• Title/Summary/Keyword: 혈관 내 성형

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Effects of Extruded Job s-tear Cereal on Lipid Metabolism in High Fat Fed Rats (압출성형된 율무 시리얼 식이가 고지방섭취 흰쥐의 지질대사에 미치는 영향)

  • 김병용;강병선;원혜진;함영태;김혜경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.2
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    • pp.252-256
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    • 2000
  • Coronary heart disease (CHD) is caused by elevated blood lipids and the death rate from CHD is continuously increasing in recent years. In Korea, death rate from CHD is more than 30%. Recently, it has been reported that Job's tear decreaseds blood cholesterol level. However, most of the reports used Job's tear itself. Therefore, we have examined the effect of extruded Job's-tear cereal on blood and liver lipid levels in rats fed with a high fat diet for 5 weeks. The energy intake and body weight gain were higher in Job's tear cereal group (JFD) than in high fat fed group(HFD). Blood triglyceride concentration was significantly reduced in JFD group (p<0.05). And Atherogenic Index was decreased about 20% in JFD suggesting favorable effect of Job's-tear cereal on hyperlipidemia. Liver lipids levels were not affected by Job's-tear cereal.

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Effect of Reperfusion after 20 min Ligation of the Left Coronary Artery in Open-chest Bovine Heart: An Ultrastructural Study (재관류가 허혈 심근세포의 미세구조에 미치는 영향 : 재관류 손상에 관한 연구)

  • 이종욱;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.739-748
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    • 1998
  • Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

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Multimarker Approach by Troponin T, C-Reactive Protein, and CK-MB to Assessment in AMI in the Emergency Department

  • Lee, Sam-Beom;Kim, Jung-Ho;Do, Byung-Soo
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.197-205
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    • 2003
  • 서론: 급성 관동맥 증후군과 심근경색증의 진단과 예후 예측에 도움을 주는 새로운 심효소인자가 여러 가지 발견이 되어 현재 응급의료센터에서도 기본적으로 허혈성 흉통이 있는 환자에게 많이 사용하고 있다. 특히 최근에는 troponin과 CK-MB의 유용성에 대해서 많이 언급을 하고 있다. CRP도 역시 급성 관상동맥증후군에서 중요성이 인식되고 있다. 저자들은 세 가지 인자를 동시에 평가하여 상승되는 인자 수에 따라 그 중요성이 다를 수 있다는 가정 하에 총체적인 환자에 대한 정보를 제공할 수 있고, 응급실 근무 의사에게 급성 심근 경색증 환자를 좀 더 효율적으로 평가 할 수 있도록 하기 위하여 다표지 인자에 관한 연구를 시작하였다. 방법: 저자들은 응급의료센터에 내원한 급성 허혈성 흉통이 있는 환자 중 심효소 검사와 심전도에서 급성 심근 경색증에 합당한 소견을 보이고 이후 검사한 심혈관 조영술에서 심근경색증으로 확진된 환자를 대상으로 하였다. 내원 초기에 troponin T와 CK-MB, CRP를 동시에 측정하였고 또한 후향적으로 환자에 대한 기본적인 특징과 정보, 심전도 소견, 합병증 발생, 심혈관 조영술 소견과 경색관련 혈관 수, 치료 및 치료결과 등에 대한 자료를 정리하여 분석하여 보았다. 이때 환자는 두 군으로 나누어 분석하였는데, 1군은 증가된 효소수가 1개 이하인 경우이고, 2군은 2개 또는 3개 및 좌주관상동맥을 포함한 경우로 하였다. 결과: 전체 130명의 환자가 대상이 되었고, 1군 40례, 2군 90례로 2군이 훨씬 많았다. 과거력에서 이전에 관동맥 성형술을 시술받은 경우가 2군에서 유의 있게 많았다(p<0.05). 이전의 약물 복용은 전체적으로 1군에서 많았으나 질산제 복용(p<0.05)을 제외하고는 의의가 없었다. 치료는 혈전용해제 사용이 오히려 1군에서 의의있게 많았으나(p<0.05), 합병증으로 쇽이나 폐부종을 동반한 경우가 2군에서 많았다. 하지만 본 연구에서는 6개월 추적 기간중의 사건 발생이나 합병증, 예후 결과에 대한 양군간의 차이를 발견하지 못했다. 결론: 급성 심근경색증 환자에게 다표지 인자를 이용한 접근법을 적용한 결과, 기본적으로 환자에 대한 몇 가지 정보, 즉 과거에 약물 투여 여부와 혈전용해제 사용, 혈관성형술을 시술 받은 경력과 같은 기초자료에 대한 제한적인 차이를 발견할 수 있었으나, 본 연구에서는 다표지 인자를 이용하여 추적기간중 환자의 상태와 예후를 평가하고 합병증을 조기에 예측한다든지 하는 중요한 역할을 발견하지 못하였다. 그래서 향후 이에 대한 제한점을 해결한 더 보완된 연구가 필요할 것으로 사료된다.

