• 제목/요약/키워드: Pulmonary Artery

검색결과 832건 처리시간 0.03초

산삼 배양근 추출물의 혈압강화 및 혈관이완 효과 (The Antihypertensive and Vasodilating Effects of Adventitious Root Extracts of Wild Ginseng)

  • 홍민희;임희경;박지은;전능재;이영재;조문제;김소미
    • Applied Biological Chemistry
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    • 제51권2호
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    • pp.102-107
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    • 2008
  • 본 연구에서는 산삼 배양근이 NO 생성과 NO와 연관된 생리활성에 미치는 효과에 대해 조사하였다. ECV304 세포에 산삼 배양근 열수 추출물(WE) 혹은 부탄올 추출물의 수용액 분획물(ABE)를 처리하게 되면 상당량의 NO가 발생하는 것을 확인하였다. 추출물에 의한 ECV304 세포 내 endothelial nitric oxide synthase(eNOS)의 발현 양 변화는 거의 없었으며 100${\mu}g$의 ABE에 의해 약 6%의 ACE 억제 효과가 관찰되었다. 동맥 혈관에서의 혈관이완 효과는 WE는 2.5 mg/ml일 때 44.8%의 이완율을 나타낸 것에 비해 ABE는 0.1 mg/ml일때 91.3%의 혈관 이완율을 보였다. 선청성 고혈압 쥐인 SHR에서의 단 회 경구투여 시 혈장강화 효과는, 8시간 경과 후 최저혈압(154.5${\pm}$8.6 mmHg)을 보였고, 24시간이 지나면 초기 수준으로 회복되는 것을 확인할 수 있었다.

The outcome of percutaneous stent implantation in congenital heart disease: experience of a single institute

  • Kim, Moon Sun;Yoon, Ja Kyoung;Kim, Seong Ho;Bang, Ji Seok;Jang, So Ick;Lee, Sang Yoon;Choi, Eun Young;Park, Su Jin;Kwon, Hye Won
    • Clinical and Experimental Pediatrics
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    • 제61권6호
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    • pp.187-193
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    • 2018
  • Purpose: The efficacy of percutaneous stent implantation for congenital heart disease (CHD) in Korea, where stent availability is limited, has not been determined. This study evaluated the acute and midterm results of stent implantation in different CHD subgroups. Methods: Stents were implanted in 75 patients with 81 lesions: (1) pulmonary artery stenosis (PAS) group, 56 lesions in 51 patients; (2) coarctation of the aorta (CoA) group, 5 lesions in 5 patients; (3) Fontan group, 13 lesions in 12 patients; (4) ductal stent group, 3 lesions in 3 patients; and (5) other CHD group, 4 lesions in 4 patients. Mean follow-up duration was 2.1 years (0.1-4 years). Medical records were reviewed retrospectively. Results: The minimum lumen diameter (MLD) in PAS and CoA increased from $5.0{\pm}1.9mm$ and $8.4{\pm}1.6mm$ to $10.1{\pm}3.6mm$ and $12.3{\pm}2.5mm$, respectively (P<0.01). In the PAS group, pressure gradient decreased from $25.7{\pm}15.6mmHg$ to $10.4{\pm}10.1mmHg$, and right ventricular to aortic pressure ratio from $0.56{\pm}0.21$ to $0.46{\pm}0.19$. In the CoA group, the pressure gradient decreased from $50{\pm}33mmHg$ to $17{\pm}8mmHg$. In the ductal stent group, the MLD of the ductus increased from 2.3 mm to 4.3 mm and arterial oxygen saturation from 40%-70% to 90%. No deaths were associated with stent implantation. Stent migration occurred in 3 patients, but repositioning was successful in all. Stent redilation was performed successfully in 26 cases after $29{\pm}12months$. Conclusion: Percutaneous stent implantation was safe and effective, with acceptable short and mid-term outcomes in Korean CHD patients.

