube, or nasal cannula, is inserted to maintain the patency of the cyst. However, this may cause clinical problems, such as irritation or trauma to the adjacent tissues, as well as discomfort to the patient, or failure of the stent due to cyst shrinkage. It can also be a reason for patient noncompliance. In the cases described here, a minimally invasive marsupialization technique using a metal tube made from a 16-gauge needle was used for odontogenic cysts in pediatric patients associated with unerupted teeth. Through this method, the lesions were removed, with patient cooperation, and the cyst-associated teeth erupted spontaneously.

Clinical Analysis of Palliative Treatments in Occlusive Vascular Disease (폐쇄성 혈관 질환을 가진 환자의 고식적 치료에 관한 임상적 고찰)

  • 김학제;조원민;류세민;황재준;송영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.283-289
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    • 2002
  • Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

Early Results of the Heart Transplantation for End Stage Heart Failure (말기 심부전증 환자에 대한 심장이식술의 조기 성적)

  • 노준량;원태희
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.876-884
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    • 1997
  • Fourteen patients underwent orthotopic heart transplantation between March 1994 and May 1996 in Seoul National University Hospital. There were 9 male and 5 female patients, and the mean age was 40.8 $\pm$ 12.4 years ranged from 12 to 56 years. All patient were in NYHA Fc III or IV preoperatively. The underlying heart diseases were dilated cardiomyopathy in 11 and restrictive cardiomyopathy in 3. The mean age of donors was 24.9$\pm$ 10.2 years and the causes of the brain death were head trauma by traffic accidents in 8, subarachnoid hemorrhage in 2, 1 asphyxia, 1 fall down injury, 1 brain tumo , and 1 drowning, respectively The blood type was identical in 11, compatible in 2, and incompatible in 1 patient. The direct bicaval anastomosis technique was used in 11 cases, and standard right atrial anastomosis was done in the remaining 3 cases. The graft ischemic time was 158$\pm$44 minutes ranged 94 to 220 minutes. There were two hospital deaths(14.3%). The causes of deaths were 1 right ventricular failure followed by suspected cyclosporine induced hemolytic uremic syndrome and rejection, and 1 delayed massive bleeding, probably from rupture of the anastomotic pseudoaneurysm, respectively. The follow-up duration was 16$\pm$9 months(3 to 28 months). There was one late death(8.3%). All the other patients were in NYHA Fc I except one patient who was in hospital because of the acute rejection. The actuarial survival rates including hospital deaths were 93.7% at 1 month, 86.9% at 6 months, and 77$\pm$12% at 2 years. Conclusively, heart transplantation is the good strategy for the management of end stage heart disease with acceptable operative mortality and early follow-up results.

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A Case of Micturition Syncope in a Child (소아에서 발현한 배뇨 후 실신 1례)

  • Lee, Sun Youn;Ryu, Su Jeong;Kim, Deok Soo;Kim, Young Hwue;Ko, Tae Sung;Kim, Jae Moon
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1274-1278
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    • 2003
  • Syncope in children and adolescents have a common occurrence according for up to 15% before adulthood. Micturition syncope, a kind of situational syncope, can be considered a form of reflex syncope. It can typically occur in healthy young men after rising from bed in the early morning who experience sudden loss of consciousness during or immediately after urination. The mechanism of micturition syncope is not completely understood, but it has been suggested that vasovagal reflex mediated bradycardia and peripheral vasodilation and decreased venous return due to Valsalva effect and standing position lead to the decrease in cerebral blood flow resulting in syncope. The causes of syncope are variable. So complete history taking, physical examination, electrocardiography, exercise stress test, echocardiography, head-up tilt table test, electroencephalography(EEG), brain magnetic resonance image and urodynamic study should be required for the diagnosis of micturition syncope. There were several reports about micturition syncope. However, literature of micturition syncope at the pediatric age has rarely been reported in Korea so far. Therefore, we report a case of a 9-year-old boy with micturition syncope with typical EEG findings of high amplitude delta wave and flattening during syncope.

