• Title/Summary/Keyword: 혈관염

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A Study of Chronic Constrictive Pericarditis (만성 수축성 심낭염의 임상적 고찰)

  • 김현경
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.973-978
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    • 1991
  • From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

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Myocardial Abscess with Coronary Artery Occlusion -One Case Report (우관상동맥 폐색을 초래한 심근 농양 -1례 보고-)

  • 이재익;김기봉
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.823-826
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    • 1997
  • Myocardial abscess usually occurs as a complication of infective endocarditis or overwhelming septicemia. Coronary artery occlusion caused by myocardial abscess has been rarely reported. A 61-year-old man presented with fever and chill that developed 6 weeks prior to admission. He had a history of cardiopulmonary resuscitation for ventricular fibrillation and cardiac arrest 4 weeks prior to admission. Echocardiography showed a 3xfcm sized mass in the area of the right atrioventricular groove and coronary angiography showed complete occlusion of the proximal right coronary artery. Under the diagnosis of myocardial infarction complicating myocardial abscess, debridement of abscess and coronary artery bypass grafting with right internal mammary artery to distal right coronary artery was performed. Culture from the abscess cavity demonstrated Salmonella arizona.

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The Alteration of Endothelium-Dependent Vascular Response at Early Stage of 1K1C Renal Hypertensive Rats (신성 고혈압 흰쥐의 초기단계에서 내피 의존적인 혈관반응의 변화)

  • 김주원;김학림;박조영;염지현;라현오;이영욱;안형수;손의동;허인회
    • YAKHAK HOEJI
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    • v.43 no.6
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    • pp.843-850
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    • 1999
  • We investigated whether endothelium-derived NO and endothelin-1 might result enhanced vasoconstriction induced by administration of norepinephrien (NE) at the early stage of one-kidney, one-clip (1K1C) renal hypertensive rats. We also studied the relation ship of renin-angiotensin system (RAS) using rat aorta in this hypothesis. L-NMMA (30$\mu$M) and L-NAME(30${\mu}M$) enhanced vasoconstriction induced by NE in thoracic aorta of control rats. However angiotensin converting enzyme (ACE) inhibitor didn't. The aorta of 1KIC rats showed a singnificantly exaggerated contractile response to NE as compared with control rats. Rub-bing the endothelium abolished this difference. Ach and SNP-induced vasorelaxation show no significant difference between 1KIC and control rats. The treatment of phosphoramidon (10${\mu}M$) and oral administration of captopril (0.05, w/v%) abolished the exaggerated contractile response to NE at early stage of 1KIC rats. These results suggest that the increase of contractile response at the early phase in 1KIC rat is partially involved in the activation of ACE.

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원자로 생산 방사성 핵종의 임상이용

  • 임상무
    • Nuclear Engineering and Technology
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    • v.27 no.4
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    • pp.635-643
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    • 1995
  • 핵의학(nuclear medicine )이 란 방사성 및 안정 핵종의 동위원소표지 화합물을 인체에 투여하여, 관심장기의 형태 및 기능을 평가하여 해부학적 또는 생리학적 상태를 진단, 치료하는 의학의 전문 분야이다. 핵의학에 이용되던 방사성 핵종은 1960년대 까지만 해도 $^{131}$ I이 주였으나 1970년대 부터는 $^{99}$Mo -$^{99m}$ Tc 발생기와 $^{99m}$ TC으로 표지된 방사성의 약품이 활발히 이용되면서 $^{131}$ I을 대신하게 되었다. 원자로-생산핵종들의 특성은 중성자가 과잉이어 붕괴시 배타입자를 방출하는 점으로, 이것이 각종 질병의 치료에 이용되고 있다. 특히 각종 표시 화합물의 성질을 이용하여 원하는 부위에 방사선을 집중시킬 수 있음이 외부조사보다 유리한 점이다. 방사성핵종을 이용한 악성종양의 치료에 가장 성공적인 것은 분화된 갑상선 암환자에서 $^{131}$ I을 사용한 것이며, 갈색세포종 등에 $^{131}$ I-MIBG도 효과적이다. 악성종양의 골전이 치료에 베타선을 방출하는$^{32}$P, $^{186}$ Re, $^{153}$ Sm 등이 이용되었다. 종양의 동맥에 주입하여 세동맥이나 모세혈관에 걸리는 기름, 교진 또는 입자에 의한 치료에 $^{131}$ I-lipiodol, ethiodol, $^{32}$P 또는$^{90}$ Y흡사 ceramic resin 미소구 $^{166}$ Ho 유산중합체 미소구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다.

