• Title/Summary/Keyword: 협착증

Search Result 592, Processing Time 0.027 seconds

Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
    • /
    • v.37 no.1
    • /
    • pp.56-63
    • /
    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

Circunferential resection and direct end to end anastomosis of mediastinal trachea on a post tracheostomy stenosis (기관절개술후 종격동기관 협착증에 대한 기관절제 단단 문합술)

  • Kim, Se-Wha;Park, Hee-Chul;Lee, Hong-Kyun
    • Journal of Chest Surgery
    • /
    • v.13 no.4
    • /
    • pp.495-502
    • /
    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

  • PDF

A Case Report of Lumbar Spinal Stenosis Improved with Diarrhea-Inducing Treatment by Gamsui-mal and Korean Medicine Treatment (감수말 공하법을 병행한 한방치료로 호전된 요추 척추관 협착증 환자의 증례보고)

  • Nam, Suhyun;Kim, Donghoo;Choi, Hyunmin;Kang, Jun-Hyuk;Hyun, Minkyoung
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.27 no.1
    • /
    • pp.67-75
    • /
    • 2017
  • The purpose of this study is to report the effectiveness of diarrhea-inducing treatment by Gamsui-mal for lumbar spinal stenosis. During hospitalization four patients with lumbar spinal stenosis were treated with diarrhea-inducing treatment by Gamsui-mal and acupuncture, herbal medicine, moxibustion, cupping treatment, Bee-venom pharmacopuncture. Before treatment, we explained in detail about diarrhea-inducing treatment by Gamsui-mal and patients agreed with treatment. The symptoms appeared in patients of diarrhea, abdominal pain, and vomiting in the treatment process. We evaluated the degree of improvement by visual analogue scale (VAS), oswestry disability index (ODI). After treatment, we found that pain was reduced and patient's symptoms were improved by visual analogue scale (VAS), oswestry disability index (ODI) score. The results show that diarrhea-inducing treatment by Gamsui-mal was rapidly improving symptoms. Further studies are needed to clarify the effect of diarrhea-inducing treatment by Gamsui-mal.

Infantile Hypertrophic Pyloric Stenosis (IHPS) -Early postoperative changes of pylorus after pyloromyotomy using ultrasonogram in patients with IHPS- (영아 비후성 유문부 협착증에서 초음파 검사를 이용한 수술 후 유문부의 조기 변화)

  • Baik, Hong-Kyu;Jung, Poong-Man;Kim, Yong-Soo
    • Advances in pediatric surgery
    • /
    • v.5 no.1
    • /
    • pp.64-68
    • /
    • 1999
  • The length, diameter and muscle thickness of the pylorus were measured by ultrasonograms in 15 infants with infantile hypertrophic pyloric stenosis(IHPS). These measurements were compared to assemble measurements of infants who came in for the routine vaccination and underwent ultrasonogram. This study also studied by ultrasound the changes in the pylorus of patients who underwent pyloromyotomy 4 weeks and 8 weeks postoperatively. According to $Carver^5$, the pyloric muscle volume(PMV) and pyloric muscle index(PMI) were calculated in each case. The pyloric muscle volume, PMI and the thickness of pyloric muscle proved to be a more reliable guide to diagnose IHPS than length and diameter of pylorus. The pyloric muscle length, diameter, thickness and pyloric muscle volume were not normalized at 4 and 8 weeks after pyloromyotomy. However, pyloric muscle index was normalized at 4 weeks postoperatively perhaps as the result of rapid weight gain after pyloromyotomy.

  • PDF

Stent Design Using Computational Fluid Dynamics (전산유체역학을 이용한 스텐트 설계)

  • Kim, Tae-Dong;Barakat, Abdul;Seo, Tae-Won
    • Transactions of the Korean Society of Mechanical Engineers B
    • /
    • v.29 no.9 s.240
    • /
    • pp.1042-1048
    • /
    • 2005
  • Numerical investigation has been made on the stent design to minimize the neointimal hyperplasia. Computational fluid dynamics is applied to investigate the flow distributions in the immediate vicinity of the given idealized stent implanted in the blood vessel. Parametric study on the variations of the number of stouts, stent diameters, stent spacings and Reynolds numbers has been conducted using axi-symmetric Navier-Stokes equations. An initial difficulty in the study is to determine the optimal stent design to understand the flow physics of the flow disturbance induced by stent. The size of recirculation zone around stent is depend on the stent diameter, number of stent wire and Reynolds number but is insensitive to the stent wire spacing. It is also found that when the flow is in acceleration, the flow sees a more favorable pressure gradient, and the separation zones are smaller than the steady flow case. When the flow is in deceleration and the flow sees a more adverse pressure gradient so that the separation zones are larger.

