• Title/Summary/Keyword: 혈관확장제

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Surgical Treatment of Esophageal Atresia with Tracheoesophageal Fistula -4 Cases Report- (기관식도루를 동반한 식도폐쇄의 외과적 치료 4례)

  • 김용성;이서원
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.466-471
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    • 1996
  • Esophageal atresia with tracheoesophageal fistula is a common form of congenital malformation of the esophagus, which was usually overlooked during the physical examination after delivery. The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas-Gibson in 1696. We have performed primary repair by extrapleural approach through the right 4th intercostal space in 4 cases of congenital esophageal atresia with distal racheoesophageal fistula. End to end anastomosis was performed by Haight method in all cases. Postoperatively, two patients showed severe stenosis and one patient showed mild stenosis at the anastomotic site. Ballots dilatation was performed two cases with severe anastomotic stenosis.

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Left Lower Lobectomy with Bronchoplasty for Treatment of Tuberculous Bronchial Stricture (좌하엽 절제술 및 기관지성형술을 통한 결핵성 기관지협착의 치료)

  • 윤찬식;정재일;김재욱;이홍섭
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.640-643
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    • 2001
  • A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberclous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.

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A Case Report of Tracheal Bronchus Associated with Pulmonary Actinomycosis (폐방성균증을 동반한 기관기관지 환자 수술 치험 1예)

  • 양승인;이형렬;박준호;이민기;박순규;김건일;이창훈
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.878-882
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    • 2003
  • Tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and may be related to inflammatory conditions affecting the lung, including recurrent pneumonia, bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but either clinical or radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6month follow-up period.

Effects of Herbicides on Growth and Reproductive Characters of Glycine max (대두(Glycine max)의 생장 및 번식 특성에 미치는 제초제의 영향)

  • Gang, Hye-Sun;Ha, Seung-Hui
    • The Korean Journal of Ecology
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    • v.24 no.3
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    • pp.157-168
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    • 2001
  • Herbicides have been used to control weeds for decades. If detoxification upon exposure to herbicides requires considerable amounts of energy, it could affect the pattern of resource allocation to growth and reproduction of crops. We examined the effects of three levels of a herbicide (Control, Low, and High) on germination, growth and reproductive characters of Glycine max treated twice, i.e., before and after seed germination. Since flowering time of G. max was separated into two groups, flowering time was also considered as a variable in this study. The rate of seed germination tended to be higher at the low level of herbicide compared to other levels. Chlorosis and shape variation of leaves were apparent after the second herbicide treatment, but completely disappeared after six weeks of treatment. The herbicide effects on growth characters were somewhat different between early and late flowering plants, but plants treated with both low and high levels of herbicide reduced their growth compared to those in the control group regardless of flowering time. Plants at the high level of herbicide exhibited the highest growth rate later in the season, suggesting that plants compensated to some extent for reduced growth. However, growth reduction among plants at the high level of herbicide was persistent until the end of growing season. Among plants flowered late in the season, plants in the control level bore a higher number of nodules per plant than those in other levels; such a pattern did not exist among plants flowered early in the season. Plants treated with low and high levels of herbicide produced a lower number of flowers than those in the control. Thus, the herbicide examined affected not only the growth and reproductive characters of non-target crops but also the development and growth of root nodules.

