• Title/Summary/Keyword: Dilated

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Atypical Aortic Coarctation at the Level of Aortic Hiatus: Report of a case treated by bypass graft (대동맥 열공부에 발생한 비전형적 대동맥 협착증: 외과적 수술을 가한 1례)

  • 남민우;유회성;지정희
    • Journal of Chest Surgery
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    • v.5 no.1
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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.

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A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF (소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예)

  • Ra, Yong-Joon;Koak, Jae-Gun;Kim, Jin-Hyun;Oh, Se-Jin;Lee, Jae-Hang;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.854-857
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    • 2006
  • The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

Tc-99m DTPA and Tc-99m DMSA Renal Scan findings in Patients with Congenital Megacalyces and Megaureter without Urinary Tract Obstruction (선천성 거대신배증과 거대뇨관증을 가지나 요로폐쇄가 없는 환아의 Tc-99m DPTA 및 Tc-99m DMSA 신장스캔 소견)

  • Ahn, Byeong-Cheol;Bae, Jin-Ho;Jeong, Sin-Young;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.202-205
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    • 2003
  • A 10 days old male infant with congenital megacalyces and megaureter, diagnosed by prenatal ultrasonographic screening, underwent Tc-99m DTPA renal scan for evaluation of urinary tract patency, Tc-99m DMSA scan for evaluation of renal cortical damage. He also underwent intravenous urography(IVU) and renal ultrasonography. Tc-99m DTPA renal scan demonstrates intense tracer accumulation in enlarged both renal pelvocalyses and ureters, which rapidly washout without diuretics administration. Tc-99m DMSA renal cortical scan shows no remarkable photon defect in both renal cortices and visible tracer uptake in both megaureter areas. Ultasonographic and IVU studios show enlarged both renal calyses and bullously dilated ureters, but no dilatation in renal pelvis. Follow up Tc-99m DTPA renal scan, peformed at one year later, also reveals intense tracer accumulation in enlarged both urinary tracts which rapidly washout without diuretics, and shows no significant change compare to the previous Tc-99m DTPA renal scan. Urinary tract obstruction and renal cortical damage can be easily evaluated with Tc-99m DTPA and Tc-99m DMSA scans in patiens with megacalyces and megaureter.

Effects of Sagungsan on the Hemostasis, Intracranial Pressure, Blood Pressure and Cardiovascular System in Expreimental Animals (사궁산(莎芎散)이 실험동물(實驗動物)의 지혈(止血), 뇌압(腦壓), 혈압(血壓) 및 심혈관계(心血管系)에 미치는 영향(影響))

  • An, Il-Hoe;Park, Young-Soon;Kim, Seh-Gil
    • The Journal of Internal Korean Medicine
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    • v.15 no.1
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    • pp.80-98
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    • 1994
  • According to the original documents, Sagungsan is considered as an effective drug for controlling the hypertensive epistaxis induced by tension of autonomic nerve and it's hyperfunction. The present experiment was designed to understand the effect of Sagungsan extract on the hemostatic action, intracranial pressure, blood pressure and cardiovascular system in experimental animals. And thus the bleeding time, prothrombin time, capillary dilation, blood pressure, Intracranial pressure, and enzymatic analysis of the ATPase activities were studied. The result obtained here were as followings: 1. Sagungsan water extract reduced the bleeding time in mouse, and prolonged the prothrombin time in rabbits. 2. The drug extract increased the tail volume by capillary dilation in rats. 3. The drug extract inhibited the increase of intracranial pressure and arterial blood pressure in rabbits. 4. At the early time, the increase of arterial blood pressure by the drug extract significantly inhibited by pretreated atropin and regitine in rabbits. 5. The drug extract relaxed the smooth muscle by stimulating the Mg2+-Ca2+-ATPase activities of gastric sarcoplasmic reticulum isolated from rabbit stomach. 6. The drug extract stimulated the heart contraction by inhibiting the $Mg^{2+}-Ca^{2+}-ATPase$ activities of cardiac sarcoplasmic reticulum isolated from rabbit heart. The inhibitory mechanism was reversible and noncompatitive. 7. The drug extract increased the hepatic blood volume by stimulating the hepatic total ATPase activities and hepatic metabolism. 8. The drug extract acted as a tranquilizer by inhibiting the neural Na+-K+-ATPase activity. According to the results, Sagungsan water extract dilated the capillaries, stimulated the heart beat, and thus increased the blood flow with decreasing the intracranial pressure and blood pressure. These effects stanches the epistaxis collectively.

