• Title/Summary/Keyword: Stenosis

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Modified Puestow Procedure for Chronic Pancreatitis in a Child Due to Annular Pancreas and Duodenal Duplication: A Case Report

  • Alatas, Fatima Safira;Masumoto, Kouji;Matsuura, Toshiharu;Pudjiadi, Antonius Hocky;Taguchi, Tomoaki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.3
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    • pp.304-309
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    • 2020
  • An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

Biomechanical Evaluation of SMA Dynamic Stabilization for Spinal fusion (척추고정용 형상기억합금 동적안정기기의 생체역학적 성능 평가)

  • Kim Y.H.;Park W.M.;Kim K.;Park H.K.;Joo J.W.;Park K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.517-518
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    • 2006
  • In this study, a commercial fixation device, BioFlex, which was designed with shape memory alloy(SMA) for dynamic stabilization of spine was biomechanically evaluated. The finite element model of intact lumbar spine from L1 to S was developed using CT images. Also, low FE models of 2-level(L4-L5-S) and 3-level(L3-L4-L5-S) posteriori fixation using titanium(Ti) rod and BioFlex(SMA) rod. The rotations of bone segments in the intact model and four models were predicted. Although the rotations of the BioFlex fixation model were smaller than those of the intact model, they were relatively larger than those of Ti fixation. The present can be applied for not only evaluation of the stability of interbody fixator, but also development of new implant.

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Two-stage Ear Reconstruction with Canaloplasty in Congenital Microtia (외이도성형술을 병행한 선천작은귀증의 두단계 재건)

  • Kim, Jong Yeop;Cho, Byung Chae;Lee, Sang Heun
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.53-60
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    • 2006
  • The current authors performed two-stage ear reconstruction of microtia using autogenous costal cartilage combined with canaloplasty of the acoustic meatus in a team approach. In the first stage, lobule transposition, fabrication of the cartilage framework, and implantation of the framework were peformed. In the second stage, elevation of the auricle, cartilage graft for posterior auricular sulcus, coverage with the mastoid fascia flap and skin graft, and concha excavation were performed. The canaloplasty was combined simultaneously in patients with radiologic and audiometric evidence of cochlear function in the second stage. A total of 36 consecutive patients with congenital microtia were treated from 1998 to 2003. Among them, 27 patients(male: 18, female: 9) ranging from 7 to 43 years old were combined with canaloplasty. The follow-up period was one year to 5 years. Thirteen patients exhibited improved hearing over 30 dB PTA(pure tone average), 9 patients below 30 dB, and 5 patients with no improvement. Complications related to the canaloplasty were chronic drainages of the auditory meatus and meatal stenosis. Lobule type deformity combined with the canaloplasty showed higher complications than concha type. Therefore, in the lobule type, meticulous manipulation is necessary to reduce complications after the canaloplasty.

Surgical correction of adult tetralogy : Results of repair in 123 patients (성인 활로 4징증에 대한 개심술)

  • An, Hyuk;Suh, Kyung-Phill;Lee, Yung-Woo
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.627-632
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    • 1986
  • This report describes our 17-years experience with intracardiac repair in 123 patients older than 15 years with tetralogy of Fallot. Major clinical manifestation was cyanosis and clubbing [102 Pts], but other minor associated manifestation were infective endocarditis, pulmonary tuberculosis, brain abscess, congestive heart failure, nephrotic syndrome, and tuberculous spondylitis. Prior palliative shunts had been performed in 10 patients. Preoperative hemoglobin ranged from 9.7 gm/dl to 25 gm/dl [mean 19 gm/dl]. The type of ventricular septal defect were typical perimembranous type, and total canal defect [13%]. The right ventricular outflow tract obstruction was due to combined [58.5%], infundibular [35%], and valvular stenosis [6.5%]. Transannular patch was used in 17% of patients. Hospital mortality was 9.8% in overall, but decreased to 1.7% since 1982. There was two late death [12 year actuarial survival [97%] due to fulminant hepatitis, residual abnormalities [PS, VSD]. Ninety two percent of survivors at follow-up are asymptomatic and leading an active normal life. Residual ventricular septal defect was detected with radionuclide single pass study in 15.3% of patients but almost cases were Qp/Qs less than 1.5, and only two patients had been candidates for reoperation.

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Surgical Correction of TO in Adults - 42 Cases Report - (성인 활로씨 사징증의 외과적 교정)

  • 안욱수
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.1-7
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    • 1991
  • This report describes our 10-year experience with intracardiac repair in 42 patients older than 16 year with tetralogy of Fallot. The mean age was 22.0$\pm$5.18 years[range 16~41]. The preoperative clinical manifestations were cyanosis & clubbing[93%], frequent URI [55%], anoxic spell[40%], pulmonary tuberculosis[21%], tuberculous empyema[7%], chronic renal failure[7%], congestive heart failure[7%] and subacute bacterial endocarditis [2%], etc. The previous shunt procedure for palliation had been performed in 7 patients. The type of VSD were typical perimembranous type[67%], total canal defect[28%] and combined type[5%]. The right ventricular outflow tract obstruction were combined type[69%], infundibular type[21%] and valvular type[10%]. Transannular patch was used in 50% of patients. Associated cardiovascular anomalies were ASD[33%], PFO[31%], Rt. aortic arch[10%], Lt. SVC[10%], single Rt. pulmonary artery, single Lt. coronary artery, ASI, proximal stenosis of Rt. pulmonary artery and anomalous systemic venous return, etc. Hospital mortality was 7.1%[3 cases]in overall. The causes of hospital deaths were revealed low cardiac output & acute renal failure[2 cases], postoperative bleeding[1 case]. There were 2 late deaths 3 & 68 months after surgery. Residual intracardiac shunt was detected in 2 patients. one patient was successfully reoperated and another patient had Qp /Qs ratio less than 1.5.