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Pre- and Postoperative Hemodynamic Studies in the Patients with Constrictive Pericarditis (수축성 심막염에 대한 심막절제술 전후의 수술방법에 따른 혈역학적 비교)

  • 조인택
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.68-74
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    • 1986
  • 15 patients with constrictive pericarditis who underwent interphrenic pericardiectomy from January, 1981 to April, 1983 and 11 patients who underwent radical pericardiectomy from May, 1983 to September, 1984 were compared to the clinical improvement and the results of pre- and postoperative cardiac catheterization. In the group of partial pericardiectomy the pericardium was removed anteriorly from the left phrenic nerve to the right phrenic nerve and in the group of radical pericardiectomy the pericardium was removed from almost entire surface of the heart including diaphragmatic surface and posterior wall of the left ventricle. The following results were obtained. 1. Both group of the patients showed marked symptomatic improvement early after operation. 2. The central venous pressure was decreased significantly after operation in both group of the patients. 3. The right atrial mean pressure and pulmonary arterial mean pressure decreased significantly after operation in both group of the patients and there was no significant difference in the amplitude of decrease between the two groups. 4. The right ventricular end-diastolic pressure and left ventricular end-diastolic pressure were decreased postoperatively in both group of the patients and the patients of the radical pericardiectomy showed more decrease than the patients of interphrenic pericardiectomy, and in the group of radical pericardiectomy the right and left ventricular end-diastolic pressure were normalized postoperatively but in the group of partial pericardiectomy they showed abnormally high pressure persistently. 5. The ejection fraction showed normal level pre- and postoperatively in both group of the patients.

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Surgical treatment of chronic constrictive pericarditis: Report of 23 cases (만성 교약성 심낭염 (23례 수술 보고))

  • 박영관
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.61-68
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    • 1968
  • In the 10 years from 1958 through 1968, 23 patients have undergone 24 times of operation for constrictive pericarditis at this department. Follow-up data were available for periods varying several months to almost 10 years from examination at this department or follow-up letters. There were 21 males and 2 females in this series. Range of the age varied from 2 years to 53 years. Seven cases were below 15 years of age. There were two hospital death, one expired two weeks and another four weeks after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factors. Clinical and histological study showed tuberculous origin in 12 cases, non-specific chronic infiammatory changes in 8 cases and in 3 cases previous pyogenic pericardial infection by staphylococcus preceded to the constriction. In 11 cases bone tissue was noted microscopically in the pericardium: Sixteen patients[70 %]had pleural effusions, five cases had bilateral, 6 right, and 5 left. Calcification was seen along cardiac border in 9 cases. In 15 catheterized patients, 6 showed pressure gradients between vena cava and right atrium, ranging from 6 mmHg to 10 mmHg. One case was reoperated 3 months after the original operation resulting in marked improvement. In this reoperated case the original pericardiectomy seemed to be incomplete. In 21 cases. excluding 2 hospital death, symptoms and physical findings improved markedly in every patient

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Surgical Treatment of Ruptured Sinus of Valsalva Aneurysm (발살바동 동맥류 파열의 외과적 치료 - 10례 보고 -)

  • 김우찬;윤정섭;김치경;조규도;왕영필;곽문섭
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1207-1211
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    • 1996
  • During the recent 10 years, ten patients with ruptured sinus of Valsalva were operated on our institute. Eight patients were congenital but two patients were proved acquired lesions due to bacterial endocarditis. Coexistent cardiac lesions were 4 aortic regurgitations, 2 atrial septal defects, 1 ventricular septal defect, 1 tricuspid regurgitation and 1 mitral regurgitation. In all cases, aneurysms of sinus of Valsalva arose from the right coronary sinus, and they ruptured to right ventricle in 8 patients and to right atrium in 2 patients. We preferred double approach, through both the aorta and the involver. cardiac chamber, The repair of ruptured site was performed Dacron patch graft in 8 patients and simple closure in 2 patients. Operative results were very good in all cases with no surgical mortality.

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A Case of Cardiac Lymphoma Developed in Right Atrium (우심방에 발생한 심장 임파종 -1례 보고-)

  • Won, Yong-Soon;Kim, Jin-Ho;Kweon, Jong-Bum;Park, Kuhn;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.971-973
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    • 2000
  • 원발성 심장 림프종은 드문 질환으로 원발성 심장종양의 1.3%를 차지하며 절외성 림프종의 0.5%에서 발생한다. 그러나 악성 림프종에 의한 이차성 심장 전이는 비교적 빈번해서 약 8.7-27.2%로 보고 되고 있다. 66세남자 환자는 호흡곤란을 주소로 내원하였다. 경흉부 심초음파에서 우심방내에 종괴가 관찰되었다. 종양의 수술적 제거를 시행하였고 조직학적 검사에서 우심방을 침범한 악성 임파종으로 진단되었다. 환자는 급성 종격동염이 발생하였고 술후 9일째 패혈증과 수술부위 출혈로 사망하였다.

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Tracheoesophageal Fistula Due to Endotracheal Intubation: a case Report of Requiring Tracheal Reconstruction (기관상관후 발생한 기관식도루의 교정 1 례)

  • 신원선;곽영태
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.636-640
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    • 1997
  • The common cause of tracheoesophageal fistula(T-I fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-I fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed ope ative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.

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Carotid Artery Disease in Duplex Sonography: 3 Cases (이중초음파에서 관찰된 목동맥 질환: 3례)

  • Han, Minho;Choi, Junghye;Seo, Gang Sik;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.114-118
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    • 2019
  • Duplex sonography has been used to non-invasively diagnose carotid artery disease and to follow up patients with this disease. In carotid artery disease, carotid mobile thrombus and dissection are rarely detected by duplex sonography in patients with cerebrovascular events. In particular, carotid dissection occurs when a small tear forms in the tunica intima and makes 2 lumens in the carotid artery, including true and false lumens. This study reports 3 rare cases of carotid mobile thrombus, spontaneous carotid dissection, and carotid dissection in Takayasu arteritis.