• Title/Summary/Keyword: 혈관내 치료

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Clinical Experience of Spontaneous Hemopneumothorax (자연성 혈기흉의 임상적 경험)

  • Moon, Hyeon-Jong;Hwang, Seong-Wook
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.669-674
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    • 2010
  • Background: Spontaneous hemopneumothorax is characterized by the accumulation of air and more than 400 mL of blood in pleural cavity without any apparent cause. It is a rare disease and can cause life-threatening situation. We analyzed clinical reviews of two medical centers to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with 18 spontaneous hemopneumothorax patients was made. Result: These 18 patients were comprised of 15 male and 3 female with average 24.6 years (range 15~46 years). Almost patients (16) underwent a closed thoracostomy initially and 15 patients received video-assisted thoracic surgery (VATS). Mean postoperative chest tube removal was 2.9 days and one complication was post-removal pneumothorax. During the follow-up periods there were no other complications and recurrence. Conclusion: Proper initial diagnosis and management of spontaneous hemopneumothorax prevent significant hypovolemic shock. Video-assisted thoracic surgery should be considered an early surgical management in spontaneous hemopneumothorax. However conservative manage without bleb excision may be effective in selected patients.

Intravitreal Anti-vascular Endothelial Growth Factor Injections to Treat Neovascular Age-related Macular Degeneration: Long-term Treatment Outcomes (삼출 나이관련황반변성에 대한 항혈관내피성장인자 유리체내주사 치료의 장기 임상 결과)

  • Park, Yu Jeong;Son, Gi Sung;Kim, Yoon Jeon;Kim, June-Gone;Yoon, Young Hee;Lee, Joo Yong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1142-1151
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    • 2018
  • Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.

Endovascular Repair of Acute Type B Aortic Dissection: The Early Results and Aortic Wall Changes (급성 B형 대동맥 박리의 혈관내 스텐트-그라프트 삽입이 초기성적 및 대동맥 벽의 변화)

  • Her, Keun;Won, Yong-Soon;Shin, Hwa-Kyun;Yang, Jin-Sung;Baek, Kang-Seok
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.648-654
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    • 2010
  • Background: This study assessed the early results of endovascular repair of acute type B aortic dissection and the aortic wall changes following endovascular repair. Material and Method: From July 2008 to May 2009, the preoperative and follow-up computed tomography (CT) scans of 5 patients with acute type B aortic dissection were evaluated, and these patients had underwent stent graft implantation within 13 days of the onset of dissection (mean: 7 days; range: 3~13). The whole lumen (WL), true lumen (TL) and false lumen (FL) diameters were measured at the proximal (p), middle (m) and distal (d) third of the descending thoracic aorta. Result: The study included four men and one woman with an average age of $59.4{\pm}20.1$ years (age range: 37~79 years). The follow-up CT was performed and evaluated at 7 days and 6 months. The primary tear was completely sealed in all the patients. No paraplegia, paresis or peripheral ischemia occurred and none of the patients died. No endoleaks developed in any of the patients during follow-up. The TL diameters increased from 20.4 to 33.5 mm in the proximal third (p/3), from 19.5 to 29.8 mm in the middle third (m/3) and from 15.2 to 23.5 mm in the distal third (d/3). The FL diameters decreased from 18.7 to 0 mm in the p/3, from 15.4 to 0 mm in the m/3 and from 21.4 to 8.7 mm in the d/3. The changes in the TL diameter were statistically significant in the middle and distal aorta, and those changes in the FL diameter were not statistically significant. There was a decrease in the WL after repair, but this was not statistically Significant. In three patients, the false lumen disappeared completely on follow-up CT at 6 months. Two patients had patent false lumens and no thrombosis. Conclusion: The early results showed that endovascular repair was effective in treating acute type B aortic dissection, and endovascular repair promoted positive aortic wall changes.

