• 제목/요약/키워드: Vasculature

검색결과 158건 처리시간 0.023초

Technical Considerations to Prevent Postoperative Endocrine Dysfunction after the Fenestration of Suprasellar Arachnoid Cyst

  • Choi, Ki-Young;Jung, Shin;Kang, Sam-Suk;Kim, In-Young;Jung, Tae-Young;Jang, Woo-Yeol
    • Journal of Korean Neurosurgical Society
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    • 제49권5호
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    • pp.262-266
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    • 2011
  • Objective : The endocrine dysfunction after the operation for suprasellar arachnoid cysts is not rare. The careful operation to prevent structures can prevent this complication, but it is not enough and effective to prevent it. Authors present technical surgical considerations to prevent this complication with a review of our suprasellar arachnoid cyst patients who had postoperative endocrine dysfunction. Methods : From January 2002 to December 2009, eight patients who had suprasellar arachnoid cysts with visual impairment underwent surgery. The mean age was 57.1 years (range, 33-77). Preoperatively, their endocrine function was clinically normal, and laboratory hormonal levels were within normal ranges. Cyst fenestration was performed by craniotomy (n=6) or by a neuro-endoscopic procedure (n=2), and, simultaneously, along with a cyst wall biopsy. Results : The surgery was uneventful in all eight patients, and there were no neurological morbidities. However, in four patients, endocrine dysfunction occurred postoperatively. We compared these four patients (group A) to the other 4 patients without endocrine dysfunction (group B) with intraoperative findings and with the histopathological findings of the cyst wall biopsy. The group A patients had more abundant vasculature on the cystic wall than the group B patients according to both the intraoperative findings and the histopathological findings. Conclusion : When performing a surgical cyst wall fenestration, surgeons should try to minimize the destruction of the cystic wall vasculature and not to make the fenestration at a site that contains many vascular striae.

Chronic cerebral hypoperfusion and plasticity of the posterior cerebral artery following permanent bilateral common carotid artery occlusion

  • Cho, Kyung-Ok;Kim, Seul-Ki;Kim, Seong Yun
    • The Korean Journal of Physiology and Pharmacology
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    • 제21권6호
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    • pp.643-650
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    • 2017
  • Vascular dementia (VaD) is a group of heterogeneous diseases with the common feature of cerebral hypoperfusion. To identify key factors contributing to VaD pathophysiology, we performed a detailed comparison of Wistar and Sprague-Dawley (SD) rats subjected to permanent bilateral common carotid artery occlusion (BCCAo). Eight-week old male Wistar and SD rats underwent BCCAo, followed by a reference memory test using a five-radial arm maze with tactile cues. Continuous monitoring of cerebral blood flow (CBF) was performed with a laser Doppler perfusion imaging (LDPI) system. A separate cohort of animals was sacrificed for evaluation of the brain vasculature and white matter damage after BCCAo. We found reference memory impairment in Wistar rats, but not in SD rats. Moreover, our LDPI system revealed that Wistar rats had significant hypoperfusion in the brain region supplied by the posterior cerebral artery (PCA). Furthermore, Wistar rats showed more profound CBF reduction in the forebrain region than did SD rats. Post-mortem analysis of brain vasculature demonstrated greater PCA plasticity at all time points after BCCAo in Wistar rats. Finally, we confirmed white matter rarefaction that was only observed in Wistar rats. Our studies show a comprehensive and dynamic CBF status after BCCAo in Wistar rats in addition to severe PCA dolichoectasia, which correlated well with white matter lesion and memory decline.

Dye-Perfused Human Placenta for Simulation in a Microsurgery Laboratory for Plastic Surgeons

  • Laura C. Zambrano-Jerez;Karen D. Diaz-Santamaria;Maria A. Rodriguez-Santos;Diego F. Alarcon-Ariza;Genny L. Melendez-Florez;Monica A. Ramirez-Blanco
    • Archives of Plastic Surgery
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    • 제50권6호
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    • pp.627-634
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    • 2023
  • In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

실험적 급성 폐색전증에서 폐동맥혈역학 및 폐혈관저항의 변화 (Change of Pulmonary Artery Hemodynamics and Pulmonary Vascular Resistance in Experimental Pulmonary Embolism)

