• Journal of Chest Surgery
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• 제3권2호
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• pp.139-142
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• 1970

A Case of thoraco-abdominal aortic aneurysm involving from the lower descending- thoracic aorta to bifurcation of abdominal aorta into both common iliac artery is presented in special view-point of its surgical technic and postoperative complication. Operative technic is the most popular method of Dr. De Bakey's shunt of Dacron which is bridging thoracic aorta to terminal abdominal aorta primarily as temporary shunt but after anastomosing the individual hranch of left Renal, Celiac, Sup. meseateric and right Renal artery to corresponding part of the Dacron tube, the Dacroa graft is fixed as permanent graft in stead of excised thoraco-abdominal aorta. The patient died of acute renal failure and increasing evidence of CNS damage due to respiratory acidosis on 6th postoperative day hut this report will he a good experience in respect of further progress of aortic surgery in Korea.

• Clinical and Experimental Pediatrics
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• 제46권1호
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• pp.86-90
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• 2003

Alagille 증후군은 간내 담도 형성 부전으로 인한 만성 담즙 정체, 말초 폐동맥 협착, 골격 이상, 눈의 이상, 특징적인 얼굴 모양 등을 주요 증상으로 하는 상염색체 우성 유전 질환으로 말초 폐동맥 협착 이외에도 여러 말초 혈관 병변들이 동반된다. 관련된 유전자로 20번 염색체 위에 존재하는 JAG1이 발견되었고, 이 유전자의 결손으로 인한 Notch 신호전달체계의 결함이 혈관형성에 영향을 미친다고 생각되고 있다. Alagille 증후군에서 만성 뇌동맥 폐색질환인 moyamoya병이 발생한 예들이 보고된 바 있는데, Alagille 증후군의 혈관병증의 또 다른 한 발현으로 이해되어야 할 것이다. 저자들은 생후 2개월에 Alagille 증후군을 진단받고 추적 관찰 중에 갑자기 편측 마비가 발생하여 뇌혈관 조영술을 통해 moyamoya병을 진단받은 25개월 여아를 경험하였기에 이를 보고하는 바이다.

• The Korean Journal of Physiology and Pharmacology
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• 제2권4호
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• pp.511-519
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• 1998

This study investigated the role of nitric oxide on the oxidative damage in gastric mucosa of rats which received ischemia/reperfusion and its relation to mucus. Nitric oxide synthesis modulators such as L-arginine and $N^G-nitro-L-arginine$ methyl ester, and sodium nitroprusside, a nitric oxide donor, were injected intraperitoneally to the rats 30 min prior to ischemia/reperfusion which was induced by clamping the celiac artery and the superior mesenteric artery for 30 min and reperfusion for 1 h. Lipid peroxide production, the contents of glutathione and mucus, and glutathione peroxidase activities of gastric mucosa were determined. Histological observation of gastric mucosa was performed by using hematoxylin-eosin staining and scanning electron microscopy. The result showed that ischemia/reperfusion increased lipid peroxide production and decreased the contents of glutathione and mucus as well as glutathione peroxidase activities of gastric mucosa. Ischemia/reperfusion induced gastric erosion and gross epithelial disruption of gastric mucosa. Pretreatment of L-arginine, a substrate for nitric oxide synthase, and sodium nitroprusside prevented ischemia/reperfusion-induced alterations of gastric mucosa. However, $N^G-nitro-$ L- arginine methyl ester, a nitric oxide synthase inhibitor, deteriorated oxidative damage induced by ischemia/reperfusion. In conclusion, nitric oxide has an antioxidant defensive role on gastric mucosa by maintaining mucus, glutathione, and glutathione peroxidase of gastric mucosa.

• Journal of Acupuncture Research
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• 제21권5호
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• pp.241-248
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• 2004

Objectives : The purpose of this study is to examine the hemodynamic characteristics of pulse point. Methods : The computational analysis algorithms of arterial tree system was derived. In order to investigate the effect of internal organ on the pulse point, the diameter of celiac artery was reduced by half. Results : The sensitivity of flow change at the Inyoung(Renying) is better than that of the Chongu(Cunkou). but the Inyoung was worse than the Chongu in the point of the left and right symmetry. The pressure changes at the Inyoung and the Chongu were in the similar range. Conclusions : It was found from the result that the Chongu shows the more symmetrical hemodynamic characteristics than the Inyoung.

