• Title/Summary/Keyword: 협착증

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Treatment of Diffuse Tracheobronchial Amyloidosis by Repeated Electrocautry Under Fiberoptic Bronchoscopy (굴곡성 기관지경하 전기소각술로 치료한 미만성 기관기관지형 유전분증 1예)

  • Kim, Ho-Joong;Koh, Jong-Hoon;Chang, Myeong-Jun;Hong, Sung-Hun;Kim, Kyung-Hwan;Hyun, In-Kyu;Lee, Myoung-Koo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.250-255
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    • 1995
  • Diffuse tracheobronchial amyloidosis is an uncommon form of pulmonary involvement, and causes prolonged cough, dyspnea, wheezing and repeated development of pneumonia. We report a case of diffuse tracheobronchial amyloidosis in 58-year-old woman that was traeted by repeated electrocautry under flexible fiberoptic bronchoscopy. The patient had a long-standing history of dyspnea and was admitted due to resting dyspnea, which was aggravated to impending respiratory failure after diagnostic procedures. We applied repeated electrocautry to the endobronchial amyloid tumors and successfully reduced bronchial stenosis and the pateint didn't feel dyspnea. We suppose that, in certain cases of tracheobronchial amyloidosis patients, endobronchial electrocautry would be a helpful procedure.

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Extended Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy -Report of a case- (비후형 심근증 환아에서 시행한 광범위 중격절제술 - 1예 보고 -)

  • Lee Jae-Hang;Kwak Jae-Gun;Jung Eui-Suk;Oh Se-Jin;Chang Myoung-Woo;Kim Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.775-778
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    • 2006
  • Hypertrophic cardiomyopathy is characterized by inappropriate hypertrophy of the myocardium and is associated with various clinical presentations ranging from complete absence of symptoms to sudden, unexpected death. These are caused by dynamic obstruction of the left ventricular outflow tract and surgical approaches were initiated. But, the complete resection of hypertrophied midventricular septum is impossible by standard, transaortic approach, because of narrow vision and limited approach. And it leads to inadequate excision, will leave residual left ventricular out-flow tract obstruction or systolic anterior motion of mitral leaflet, and limit symptomatic improvement and patient's survival. We report a case of extended septal myectomy for hypertrophic cardiomyopathy of mid-septum in a child. The extended septal myectomy was performed by aortotomy and left ventricular apical incision, and made possible the complete resection of mid-ventricular septum, abnormal papillary muscles and chordae. The patient's symptom was improved and the postoperative course was uneventful.

The Immediate and Long Term Result of Surgical Angioplasty of Left Main and Proximal Left Anterior Decending Coronary Artery (좌주관상동맥 및 좌전하행지기시부의 수술적 혈관 성형술의 중장기 성적)

  • 안현성;김응중;신윤철;지현근;이원용
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.692-697
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    • 2001
  • Background: The left main coronary artery surgical angioplasty has become the choice of surgical procedure in isolated LM disease. We have performed 22 cases of LMCA surgical angioplasy since 1996. We report the immediate and long term result of the surgical angioplasty with their postoperative angiography. Material and Method: Between July 1994 and October 2000, 22 patients(11 men and 11 women) were subjected to surgical patch angioplasty of the LMCA, 1 patient had an additional angioplasty performed on the proximal right coronary artery. The LMCA was approached anteriorly with or without transection of the main pulmonary artery(21 cases), and in a patient who had undergone an aortic valve replacement, LMCA was approached superiorly with transection of the ascending aorta. Additional grafting was required in 5 cases. The on-lay patch was used with autologous pericardium in 6 cases and bovine pericardium in 16 cases. Result: There was no operative mortality. There was 30~50% stenosis of the anastomosis site in 3 cases at the postop. coronary angiography. Coronary angiography was reperformed in 5 cases between 5th months and 15th months postoperatively. There was 40~60% stenosis of the anastomosis site in 2 cases. There was one death at 42nd months postoperatively but the cause was unknown. No patient complained of angina with a mean follow up of 48.$\pm$22.5 months. Conclusion: There were only several coronary angiographic results in long term follow-up but we had relatively good clinical results for LMCA surgical angioplasty in the immediate and long term. The excellence of LMCA surgical angioplasty needs the result of the long term follow-up.

