• Title/Summary/Keyword: 혈관염

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Clinical Analysis of 500 Cases of Coronary Artery Bypass Grafting (관상동맥 우회술 500례의 임상적 고찰)

  • Shin, Yoon-Cheol;Kim, Ki-Bong;Ahn, Hyuk;Chae, Hurn;Rho, Joon-Ryang;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.525-531
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    • 1999
  • Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.

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Bee Venom Inhibits Angiogenesis by Decreasing HIF-1α Expression in HCT116 Cells (봉독의 HIF-1α 발현감소를 통한 혈관신생 억제효과)

  • Shin, Jae-Moon;Jeong, Yun-Jeong;Park, Kwan-Kyu;Choe, Jung-Yoon;Han, Sang-Mi;Lee, Kwang-Gill;Yeo, Joo-Hong;Chung, Il-Kyung;Chang, Young-Chae
    • Journal of Life Science
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    • v.22 no.1
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    • pp.41-48
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    • 2012
  • Bee venom (BV) has been used in medicine to treat a variety of diseases including arthritis, rheumatism, and various cancers. Recent reports indicate that BV has anti-angiogenic effects, but the precise molecular mechanism underlying the effects of BV against colorectal cancer remains to be elucidated. We examined the effects of BV and its major components (melittin and apamin) on tumor angiogenesis and found that BV significantly decreased protein levels of hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$), an important factor involved in angiogenesis and tumor progression, in human colorectal carcinoma HCT116 cells. BV also suppressed the transcription of HIF-$1{\alpha}$ under hypoxia, leading to a decrease in the expression of vascular endothelial growth factor (VEGF), a major target gene of HIF-$1{\alpha}$. We also found that these effects were mainly elicited by apamin, but not melittin. BV specifically inhibited the phosphorylation of ERK1/2 without changing the total levels of this protein, but had no effect on kinases of p38/JNK and AKT. Our results suggest that BV may inhibit human colorectal cancer progression and angiogenesis by inhibiting HIF-$1{\alpha}$ and VEGF expression, thereby providing a novel potential mechanism for the anticancer action of BV.

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.

Mitral Valve Repair for Mitral Regurgitation (승모판막폐쇄부전에 대한 승모판막재건술)

  • 최세영;유영선;박기성;최대융;박창권;이광숙
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.221-225
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    • 1998
  • From February 1996 to May 1997, 18 patients underwent mitral valve repair for mitral regurgitation. There were 9 male and 9 female patients aged from 19 to 68 years(mean, 53). Thirteen patients were in New York Heart Association(NYHA) class III and IV. The cause of mitral regurgitation was degenerative in 12 patients, rheumatic in 5 patients and infective in 1 patient. Fifteen patients were in Carpentier's functional classification II, 2 patients in Carpentier's class III and 1 patient in Carpentier's class I. Surgical procedures included prosthetic ring annuloplasty(16 cases), rectangular resection of posterior leaflet(15 cases), chordal shortening(5 cases), triangular resection of anterior leaflet(2 cases), commissurotomy(2 cases), partial transposition of posterior leaflet(1 case). These procedures were combined in most patients. There was no operative death. These patients have been followed from 1 to 15 months, mean of 6.7 months. There was one late death resulted from low cardiac output following mitral valve replacement. The function of the repaired valve in other 17 patients has remained satisfactory during the observed interval. We consider that mitral valve repair is highly satisfactory in patients with mitral regurgitation.

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Surgical Experience of Pericardial Mesothelioma: 2 Cases (심막에 발생한 중피종의 수술적 치험 2예)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Hong, Sook-Hee;Roh, Mee-Sook
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.437-440
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    • 2010
  • Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

Early Detection and Successful Treatment of Vertically Transmitted Fulminant Enteroviral Infection Associated with Various Forms of Arrhythmia and Severe Hepatitis with Coagulopathy

  • Lee, So Ra;Ko, Sun Young;Yoon, So Young;Lee, Yeon Kyung;Shin, Son Moon
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.199-205
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    • 2019
  • Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the fourth day of life and developed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected an enteroviral infection. Thus, we initiated prompt evaluation of enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of vertical enterovirus infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early symptoms of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reduce the risk of complications and mortality associated with enteroviral infections in neonates.

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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A Case of Empyema and Mediastinitis by Non-typhi Salmonella (비장티푸스성 살모넬라 감염으로 발생한 농흉과 종격동염 1예)

  • Yang, Suh Yoon;Kwak, Hee Won;Song, Ju Han;Jeon, Eun Ju;Choi, Jae Cheol;Shin, Jong Wook;Kim, Jae Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.537-540
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    • 2008
  • There are few reports of the pleuropulmonary involvement of a non-typhi Salmonella infection in immunocompromised patients with AIDS, malignancy, collagen vascular diseases, extended use of corticosteroids, sickle cell disease, or diabetes. We report a case of a non-immunocompromised patient who presented with concomitant empyema and mediastinitis due to Salmonella without a comorbid disease. A 26-year-old male patient, with a history of pneumonia 5 years earlier and having lived abroad for several years, presented chronic cough and febrile sensation. Pneumonia, empyema and mediastinitis were noted in a chest CT scan and Salmonella enteritidis and ${\beta}-hemolytic$ streptococcus were identified from a culture of the pleural fluid. Initially, he was treated with cefepime, metronidazole and clarithromycin. He was cured clinically and radiographically after an 8 week treatment with antibiotics. In conclusion, this report suggests that S. enteritidis can cause empyema and mediastinitis, albeit rarely.

Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 흉강경폐생검)

  • Son, Dong-Seop;Jo, Dae-Yun;Yang, Ki-Min
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1232-1236
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    • 1997
  • Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

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Alternative Technique of Aortic Valve Replacement -Implantation of Mechanical Aortic Valve at a Supra-Annular Level- (기계판막을 판륜상연에 위치시킨 대동맥판 치환술)

  • 최종범;이삼윤
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.504-509
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    • 1996
  • When a valve prosthesis is to be implanted in the aortic position, simple interrupted suture, figure-of- eight suture, or horizontal mattress suture technique is used as a suture method. However, the suture techniques may be unacceptable for aortic valve replacement in patients with friable annulus caused by some lesions, such as endocarditis and degenerative change. We used an alternative technique for the aortic vlave replacement in 4 patients with valve endocarditis, ) patients with degenerative valvular lesion, and 1 with rheumatic valvular disease. Mattress sutures through the annulus were placed with pledgets on the ventricular side of the annulus, whi h resulted in implantation of the prosthesis at a supra-annular level. Mechanical valves of 21 mm or larger were implanted in the supra-annular position in all patients and there was no impeded motion of leaflets during the follow-up period of mean 13.3 mouths. The transvalvular pressure gradient was less than 6 mm Hg in 3 patients and 20 to 40 mm Hg in 5 patients. The supra-annular implantation of mechanical aortic valve using a vertical mattress suture technique may be a useful alternative method of aortic valve replacement for the selected patients with friable or destroyed aortic annulus.

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