• Title/Summary/Keyword: 혈관내 치료

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Surgical Treatment of the Pseudoaneurysm of the Ascending Aorta Following the Repair of Congenital VSD -1 case report- (선천성 심실중격결손증 교정술 후 발생한 가성 상행대동맥류 수술 치험 -1례 보고-)

  • An, Byeong-Hui;Kim, Gwang-Hyu;Na, Guk-Ju;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.564-568
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    • 1996
  • Pseudoaneurysm of the ascending aorta following cardiac surgery is very unusual and it is poten- tially fatal. We report here a fourteen year-old female patient with pseudoaneurysm of the ascending aorta following a repair of a congenital ventricular septal defect at other hospital 50 months ago. Although she had a mild superficial wound infection postoperatively, she enjoyed uneventful. life until she visited our hospital for a generalized weakness and exertional dyspnea which developed a month ago. Chest CT and echocardiogram showed partially calcified pseudoaneurysm of the ascending aorta. Two aortic defects were located on the anterolateral ascending aortic wall wkere it was suspected as a previous sites of aortic and cardioplegic cannulation. The internal wall of the pseudoaneurysm was covered with neoendothelium and intervened by septal tissue. Two defects on he aortic wall were oval in shape and about 1.5cm in the greatest diameter The defects were trimmed to make a one large de- fect and it was reconstructed with patch designed from 22mm collagen impregnated double velour Dacron graft. The postoperative course was uneventful.

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Histological Examination of Tissue Isolated from Fascia with a View of Meridian System (경락의 관점에서 본 근막 분리조직의 조직학적 연구)

  • Kim, Dong-Heui;Deung, Young-Kun;Chang, Byung-Soo;Jung, Han-Suk;Jin, Dan;Kwon, Ki-Rok;Lee, Kyu-Jae
    • Applied Microscopy
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    • v.36 no.3
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    • pp.183-194
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    • 2006
  • The threadlike structures of fascia were examined by tight and electron microscopy. In order to distinguish its tissue organization, we used staining methods including hematoxylin-eosin, Masson's trichrome, Van Gieson's collagen fiber stain and Kluver-Barrera's luxol fast blue for nerve stain. Under the light microscope, the threadlike structures were composed of many collagen fibers and nerve. In higher magnification, they looked like as the bundle of tubular structures. Many myoid cell-spindle nuclei were observed in the tissue, which were taken from the fascia. It was identical with Bonghan duct known as one of meridian network theory. In the early 1960's the North Korean Bong-Han Kim showed the anatomical structures of the acupuncture points, and explained the meridian system as the concrete duct network system. According to Bonghan theory the Bonghan ducts spread throughout the body Because it is believed that the duct could have the role of signal pathway, the theory was reinvestigated in these days. All of the threadlike structures isolated from fascia shows the abundance of collagen fibers. The electron microscope examination (TEM) could confirm the well arranged collagen fiber and nerve. This investigation reveals that superficial Bohghan duct are nerve fiber parallel running with collagen fibers. We conjectured that the intermingled structure of collagen fiber, blood vessel and nerve fiber might have the role of meridian system. And the more, regardless of histological research, the study on collagen fiber as response transmitter in acupuncture treatment are in need.

The Preservation of Left Gastric Artery in Laparoscopy-Assisted Subtotal Gastrectomy with Splenectomy of Stomach Cancer (위암에서 복강경보조 원위부 위아전절제술 및 비장합병절제술 좌위동맥의 보존 증례 보고)

  • Lee, Sang-Rim;Park, Jong-Min;Han, Sang-Uk;Cho, Young-Kwan
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.42-46
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    • 2007
  • Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

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Effects of Caffeine on Nerve Conduction Velocity (카페인이 신경전도속도에 미치는 영향)