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The Measurement of Ho-166 Absorbed Dose for the Endovascular Irradiation with a Balloon Angio Catheter Using a GafChromic Film (GafChromic 필름을 이용한 Ho-166 의 혈관내 방사선조사를 위한 선량분포 측정)

  • 강해진;조철우;박찬희;오영택;전미선;김영미;박경배
    • Progress in Medical Physics
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    • v.10 no.3
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    • pp.151-157
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    • 1999
  • The GafChromic film was used for the dosimetry of a balloon angio catheter filled with the radioisotope HO-166 for endovascular irradiation. The balloon angio catheter was 2 cm long and 3 mm in diameter when inflated. The isotope, Ho-166, was produced by the neutron bombardment using the research reactor in Korea Atomic Energy Research Insititute. Co-60 teletherapy beam was used for making H-D curve for the Gaf-Chromic film. The film dosimetry was measured with a videodensitometer. The radial dose distribution indicated that the absorbed dose dropped to about 20% of the surface dose at the 1 mm away from the balloon surface and at 5 mm position the dose decreased to below 1% of the surface dose. The result also shows that with the specific activity of Ho-l66, 250 mCi/ml it takes 230 seconds to deliver 1200 cGy to the region where is 1mm away from the balloon surface. The concentric isodose curves were also presented. The Ho-166 is an another alternative for endovascualr irradiation to prevent restenosis after PTCA (Percutaneous Trans Coronary Angioplasty)

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The Apoptotic Effect of Bee Venom and Melittin on FBS-induced Vascular Smooth Muscle Cells Proliferation (봉약침액과 melittin의 세포고사 효과가 FBS에 의하여 유도되는 혈관 평활근 세포 증식에 미치는 영향)

  • Han, Jae-Choon;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.23 no.3
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    • pp.91-102
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    • 2006
  • 목적 : 이 연구에서는 FBS에 의하여 유도되는 혈관 평활근 세포 증식에 대한 봉약침액과 Melittin의 세포 고사효과의 영향 및 작용 기전을 살펴보고자 하였다. 방법 : $I{\kappa}Ba$, p-$I{\kappa}Ba$, p-ERK1/2, p-Akt, p53, Bcl-2, Bax 및 active caspase-3는 Western blotting을, $NF-{\kappa}B$는 EMSA와 immunofluorescence staining을 이용하여 측정하였다. 결과 : 1. Melittin은 $NF-{\kappa}B$ 활성에 대하여 $I{\kappa}Ba$의 인산화를 유의하게 익제하고 $I{\kappa}Ba$를 증가시켰으며, $NF-{\kappa}B$의 DNA 결합과 $NF-{\kappa}B$ p50의 핵 내 유입을 유의하게 감소시켰다. 2. Melittin은 $NF-{\kappa}B$ 활성을 증가시키는 물질인 Akt의 인산화를 유의하게 억제하였고, ERK1/2의 인산화도 억제하였다. 3. Melittin은 세포사멸 전구 단백질인 p53, Bax 및 caspase-3의 발현을 유의하게 증가시켰고, 세포사멸억제 단백질인 Bcl-2의 발현은 감소시켰다. 결론 : 이상의 결과는 $NF-{\kappa}B$ 와 Akt 활성을 억제함으로써 혈관평활근세포 증식을 억제하는 효과가 있음을 입증한 것이며, 향후 안전성 연구를 바탕으로 혈관성형술 후 재발성협착증과 동맥경화증의 치료제로 사용될 수 있을 것으로 기대된다.

