• Title/Summary/Keyword: Stenosis

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A Case of Takayasu's Arteritis with Multiple Occlusion of Pulmonary Arteries (다발성 폐동맥 폐쇄를 동반한 Takayasu 동맥염 1예)

  • Jung, Ja-Hun;Lee, Kyung-Jin;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Choi, Yo-Won
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.267-273
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    • 1996
  • Takayasu's arteritis(aortoarteritis) is a chronic inflammatory disease involving the aorta, the arteries arising from the aorta, and the pulmonary arteries also may be involved. The inflammation leads to either stenosis and occlusion of the involved artery or formation of aneurysm or both. The arterial lesions can lead to secondary hypertension, retinopathy, cardiac involvement, cerebrovascular events, and premature death. The course and prognosis of patients with aortoarteritis show wide variation, and few authors have published systematic studies documenting the natural history of this disease. While the etiology of Takayasu's arteritis remains unknown, various modes of treatment including steroids, vascular surgery, and balloon angioplasty have been used for management of these patients. We experienced a case of Takayasu's arteritis with multiple occlusion of pulmonary arteries, which was confirmed by angiography and perfusion scan, so reported it with a review of literature.

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A Case of Primary Localized Tracheobronchial Amyloidosis (원발성 국한성 기관기관지형 유전분증 1예)

  • Kwak, Yee-Gyung;Kim, Hyun-Jeong;Lee, Chung-Hwon;Kim, Sung-Yeon;Cho, Jae-Hwa;Kwak, Sung-Min;Lee, Hong-Lyeol;Kim, Joon-Mee;Han, Hye-Seung;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.174-178
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    • 2002
  • Primary pulmonary amyloidosis is a rare condition that can be classified into the tracheobronchial, diffuse alveolar septal, and nodular parenchymal type. Tracheobronchial amyloidosis is characterized by deposition of fibrilar proteins in the tracheobronchial tree, and it can be subdivided into diffuse and focal varieties. In this report, a case of diffuse tracheobronchial amyloidosis confirmed by flexible fiberoptic bronchoscopic biopsy is presented. The patient was a 43-year old male with a chief complaint of cough and sputum for 20 days and dyspnea for one day. The chest CT scan showed diffusely thickened walls of both the main and lobar bronchi with calcification. The bronchoscopic findings showed nodular lesions of the trachea, a diffuse bronchial stenosis of both the main bronchi and a pinpoint narrowing of the left upper and right middle lobar bronchus. The biopsy showed submucosal deposits of homogenous eosinophilic amyloid materials and an apple-green birefringence under polarizing microscopy following the Congo-red stain.

Current Status(1994) of Neonatal Surgery in Korea -Survey among the members of Korean Association of Pediatric Surgeons- (1994년도 한국신생아외과의 현황 - 대한소아외과학회 회원대상 전국조사 -)

  • Kim, W.K.;Kim, S.Y.;Kim, S.K.;Kim, I.K.;Kim, J.C.;Park, K.W.;Park, Y.S.;Park, W.H.;Park, J.S.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Chang, S.I.;Chung, E.S.;Jung, P.M.;Joo, J.S.;Choi, S.O.;Huh, Y.S.;Hwang, E.H.
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.26-32
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    • 1996
  • To understand the current status of neonatal surgery in Korea, a survey was made among the 27 members of Korean Association of Pediatric Surgeons. Response rate among surgeons was 78 percent, eighteen hospitals participated in this study. Five hundred and three cases of neonatal surgical patients were analyzed. In Korea, about 50% of cases were treated at the hospital in the capital city area. Regional number of patients were closely related to the regional population. Imperforate anus(19%), atresia/stenosis of gut(12%), and Hirschsprung's diseases(12%) were sitting at the top in the list. Majority of operation was done within the first week of life, especially during the first 24 hour period. Eighty per cent was major or so called index cases. Mortality in so-called index cases was 17%. High mortality was observed in patients with diaphragmatic hernia(47%), gastrointestinal perforation(65%) and esophageal atresia(28%). Low birth weight babies showed higher mortality in gastrointestinal perforation, esophageal atresia and abdominal wall defect. These were compared to 1993 survey of Japanese Society of Pediatric Surgeons.

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Development of Drug Eluting Stent for the Treatment of Benign Biliary Stricture by Electro-spray Method (전기분사를 이용한 양성담관 협착 치료용 약물방출 스텐트 개발)

  • Shin, Il-Gyun;Kim, Dong-Gon;Kim, Han-Ki;Kim, Sang-Ho;Jeon, Dong-Min;Suh, Tae-Seok;Jang, Hong-Seok
    • Polymer(Korea)
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    • v.36 no.2
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    • pp.163-168
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    • 2012
  • Recently, along with technology development of endoscopic equipment, the stent technology has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. In this study, paclitaxel-eluting metal stents for treatment of biliary benign stenosis were developed through an electrospray-coating method. Polyether-based polyurethane (PELLETHANE 2363-80AE$^{(R)}$)) and paclitaxel were coated onto the surface of a metallic stent and Pluronic F127 was used as an additive. As a result, physicochemical characterization of paclitaxel via SEM, FTIR, contact angle and XRD techniques revealed the information of solid state of paclitaxel-loaded PU film. The in vitro release profile showed a slower release rate with a higher content of paclitaxel.

