• 제목/요약/키워드: Luminal A

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Synchronous ileal inflammatory fibroid polyp and Meckel's diverticulum found during laparoscopic surgery for adult intussusception

  • Kang, Sung Il;Gu, Mi Jin
    • Journal of Yeungnam Medical Science
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    • 제37권3호
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    • pp.226-229
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    • 2020
  • We present a rare case of synchronous ileal inflammatory fibroid polyp and Meckel's diverticulum detected during laparoscopic surgery for adult intussusception. A 48-year-old woman presented with sudden onset of severe abdominal pain. Abdominal computed tomography revealed a segment of ileocecal intussusception. Thus, laparoscopic exploration was performed, which revealed an ileal mass with an outpouching closed luminal structure in the distal ileum. Two abnormal structures were resected via mini-laparotomy, and the patient was discharged without postoperative complications. Histopathological examination confirmed an ileal inflammatory fibroid polyp and Meckel's diverticulum with ectopic pancreatic tissue.

지주막하 출혈에 따른 Vasospasm에 대한 Transcranial Doppler의 임상적 적용 (Transcranial Doppler Detection of Vasospasm Following Subarachnoid Hemorrhage)

  • 이준홍
    • Annals of Clinical Neurophysiology
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    • 제1권1호
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    • pp.55-59
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    • 1999
  • Vasoconstriction of intracerebral arteries is the leading cause of delayed cerebral infarction and mortality following aneurysmal subarachnoid hemorrhage. Transcranial Doppler studies show and increase in the flow velocities of basal cerebral arteries, which usually start around day 4 following a subarachnoid hemorrhage, and peaking by days 7 to 14. Angiographic studies confirm the presence of at least some degree of MCA vasospasm when the flow velocities are higher than 100 cm/sec. Mean velocities in the 120 to 200 cm/sec range correspond to 25 to 50% luminal narrowing. MCA and ACA vsospasm is detected with around 90% specificity. Sensitivity is 80% and 50% respectively. A 200cm/sec threshold and rapid flow velocity increase exceeding 50 cm/sec on consecutive days, has been associated with subsequent infarction. Transcranial Doppler is also used to monitor the effects of endovascular treatment of vasospasm. Flow velocities decrease following successful angioplasty or papaverine infusion. Overall, transcranial Doppler studies are considered to have acceptable accuracy for the evaluation of vasospasm in aneurysmal subarachnoid hemorrhage, with limitations that have to be taken into consideration in the clinical setting.

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Diagnostic Usefulness of High Resolution Cross Sectional MRI in Symptomatic Middle Cerabral Arterial Dissection

  • Lee, Hai-Ong;Kwak, Hyo-Sung;Chung, Gyung-Ho;Hwang, Seung-Bae
    • Journal of Korean Neurosurgical Society
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    • 제49권6호
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    • pp.370-372
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    • 2011
  • Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of the vertebrobasilar system or carotid artery. Recently, high-resolution cross sectional MR imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA, We introduce the findings of HRMRI in a 56-year-old woman with traumatic MCA dissection, HRMRI showed an intimal flap and tapered pseudolumen with intra-luminal hemorrhage, We performed stent deployment about MCA dissection after failed medical treatment Three months later, there was no in-stent restenosis and no further neurological deficit were noted.

동양달팽이 (Nesiohelix samarangae) 타액선의 조직화학적 및 미세구조적 연구 (Histochemical and Ultrastructural Studies on the Salivary Gland of a Land Snail, Nesiohelix samarangae)

  • 이용석;강보라;신희진;정계헌
    • 한국패류학회지
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    • 제20권1호
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    • pp.7-16
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    • 2004
  • Histochemical and ultrastructural studies on the salivary gland and salivary duct of a land snail Nesiohelix samarangae were conducted to observe structural characteristics and function. The salivary gland consisted of one type of epithelial cell, one type of supporting cell, and six types of gland cells. Four out of six gland cell types were histochemically identified on these secretions. The one secreted acid mucopolysaccharide and the other three secreted neutral mucopolysaccharide. The salivary duct epithelium had only one type of columnar cell with microvilli on its luminal surface. The basal protoplasmic membranes of the epithelial cells were deeply infolded so many times all along the cell bases.

