• Title/Summary/Keyword: 혈관내치료 치료결과

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Triglycerides increase mRNA Expression of Pro-inflammatory Cytokines Via the iNOS in Jurkat T lymphocyte and U937 Monocyte Cell Lines (Jurkat T 림프구와 U937 단핵구에서 중성지방 처리 시 iNOS를 통한 염증성 사이토카인의 mRNA 발현 증가)

  • Chang, Jeong Hyun
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.133-140
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    • 2019
  • Triglycerides (TG) are one of the triggers of chronic inflammatory lesions in the blood vessels. In the key factors in the development of inflammatory diseases, Pro-inflammatory cytokines such as tumor necrosis factor-alpha $(TNF-){\alpha}$ and interleukin-1 beta ($IL-1{\beta}$) contribute to the development of inflammatory lesions by recruiting other immune cells in the inflamed area or causing cell necrotic death. In this study, I investigated the effect of Jurkat T lymphocytes and U937 monocytes involved in vascular inflammation development on the expression of $TNF-{\alpha}$ and $IL-1{\beta}$ on exposure to TGs. In Jurkat cells, mRNA expression of $TNF-{\alpha}$ is increased by exposure to TGs. However, the expression levels of $TNF-{\alpha}$ and $IL-1{\beta}$ were increased by TGs in U937 cells. To investigate whether inducible nitric oxide synthase (iNOS) is involved in the increase of expression of $TNF-{\alpha}$ and $IL-1{\beta}$ by TGs, treatment of W1400 (an iNOS inhibitor) resulted in recovery of expression level both $TNF-{\alpha}$ and $IL-1{\beta}$. Based on the present study, it was confirmed that the expression of $TNF-{\alpha}$ and $IL-1{\beta}$ in monocytes and T lymphocytes. This increased cytokines contribute to development of vascular inflammatory lesions. In addition, iNOS is involved in the increase of $TNF-{\alpha}$ and $IL-1{\beta}$ expression by TGs.

The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

Analysis of micro inorganic materials in linerboard mill (골판지 원지 제조 공정 내 미세 무기물질의 분석)

  • 윤혜정;류정용;김용환;신종호;송봉근
    • Proceedings of the Korea Technical Association of the Pulp and Paper Industry Conference
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    • 2000.11a
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    • pp.132-132
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    • 2000
  • 환경오염과 이상기후의 영향으로 인한 수자원의 고갈과 함께 국내의 경우 수자원 개발 계획 및 수요량을 감안할 때 향후 7 년 내에 물부족 현상을 겪을 것이라는 보고가 있 었으며, 환경부담을 줄이기 위해 폐수의 배출기준은 강화되고 있다. 이러한 상황에서 제조 특성상 타 업종에 비해 폐수 발생량이 높은 편인 국내의 제지산업은 여러 해전부터 이에 대 한 방안을 모색하여 왔다. 일반적으로 폐수 수질 관리와 청수 사용량의 절감을 위해 고가의 폐수 처리 장치를 설치하거나 폐수 재활용을 통해 공정을 극도로 폐쇄화하는 방안으로 연구 가 진행되어 왔다. 이 중 용수의 재활용이 가장 경제적인 방법이지만, 재활용이 지속될수록 각종 무기염과 콜로이드성 유기물질이 축적되어 각종 약품의 효능 저하, 탈수속도의 저하 및 생산 제품의 품질 악화 등의 문제를 유발한다고 알려져 있다. 이를 해결하고자 하는 노 력으로 펄프 원료에 따른 공정수 내 용해성 물질의 분석과 재활용 횟수에 따른 각종 SS와 D DS의 축적 정도에 대한 기초 연구가 수행되었으며, 고폐쇄화된 공정에서 성능을 발휘할 수 있는 첨가제의 개발과 적용 방법에 대한 연구도 수행된 바 있다.여러 지종 가운데 골판지 원지는 용수의 재활용률이 상당히 높은 지종이기 때문에 공정수의 재활용이 진행될수록 열악한 저급 원료로부터 각종의 다양한 물질이 용출 혹은 배 출되며, 이러한‘물질은 골판지 원지의 강도 발현에 더욱 악영향을 미칠 것으로 판단되었다. 미세분으로 구성된 SS의 경우 이미 많은 연구를 통해 특성이 파악되었기 때문에 본 연구에 서는 ss를 제외한 공정수를 두 가지로 크게 나누어 고려하였다. 즉, ss로 측정되지 않지만 닥도를 유발할 수 있는 미세 무기물질과, 용해성의 무기염, 첨가제 및 추출물 둥으로 이루어 진 용해성 성분으로 나누어 분석하였으며, 또한 각각이 초지 특성에 미치는 영향을 살펴보 고자 하였다.을 해석코자 하였으며, 그 방법으 로 수치해석기법을 도입하였다. 또 실제 캘린더링 전후의 두께 변화를 측정하여 유리전이온도 의 도달 깊이와 비교하였다. 지필의 압축 정도는 롤의 직경과 닙 폭을 이용하여 MD 방향으 로 함수화하였으며, 열전달 계수로는 겉보기 값을 사용하였다. 이때 지펼은 균질한 것으로 가 정하였다. 함수율은 유리전이온도를 좌우하는 가장 큰 인자이나 본 연구에서는 항온항습처리 를 통해 유입지의 함수율을 고정시켰으며 캘린더링 시 함수율의 변이는 없다고 가정하였다. 그 결과 열침투깊이가 증가할수록 지필은 보다 변형되기 쉬운 상태가 되어 주어진 압력 조건에 대해 소성변형 정도가 증가하는 것으로 나타났다. 이는 캘린더링 전후에 두께 변화를 측정하여 정량적으로 평가할 수 있었다. 수치해석기법을 통해 같은 압력 조건에서 온도가 증 가함에 따라 혹은 같은 온도 조건에서 압력이 증가함에 따라 지필 내의 유리전이온도의 침투 깊이가 증가함을 알 수 있었으며 이는 캘린더링 전후의 두께 변화의 측정 결과와 일치하였 다. 또 NRT가 증가함에 따라서도 유리전이온도 침투 깊이가 증가하였다.합편에 비해 일부 우수한 양상을 보였지만 본 실험의 범위내에서는 통계적 정량적 차이를 제시할 수는 없었다. 향후 보다 광범위한 동물 실험이 필요할 것으로 사료된다.된다.하고도 완전교정술 도달 확률이 높은 치료전략이라는 사실을 입증하였으며 주대동맥폐동맥혈관부행지의 크기나 숫자가 단일화하기 쉬운 형태학적 특징을 지닌 경우에는 조기에 일단계완전교정술을 시행하여 양호한 결과를 얻을 수 있다는 사실을 발견하였다. 반면 본 환아군 중 단일화술을 먼저 시도한 군에서는 비록 단계적인 단일화를 시도한 군에서 단일화술과 관계된 수술사망율이 약간 낮기는 하였으나 완전교정술까지 완료될 가능성에는 차이가 없었다. 그러나 이 경우 보다 정련된 적응 환자의 선택을 통한 단일화 우선전략의 시도와 장기 추

