• Title/Summary/Keyword: 혈관부종

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Inferior Vena Cava Thrombectomy in a Patient with Antiphospholipid Syndrome - A case report - (하대정맥의 혈전증을 동반한 인지질항체 증후군의 수술적 치료 - 1예 보고 -)

  • Jang, Jae-Seok;Kwon, Oh-Choon;Lee, Sub;Kim, Seok
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.371-374
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    • 2009
  • A 36-year-old woman with a history of spontaneous abortion and photosensitivity was admitted to our hospital with periumbilical pain and lower extremity edema. The preoperative CT scan revealed massive inferior vena cava thrombus, which extended from the suprarenal portion of the vena cava to the hepatic vein. The laboratory data showed an elevated level of anticardiolipin antibody, which suggested the diagnosis of antiphospholipid syndrome. After medical management, she underwent an operation for removal of an vena cava thrombus by performing cavectomy and thrombectomy. After the operation, she has been taking oral anticoagulation and she is doing quite well at 9 months after her operation.

Primary Tracheal Tumor C (원발성 기관 종양)

  • 이종호;문석환;조건현;왕영필;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.799-803
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    • 1998
  • Background: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. Materials and methods: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. Results: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.

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A Case of Hypernatremic Dehydration in an Exclusively Breast-Fed Newborn Infant (모유수유 신생아에게 발생한 고나트륨혈성 탈수증 1례)

  • Park, Kyung Pil;Kim, Jin Kyung;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.790-795
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    • 2002
  • Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.

Expression of Vascular Endothelial Growth Factor and Peritumoral Brain Edema in Intracranial Meningiomas (수막종에서 혈관내피성장인자의 발현과 종양주변부 부종)

  • Kim, Tae Young;Park, Jong Tae;Han, Weon Cheol;Moon, Seong Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1222-1227
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    • 2000
  • Objective : Vascular endothelial growth factor(VEGF), an endothelial cell specific cytokine, is a potent angiogenic growth factor implicated in the tumor angiogenesis and increases vascular permeability dramatically. Peritumoral brain edema(PTBE) occurs in 40-60% of meningiomas. Many causative factors have been investigated, but the mechanism of PTBE associate with meningioma is unclear. VEGF has been implicated as one of the causative factors of PTBE. This study was designed to determine whether the extent of VEGF expression is correlated with degree of PTBE in meningiomas. Methods : Meningioma tissue samples from 40 patients(7 men and 33 women, mean age $53{\pm}13years$) who underwent surgery were examined retrospectively for the expression of VEGF immunohistochemically. The extent of PTBE was estimated by using preoperative CT or MRI as an edema index(EI). In addition to VEGF, several causative factors including tumor size, location, histologic type, microvasculature(CD31) were compared with EI. Results : Twenty-six meningiomas demonstrated PTBE, and the other 14 did not. Of the 40 patients of meningiomas, 28 were positive(17 were 1+ and 11 were 2+) for VEGF. The EI increased significantly just as VEGF was strongly expressed(p=0.006). Microvascular proliferation was also closely correlated with the extent of peritumoral brain edema(p<0.05). Conclusion : These data suggest that VEGF expression and microvascular proliferation are closely correlated with PTBE in meningioma.

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Respiratory Viral Infection and Bronchial Asthma (호흡기 바이러스 감염과 기관지 천식)

