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Effects of the Geometric Dimensions on the Hemodynamics of Aorto-Coronary Bypass (Aorto-Coronary Bypass의 기하학적 형상이 관상동맥의 혈류특성에 미치는 영향)

  • Suh, S.H.;Roh, H.W.;Yoo, S.S.;Kwon, H.M.;Kim, D.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.254-257
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    • 1996
  • An aorto-coronary bypass graft is frequently adopted for the interventional therapy of the diseased atherosclerotic coronary artery grafting. The bypass artery is often occluded due to restenosis and/or anastomotic neointimal fibrous hyperplasia after bypass graft. The optimal aorto-coronary bypass procedure must be studied in order to improve patency rate for the arterial bypass techniques. The objective of this study is to investigate the influences of geometric dimensions of bypass on the hemodynamics around the anastomosis in the stenosed coronary artery with aorto-coronary bypass.

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Cavoatrial shunt procedure for Budd-Chiari syndrome complicated by inferior vena caval thrombosis. One case report (하공정맥우심방 단락술에 의한 BuddChiari Syndrome 수술치험 1례 보고)

  • 이승구
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.673-678
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    • 1985
  • A 21 year-old male patient had a diagnosis of Budd-Chiari syndrome caused by inferior vena caval obstruction. Conservative medical therapy failed to control the symptoms of both portal hypertension and inferior vena caval stasis. Portocaval or mesocaval shunts may relive the symptoms of chronic forms of Budd-Chiari syndrome. But when inferior vena caval stenosis is severe, another procedure has to be used. Cavoatrial or portoatrial shunt has been suggested. Therefore, a long Dacron graft was placed from the inferior vena cava just below the left renal vein to the right atrium. He exhibited almost complete relief of symptoms for 1.5 year postoperatively. And there was angiographic proof of patency of the graft. This simple procedure should be encouraged in treatment of these patients.

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Aortic valve Replacement Concomitant with Aorto-Coronary Bypass Surgery -One case report- (관상동맥 우회술을 병행한 대동맥판막 치환술 치험 1례)

  • 정언섭
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.514-521
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    • 1990
  • Patient with aortic valvular disease have increased left ventricular work and greater myocardial oxygen demand, which may aggravate the effect of concomitant coronary artery disease. Thus in patient who repair aortic valve replacement, concomitant aortocoronary bypass surgery is often performed when angiographically significant coronary artery disease is present. This approach is supported by reports that revascularization does not increase operative risk when associated coronary artery disease is present and significantly reduce the occurrence of late sudden death. Recently we have experienced one case of aortic valve replacement concomitant with aorta-coronary bypass surgery. The patient was 56 year-old male and admitted with complaint of anterior chest pain especially during his exercise. He was diagnosed as aortic valve stenosis and regurgitation [GIII] with proximal right main coronary artery occlusion We performed aortic valve replacement with aorta coronary bypass surgery by use of saphenous vein. Post operative course was uneventful and chest pain was relieved. Post operative coronary angiogram disclosed good patency of grafted vessel.

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Comparison of apical seal with or without the use of dentin adhesive system

  • Lee, Min-Jo;Choi, Kyoung-Kyu;Choi, Gi-Woon
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.600-600
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    • 2003
  • I. Objectives Effective endodontic obturation must provide a complete, three-dimensional filling of the root canal system, preventing the communication of fluids between root canal and surrounding periapical tissues. The objective of this study was to compare the apical leakage with or without the use of dentin adhesive system. II. Materials and Methods Forth extracted human teeth with single canals were decoronated. Root canals were instrumented using GT rotary files and Profile .04 file up to #40, 1mm short of the apex. After each instrumentation, copious irrigation with 5.25% sodium hypochlorite solution and confirmation of apical patency were performed.(omitted)

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Sleep Characteristics in Infants (영아의 수면 특성)

  • Rhie, Seonkyeong
    • Sleep Medicine and Psychophysiology
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    • v.27 no.2
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    • pp.33-40
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    • 2020
  • An infant's sleep varies considerably from that of adults in terms of structure, amount, and breathing pattern. After birth, sleep becomes evenly distributed throughout the day and night. Nighttime sleep gradually increases with the maturation of circadian rhythm, and sleep is gradually consolidated. Electroencephalography characteristics change with age, from early and dominant active (REM) sleep in newborns to increasing NREM sleep. Similar to other elements of growth, the upper respiratory tract and ribcage gradually increase in size with age, and respiratory control also improves. With these changes, sleep patterns also change. At this time that various sleep disorders may appear. Improved understanding of age-dependent changes in infant sleep can help determine the etiology and facilitate diagnosis of infant sleep diseases.

Role of radiofrequency ablation in advanced malignant hilar biliary obstruction

  • Mamoru Takenaka;Tae Hoon Lee
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.155-163
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    • 2023
  • Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

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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    • v.2 no.1
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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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Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation

  • Tayyaba Mohammad;Michel Kahaleh
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.347-354
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    • 2022
  • Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply, but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

Komi type 2 pancreaticobiliary maljunction: Minimal access surgical treatment (with video)

  • Freddy Pereira Graterol;Francisco Salazar Marcano;Yeisson Rivero-Moreno;Yajaira Venales Barrios
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.393-396
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    • 2024
  • Pancreaticobiliary maljunction (PBM) is associated with the development of neoplasms of bile ducts. Cholecystectomy with diversion of the biliary-pancreatic flow is considered the treatment of choice. To describe the surgical treatment employed for a patient with Komi's type 2 PBM and its long-term results. Laparoscopic common bile duct exploration, intraoperative cholangioscopy, and Roux-en-Y hepatico-jejunostomy were performed. Postoperative evolution was satisfactory. The patient was discharge 72 hours after the surgery. There was no associated morbidity. At 62-month follow-up, clinical examination, laboratory tests, and imaging studies confirmed an adequate patency of bilio-enteric anastomosis. The surgical approach employed was effective and safe, with satisfactory long-term results.

The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.