동맥관 개존증(PDA)에 이환된 개에서의 전사 인자 AP-2 beta(TFAP2B) 유전자 스크리닝 (Genetic Screening of the Canine Transcription Factor AP-2 Beta(TFAP2B) Gene in Dogs with Patent Ductus Arteriosus(PDA))

  • 남소정;현창백
    • 한국임상수의학회지
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    • 제26권2호
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    • pp.123-129
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    • 2009
  • 동맥관 개존증(PDA)은 동맥관의 불완전한 폐쇄로 인해 하행 대동맥과 폐동맥 사이에 비정상적인 단락이 형성된 것이다. 최근 인간의 유전자 연구에서 전사인자 AP-2 beta(TFAP2B)의 유전자 변이가 PDA 증후적 사례를 초래함을 발견하였다. TFAP2B 유전자의 변이는 사람의 PDA와 같은 특정 선천성 심장 기형과 관련되어 있다. 본 연구에서는 PDA에 이환된 개의 유전자 스크리닝을 하기 위해 개 TFAP2B유전자의 전체 exon 부위를 분리하였다. 개 TFAP2B유전자는 사람의 TFAP2B와 아미노산 서열이 매우 유사하였다. PDA에 이환된 말티즈견의 TFAP2B유전자 스크리닝에서 단일 c.936+203G>A 염기 변화가 발견되었다. 그러나 대조군의 유전자 스크리닝에서도 동일한 염기 변화가 발견되었다. 이 염기의 변화는 인트론 지역에 위치해 있었으며 이환되지 않은 대조군 개에서 발견된 것으로 보아 TFAP2B는 말티즈 견의 유전성 PDA와 다른 종의 PDA 환자를 초래하지 않을 것으로 보인다. 향후 더 많은 샘플을 모으고 PDA에 이환된 다양한 종과 다른 선천성 심장 기형을 가진 환축에서 TFAP2B를 스크리닝하는 연구가 필요하다.

단심실 -III C Solitus 형의 수술치험- (Surgical Repair of Single Ventricle (Type III C solitus))

  • naf
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Ebstein 기형의 수술 -2례 보고- (Surgical Repair for Ebstein's Anomaly)

  • naf
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.289-296
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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비글견의 컴퓨터단층영상에서 기관내강과 폐동맥 직경비율의 마취제에 따른 영향평가 (Influences of Anesthetics in term of Computed Tomography Bronchial Lumen to Pulmonary Artery Diameter Ratio in Beagle Dogs)

  • 임종수;황태성;윤영민;정동인;연성찬;이희천
    • 한국임상수의학회지
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    • 제33권1호
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    • pp.6-9
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    • 2016
  • Bronchoarterial (BA) ratio is a commonly used criterion to define airway dilatation despite the lack of normative human and animals. The objective of our study was to compare the range of normal bronchial to accompanying arterial diameter ratio with previous reports on CT scan of the thorax in dogs and assess influence anesthetics on BA ratio in dogs. Dogs undergoing multidetector CT scan of the chest for nonpulmonary conditions at a single center were prospectively identified. High-resolution reconstruction was performed on those included and both airway lumen and vessel diameters were measured in the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes. Eight dog were included; Mean of the mean BA ratios was $1.43{\pm}0.24$ (95% CI = 1.36 - 1.50) in inhalation anesthetic group. In propofol group, the mean of the mean BA ratios was $1.13{\pm}0.29$ (95% CI = 1.04 - 1.22). In medetomidine group, the mean of the mean BA ratios was $0.89{\pm}0.19$ (95% CI = 0.83 - 0.95). Comparing individual lobes within anesthetic category, there was no signicant difference in mean BA ratio between lung lobes or between dog according to inhalation, propofol, and medetomidine group (P = 0.630, P = 0.878, and P = 0.508, respectively). The BA ratio in these clinically normal dogs was consistent and may be a useful tool in evaluating for bronchiectasis on CT images. However, some different criteria for bronchiectasis were applied by the anesthetic methods.

심폐소생술에 대한 현장업무 프로토콜 교육 효과 비교 (The Comparison of Effectiveness in Prehospital Protocol Education on CardioPulmonary Resuscitation)

