• 제목/요약/키워드: Surgery, vessel

검색결과 555건 처리시간 0.025초

구강내 과다출혈로 내원한 응급환자에 관한 임상적 연구 (A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING)

  • 유재하;강상훈;김현실;김종배
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권5호
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    • pp.383-389
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    • 2002
  • This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

A Post Smoothing Algorithm for Vessel Segmentation

  • Li, Jiangtao;Lee, Hyo Jong
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2009년도 추계학술발표대회
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    • pp.345-346
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    • 2009
  • The segmentation of vessel including portal vein, hepatic vein and artery, from Computed Tomography (CT) images plays an important role in the therapeutic strategies for hepatic diseases. Representing segmented vessels in three dimensional spaces is extremely useful for doctors to plan liver surgery. In this paper, proposed method is focused on smoothing technique of segmented 3D liver vessels, which derived from 3D region growing approach. A pixel expand algorithm has been developed first to avoid vessel lose and disconnection cased by the next smoothing technique. And then a binary volume filtering technique has been implemented and applied to make the segmented binary vessel volume qualitatively smoother. This strategy uses an iterative relaxation process to extract isosurfaces from binary volumes while retaining anatomical structure and important features in the volume. Hard and irregular place in volume image has been eliminated as shown in the result part, which also demonstrated that proposed method is a suitable smoothing solution for post processing of fine vessel segmentation.

Videoscopic Surgery for Arteriovenous Hemodialysis Access

  • Jeong, Hyuncheol;Bae, Miju;Chung, Sung Woon;Lee, Chung Won;Huh, Up;Kim, Min Su
    • Journal of Chest Surgery
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    • 제53권1호
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    • pp.28-33
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    • 2020
  • Background: When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. Methods: Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. Results: Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). Conclusion: Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.

미세혈관 수술시 혈관개존율 향상을 위한 연구 (Continuous Sutures for Microarterial Anastomosis)

  • 정영식;정재호;최시호;설정현
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.237-241
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    • 1986
  • 본 교실에서 백서의 대퇴동맥을 이용하여 혈관감자의 회전없이 continuous suture로 미세혈관 문합을 시행해본 결과 다음과 같은 결론을 얻었다. end-to-end anastomosis시 double c1app의 회전이 어려울 정도로 작업공간이 제한된 경우나 end-to-side anastomosis시 secondary Vessel의 길이가 짧아서 후벽을 잘 볼 수 없는 경우에 continuous suture을 이용하면 Back wall을 완전히 노출시킨 상태에서 쉽게 혈관 문합을 시행할 수 있으며 문합시간도 단축시킬 수 있을 것으로 사료된다.

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Coronary three vessel disease: hydrodynamic simulations including the time-dependence of the microvascular resistances

  • Harmouche, Majid;Anselmi, Amedeo;Maasrani, Mahmoud;Mariano, Chiara;Corbineau, Herve;Verhoye, Jean-Philippe;Drochon, Agnes
    • Advances in biomechanics and applications
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    • 제1권4호
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    • pp.279-292
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    • 2014
  • This paper presents some simulations of fluxes and pressures in the coronary network, in the case of very severe coronary disease (several stenoses on the left branches and total occlusion of the right coronary artery). In that case, coronary artery bypass graft surgery is the commonly performed procedure. However, the success of the intervention depends on many factors. Modeling of the coronary circulation is thus important since it can help to understand the influence of all these factors on the coronary haemodynamics. We previously developed an analog electrical model that includes the eventual presence of collateral flows, and can describe the different revascularization strategies (two grafts, three grafts, ...). The aim of the present work is to introduce in our simulations the time-dependence of the coronary microvascular resistances, in order to better represent the effect of the systolic ventricular contraction (which induces an elevation of the resistances because the vessels are squeezed).

A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients

  • Kim, Ji Min;Tak, Min Sung;Kang, Jin Seok;Moon, Chul
    • Archives of Plastic Surgery
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    • 제48권3호
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    • pp.287-292
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    • 2021
  • Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis. Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications. Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure. Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.