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Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Comparison of Tranatrial-transpulmonary and Transventricular Repair of Tetralogy of Fallot (활로4징증의 완전한 교정술에 있어서 경심방-경폐동맥교정술과 경심교정술의 비교)

  • 김덕실
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.202-208
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    • 1994
  • We reviewed 30 patients with tetralogy of Fallot who had underwent transannular patch reconstruction of the right ventricular outflow tract from January 1990 to May 1993. The patients were divided into two groups according to the approaching pattern for the corrective surgery: 12 patients[aged 11 months to 4 years; mean age, 2.3 years] in transatrial group who were repaired by transatrial-transpulmonary approach; 18 patients[aged 13 months to 6 years; mean age, 3.2 years] in transventricular group who were repaired by transventricular approach. The incidence of postoperative right bundle branch block was not statistically different between two groups. With follow up from 3 months to 32 months after operation, none in transatrial group revealed a remnant RVOT stenosis over 50mmHg or tricuspid regurgitation more than grade II with 2D-echocardiography, but two cases[7.7%] in transventricular group revealed these complications. Early postoperative death was 4 cases[13.3%] which all belonged to transventricular group. In conclusion successful repair of tetralogy of Fallot can be accomplished in most patients by transatrial-transpulmonary approach and we can anticipate better results by this approach in terms of postoperative right ventricular function and arrhythmia than conventional transventricular approach.

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Clinical Analysis of Laryngectomized Patients (후두전적출술 52 례에 대한 임상통계학적 고찰)

  • Wang Soo-Geun;Chon Kyong-Myong;Lee Jong-Dam
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.55-63
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    • 1987
  • A retrospective investigation of 52 cases of carcinoma of the larynx, who underwent total laryngectomy $\bar{c}\;or\;\bar{s}$ neck dissection at Pusan National University Hospital from 1978 to 1985, was performed. The results obtained were as follows: 1) There were 32 glottic(62.7%), 18 supraglottic(35.3%) and 1 subglottic(2.0%) carcinoma. 2) In stage grouping, stage ill was the most(64.7%) and then stage II, stage IV, stage I in order. 3) Overall rate of cervical metastasis was 29.4%. In glottic carcinoma, 0% of $T_1,\;40%\;of\;T_2,\;18%\;of\;T_3\;and\;25%\;of\;T_4$. In supraglottic carcinoma, there was 0% of $T_1,\;29%\;of\;T_2,\;56%\;of\;T_3\;and\;50%\;of\;T_4$. 4) The incidence of postoperative complication was 31.4% and stomal stenosis was the most(13.7%) 5) There were 8 cases of local recurrence and 3 cases of distant metastasis(2 cases in lung, 1 case in esophagus) among 40 cases which were able to follow up. 6) 3 year estimated survival rate for glottic and supraglottic carcinoma were 73.3 % and 85.7% respectively.

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Dynamic response of heat and mass transfer in blood flow through stenosed bifurcated arteries

  • Charkravarty S.;Sen S.
    • Korea-Australia Rheology Journal
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    • v.17 no.2
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    • pp.47-62
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    • 2005
  • The present study deals with a mathematical model describing the dynamic response of heat and mass transfer in blood flow through bifurcated arteries under stenotic condition. The geometry of the bifurcated arterial segment possessing constrictions in both the parent and the daughter arterial lumen frequently appearing in the diseased arteries causing malfunction of the cardiovascular system, is formulated mathematically with the introduction of the suitable curvatures at the lateral junction and the flow divider. The blood flowing through the artery is treated to be Newtonian. The nonlinear unsteady flow phenomena is governed by the Navier-Stokes equations while those of heat and mass transfer are controlled by the heat conduction and the convection-diffusion equations respectively. All these equations together with the appropriate boundary conditions describing the present biomechanical problem following the radial coordinate transformation are solved numerically by adopting finite difference technique. The respective profiles of the flow field, the temperature and the concentration and their distributions as well are obtained. The influences of the stenosis, the arterial wall motion and the unsteady behaviour of the system in terms of the heat and mass transfer on the blood stream in the entire arterial segment are high­lighted through several plots presented at the end of the paper in order to illustrate the applicability of the present model under study.

Case Report of the Neurogenic Bladder after Spine Surgery (수술 후 발생한 신경인성 방광 환자에 대한 치험 1례)

  • Shim Ha-Na;Kim Yu-Hyung;An Ki-Young;Kim Sang-Woo;Song Bong-Keun;Park Hyoung-Jin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1685-1688
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    • 2005
  • We treated a 51 year-old female patient of neurogenic bladder. The patient complained of urinary incontinence, lack of urine sense, loss of right leg sense etc. The symptoms developed right after spinal stenosis surgery. The symptoms didn't show any improvement continually. But after admission and treatment in our hospital, symptoms were improved from severe to mild and the score of Assesment of Bladder function got better. We continued to prescribe the herbal medicine over 8 weeks and could observe that symptoms were improved. This result suggests that oriental medical therapy is useful enough to treat the neurogenic bladder. Therefore further study of the approach and application of this treatment for neurogenic bladder would be necessary.