• Title/Summary/Keyword: 협착증

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Surgical Treatment of Tracheal Stenosis (기관협착증의 외과적 치료)

  • 조경수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.834-838
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    • 1989
  • Tracheal stenosis is being encountered more frequently as ventilatory support and cuffed tubes are increasingly used for treatment of respiratory failure. We experienced 13 cases of tracheal stenosis treated surgically at department of Thoracic and Cardiovascular Surgery, school of medicine, Kyung Hee university during the 4 years. The causes of tracheal stenosis were prolonged endotracheal intubation 5 cases, tracheostomy 3 cases, tracheal tumor 2 cases, thyroid tumor 1 case and congenital double aortic arch 1 case. The methods used to manage the tracheal stenosis were tracheal resection % end to end anastomosis 8 cases, 2 cases of subglottic stenosis were underwent primary laryngotracheal anastomosis, Lt. aortic arch division 1 case, and stent insertion 2 cases. In two cases, who had 6 cm in length of tracheal stenosis, we were underwent tracheal resection k end to end anastomosis with supralaryngeal release procedure. Postoperative courses were uneventful except one case with tracheal tumor.

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Surgical Treatment of Supravalvar Aortic Stenosis - A Case Report - (대동맥판상협착증 치험 1례)

  • 이성광
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.721-726
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    • 1988
  • Congenital supravalvar aortic stenosis is an obstruction caused by localized or diffuse narrowing of the aortic lumen commencing immediately above the aortic valve. We experienced a case of diffuse supravalvar aortic stenosis involving ascending aorta from just above the sinuses of Valsalva to the proximal l cm of the innominate artery. Supravalvar aortic stenosis in this patient, in contrast to the form seen in infants and children, was not associated with mental retardation, peculiar faces or the syndrome of hypercalcemia. Diagnosis was confirmed by retrograde left heart catheterization and left ventriculography. Surgical correction was performed by the replacement of oval shaped Woven Dacron patch over the narrow segment of aorta under the cardiopulmonary bypass. Blood pressure was controlled sufficiently with some adjunct of Inderal postoperatively. The patient was discharged with much improvement.

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Left Ventricular Rhabdomyoma with Tuberous Sclerosis - A Report of one case- (결절성 뇌경화증과 동반된 좌심실내 횡문근종의 수술치료 -1례보고-)

  • 문상호;서필원;박성식;임수빈;김삼현
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.467-470
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    • 2002
  • The most common primary heart tumor in infants is the rhabdomyoma. It is known that tuberous sclerosis is found in half of the patients with cardiac rhabdomyoma. Because the prognosis of this tumor associated with subaortic stenosis is poor, the surgical intervention is indicated. We report one case of left ventricular rhabdomyoma with tuberous sclerosis.

Single Coronary Artery Associated with Bicupid Aortic Valvular Stenosis -1 Case Report- (이첨 대동맥판막협착을 동반한 단일 관상동맥증 -1례 보고-)

  • 김우찬
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.472-476
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    • 1994
  • The incidence of single coronary artery is extremely rare in a review of congenital anomalies of the coronary arteries. This 27-year-old male patient was referred for the evaluation of cardiac condition showing exertional dyspnea[NYHA class II-III] and chest discomfort for about 1 year. A complete catheterization study including angiogram disclosed large single coronary artery arising from left aortic sinus [Ogden classification L-4] associated with bicuspid aortic valvular stenosis and low grade supravalvular aortic stenosis. Calcified stenotic aortic valve was fully removed with caution and the 19mm St. Jude Medical valve was then implanted in the small nortic annulus. The patient had an uneventful recovery and was discharged on 13th postoperative day.

