• Title/Summary/Keyword: Dilated

검색결과 489건 처리시간 0.024초

상대정맥 증후군의 임상적 고찰 (The Clinical Review of Superior Vena Cava Syndrome)

  • 강중순;이삼범;이충기;정진홍;이형우;이관호;현명수;이현우;신세원;김명세
    • Journal of Yeungnam Medical Science
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    • 제7권2호
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    • pp.151-158
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    • 1990
  • We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows : 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology : 14 cases (46%) of bronchogenic ca. 4 cases (14%) of lymphoma, 3 cases (10%) of metastic lung ca. Of bronchogenic ca. small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified ca was 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone. 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

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지속적 양압공급치료로 임상적 호전을 보인 활동성 선단거대증에 동반된 폐쇄성 수면 무호흡증후군 1예 (Continuous Positive Airway Pressure Therapy in a Obstructive Sleep Apnea Syndrome associated with Active Acromegaly)

  • 문화식;최영미;안석주;김치홍;권순석;김영균;김관형;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제42권4호
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    • pp.610-617
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    • 1995
  • 저자들은 활동성 선단거대증과 이로 인하여 생긴 확장형 성근병증에 의한 울혈성 심부전과 중증의 심실성 부정맥이 있는 환자에 동반된 폐쇄성 수면 무호흡증후군을 치료하기 위하여 4개월간 지속적 영양공급치료를 시행한 예를 경험하였기에 문헌고찰과 함께 보고한다.

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Biligrafin 투여 마우스 간세포의 미세구조적 및 세포화학적 연구 (Some Observations on the Organelles Participating in the Biliary Excretion in the Hepatocyte of the Biligrafin Injected Mouse)

  • 김향;신영철
    • Applied Microscopy
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    • 제23권2호
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    • pp.53-77
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    • 1993
  • In this study, an attempt was made to investigate the probable organelles participating in the secretion of biligrafin. The animals (ICR male mice, 25-30gm) were divided into normal control and 6 biligrafin injected groups to which 30% biligrafin (0.006ml/gm b.w.) were injected at 10, 20, 40, 80, 160 and 320 min prior to the sampling. The mice of each group were perfused through the heart with ice-cold 2.5% glutaraldehyde buffered with 0.1M Na-cacodylate (pH. 7.4) under the Na-pentobarbital (Nembtal 0.0015mg/gm b.w.) anesthesia and liver tissues were taken from each group. Some specimens were immersed 1 hr in the same solution used in the perfusion. After an overnight rinse in 0.1M Na-cacodylate buffer containing 10% DMSO and 7.6% sucrose, $75{\mu}m$ fronzen sections were made for cytochemical study. The sections were incubated in thiamin pyrophosphatase (TPPase) and inosine diphosphatase (ID Pase) media for 70 min at $37^{\circ}C$ respectively and acid phosphatase (AcPase) medium for 40 min at $37^{\circ}C$. They were postfixed in 1 % $OsO_4$ for 1 hr. The other specimens were immersed for 8 hrs in the fixative consisting of 2.5% glutaraldehyde and 3.0% paraformaldehyde buffered with Na-cacodylate (pH. 7.4). All of the osmificated specimens were processed for electron microscopy. In both normal and biligrafin injected groups, endoplasmic reticulum (ER), vacuoles, Golgi apparatus and lysosomes were seen in the vicinity of bile canaliculus. In the biligrafin injected groups, however, the Golgi apparatus appeared to be decreased and ER and vacuoles were dilated and increased. The rough endoplasmic reticulum (RER) having a few attached ribosomes appeared to be the round saccule, especially at 20 min after biligrafin injection. Smooth endoplasmic reticulum (SER) seemed to be formed by the detachment of ribosomes at the cisternal end of RER. The cistern of SER showed saccules which probably budded off to form the vacuole. The vacuoles were devoid of visible centents. This finding seemed to be in agreement with the biochemical property of the bile constituents. The fusion between the vacuoles and bile canaliculus were frequently seen in the groups injected with biligrafin. The lysosome did not show any changes in the biligrafin injected groups. Accumulation of some material and lipid droplets were seen at the 40 and 80 min after biligrafin injection, especially at the latter. At 160 and 320 min after biligrafin injections, however, they were decreased successively while the RER stack, free ribosomes and polysomes were increased. Although the reactive products of TPPase and IDPase were observed in the ER saccules and vesicles of the normal control and biligrafin injected groups, the fusion between the bile canaliculus and saccules or vesicles could easily be seen in the latter. The AcPase activity, however, was observed in the cistern at the maturing face of Golgi apparatus and lysosomes in both normal and biligrafin groups. The results suggest that the biligrafin is excreted via the vesicles, vacuoles or sacoules probably derived from the SER without the participation of Golgi apparatus and lysosomes, and the excess amount of material is stored as inclusions during the repairing of the organelles being overactive.

