• 제목/요약/키워드: Abdominal, aorta

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중년 여자 환자에서 비전형적 Middle Aortic Syndrome의 수술치험 1예 (Atypical Middle Aortic Syndrome in a Middle Aged Woman -A case report-)

  • 김우식;배윤숙;정성철;신용철;유환국;김병열
    • Journal of Chest Surgery
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    • 제37권1호
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    • pp.80-83
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    • 2004
  • 원위 흉부 대동맥이나 복부 대동맥 혹은 두 부위가 좁아져 있는 Middle aortic syndrome (이하 MAS) 또는 mid aortic dysplastic syndrome은 매우 드물게 발생한다. 원인이 불분명하고 흔히 젊은 여성에게서 잘 나타나는 이 질환은 뇌출혈뿐만 아니라 심장, 신장의 손상을 초래할 수 있으므로 적극적인 수술적 치료로 혈류를 개선하여 효과를 볼 수 있으나 대동맥 혈관의 섬유화로 인한 수술 술기의 어려움이 따른다. 최근 국립의료원 흉부외과에서는 광범위한 석회화 병변을 동반한 하부 대동맥협착을 가진 51세 여자 환자에서 6.0-mmPTFE (polytetrafluoroethylene) 인조혈관을 이용하여 양측 액와-대퇴 동맥간 우회로술을 시행함으로써 우수한 수술 결과를 보였기에 보고하는 바이다.

Contrast-Enhanced Magnetic Resonance Angiography: Dose the Test Dose Bolus Represent the Main Dose Bolus Accurately?

  • Jongmin J. Lee;Yongmin Chang;Duk-Sik Kang
    • Korean Journal of Radiology
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    • 제1권2호
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    • pp.91-97
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    • 2000
  • Objective: To determine whether the time-intensity curves acquired by test and main dose contrast injections for MR angiography are similar. Materials and Methods: In 11 patients, repeated contrast-enhanced 2D-turbo-FLASH scans with 1-sec interval were obtained. Both test and main dose timeintensity curves were acquired from the abdominal aorta, and the parameters of time-intensity curves for the test and main boluses were compared. The parameters used were arterial and venous enhancement times, arterial peak enhancement time, arteriovenous circulation time, enhancement duration and enhancement expansion ratio. Results: Between the main and test boluses, arterial and venous enhancement times and arteriovenous circulation time showed statistically significant correlation (p < 0.01), with correlation coefficients of 0.95, 0.92 and 0.98 respectively. Although the enhancement duration was definitely greater than infusion time, reasonable measurement of the end enhancement point in the main bolus was impossible. Conclusion: Only arterial and venous enhancement times and arteriovenous circulation time of the main bolus could be predicted from the test-bolus results. The use of these reliable parameters would lead to improvements in the scan timing method for MR angiography.

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초음파 결합형 압통계를 활용한 압통시 소화불량 환자와 건강인의 복강내 조직 변화 비교: 비무작위 대조군 예비 임상시험 (Investigation of changes in abdominal cavity between dyspepsia patients and healthy participants when pressure pain occurs using an algometer combined with an ultrasound device: a non-randomized, controlled, pilot trial)

  • 임진웅;정태성;정호석;강선이;최창민;김동웅
    • 대한예방한의학회지
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    • 제27권1호
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    • pp.43-52
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    • 2023
  • Objectives : The aim of this study was to evaluate the differences in the abdominal cavity between functional dyspepsia patients and healthy people using an algometer combined with an ultrasound device. Methods : A non-randomized, controlled, pilot trial was conducted. Thirty patients in the experimental group and fifteen participants in the control group were recruited. We collected demographical data, and measured abdominal circumference, height of the body cavity, subcutaneous fat thickness, visual analogue scale of dyspepsia symptoms in the experimental group, depth of algometer and pressure of algometer when pressure pain occurred, and the whole ultrasonic image from the beginning of pressurization to the time when pressure pain occurred. The measurements were carried out twice with the duration of 1 week. Generalized linear regression was conducted to adjust baseline characteristics. Results : A total of 45 participants (30 in experimental group, 15 in control group) were recruited and finished the trial. Females were recruited more in the experimental group than in the control group and it was statistically significant. The difference in thickness of abdominal cavity between a second before the pressure pain and at the time when pressure pain occurred was statistically significant on 1st visit, and other measurements were not statistically significant. From the results of the regression analysis, the difference between two groups was statistically significant in the differences in the thickness of stomach and up to abdominal aorta on 1st visit, and the thickness of stomach on 2nd visit, and other measurements were not statistically different. Conclusions : According to the results, there were not statistically significant differences in abdominal examination when pressure pain occurred between dyspepsia patients and healthy people. Further studies are warranted to assess the abdominal examination using devices including algometer and ultrasound devices, regarding the results of the present study.