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Experimental Study of the Influence of the Upper Airway Obstruction on the Blood Gas Analysis (인위적인 기도협착이 동맥혈액가스에 미치는 영향)

  • 정해영;김중환;조영상
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.8.2-8
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    • 1979
  • Acute obstruction of the upper airway from trachea, a foreign body or Iaryngospasm may lead to death in a few minutes. The immediate restoration of an adequate airway in these patients may be lifesaving. Spontaneous respiration by means of a needle inserted into the trachea was studied in 21 rabbits using 16, 18, and 20 gauge extrcatheters. The results are as follows; 1) Airway resistance was markedly increased in all experimental animals. consequently tidal volume was also significantly decreased, but this seems to be compensatory by increased of respiratory frequency in l6G group. 2) Blood gas analysis revealed adequate pulmonary ventilation through the constricted airway (about 1/3 of normal sized trachea) during 60 minutes. In the other hand, hypercarbia, hypoxemia, and metabolic acidosis were developed in the group with severe constriction of the upper airway (about 1/4-1/6 of normal sized trachea). 3) The further study is postulated to confirm the the possibility of application of needle trcheostomy in man, but the rabbits were tolerable to the constricted airway with a small sized needle (l6G) into the trachea for 60 minutes.

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Altered Expression of ${\beta}_3$ Integrin on Sclerotic Aortic Valves in a Hypercholesterolemic Rabbit Model (고콜레스테롤혈증을 유발한 토끼의 대동맥 판막에서 ${\beta}_3$ Integrin 발현의 변화)

  • Park, Chan-Beom;Kim, Young-Du;Choe, Mi-Sun;Jin, Ung;Moon, Seok-Whan;Kim, Yong-Han;Kim, Chi-Kyung;Jo, Keon-Hyon;Kweon, Jong-Bum
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.687-694
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    • 2008
  • Background: Although aortic valve sclerosis causes no significant hemodynamic alterations, it is associated with an increased risk of cardiovascular death and myocardial infarction. However, the role of ${\beta}_3$ integrin in aortic valve sclerosis remains unclear. Material and Method: Twenty male New Zealand rabbits were divided into two groups. Group 1 rabbits (n=10) received a normal chow diet, while group 2 (n=10) rabbits received a diet containing 1% cholesterol for 12 weeks. After the rabbits were euthanized, their aortic valves and ascending aortas were excised for analysis. Result: Total serum cholesterol ($2,148.3{\pm}1,012.5\;mg/dL$ versus $53.7{\pm}31.8\;mg/dL$, p<0.05), triglyceride ($240.4{\pm}218.3\;mg/dL$ versus $31.6{\pm}6.4\;mg/dL$, p<0.05), and low density lipoprotein (LDL)-cholesterol($2,065.3{\pm}960.9\;mg/dL$ versus $29.1{\pm}30.9\;mg/dL$, p<0.05) levels were significantly higher in the cholesterol diet group compared with the normal diet group. Myofibroblasts and macrophages were more highly expressed in the aortic valve leaflets of rabbits in the cholesterol diet group than of those in the normal diet group. A real-time polymerase chain reaction revealed decreased ${\beta}_3$ integrin mRNA levels in the hypercholesterolemic aortic valves and aortas. Conclusion: The present study shows that hypercholesterolemia induces aortic valve sclerosis. These findings suggest that alterations in ${\beta}_3$ integrin may playa role in the development of aortic valve sclerosis.

The Analysis on Surgical Result and Prognostic Factors of Thoracic Spinal Stenosis (흉추강 협착증의 수술적 치료 결과와 예후인자에 관한 분석)

  • Chang, Ung Kyu;Chung, Sang Kee;Kim, Dong Yoon;Chung, Chun Kee;Kim, Hyun Jib
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.761-768
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    • 2001
  • Objective : To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed Materials & Method : Twenty-eight patients(male, 15 ; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with $SPSS^{(R)}$ was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. Result : Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). Conclusion : Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.