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한국산 긴날개박쥐 (Miniopterus schreibersi fuligino년)의 정자변태동안의 소포체와 골지체에 관한 전자현미경적 관찰 (Electron Microscopic Observations on the Endoplasmic Reticulum and Golgi Complex during Spermiogenesis in the Long-Fingered Bat (Miniopterus schreibersi fuliginosus Hodgson))

  • 최병진;손성원;이정훈;이계일
    • Applied Microscopy
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    • 제28권4호
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    • pp.603-613
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    • 1998
  • The present study was designed in order to observe relationship between the endoplasmic reticulum and the Golgi complex during spermiogenesis of the long-fingered bat (Miniopterus schreibersi fuliginosus). The testes were obtained from adult bats and treated with the prolonged osmification or fixed with ferrocyanide reduced osmiun. In the Golgi phase, The Golgi complex shows an oval shape, and was composed of a cortex and a medullar enclosing acrosome. The Golgi vacuoles with electron-dense granules of crescent shape were fused with each other. The smooth endoplasrnic reticulum was scattered in all the area of the cytoplasm. In the cap phase, The Golgi complex was crescent in shape, and faced to a nucleus. Large and small vesicles were fused with each other, and then fused with a acrosomal vacuole. The rough endoplasmic reticulum was close to the large Golgi vacuole. In the acrosome phase, The Golgi complex was moved to behind of the acrosome face. Small vesicles were fused with an acrosome, and cisternae of the trans-face of Golgi complex was connected with an acrosome in the early acrosome phase. The smooth endoplasmic reticulum was distributed in the cytoplasm. The annulate lamellar was originated from a radial body-annulate lammellae complex. In the maturation phase, The Golgi complex with dilated cistrern appeared in the cytoplasm, and also, annulate lamellar was observed in the cytoplasm. The connection of the annulate lamellar with the cistern of radial body suggests that an annulate lamellar seems to be closely related to radial body. The smooth endoplasmic reticulum was scattered in the cytoplasm in the early Golgi phase, but annulate lamellar-radial body complex which might be a residual and disappearing form of the smooth endoplasmic reticulum appeared in the acrosome phase. The Golgi complex steadily remained in the late maturation phase when the endoplasmic reticulum began to disappear from the cytoplasm: the Golgi complex was still occurred after acrosome formation. The observations obtained in the present study, which was characterized by the presence of the Golgi complex in the late maturation phase, suggests that the Golgi complex may play an important role also even after the acrosome formation.