고전적 및 삼각조각 기법을 이용한 단-측면 미세동맥 접합술의 실험적 연구 (The Experimental Study of the End-to-side Microarterial Anastomosis with the Longitudinal Slit and the Triangular Flap)

  • 이준모;이강욱;이동근
    • Archives of Reconstructive Microsurgery
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    • 제1권1호
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    • pp.51-55
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    • 1992
  • Problems of composite tissue transfer commonly arise when a single indispensable recipient vessel receives the graft vssel, and the graft vessel must be sutured in end-to-side fashion so as not todisturb the vascularity of the recipient vessel. The triangular flap in the recipient vessel wall gives an intact endothelial surface when the flow of blood stream is presented and may reduce the chance of anastomosis. We selected mature Wistar rats weighing over 450 grams to compare the conventional longitudinal slit from the triangular flap in the recipient carotid artery over bloood pressure and blood flow when the donor carotid artery was anastomosed in end-to-side fashion. In 30 minutes after anastomosis, maximum blood pressure measured in the donor carotid arterial side when the recipient arterial wall was fasioned with the longitudinal slit was recorded 114 mmHg and with the triangular flap 100mmHg. Minimum blood pressure with the longitudinal slit was 98mmHg and with the triangular flap 88mmHg. The amount of blood collected for 30 seconds in the conventional longitudinal slit was 1.18mg and in the triangular flap 0.78mg. Histology study in 30 minutes, the conventional longitudinal slit demonstrated the more hemorrhagic features around the suture material compared to that of the triangular. flap and, in the 7th day, the conventional longitudinal slit demonstrated the more prominent granulomatous reactions and vascular proliferations around the suture material compared to that of the triangular flap.

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구강편평세포암종의 미세혈관 밀도와 악성도간 상관관계에 관한 임상병리학적 연구 (THE CLINICOPATHOLOGICAL STUDY ON THE RELATION OF MICROVESSEL DENSITY AND AGGRESSIVENESS IN ORAL SQUAMOUS CELL CARCINOMA)

  • 이기철;명훈;임성삼;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권2호
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    • pp.155-160
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    • 2002
  • Oral squamous cell carcinoma (OSCC), the most common head and neck cancer, shows poor prognosis as a result of frequent local invasion and lymph node metastasis that is mediated by multiple proteolytic enzymes and angiogenesis. In recent reports, angiogenesis is known to play an important role in tumor invasion and metastasis. The purpose of this study was to determine the role of angiogenesis in OSCCs, particularly with respect to the invasive and the metastatic potential. The microvessel density (CD31) in 34 human OSCC cases were investigated by immunohistochemistry, and reviewed with respect to the invasiveness and the presence of lymph node metastasis and following results were obtained. The blood vessel density $(28.8{\pm}7.9)$ in the strong invasive cases were significantly higher than those $(23.3{\pm}6.9)$ in the weak invasive cases. (p<0.05) In the 14 cases with lymph node metastasis, the average blood vessel density was $28.5{\pm}9.6$. On the other hand, in the 20 cases without lymph node metastasis, the blood vessel density was $25.2{\pm}6.4$. The blood vessel density was not statistically related to lymph node metastasis. (p>0.05) These results suggest that angiogenesis may be related to the local invasion of OSCC and further research will be needed to investigate the possibility that antiangiogenic agent can be used as an anticancer agent for OSCC.

악변형환자의 악교정수술시 합병증에 관한 연구 (CLINICAL STUDY OF COMPLICATIONS OF ORTHOGNATHIC SURGERY FOR THE DENTOFACIAL DEFORMITIES)

  • 김여갑;이상철;이백수;김병주
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권3호
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    • pp.247-258
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    • 1994
  • We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

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An Unusual Form of Coronary Artery Fistula: A Small Aneurysm of Vieussens' Arterial Ring Communicating with the Pulmonary Artery

  • Lee, Hae Young;Cho, Seong Ho
    • Journal of Chest Surgery
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    • 제47권2호
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    • pp.152-154
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    • 2014
  • Vieussens' arterial ring (VAR) is the connection between the conus branch of the right coronary artery and the proximal right ventricular branch of the left anterior descending coronary artery. VARs are found in 48% of the population; however, pathologic VAR is rare. We experienced a case of pathologic VAR that involved a fistula connecting to the main pulmonary artery.