• Title/Summary/Keyword: 협착증

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Surgical Treatment of the Supravalvular Aortic Stenosis (판막상부 대동맥 협착증의 수술요법)

  • Lee, Won-Yong;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1146-1151
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    • 1990
  • Supravavular aortic stenosis is a congenital narrowing of the ascending aorta just distal to the level of the origins of the coronary arteries, that may be localized or diffuse. Five patients with supravalvular aortic stenosis were operated upon between July, 1986 arid June, 1990. Four of these patients were William`s syndrome [mental retardation, elfin face], and one was isolated supravalvular aortic stenosis. Preoperative diagnosis of the supravalvular aortic stenosis was made by left side cardiac catheterization and angiocardiography. There are three types of supravalvular aortic stenosis such as membranous, hourglass and hypoplastic. Four of our patients were of hourglass type, and one was hypoplastic type. Patch aortoplasty was performed in all cases. Preoperative systolic gradients ranged from 45 to 1SO mmHg [average 102.6 mmHg]: postoperative gradients ranged from 0 to 75 mmHg [average 39 mmHg]. The patient of hypoplastic type has been suffered from mild exercise intolerance even after the operation, and the postoperative echocardiography revealed the systolic gradient of 100 mmHg [preoperative 180 mmHg]. The results of surgery for hourglass type were excellent. But the patient with hypoplastic form would be benefited from some modifications of the operation.

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The Clinical Study on Effects of Bee Venom Pharmacupuncture Therapy in Patients with Lumbar Spinal Stenosis (요추관 협착증에 대한 봉약침 병행 치료 효과의 임상적 연구)

  • Jeong, Seon-Mee;Park, Chan-Kyu;Kim, Kwang-Ho;Kim, Ja-Young;Sohn, Sung-Chul
    • Journal of Acupuncture Research
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    • v.25 no.1
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    • pp.97-106
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    • 2008
  • Objectives : This study was designed to evaluate the effects of Bee Venom Pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : We investigated 16 patients with lumbar spinal stenosis. We divided patients into two groups : Bee Venom Pharmacopuncture was performed with acupuncture therapy for one group, and the other group received acupuncture therapy only. To evaluate the effectiveness of the treatment applied to the two groups, we used the Visual Analog Scale(VAS) and the Oswestry Low-back Pain Disability Index(ODI). We compared the VAS and ODI scores of the two groups statistically. Results : The Bee Venom Pharmacopuncture group received more effective relief than the acupunctureonly group as measured by decreasedpain and disability reported on the VAS and ODI by patients with lumbar spinal stenosis. Conclusions: Bee Venom Pharmacopuncture therapy can be used in addition to acupuncture therapy for highly effective treatment of patients with lumbar spinal stenosis. Further clinical studies are needed to verify these findings.

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The Clinical Report on 3 cases of the patient of lumbar stenosis Treated with Motion Style Treatment (동작 침법을 시행한 요추부 척추관 협착증 환자의 치험 2례 보고)

  • Kim, Ki-Yuk;Lee, Ki-Ha;Kim, Wu-Young;Kim, Hyun-Jong;Kim, Chang-Yeon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.1
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    • pp.29-36
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    • 2008
  • Objectives : the purpose of this study is to report the improvement of stenosis patients, who treated by M.S.T.(Motion Style Treatment) Methods : the clinical study was done on 2 cases of patients with lumbar stenosis who admission in Jaseng Oriental Medicine hospital. We checked VNRS score after the treatment of M.S.T.(Motion Style Treatment) each day, and checked ODI score at admission and discharge. Results : VNRS score and ODI score decreased after the treatment of M.S.T.(Motion Style Treatment)

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Numerical Analysis on the Effect of Wall Shear Stress Around the Ring Drug-Eluting Stent (고리형 약물분출 스텐트 주위 벽전단응력의 영향에 대한 수치해석)

  • Seo, Tae-Won;Barakat, Abdul
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.31 no.1 s.256
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    • pp.21-28
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    • 2007
  • The use of drug-eluting stents has dramatically reduced the incidence of restenosis however, much remains to be teamed about the performance of these stouts. In the present study, we tested the hypothesis that the design of drug-eluting stents influences the efficacy of local drug delivery to the arterial wall and that this effect depends on both arterial geometry and the prevailing flow conditions. We performed computational simulations in which the coupled Navier-Stokes and advection-diffusion equations were solved to determine the flow field and drug concentration in the vicinity of model drug-eluting stouts It is found that the characteristics of flow phenomena can be influenced greatly by the ratio of stent diameter to vessel diameter. The presence of drug-eluting stent may have profound effect on wall shear stresses, recirculation sizes and drug distributions. The results show that recirculation zone is influenced by the imposed flow conditions and stent diameter. In pulsatile flow, the low wall shear stress and high drug concentration occur along the arterial wall during the decelerating flow conditions. These results could provide the guideline for future drug-eluting stent designs toward reducing restenosis by affecting local wall shear stress distributions associated with neointimal hyperplasia.

