• 대한방사선기술학회지:방사선기술과학
• /
• 제24권2호
• /
• pp.13-17
• /
• 2001

When most patients are diagnosed with the quiet progressed hepatoma which often would make the operation impossible, the Interventional Radiology hepatic artery embolization is an extremely useful method for such patients. An existence of the malfunction is evaluated by gaining a portal vein image as a delayed phase image after injecting a contrast media into the superior mesenteric artery. However, it is difficult to make a definite judgement due to the extended exposure time with the peristalsis and the intestine gas obstructing the sharpness of the image when the Patient exposure time increases and due to the increased usage of contrast media and its side effect. The portal vein can be evaluated by obtaining the MIP image after reconstructing a 3-dimensional personal computer setting using the 2-dimensional from an enhancement abdomen CT image that is almost a requisite in operation to a hepatoma patient. Such method nay prevent a decrease in the quality of image based upon the time delay and intestine gas; also, because the patient exposure dose and contrast media usage may be reduced, it is a new, valuable way to decide the operational matter of hepatic artery embolization on a pre-angiography.

• Childhood Kidney Diseases
• /
• 제14권2호
• /
• pp.240-245
• /
• 2010

호두까기 증후군은 대동맥과 상장간막 동맥 사이에 좌신 정맥이 압박되어 혈뇨나 단백뇨가 보이는 임상 증후군으로 그 유전성에 대해서는 알려져 있는 바가 없다. 저자들은 무증상 혈뇨를 주소로 내원한 형제에게 모두 도플러 초음파로 진단된 호두까기 증후군을 접하였기에 간단한 문헌 고찰과 함께 보고하는 바이다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제2권4호
• /
• pp.511-519
• /
• 1998

This study investigated the role of nitric oxide on the oxidative damage in gastric mucosa of rats which received ischemia/reperfusion and its relation to mucus. Nitric oxide synthesis modulators such as L-arginine and $N^G-nitro-L-arginine$ methyl ester, and sodium nitroprusside, a nitric oxide donor, were injected intraperitoneally to the rats 30 min prior to ischemia/reperfusion which was induced by clamping the celiac artery and the superior mesenteric artery for 30 min and reperfusion for 1 h. Lipid peroxide production, the contents of glutathione and mucus, and glutathione peroxidase activities of gastric mucosa were determined. Histological observation of gastric mucosa was performed by using hematoxylin-eosin staining and scanning electron microscopy. The result showed that ischemia/reperfusion increased lipid peroxide production and decreased the contents of glutathione and mucus as well as glutathione peroxidase activities of gastric mucosa. Ischemia/reperfusion induced gastric erosion and gross epithelial disruption of gastric mucosa. Pretreatment of L-arginine, a substrate for nitric oxide synthase, and sodium nitroprusside prevented ischemia/reperfusion-induced alterations of gastric mucosa. However, $N^G-nitro-$ L- arginine methyl ester, a nitric oxide synthase inhibitor, deteriorated oxidative damage induced by ischemia/reperfusion. In conclusion, nitric oxide has an antioxidant defensive role on gastric mucosa by maintaining mucus, glutathione, and glutathione peroxidase of gastric mucosa.

• Advances in pediatric surgery
• /
• 제12권2호
• /
• pp.257-261
• /
• 2006

Appendicitis is a common disease in children. But left lower abdominal pain in acute appendicitis is a rare clinical feature. A 6 year-old-girl complained of left sided abdominal pain for 2 days. Past medical history was not contributory. Abdominal tenderness and guarding in left lower quadrant were noticed. Abdominal sonography and abdominal computed tomography scan demonstrated reversed position between superior mesenteric artery and vein, and a mass in the left lower quadrant abdomen suggesting appendicitis. Acute appendicitis in left lower quadrant, associated with intestinal malrotation, was found at laparatomy.

• Childhood Kidney Diseases
• /
• 제27권2호
• /
• pp.133-138
• /
• 2023

Nutcracker syndrome (NCS) is a disease caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Immunoglobulin A (IgA) nephropathy (IgAN) is characterized by the predominance of IgA deposits in the glomerular mesangial area. Hematuria and proteinuria can be present in both diseases, and some patients can be concurrently diagnosed with NCS and IgAN; however, a causal relationship between the two diseases has not yet been clarified. Here, we report two pediatric cases of NCS combined with IgAN. The first patient presenting with microscopic hematuria and proteinuria was diagnosed with NCS at the initial visit, and the second patient was later diagnosed with NCS when proteinuria worsened. Both patients were diagnosed with IgAN based on kidney biopsy findings and treated with angiotensin-converting enzyme inhibitors and immunosuppressants. A high index of suspicion and timely imaging or biopsy are essential for the proper management of NCS combined with glomerulopathy.