  • 정희순;이재호;김철호
    • Tuberculosis and Respiratory Diseases
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    • 제42권6호
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    • pp.913-922
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    • 1995
  • 연구배경: 혈류의 누가현상이 일어나는 폐혈관계의 압력을 유효유출압($P_I$), 심박출량의 변화분에 대한 폐동맥압의 변화분을 폐혈관저항증분(IR)이라고 정의할때에 $P_I$ 및 IR과 폐혈관저항을 비교해보면 폐혈관저항의 문제점이 발견된다. 즉 폐혈관상이 감소하는 폐색전증에서는 이론상 IR이 주로 증가해야 하는데, 여러 연구에 의하여 상반된 결과가 보고되어있고 폐혈관저항과 $P_I$, IR간에는 상위점이 존재하는 것이 알려져 왔다. 이에 따라 본 연구에서는 폐혈관저항을 폐혈관계의 유효유출압($P_I$)과 폐혈관저항증분(IR)으로 세분할때 폐색전증의 유발 및 치료시 아들이 어떻게 변화하는가를 관찰하여 이러한 새로운 지표들의 의미와 일반적으로 사용되는 폐혈관저항과의 차이점을 알아보고자 하였다. 방법: 실험전에 동정맥루를 만든후 10~15분 간격으로 조직하여, 동정맥루가 모두 폐쇄된 상태, 하나의 동정맥루가 개방된 상태, 그리고 두개의 동정맥루가 모두 개방된 상태의 3가지 경우로 심박출량올 변화시키면서 방사성동위원소로 표지된 자가혈병으로 대량의 폐색전증을 유발시킨후의 평균폐동맥압을 측정하여 폐혈관계의 유효유출압과 폐혈관저항증분을 계산하였다. 이때 대조군은 특이 치료를 하지않고, 제 1 치료군은 15분 동안, 제 2치료군은 3시간에 걸쳐서 재조합형의 조직형 플라스미노겐 활성체를 체중당 1mg씩 정맥주입하면서 유효유출압과 폐혈관저항증분의 변화양상을 관찰하였다. 곁과: 1) 폐혈관저항은 폐동맥압의 변화양상과 유사하게 변화했는데, 세군 모두 폐혈관저항이 유의하게 증가하였고, 제 1 치료군 및 제 2 치료군에서는 치료후 폐혈관저항이 계속 감소하는 경향을 보였는데, 제 1 치료군의 감소속도가 제 2 치료군보다 유의하게 빨랐다. 2) 최소자승법으로 산출한 심박출량과 폐동맥압과의 직선관계는 절편($P_I$) 및 기울기(IR)가 유의하였다. 3) $P_I$(폐혈관계의 유효유출압)는 폐혈관저항과 동일한 양상으로 변화한 반면에, 이론상 폐혈관저항과 가까운 IR(폐혈관저항증분)에서는 세군간의 유의한 차이나 조직형 플라스미노겐 활성체 투여후의 의미있는 변화는 거의 없었다. 결론: 폐색전증에서는 폐혈관계의 실제저항을 의미하는 폐혈관저항증분과 폐색전증에 대한 이차적 혈관 수축때문에 생기는 폐혈관계의 유효유출압의 변화가 동시에 반영된다고 할 수 있겠다.

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First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature

  • Valente, Tullio;Bocchini, Giorgio;Bigazzi, Maurizio Cappelli;Muto, Massimo;Golino, Paolo;Sica, Giacomo
    • Journal of Chest Surgery
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    • 제53권5호
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    • pp.310-312
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    • 2020
  • Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.

Bronchopulmonary Sequestration: 1례 보고 (Bronchopulmonary Sequestration: Report of One Case)

  • 이홍균;홍기우
    • Journal of Chest Surgery
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    • 제6권2호
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    • pp.159-164
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    • 1973
  • Bronchopulmonary sequestration is a congenital malformation characterized by a cystic portion of the lung that derives its arterial blood supply through anomalous aberrant vessel directly of the systemic circulation. An aberrant systemic vessel supplying the lung was reported by Huber in 1777. Although this lesion is uncommon disorder, there are several reports on operative death caused by exanguinating hemorrhage from the aberrant arteries to the bronchopulmonary sequestration to that it has received a great deal of attention. Two type of bronchopulmonary sequestration have been identified: Intralobar pulmonary sequestration is usually contained within the visceral pleura of a pulmonary lobe and its venous drainage to the pulmonary venous system. Extrapulmonary sequestration is usually within the pleural sheath its own and its vasculature drains into the azygos or hemiazygos system. we presented one case of intralobar pulmonary sequestration which led to motor paralysis, chylothorax and hemorrhage that are consequent on postoperative complication.