Surgical Management of Tracheal and Bronchial Stenosis (기관및 기관지 협착증 환자의 외과적 치료)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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Hypertrophic Pyloric Stenosis Occurring in Fasting State with Gastrostomy After Surgery for Esophageal Atresia with Tracheoesophageal Fistula (선천성 식도 폐쇄 환자에서 출생 후 위루관 삽입술과 계속적인 금식상태에서 근본수술 후 발생한 비후성 유문 협착증 - 1예 보고 -)

  • Jung, Eun-Young;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.88-92
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    • 2011
  • The onset of hypertrophic pyloric stenosis in the postoperative course of esophageal atresia with tracheoesophageal fistula is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed since birth. The infant presented with an increased amount of orogastric tube drainage and consistently distended gastric air on simple abdominal X-ray. Abdominal ultrasonography showed hypertrophic thick pyloric muscle. The diagnosis of pyloric stenosis was confirmed d is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed. The infant presented with uring surgery, After pyloromyotomy, the patient's condition improved.

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Subvalvular Pulmonic Stenosis with Congestive Heart Failure in a Yorkshire terrier (요크셔테리어종에서의 울혈성 심부전을 동반한 판막하형 폐동맥판 협착증)

  • 박현정;채형규;이승진;이영원;오태호;장광호;박성준
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.452-454
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    • 2001
  • A two-month-old female Yorkshire terrier was referred to the Veterinary Teaching Hospital, College of Veterinary Medicine, Kyungpook national University. The patient was presented with a history of dyspnea, cough, exercise intolerance and abdominal distension, but she was appetence. In physical examination the puppy was coughed on slight tracheal compression. Rectal temperature, pulse and respiratory rate were normal, and grade 3/6 systolic murmur heard at the left heart base. The murmur was crescendo-decrescendo. Electrocardiography showed sinus arrhythmia, right-ventricular hypertrophy pattern, and right axis deviation. Thoracic radiography revealed cardiomegaly, bulging of the main pulmonary artery, and enlarged left side heart. Abdominal radiography revealed abdkominal distention. Echocardiography showed hypertrophy of right ventricle and turbulence in the pulmonary artery in parasternal oblique view. Subvalvular pulmonic stenosis was diagnosis based upon the clinical signs, physical examination, electrocardiography, radiography and echocardiography. We treated the patient with furosemide, enalapril and $\beta$-blocker. After the clinical signs of cough, abdominal distension and dyspnea were disappeared, she was on just $\beta$-blocker for prevention of occurrence of congestive heart failure. Now she was recovered her health, and she is not on any medication.

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Biomechanical Evaluation of SMA Dynamic Stabilization for Spinal fusion (척추고정용 형상기억합금 동적안정기기의 생체역학적 성능 평가)

  • Kim Y.H.;Park W.M.;Kim K.;Park H.K.;Joo J.W.;Park K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.517-518
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    • 2006
  • In this study, a commercial fixation device, BioFlex, which was designed with shape memory alloy(SMA) for dynamic stabilization of spine was biomechanically evaluated. The finite element model of intact lumbar spine from L1 to S was developed using CT images. Also, low FE models of 2-level(L4-L5-S) and 3-level(L3-L4-L5-S) posteriori fixation using titanium(Ti) rod and BioFlex(SMA) rod. The rotations of bone segments in the intact model and four models were predicted. Although the rotations of the BioFlex fixation model were smaller than those of the intact model, they were relatively larger than those of Ti fixation. The present can be applied for not only evaluation of the stability of interbody fixator, but also development of new implant.

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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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Congenital Esophageal Stenosis due to Tracheobronchial Remnants -1 case report- (기관기관지 잔유조직에 의한 선천성 식도협착 -1례 보고-)

  • 이선희;권종범
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.248-250
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    • 1996
  • Congenital esophageal stenosis due to tracheobronchial remnant is very rare disease entity and usually occurs in mid and lower esophagus. The cause is esophageal sequestration of a tracheobronchial anlage before embryologic separation. A 4 years old girl was admitted with swallowing difficulty, food regurgitation which progressively got worse in recent 2 years. She was operated under the dagnosis of achalasia. During the myoto y procedure we found the bean sized hard nodular mass, which was 4cm above the esophagogastric junction, and after the resection of mass, esophagoplasty was carried out. The histologic finding of the mass revealed traheal cartilages and respiratory glands.

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