  • Kang, Yun-Jung
    • Journal of Convergence for Information Technology
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    • v.10 no.3
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    • pp.195-199
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    • 2020
  • This study examined the effect of the nervous-system-stimulating caffeine on the nerve conduction velocity. The purpose of this study is to investigate the effect of caffeine that stimulates the nervous system on nerve conduction test. Although both measurement intervals did not show statistically significant differences when comparing the pre- and post-NCV values within the control and individual experimental groups, it was found that the nerve conductivity in the Axilla-Above Elbow section increased significantly after caffeine intake for the experimental group. Caffeine intake, which has increased the nerve conduction velocity (NCV), was determined to play roles in improving motor skills, muscle strength and nerve performance by temporarily increasing the nerve conduction velocity. Through this study, we learned that caffeine has an influence on the peripheral nervous system as it helps to improve the nerve conduction velocity. upon an appropriate amount of caffeine intake. We hope that these results will help develop treatment and diagnostic methods for patients with nerve dysfunction and myofunctional disorders.

The Morphological Changes of Cryopreserved Rat Trachea After Heterotopic Transplantation (쥐의 초냉동기관 이소 이식 후 형태학적 변화)

  • 성숙환;서정욱;박종호;김경환
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1182-1190
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    • 1996
  • The best treatment of congenital or acquired tracheal stenosis is resection and end to end anastomosis. Various prosthetic material and tissue graft replacement can be considered when the stenotic segment is too long, but their uses are still limited due to many serious complications. The present study examined the effect of immunosuppression and cryopreserved allograft trachea after intraperitoneal omental implantation for evaluation of the possibility of tracheal transplantation. Thirty tracheal segments were harvested from fifteen donor Wistar rats. Among them eighteen segments were implanted immediately(group I, II, III) and twelve segments were used for cryopreservation(group IV, V). Heterotopical intraperitoneal implantation was performed in five groups of rats(n=6); Group I was Wistar syngeneic controls and received no immunosuppression. Group II and III were those of Sprague-Dawley recipients, the former receiving no immunosuppression and the latter receiving immunosuppression(Cyclosporin A 15mg/kg/day, Methylprednisolone 2mg/kg/day). Group IV and V were groups of Sprague-Dawley recipients, the former receiving immunosuppression and the latter receiving no Immunosuppression. After 28 days, rats were sacrificed and the tracheal segments were histologically evaluated. Epithelial thickness was significantly decreased in group II, IV. Epithelial regeneration score was also significantly decreased in II. All rats maintained well their round tracheal contour. In conclusion; I) trachea could be preserved for a long time with cryo method, 2) epithelium could regenerate fully with omentopexy in cryopreserved trachea, 3) immunosuppresion was not necessary with cryopreserved trachea.

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Clinical Usefulness of Ultrasonography in the Diagnosis of Fatty Liver (지방간 진단에 있어 초음파 검사의 임상적 유용성 연구)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.349-357
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    • 2019
  • The purpose of this study was to evaluate the clinical significance of ultrasonographic classification of fatty liver in three grades. From June 2018 to April 2019, 1047 patients (818 males and 229 females) diagnosed as fatty liver among 3607 patients who underwent abdominal ultrasonography at Busan screening center. Ultrasonography was classified into three grades: Grade I (mild fatty liver), Grade II (moderate fatty liver), and Grade III (severe fatty liver) according to the degree of parenchyma texture, acoustic attenuation, Obesity index, hematological test, and metabolic syndrome. The average age of men in each sex increased with the increase of the fatty liver. Body mass index (BMI) and waist circumference were significantly increased in both men and women (p=.000). hematological analysis showed that AST, ALT, ${\gamma}-GTP$, TG, fasting blood sugar, and glycated hemoglobin were significantly different from each other (p<.05). In women, ALT, ${\gamma}-GTP$ and TG showed a significant difference with increasing fatty liver (p<.05). The prevalence of metabolic syndrome was significantly increased in both sexes as the grade of fatty liver increased (p=.000). Based on the results of this study, it is suggested that the use of ultrasound - guided fatty liver according to severity may be useful for the treatment and follow - up of fatty liver if the liver grade is divided in consideration of hematological variables and metabolic syndrome.