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정맥 내 980-nm 다이오드 레이저를 이용한 대복재정맥 역류의 치료 (Endovenous 980-nm Diode Laser Treatment of Incompetent Great Saphenous Vein)

  • 김건일;조태준;이재웅;홍기우;이원용
    • Journal of Chest Surgery
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    • 제40권2호
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    • pp.97-102
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    • 2007
  • 배경 : 최근 하지 정맥류 치료에 정맥 내 레이저 치료가 도입되어 비침습적이면서도 좋은 치료 결과들이 많이 보고되고 있다. 저자들은 대복재정맥 역류로 인한 하지 정맥류 환자에서 980-nm 다이오드레이저를 이용하여 대복재정맥 폐쇄술을 시행하였으며 그 치료 효과를 분석하였다. 대상 및 방법: 2003년 9월부터 2006년 2월까지 대복재정맥 역류로 인한 하지 정맥류 환자 238명(332예)을 대상으로 980-nm 다이오드 레이저를 이용하여 정맥 내 레이저 치료를 시행하였다. 수술은 레이저 치료와 동시에 보행적 정맥류 제거술을 시행하였다. 수술 전 임상 양상과 수술 합병증, 그리고 수술 후 1개월과 3개월의 추적 듀플렉스 초음파 검사 결과를 분석하였다. 결과 : 수술 후 합병증으로는 대부분의 환자에서 반상 출혈이 발생하였고, 감각 이상이 68예(20.5%), 피부화상이 3예(0.9%) 발생하였다. 추적 초음파 검사에서 수술 1개월 후 26예, 3개월 후에는 10예에서 추가로 대복재 정맥 역류 혹은 부분 혈류재개가 확인되어 치료성공률은 각각 91.3%, 87.9%였다. 결론: 레이저를 이용한 대복재정맥 폐쇄술이 기존의 대복재정맥 발거술에 비하여 비침습적이기는 하지만 저자들은 다소 높은 대복재정맥의 재개통을 경험하였다. 이는 적절치 않은 레이저 강도나 적용 시간(속도), 과도하게 확장된 대복재정맥 등이 원인일 것으로 생각되며 시술 후 정맥의 재개통을 줄이기 위한 많은 연구 노력과 함께 초음파 검사를 통한 정확한 추적 관찰이 필요할 것으로 생각한다.

심장이식후에 발생한 외과적 합병증 - 단일 센터 경험 - (Surgical Complications in Heart Transplant Recipients - A Single Center Experience -)

  • 박국양;박철현;전양빈;최창휴;이재익
    • Journal of Chest Surgery
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    • 제42권6호
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    • pp.719-724
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    • 2009
  • 배경: 심장이식이 최근 증가하면서 거부반응과 감염외의 외과적합병증도 증가하고 있다. 이 논문에서는 한 외과의에 실시된 심장이식후에 발생한 외과적합병증을 보고하고자 한다. 대상 및 방법: 1994년 4월부터 2003년 9월까지 실시된 37명의 심장이식환자를 대상으로 하였으며 심장이식의 적응은 확장성 심근증, 허혈성심근증, 판막심근증, 가족력심근증 등이었다. 결과: 총 15명의 이식환자에서 20예의 합병증이 발생하였으며 실시된 외과적 수술의 종류는 출혈로 인한 재개흉(5), 심낭액저류배액술(4), 인공박동기거치술(1), 아스페르질루스증에 의한 우하엽절제술(1), 요석제거술(1), 담낭제거술(1), 직장주위절개술(1), 부비동배액술(1), 고관절치환술(1), 치주비대에 의한 치주절개술(1), 뇨도절개술(1), 추간판 탈출증수술(1), 자궁근종으로 인한 자궁적출술(1)이 있었다. 합병증의 위치는 흉곽내가 10예, 흉곽외가 10예였다. 결론: 심장이식 수술후에는 흉곽 뿐만 아니라 다른 부위장기에 많은 합병증을 가져올 수 있기 때문에 장기생존율을 높이기 위해서는 다학제간의 적극적인 치료가 매우 중요하다.