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양측폐 상엽에서 유발된 객혈의 치료 :1례 보고 (Treatment of Hemoptysis developed from Both Upper Lung Fields -A Case Report-)

  • 이광선
    • Journal of Chest Surgery
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    • 제28권11호
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    • pp.1058-1062
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    • 1995
  • We have experienced one case of hemoptysis which developed from both upper lung fields due to pulmonary aspergilloma combined with pulmonary tuberculosis. A 48 year old female patient was admitted with 10 years history of recurrent hemoptysis. Chest X-ray film revealed moderately advanced active pulmonary tuberculosis lesion on both upper lung fields, and cresentic radiolucent space between cavity wall and round radiopaque lesion on left upper lung field. Bronchial arteriogram showed hypervascularity and extravasation of contrast media in the right lung and it was treated by bronchial artery embolization. Hemoptysis recurred 7 months after embolization and repeat examination revealed greatly increased bronchial vasculature in the left upper lobe and therefore underwent left upper lobectomy. The pathologic result was compatible with aspergillosis, and the postoperative recovery was uneventful.

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다량 객혈을 합병한 폐동정맥루 (Pulmonary Arteriovenous Fistula)

  • 박효수
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.327-333
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    • 1985
  • Pulmonary arteriovenous fistula is a congenital malformation of the pulmonary vasculature in which there is a persistence of one or more sizable communications that bypass the pulmonary capillary bed that thus directs unoxygenated pulmonary arterial blood directly into the pulmonary venous system. The developmental cause of pulmonary arteriovenous fistula is unknown, but it is postulated that the abnormal channels represent persistent vessels of the primitive splanchnic capillary bed that do not resorb during growth and maturation. We have experienced a case of pulmonary arteriovenous fistula. The 45 years old woman admitted to Kosin Medical College Hospital via emergency room because of massive hemoptysis, and was diagnosed pulmonary arteriovenous fistula by twice postoperative histopathologic examination. The postoperative course was uneventful and she was discharged on the 16th, second postoperative day in a healthy condition.

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n-3 지방산과 건강

  • 이수환
    • 한국식품위생안전성학회:학술대회논문집
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    • 한국식품위생안전성학회 1992년도 학술강연회
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    • pp.1-5
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    • 1992
  • There is increasing awareness of the devastating socio-economic cost of cardiovascular disease. As a result there have been a lot of extensive researches both on basic mechanisms involved and on the areas of epidemiology and clinical trials. Now, it is being generally accepted that dietary n-3 fatty acids abundant in marine products, may reduce the incidence of cardiovascular disease. Fish oil, with its complement of n-3 fatty acids, has been shown to have diverse and sometimes potent actions on cells of the blood and vasculature, which may explain some of its positive effects on vascular disease. However, the appropriate intake of n-3 fatty acids has not been established. This may vary with desired effects, the duration of ingestion, the type of seafood or fish oil and amount of other fatty acids, especially nf fatty acid being consumed in the diet, Although the beneficial effects have been extensively studied, little is known about potential adverse effects with excessive intake of n-3 fatty acids. Thus, it is needed to study on the possible unfavorable effects including genetic effects.

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n-3 지방산과 건강 (n-3 Fatty Acids (EPA, DHA) and Health)

  • 이수환
    • 한국식품위생안전성학회지
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    • 제7권2호
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    • pp.101-105
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    • 1992
  • There is increasing awareness of the devastating socio-economic cost of cardiovascular disease. As a result there have been a lot of extensive researches both on basic mechanisms involved and on the areas of epidemiology and clinical trials. Now it is being generally accepted that dietary n-3 fatty acids abundant in marine products, may reduce the incidence of cadiovascular disease. Fish oil . with its complement of n-3 fatty acids, has been shown the have diverse and sometimes potent actions on cells of the blood and vasculature, which may explain some of its positive effects on vascular disease. However, the appropriate intake of n-3 fatty acids has not been established. This may vary with desired effects, the duration of ingestion, the type of seafood or fish oil and amount of other fatty acids, especially n-6 fatty acid being consumed in the diet. Although the beneficial effects have been extensively studied, little is known about potential adverse effects with excessive intake of n-3 fatty acids. Thus, it is needed to study on the possible unfavorable effects including genetic effects.

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