돼지 장기이식에서 급성거부반응 연구에 효과적인 엉덩오목이식 동물모델: 줄기세포유래 Humanized 조직의 안전성 평가모델 (The Iliac Fossa Transplant as an Acute Rejection Model in Porcine Kidney Transplantation: a Tool for the Safety Study of the Stem Cell- induced Humanized Tissue)

  • 곽호현;남현숙;우흥명
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.63-70
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    • 2011
  • To consider the iliac fossa as the vascular anastomosis site of kidney transplantation for the short-term study of acute rejection in pigs. Twelve domestic pigs weighing 39~48 kg underwent heterotopic renal allgraft transplantation. The experimental animals were divided into 2 groups in terms of renal vascular anastomosis site; the external iliac artery and vein were used in iliac fossa model (n = 6), the abdominal aorta and the caudal vena cava inferior to the kidney were used in abdominal cavity model (n = 6). Renal function was evaluated by daily measurement of plasma creatinine and BUN concentrations. The experiments' health including postoperative complications was also assessed daily for 8 days after transplantation. After euthanazation gross and histopathologic analysis was performed. All six pigs in iliac fossa model developed neuropraxia and lameness of the ipsilateral pelvic limb. However, no necrosis was observed in any pigs. In the abdominal cavity model, durations of both the surgical operation and the vascular anastomosis were significantly longer than those in the iliac fossa model. Furthermore, ischemia injury of the transplanted kidney was increased in abdominal cavity model, which induced accelerated-acute immune response from day 4 after transplantation. Despite of pelvic limb complication, the iliac fossa model showed more advantages including not only less ischemia time related to easy vascular anastomosis, but also less immune response during the acute rejection period. The results indicate that the iliac fossa model may be appropriate to the study of acute rejection in porcine kidney transplantation.

Clinical Efficacy of Endovascular Abdominal Aortic Aneurysm Repair

  • Son, Bong-Su;Chung, Sung-Woon;Lee, Chung-Won;Ahn, Hyo-Yeong;Kim, Sang-Pil;Kim, Chang-Won
    • Journal of Chest Surgery
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    • 제44권2호
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    • pp.142-147
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    • 2011
  • Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.

고콜레스테롤 식이로 유발된 동맥경화병태흰쥐의 혈관조직내 지질과산화 및 산화스트레스에 대한 삼칠근의 영향 (Influence of Panax notoginseng on the Atherosclerosis Induced by High-cholesterol Feed in Rats)

  • 김종구;박선동;박원환
    • 동의생리병리학회지
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    • 제20권5호
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    • pp.1187-1195
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    • 2006
  • Panax notoginseng exhibit several beneficial effects including anti-oxidant effects. P. notoginseng is used as a therapeutic agent to stop haemorrhages and a tonic to promoted health in Korean and Chinese medicine. The pharmacokinetic profiles of the main P. notoginseng are still not accurately investigated. The exact mechanism of the anti-oxidant activitys of water extracts of P. notoginseng, however, has not been determined. in present study, I examined the effects of water extracts of P. notoginseng on high cholesterol diet atherosclerosis-induced rats in serum and abdominal aorta. A total of 3-week old 9 male rats of Sprague-Dawley were divided into 3 groups and fed with the basal diet (normal group), high cholesterol diet (atherosclerosis induced group) for 8 weeks, high cholesterol diet supplemented with water extracts of P. notoginseng (P. notoginseng group) for 4 weeks. And rats were sacrificed, serum lipid level, abodominal aortic anti-oxidant activities and lipid peroxide were measured. These results indicated that serum total cholesterl, LDL-cholesterol, triglycerides concentration significently lowered in P. notoginseng group than high cholesterol diet group. But HDL-cholesterol concentraion significently higher in P. notoginseng group than high cholesterol feed group. And abdominal aortic xanthine oxidase activity was significantly reduced by dietary water extracts of P. notoginseng supplementation (p<0.05) Also abdominal aortic superoxide dismutase, catalase, glutathione peroxidase activities were significantly increased by dietary water extracts of P. notoginseng supplementation (p<0.05) Especially, abdominal aortic level of lipid peroxide tended to increase in high cholesterol feed group, but water extract of P. notoginseng intake reduced the value (p<0.05).