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위식도역류질환과 인후두역류질환의 대한 최신지견 (Update of Pathophysiology in GERO/LPR)

  • 우정수
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.83-90
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    • 2010
  • The pathophysiology of Gastroesophageal reflux disease (GERD) has been known that it is developed when the offense-primarily the gastric acid-pepsin content of the refluxate-overcomes a 3-tiered esophageal protective defense. consisting of antireflux mechanisms, luminal clearance mechanisms, and tissue resistance. Laryngopharyngeal reflux (LPR), which is known as an extraesophageal variant of GERD, has been considered to be developed by transient lower esophageal sphincter relaxation (TLESR), direct mucosal injury by gastric contents, more sensitive mucosa compared to esophagus, and absence of buffering effect and aggravation of the injury due to pepsin. However, hypothesis of the pathophysiology in both entities are numerous and still lack of understanding for being a theory. There is no conflict that understanding the pathophysiology is necessary for resolving the problems of these diseases and numerous studies and results have been releasing. This review could provide clinicians dealing with GERD and LPR with applicable new information and help for overcoming the clinical obstruction.

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Treatment of Internal Carotid Artery Dissections with Endovascular Stent Placement: Report of Two Cases

  • Deok Hee Lee;Seung Ho Hur;Hyeon Gak Kim;Seung Mun Jung;Dae Sik Ryu;Man Soo Park
    • Korean Journal of Radiology
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    • 제2권1호
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    • pp.52-56
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    • 2001
  • Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.

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항혈전성 소구경 인조 혈관 및 봉합편에 대한 동물 실험 (Animal Experiments on an Antithrombogenic Small-Caliber Vascular Prostheses and Vascualr Patch : Observation in Canine Models)

  • 김수철;김원곤;유세영
    • Journal of Chest Surgery
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    • 제36권2호
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    • pp.63-72
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    • 2003
  • 최근 증가 추세에 있는 동맥 경화성 혈관 질환에 대한 가장 중요한 외과적 치료 도구로서 생체 적합성이 우수한 인조 혈관의 필요성이 더욱 강조되고 있는 실정이다. 새로운 항혈전성 중합체 혈액 접촉 표면으로서 폴리비닐알코올-폴리우레탄 융합체와 폴리우레탄-흑연 융합체를 개발하여 실험견의 대퇴동맥에 장단기 삽입 실험을 시행함으로써 그 혈액 적합성 및 조직 적합성을 분석, 연구하는데 본 연구의 목적이 있다. 대상 및 방법 : 폴리비닐알코올-폴리우레탄 융합체로 제작된 소구경 인조 혈관 및 폴리우레탄-흑연 융합체로 제작된 봉합편과 폴리우레탄만으로 제작된 소구경 인조 혈관 및 봉합편을 6마리의 실험견에 삽입 실험(1, 2, 4, 6, 8, 16주)을 시행하였고, 4마리의 실험견에 폴리우레탄-흑연 융합체 봉합편 및 폴리우레탄 봉합편 삽입실험(1, 2, 4, 6주)을 시행하여 혈액 적합성 및 조직 적합성을 비교, 분석하였다. 결과 : 폴리비닐알코올-폴리우레탄 융합체 인조 혈관 및 폴리우레탄 인조 혈관 삽입 실험에서 1, 4, 6, 8주 실험견에서는 실험군 및 대조군 모두에서 개방성이 관찰되지 않고 혈전으로 폐쇄되어 있었고, 2주 실험견에서는 모두 개방성이 관찰되었다. 그러나 16주 실험견에서는 폴리비닐알코올-폴리우레탄 융합체 인조 혈관만이 개방성을 유지하고 있는 것이 관찰되었는데 혈액 접촉 표면은 혈전 부착이 거의 없는 깨끗한 상태를 유지하고 있었고 병리 조직 검사에서 인조 혈관의 유공성 사이로 주위 조직의 침투가 관찰되었다. 반면 폴리우레탄 인조 혈관에서는 문합부를 중심으로 혈전 형성으로 인한 폐쇄가 관찰되었다. 폴리우레탄-흑연 융합체 봉합편 및 폴리우레탄 봉합편 삽입 실험에서 2주 실험견을 제외하고는 실험군 및 대조군 모두에서 개방성을 유지하고 있는 것이 관찰되었다. 개방성을 유지하였던 봉합편에서는 봉합편 내면 위로 혈전 형성은 관찰되지 않았으며 4, 6주 실험견에서는 봉합편 내면 위로 신내막이 형성되어 있는 것이 관찰되었다. 주사형 전자 현미경 관찰 결과 폴리우레탄-흑연 봉합편의 경우 1주 실험견에서는 봉합편 내면에 섬유소가 피복되어 있었으며 간헐적으로 세포가 혼합되어 있는 것이 관찰되었다. 이와 대조적으로 4주 실험견에서는 뚜렷한 초기 형태의 내피세포가 섬유소층을 덮어서 자라고 있는 것이 관찰되었다. 이 시기에 관찰한 내피세포의 확대 사진에는 내피세포의 활성을 나타내는 미세융모가 잘 관찰되었다. 그리고 6주 실험견에서는 내피세포가 보다 성숙하여 내피세포간 단층으로 밀접한 연결을 이루면서 상대적으로 납작한 모양을 보여 마치 자갈 모양의 전형적 형태를 취하고 있었다. 폴리우레탄 봉합편의 경우 전체적으로는 폴리우레탄-흑연 봉합편과 유사한 소견을 보였지만 4, 6주 실험견에서 상대적으로 내피세포 피복 정도가 적은 것이 관찰되었다. 그러나 전자 현미경 분석의 제한상 두 군간에 내피세포 피복 정도를 정량화하기는 어려웠다. 이상의 결과로 폴리비닐알코올-폴리우레탄 융합체와 폴리우레탄-흑연 융합체는 대조군인 폴리우레탄 인조 혈관 및 봉합편에 비해 일부 우수한 양상을 보였지만 본 실험의 범위내에서는 통계적 정량적 차이를 제시할 수는 없었다. 향후 보다 광범위한 동물 실험이 필요할 것으로 사료된다.

