• Title/Summary/Keyword: 정맥형

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Surgical Correction of Total Anomalous Pulmonary Venous Return (총폐정맥 환류이상증의 외과적 치료)

  • 금동윤;이광숙
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.292-296
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    • 1996
  • Total anomalous pulmonary venous return is a rare but serious cardiac malformation, accounting for only about 1.5~3% of congenital heart disease. Surgical results have been dramatically improved in the last two decades, largely owing to improved techniques of cardiopulmonary bypass and perloperative management. Seven patients ranging in age from 15 days to 11 years with total anomalous pulmonary venous return underwent repair between 1984 and 1995. The types of anomalous return were supracardiac in 5, and cardiac in 2. There were 5 boys and 2 girls. There were two hospital death, occurred in 15-day-old, and 40-day-old infants with supracardiac type. Follow-up periods have ranged from 3 months to 11 years, and all survivors have remained asymptomatic with normal growth and development.

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The Norwood Operation in Infants with Complex Congenital Heart Disease (복잡 선천성 심기형 환자에서의 Norwood 술식)

  • 박정준;김용진
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.263-269
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    • 1997
  • From April 1987 to May 1996, 13 infants underwent a Norwood operation for complex congenital heart diseases including hypoplastic left heart syndrome (n : 7), mitral stenosis with small VSD and subaortic stenosis (n : 1), mitral atresia with ventricular septal defect, coarctation of aorta, and subaortic stenosis (n = 1), interrupted aortic arch with ventricular septal defect and subaortic stenosis (n : 1), tricuspid atresia with transposition of the great arteries (n = 1), and complex double-inlet left ventricle (n : 2). All patients without hypoplastic left heart syndrome were associated wit hypoplasia of ascending aorta and arch. Age at operation ranged from 3 days to 8.7 months (mean 60.6 $\pm$ 71.6 days, median 39 days). The operative mortality( < 30 days) was 46% (6 patients). Late mortality was 15% (2 patients). All operative deaths occured during the Erst 24 hours after the operation as a result of cardiopulmonary bypass weaning failure (5 patients) and sudden hemodynamic instability postoperatively (1 patient). Late death was due to aspiration pneumonia in two cases. There are 5 long-term survivals (39%). Three of them have undergone a two-stage repair with a modified Fontan operation in two and total cavopulmonary shunt in one at 12, 17, 4.5 months after Norwood procedure with no mortality. Two patients have entered a three-stage repair strategy by undergoing a bidirectional cavopulmonary shunt at 3 and 5.5 months after initial operation with 1 operative death. The actuarial survival rate for all patients at the first-stage operation, including hospital deaths and ate death was 30.8% at 1 year. In conclusion, the operative mortality of Norwood operation was relatively high compared to other operation for major cardiac anomalies, continuing experience will lead to an improvement in result.

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Idiopathic Fibrosing Mediastinitis Causing Extensive Fibrotic Veno-occlusion with Minimal Mediastinal Involvement (광범위한 섬유성 정맥 폐쇄를 동반한 특발성 섬유화성 종격동염 1예)

  • Kim, Je-Hyeong;Hur, Gyu-Young;Lee, Seung-Heon;Lee, Sang-Yeub;Park, Sang-Myun;Shin, Chol;Shim, Jae-Jeong;In, Kwang-Ho;Kim, Han-Kyeom;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.278-282
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    • 2002
  • A 68-year-old woman was admitted after suffering facial edema with neck vein engorgement for approximately 2 months. A chest X-ray showed a mild widening of the superior mediastinum and a luminal obliteration of the superior vena cava(SVC) was noted on a computed tomograph. Venography showed that both subclavian veins were obstructed at the level of the proximal clavicle with a nonvisualization of the SVC. The SVC, both the innominate and the left internal jugular veins were completely obstructed with extensive cord-like fibrotic changes despite the absence of mediastinal involvement. The microscopic features showed a chronic granulomatous inflammation with a fibrosis minimally invading the mediastinal fat, which is consistent with fibrosing mediastinitis.

