• 제목/요약/키워드: Graft failure

검색결과 276건 처리시간 0.025초

하행대동맥-총장골동맥간 Long Bypass Graft 를 실시한 원발성 동맥염 1예 (Long Bypass Graft from Descending Aorta to Common Iliac Artery in Primary Arteritis -Report of A Case-)

  • 유병하
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.170-173
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    • 1979
  • Since John Davy reported the first well-documented case of occlusive disease involving the branches of the aortic arch in 1839, many similar cases have been reported in literature, especially from oriental countries. The prognosis and symptoms depend on the degree and extent of the occlusive lesions and also on the importance of the arteries affected. The course may progress slowly or rapidly with remissions and exacerbation, and death may result from acute CVA, cardiac failure or pulmonary edema, and renal failure. No medical therapy has been able to alter conclusively the course of the disease, so various surgical procedures have been applied to relieve the obstruction and to prolong the life. We present the case of an 18 year-old female with multiple stenosis of the aorta, and performed the long bypass graft from descending aorta to common lilac artery, and the result was excellent.

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Pediatric heart transplantation: how to manage problems affecting long-term outcomes?

  • Kim, Young Hwue
    • Clinical and Experimental Pediatrics
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    • 제64권2호
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    • pp.49-59
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    • 2021
  • Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500-550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart transplantations were comparable to those of adults. Issues affecting long-term outcomes include acute cellular rejection, antibody-mediated rejection, cardiac allograft vasculopathy, infection, prolonged renal dysfunction, and malignancies such as posttransplant lymphoproliferative disorder. This article focuses on medical issues before pediatric heart transplantation, according to the Korean Network of Organ Sharing registry and as well as major problems such as graft rejection and cardiac allograft vasculopathy. To reduce graft failure rate and improve long-term outcomes, meticulous monitoring for rejection and medication compliance are also important, especially in adolescents.

혈액 투석시 충혈방법에 따른 인조혈관 내 유동 특성에 관한 수치해석 연구 (NUMERICAL ANALYSIS ON THE BLOOD FLOW CHARACTERISTIC IN THE ARTERIOVENOUS GRAFT FOR DIFFERENT INJECTION METHOD OF BLOOD)

  • 김지태;성건혁;유홍선
    • 한국전산유체공학회지
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    • 제18권3호
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    • pp.14-19
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    • 2013
  • Renal failure patients have to operate arteriovenous graft for hemodialysis. Blood flow characteristics influence the patency rate of arteriovenous graft. Numerical investigation is performed with the arteriovenous graft according to injection of blood. As a result, when the injection is not applied to venous graft, the low wall shear stress region appears at venous anastomosis. It may cause intimal hyperplasia at venous anastomosis.

폐림프관 평활근종증 환자에서 이식편 기능부전에 의한 반대쪽 단측폐 재이식수술 (Contvalateral Single Lung Re-transplantation in the Patient with Lymphangioleiomyomatosis due to Graft Failure)

  • 정은규;황정주;김재호;윤영남;이두연;백효채
    • Journal of Chest Surgery
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    • 제39권4호
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    • pp.323-327
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    • 2006
  • 호흡부전을 동반한 말기 폐림프관 평활근종증은 가임기 여성에서 발병하는 매우 드문 질환으로서 폐이식이 유일한 치료법으로 알려져 있다. 이런 환자에서 폐이식을 시행하는 경우 단측 폐이식이 추천되고 있으나 이식한 폐의 기능부전이나 이식하지 않은 폐에서 원발질환의 악화가 문제점으로 제시되고 있다. 본원에서는 폐림프관 평활근종증을 앓고 있던 말기 호흡부전의 36세 여자 환자에게 우측 단일 폐이식술을 시행한 이후 이식폐의 폐허탈로 인한 기능부전으로 인하여 내과적 또는 외과적 치료에도 불구하고 호전이 없어 반대쪽의 단측폐 재이식수술을 시행한 후 좋은 결과를 얻었기에 이를 보고하는 바이다.

인조혈관 동정맥루의 혈액 투석량에 따른 인조혈관 내부 유동 특성에 관한 수치해석 연구 (NUMERICAL STUDY ON BLOOD FLOW CHARACTERISTICS IN A ARTERIOVENOUS GRAFT WITH DELIVERED DOSE DURING HEMODIALYSIS)

  • 김재열;노경철;유홍선
    • 한국전산유체공학회지
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    • 제16권4호
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    • pp.84-91
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    • 2011
  • Hemodialysis is essential for patients with end stage renal failure. It is important to improve the patency rate and to minimize occurrence of the stenosis. Also, the blood flow to the artificial kidney can affect the blood flow characteristics through arteriovenous graft. Thus, the delivered dose are important factors for analyzing hemodynamic characteristics during hemodialysis access. In this study, the numerical analysis was performed for the effect of the delivered dose during hemodialysis access on the blood flow through the graft. As a result, The adverse pressure gradient occurred in case of a larger delivered dose through a catheter than standard dose and the flow instability increased. Also the circulation flow appeared largely at anastomotic site of the vein when the delivered dose was exceeded about half blood flow of inlet blood flow.

전방십자인대 재건술의 합병증 (Complications of Anterior Cruciate Ligament Reconstruction)

  • 송은규;김종석
    • 대한정형외과스포츠의학회지
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    • 제2권1호
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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혈액 투석 시 주사침에서의 투석량에 따른 인조혈관 내부 유동 특성에 관한 수치해석 연구 (Numerical Study on Blood Flow Characteristics in a Arteriovenous Graft with Delivered dose During Hemodialysis)

  • 김재열;노경철;유홍선
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2011년 춘계학술대회논문집
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    • pp.469-476
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    • 2011
  • Hemodialysis is essential for patients with end stage renal failure. It is important to improve the patency rate and to minimize occurrence of the stenosis. Also, the blood flow to the artificial kidney can affect the blood flow characteristics though arteriovenous graft. Thus, the delivered dose are important factors for analyzing hemodynamic characteristics during hemodialysis access. In this study, the numerical analysis was performed for the effect of the delivered dose during hemodialysis access on the blood flow through the graft. As a result, The adverse pressure gradient occurred in case of a larger delivered dose through a catheter than standard dose and the flow instability increased. Also the circulation flow appeared largely at anastomotic site of the vein when the delivered dose was exceeded about half blood flow of inlet blood flow.

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Clinical and Radiological Results after Arthroscopic Superior Capsular Reconstruction in Patients with Massive Irreparable Rotator Cuff Tears

  • Yoon, Jeong Yong;Kim, Paul Shinil;Jo, Chris Hyunchul
    • Clinics in Shoulder and Elbow
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    • 제21권2호
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    • pp.59-66
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    • 2018
  • Background: Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature. Methods: Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray. Results: All patients were men, and the average age was $59.5{\pm}4.18years$ (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was $27.33{\pm}7.58months$ (range, 18-36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR. Conclusions: Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

Retrospective case series analysis of vestibuloplasty with free gingival graft and titanium mesh around dental implant

  • Ku, Jeong-Kui;Leem, Dae Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권6호
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    • pp.417-421
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    • 2020
  • Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

혈액투석을 위한 동정맥루의 장기관찰 성적 (Long-Term Results of Arteriovenous Fistula for Hemodialysis in Chronic Renal Failure)

  • 김인광
    • Journal of Chest Surgery
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    • 제27권9호
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    • pp.764-769
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    • 1994
  • From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

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