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Pharmacokinetic Analysis of the Effect of Extrahepatic Cholestasis by Common Bile Duct Ligation on Hepatic Function in Rats (총수담관 결찰에 의한 간외 담즙분비정체가 흰쥐의 간기능에 미치는 영향에 대한 약물속도론적 분석)

  • Lee, Yong-Bok;Na, Eun-Yeong;Joo, Eun-Hee;Jeong, Sug-Jin;Koh, Ik-Bae
    • Journal of Pharmaceutical Investigation
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    • v.25 no.3
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    • pp.193-204
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    • 1995
  • In order to examine the effect of extrahepatic cholestasis induced by common bile duct ligation on the hepatic function, the pharmacokinetics of antipyrine and d-propranolol were investigated in rats. In addition, in an attempt to observe the degree of direct hepatic injury, light and electron microscopic observations and conventional pathologic test using serum were performed. Five days after common bile duct ligation, antipyrine(15 mg/kg) and d-propranolol(3 mg/kg) were intravenously administrated to the rats, respectively. The total clearances of antipyrine and d-propranolol were significantly(p<0.05) decreased. Because hepatic clearance of antipyrine poorly extracted by the liver and that of d-propranolol highly extracted by the liver are respectively dependent on the hepatic intrinsic clearance and the hepatic blood flow, it may be concluded that extrahepatic cholestasis following five days after common bile duct ligation decreased the hepatic intrinsic clearance and the hepatic blood flow. SGPT, SGOT, cholesterol, bilirubin(total bilirubin, direct bilirubin) and alkaline phosphatase were significantly increased(p<0.05). The proliferation of bile ducts was prominent, and degeneration and necrosis of hepatocytes were observed by light microscope. Also, ultrastructurally, bile canaliculi were containing the amorphous materials and losing microvilli, and SER and RER in hepatocytes were dilated and vacuolated.

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Study on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in Patients with Hypertensive Intracerebral Hemorrhage (고혈압성(高血壓性) 뇌출혈(腦出血) 환자(患者)의 Brain-CT소견과 일상생활능력(ADL)평가를 통한 예후인자에 대한 고찰)

  • Jung, Seung-Hyun;Shin, Gil-Cho;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.87-100
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    • 1997
  • Clinical Observation was made on 29 cases of Hypertensive intracerebral hemorrhage patients in the ICU of In-Chon Oriental Medical Hosptital of Dongguk University from October in 1994 to June in 1996. The observation are ability in daily life(ADL) of patients by Location and Type of Hemorrhage, Amounts of Hematoma, Graeb's Score, Intraventricular Hemorrhage, States 4th Ventricle, Surrounding Edema around the Hematoma, Middle Line Shift, Age, Level of Consciousness. Pupillary Light Reflex and Treatment Modalities. Our conclusions on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in patients with Hypertensive Intracerebral Hemorrhage Patients are as follows. A variety of prognostic factors that influence ADL5+6(%) were observed. 1. ADL5+6($\%$) of total cases was 34.9%. The prognosis were unfavorable when high Graeb score(P<0.05), dilated 4th ventricle(P<0.01), much surrounding edema around the hematoma (P<0.05), unilateral unreactive or both unreactive pupillary light reflex(P<0.05). 2. There was no difference of ADL5+6(%) in both hypertensive basal ganglionic and thalamic intracerebral hemorrhage. 3. The prognosis gets poorer as the volume of hematoma is more than 16cc. But there was no difference of ADL5+6(%) in each group. 4. The prognosis gets poorer in cases with IVH than without IVH. But there was no difference of ADL5+6(%) in each group. 5. The prognosis gets poorer as the middle line shift is more than 6mm. But there was no. difference of ADL5+6(%) in each group. 6. The prognosis gets poorer as the level of consciousness is more than drowsy. But there' was no difference of ADL5+6(%) in each group.

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A Case of Bronchiolar Papilloma (세기관지 유두종 1예)

  • Lee, Sang Hak;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Jang, Eun Deok
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.792-797
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    • 1996
  • A 59-year-old woman was admintted to the hospital because of intermittent fever and right side chest pain. She has a same episode eight months before this entry. Chest CT scan demonstrated ill-defined parenchymal consolidation containing dilated bronchi of right lower lung field, but no endobronchial mass in the bronchial trees. Fiberoptic bronchoscopy seeking the cause of recurrent pneumonia revealed a small, round mass nearly completely obstructing me lumen of basal segmental bronchus of right lower lobe. The diagnosis of bronchiolar papilloma was made from the biopsy specimens of the bronchoscopic examination. The patient was treated with right lower lobectomy because of irreversible secondary changes below the obstructed bronchus. This thoracotomic excision resulted in complete relief of symptoms and the postoperative course was uneventful for 12 months. Here we report a extremely rare umor with a brief review of literatures.