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브라디키닌 수용체에 관한 연구

  • 정성현
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.28-28
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    • 1992
  • 브라디키닌은 체내에서 강력한 혈관 확장 작용을 일으키는 autacoid(local hormone)로서 혈압의 항상성 유지, 모세혈관 투과성 증진, 염증 및 통증 반응 등에 관여하고 여러 장관 평활근을 수축시킨다. 또한 septic 혹은 endotoxic shock의 여러 원인 물질로도 생각되어진다. 최근 rhinovirus로 인한 감기의 제증상 원인 물질로도 브라디키닌이 주목을 받고있다. 이와같이 브라디키닌온 다양한 질병에 있어 중요한 원인 물질로 여겨지므로 브라디키닌 길항제들은 한두 질병의 치료제로 개발될 가능성이 높음이 강력히 제시되고 있는 실정이다. 이의 개발을 위해서 브라디키닌 수용체에 대한 연구는 필수적이라고 할 수 있다. 본 연구는 두 부분으로 나누어 진행중인데 첫째, 이제까지 보고된 브라디키닌 길항 물질들은 대부분이 브라디키닌의 특정 아미노산 잔기를 치환시킨 펩타이드 유도체로서 이들을 경구 투여시 peptidase어 의하여 쉽게 분해되고 또한 부분적인 효능제 활성을 갖는 불리한 점을 감안하여, 비펩타이드성 브라디키닌 길항제를 개발할 목적으로 한방 및 민간에서 자주 사용되어온 생약중에 브라디키닌 작용에 선택적 길항효과가 있는 물질을 검색한 바 활성을 보인 황금으로부터 작용 성분을 추적중에 있다. 둘째, 브라디키닌 수용체를 순수하게 분리 정제하기 위한 첫 단계로서 이 수용체의 결합시험(binding assay) 방법을 확립하고 더불어 여러 조직내(흰쥐의 여러 기관, 토끼 및 사람의 신장)의 브라디키닌 수용체의 분포를 파악하는 일이다. 횐쥐 조직의 실험 결과로부터 신장에 브라디키닌 수용체가 많이 분포함을 확인되었고 향후 토끼 신장으로부터 동수용체를 분리하고자 한다. 또한 토끼 신장의 근위세뇨관일차배양세포을 이용하여 브라디키닌의 신장에서의 작용기전도 살펴보고 있다.+}$, $Na^{+}$, NH$_{4}$$^{+}$ 및 H$^{+}$) 수용액 메디움에서의 Cd(II), Mg(II) 및 Zn(II)의 Dowex 1-X8, Cl$^{-}$ 수지에 대한 흡착은 역시 어떤 메디움에서도 Cd(II) 흡착이 제일 크며, 다음이 Zn(II) 이고 착이온을 형성않는 Mg(II)이 제일 작았다. 한편 메디움 종류별 D값의 크기순위는 H$^{+}$>K$^{+}$> $Na^{+}$>NH$_{4}$$^{+}$이였다. 메디움의 종류에 따라 D값의 차이가 나는 것은 금속이온의 착이온 형성과 금속이온의 용액내에서의 이온종의 상태와 관련이 있다고 생각된다. 마. MCl(M:K$^{+}$, $Na^{+}$, NH$_{4}$$^{+}$ 및 H$^{+}$)과 MNO$_{3}$ 용리액에 의한 Cd(II), Mg(II) 및 Zn(II)의 용리는 예상한 바와 같이 MCl에서 작은 Dv 값을 갖는데, 이것은 CdCl$_{4}$$^{2-}$ 착이온을 형성하거나 ZnCl$_{4}$$^{2-}$ , ZnCl$_{3}$$^{-}$같은 이온과 MgCl$^{+}$, MgCl$_{2}$같은 이온종을 형성하기 때문인것 같다. 한편 어떠한 용리액에서던지 NH$_{4}$$^{+}$의 경우

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A Case of Primary Pulmonary Hypertension in Pregnancy Presented as Massive Hemoptysis (임신 중 대량객혈로 발현된 원발성 폐고혈압 1예)

  • Kim, Myung Sook;Kim, Hyoung Doo;Kim, Seok Chan;Kwan, Soon Suk;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.66-71
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    • 2004
  • Primary pulmonary hypertension (PPH) is a rare, progressive and incurable disease, which is characterized by an increase in the pulmonary artery pressure without a demonstrable cause. The most common presenting symptom is dyspnea on exertion, with other symptoms comprising of chest pain, syncope and hemoptysis. The diagnosis is one of exclusion of any of the known causes of pulmonary hypertension. When associated with pregnancy, the maternal mortality ranges from 30 to 50%. Because pregnancy and labor are very serious problems for patients with PPH, the available evidence suggests that pregnancy when afflicted with PPH should be avoided. In account the case of a 33-year old patient, reporting with massive hemoptysis, and diagnosed with PPH during her twenty seventh week of gestation, is presented. She was treated with conservative management, including oxygen and a vasodilator, and underwent a pregnancy termination. However, due to aggravation of right heart failure, she presented with severe systemic hypotension and hypoxemia, and eventually died. This case is reported, with brief review of the literature.