A Case of Concurrent Chemoradiotherapy After Endoscopic Resection For Early Esophageal Cancer (조기 식도암에서 내시경점막하박리술 시행 후 항암방사선동시요법을 시행한 1예)

  • Kyuhyun Han;Sunyoung Shin;Junil Moon;Gawon Song;Wonjin Koh;Wonhee Kim;Sungpyo Hong;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.35-38
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    • 2015
  • 62-year-old patient who had past history of endoscopic submucosal dissection for early gastric cancer at September 2008, underwent endoscopic submucosal dissection of esophagus for early esophageal cancer at mid esophagus during health screening service. Because there was a high risk of lymph node metastasis at biopsy results, concurrent chemoradiotherapy was added to endoscopic submucosal dissection. There was a metachronous cancer at mid-esophagus at March 2013. He underwent endoscopic mucosal resection and photodynamic therapy. Concurrentchemoradiotherapy after endoscopic submucosal dissection is an effective treatment method.

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A Case of Pulmonary Cavernous Hemangiomatosis Presented with Right Shoulder Pain (우측 어깨의 통증을 주소로 내원한 해면상 폐혈관종증 1례)

  • Lee, Eun-Young;Hong, Sang-Bum;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Dong-Kwan;Lee, In-Chul;Moon, Dae-Hyuck;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.99-104
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    • 2000
  • Pulmonary hemangiomatosis is a rare disease of unknown etiology characterized by diffuse proliferating microvessels that infiltrate not only the lung but also all of the thoracic tissues. The disease is rapidly progressive and usually results in death due to complications of pulmonary hypertension and pulmonary hemorrhage. There are two histologic patterns of pulmonary hemangiomatosis : capillary and cavernous. We describe a 21-year-old man with cavernous-type pulmonary hemangiomatosis presented with right side shoulder pain. He was treated with percutaneous transarterial embolization and then followed with interferon alfa-2a for one year with favorable clinical and radiological response.

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Stereotactic Target Point Verification in Actual Treatment Position of Radiosurgery (방사선수술시 두개내 표적의 정위적좌표의 치료위치에서의 확인)

  • Yun, Hyong-Geun;Lee, Hyun-Koo
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.403-409
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    • 1995
  • Purpose : Authors tried to enhance the safety and accuracy of radiosurgery by verifying stereotacitc target point in actual treatment position prior to irradiation. Materials and Methods : Before the actual treatment, several sections of anthropomorphic head phantom were used to create a condition of unknown coordinates of the target point. A film was sandwitched between the phantom sections and punctured by sharp needle tip. The tip of the needle represented the target point. The head phantom was fixed to the stereotactic ring and CT scan was done with CT localizer attached to the ring. After the CT scanning, the stereotactic coordinates of the target point were determined. The head phantom was secured to accelerator's treatment couch and the movement of laser isocenter to the stereotactic coordinates determined by CT scanning was performed using target positioner. Accelerator's anteroposterior and lateral portal films were taken using angiographic localizers. The stereotactic coordinates determined by analysis of portal films were compared with the stereotactic coordinates previously determined by CT scanning. Following the correction of discrepancy the head phantom was irradiated using a stereotactic technique of several arcs. After the irradiation, the film which was sandwitched between the phantom sections was developed and the degree of coincidence between the center of the radiation distribution with the target point represented by the hole in the film was measured. In the treatment of the actual patients, the way of determining the stereotactic coordinates with CT localizers and angiograuhic localizers was the same as the phantom study. After the correction of the discrepancy between two sets of coordinates, we proceeded to the irradiation of the actual patient. Results : In the phantom study, the agreement between the center of the radiation distribution and the localized target point was very good. By measuring optical density profiles of the sandwitched film along axes that intersected the target point, authors could confirm the discrepancy was 0.3 mm. In the treatment of an actual patient, the discrepancy between the stereotactic coordinates with CT localizers and angiographic localizers was 0.6 mm. Conclusion : By verifying stereotactic target point in actual treatment position prior to irradiation, the accuracy and safety of streotactic radiosurgery procedure were established.

