• Title/Summary/Keyword: Vascular surgery

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Correlation Between Knowledge and Educational Needs Related to Recurrent in Coronary Artery bypass graft patients (관상동맥 우회술환자의 수술 후 재발 관련 지식과 교육요구도와의 상관관계)

  • 김희승;박민정
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.549-559
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    • 2000
  • The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

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Comparative Study of Wound Healing in Porcine Uterus with $CO_2$ Laser and Scalpel Incisions ($CO_2$ Laser와 Scalpel을 이용한 절개 시 돼지 자궁에서의 창상 치유 평가)

  • Lee, Jae-Yeon;Park, Chang-Sik;Cho, Sung-Whan;Jeong, Seong-Mok;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.563-567
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    • 2009
  • This study compared the instrument performance and tissue healing of a steel scalpel with a $CO_2$ laser in an animal uterine surgery model. Five Landrace and Yorkshire mixed breed pigs were used. Two symmetrical incisions were made in the uterine of each pig. One incision was made on the left side of the uterine horn using a steel scalpel, while the other incision was performed on the right side using a $CO_2$ laser with an 8W output power. Each instrument was evaluated clinically for speed, ease of incision, and extent of bleeding. An ovariohysterectomy was performed at 21 days after the surgical procedure for a histological examination. The scalpel was an easier instrument to use in the confines of the uterine tissue, compared with the laser. However, there is no significant difference between the two groups. The amount of bleeding was less in the laser group but the time of the incisions was shorter with the scalpel. Postoperative uterus adhesion in the $CO_2$ laser incisions was lower than the scalpel incisions. Scalpel incisions showed complete restoration of the epithelium and endometrial gland. On the other hand, the laser incisions showed incomplete restoration of the epithelium and endometrial gland. Although the scalpel produced less damage to the uterine tissue and was easier to handle than the $CO_2$ laser, it did not provide hemostasis that was helpful for use on highly vascular tissue. The $CO_2$ laser provided good hemostasis but delayed wound healing.

Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease (어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가)

  • Lee, D.S.;Hyun, I.Y.;Wang, K.C.;Cho, B.K.;Chung, J.K.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.314-324
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    • 1998
  • Purpose: This study was performed to evaluate the outcome of encephalo-duro-arterio-synangiosis (EDAS) surgery with rest/acetazolamide Tc-99m HMPAO SPECT in moyamoya disease. Materials and Methods: Rost/acetazolamide subtraction SPECT with consecutive acquisition were done before and 2 months after 21 EDAS surgeries in 18 patients. Perfusion decrease was graded visually for 14 areas of each hemisphere as 0 (normal) to 3 (defect) using 4 point scoring system. Postoperative rest perfusion or perfusion reserve was compared with preoperative ones. Results: Among 294 areas of 21 hemispheres, rest perfusion abnormality was found in 91 areas of 15 hemispheres. Decrease of perfusion reserve was found in 146 areas of 18 hemispheres. Six hemispheres having normal rest perfusion and 12 of 15 hemispheres having rest perfusion abnormality showed reserve decrease. Three having rest perfusion defect did not change after acetazolamide in preoperative SPECT. After operation, 16 patients (89%) demonstrated clinical improvement. Fifteen among 18 hemispheres (83%) with decreased reserve improved. Rest perfusion abnormality improved in 6 among the 15 hemispheres (40%). The areas having rest perfusion and/or reserve decrease improved in 87 among 146 areas (60%). Decrease of reserve, improved in 85% (68/80). However, areas without reserve decrease also improved in 29% (19/66). The better was preoperative rest perfusion in involved areas or the more decreased vascular reserve, the more improved perfusion and reserve after operation. Conclusion: We conclude that assessment of perfusion and Perfusion reserve using rest/acetazolamide brain perfusion SPECT predict the surgical outcome in patients with moyamoya disease.