  • 신상열;정지연
    • 한국산학기술학회논문지
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    • 제10권11호
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    • pp.3418-3426
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    • 2009
  • 본 연구의 목적은 비외상성 심정지 환자에게 적용하는 심폐소생술에 대한 현장업무 프로토콜의 유용성을 검증하는 것이다. 연구는 2008년 5월 1일부터 동년 6월 27일까지, 전라남도와 전라북도에 소재한 J, K대학에 재학 중인 응급구조과 학생 150명을 대상으로 하였다. 비동등성 대조군 전.후 유사 실험 설계(nonequivalent control group pretest-posttest design)를 사용하여, 실무적합성 검증을 실시하였다. 현장업무 프로토콜을 적용한 실험군과 기존의 심폐소생술을 적용한 대조군으로 나누어, 각 프로토콜 항목들의 소요시간을 비교하여 통계 분석하였다. 연구 결과, 5개항목(의식상태 평가, 기도유지, 인공호,,흡 2회 실시, 순환 확인, 심폐소생술 5주기 실시)을 제외한 나머지 18개 항목에서 3초 이상 수행시간이 단축되었다. 60초 이상의 단축을 보인 항목은 6개로, 기관삽관 튜브 고정(78.70초), 말초정맥로 확보(64.45초), 의식상태 재평가, 동공반사 확인(110.05초), 목동맥 확인(112. 55초), 활력징후 평가(85.7초)였으며, 전체시간은 110.85초가 단축되었다. 실험군과 대조군의 프로토콜 적용에 따른 사전.사후 변화에서 전체시간(t=-6.580, p=.000)은 통계학적으로 유의하게 감소한 것으로 나타났다. 따라서 비외상성 심정지 환자의 심폐소생술에 대한 현장업무 프로토콜은 정확하고 신속한 의사결정을 지원할 수 있는 지침으로 활용될 수 있으며 응급의료 서비스를 향상시킬 것으로 사료된다.

Analysis of Patients with Hemoptysis in a Tertiary Referral Hospital

  • Lee, Bo Ram;Yu, Jin Yeong;Ban, Hee Jung;Oh, In Jae;Kim, Kyu Sik;Kwon, Yong Soo;Kim, Yu Il;Kim, Young Chul;Lim, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • 제73권2호
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    • pp.107-114
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    • 2012
  • Background: This study attempted to investigate the main causes of hemoptysis, the type of examinations used for diagnosis, the treatment modalities and outcomes. Methods: A retrospective study was conducted on the medical records of 221 patients admitted to the Chonnam National University Hospital, between January 2005 and February 2010, with hemoptysis. Results: Bronchiectasis (32.6%), active pulmonary tuberculosis (18.5%), fungus ball (10.8%), and lung cancer (5.9%) accounted for most causes of hemoptysis. Computed tomography scan was the most sensitive diagnostic test when employed alone, with positive yield of 93.2%. There were 161 cases of conservative treatment (72.9%), 42 cases of bronchial artery embolization (BAE) (19.0%), and 18 cases of surgery (8.1%). Regarding the amount of hemoptysis, 70 cases, out of 221 cases, were mild (31.5%), 36 cases moderate (16.2%), and 115 cases massive hemoptysis (52.0%). Most of the patients were treated conservatively, but if there was more bleeding present, BAE or surgery was more commonly performed than the conservative treatment ($p{\leq}0.0001$). In the multivariate model, severe hemoptysis and lung cancer were independently associated with short-term recurrence. BAE was independently associated with long-term recurrence, and lung cancer was associated with in-hospital mortality. The overall in-hospital mortality rate was 11.3%. Conclusion: Hemoptysis is a common symptom with a good prognosis in most cases. However, patients exhibiting massive bleeding or those with malignancy had a poorer prognosis. In-hospital mortality was strongly related to the cause, especially in lung cancer.

폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예 (Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer)

  • 주진영;조재영;임정환;조계중;채동렬;오인재;김규식;김유일;임성철;김영철;송상윤;나국주;김윤현;김재규
    • Tuberculosis and Respiratory Diseases
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    • 제63권5호
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    • pp.449-453
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    • 2007
  • 항암제 치료 등을 위해서 피하매몰 중심정맥포트를 유치한 환자에서 도관 골절 및 원위부의 색전증은 드물게 발생하는 합병증으로 일반적인 경우는 경피적으로 도관의 제거가 가능하나, 임상의사들이 미리 이러한 합병증을 예측할 수 있는 임상적 및 방사선학적인 소견을 인지하고 조기에 발견하여 올바른 처치를 하는 것이 중요하며, 이러한 합병증을 예방하기 위한 방법 등에 대해서 숙지하는 것이 필요하다.

신경섬유종증에 동반된 가성동맥류 파열로 발생한 자연 혈흉 1예 (A Case of Spontaneous Hemothorax Due to Rupture of Pseudoaneurysm in Type 1 Neurofibromatosis)

  • 김순종;정훈;이성순;임채만;이상도;고윤석;김우성;김동순;김원동;심태선
    • Tuberculosis and Respiratory Diseases
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    • 제50권1호
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    • pp.122-126
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    • 2001
  • 저자들은 신경섬유종증 환자에서 우측 내유동맥에 생긴 가성동맥류의 파열로 인한 자연 혈흉을 진단하고 혈관색전술로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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