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Tuberculous Aortitis with Aorto-bronchial Fistula (대동맥-기관지루를 동반한 결핵성 대동맥염)

  • Wi, Jin-Hong;Han, Il-Yong;Yoon, Young-Chul;Lee, Yang-Haeng;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.277-280
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    • 2008
  • Tuberculous aortitis is a very rare disease. Furthermore, it is all the more rare for it to be complicated by the development of an aortic aneurysm or the formation of aorto-bronchial fistula. If it is complicated by rupture of the aorta, mortality is very high. If the patient didn't contract tuberculosis, but was expectorating blood, we would have to carry out a chest CT promptly, in order to make a rapid and accurate diagnosis of this disease. A 46-year-old male patient was admitted due to the sudden onset of intermittent hemoptysis and chest discomfort. CT scans of the chest showed an aneurysmal change to the descending thoracic aorta, and the formation of an aorto-bronchial fistula, which originated from this aneurysm and communicated with its left lower lobe. We operated with an artificial vessel graft interposition of the descending thoracic aorta and a left lower lobectomy. Because the diagnosis was of tuberculosis, we started anti-Tbc medication and long term anti-Tbc medication was recommended.

The Short Term and Intermediate Term Results of using a T-tube in Patients with Tracheal Stenosis (기관 협착 환자에서의 T-튜브의 중단기 결과)

  • Sa, Young Jo;Moon, Seok-Whan;Kim, Young-Du;Jin, Ung;Park, Jae-Kil;Kim, Jae Jun;Kim, Chi-Kyung;Jo, Keon Hyon;Park, Chan Beom;Yim, Hyeon Woo
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.63-71
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    • 2009
  • Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results (심폐바이패스 없이 시행하는 관상동맥우회술과 경피적 관상동맥중재술의 병합요법 : 적응증 및 조기성적)

  • Hwang Ho Young;Kim Jin Hyun;Cho Kwang Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.733-738
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    • 2005
  • Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

Clincal Results according to the Level and Extent of Sympathicotomy in Axillary Hyperhidrosis (액와부 발한을 동반한 일차성다한증 환자에 있어서 수술방법에 따른 결과 비교)

