• Title/Summary/Keyword: Vascular Condition

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Management of Proximal Iliac Artery Injury during Lumbar Discectomy with Stent Graft

  • Jin, Sung-Cheol;Park, Sang-Woo;Cho, Do-Sang
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.227-229
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    • 2012
  • Iatrogenic vascular injuries during lumbar disc surgery may occur rarely but they are serious complications, which can be fatal without appropriate management Prompt diagnosis and management of these complications are imperative to prevent a desperate outcome. A 72-year-Old female with proximal left common iliac artery iatrogenic injury during lumbar discectomy was successfully treated by percutaneous deployment of a stent graft in an emergency setting. Postprocedural angiogram demonstrated complete exclusion of the iliac artery laceration. The patient became hemodynamically stable. Two weeks later she complained of vascular claudication. Follow-up angiography revealed decreased arterial flow in the opposite common iliac artery. An additional kissing stent was inserted into the right common iliac artery and the symptoms of vascular claudication disappeared. Endovascular stenting offers a safe and effective method for the treatment of an iatrogenic arterial laceration, particularly in a critical condition. But, the contralateral iliac arterial flow should be kept intact in case of proximal iliac artery injury. Otherwise, additional treatments may be needed.

Interactive image segmentation for ultrasound vascular imaging (초음파 혈관 영상의 상호적 영상 분할)

  • Lee, Onseok;Kim, Mingi;Ha, Seunghan
    • Journal of the Korea Convergence Society
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    • v.3 no.4
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    • pp.15-21
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    • 2012
  • Image segmentation for object to extract data from ultrasound acquired is an essential preprocessing step for the effective diagnosis. Various image segmentation methods have been studied. In this study, interactive image segmentation method by graph cut algorithm is proposed to develop a variety of applications of vascular ultrasound imaging and diagnostics. General imaging and vascular ultrasound imaging segmentation by entering constrain condition such as foreground and background. In the future it will be able to develop new ultrasound diagnostics.

Experiencing cardiac arrest during surgical exploration in hemodynamically stable patients with multiple stab wounds, including lower extremity in Korea: a case report

  • Jung Rae Cho;Dae Sung Ma
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.166-169
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    • 2024
  • Stab wounds, particularly those affecting multiple body regions, present considerable challenges in trauma care. This report describes a case of sustained self-inflicted stab injuries to the abdomen and thighs of a 23-year-old male patient. Although the patient's vital signs were stable and bleeding was minimal from thigh wounds without overt signs of vascular injury, the patient experienced a sudden, profound hemorrhage from the right thigh, leading to cardiac arrest. Successful resuscitation was followed by surgical repair of a right superficial femoral arterial injury accompanying a resuscitative endovascular balloon of the aorta. Subsequent lower extremity computed tomography angiography revealed no additional vascular abnormalities. The patient was discharged in stable condition on the 12th postoperative day. This case underscores the unpredictability of stab wound trajectories and the potential for hidden vascular injuries, even in the absence of immediate life-threatening signs. It also emphasizes the critical role of advanced imaging modalities, such as computed tomography angiography, in identifying concealed injuries, and the importance of strategic intraoperative techniques, including resuscitative endovascular balloon occlusion of the aorta, in achieving favorable patient outcomes.

Clinical assessment and management of auricular arteriovenous malformation: retrospective study

  • Kim, Do Gon;Cho, Hyun Geun;Ryu, Jeong Yeop;Lee, Joon Seok;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.141-147
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    • 2021
  • Background: Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. Methods: Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. Results: Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. Conclusion: Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.