개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가 (Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog)

  • 신승호;이기창
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.208-213
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    • 2007
  • 호흡곤란과 후지마비 및 발등부위의 괴사를 나타낸 수컷 진돗개가 전북대학교 동물의료센터에 내원하였다. 초기 검사에서 심장 사상충 감염이 확인되었다. 흉부방사선 외측상에서 폐동맥의 확장과 후엽의 간질패턴, 그리고 복배상에서 주 폐동맥의 뚜렷한 확장등이 관찰되어 심장사상충증을 뒷받침하였고, 복부 외측상 및 복배상에서 복부세부음영 소실이 관찰되어 복수를 의심하였다. 초음파상에서 복수와 불규칙한 간변연 그리고 신장양극의 피질에서 쐐기모양의 국소적 고에코상을 관찰하였으며 복부대동맥에서 분지하여 주행하는 바깥장골동맥의 3상형 동맥파형이 분지부 근위에서 관찰되었으나 이 후 대퇴동맥의 파형은 확인되지 않았다. 혈액화학검사에서 백혈구증다증, 빈혈, 혈색소 뇨, 고빌리루빈혈증, 저 알부민혈증, 전해질불균형, 그리고 간장 및 신장효소치의 상승등이 관찰되어 광범위한 장기의 손상이 의심되었다. 특히 글루코스는 정상적인 전지와 마비를 보이는 후지에서 비교한 결과 후지의 글루코스 수치가 현저하게 낮았다. 전산화단층촬영술 후 3차원으로 재구성한 영상을 이용하여 후지 마비의 원인으로 여겨지는 후지 동맥의 혈전색전증과 폐동맥혈전색전증 및 신장경색 등을 확인하였다. 예후불량으로 판단되었으며 실험적 중재적 방사선술을 시도하였으나 마취에서 깨어나지 못했다. 3차원 재구성 CT 영상은 색전증의 빠르고 정확한 진단에 유용하며 효과적인 치료 계획을 수립하는데도 큰 도움이 된다고 판단된다.

개의 다발성 간외성 간문맥전신단락증의 진단 2예 (Diagnosis of Multiple Extrahepatic Portosystemic Shunt in Two Dogs)

  • 김주형;한성영;전혜영;김태훈;강지훈;한태성;나기정;양만표;김근형;강상철;김재훈;장동우
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.269-275
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    • 2007
  • Two dogs referred to Veterinary Medical Center, Chungbuk National University diagnosed as multiple extrahepatic portosystemic shunt were reported. The first dog was a 20-month-old, 8 kg, male Cocker spaniel with history of peritoneal effusion, diarrhea, anorexia and stunted growth. The second dog was a 3-year-old, 13.4 kg, male Jindo with a history of severe depression. Hematologic examination of first dog revealed mild microcytosis and nonregenerative anemia. All of 2 cases, serum chemical values showed increase of serum ammonia, ALP, r-GTP and glucose. In survey radiography, microhepatia was apparent. In the color Doppler ultrasonographic examination, the first dog revealed a dilated tortuous vein communicating with caudal vena cava was observed near the left kidney and the second dog revealed numerous shunting vessels ventral to L5 and L6. Transcolonic portal scintigraphy of the first dog confirmed the presence of portosystemic shunt. In intraoperative jejunoportography, the first dog showed single congenital extrahepatic portosystemic shunt and multiple acquired extrahepatic portosystemic shunts. The second dog showed multiple acquired extrahepatic portosystemic shunts. In these dogs, the presence of congenital and acquried portosystemic shunts and histopathologic findings were considered to represent a combination of multiple extrahepatic portosystemic shunts and noncirrhotic portal hypertension or portal vein hypoplasia.

