• Title/Summary/Keyword: Stenosis

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Radiation Damage Mechanism of the Small Intestine's Absorptive Epithelium and Radioprotection Effect after Propolis Abdominal Cavity Injection (프로폴리스 복강 주사 후 소장 흡수상피조직의 방사선 손상 기전과 방어효과)

  • Ji, Tae-Jeong;Lee, Sang-Hun
    • The Journal of the Korea Contents Association
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    • v.10 no.7
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    • pp.297-304
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    • 2010
  • As Small Intestine Absorptive Epithelium Cells are surrounded by mucus polysaccharide and lymphocytes and mitochondria, they are sensitive to radiation energy. Damaged cells lead to a deficiency of nutrients and the imbalance of electrolyte metabolism, which in turn can becomes a major cause of an intestine tract death. This research observed ultra structures after injecting propolis into the abdominal cavity in order to reveal the radiation damage mechanism and radioprotection effect of intestine absorptive epithelium cells. The result of this research's observation found that stenosis occurred in the small intestine in some tissues 20 days after 5Gy irradiation, their surface turned black, and their elasticity dropped. Through observation with an optical microscope, it was found that the size of the goblet cells decreased, while the paneth granulate cells atrophied and were vacuolated. Observation with an transmission electron microscope(TEM) revealed that while microvill and lysosome were normally observed in jejunum tissues, mitochondria membrane was damaged and uneven surfaces were formed on lymphocytes. The membrane of absorptive epithelium cells hypertrophied in tissues of the ileum, and vacuole was observed. However, the observation after injecting propolis into the abdominal cavity found that mitochondria damage dropped dramatically, and radioprotection effects were to some extent confirmed, considering that glycocalyx of villi was clear, and M cells could be observed.

The Relationship between Coldness of Hands and Feet and the Erythrocyte Deformability in Stroke Patients (중풍환자에서 수족냉증과 적혈구변형능의 관련성 연구)

  • Park, Joo-Young;Leem, Jung-Tae;Park, Su-Kyung;Woo, Su-Kyung;Kwak, Seung-Hyuk;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Park, Sung-Wook;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.31 no.3
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    • pp.578-585
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    • 2010
  • Objectives : Coldness of hands and feet has been regarded to be associated with blood circulation. This study was performed to assess the correlation between erythrocyte deformability and coldness of hands and feet. Methods : 145 patients who had taken an erythrocyte deformability test were selected for this study among hospitalized patients within 4 weeks after their cerebral infarction at the Internal Medical Department at Kyunghee Oriental Medical Center from August 2008 to August 2009. We divided the selected patients into two groups, with and without of coldness of hands and feet groups. The two groups were compared on risk factors for atherosclerosis and examined for variables including erythrocyte deformability. Results : 1. On demographic variables of the patients, only body mass index was significantly lower in the coldness of hands and feet group than the control group. There was no significant difference of the rate of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, smoking, drinking and carotid artery stenosis between the two groups. 2. According to blood test, the coldness of hands and feet group showed significantly lower erythrocyte deformability index than the control group. 3. Body mass index and erythrocyte deformability index showed a close relationship with coldness of hands and feet in multivariate analysis. Conclusions : The correlation between the erythrocyte deformability and coldness of hands and feet in cerebral infarction patients were decreased erythrocyte deformability participated in the mechanism of coldness of hands and feet.

Formation of an Intestine-Cartilage Composite Graft for Tracheal Reconstruction (기관 재건을 위한 장과 연골의 복합 이식판 개발)

  • Jheon, Sang-Hoon;Lee, Sub;Jung, Jin-Yong;Kong, Jun-Hyuk;Lim, Jeong-Ok;Kim, Yu-Mi;Jin, Chun-Jin;Park, Tae-In;Lee, jae-Ik;Sung, Seok-Whan;Choh, Joong-Haeng
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.474-481
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    • 2004
  • Background: Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and other oncologic conditions but bears. many critical problems compared to other organ transplantations. The purpose of this study was to develop intestine-cartilage composite grafts for potential application in tracheal reconstruction by free intestinal graft. Material and Method: Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chondrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3 kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Result: We identified implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory. Microscopic examinations included special stain s howed absorption of scaffold and cartilage formation even though it was not fully matured. Conclusion: Intestine-cartilage composite graft could be applicable in the future as tracheal substitute and should be further investigated.