Roles of Local Estrogen and Progesterone Mediated Receptors in the Regulation of Endometrial Inflammation (자궁내막 염증에 대한 지엽적 에스트로겐 및 프로게스테론 매개 수용체의 역할)

  • Gyesik Min
    • Journal of Life Science
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    • v.33 no.1
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    • pp.102-113
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    • 2023
  • This review discusses the cellular and molecular mechanisms by which the endometrial estrogen and progesterone receptors regulate local estrogen production, expression of the specific estrogen receptors, progesterone resistance, inflammatory responses and the differentiation and survival of endometriotic cells in endometrial inflammation. The epigenetic aberrations of endometrial stromal cells play an important role in the pathogenesis and progression of endometriosis. In particular, differential methylation of the estrogen receptor genes changes in the stromal cells the dominancy of estrogen receptor from ERα into ERβ, and results in the abnormal estrogen responses including inflammation, progesterone resistance and the disturbance of retinoid synthesis. These stromal cells also stimulate local estrogen production in response to PGE2 and the SF-1 mediated induction of steroidogenic enzyme expression, and the increased estradiol then feeds back into the ERβ to repeat the vicious inflammatory cycle through the activation of COX-2. In addition, high levels of ERβ expression may also change the chromatin structure of endometrial mesenchymal stem cells, and together with the repeated menstrual cycles can induce formation of the endometriotic tissue. The cascade of these serial events then leads to cell adhesion, angiogenesis and survival of the differentiation-disregulated stromal cells through the action of inflammatory factors such as ERβ-mediated estrogen, TNF-α and TGF-β1. Therefore, understanding of the dynamic hormonal changes during the menstrual cycle and the corresponding signal transduction mechanisms of the related nuclear receptors in endometrium would provide new insights for treating inflammatory diseases such as the endometriosis.

Imaging of Sequestered Lumbar Discs (요추 분리추간판의 영상 소견)

  • Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.3-23
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    • 2024
  • Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

Transcatheter Arterial Embolization for Palliation of Uterine Body Cancer Bleeding (자궁체부암 출혈에 대한 보존적 치료로써의 경카테터 동맥 색전술)

  • Jaeyeon Choi;Ji Hoon Shin;Hee Ho Chu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.606-614
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    • 2023
  • Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.

Mid-term Results of Neonatal Surgical Management of Pulmonary Atresia with Intact Ventricular Septum (온전한 심실 중격을 가진 폐동맥 폐쇄증의 신생아기 수술 치료의 중기 성적)

  • Kwak Jae Gun;Kim Woong-Han;Kim Dong Jin;Lee Chang Ha;Lee Jeong Ryul;Kim Yong Jin;Rho Joon Ryang
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.815-820
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    • 2005
  • Background: Pulmonary atresia with intact ventricular septum is a rare congenital cardiac disease. There have been various surgical options, but there are still controversies. Material and Method: Fourteen neonates who were operated on between 1999 and 2000 were enrolled in this study. We measured Z-value of tricuspid valve by echocardiography. We performed right ventricular outflow tract transannular patch in 9 patients. Modified Blalock-Taussig shunt was placed according to the condition of patients. Mean follow up period was 46.0 months. Result: There were 2 operative mortality and 1 late mortality. Biventricular repair was possible in 7 patients. One and a half ventricular repair were done in 3 (tricuspid valve Z-value was -2, -2.5 and -3) and single ventricular repair in 2 patients (tricuspid z-value was -4.6, -4.5) The tricuspid valve Z-value for the patients who had biventricular repair and one and a half ventricular repair were -0.8$\pm$1.50 (-3.2$\∼$1.2) and -2.5$\∼$0.5 (-3$\∼$ -2) respectively. All patients who survived had fair to good right ventricular function, good left ventricular function and good clinical states. Conclusion: Neonatal surgical management of pulmonary atresia with intact ventricular septum has a good surgical outcome, z-value of tricuspid may be helpful for the determination of surgical options.