Early Results in Surgical Treatment of Thoracic Aortic Aneurysm (흉부 대동맥류의 외과적 치료)

  • An, Byeong-Hui;Sin, Seong-Hyeon;Na, Guk-Ju
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.686-692
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    • 1997
  • This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .

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가교키토산 복합막을 이용한 에틸렌글리콜/물 혼합액의 투과증발분리

  • 남상용;이영무
    • Proceedings of the Membrane Society of Korea Conference
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    • 1996.10a
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    • pp.82-83
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    • 1996
  • 키토산 막을 이용한 유기혼합물 중의 물을 효율적으로 분리해내는 투과증발공정은 많은 발전을 거듭해 왔으며, 특히 에탄올중의 물을 효율적으로 탈수하는 것에는 탁월한 성능을 보고한 바 있다. 키토산은 주로 게등의 갑각류의 외피에서 얻을 수 있는 키닌을 주원료로 하는 물질로서 친수성이 뛰어난 막재료뿐만 아니라 생체적 합성이 요구되는 생체재료로도 널리 사용이 되고 있는 물질이다. 에틸렌즐리콜은 석유화학공정에서 생성되는 에틸렌 옥시이드를 원료로 하여 제조가 되고 있는 물질이다. 에틸렌글리콜은 PET의 원료로서 사용이 많이 되고 있으며, 겨울철에는 자동차등의 부동액이나 눈이 많이 내리는 지역에서 효율적으로 눈을 제거하기 위하여 공항의 활주로등에서 주로 사용이 되고 있는 물질이다. 에틸렌글리콜의 제조공정중에서 물을 효과적으로 제거하는 방법으로는 증류법이 있을 수 있으나 에틸렌글리콜의 비점이 물보다 현저히 높기 때문에, 공비혼합물을 생성하지 않는 이 혼합물의 특성과는 무관하게, 투과증발법을 이용할 경우 에너지의 절감이 이루어지게 되기 때문에 매우 효용적이고 추천할만할 공정이다. 또한 활주로의 부동액등으로 사용되는 경우 에틸렌글리콜의 재활용이 이루어질 경우 경비의 절감이나 환경적인 문제의 해결등의 장점이 있어서 물의 분리가 요구되고 있다. 이 경우에는 마찬가지로 에틸렌글리콜과 물의 분리는 일반적인 분리에 비해서 투과증발법이 유용하다고 할 수 있다. 본 실험에서는 키토산 막의 효율적인 응용예로서 기존의 알콜의 탈수와 더불어서 에틸렌글리콜의 탈수를 고찰해보고자 하였다.관리가 간편하며, 용존산소량을 줄일수 있다는 점에서 장점이 있으나, 전 ultra pure water의 system이 열적으로 안정해야 하고 경제적인 문제가 수반하는 단점을 가지고 있다. 후자의 경우, 미량의 과산화수소수 (1~10,000 ppm)를 이용해 처리 해주는 방법의 경우 경제적으로 큰 장점이 있고, 처리가 단순하다는 장점이 있으나 과산화수소수 자체에 포함하고 있는 높은 impurit level, 그리고 처리후 장시간의 flushing time을 가져야 한다는 단점등이 존재 하고 있다.요구된다. 몰입이 가능하여 임계치가 저하된 것으로 여겨진다. 또한 광학적 이득의 존재는 이 구조에 의한 극단파장 반도체 레이저다이오드의 실현 가능성을 나타내는 것이다.548 mL에 비해 통계학적으로 의의 있게 적었다(p<0.05). 결론: 관상동맥우회로 조성수술에서 전방온혈심정지액을 사용할 때 희석되지 많은 고농도 포타슘은 fliud overload와 수혈을 피하고 delivery kit를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.를 보였다.4주까지에서는 비교적 폐포는 정상적 구조를 유지하면서 부분적으로 소폐동맥 중막의 비후와 간질에 호산구 침윤의 소견이 특징적으로 관찰되었다. 결론: 분리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았

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