Increase of Vδ2+ T Cells That Robustly Produce IL-17A in Advanced Abdominal Aortic Aneurysm Tissues

  • In-Ho Seo;Seung-Jun Lee;Tae Wook Noh;Jung-Hwan Kim;Hyun-Chel Joo;Eui-Cheol Shin;Su-Hyung Park;Young-Guk Ko
    • IMMUNE NETWORK
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    • 제21권2호
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    • pp.17.1-17.10
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    • 2021
  • Abdominal aortic aneurysm (AAA) is a chronic dilation of the aorta with a tendency to enlarge and eventually rupture, which constitutes a major cause of cardiovascular mortality. Although T-cell infiltrates have been observed in AAA, the cellular, phenotypic, and functional characteristics of these tissue-infiltrating T cells are not fully understood. Here, we investigated the proportional changes of T-cell subsets-including CD4+ T cells, CD8+ T cells, and γδ T cells-and their effector functions in AAAs. We found that Vδ2+ T cells were presented at a higher frequency in aortic aneurysmal tissue compared to normal aortic tissue and PBMCs from patients with AAA. In contrast, no differences were observed in the frequencies of CD4+, CD8+, and Vδ1+ T cells. Moreover, we observed that the Vδ2+ T cells from AAA tissue displayed immunophenotypes indicative of CCR5+ non-exhausted effector memory cells, with a decreased proportion of CD16+ cells. Finally, we found that these Vδ2+ T cells were the main source of IL-17A in abdominal aortic aneurysmal tissue. In conclusion, our results suggest that increased Vδ2+ T cells that robustly produce IL-17A in aortic aneurysmal tissue may contribute to AAA pathogenesis and progression.

허혈성 척수 손상의 동물실험모델에서 Trimetazidine의 척수 보호효과 (Protective Effects of Trimetazidine in a Rabbit Model of Transient Spinal Cord Ischemia)

  • 장운하;최주원;김미혜;오태윤;한진수;김종성;이수윤
    • Journal of Chest Surgery
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    • 제35권4호
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    • pp.255-260
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    • 2002
  • 배경: 흉부 및 흉복부 대동맥 수술시에 발생하는 척수의 허혈성 손상에 의한 신경학적 합병증은 발병 전의 예측이 어려울 뿐만 아니라 중증의 장애를 남기게 된다. 본 연구에서는 허혈성 심근 질환 치료에 쓰이고 있는 Trimetazidine(이하 TMZ)의 척수의 허혈성 손상에 대한 보호 효과를 동물실험모델에서 실험하였다. 대상 및 방법: 다 자란 New-Zealand White Rabbits 33마리를 대조군(Group 1, N-17)과 실험군(Group 2, N=16)으로 나누어 실험하였다. 수술은 대조군에서는 전신마취 후 정중개복하여 좌측 신동맥 기시 직하부위에서 복부대동맥을 혈관 점자로 30분간 폐쇄하여 척수 허혈을 유발하였으며, 실험군에서는 TMZ 3mg/kg을 대동맥 겸자전 투여하였다. 수술 2시간 후, 24시간 후, 48시간 후에 Modified Talrov scale에 의한 운동능력을 평가하였으며 술 후 48시간에 요천추부 척수를 적출하여 조직검사를 시행하였다. 결과: 대조군과 실험군에서 각각 7 마리(17마리 중 10마리 사망)와 11마리(16마리 중 5마리 사망)가 실험 종료가지 생존하여 척수 조직을 채취하였다. Modified Talrov scale은 대조군과 실험군에서 각각 수술 2시간 후 1.13 $\pm$ 1.25와 3.20 $\pm$ 0.77, 24시간 후 1.45 $\pm$ 1.57와 3.50 $\pm$ 0.76, 48시간 후 1.86 $\pm$ 1.86와 3.91 $\pm$ 0.30이었다(p$\leq$0.05). 척수의 조직학적 검사에서는 신경학적 결손이 큰 대조군(Group 1)의 척수조직에서 허혈성 손상이 더 심하게 일어난 것이 관찰되었다. 결론: TMZ은 동물실험에서 척수의 일과성 허혈성 손상에 대하여 통계적으로 유의한 척수 보호효과를 나타내었다.

