• Title/Summary/Keyword: Vessel disease

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Open Heart Surgery:Clinical Analysis of 180 Cases (개심술 180례에 대한 임상적 고찰)

  • 나명훈
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.460-471
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    • 1994
  • Between Feb. 1990 and Aug. 1993, 180 cases of the open heart surgery were performed under cardiopulmonary bypass in the Department of Thoracic & Cardiovascular surgery, Gil General Hospital. There were 83 cases with congenital heart diseases [CHD] and 97 cases with acquired heart diseases [AHD]. The CHD consisted of 78 acyanotic[mortality: 3.8 %] and 5 cyanotic cases with heart anomaly[mortality:l case]. The AHD were 97 cases, which contained 53 valvular, 27 ischemic heart diseases, 10 aortic diseases, 5 cases with myxoma, 1 case with post-infarct VSD, and 1 case with removal of infected pacing wire in right ventricle. In the 53 valvular heart diseases, there were 45 cases with valve replacement[MVR 27, AVR 9,MVR + AVR 9] and 8 cases with valvuloplasty. The number of the implanted prosthetic valves were 53. In MVR, 25 St. Jude, 6 Sorin, 3 Carpentier-Edward and 2 Intact medical valves were used. In aortic position, 13 St. Jude, 3 Sorin and 1 Intact medical valves were applied. The operative mortality was 5.6 % [3/53]. The annuloplasty applying artificial ring was performed in 17 patients[4 cases associated with MVR] and the number of the implanted ring was 19, which included 14 Duran ring[10 mitral, 4 tricuspid] and 5 Carpentier ring [3 mitral, 22 tricuspid]. In the 27 ischemic heart diseases, there were 9 cases with left main coronary artery lesions, 7 one vessel, 5 two vessels, and 6 three vessels. Average number of anastomosis was 2.8 per patient. The operative mortality was 14.3 % [4/27]. Among the 10 patients with aortic diseases, 7 cases were aortic dissection[type A: 5, type B: 2] and 3 cases were descending thoracic aortic aneurysm. The operative morality occurred in 3 cases. The overall mortality and the operative mortality of congenital and acquired heart disease was 7.8 %, 4.8% and 10.4%, respectively.

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An Alternative Surgical Technique for Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

  • Kim, Young-Su;Lee, Mina;Cho, Yang Hyun;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.220-224
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    • 2014
  • Background: For the surgical management of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), there have been various techniques that reduce the tension and kinking of the coronary artery during reimplantation to the aorta. The aim of this study is to describe the results of our modified technique of coronary reimplantation for the treatment of ALCAPA. Methods: Between October 2003 and February 2011, seven patients underwent coronary reimplantation with the modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta). The median follow-up duration was 52 months (range, 4 to 72 months). Clinical outcomes and serial echocardiographic data were reviewed. Results: There was no mortality. One patient had a small amount of cerebral hemorrhage postoperatively and improved without any sequelae. Another patient had left diaphragm palsy and underwent diaphragm plication. Follow-up echocardiogram showed that all patients had normal ventricular function without chamber enlargement. Conclusion: Our modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta) demonstrated successful clinical outcomes. We conclude that this surgical technique can be a potential alternative for the treatment of ALCAPA.

A Case of $Henoch-Sch{\"{o}}nlein$ Purpura with Hemorrhagic Bullae in a Child (소아에서 출혈성 수포를 동반한 $Henoch-Sch{\"{o}}nlein$ 자반병 1례)

  • Oh Yeon-Mi;Jung Mi-Rim;Choi Hye-Jeong;Cha Hee-Jeong;Jeong Jin-Young
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.40-44
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    • 2006
  • [ $Henoch-Sch{\"{o}}nlein$ ] purpura(HSP) is a systemic small vessel vasculitis characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. The characteristic rash of HSP consists of palpable purpura on the buttocks and lower extremities. Bullous lesions often appear in adults with HSP, whereas they are very rare in children with HSP. In this case report, the patient presented with arthralgia and abdominal pain and had hemorrhagic bullae as a prominent manifestation of the disease. The skin biopsy of the patient revealed typical leukocytoclastic vasculitis of dermal vessels and prominent IgA and fibrinogen deposits on capillary walls by direct immunofluorescence. We confirmed the diagnosis of HSP and observed improvement of clinical symptoms and signs within a few days after corticosteroid treatment. We therefore report a case with a review of the literature.

