• 제목/요약/키워드: Heart treatment

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선천성 심질환에 대한 중재적 치료술의 최근 진전 (Recent advances in transcatheter treatment of congenital heart disease)

  • 최재영
    • Clinical and Experimental Pediatrics
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    • 제49권9호
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    • pp.917-929
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    • 2006
  • Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus

  • Kim, Hyun Sik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • 제63권4호
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    • pp.532-538
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    • 2020
  • Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

동통을 동반한 양측성 발음성 견갑골 - 1예 보고 - (Bilateral Painful Snapping Scapula - A Case Report -)

  • 신성룡;고영석;박용욱;이상수;정운섭;김도영
    • Clinics in Shoulder and Elbow
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    • 제8권2호
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    • pp.170-175
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    • 2005
  • Painful and disabling snapping scapula is an unusual condition and there have been several reports that have revealed good results after surgical treatment for unilateral snapping scapula. We experienced a case of bilateral painful snapping scapula in a young man, but with successful treatment by partial resection of the superomedial angle of both scapula. Preoperative 3-dimensional CT revealed bony prominence of the superomedial angle of both scapula and narrowing between superior scapular angle and chest wall.

Complete resolution of the giant pulmonary bulla: a case of inflammatory autobullectomy

  • Park, Sungrock;Shi, Hyejin;Wang, Sungho;Lee, Sangki;Ko, Yousang;Park, Yong Bum
    • 고신대학교 의과대학 학술지
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    • 제33권3호
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    • pp.409-414
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    • 2018
  • Giant pulmonary bulla (GPB) is a rare manifestation of emphysema and usually enlarges gradually over time, occasionally resulting in complications. Hence, more often than not, the surgical intervention of a Bullectomy is the standard method of treatment for GPB. However, there are case reports that show the complete resolution of GPB after its inflammation process even without surgical intervention. A 51-year-old man was admitted to our clinic due to pleuritic pain. After a chest X-ray and CT scan, a new air-fluid level within the GPB was revealed in the right upper lobe of his lung. His clinical status had improved promptly with intravenous antibiotics. A one-year follow-up study showed the GPB was completely resolved.

중추성 수면 무호흡이 동반된 심부전 환자에서 지속적 상기도 양압술 적용 1례 (A Case of Continuous Positive Airway Pressure Therapy in a Patient with Central Sleep Apnea and Heart Failure)

  • 안지영;김신범;강현희
    • 수면정신생리
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    • 제24권2호
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    • pp.118-123
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    • 2017
  • 일반적으로 폐쇄성 수면 무호흡이 중추성 수면 무호흡보다 발생 비율이 높지만 심부전 환자에서는 체인-스토크스 호흡이 동반된 중추성 수면 무호흡이 흔하며, 실제로 심부전 환자에서 25~40%까지 중추성 수면 무호흡이 발생한다고 한다. 저자들은 호흡곤란으로 내원하여 심부전으로 진단된 환자가 관상동맥 중재술을 시행하고 난 이후 추적 시행한 심초음파 결과에 비해 주관적인 호흡곤란이 해결되지 않은 경우, 의료진의 자세한 병력 청취를 통해 환자가 평소 코골이와 수면 무호흡이 심하다는 소견을 바탕으로 조기에 수면 다원검사를 시행했다. 환자는 체인-스토크스 호흡을 동반한 중추성 수면 무호흡으로 진단 되어 지속적 상기도 양압술을 적용 후 호흡곤란 및 주간 졸림증이 호전 되었다. 심부전 환자에서 중추성 수면 무호흡이 동반된 경우, 피로감, 주간 졸림증 등과 같은 수면 무호흡의 일반적인 증상이 심부전 자체로 인한 증상으로 오인되어 중추성 수면 무호흡의 진단이 늦어 질 수 있으며, 이 경우 환자의 예후에 나쁜 영향을 끼칠 수 있다. 본 증례의 경우와 같이 심부전 환자의 치료 시 수면 무호흡을 의심할 만한 증상이 있는 경우 중추성 수면 무호흡의 동반 가능성을 염두해 두고 수면다원검사를 통해 중추성 수면 무호흡을 조기에 진단하는 것이 증상 호전 및 예후에 긍정적인 영향을 끼치는 것을 경험하였기에 보고하는 바이다.