동맥경화증이 유발된 $ApoE^{(-/-)}$ mouse에서 혈부축어탕(血府逐瘀湯)과 Aspirin의 병용투여 효과에 대한 연구 (Effects of Concurrent Administration of Hyeolbuchukeo-tang and Aspirin on Atherosclerosis in the $ApoE^{(-/-)}$ Mouse)

  • 이범준;윤승연;박현우;박지혁;조인영;이정숙;류재환
    • 대한한의학회지
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    • 제32권1호
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    • pp.164-174
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    • 2011
  • Objective: The antiplatelet agent aspirin has been widely used for treating atherosclerosis in western medicine, and its efficacy has been proven in cardiac and extracardiac vascular diseases. On the other hand, Hyeolbuchukeo-tang has been widely used for treating blood stasis syndrome in traditional medicine. Therefore we investigated whether Hyeolbuchukeo-tang could have a synergic effect along with aspirin. Methods & Materials: Male $ApoE^{(-/-)}$ mice were randomly divided into three different experimental groups: a non-treated group(Control group), an aspirin-treated group(AP group), and an aspirin with Hyeolbuchukeo-tang-treated group(APH group). The control group was fed only an atherogenic diet, the AP group an atherogenic diet plus Aspirin 5 mg/kg, and the APH group an atherogenic diet plus Aspirin 5 mg/kg with Hyeolbuchukeo-tang 100 mg/kg. We investigated plasma lipid with liver function test, and performed the histological investigation of liver and abdominal aorta. Results: 1. We investigated photomicrographic changes of liver and abdominal aorta tissue. They showed that histological injury of aorta and lipid accumulations of the liver were lower in the AP and APH groups than in the control group. 2. In the APH group, plasma triglyceride levels were significantly lower than those in the control and AP groups. 3. There were no differences in aspartate aminotransferase and alanine aminotransferase levels among the control, AP and APH groups. Conclusion: The above results show that a combined treatment of Hyeolbuchukeo-tang and aspirin has a somewhat synergic effect in terms of inhibiting vessel injury and decreasing lipid deposits on liver cells without liver toxicity.

신동맥 상방의 파열된 Salmonella 복부 대동맥류 - 1예 보고 - (A Ruptured Salmonella-Infected Abdominal Aortic Aneurysm of the Suprarenal Type -A case report-)

  • 문종환;홍유선;임상현;정준호
    • Journal of Chest Surgery
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    • 제43권2호
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    • pp.199-203
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    • 2010
  • 세균성 대동맥류는 드물지만 높은 사망률을 보인다. 세균성 동맥류의 표준적인 치료는 수술적인 방법이지만 그 결과는 실망스럽다. 높은 사망률에 관련된 위험인자로는 대동맥류의 파열과 대동맥류가 신동맥의 상방에 위치하는 경우를 들 수 있다. 세균성 대동맥류의 치료는 대동맥류 제거, 주변 조직의 제거, 감염 부위에서 떨어지게 동맥을 재건하는 수술적 치료와 항생제 치료이다. 신동맥 상방의 대동맥류의 경우는 신동맥 또는 주변 장기로 가는 혈관들의 재이식이 필요하며 인조혈관과 관련된 합병증의 위험성으로 인하여 치료 결과가 좋지 않다. 저자들은 55세 남자 환자에서 신동맥 상방의 감염성 대동맥류를 경험하였기에 문헌고찰과 함께 보고하는 바이다.