Dual Grafting of Left Internal Thoracic Artery and Saphenous Vein to Left Anterior Descending Artery (좌내흉동맥편과 복재정맥편을 좌전하행지에 동시에 문합한 관상동맥 우회로술의 임상적 결과)

  • 최종범;양현웅;한재오;최순호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.709-714
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    • 1999
  • Background: When internal thoracic artery (ITA) and saphenous vein graft are anastomosed to the same coronary artery, the patency rate of the internal thoracic artery graft with relatively narrow diameter may be decreased owing to competition of pressure and flow rate. We evaluate the clinical outcome and the patency of the ITA graft in patients undergoing dual grafting to the same coronary artery. Material and Method: In 14 patients with the ITA graft having relatively low flow, the ITA and saphenous vein graft were anastomosed to the same coronary artery. During the mean follow-up period of 33.5 months, coronary angiography was performed in 6 patients who complained of recurrent angina, needed confirmation of graft flow, or showed postoperative Q wave. Result: In all 6 patients, the ITA and saphenous vein grafts were patent without stenosis or obstruction. Two patients showed good flow in both grafts, 2 showed competitive flow in the ITA graft, and the remaining 2 showed poor flow in the ITA graft. Conclusion: Early operative closure When saphenous vein grafting was added to the same coronary artery that the internal thoracic artery was anastomosed to, the perfusion to the coronary artery was satisfied and the dual grafting did not affect the short-term and mid-term patency rate of the ITA.

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Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea (좌측 주기관지 및 기관에 발생한 선양낭포성암 2례)

  • Cho, Young-Bog;Lee, Hak-Jun;Kim, Ki-Beom;Jung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Kim, Mi-Jin
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.347-359
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    • 1996
  • Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usually arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential for extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolonged course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She has been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed as bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenoid cystic carcinoma by bronchoscopic biopsy. The patient underwent radiation to relieve a bronchial stenosis caused by her tumor. The patient has remained well and is asymptomatic without evidence of clinical recurrence. The other case was 25 year old female. She complained shortness of breath and inspiratory difficulty during sleep. The tumor was located in upper trachea, which protruded from the posterior wall of the trachea and obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenocystic carcinoma by rigid bronchoscopic biopsy. The patient was underwent operation for removal of the mass and received radiotherapy. The patient has remained well are following up now.

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A survey on Patients' Compliance with Follow-up Coronary Angiogram after Coronary Intervention (관상동맥 중재술후 추적 관상동맥조영술 실천에 대한 조사연구)

  • Kim, Yoo Jung;Park, Oh Jang
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.30-39
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    • 2000
  • Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: $61{\pm}15$), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3. The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.

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Impact of postoperative duration of Aspirin use on longevity of bioprosthetic pulmonary valve in patients who underwent congenital heart disease repair

  • Hwang, Tae-Woong;Kim, Sung-Ook;Lee, Sang-Yun;Kim, Seong-Ho;Choi, Eun-Young;Jang, So-Ick;Park, Su-Jin;Kwon, Hye-Won;Lim, Hyo-Bin;Lee, Chang-Ha;Choi, Eun-Seok
    • Clinical and Experimental Pediatrics
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    • v.59 no.11
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    • pp.446-450
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    • 2016
  • Purpose: Generally, aspirin is used as a protective agent against thrombogenic phenomenon after pulmonary valve replacement (PVR) using a bioprosthetic valve. However, the appropriate duration of aspirin use is unclear. We analyzed the impact of postoperative duration of aspirin use on the longevity of bioprosthetic pulmonary valves in patients who underwent repair for congenital heart diseases. Methods: We retrospectively reviewed the clinical data of 137 patients who underwent PVR using a bioprosthetic valve between January 2000 and December 2003. Among these patients, 89 were included in our study and divided into groups I (${\leq}12$ months) and II (>12 months) according to duration of aspirin use. We analyzed echocardiographic data from 9 to 11 years after PVR. Pulmonary vale stenosis and regurgitation were classified as mild, moderate, or severe. Results: The 89 patients consisted of 53 males and 36 females. Their mean age was $14.3{\pm}8.9$ years (range, 2.6-48 years) and body weight was $37.6{\pm}14.7kg$ (range, 14-72 kg). The postoperative duration of aspirin use was $7.3{\pm}2.9$ months in group I and $32.8{\pm}28.4$ months in group II. However, no significant difference in sex ratio, age, body weight, type of bioprosthetic valve, and number of early redo-PVRs. In the comparison of echocardiographic data about 10 years later, no significant difference in pulmonary valve function was found. The overall freedom rate from redo-PVR at 10 years showed no significant difference (P=0.498). Conclusion: Our results indicated no benefit from long-term aspirin medication (>6 months) in patients who underwent PVR with a bioprosthetic valve.