Biomechanical Analysis of Lumbar Interspinous Process Fixators (요추부 극돌기간 고정기구의 생체역학적 해석)

  • Heo Soon;Park Jung-Hong;Lee Sung-Jae;Son Kwon
    • Journal of the Korean Society for Precision Engineering
    • /
    • v.23 no.3 s.180
    • /
    • pp.195-202
    • /
    • 2006
  • The degenerative lumbar spinal stenosis (DLSS) is a disease inducing low back pain, leg pain, convulsion. numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degeneration of neighbor lesion after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified it using the finite element analysis (FEA). The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and calculated from the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator. Three prototypes were manufactured using FEA results. Mechanical tests under the biomechanical loading condition were performed to select the best one from these three. The selected fixator increased flexiblity by 32.9%.

A case of congenital ductus arteriosus aneurysm (Congenital ductus arteriosus aneurysm 1례)

  • Wang, Sheng Wen;Kim, Ji Eun;Lee, Young Seok;Lee, Young Ah
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.12
    • /
    • pp.1363-1366
    • /
    • 2006
  • Aneurysmal dilatation of the ductus arteriosis has been considered a rare but potentially fatal abnormality. The mechanism of ductal aneurysmal formation remains uncertain. Plain chest radiography has proven helpful in the diagnosis of ductus arteriosus aneurysm (DAA), before the application of transthoracic echocardiography. The transthoracic echocardiography is an important tool for the diagnosis and follow-up of DAA. We present a case of congenital ductus arteriosus aneurysm in a newborn, that was an incidental discovery. The diagnosis was made by echocardiography, three-dimensional surface rendering computed tomography (CT), and spontaneous regression after four weeks of follow-up.

Anterior Epidural Irrigation in a Lumbar Spinal Stenosis Patient (척추관 협착증 환자에서 전 경막외강 세정요법)

  • Lee, Jun Seok;Kwon, Hong Tae;Park, Chan Hong
    • The Korean Journal of Pain
    • /
    • v.19 no.1
    • /
    • pp.63-67
    • /
    • 2006
  • Background: Pain due to spinal stenosis is one of the major causes of low back pain, and it sometimes does not respond to conservative treatment. We postulated that anterior epidural irrigation could be a good choice for treating lumbar spinal stenosis patients. However, the effects and theoretical basis of anterior epidural irrigation have not been investigated for spinal stenosis. So, this study was designed to identify the clinical efficacy of anterior epidural irrigation for treating lumbar spinal stenosis. Methods: 71 patients with lumbar spinal stenosis underwent anterior epidural irrigation. Anterior epidural irrigation was performed with normal saline and a mixture of local anesthetic with steroid through a catheter under fluoroscopic guidance. The findings were evaluated with using visual analogue scales for low back pain and leg symptoms. Results: Relief from low back pain and leg pain was observed for up to 12 months after anterior epidural irrigation. None of the patients showed any deterioration of their motor or sensory deficits during follow up. Conclusions: Anterior epidural irrigation is effective for the relief of back and leg pain in spinal stenosis patients.

Valvular Pulmonic Stenosis with Congestive Heart Failure in a Fox Terrier (폭스테리어 종에서의 울혈성 우심부전을 동반한 판막형 폐동맥판 협착증)

  • Jung, Dong-In;Park, Ki-Tae;Wang, Ji-Hwan;Kim, Young-Ki;Lee, Kyung-Woo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
    • /
    • v.28 no.1
    • /
    • pp.133-138
    • /
    • 2011
  • A 4-year-old female Fox Terrier dog (weighting 8 kg) with history of severe abdominal distention and anorexia was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed right ventricular enlargement (right axis deviation and deep S wave) and right atrial enlargement (P pulmonale). Diagnostic imaging studies revealed hypertrophy of right ventricle, enlargement of right atrium and tricuspid regurgitation and turbulence in the pulmonary artery in right parastenal short axis view. Based on the diagnostic findings, the dog was diagnosed as a case of valvular pulmonic stenosis.

Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft (만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예)

  • Jang, Un-Ha;Yu, Hoe-Seong
    • Journal of Chest Surgery
    • /
    • v.11 no.1
    • /
    • pp.81-84
    • /
    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

  • PDF