• Molecules and Cells
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• 제37권11호
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• pp.804-811
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• 2014

The protease-activated receptor (PAR)-2 is highly expressed in endothelial cells and vascular smooth muscle cells. It plays a crucial role in regulating blood pressure via the modulation of peripheral vascular tone. Although several mechanisms have been suggested to explain PAR-2-induced hypotension, the precise mechanism remains to be elucidated. To investigate this possibility, we investigated the effects of PAR-2 activation on N-type $Ca^{2+}$ currents ($I_{Ca-N}$) in isolated neurons of the celiac ganglion (CG), which is involved in the sympathetic regulation of mesenteric artery vascular tone. PAR-2 agonists irreversibly diminished voltage-gated $Ca^{2+}$ currents ($I_{Ca}$), measured using the patch-clamp method, in rat CG neurons, whereas thrombin had little effect on $I_{Ca}$. This PAR-2-induced inhibition was almost completely prevented by ${\omega}$-CgTx, a potent N-type $Ca^{2+}$ channel blocker, suggesting the involvement of N-type $Ca^{2+}$ channels in PAR-2-induced inhibition. In addition, PAR-2 agonists inhibited $I_{Ca-N}$ in a voltage-independent manner in rat CG neurons. Moreover, PAR-2 agonists reduced action potential (AP) firing frequency as measured using the current-clamp method in rat CG neurons. This inhibition of AP firing induced by PAR-2 agonists was almost completely prevented by ${\omega}$-CgTx, indicating that PAR-2 activation may regulate the membrane excitability of peripheral sympathetic neurons through modulation of N-type $Ca^{2+}$ channels. In conclusion, the present findings demonstrate that the activation of PAR-2 suppresses peripheral sympathetic outflow by modulating N-type $Ca^{2+}$ channel activity, which appears to be involved in PAR-2-induced hypotension, in peripheral sympathetic nerve terminals.

• Journal of Chest Surgery
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• 제30권6호
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• pp.625-630
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• 1997

56세 남자 환자가 신경과에 내원하였는데, 그는 최근에 심해지는 우측 세번째에서 다섯번째 수지의 반복 적인 저린 통증과 파악력의 약화를 주소로 하였다. 이와 함께 보행시 하지 동통을 호소하였다. 경동맥 조영술상 우내경동맥이 완전히 막혀 있었고 좌우총경동맥과 외경동맥, 좌내 경동맥은 심각한 협착이 있었다. 함께 시행한 대동맥 조영술상 신동맥이하는 완전한 폐색을 보였고 양측 대퇴 동맥은 지연 조영 을 보였다. 두개의 동맥 병변에 대해 단계별로 수술 계획을 세웠다. 양측 경동맥 병변은 경동맥 내막절제술을 시행 하였다. 이 때 좌측은·경동맥 션트를 사용하였다. 복부대동맥 병변은 2주후에 시행되었으며 복강동맥하방의 대동맥을 결찰하고 허혈시 신장을 보존하기위 해 신보존액을 주입하였다. 역 Y 회로 이식술과 신보존을 시행하여 린분간의 허혈동안에도 성공적으로 시술되었으며 별다른 문제없이 술 후 보름만에 퇴원하였다.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.142-146
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• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

• Radiation Oncology Journal
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• 제32권2호
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• pp.63-69
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• 2014

Purpose: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. Materials and Methods: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. Results: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (${\geq}37U/mL$) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). Conclusion: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.

• Journal of Chest Surgery
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• 제5권1호
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• The Korean Journal of Physiology and Pharmacology
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• 제15권5호
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• pp.307-312
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• 2011

It has been rereported that axons which display 5-hydroxytryptamine (5-HT) immunoreactivity are abundant in the pancreas and the majority of serotonergic axons terminate within intrapancreatic ganglia, islet and acini. This histological result strongly suggests that intrapancreatic serotonergic nerves could affect to the pancreatic endocrine and exocrine secretion. Thus, this study was aimed to investigate whether intrapancreatic serotonergic nerves could affect pancreatic exocrine secretion and an action mechanism of the intrapancreatic serotonergic nerves. The rats were anesthetized with a single injection of urethane. The median line and the abdominal aorta was carefully dissected and cannulated with PE-50 tubing just above the celiac artery, and then tightly ligated just below the superior mesenteric artery. The pancreatic duct was also cannulated with Tygon microbore tubing. With the addition of serotonin, pancreatic volume flow and amylase output were significantly inhibited electrical field stimulation (EFS). On the other hand, pancreatic volume flow and amylase output were significantly elevated in EFS with the addition of spiperone. EFS application, however, pancreatic volume flow and amylase output had no significant change in cholecystokinin (CCK) alone when serotonin was applied under a 5.6 mM glucose background. Pancreatic volume flow and amylase output under 18 mM glucose background were significantly elevated in CCK plus serotonin than in CCK alone. These data suggest that intrapancreatic serotonergic nerves play an inhibitory role in pancreatic exocrine secretion and an important role in the insulin action or release.