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Thrombolysis for Prosthetic Mitral Valve Thrombosis - 3 cases report - (인공승모판막 혈전의 용해 치료 - 3례 보고 -)

  • Baek, Man-Jong;Kim, Hyoung-Mook;Lee, In-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.70-74
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    • 1999
  • Thrombosis in valve or left atrium after mechanical mitral valve replacement causes prosthetic valve dysfunction or thromboembolism. Early and adequate therapy is very important but clinically not easy. Thrombolysis can avoid reoperation-related risks and act as an optimal therapy for prosthetic valve thrombosis. This report describes three patients who were treated by using low molecular weight heparin (LMWH) and wafarin. Two patients, including one pregnant woman, had prosthetic valve thrombosis and immobility of valve leaflets, and one patient with recent cerebral infarction due to thromboembolism had thrombus in left atrium. Fraxiparine 0.3 cc (7,500 ICU AXa) was administrated subcutaneously twice or triple daily. At discharge, thrombosis in valve and left atrium were completely or near totally lysed and valve leaflets were normally mobile. During the period of thrombolysis and follow up, there were no complications in all patients.

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Giant Fibrovascular Polyp of the Esophagus -A Case Report- (식도에 발생한 거대 섬유혈관성 용종)

  • 오삼세;심영목
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.675-680
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    • 1996
  • A case of giant fibrovascular polyp of the esophagus with a review of the literature is presented. A 52 year old man with into rmittent dysphagia was found to have an intraluminal esophageal lesion of remarkable size by the radiological studies, but overlooked at esophagoscopy. A giant esophageal polyp w s successfully re- moved surgically by transthoracic approach, although preoperative evaluation of the location and characteristics of the lesion was problematic. These pedunculated intraluminal polyps are rare and characterized by slow growing. benign nature that almost always originate at the level of. the cricopharyngeus muscle, and often attain giant proportions. Symptoms are related to esophageal ob- struction and sudden death by asphyxia can occur. Surgical removal is the choice of treatment.

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Clinical Applications of Intracoronary OCT (Invited Paper) (심혈관 OCT의 임상적 응용)

  • Ha, Jinyong;Kim, Jung-Sun;Hong, Myeong-Ki
    • Korean Journal of Optics and Photonics
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    • v.26 no.1
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    • pp.1-8
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    • 2015
  • The most common cause of a heart attack is known as coronary artery disease, which narrows the arteries and reduces the blood flow to the heart. To treat coronary artery stenosis, percutaneous coronary intervention (PCI) (a nonsurgical procedure to install a stent, which holds the artery wall open) is performed. Intracoronary optical coherence tomography (OCT) is a catheter-based, invasive optical imaging system. To determine whether PCI is appropriate, and to perform stent evaluation in a catheterization laboratory, OCT examinations are carried out. This review details the fundamental principles and technological status of intracoronary OCT imaging, and discusses the ongoing clinical applications to determine the benefits of OCT-guided PCI.

Endovascular Stenting of a Traumatic Pseudoaneurysm on C5 Portion of the Internal Carotic Artery - A Case Report - (내경동맥에 발생한 외상성 가성동맥류에 대한 혈관내 스텐트 치료)

  • Jung, Hyun Ho;Kim, Hun Joo;Lee, Myeung Sub;Whang, Kum;Cho, Sung Min;Hu, Chul;Pyen, Jhin Soo;Hong, Soon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.332-336
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    • 2001
  • This 18-year-old male patient had a massive epistaxis after motorcycle traffic accident on 1st day of admission. There were no other significant brain parenchymal lesion on initial brain CT exam, except multiple pneumocephalus and basal skull fracture lines. We treated epistaxis conservatively till vital signs were corrected, and then conventional cerebral angiogram was followed. On angiogram, there was traumatic pseudoaneurysm on C5 portion(by Fischer) of ICA, so we treated it only by endovascular stenting. For the purpose of sparing parent arterial patency, endovascular stenting on pseudoaneurysm may play a role with safety and good results.

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