  • Kim, Byung-Ho;Huh, Dong-Myung
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.570-575
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    • 2005
  • Background: Video-assisted thoracic sympathicotomy plays an important role as an effective method for the treatment of axillary hyperhidrosis. People with axillary hyperhidrosis were not satisfied by the occurrence of the high rate of disabling compensatory hyperhidrosis and axillary resweating. Therefore, by comparing and assessing the clincal results according to the level and extent of sympathicotomy in axillary hyperhidrosis, we aim to determine which method will result in maximal benefits. Material and Method: Among 70 patients suffering from axillary hyperhidrosis having undergone thoracoscopic sympathicotomy from January 2001 through December 2003, 57 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into two groups, Group 1 (n=25): patients having undergone R3, 4, 5 sympathicotomy which consist of blocking the interganglionic neural fiber on the third, fourth, and fifth rib, Group 11 (n=32): patients having undergone R3,4 sympathicotomy which consist of blocking the interganglionic neural fiber on the third and fourth rib. The study parameters were satisfaction rate and degree of compensatory sweating. Result: There was no difference on age and sex, family history, combined hyperhidrosis, and mean follow up month between the two groups. Patients expressing satisfaction were $88.0\%$ in group and $56.3\%$ in groups 11 with statistically significant difference (p=0.02). Moderate to severe compensatory sweating were $52.0\%$ (embrassing 6 patients, disabling 7 patients) in group 1 and $62.5\%$ (embrassing 5 patients, disabling 15 patients) in groups 11 with no significance in the statistical analysis. Conclusion: R3, 4, 5 sympathicotomy was an effective means of treating axillary hyperhidrosis because of higher long term satisfaction rate.

Correlation between Cyclin D1, p53, Bcl-2 Protein Expression and Prognosis in Primary, Resected Stage IIIA Non-Small Cell Lung Cancer (NSCLC) (완전 절제된 제IIIA기 비소세포폐암에서 Cyclin D1, p53, Bcl-2 단백질 발현의 의의)

  • 정경영;양우익
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1200-1205
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    • 1998
  • Background: Lung cancer formation is a multistage process involving activation of protooncogene and inactivation of tumor suppressor genes. We evaluate the significance of cyclin D1, p53, bcl-2 gene mutations in patients with curatively resected stage IIIA non-small cell lung cancer(NSCLC). Material and Method: One hundred consecutive cases of stage IIIA lung cancers from patients operated on curatvely between 1990 and 1995 for which adequate paraffin blocks and clinical history were available. Immunohistochemical studies were performed on the representative tissue sections from each case by the labelled streptovidin- biotin method. Sections for cyclin D1, p53, Bcl-2 immunostaining were pretreated in a microwave oven for 10 to 20 minutes in citrate buffer before immunostaining. The overnight incubation with NCL-cyclin D1-GM for cyclin D1, with clone DO-7 for p53, with clone 124 for bcl-2 was done. Mean follow-up was 24.1 months (range 2-84 months) after operation. Result: One hundred cases of lung cancers were composed of 56 cases of squamous cell carcinoma, 37 cases of adenocarcinoma, 5 cases of adenosquamous cell carcinoma, and 2 cases of large cell carcinoma. The 5-year survival was 32.1%. The positive expression rate of cyclin D1 was 35%, p53 was 56%, and bcl-2 was 17%. But there were no correlation between cyclin D1, p53, Bcl-2 protein expression and survival. Conclusion: These observation indicate that cyclin D1, p53, bcl-2 protein overexpression might be implicated in the oncogenesis of non-small cell lung carcinomas but they have no usefulness as a prognostic marker.

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AUTOTRANSPLANTATION OF TOOTH WITH IMMATURE ROOT FORMATION (치근단 미완성 치아의 자가치아이식)

  • Jung, Ji-Sook;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.66-72
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    • 2012
  • Autogenous tooth transplantation can be defined as the surgical movement of a tooth from one position in the mouth to another in the same individual. The most common reasons for tooth transplantation include replacement of a missing first molar, transplantation of impacted canines to their normal positions in the arch, and transplantation of premolars in areas of missing teeth, especially in the anterior area of the mouth. The key to successful tooth transplantation is proper selection of graft with adequate root development as well as the design of surgical operation. Root development stage with half to three-quarter-developed roots increase the success rate of autotransplantation. We report the cases of successful autotransplantation which resulted in ideal healing of periodontal ligament, gingiva and alveolar bone. All transplanted teeth presented immature root formation at the moment of the procedure. After surgical procedure, we can observe good healing pattern without endodontic problem.

Treatment of Acute Pulmonary Thromboembolism with Left Atrial Thrombus via Atrial Septal Defect - A case report- (심방중격결손을 통해 좌심방으로 유입되어 있는 혈전을 동반한 급성 폐동맥 혈전색전증의 치험)

  • 김시욱;최재성;유재현;임승평;이영;나명훈
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1010-1014
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    • 2004
  • Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.