Altered Functions of Adrenoceptors in Splanchnic Vascular Beds in Portal Hypertensive Rat Model: Effect of Propranolol (문맥 고혈압 흰쥐에 있어서 내장혈관의 아드레나린성 수용체의 기능변동과 이에 대한 Propranolol의 효과)

  • Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.63-70
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    • 1988
  • Alterations in splanchnic circulatory hemodynamics along with reactivities to the alpha adrenoceptor agonists were assessed in association with the preventive effects of propranolol 10 days after portal ligation. Decreases in precapillary resistance (Ra) and postcapillary resistance (Rv) along with increases in mesenteric blood flow (MBF) and capillary pressure (CP) were observed in conjunction with an increment of splenic pulp pressure (SPP). Dose-dependent increase in Rv in response to noradrenaline, increases in Ra and RV to adrenaline, and increases in superior mesenteric arterial pressure (SMAP), Ra and Rv to phenylephrine observed in sham group were significantly attenuated by portal vein stenosis. In PPL-3 group (propranolol 3 mg/kg, i.p. three times daily for 10 days), MBF was significantly decreased in association with decrease in mesenteric venous pressure (MVP) when compared with those of protal ligated (PL) group, and decreased Ra and Rv in PL group were recovered toward the values of sham group. Likewise, in PPL-1 group (propranolol 5 mg/kg, i.p. once daily for 10 days), the pressor response of Rv to adrenaline was recovered up to the level of sham group. Thus, it is suggested that decreases in Ra and Rv in association with increases in MBF and CP may have a close relevance to the increased SPP, and the changes in circulatory hemodynamics and vascular reactivities were effectively reversed by longterm propranolol treatment. Based on these results, it is concluded that these changes observed in portal hypertension are closely related with the altered functions of the adrenoceptors in the splanchnic vascular beds.

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Clinical Experiences and Usefulness of Cervical Posterior Stabilization with Polyaxial Screw-Rod System

  • Hwang, In-Chang;Kang, Dong-Ho;Han, Jong-Woo;Park, In-Sung;Lee, Chul-Hee;Park, Sun-Young
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.311-316
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    • 2007
  • Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

Paclitaxel Coating on ePTFE Artificial Graft and the Release Behavior (ePTFE 인공혈관에 대한 파클리탁셀의 코팅 및 방출거동)

  • Lim, Soon-Yong;Kim, Cheol-Joo;Kim, Eun-Jin;Kwon, Oh-Kyoung;Kwon, Oh-Hyeong
    • Polymer(Korea)
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    • v.36 no.3
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    • pp.326-331
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    • 2012
  • In this study, expanded poly(tetrafluoro ethylene) (ePTFE) graft was modified to be used as a hemodialysis vascular access. Biodegradable poly(D,L-lactide-$co$-glycolide) (PLGA) was coated onto the inner surface of ePTFE graft with paclitaxel, which is often used as an anti-cancer agent and for reducing neointimal hyperplasia. Surface characterization before and after PLGA coating was carried out by SEM and ATR-FTIR. Porous sturcture of ePTFE was maintained after coating of PLGA solution. The amounts of coated PLGA and paclitaxel determined by ATR-FTIR and HPLC were 1.96 and 0.263 mg/$cm^2$, respectively. Young's modulus was decreased and tensile strength was increased by PLGA coating. Released paclitaxel as a function of incubation time was monitored by HPLC. Approximately 35% of coated paclitaxel was released steadily for 4 weeks with the biodegradation of PLGA. From these results, it is expected that the effect of paclitaxel on reducing neointimal hyperplasia and stenosis is maintained for a long time.