청폐사간탕(淸肺瀉肝湯)과 Mannitol투여(投與)의 뇌경색환자(腦硬塞患者)에서 흉막삼출증병발보고(胸膜渗出症倂發報告) (One Case of Fleural Effusion by Treatment of Chungpesagan-tang and Mannitol in Cerebral Infartion)

  • 김종대;김선강
    • 대한한방내과학회지
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    • 제21권4호
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    • pp.667-670
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    • 2000
  • The patient who has DM, Hypertension, Arrithemia, Arteral fibrillation, Heart failure attacted cerebral infartion and he was took treatment by chungpesagan-tang and mannitol at the same time for 4 days and only chungpesagan-tang for 3 days. General condition improved but at seventh day cold sweating and hypothermia appeared. So we take chest x-ray. The result is fleural effusion. Chungpesagan-tang is the method of Purgative action so heart function is injured in circulation. In the results we consider that the medication of chungpesagan-tang and mannitol at the same time is bad influence on heart and induce ftueral effusion.

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Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern

  • Park, In-Young;Kim, Ji-Hyun;Park, Yang-Ho
    • 대한치과교정학회지
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    • 제45권2호
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    • pp.66-73
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    • 2015
  • Objective: To compare condylar position and morphology among different vertical skeletal patterns. Methods: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. Results: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. Conclusions: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

건망(健忘)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literature Study of Jianwang(健忘) : Forgetfulness(Amnesia))

  • 유금용;장규태;김장현
    • 대한한방소아과학회지
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    • 제13권1호
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    • pp.1-16
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    • 1999
  • A literature study was progressed for oriental medical diagnosis and treatment for Jianwang(健忘) : forgetfulness(amnesia). In orental medicine, the reason of Jianwang(健忘) was congenital insufficiency(稟賦不足), meditational excessiveness(思慮過多), deficiency of heart(心虛), phlegm retention(痰飮), deficiency of kidney(腎裏), breakdown of the normal physiological coordination between the heart and the kidney(心腎不交), blood stasis(瘀血). The method of medical treatment was invigorating vital energy and enriching the blood(大補氣血), invigorating the heart and nourishing blood(補心養血), dissipating phlegm and relieving mental stress(化痰寧神), regulating the spleen corresponds to earth(理脾土), invigorating the heart and the kidney(補心腎), reinforcing the liver and the kidney(培肝腎), promoting blood circulation to remove blood stasis(活血祛瘀) and etc. Herbal medication was followed as those method. The prescription was commonly used as Guibitang(歸脾湯), Insuksan(仁熟散), Chunwangbosimdan(天王補心丹), Susunghwan(壽星丸), Samjohwan(蔘棗丸) and etc.

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Numerical Investigation of Hemodynamics in a Bileaflet Mechanical Heart Valve using an Implicit FSI Based on the ALE Approach

  • Hong, Tae-Hyub;Choi, Choeng-Ryul;Kim, Chang-Nyung
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2008년도 추계학술대회B
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    • pp.2410-2414
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    • 2008
  • Human heart valves diseased by congenital heart defects, rheumatic fever, bacterial infection, cancer may cause stenosis or insufficiency in the valves. Treatment may be with medication but often involves valve repair or replacement (insertion of an artificial heart valve). Bileaflet mechanical heart valves (BMHVs) are widely implanted to replace the diseased heart valves, but still suffer from complications such as hemolysis, platelet activation, tissue overgrowth and device failure. These complications are closely related to both flow characteristics through the valves and leaflet dynamics. In this study, the physiological flow interacting with the moving leaflets in a bileaflet mechanical heart valve (BMHV) is simulated with a strongly coupled implicit fluid-structure interaction (FSI) method which is newly organized based on the Arbitrary-Lagrangian-Eulerian (ALE) approach and the dynamic mesh method (remeshing) in FLUENT. The simulated results are in good agreement with previous experimental studies. This study shows the applicability of the present FSI model to the complicated physics interacting between fluid flow and moving boundary.

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선천성 심장질환에 있어서 우심도자법의 임상적 연구 (Right Heart Catheterization as Study of Congenital Heart Disease)

  • 김규태
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.523-528
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    • 1978
  • Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, , Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

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