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GORHAM-STOUT DISEASE OF THE MANDIBLE: A CASE REPORT (하악골에 발생한 Gorham-Stout 증후군: 증례 보고)

  • Ji, Young-Min;Song, Gin-Ah;Shin, Jung-Hyun;Pang, Kang-Mi;Kim, Soung-Min;Myoung, Hoon;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Hwang, Soon-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.572-576
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    • 2008
  • Gorham-Stout disease is a rare skeletal disease which is progressive and spontaneous and idiopathic resorption of whole body bone. In the initial stage, the osteolytic site is replaced by histologically benign vascular proliferation without new bone formation and finally by dense fibrous tissues. We encountered with a patient involving the mandible with attention by the clinical, radiographic, scintigraphic, angiographic, and computed tomography. We resected the mandibular lesion which was reconstructed with a fibular free flap. We report literature review with a mandibular lesion involved with Gorham-Stout disease.

Clinical Study of Isolated and Combined Aortic Valve Replacement (대동맥판막치환술을 주(主)로 한 판막치환술의 임상성적)

  • 박동욱;황윤호;최강주;최석철;조광현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.262-269
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    • 1999
  • Background: To review the middle and long term results of aortic valve replacement(AVR) for 11 years, we surveyed and followed up the patients who underwent AVR. Material and Method: Between Feb. 1986 and May 1997, 134 patients underwent AVR. The patients consisted of 71 men and 63 women whose mean age was 38.9 years, ranging from 17 to 70. Result: The concomitant operations were 62 mitral valve replacement(MVR), 14 MVR + tricuspid valve annuloplasty, 10 Cabrol operation, 16 aortic annulus widening, and so forth. We used 119 mechanical(75 St. Jude Medical, 38 CarboMedics, 6 Sorin) and 15 tissue (Carpentier-Edwards) valves. Early postoperative complications occurred in 35 cases; 9 congestive heart failure, 6 low cardiac output, 5 postoperative bleeding, 5 pleural effusion, and so forth. There were 13 early postoperative deaths(9.7%) due to low cardiac output(5), CHF (2), disseminated intravascular coagulopathy(2), and so forth. The cumulative total follow-up period was 452.7 patient-years with a mean of 3.4${\pm}$3.1 years/patient. There were 9 cases of valve-related complications; anticoagulant-related bleeding(4), prosthetic valve endocarditis(2), thromboembolism(2) and prosthetic valve failure(1) occured at rate of 0.9, 0.4, 0.4, 0.2%/ pt-yr, respectively. Late valve-related death occurred in 3 cases(2.0%/pt-yr) associated with anticoagulant-related bleeding(2) and prosthetic valve endocarditis(1). Conclusion: Actuarial survival rate by Kaplan-Meier method was 91.0${\pm}$4.3 % at 11 years.

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May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.343-347
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    • 2020
  • May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

Clinecal Investigation and Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum (전흉벽 늑연골의 리모델링 성형술을 이용한 누두흉수술의 임상적 고찰 초기합병증)

  • Her, Keun;Song, Cheol-Min;Jeon, Cheol-Woo;Jang, Won-Ho;Kim, Hyun-Jo;Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.882-889
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    • 2002
  • Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus excavatum Recently, Remodelling Plasty of Costochondral Rib Cage has been introduced as an minimally invasive procedure and expanded its application for pectus excavatum. Outcomes and acute complications were reviewed Material and Method: A retrospective survey of 55 patients who underwent Remodelling Plasty of Costochondral Rib Cage from September, 1999 to February, 2002 was conducted to review complications, postoperative treatments, and outcomes. Result: Age ranged from 1 to 27 years(mean 11.4 $\pm$ 7.1). 35(64%) were less than 15-year old and 20(36%) were more than 15-year old. There were 44(80%) Male patients and 11(20%) female patients. Length of hospital stay was 7.8 $\pm$ 2.1 days for less than 15-Y-old group, 10.6 $\pm$ 6.2 days for more than 15-Y-old group(p = 0.042) One substernal bar was inserted in 52 patients and two substernal bars were inserted in 3 patients. As for stabilizer, one lateral side was fastened in 15 patients and both lateral sides were fastened in 6 patients. In the less than 15-Y-old group, 4 patients needed stabilizer, whereas in the more than 15-Y-old group, 18 patients needed stebilizer(s)(p = 0.000). Including all kinds of complications, 28(51 %)patients had postoperative complications. Of them, only 7 patients were treated for complications(C-tube insertion was done in 7 patients and reoperation for bar refixation or removal was done in 3 patients of them). Conclusion: Most complications after Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum were trivial without treatment although C-tube drainage was needed in some patients. However bar displacement such as rotation and lateral sliding should be corrected as soon as detected in order not to remove the bar(the worst situation).

Surgical Treatment and Analysis of Esophageal Diseases (식도 질환의 외과적 치료 및 분석)

  • Choe, Yeong-Ho;Jo, Seong-Jun;Jo, Won-Min;Kim, Gwang-Taek
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1123-1128
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    • 1996
  • A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.

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Repair of Ruptured Papillary Muscle of the Tricuspid Valve as a Cause of Tricuspid Insufficiency Following Blunt Chest Trauma (흉부 둔상후 삼첨판막 폐쇄부전을 유발한 삼첨판막 유두근 파열의 치료)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Lee, Jung-Hoon
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.413-416
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    • 2010
  • A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.

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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