Musculocutaneus Island Flap Based on the Distal Vascular Pedicle of Gracilis Muscle (박근의 원위혈관경을 이용한 도서형 근피판술)

  • Chung, Duke-Whan;Lee, Yong-Wook;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.96-102
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    • 1997
  • The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

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A Comparative Study on Vascular Conditions and Stress on Leisure Activity in the Elderly (노인의 여가활동에 대한 혈관상태와 스트레스 비교연구)

  • Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.53-61
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    • 2020
  • Objective : The purpose of this study was to find out the stress of vascular conditions and leisure activities for the elderly and the effect of stress problems on the vascular conditions of the elderly. Methods : The study surveyed 172 elderly people, conducted a validity and reliability analysis to organize items of leisure activities, analyzed vascular conditions and stress for leisure activities, and conducted a regression analysis to analyze stress factors affecting the blood vessel conditions of the elderly. Results : First, there was a significant difference in comparing the average value of vascular conditions for leisure activities in the elderly (p=.012) and sports activity was the most stable in vascular conditions. Second, there was a significant difference in comparing the average value of stress for leisure activities of the elderly (p=.035) and rest and other activities were higher than other activities. Third, the effect of stress problems in older people on vascular conditions has been shown to be influenced by financial difficulties and health problems. Conclusion : Leisure activities in older people can act as a factor in changing the quality of life. Older adults can expect improvement of vascular conditions and reduction of stress through leisure activities, especially sports activities have a high relationship of vascular conditions, and rest and other activities have a high relationship with stress. As a result, this study confirmed the importance of selecting and continuing participation in leisure activities for the elderly.

Hypoxia Induced Expression of Vascular Endothelial Growth Factor in Rat Pulmonary Artery Smooth Muscle Cells (쥐의 폐동맥 평활근 세포에서 저산소에 의한 Vascular Endothelial Growth Factor의 발현)

  • Nho, Un Seok;Kim, Yeo Hyang;Hyun, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.167-172
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    • 2003
  • Purpose : Pulmonary vascular hypertension is a common problem in congenital heart disease, the most common cardiac condition in childhood. However, the mechanisms responsible for this pathologic change, treatment, and prevention are poorly understood. Therefore, we studied the gene expression of vascular endothelial growth factor(VEGF) by using a hypoxic model of the pulmonary artery smooth muscle cells. Methods : The main pulmonary artery and its proximal branches of a 6 wk old Fischer rat were excised. They were cut into multiple small pieces and suspended in DMEM medium supplemented with 20% fetal bovine serum and incubated in 5% $CO_2$-95% air atmosphere. The smooth muscle cells were confirmed by immunostaining with smooth muscle myosin and ${\alpha}$-smooth muscle actin antibodies. The VEGF gene expression in the hypoxic group was compared with the one in control the group as well as the one in the starved group by RT-PCR and Northern blot hybridization. Results : There was no statistically significant difference among the control, hypoxic and starved groups. Conclusion : There are few studies of pulmonary vascular hypertension at the molecular level in Korea. Therefore, we studied the expression of VEGF gene in hypoxic pulmonary vascular smooth muscle cells. Further studies will be needed to find the difference between newly born and adult rats, or human and rat pulmonary vascular smooth muscle cells in gene expression. We hope that the study will lead to a better understanding of pulmonary vascular hypertension.

Estimation of the Variation of Quantity in PWV in Accordance with the Changes of Position in Human (자세변화에 따른 PWV 변화량의 평가)

  • Jun, Suk-Hwan;Jeong, In-Cheol;Jung, Sang-O;Yoon, Hyung-Ro
    • Journal of Biomedical Engineering Research
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    • v.30 no.2
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    • pp.129-134
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    • 2009
  • The ideal method which measures a blood vessel of senility and degree of arteriosclerosis is to measure compliance of arterial and condition of blood circulation at the periphery. In these days vascular stiffness have been assessed by analyzing PTT (pulse transit time) from ECG and PPG. PTT is that between toe and finger each subject estimated through ECG and PPG signals. Two parameters, which are related to PWV, were tested with the time delay between the finger and toe. PWV is a variation of quantity which is associated with vascular stiffness. These researches which use PTT and PWV don't consider the blood vessel characteristic of an individual. In this current research, we have used with the blood vessel characteristic of an individual. That is an assessment of vascular stiffness using the variation of quantity in PWV with the changes of position in the subject. PWV variation increased as functions of the subject's age. The increase of the PWV variation parameters with age is attributed to the direct decrease of the blood vessel compliance with different position. The quantity of variation estimated by experimental results is that old age's (75.78${\pm}$7.75) case is 113.68% and young age's (26.47${\pm}$2.04) case is 85.69%. We proved and presented about estimation of vascular stiffness of possibility by this result.