Angiomyoma on Face : A Case Report (안면부에 발생한 혈관근종의 치험례 : 증례보고)

  • Choi, Junho;Chang, Hak
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.48-50
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    • 2013
  • Angiomyoma is a rare, benign smooth muscle cell tumor. These tumors may be found anywhere in the body. They frequently occur in the lower extremities except venous type. Angiomyoma in the head and neck area is very rare, and only a few cases have been reported. A 63 year-old male patient visited to outpatient clinic due to size-growing nodule-like lesion in the Lt. alar area. Excisional biopsy was done for diagnosis. The lesion was totally excised with 2 mm safety margin. Frozen biopsy of the lesion was requested, and all resection margins were proved negative. To cover the raw surface, full thickness skin grafting was performed. The graft was harvested from Rt. posterior auricular area. Tie over dressing was applyed on Lt. alar area. The graft was well taken and healed without any complication in both short term and long term follow up periods of 2 weeks, 1 month, 2 months, and 6 months. Donor site completed healed without any complications. The leiomyoma is benign tumor originated from smooth muscle, and it can be classified into solid leiomyoma, angiomyoma, and epithelioid leiomyoma. Especially, the angiomyoma consists of smooth muscle cell and blood vessel, and it is originated from the tunica media of blood vessel. Angiomyoma alone frequently occurs in the lower extremities as solitary painless subcutaneous tumor. Venous type of angiomyoma in the oral cavity was reported in other references, but on the facial surface it may be the first case reported as paper. So this report can be very meaningful.

Extract of Rubus coreanus Fruits Increases Expression and Activity of Endothelial Nitric Oxide Synthase in the Human Umbilical Vein Endothelial Cells (복분자 추출물에 의한 내피세포 NO 합성효소의 활성과 발현 증가)

  • Yoon, Hyun-Joong;Park, Soo-Young;Oh, Sung-Tack;Lee, Kee-Young;Yang, Sung-Yeul
    • Journal of Life Science
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    • v.21 no.1
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    • pp.44-55
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    • 2011
  • This study aimed to investigate the effects of water extract of Rubus coreanus (RCE) on the expression and activity of endothelial nitric oxide synthase (eNOS), as well as its signal transduction pathways in human umbilical vein endothelial cells (HUVECs). The specific inhibitors of NOS show RCE treatment increases NO production in HUVECs due to the up-regulation of eNOS rather than iNOS. The real-time expression level of eNOS mRNA was also increased upon RCE treatment in HUVECs. While a PKC-specific inhibitor, RO-317549, did not alter RCE-induced NO production in HUVECs, tamoxifen (estrogen receptor-specific inhibitor), PD98059 (ERK-specific inhibitor) and LY-294002 (PI3K/Akt-specific inhibitor) did have suppressive effects. Increased NO production by RCE seems to result from a higher level of active eNOS (pSer1177). Specifically, inhibition of ERK not only decreased the level of active eNOS, but also increased the inactive form of the enzyme (pThr495) in HUVECs. This study suggests that RCE treatment increases NO production in HUVECs due to the increased expression and activity of eNOS. It is also shown that RCE-induced eNOS activation occurs partly through the binding of RCE to the estrogen receptor, along with ERK and PI3K/Akt-dependent signal transduction pathways. In addition, the regulatory binding proteins of eNOS including Hsp90 and caveolin-1 were related to these effects of RCE on eNOS activity in HUVECs.

Early Results of Extracardiac Fontan Operation (심장외폰탄수술의 조기성적)

  • 김웅한;정도현;김수철;전홍주;이창하;김욱성;오삼세;정철현;나찬영
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.650-659
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    • 1998
  • Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

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Isolation of Endothelial Cells and Smooth Muscle Cells from Rat Aort (흰쥐 대동맥의 내피세포와 민무늬근육세포 분리)