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Clinical Observation on 119 Patients with Lumbar Spinal Stenosis Treated with Bee Venom Pharmacopuncture Therapy (봉약침 병행치료한 요추관 협착증 환자 119례에 대한 임상고찰)

  • Han, Kyung-Wan;Kim, Eun-Seok;Woo, Jae-Hyuk;Lee, Seul-Ji;Lee, Joon-Seok;Nam, Ji-Hwan;Kim, Kie-Won;Koh, Kang-Hoon;Yoo, In-Sik
    • Journal of Acupuncture Research
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    • v.28 no.3
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    • pp.21-31
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    • 2011
  • Objectives : The purpose of this study was to evaluate the effect of bee venom pharmacopuncture therapy in patients with lumbar spinal stenosis. Methods : This clinical study was carried out on 119 patients with lumbar spinal stenosis, who had been admitted from May, 2009 to March, 2011. Patients were sorted into two groups ; One group(bee venom pharmacopuncture group) was treated with bee venom pharmacopuncture and acupuncture therapy, the other(non-bee venom pharmacopuncture group) with acupuncture therapy only. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluate the effectiveness of the treatment in both groups. VNRS and ODI scores of the two groups were statistically compared. Results : The bee venom pharmacopuncture group demonstrated a more significant improvement than non-bee venom pharmacopuncture group when evaluated with VNRS and ODI. Conclusions : In the case of the patients with spinal stenosis, it was found that treatment with combination of bee venom pharmacopuncture and acupuncture was more effective in improving the conditions of the patients (subsidence of the symptoms) than the acupuncture treatment only.

Acupuncture for Lumbar Spinal Stenosis in Korean Literature: a Systematic Review (요추 척추관 협착증에 대한 침구치료의 국내 임상근거: 체계적 문헌고찰)

  • Kim, Kun-Hyung;Noh, Seung-Hee;Lee, Byung-Ryul;Kim, Jae-Kyu;Yang, Gi-Young
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.93-105
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    • 2011
  • Objectives : This study aims to evaluate currently available clinical evidence for the use of acupuncture in patients with lumbar spinal stenosis in the context of Republic of Korea. Methods : Five Korean databases were searched for all clinical studies employing acupuncture for patients with lumbar spinal stenosis. The exceptions were case reports and series involving less than 10 patients from their inception to September 2011. Only studies reported in Korean databases were searched. Results : Five retrospective audits among 22 initially identified studies were eligible for analysis in this review. There was no randomized controlled trial for this topic. The number of patients varied between 15 and 119 in each audit, and all the patients analyzed were inpatients. In all the included studies, acupuncture was conducted in combination with other concomitant treatments, including moxibustion, cupping, herbal remedies, acupoint injection, Chuna, and various physical therapies. All the included audits reported symptomatic and/or functional improvements compared to baseline. None of the included audits indicated whether any adverse events were reported. Conclusions : Current evidence for the use of acupuncture in patients with lumbar spinal stenosis in the context of South Korea is based solely on five retrospective audits that are very likely prone to a high risk of bias. Thus, further prospective and methodologically sound clinical trials to overcome this huge gap between clinical practice and the available evidence for the use of acupuncture in patients with lumbar spinal stenosis are needed.

The Clinical Study on Spinal Stenosis of Lumbar Spine (요추 척추관 협착증 환자 118례에 대한 임상적 고찰)

  • Cho, Jae-Hee;Lee, Hyo-Eun;Moon, Ja-Young;Lim, Myung-Jang;Kang, In;Lee, Han;Jung, Ho-Suk;Kim, Ji-Hyung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.77-85
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    • 2008
  • Object : These studies are designed to make a survey of the effectiveness of the non surgical oriental medicine treatment with Chuna on spinal stenosis of lumbar spine. Methods : The clinical study was done on 118 cases of patients with spinal stenosis of lumbar spine diagnosed by M.R.I, symptoms and physical test who was in the admission in Ja-Seng Oriental Medcine Hospital from October 2006 to October 2008. after treatment we checked VNRS score to estimate the efficacy of treatment. Results : 1. As a Objectivity treatment record, they test excellent 17%, good 69%, fair 8%, poor 6%. 2. The mean NRS score decreased about 3.26 after the treatment. Conclusions : Non surgical oriental medicine treatment with Chuna has on useful effect on spinal stenosis of lumbar spine.

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