Anti-apoptotic effects of autophagy via ROS regulation in microtubule-targeted and PDGF-stimulated vascular smooth muscle cells

  • Park, Hyun-Soo;Han, Joo-Hui;Jung, Sang-Hyuk;Lee, Do-Hyung;Heo, Kyung-Sun;Myung, Chang-Seon
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.3
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    • pp.349-360
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    • 2018
  • Autophagy has been studied as a therapeutic strategy for cardiovascular diseases. However, insufficient studies have been reported concerning the influence of vascular smooth muscle cells (VSMCs) through autophagy regulation. The aim of the present study was to determine the effects of VSMCs on the regulation of autophagy under in vitro conditions similar to vascular status of the equipped micro-tubule target agent-eluting stent and increased release of platelet-derived growth factor-BB (PDGF-BB). Cell viability and proliferation were measured using MTT and cell counting assays. Immunofluorescence using an $anti-{\alpha}-tubulin$ antibody was performed to determine microtubule dynamic formation. Cell apoptosis was measured by cleavage of caspase-3 using western blot analysis, and by nuclear fragmentation using a fluorescence assay. Autophagy activity was assessed by microtubule-associated protein light chain 3-II (LC-II) using western blot analysis. Levels of intracellular reactive oxygen species (ROS) were measured using $H_2DCFDA$. The proliferation and viability of VSMCs were inhibited by microtubule regulation. Additionally, microtubule-regulated and PDGF-BB-stimulated VSMCs increased the cleavage of caspase-3 more than only the microtubule-regulated condition, similar to that of LC3-II, implying autophagy. Inhibitory autophagy of microtubule-regulated and PDGF-BB-stimulated VSMCs resulted in low viability. However, enhancement of autophagy maintained survival through the reduction of ROS. These results suggest that the apoptosis of conditioned VSMCs is decreased by the blocking generation of ROS via the promotion of autophagy, and proliferation is also inhibited. Thus, promoting autophagy as a therapeutic target for vascular restenosis and atherosclerosis may be a good strategy.

A rare case report of Mirizzi syndrome type III treatment algorithm in situs inversus totalis, large ventricular septal defect and transposition of great arteries in a young diabetic patient

  • Raju Badipati;Samali Maity;Muralidharsai Maddasani;Syed Mazhar Galib Ali;Farha Naaz Khatoon;Lakshmi Durga Kasinikota;Kushal Gunturu;Gopu Prameela
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.322-327
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    • 2023
  • Situs inversus totalis (SIT) is a rare condition in which cardiac and abdominal organs are inverted from their normal left-sided orientation. Mirizzi syndrome, characterized by the obstruction of the common hepatic duct or the common bile duct by gallstone, is a rare condition. Mirizzi syndrome co-occurrence in SIT patients is rare. Gallbladder in sinistroposition is extremely uncommon in SIT patients. We report a known case of diabetes, ventricular septal defect with transposition of the great arteries in a 32-year-old female who presented with jaundice, cholangitis, chills, and fever that had lasted for 10 days. She was confirmed to have SIT with type III Mirizzi syndrome following a series of diagnostic procedures. Primarily, endoscopic retrograde cholangiopancreatography along with common bile duct stenting was performed to initially reduce cholangitis. After an eight-week follow-up after the reduction of cholangitis, surgery was conducted. Mirror-imaged ports were used for the laparoscopic procedure, and the surgeon was on the patient's right side rather than the usual left side. The patient was discharged from the hospital following two days of uneventful healing.