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Effects of Lemakalim, a Potassium Channel Opener, on the Contractility and Electrical Activity of the Antral Circular Muscle in Guinea-Pig Stomach

  • Kim, Sung-Joon;Jun, Jae-Yeoul;Choi, Youn-Baik;Kim, Ki-Whan;Kim, Woo-Gyeum
    • The Korean Journal of Physiology
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    • v.28 no.1
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    • pp.37-50
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    • 1994
  • Synthetic potassium channel openers (KCOs) are agents capable of opening K-channels in excitable cells. These agents are known to have their maximal potency in the smooth muscle tissue, especially in the vascular smooth muscle. Much attention has been focused on the type of K-channel that is responsible for mediating the effects of KCOs. As the KCO-induced changes are antagonized by glibenclamide, an $K_{ATP}$ (ATP-sensitive K-channel) blocker in the pancreatic ${\beta}-cell,\;K_{ATP}$ was suggested to be the channel responsible. However, there also are many results in favor of other types of K-channel $$(maxi-K,\;small\;conductance\;K_{Ca,}\; SK_{ATP}) mediating the effects of KCOs. Effects of lemakalim, (-)enantiomer of cromakalim (BRL 34915), on the spontaneous contractions and slow waves, were investigated in the antral circular muscle of the guinea-pig stomach. Membrane currents and the effects on membrane currents and single channel activities were also measured in single smooth muscle cells and excised membrane patches by using the patch clamp method. Lemakalim induced hyperpolarization and inhibited spontaneous contractions in a dose-dependent manner. These effects were blocked by glibenclamide and low concentrations of tetraethyl ammonium (< mM). Glibenclamide blocked the effect of lemakalim on the membrane potential and slow waves. The mechanoinhibitory effect of lemakalim was blocked by pretreatment with glibenclamide. In a whole ceIl patch clamp condition, lemakalim largely increased outward K currents. These outward K currents were blocked by TEA, glibenclamide and a high concentration of intracelIular EGTA (10 mM). Volatage-gated Ca currents were not affected by lemakalim. In inside-out patch clamp experiments, lemakalim increased the opening frequency of the large conductance $Ca^{2+}-activated$ K channels $(BK_{Ca},\;Maxi-K).$ From these results, it is suggested that lemakalim induces hyperpolarization by opening K-channels which are sensitive to internal Ca and such a hyperpolarization leads to the inhibition of the spontaneous contraction.

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Recognition of Complication of Superficial Brachial Axial Pattern Flap in a Dog (표층상완축상피판이식술과 전층망상식피술의 적용 예)

  • Kim, Se-Hoon;Heo, Su-Young;Cho, Young-Kwon;Lee, Hae-Beom;Lee, Ki-Chang;Kim, Min-Su;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.637-640
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    • 2009
  • A 13-year-old female 30 kg Korean Jin-do dog was presented with severe defects due to vasculitis and perivascular dermatitis at the left antebrachium area. A left superficial brachial axial pattern flap was elevated to cover the defect and the wound was covered. However, one week post surgery, the flap was survived about 1/3 of total flap length. Remaining two thirds defects were performed by the free skin mesh graft as an additional method. After ten days, the entire wound was achieved completely. Skin flaps carry own blood supply in other hands, the flap method is dependent upon continuation of adequate circulation until vascularization takes place. Because they are much thicker than other grafts, this is a slower process and the flap method is vulnerable to problems with kinking or tension of the base. According to this case, a practician has to consider length of flap and thickness in order to vascular perfusion when superficial brachial axial pattern flap is performed in a dog.

Adenoviral-Mediated Ref-1 Overexpression Potentiates NO Production in Bradykinin-Stimulated Endothelial Cells (Bradykinin으로 자극한 혈관내피세포에서 Ref-1의 세포내 과발현에 의한 NO 생성 증진 효과에 대한 연구)

  • Song, Ju-Dong;Kim, Kang-Mi;Lee, Sang-Kwon;Kim, Jong-Min;Park, Young-Chul
    • Journal of Life Science
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    • v.17 no.7 s.87
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    • pp.905-909
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    • 2007
  • The dual-function protein redox factor-1 (Ref-1) is essential for base excision repair of oxidatively damaged DNA and also governs the activation of many redox-sensitive transcription factors. We examined the role of Ref-1 in regulation of nitric oxide (NO) synthesis employing adenoviral-mediatedoverexpression of Ref-1 in bradykinin-stimulated endothelial cells. Intracellular NO was detected with the NO-sensitive fluorophore DAF-2. Overexpression of Ref-1 potentiates bradykinin-stimulated NO production in endothelial cells. And, cells ifected with AdRef-1 showed higher fluorescence intensity compared with uninfected or AdD1312-infected cells. In parallel with this, over expression of Ref-1 also stimulated endothelial NO synthase (eNOS) enzyme activity, compared with unifected or AdD1312-infected cells, in bradykinin-stimulated cells as well as in unstimulated cells. These results suggest that Ref-1 implicates in endothelium-dependent vasorelaxation resulting from NO production in vascular system.

