• Title/Summary/Keyword: Stenosis

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A Case of Intestinal Tuberculosis Complicated with Pulmonary Tuberculosis in a Young Aldolescent with Cerebral Palsy (뇌성마비 소아에서 진단된 폐결핵에 병발된 결핵성 장염 1례)

  • Choi, Sung Yun;Kim, Young Min;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.102-107
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    • 2004
  • About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old aldelescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.

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Endoscopic Balloon Dilation for Treatment of Congenital Antral Web

  • Peck, Jacquelin;Khalaf, Racha;Marth, Ryan;Phen, Claudia;Sosa, Roberto;Cordero, Francisco Balsells;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.351-354
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    • 2018
  • Congenital antral webs are a rare but relevant cause of gastric outlet obstruction in infants and children. The condition may lead to feeding refusal, vomiting, and poor growth. Due to the relative rarity of the disease, cases of congenital antral web are frequently misdiagnosed or diagnosed with significant delay as physicians favorably pursue diagnoses of pyloric stenosis and gastric ulcer disease, which are more prevalent. We report a case of an eight-month-old female who presented with persistent non-bilious emesis, feeding difficulties, and failure to thrive and was discovered to have an antral web. The web was successfully treated with endoscopic balloon dilation, which resolved her symptoms. Two years later, the patient remains asymptomatic and is thriving with weight at the 75th percentile for her age.

Neurovascular Manifestation of Loeys-Dietz Syndrome: A Case Report

  • Lee, Yun-Jeong;Yum, Mi-Sun;Kim, Eun-Hee;Choi, Hae-Won;Lee, Beom Hee;Yoo, Han-Wook;Ko, Tae-Sung
    • Journal of Genetic Medicine
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    • v.10 no.1
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    • pp.47-51
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    • 2013
  • Loeys-Dietz syndrome (LDS) is an autosomal dominant disorder caused by heterozygous mutations in the genes encoding transforming growth factor-${\beta}$ receptor type 1 or 2. It is typically characterized by a triad of hypertelorism, cleft palate or bifid uvula, and arterial tortuosity with aneurysm or dissection. Characteristic vascular abnormalities such as tortuosity, aneurysms, dissections, and stenosis are the most severe complications of LDS and can occur in the neurovascular system. We report a 5-year-old boy who presented with headaches and neurovascular abnormalities and was diagnosed with LDS with a novel mutation of the TGFBR1 gene. It is the first Korean report of neurovascular abnormalities in LDS.

Hemodynamic Stress Changes due to Compensatory Remodelling of Stenosed Coronary Artery (협착이 발생된 관상동맥의 보상적 재형성에 따른 혈류역학적 응력변화)

  • Cho, Min-Tae;Suh, Sang-Ho;Lee, Byoung-Kwon;Kwon, Hyuck-Moon;Yoo, Sang-Sin
    • Proceedings of the KSME Conference
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    • 2001.11b
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    • pp.529-532
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    • 2001
  • The purposes of the present study are to investigate hemodynamic characteristics and to define shear-sensitive remodeling in the stenosed coronary models. Two models for the compensatory remodelling used for this research are a pre-stenotic dilation and a post-stenotic dilation models for the computer simulation. The peak wall shear stress on the post-stenotic model is higher than that of the pre-stenotic model. Two recirculation zones are generated in the pre-stenotic model, and the zones in the pre-stenotic model are smaller than those in the post-stenotic model. Variation of the wall shear stress in the pre-stenotic model is lower than that in the post-stenotic model. In computer simulation with the post-stenotic model, higher temporal and spatial shear fluctuation and stress suggested shear-sensitive remodeling. Shear-sensitive remodeling may be associated with the increased risk of plaque rupture, the underlying cause of acute coronary syndromes, and sudden cardiac death.

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Intracoronary Radiation Therapy Using Re-188 after percutaneous Coronary Angioplasty (경피적 관동맥혈관성형술 후 Re-188을 이용한 혈관 내 방사선조사요법)

  • Chae, In-Ho;Lee, Myoung-Mook;Lee, Dong-Soo
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.228-241
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    • 1999
  • Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, intimal hyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.

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A Case of Successful Recovery from High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasospasm with Hemodynamic Collapse

  • Koh, Won-Jun;Cho, Jeong-Hyeon;Lee, Ji-Hyun;Kang, Won-Sik;Lee, Min-Kyung;Kim, Jun-Hyoung;Cho, Deok-Kyu
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.129-131
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    • 2012
  • A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

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A Surgical Idea for Wide Communicated Wound on Laryngopharynx (인후두의 개방적 외상에 대한 수술적 고찰)

  • 이종원;국태진;이정헌;염시경
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.7.4-8
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    • 1982
  • The common causes of neck closed injuries are automobile accidents and sports troubles; open injuries are gun-shot wounds and stab wounds. Generally, the treatment of wide laryngopharyngeal injuries consists of tracheostomy for adequate airway, simple repair and, later, surgical intervention for chronic laryngeal stenosis and hypopharyngeal reconstruction. Recently, authors experienced a case of extensive communicated wound with large defect on the layngopharyngeal structures and anterior neck skin. This large defect was reconstructed with horizontal cervical skin flap after total laryngectomy.

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A Case of Contralateral Hypoglossal Nerve Palsy after Peroral Resection of Submandibular Gland (경구강 악하선 절제술 후 발생한 반대측 설하신경 마비 1례)

  • Ban, Won Woo;Ban, Myung Jin;Lee, Chi-Kyou;Park, Jae Hong
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.1
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    • pp.41-44
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    • 2016
  • The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report- (좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고-)

  • 권중혁
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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Surgical Management of Coarctation of Aorta (대동맥교약증의 임상연구)

  • Kim, H.;Kang, M.S.;Hong, Y.S.;Cho, B.K.;Hong, S.N.
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.59-66
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    • 1989
  • Coarctation of aorta, a well known congenital cardiovascular defect, can be recognized in the most instances by simple finding of physical examination. This condition shortens life if untreated, but it can be corrected surgically to render the patient functionally normal. It seems relatively rare in Asian. During Six-Year period from January, 1982 through June, 1988, twenty four consecutive operations for the coarctation of the aorta were performed at Yonsei Medical Center. The patients included 14 males and 10 females in the range, 2 months and 34 years old. Associated Cardiac anomalies were patient ductus arteriosus, ventricular septal defect, mitral valve regurgitation, aortic stenosis, double outlet right ventricle, corrected transposition of great vessel, etc. The preoperative main symptoms were frequent URI and dyspnea. Congestive heart failure was the most common symptom at the group younger than 2 year olds. Operative techniques for the coarctation of the aorta were prosthetic patch aortoplasty in 18 patients, resection & vascular graft interposition in 4, resection and end to-end anastomosis in 2. There was no operative death. Four patients had persistent or paradoxical hypertension, and one had postoperative paraplegia.

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