Effect of Blood Pressure on the Endothelium-Dependent Contraction in Rat Aorta

  • Jeon, Byeong-Hwa;Kim, Hoe-Suk;Kim, Se-Hoon;Chang, Seok-Jong
    • The Korean Journal of Physiology
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    • v.30 no.1
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    • pp.21-31
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    • 1996
  • To investigate the mechanisms of increased endothelium-dependent contraction by acetylcholine in hypertensive rats, the relationship between endothelium-dependent contraction by acetylcholine and blood pressure was studied in spontaneously hypertensive rats (SHR), one-kidney, one clip Goldblatt hypertension (1K,1C-GBH) rats, and Wistar-Kyoto rats (WKY). SHR were treated orally with enalapril or nicardipine in order to prevent development of hypertension or suppress the developed hypertension. 1K,1C-GBH rats were made by renal artery stenosis with contralateral nephrectomy in 8 week-WKY. 1. Endothelium-dependent contractions by acetylcholine $(10^{-6}{\sim}10^{-5}\;M)$ in SHR were significantly greater than those in WKY. 2. Chronic treatment with enalapril or nicardipine reduced the endothelium-dependent contraction in SHR 3. The degree of reduction of endothelium-dependent contraction was greater in SHR which was prevented from developing hypertension than in SHR of which high blood pressure was suppressed. 4. In aortic rings from 1K,1C-GBH rats, endothelium-dependent contractions by acetylcholine were augmented as compared with WKY. 5. There is good relationship between the value of blood pressure and magnitude of endothelium-dependent contraction. Thus, it is suggested that increased endothelium-dependent contraction in hypertensive rats may he due to the high blood pressure and endothelium-dependent contraction may not be a cause of the initiation of hypertension in SHR.

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Clinical Outcomes and Complications of Tendoscopic Treatment for Flexor Hallucis Longus Tenosynovitis (장무지굴건 건초염에 대한 건내시경적 치료의 임상적 결과 및 합병증)

  • Kim, Bom Soo;Choi, Geun Hong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.294-301
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    • 2013
  • Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

Linear-Shaped Gastroduodenostomy in Totally Laparoscopic Distal Gastrectomy

  • Son, Hyaung-Mi;Lee, Sang-Lim;Hur, Hoon;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.10 no.2
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    • pp.69-74
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    • 2010
  • Purpose: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy. Materials and Methods: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler. Results: There were 12 female and 13 male patients with a mean age of $55.6{\pm}11.2$. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was $179.5{\pm}27.4$ minutes, the mean anastomotic time was $17.5{\pm}3.4$ minutes. The mean number of stapler cartridges was $5.6{\pm}0.8$. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was $6.7{\pm}1.0$ days except the complication case, and there was no case of conversion to open procedure and postoperative mortality. Conclusions: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.

A Case of Alagille's Syndrome (Alagille 증후군의 1예)

  • Kim, Sung-Eun;Choe, Won-Sick;Chun, Yong-Soon;Yoon, Hye-Kyoung
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.154-158
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    • 2000
  • This is a case report of a 5-month-old male who was brought in to hospital for evaluation of jaundice from birth. The baby had a history of ileal atresia operated 2 days after birth. At the age of one month, Tc-99m DISIDA hepatobiliary scintigraphy was performed at other hospital and reported to show good hepatic uptake of the tracer but no uptake in the biliary tree, gall bladder, or intestine for 24 hours post injection. He was judged to have biliary atresia. However, subsequent exploratory laparotomy revealed that the hepatobiliary tree appeared intact and that there was a gall bladder. Additionally, the patient had central aorto-pulmonary shunt for the right ventricular septal defect with pulmonary stenosis of a peripheral type at the age of 4 months. The second hepatobiliary scintigraphy was performed on admission at the age of 5 months, showing a gall bladder but no intestinal uptake up to 24 hours. Retrospectively, the histological specimen of the liver obtained at the exploratory laparotomy was re-evaluated, and by the histological findings coupled with clinical data, arteriohepatic dysplasia (Alagille's syndrome) was diagnosed. In this report, we emphasize the diagnostic limitation of hepatobiliary scintigraphy and the importance of overall clinical and histologic evaluation in a case of Alagille's syndrome.

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The Effect of Three 20 mg Caudal Epidural Injections of Triamcinolon on the Blood Glucose, ACTH and Cortisol Concentrations in the Elderly Women (노인에서 경막외강에 3회 분할 투여된 Triamcinolone 60 mg이 혈중 포도당, ACTH와 Cortisol에 미치는 영향)

  • Goh, Jee Eun;Min, Soon;Jeong, Young Ju;Lee, Heon Keun
    • The Korean Journal of Pain
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    • v.18 no.1
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    • pp.15-18
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    • 2005
  • Background: Epidural steroid injections (ESI) have been used widely for the treatment of back and radiating extremity pain. Although its effects on the metabolic and endocrine system have been studied, the effects following repeated injections remain to be determined. We studied the effects of three repeated caudal epidural injections of low dose triamcinolone. Methods: the subject were 10 elderly women with spinal stenosis. Caudal epidural injections were performed biweekly. Triamcinolone (20 mg), mixed with 15 ml of 0.25% lidocaine, was used as the ESI injectate. The procedures were performed with the patient in the prone position. Blood sampling was performed just before the first injection, and used as the baseline, and then just before each injection on the same day of the 2nd and 4th weeks, with the last samples taken 2 weeks after the third injection. Results: The blood glucose concentrations showed no significant changes. The blood cortisol and ACTH concentrations were significantly decreased after the first injection, but there were no further decreases after each of the subsequent injections. The cortisol concentrations were maintained within the normal range. Conclusion: Caudal epidural injections, with low dose triamcinolone, suppressed the hypothalamus-pituitary-adrenal (HPA) axis, but no further suppression followed the subsequent repeated injections. Three consecutive caudal injections at 2 week intervals seems to be a safe procedure.

The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain (요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자)

  • Choi, Byung In;Han, Jeong Mi;Kweon, Tae Dong;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.54-59
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    • 2007
  • Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.