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Diabetic Atherosclerosis and Glycation of LDL(Low Density Lipoprotein)

  • Park, Young-June;Kim, Tae-Woong
    • Preventive Nutrition and Food Science
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    • v.1 no.1
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    • pp.134-142
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    • 1996
  • Diabetes carries an increased risk of atherosclerotic disease that is not fully explained by known car-diovascular risk factors. There is accumulating evidence that advanced glycation of structural proteins, and oxidation and glycation of circulating lipoproteins, are implicated in the pathogenesis of diabetic ather-osclerosis. Reactions involving glycation and oxidation of proteins and lipids are believed to contribute to atherogenesis. Glycation, the nonenzymatic binding of glucose to protein molecules, can increase the ather-ogenic potential of certain plasma constituents, including low density lipoptotein(LDL). Glycation of LDL is significant increased in diabetic patients compared with normal subjects, even in the presence of good glycemic control. Metabolic abnormalities associated with glycation of LDL include diminished recognition of LDL by the classic LDL receptor; increased covalent binding of LDL in vessel walls ; enhanced uptake of LDL by the macrophages, thus stimulating foam cell formation ; increased platelet aggregation; formation of LDL-immune complexes ; and generation of oxygen free radicals, resulting on oxidative damage to both the lipid and protein components of LDL and to any nearby macromolecules. Oxidized lipoproteins are characterzied by cytotoxicity, potent stimulation of foam cell formation by macrophages, and procoagulant effects. Combined glycation and oxidation, "glycoxidation" occurs when oxidative reactions affect the initial products of glycation, and results in irreversible structural alterations of proteins. Glycoxidation is of greatest significance in long lived proteins such as collagen. In these proteins, glycoxidation products, believed to be atherogenic, accumulate with advancing age : in diabetes, their rate of accumulate is accelerated. Inhibition of glycation, oxidation and glycoxidation may form the basis of future antiaterogenic strategies in both diabetic and nondiabetic individuals.dividuals.

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Comparison of mean platelet volume levels in coronary artery ectasia and healthy people: systematic review and meta-analysis

  • Moghadam, Reza Heidary;Shahmohammadi, Afshar;Asgari, Nader;Azizi, Koorosh;Mansour, Sahar Mehr;Roozbahani, Mohammad
    • BLOOD RESEARCH
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    • v.53 no.4
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    • pp.269-275
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    • 2018
  • Coronary artery ectasia (CAE) is defined as the dilation of a segment of a coronary vessel to at least 1.5 times the diameter of its normal adjacent segment. Mean platelet volume (MPV) plays a role in acute coronary syndromes, with high MPV correlating to poor prognosis for acute thrombotic events and CAE. Several studies investigated the relationship between MPV and CAE, resulting in conflicting results. These results led us to systematically review all studies investigating the relationship between MPV and ectatic heart diseases by performing a meta-analysis study in order to report a unified result. This meta-analysis study investigated all case-control articles examining the relationship between MPV and CAE. All studies in the following databases published until January 31, 2018, were investigated: Science Direct, Scopus, PubMed, Google Scholar, and Web of Science. Following a quality control evaluation, 14 articles, all of which were published following studies performed in Turkey from 2007 to 2016, met the criteria for study inclusion. After pooling the results from all of the articles, a total standardized mean difference (SMD) value of 0.584 (95% CI, 0.219, 0.95) was obtained using the D+L pooled SMD, indicating a significant difference (P=0.002) between the two groups, with higher MPV values in ectatic patients when comparing to healthy individuals. Therefore, increased MPV levels were significantly related to CAE, suggesting that platelets, with their inflammatory and thrombotic activities, play a role in this disease. Therefore, anti-platelet and anti-inflammatory therapies may be effective in treating CAE.

A narrative review of clinical studies on thread embedding acupuncture treatment for spasticity after stroke

  • Sooran Cho;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.43 no.4
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    • pp.131-144
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    • 2022
  • Objectives: This study aimed to review clinical studies on thread embedding acupuncture (TEA) for the treatment of patients with post-stroke spasticity (PSS) Methods: Clinical studies related to TEA treatment for PSS were searched for in several electronic databases, including PubMed, Cochrane Library, MEDLINE, OASIS, and CNKI. After the selection/exclusion process, information on study design, disease, experimental/control group, intervention, outcome measurement, between-group differences, and adverse events was extracted. Results: A total of 13 randomized controlled trials were included in this review. The usual frequency of TEA treatment was once every 1-2 weeks, and the treatment most commonly included 4 sessions. In the dorsal area, EX-B2 and the acupoints in governing vessel meridian were commonly used. Acupoints in the meridian of the large intestine were most frequently used in the treatment of upper limb spasticity. Except for HT1, PC6, and PC8, all TEA points for treating PSS of the upper limb were on the Yang meridians. For the lower limb spasticity, the most frequently used acupoints were ST36, GB34, GB30, BL60, and BL57 on Yang meridians, and LR3, SP6, SP9, and SP10 on Yin meridians. TEA treatment showed better effects than conventional treatment for PSS in terms of spasticity, motor dysfunction, and activities of daily livings. Nevertheless, the absence of the follow-up observation, lack of sham TEA treatment, and low quality of the included studies necessitated caution in interpreting the results. Conclusions: The results of this review are expected to provide basic data on the modalities of TEA treatment for PSS and provide insights to facilitate well-designed studies in the future.