• 대한소화기학회지
• /
• 제72권6호
• /
• pp.308-312
• /
• 2018

Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure.

• Journal of Digestive Cancer Research
• /
• 제5권1호
• /
• pp.23-27
• /
• 2017

Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

• 한국산학기술학회논문지
• /
• 제20권3호
• /
• pp.188-193
• /
• 2019

경동맥 화학색전술은 널리 이용되며 빠르게 발전하고 있는 간세포암의 비수술적 치료법이다. 만족할만한 치료결과를 얻기 위해서는 환자의 해부학적 특성을 이해하고 종양 공급 동맥을 찾아내서 올바른 치료 계획을 세워야 한다. 본 연구에서는 간세포암의 경동맥 화학색전술 중에 방해요인으로 작용한 후천성 동정맥 기형의 증례를 보고하고자 한다. 72세 남자가 2일전부터 지속된 복통으로 내원하였다. 만성 B형 간염환자로 10년 전 간세포암에 대한 고식적 경동맥 화학색전술을 시행 받고 완치된 과거력이 있었다. 전산화 단층 촬영상 간우엽의 8분절에 결절성 간세포암이 발견되었으며 우간동맥은 상장간막동맥에서 기시하는 기형을 가지고 있었으며 종양 주변에 과혈관성 종양 구조가 관찰되었다. 1차 경동맥 화학색전술을 실시하였을 때 좌간동맥에서 기시하는 종양 공급동맥을 찾아 이를 약물방출미세구와 Adriamycin 50mg을 이용하여 화학색전하였다. 우간동맥조영술을 시행하였을 때 동정맥 기형이 관찰되었으며 간세포암은 관찰되지 않았다. 1개월 후 시행한 전산화 단층 촬영상 괴사된 종양과 남은 병변이 관찰되어 2차 경동맥 화학색전술을 시행하였다. 우간동맥을 통하여 미세유도철사와 카테터를 이용하여 동정맥 기형을 지나쳐 초선택하였고 시행한 조영술에서 남은 간세포암의 병변이 조영됨을 확인할 수 있었다. 이를 약물방출미세구와 Adriamycin을 이용하여 화학색전하였다. 시술 후 혈관 조영술에서 간세포암이 조영되지 않는 것을 확인하였고, 그 후 환자는 특별한 합병증 없이 퇴원하였다. 저자들은 매우 드물게 발생하는 간세포암 주변의 후천성 동정맥 기형을 발견하였고, 방해요인으로 작용한 동정맥 기형을 넘어 초선택적 경동맥화학색전술을 시행하여 간세포암을 치료하였다.

• Childhood Kidney Diseases
• /
• 제5권1호
• /
• pp.64-68
• /
• 2001

Nutcracker증후군은 좌측 신정맥이 대동맥과 상장간막 동맥에 압박되어 발생하는 드문 질환으로 혈뇨, 단백뇨, 기립성 단백뇨의 원인이 된다. 초음파와 도플러 검사로 진단이 가능하다. 저자들은 기립성 단백뇨와 특발성 만성피로를 보인 보기드문 심한 Nutcracker 증후군 환아를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제19권1호
• /
• pp.35-42
• /
• 2015

In cardiovascular disorders, understanding of endothelial cell (EC) function is essential to elucidate the disease mechanism. Although the mouse model has many advantages for in vivo and in vitro research, efficient procedures for the isolation and propagation of primary mouse EC have been problematic. We describe a high yield process for isolation and in vitro culture of primary EC from mouse arteries (aorta, braches of superior mesenteric artery, and cerebral arteries from the circle of Willis). Mouse arteries were carefully dissected without damage under a light microscope, and small pieces of the vessels were transferred on/in a Matrigel matrix enriched with endothelial growth supplement. Primary cells that proliferated in Matrigel were propagated in advanced DMEM with fetal calf serum or platelet-derived serum, EC growth supplement, and heparin. To improve the purity of the cell culture, we applied shearing stress and anti-fibroblast antibody. EC were characterized by a monolayer cobble stone appearance, positive staining with acetylated low density lipoprotein labeled with 1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanine perchlorate, RT-PCR using primers for von-Willebrand factor, and determination of the protein level endothelial nitric oxide synthase. Our simple, efficient method would facilitate in vitro functional investigations of EC from mouse vessels.