Variations in The Size of The Ischemic Myocardium Due to Differences in The Normal File (Normal File의 차이에 따른 심근 관류결손 크기의 변화)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Heo Jae-Kyeong;Iskandrian Abdulmasshi S.
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.49-57
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    • 1992
  • 혈관확장제 투여에 의한 약물부하 심근스캔시는 운동부하 심근스캔시와 비교하여 심박출량과 관상 동백 혈류의 증가정도가 달라서 심근내 T1-201의 농도가 달라진다. 그러므로 부하 심근관류스캔의 정량적 판독시에 각각의 부하에 특이적인 Normal file을 사용하지 않으면 이러한 심근내 T1-201 농도의 차이로 인하여 관류 결손의 크기가 다르게 나타날 수 있으리라 추측할 수 있다. 본 연구는 좌전하행지의 유의한 협착이 있는 34명의 단일 혈관 관상동맥 환자에서 이러한 가정이 실제적으로 어떻게 나타나는가를 조사하였다. 환자들은 adenosine 140ug/kg/min을 정맥주사하고 T1-201 SPECT를 실시하였다. 관류결손의 크기는 답차운동부하 T1-201 스캔을 실시한 정상인에서 구한 Normal File (File-ex)과 adenosine T1-201 스캔의 Normal File (File-ad)을 각각 이용하여 만든 극성지도에서 구한 adenosine 심근스캔의 관류결손의 범위지수(extent score)와 중증도지수(severity score)로 표시하였고, 이들의 값을 비교하여 아래의 결과를 얻었다. File-ex로 구한 관류결손의 범위지수는 $19{\pm}13%$였고 File-ad로 구한 범위는 $11{\pm}10%$였다(차이 $8.1{\pm}1.6%$, p=0.0001), 중증도지수는 File-ex를 사용하였을 때 $582{\pm}479$였고 File-ad를 사용하였을때는 $310{\pm}309$였다(차이 $272{\pm}49$, p<0.0001). $50\sim70%$의 중등도의 내경 협착이 있었던 20명의 환자에서는 범위지수는 File-ex와 File-ad에서 각각 $17{\pm}10$$7{\pm}7%$(p=0.001)였고, 70% 이상의 내경 협착이 있었던 14명에서의 범위 지수는 각각 $24{\pm}16$$18{\pm}10%$ (p=0.03)로 모두에서 File-ex를 사용하였을때의 값이 컸다. 이와 같은 성적으로 보아 T1-201 스핀에서 관류결손의 정도를 정량적으로 첨가할 시에는 부하에 특이적인 Normal File을 사용하여야 관류 결손의 정도를 정확하게 추출할 수 있다는 사실을 알 수가 있다. 즉 dipyridamole이나 adenosine부하경사에서 운동부하의 Normal File을 사용하면 관류결손의 정도가 과대평가 된다는 것이다.

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Surgical Treatment of Bronchoesophageal Fistula in Adult (성인 식도 기관지루의 외과적 치료)

  • 곽영태;김동원
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.67-72
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    • 1996
  • Bronchoesophageal fistula is a rare clinical entity whether congenital or acquired in adult. We experinced 8 cases of bronchoesophageal fistula and performed surgical correction from 1991 to 1994. Of the 8 patients, 5 patients were male and three were female aging from 21 to 61 years(mean 44.12$\pm$14.62 years). Seven of 8 patients had congenital bronchesophageal fistula and the other one had acquired bronchoesophageal fistula. According to the classification of Braimbridge and Keith, 4 cases were belonged to type I and 3 cases were type II . The diagnosis was confirmed by esophagogram in six patients, by bronchoscopy and bronchogram in two patients, and in one patient, the fistula was discovered i cidentally during operation. All patients received astulectomy and concomitant procedures were applied as follows ; 4 diverticulectomy, 4 right lower lobectomy, 1 bilobectomy, 1 left lower lobectomy and 1 wedge resection of left lower lobe. All but one patient were discharged without any complication and have been in good condition.

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Effect of Hydroxocobalamin on Contractile Responses to Phenylephrine during Administration of Inhalational Anesthetics in Lipopolysaccharide-Treated Rat Aortae (흡입마취제 투여시 내독소혈증흰쥐 대동맥 수축반응에 미치는 Hydroxocobalamin의 효과)

  • Kim, In-Kyeom;Yang, Eun-Kyoung
    • The Korean Journal of Pharmacology
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    • v.32 no.3
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    • pp.381-388
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    • 1996
  • The hemodynamic changes in septic patients produced by inhalational anesthetics are sufficient to threaten the anesthesiologists. The effect of hydroxocobalamin, a vitamin $B_{12a}$, on contractile responses to phenylephrine during administration of inhalational anesthetics were evaluated in aortic ring preparations obtained from LPS-treated rats. The sepsis was developed by intraperitoneal injection of LPS (1.5 mg/kg for l8h) and confirmed by iNOS expression using RT-PCR. Statistical significances (P<0.05) were analyzed by Student's t-test or paired t-test according to data characteristics. The blood pressure, but not heart rate, was decreased in LPS-treated rats as compared to control rats. The contractile response to phenylephrine were dose-dependently increased from the doses of $10^{-8}\;M$ to that of $10^{-5}$ and were attenuated in LPS-treated rings. Both halothane and enflurane, at the doses of 1 MAC, decreased the contractile responses to phenylephrine while isoflurane did not significantly affect the contractile responses. Hydroxocobalamin ($10^{-5}$ M) significantly potentiated the contractile responses in the LPS-treated aortic ring preparations during administration of each inhalational anesthetic or not. From these results, it is suggested that hydroxocobalamin may improve the hemodynamics of septic patients during inhalational anesthesia. Abbreviations: LPS, lipopolysaccharide; RT-PCR, reverse transcription-polymerase chain reaction; MAC, minimum alveolar concentration; iNOS, inducible nitric oxide synthase; GAPDH, glyceraldehyde 3-phosphate dehydrogenase

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The First Successful Heart-Lung Transplantation in Korea (심장-폐이식 1례보고)

  • 박국양;김주이;박철현;김상익;김정철;현성열;심현자;정미진;권진형
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.610-614
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    • 1998
  • The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

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