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Effect of Ginseng Saponin on Alcohol Metabolism in the Animal Body (인삼사포닌이 동물생체의 주정대사에 미치는 영향)

  • Joo, Chung-No
    • Journal of Ginseng Research
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    • v.16 no.3
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    • pp.222-227
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    • 1992
  • Unlike carbohydrats and fats, alcohol is essentially foreign to the body and it is known that the body get rid of it by oxidizing alcohol maily in the liver. Acetaldehyde is produced during ethanol metabolism and is known to be oxidized mainly by aldehyde dehydrogenase (ALDH). ALDH activity was found mainly in the mitochondrial fraction but a significant ALDH activity was also present in microsomal and cytosol fraction. Wistar rats (150~200 g, male) were given freely with 12% ethanol (Control) and/or 12% ethanol containing 0.1% ginseng saponins (Test) instead of water for 6 days and the liver was analyzed. ALDH activities of both control and test group were lower than that of normal group but test AkDH was less inhibited than control. ADH activies of both control and test were slightly higher than that of normal group but our previous data showed that it became gradually steady after prolonged ethanol feeding. MEOS activities of both control and test group were much higher than that of normal group. MEOS enzymes are inducible but the activity of test group was greatly higher than that of control. Ethanol containing [1-i4C] ethanol (5 $\mu$Ci) was injected to the above three groups and 30 min later, the distribution of radioactivity of hepatic lipids was investigated. Radioactivities of hepatic lipids of both control and test group were higher than that of normal group, however, that of test group was much lower than that of control. Analysis of individual lipids showed that phospholipid biosynthesis was significantly impaired and fatty acid and triglycerides biosynthesis were greatly stimulated. However, it was realized that the saponin prevented phospholipid biosynthesis depression and the increase of triglyceride biosynthesis considerably. It seemed that the saponin might stimulate ADH, ALDH and MEOS and the acetaldehyde formed would be removed faster. The excess hydrogen can be shunt more quickly into lipid biosynthesis. Electron microscopic observation showed that the hepatic cell of control group was si gnificantly damaged. Mitochondria were swollen and rough endoplasmic reticulum were dilated, however, hepatocytes of test group were not damaged.

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Cyclosporine-Assoc iated Central Neurotox ic its after Hearat Transplantat ion 1 Case Report (심장이식 환자에서 Cyclosporine에 의한 중추신경독성 -1례 보고-)

  • Kim, Young-Hee;Song, Hyun;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1136-1138
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    • 1997
  • A 45-year-old man underwent heart transplantation due to dilated cardiomyopathy. Cyclosporine, 2 mg/kg per day, was intravenously givell postoperatively. As central neurotoxicity signs that were included pin-point pupil, no light reflex, coma, were presented at 8 postoperative hours, cyclosporine was decreased to 1 mg/kg er day. At that time the cyclosporine level was 345 $\mu\textrm{g}$/L, the serum creatinine level was 1.8mg/dl and the serum magnesium level was within normal limit. He awaked at 31 postoperative hours and all sign of cyclosporine-induced central neurotoxicity was resolved after postoperative days. He was discharged without sequale at postoperative day 28.

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Diagnostic Imaging of Renal Hemangiosarcoma in a Dog (개 신장 혈관육종의 진단 영상 1례)

  • Choi, Ji-Hye;Ban, Hyun-Jung;Jang, Jae-Young;Kim, Hyun-Wook;Kim, Hye-Jin;Kim, Hak-Sang;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.24 no.1
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    • pp.51-55
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    • 2007
  • A 13-year-old male Yorkshire terrier was Presented with Persistent weight loss anorexia and dark brown urine of 3-month duration. On physical examination, a firm oval mass was palpated at left renal region. In hematology and blood chemistry, neutrophilia, anemia, thrombocytopenia and elevation of ALKP were found. Abdominal radiography, ultrasonography and ultrasound-guided percutaneous pyelogram revealed masses originated from left kidney, mildly dilated renal Pelvis and intact ureter. Urinalysis showed hematuria and proteinuria. Because the state of dog became deteriorated during transfusion and the frail renal tumor was suspected to be the cause of inflammation and anemia, nephrectomy was performed. Renal masses, approximately $2{\times}3cm\;and\;5{\times}4cm$ respectively in size, was surrounded by swollen and congested mesentery and ascites. Metastatic lesion was not found in other organs. During recovery, the dog showed cardiopulmonary arrest and did not respond to critical care. Histologically the kidney was affected by necrotic and hemorrhagic change. This hemangiosarcoma most likely arose from the renal parenchyma resulting In diffuse lesions in the kidneys thought to be the cause of chronic anorexia and weight loss.