  • Yun, Young-Eun;Song, In-Hwan;Sung, Eon-Ki;Kim, Joo-Young
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.182-192
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    • 2006
  • Background: Atherosclerosis has emerged as the leading cause of death in developed countries. At present, human umbilical vein endothelial cells (HUVEC) are most commonly used for the investigation of Endothelial cells (EC). However, HUVEC are not found in arteries but only in veins. Currently there are many reports on methods used to isolate EC;, most of these methods require special equipment to remove contaminating smooth muscle cells (SMC). Materials and Methods: The method described here may be used to isolate not only ECs but also SMCs;,the approach presented here did not require special equipment. Rat aorta was treated with 2 mg/ml of type II collagenase solution for 45 minutes. The isolated cells from the aorta were incubated in medium G for a week;, only ECs could be separated. After the collagenase treatment, the rest of aorta was cut lengthwise, and left undisturbed to obtain SMCs in the culture dish for 10 days. To verify the purity of the isolated cells, we performed immunofluorescence and evaluated the results with transmission electron microscopy analysis. Results: The immunofluorescence study demonstrated specific expression of CD31 and ${\alpha}$-smooth muscle actin in the isolated ECs and SMCs, respectively. Cultured ECs and SMCs showed their own fine structure characteristics. Conclusion: These results suggest that this method for isolating ECs and SMCs may be especially useful for the study of atherosclerosis.

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Aggressive Surgical Treatment for Complex Cardiac Anomalies Associated with Right Atrial Isomerism (우심방 이성체를 동반한 복잡 심기형에 대한 적극적인 수술적 치료)

  • Hwang, Ui-Dong;Jung, Sung-Ho;Jhang, Won-Kyoung;Kim, Young-Hwue;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.569-573
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    • 2007
  • A 3 month old female baby, who had been diagnosed with right atrial isomerism associated with total anomalous pulmonary venous return (TAPVR), a functional single ventricle and major aortopulmonary collateral arteries (MAPCA), underwent left MAPCA unifocalization and left Blalock-Taussig shunt (3.5 mm) at 3 months of age. The post-operative course was complicated by pulmonary venous congestion, and the drainage site of the TAPVR was found to be stenotic on echocardiography. We performed sutureless repair of the TAPVR along with unifocalization of the right MAPCA. She was put on an extracorporeal membrane oxygenator for 8 days after the 2nd operation, and she was able to come off the oxygenator with the placement of a central shunt (3 mm). She developed tracheal stenosis, which was presumably due to longstanding endotracheal intubation, and she then underwent tracheostomy. She was discharged to home on day 104 after the 1st operation, and she has been followed up for 2 months in a good clinical condition.

Implementation of ICD(Implantable Cardioverter Defibrillator) Algorithm and Simulator for Detecting and Treatment of Patient with Arrhythmia (부정맥 환자의 진단 및 치료를 위한 ICD 알고리즘 및 시뮬레이터 구현)

  • Shin, K.S.;Kim, J.K.;Shin, H.S.;Lee, C.K.;Lee, M.H.
    • Proceedings of the KIEE Conference
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    • 2008.04a
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    • pp.127-128
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    • 2008
  • 현대인의 생활 습관 및 고령화 사회의 도래에 따라 심장질환자의 수는 기하급수적으로 늘어가고 있으며 특히 정맥 환자는 그 중에서 가장 큰 분포를 차지하고 있다. 따라서 심장질환의 검출 및 치료를 위한 기기의 개발 및 발전이 시급하다고 볼 수 있다. 그 중 본 고에서는 인체 이식형/삽입형 Pacemaker인 ICD(Implantable Cardioverter Defibrillator)의 알고리즘을 소개하고자 한다. 본 고의 전체적인 구조는 ICD 기술의 필요성을 제시하고 본론에서는 부정맥(Arrhythmia) 소개 및 구현 대상, ICD 알고리즘 관련 국내외 현황, 빈맥의 검출 및 치료, 서맥의 검출 및 치료, 시뮬레이터 구현의 내용을 담았다 또한 알고리즘의 모듈 단위 구성도와 시뮬레이터(Simulator) UI(User Interface)를 제시하였다.

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Air detector using the change of dielectric constant for medical applications (의료분야 응용을 위한 유전상수 변화를 이용한 공기감지 장치)

  • Kim, Kyung-Hwa;Shim, Joon-Hwan
    • Journal of Advanced Marine Engineering and Technology
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    • v.34 no.6
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    • pp.864-870
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    • 2010
  • Air embolism can be a lethal complication of surgical procedures during which venous pressure at the site of surgery is sub-atmospheric or air is forced under pressure into a body cavity. To solve the problem, we developed the air detector using relative dielectric constant change, which is expected to be used broadly in industrial circles. We designed air detection system with air control equipment, detection circuit and LabVIEW system for air sensing. In experiments with a mock system, the proposed system showed a signal difference depending on the amount of air in the Tygon tube of the mock system.