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Primary Esophageal Repair of Long-gap Esophageal Atresia - Report of One Case - (원간격결손 식도폐쇄증의 일차적 식도복원)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.53-58
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    • 1995
  • A delayed primary esophago-esophagostomy of a case of long-gap esophageal atresia without tracheoesophageal fistula was performed in success with three months' intermittent periodic bougienage of the upper pouch via mouth as well as the lower esophagus through Janeway gastrostomy. Meanwhile, an effective continuous sump suction from the upper pouch seemed to be a critical part of the patient management. The extra length of esophagus for primary anastomosis could be achieved by a circular myotomy. Stricture at the myotomy site, found 4 months later, was treated with periodic pneumatic baloon dilations only with temporary symptomatic reliefs. After 4 months' trials, operative esophagoplasty was performed successfully. A careful follow-up schedule for the myotomy site would be required for early detection of stricture. The previous neonatal patient is currently 8 years old, healthy school-boy, and has a normal barium swallow without stricture or gastroesophageal reflux.

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Indication and Post-Procedural Management of Upper GI Stent Implantation (상부 위장관 스텐트 삽입술의 이해 -적응증 및 추적 관리-)

  • Joo, Moon-Kyung;Park, Jong-Jae
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.49-55
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    • 2009
  • Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

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A Case of Achalasia (Achalasia(무이완증)의 일례)

  • 임의순;김진구;유방환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.16.3-17
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    • 1972
  • We experienced a case of Achalasia, who had been impressed as a bronchial asthma and treated at a local clinic. Fluoroscopic findings revealed narrowed vestibular portion with markedly dilated body of the esophagus. Hypertrophied mucosal folds on lower portion of the esophagus were noticed by the esophagoscopy but no ulcerative lesion, nor mass were found. The symptoms such as dysphagia, regurgitation, cough and retrosternal discomfortness were markedly relieved by means of daily mercury bougienage for a month duration.

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Clinical Manifestation and Associated Cardiac Anomalies of Dextrocardia (우심증에 동반된 심기형과 임상양상)

  • Kim, Sung Hoon;Hong, Seung A;Cho, Yoon Jung;Lee, Sang Lak;Kwon, Tae Chan
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.622-628
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    • 2002
  • Purpose : The purpose of this study is to ascertain the clinical manifestations and associated cardiac anomalies of dextrocardia. Methods : Twenty-four pediatric patients, who were admitted to, or visited, Dongsan Medical Center Keimyung University and were diagnosed with dextrocardia between January 1996 and July 2001, were enrolled in this study. All patients received echocardiogram and abdominal ultrasonogram to identify structural cardiac anomalies and visceral position. Results : Among 24 patients, 7 cases were situs solitus(29.2%), 10 cases(41.6%) were situs inversus and 7 cases(29.2%) were situs ambiguous. Most were diagnosed within a week of life(87.5%). They were most commonly cyanotic(45.8%), but eleven cases(45.8%) had no specific symptoms or signs. Nineteen cases(79.2%) had accompanied cardiac anomalies, and pulmonary stenosis or atresia were the most common among them. All the cases of situs solitus and ambiguous had associated cardiac anomalies, but half of the situs inversus had that. Eleven cases were dead by cardiac or extracardiac anomalies during follow up and the mortality rate was higher in situs solitus or ambiguous group than situs inversus group. Conclusion : Dextrocardia accompanies different cardiac and extracardiac anomalies. It's very important to diagnose dextrocardia and associated cardiac or extracardiac anomalies in the early stages of life to improve prognosis.

Dental Management in a Patient with Infantile Osteopetrosis : A Case Report with a 7-Year follow-up (유아기형 골화석증 환자의 치과적 관리 : 7년간의 경과 관찰)

  • Cheon, Minkyoung;Yang, Sunmi;Kim, Jaehwan;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.257-264
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    • 2018
  • Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span. A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oralrehabilitation with a removable partial denture was initiated. Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development. Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.