The bifunctional effect of propofol on thromboxane agonist (U46619)-induced vasoconstriction in isolated human pulmonary artery

  • Hao, Ning;Wang, Zhaojun;Kuang, Sujuan;Zhang, Guangyan;Deng, Chunyu;Ma, Jue;Cui, Jianxiu
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.6
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    • pp.591-598
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    • 2017
  • Propofol is known to cause vasorelaxation of several systemic vascular beds. However, its effect on the pulmonary vasculature remains controversial. In the present study, we investigated the effects of propofol on human pulmonary arteries obtained from patients who had undergone surgery. Arterial rings were mounted in a Multi-Myograph system for measurement of isometric forces. U46619 was used to induce sustained contraction of the intrapulmonary arteries, and propofol was then applied (in increments from $10-300{\mu}m$). Arteries denuded of endothelium, preincubated or not with indomethacin, were used to investigate the effects of propofol on isolated arteries. Propofol exhibited a bifunctional effect on isolated human pulmonary arteries contracted by U46619, evoking constriction at low concentrations ($10-100{\mu}m$) followed by secondary relaxation (at $100-300{\mu}m$). The extent of constriction induced by propofol was higher in an endothelium-denuded group than in an endothelium-intact group. Preincubation with indomethacin abolished constriction and potentiated relaxation. The maximal relaxation was greater in the endothelium-intact than the endothelium-denuded group. Propofol also suppressed $CaCl_2$-induced constriction in the 60 mM $K^+$-containing $Ca^{2+}$-free solution in a dose-dependent manner. Fluorescent imaging of $Ca^{2+}$ using fluo-4 showed that a 10 min incubation with propofol ($10-300{\mu}m$) inhibited the $Ca^{2+}$ influx into human pulmonary arterial smooth muscle cells induced by a 60 mM $K^+$-containing $Ca^{2+}$-free solution. In conclusion, propofol-induced arterial constriction appears to involve prostaglandin production by cyclooxygenase in pulmonary artery smooth muscle cells and the relaxation depends in part on endothelial function, principally on the inhibition of calcium influx through L-type voltage-operated calcium channels.

A Case of Bronchiectasis with High Serum CA19-9 (혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자 1예)

  • Huh, Jung Hun;Lee, Su Mi;Koo, Tae Hyoung;Shin, Bong Chul;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Rho, Mee Sook;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.383-386
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    • 2008
  • An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients' clinical condition.

A Case of Pulmonary Intravascular Lymphomatosis (폐를 침범한 혈관내 림프종증 1예)

  • Park, Sang-Jong;Bae, Sang-Su;Cheon, Eun-Mi;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Kim, Jin-Guk;Lee, Kyung-Soo;Ko, Young-Hye
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1390-1395
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    • 1997
  • Intravascular lymphomatosis(IVL) which was first described by pfleger and Tappeiner in 1959 is rare malignancy characterized by neoplastic proliferation of lymphoid cell lineage within the vascular lumen with little or no adjacent parenchymal involvement Its usual sites of involvement are central nervous system and skin or infrequently heart, lungs, pancreas, liver, spleen, kidney, adrenal glands, genitourinary tract, and bone marrow. Pulmonary involvement of IVL is not common. Symptoms of pulmonary involvement include dyspnea, cough and fever. Radiologicially, the disease is manifested with diffuse interstitial infiltrates. We report a recently experienced case of pulmonary intravascular lymphomatosis which was manifested with fever and chest pain.

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A Case of Primary Pulmonary Lymphoma of Bronchus-Associated Lymphoid Tissue associated with Systemic Lupus Erythematosus (전신성 홍반성 낭창에 동반된 기관지-관련 림프양 조직의 원발성 폐 림프종 1례)

  • Kim, Seong-Kyu;Kim, Yeon-Jae;Do, Yun-Kyung;Yu, Kuong-Sul;Lee, Byung-Ki;Kim, Won-Ho;Kim, Ik-Su;Huh, Dong-Myung
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.76-85
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    • 2002
  • A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy consolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of a low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant literatures.