  • Hwang, Young-Sil;Lee, Jong-Deog
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.18-29
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    • 2000
  • 호흡기 바이러스 감염은 모든 연령층의 천식에 상당한 영향을 미치는 데 영아에서 RSV는 천명을 야기하고 대부분 일시적이나 재발성 일수도 있다. 어릴 때 바이러스 감염은 면역체계 형성에 영향를 미쳐 알러지와 천식의 위험을 완하할 수있다고 한다. 또한 소아와 성인 천식에서 RV같은 감기 바이러스는 천식의 급성 증상을 유발한다. 호흡기 바이러스 감염에 대한 면역반응이, 기관지로 부터 바이러스 제거 기능외에 기도수축과 호흡기 증상에 관여한다고 한다. 이러한 변화가 일어나는 기전은 호흡기 바이러스가 proinflammatory 사이토카인과 매개체 생성을 유도하는 능력과 연관성이 있는 것 같고 이들이 상하기도 호흡기 증상 및 기도반응 변화에 관여하는 것으로 생각된다. 호흡기 바이러스 감염에 대한 면역반응을 요약하면 바이러스 감염으로 상피세포, 내피세포, 과립백혈구가 활성화되며, 상피세포는 사이토카인, 키모카인, 매개체들을 분비하여 항 면역 반응를 주도하다. 이와 같은 상피세포와 다른 기관지 세포들의 조기 활성화로 내피 세포에 유착분자 표현을 증가시켜 백혈구 동원 증가 및 혈관 투과성을 증가시켜 부종과 분비물을 증가시킨다. 바이러스 또는 바이러스 유발 사이토카인에 의해 활성화된 과립 백혈구, 대식세포, T세포들도 기도염증 증가, 기도폐쇄를 야기하고 기도반응을 증가시킨다. 세포독성 임파구에 의한 바이러스 감염세포의 분해, TGF-$\beta$ IL-10 같은 사이토카인에 의해 부분적으로 염증억제, 기도 remoldeling에 의한 기도구조의 재생등이 바이러스 감염후 기관지 기능의 지속적 변화를 결정한다. 끝으로 천식환자에서 RV 감염의 병인에 관한 기본적 문제는 RV감염이 정상인에서는 경한 증상을 나타내는 데 천식환자에서는 왜 심한 임상증상을 나타내는지 아직 완전히 밝혀지지 않았다. 항 바이러스에 대한 면역반응이 천식환자에서 손상되었는지 또는 천식환자에서 RV감염에 의한 중증의 임상증상은 어떤 다른 세포가 관여하는지? 이들에 대한 답은 기도염증이 천식에서 어떻게 조절되는지 또한 바이러스 감염에 의한 악화된 증상을 어떻게 치료할 것인가에 대한 방향을 제시해줄 것이다.

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Combined Intraocular Silicone Prosthesis and Conjunctival Flap for Glaucoma after Corneal Perforation in a Dog (실리콘 안내 보철물과 결막 플랩의 병용 적용을 이용한 개의 각막천공에 의한 속발성 녹내장 치료)

  • Jeong, Manbok;Ahn, Jaesang;Whitley, R. David;Ben-Shlomo, Gil;Seo, Kangmoon
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.108-111
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    • 2015
  • A 7-month-old intact male Maltese dog was presented with a 1.5-month history of glaucoma in the right eye (OD). Ophthalmic examinations revealed a corneal perforation with iris entrapment, corneal edema and neovascularization, and buphthalmos OD. Intraocular pressures were 33 mmHg OD and 19 mmHg in left eye (OS). The right eye was diagnosed with chronic glaucoma and corneal perforation with iris entrapment. Now that the eye was blind, implantation of intraocular silicone prosthesis (ISP) and conjunctival flap were elected to salvage the globe. The corneal perforation healed with the conjunctival pedicle flap and the cornea accommodated the ISP properly. A satisfactory cosmetic result was achieved without complications in the 15 months following the procedure. Therefore, this case report indicates the combined an ISP and a conjunctival flap would be an alternative for the treatment of glaucoma associated with corneal perforation in dogs.

Treatment of Deep Venous Thromboses of Lower Leg with Thrombolysis (혈전용해술을 이용한 하지 심부정맥 혈전증의 치료)

  • 이재원
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.711-715
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    • 2001
  • Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

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Chondromyxoid Fibroma of the Rib Report of one case - (늑골에 발생한 연골점액유사 섬유종 -1예 보고-)

  • Lee, Jae-Wook;Lim, Jae-Ung;Won, Yong-Soon;Kor, Eun-Suk;Shin, Hwa-Kyun
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.788-790
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    • 2005
  • Chondromyxoid fbroma (CMF) is a rare, benign tumor of the bone that represents fewer than $2\%$ of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.

Delayed Detection of a Penetrating Tracheal Foreign Body (수상 후 10년이 지나 발견된 기관 내 이물질)

  • Jang, Woo-Sung;Kim, Young-Tae;Kim, Joo-Hyun;Kang, Chang-Hyun
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.384-387
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    • 2007
  • The finding of a tracheal penetrating injury that's caused by a foreign body is rare in adulthood. A 42-year-old man had experienced penetrating trauma due to a glass fragment 10 years ago. He presented with blood tinged sputum and dyspnea on exertion, and this had developed 1 year previously. Chest CT scan and bronchoscopy revealed a foreign body crossing the tracheal lumen and the object arose from outside of the trachea; this was all associated with airway edema. We removed the foreign body, which was a 5cm length of glass fragment, and we repaired the tracheal defect using a simple primary suture. The postoperative course of the patient was uneventful and he is now being followed up at the outpatient department; he has had no additional symptoms.

Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring (인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료)

  • Son, Kuk-Hui;Son, Ho-Sung;Chung, Jae-Ho;Chung, Won-Jae;Sun, Kyung;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.489-491
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    • 2008
  • A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the tarumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.