Molecular characterization of H3N2 influenza A virus isolated from a pig by next generation sequencing in Korea

  • Oh, Yeonsu;Moon, Sung-Hyun;Ko, Young-Seung;Na, Eun-Jee;Tark, Dong-Seob;Oem, Jae-Ku;Kim, Won-Il;Rim, Chaekwang;Cho, Ho-Seong
    • Korean Journal of Veterinary Service
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    • v.45 no.1
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    • pp.31-38
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    • 2022
  • Swine influenza (SI) is an important respiratory disease in pigs and epidemic worldwide, which is caused by influenza A virus (IAV) belonging to the family of Orthomyxoviridae. As seen again in the 2009 swine-origin influenza A H1N1 pandemic, pigs are known to be susceptible to swine, avian, and human IAVs, and can serve as a 'mixing vessel' for the generation of novel IAV variants. To this end, the emergence of swine influenza viruses must be kept under close surveillance. Herein, we report the isolation and phylogenetic study of a swine IAV, A/swine/Korea/21810/2021 (sw21810, H3N2 subtype). BLASTN sequence analysis of 8 gene segments of the isolated virus revealed a high degree of nucleotide similarity (94.76 to 100%) to porcine strains circulating in Korea and the United States. Out of 8 genome segments, the HA gene was closely related to that of isolates from cluster I. Additionally, the NA gene of the isolate belonged to a Korean Swine H1N1 origin, and the PB2, PB1, NP and NS genes of the isolate were grouped into that of the Triple reassortant swine H3N2 origin virus. The PA and M genes of the isolate belonged to 2009 Pandemic H1N1 lineage. Human infection with mutants was most common through contact with infected pigs. Our results suggest the need for periodic close monitoring of this novel swine H3N2 influenza virus from a public health perspective.

A Clinical Study on the Relationship between Warning Signs and Stroke Subtype in Acute Stroke Patients. (급성기 중풍환자에서 중풍전조증과 중풍유형간의 상관성에 대한 임상연구)

  • Choi, Dong-Jun;Han, Chang-Ho;Hyun, Jin-Ho;Shin, Won-Yong;Kim, Yong-Hyung;Kang, Amy;Lee, Won-Chul;Jun, Chan-yong;Cho, Ki-Ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.54-58
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    • 2006
  • Objectives : This study was aimed to investigated the relationship between warning signs and stroke subtype in acute stroke patients. Methods : From Oct. in 2005 to Oct. in 2006, 409 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke in DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, Department Cardiovascular and Neurologic Diseases(Stroke center) Kyung Hee University Oriental hospital. We investigated general characteristics, stroke subtype, and warning signs(facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke. (odds ratio 3.60) Small vessel occlusion had more neck stiffness than others. (odds ratio 2.03) Conclusion : To acquire more concrete conclusions on warning signs, we need further and large scale of prospective researches.

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Comparison of bone subtraction CT angiography with standard CT angiography for evaluating circle of Willis in normal dogs

  • Soyon An;Gunha Hwang;Rakhoon Kim;Tae Sung Hwang;Hee Chun Lee
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.65.1-65.9
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    • 2023
  • Background: Bone subtraction computed tomography angiography (BSCTA) is a useful alternative technique for improving visualization of vessels surrounded by skull bone. However, no studies have compared computed tomography angiography (CTA) and BSCTA for improving the visibility of canine cerebral blood vessels. Objectives: To evaluate the potential benefit of BSCTA for better delineation of brain arteries of the circle of Willis (CoW) in dogs by comparing BSCTA with non-subtraction computed tomography angiography (NSCTA). Methods: Brain CTA was performed for nine healthy beagle dogs using a bolus tracking method with saline flushing. A total dose of 600 mgI/kg of contrast agent with an iodine content of 370 mgI/mL was injected at a rate of 4 ml/s. Bone removal was achieved automatically by subtracting non-enhanced computed tomography (CT) data from contrast CT data. Five main intracranial arteries of the CoW were analyzed and graded on a scale of five for qualitative evaluation. Results: Scores of basilar artery, middle cerebral artery, and rostral cerebral artery in the BSCTA group were significantly higher than those in the NSCTA group (p = 0.001, p = 0.020, and p < 0.0001, respectively). Scores of rostral cerebellar artery (RcA) and caudal cerebral artery (CCA) did not differ significantly between the two groups. However, scores of RcA and CCA in the BSCTA group were higher than those in the NSCTA group. Conclusions: BSCTA improved visualization of intracranial arteries of the CoW with close contact to bone. Thus, it should be recommended as a routine scan method in dogs suspected of having brain vessel disease.

High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report (중증 빈혈과 관련된 가역적 뇌혈관 수축 증후군의 고해상도 자기공명영상 소견: 증례 보고)

  • Yongsang Kim;Ra Gyoung Yoon;Ji Ye Lee;Jong-Moo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.261-266
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    • 2021
  • Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.