3개월 이하 영아의 대동맥 축착증 수술치료에 대한 임상연구 (Correction of Coarctation in Infants Less than Age 3 Months)

  • 신제균;송명근
    • Journal of Chest Surgery
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    • 제23권6호
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    • pp.1139-1145
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    • 1990
  • Seven infants less than age 3 months underwent patch aortoplasty and tube graft bypass for relief of coarctation of aorta. All had intractable congestive heart failure, despite aggressive medical therapy Each infant had other cardiac anomalies including patent ductus arteriosus, ventricular septal defect, atrial septal defect and congenital mitral stenosis. All patients underwent closure of the ductus arteriosus and patch angioplasty of the aorta to produce a luminal diameter of at least 15mm or tube graft interposition utilizing the Gortex tube graft diameter larger than 10mm. In 5 patients who had ventricular defect, they underwent pulmonary arterial banding. &ere was one hospital death 17 days after operation secondary to the hydronephrosis and renal failure. Hospitalization was less than 10 days after operation except one case. In 3 patients who had associated VSD, open heart surgery[VSD closure+PA debanding]was done without difficulty. Surgical repair of critical coarctation of the aorta in infants can safely be offered despite the poor preoperative condition and presence of other cardiac anomalies.

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복재정맥을 이용한 관상동맥 우회로 술 32례의 임상적 고찰 (Clinical Evaluation of 32 Cases of Aortocoronary Bypass with Sapheneous Vein)

  • 장재현
    • Journal of Chest Surgery
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    • 제26권6호
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    • pp.452-456
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    • 1993
  • From January 1990 to May 1993, 32 patients were underwent aortocoronary bypass with venous conduit using saphenous vein at Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital. There were 19 men, 13 women and a mean age was 57.8 years[range from 46 to 68]. The involved risk factors were as follows: smoking 15 cases, hypertension 14 cases, diabetic mellitus 6 cases, cholesterol[>240mg/dl] 13 cases, and triglyceride[>180mg/dl] 11 cases. The preoperative clinical status were chronic stable angina 4 cases, unstable angina 24 cases and myocardial infarction 4 cases. At angiogram, numbers that involved in coronary artery of narrowing more than 50% luminal diameter were 54 vessels[left anterior descending 30, right coronary artery 17, circumflex 7]. We performed 53 grafts in32 patients, average was 1.7 grafts per patient, 16 patients were single bypass, 11 patients were double bypass and 5 patients were triple bypass. The overall postoperative mortality was 3 %.

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