기관지허탈 견에서 약침과 한약제를 이용한 치료 (Treatment of Canine Tracheal Collapse by Injection-Acupuncture and Herbal Medicine)

  • 전형규;정재승;서영민;박세근;이영원;김덕환
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.419-421
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    • 2007
  • 15년령의 중성화한 퍼그견이 거위울음소리 같은 기침 때문에 내원 하였다. 본 환축은 임상증상과 방사선 검사를 이용하여 기관지허탈로 진단하였다. 환축의 치료를 위하여 폐수(BL13), 중부(LU01), 척택(LU05), 공최(LU06), 열결(LU07), 태연(LU09) 및 천돌(CV22)에 10일간 butorphanol 약침을 실시하였으며, BL13, LU01 및 CV22에 9일간 butorphanol 약침을 추가로 실시하였다. 본 환축은 소청용탕(小靑龍湯)을 7일간 투여 받았으며, 소자강기탕(蘇子降氣湯)을 12일간 추가로 투여 받았다. 치료 후 환축은 기침을 하지 않았으며, 기관치의 직경이 방사선 사진에서 치료전보다 증가해 있었다. 3개월 후 정기 진단 시 기침은 전혀 관찰되지 않았으며, 기관지의 직경은 치료 후보다 더욱 증가해있었다. 결론적으로 본 환축은 butorphanol의 약침과 한약제의 병행으로 양호한 치료반응을 나타낸 개 기관지허탈 증례이었다.

간흡충 감염 마우스에 있어서 환관 상피세포의 미세구조에 대한 Aflatoxin $B_1$의 영향 (Effect of Aflatoxin $B_1$ on Ultrastructural Changes of Biliary Epithelial Cells in Mice Experimentally Infected with Clonorchis sinensis)

  • 민홍기
    • Parasites, Hosts and Diseases
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    • 제25권2호
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    • pp.99-109
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    • 1987
  • The present study was carried out to examine the effect of a calcinogen, aflatoxin B1 on the ultrastructural changes of ciliary epithelial cells in mice infected with Clonerchis sinensis. A total of 93 male albino mice(BALB/c strain) was divided into 3 groups; group I, treated with 1.0 ppm aflatoxin Bl for 12 weeks; group II, given 50 C. sinensis n;etacercariae, and group III, given 50 metacercariae and treated with 1.0 ppm aflatoxin Bl for 12 weeks. Three mice served for untreated-uninfected controls. From 4 weeks after the treatsment and/or in(ection, three mice from each group were sacrificed at 4 week intervals up to the 40th week, and their hepatobiliary tissues were prepared for transmission electron microscopy. The most prominent ultrastructural changes in group I were remarkable enlargement of nuclear size, separation of nucleolus, dispersed chromatin granules in nuclei and increased dense granules along the inner membrane of nuclei. In the cytoplasm there was slight proliferation of mitochondria and endoplasmic reticulum (ER) at earlier stage. At the 12th week separation of fibrillar and granular components of the nucleolus was a characteristic finding. As the time elapsed, epithelial cells showed fiattened-cuboidal form and a tendency of atrophy. Most of the nuclei were elongated and polygonal in shape. In group II the appearance of elaborate interwoven folds of lateral cytoplasm forming a labyrinth of interconnected intercellular space and variety in nuclear shape were the prominent fadings at earlier stage. The cytoplasm showed slight proliferation and dilatation of mitochondria and ER, and a small number of mucin droplets. In the basement membrane scanty fibrous cells were seen. With time, variety in nuclear shape, marked proliferation and dilatation of rough ER and some collagen fibrils were demonstrated. Other features of intracellular organelles and mucin droplets persisted. In group III cuboidal epithelial cells showed their remarkably enlarged and irregular nuclei, increased chromatin granules in the nuclei, separated nucleoli, proliferated and dilated rough ER. With time, sequestered mitochondria showed blob-like evaginations which lacked cristae and dense matrix, and were limited by a single membrane. Since the 20th week, microvilli were relatively scanty and poorly developed. Organelles and inclusions in the cytoplasm of metaplastic cells were poor. Nuclei were variable in shape. The nlost prominent changes at later stage were separation of nuclei from the cytoplasm, and appearance of numerous and irregularly angled electron dense granules in the nuclei.

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