• 제목/요약/키워드: ascending

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대동맥질환의 수술요법 (Surgical Treatment of Aortic Diseases)

  • 이재원
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.455-459
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    • 1994
  • We experienced 20 cases of acquired aortic diseases during last 1 year [Sep. 1992-Aug. 1993] with newly developed surgical strategies. There were 13 cases[65%] of aortic dissections, 5 cases[25%] of aortic aneurysms and 2 cases of Takayasu arteritis with mean age of 56 + 16 years[range:5-78].In ten cases of patients requiring ascending aortic replacement, femoral artery and femoral vein &/or RA auricle were used as cannulation site. With deep hypothermic circulatory arrest and retrograde cerebral perfusion of cold oxygenated blood via SVC, we can replace the ascending aorta and part of arch if necessary. The mean duration of circulatory arrest was 30 minutes[17-45 min]. In 5 cases of patients who requiring descending and thoracoabdominal aorta replacement, we used simple aortic crossclamping under normothermia with no heparin. The mean duration of aortic crossclamping was 37 minutes[25-50 min].The results of operation were as follow:Operative mortality[2 cases, 10%], delayed cerebral infarct[1], low extremity weakness[1] and intraoperative myocardial infarct[1]. There are no delayed complication or mortality as yet.

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Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis

  • Chong, Byung Kwon;Yun, Jae Kwang;Kim, Joon Bum;Park, Do Hyun
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.401-404
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    • 2016
  • The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.

소변 농축 기전과 요소운반체 (Urine Concentrating Mechanism and Urea Transporters)

  • 김동언
    • Childhood Kidney Diseases
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    • 제9권1호
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    • pp.1-7
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    • 2005
  • The production of concentrated urine is achieved by countercurrent multiplication in the renal medulla. The single effect of the outer medulla is the active NaCl reabsorption in the thick ascending limb, while the single effect of the inner medulla is the passive efflux of NaCl through the thin ascending limb. The passive mechanism in the inner medulla requires a high interstitial urea concentration which is maintained by intrarenal recycling of urea. During the past decade, many transport proteins involved in the urine concentrating mechanism have been cloned, which has enabled us to understand the countercurrent multiplication mechanism on a molecular basis. This review will summarize the locations and functions of the renal medullary transport proteins, and the recent insights that have been acquired into the long term regulation of urea transporters.

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Weak F I-extending Modules with ACC or DCC on Essential Submodules

  • Tercan, Adnan;Yasar, Ramazan
    • Kyungpook Mathematical Journal
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    • 제61권2호
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    • pp.239-248
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    • 2021
  • In this paper we study modules with the W F I+-extending property. We prove that if M satisfies the W F I+-extending, pseudo duo properties and M/(Soc M) has finite uniform dimension then M decompose into a direct sum of a semisimple submodule and a submodule of finite uniform dimension. In particular, if M satisfies the W F I+-extending, pseudo duo properties and ascending chain (respectively, descending chain) condition on essential submodules then M = M1 ⊕ M2 for some semisimple submodule M1 and Noetherian (respectively, Artinian) submodule M2. Moreover, we show that if M is a W F I-extending module with pseudo duo, C2 and essential socle then the quotient ring of its endomorphism ring with Jacobson radical is a (von Neumann) regular ring. We provide several examples which illustrate our results.

Mini-Bentall Surgery: The Right Thoracotomy Approach

  • Jawarkar, Manish;Manek, Pratik;Wadhawa, Vivek;Doshi, Chirag
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.554-557
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    • 2021
  • Surgeons are increasingly using the right mini-thoracotomy approach to perform aortic valve surgery. This approach has shown better results in terms of blood loss and length of hospital stay than the sternotomy approach. For selected patients requiring aortic root and ascending aorta surgery, a right mini-thoracotomy approach may prove beneficial. In our technique, we placed a 5-cm horizontal skin incision in the right second intercostal space. Femoro-femoral cardiopulmonary bypass was established. A valved aortic conduit was used for aortic root replacement. The patient's postoperative course was uneventful, with a short hospital stay. This technique offers a minimally invasive approach to aortic root and ascending aorta surgery with easy adaptability and reduced costs.

GENERATING FUNCTIONS OF (p, q)-ANALOGUE OF ALEPH-FUNCTION SATISFYING TRUESDELL'S ASCENDING AND DESCENDING Fp,q-EQUATION

  • ALTAF A. BHAT;M. YOUNUS BHAT;H. MAQBOOL;D.K. JAIN
    • Journal of applied mathematics & informatics
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    • 제41권2호
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    • pp.373-386
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    • 2023
  • In this paper we have obtained various forms of (p, q)-analogue of Aleph-Function satisfying Truesdell's ascending and descending Fp,q-equation. These structures have been employed to arrive at certain generating functions for (p, q)-analogue of Aleph-Function. Some specific instances of these outcomes as far as (p, q)-analogue of I-function, H-function and G-functions have likewise been obtained.

Debranch-First Technique with Zone 0 Elephant Trunk for Redo Operation of Residual Type B Aortic Dissection: The Completion of Aortic Proximalization

  • Yoshito Inoue
    • Journal of Chest Surgery
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    • 제57권1호
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    • pp.99-102
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    • 2024
  • This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

대동맥근부 혹은 상행대동맥의 재수술 (Reoperations on the Aortic Root and Ascending Aorta)

  • 백만종;나찬영;김웅한;오삼세;김수철;임청;류재욱;공준혁;김욱성;이영탁;문현수;박영관;김종환
    • Journal of Chest Surgery
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    • 제35권3호
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    • pp.188-198
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    • 2002
  • 목적: 대동맥근부 혹은 상행대동맥에 대한 재수술은 증가하고 있으나 재수술에 대한 결과 및 재수술을 예방할 수 있는 적절한 방법에 대한 연구는 많지 않다. 본 연구는 대동맥근부 혹은 상행대동맥 질환에 대한 재수술 결과 및 재수술을 예방할 수 있는 적절한 방법에 대해 알아보고자 하였다. 대상 및 방법: 1995년 5월부터 2001년 4월까지 대동맥근부 혹은 상행대동맥 질환으로 재수술을 받은 환자 30명을 대상으로 후향, 조사하였다. 최종 선행수술에서 재수술까지 기간은 평균 56$\pm$50개월(3-142개월)이었다. 재수술 적응증으로는 진성 상행대동맥류 7명(23.3%), 인공판막심내막염이 6명(20%), 가성동맥류 5명(16.7%), Behcet씨 병과 관련한 대동맥판륜 주위 누출 4명(13.3%), 인공 대동맥판막 기능부전 4명(13.3%), 그리고 대동맥박리증 3명(10%) 및 대동맥판륜확장증 1명이었다. 재수술은 대동맥근부 치환술 17명(56.7%), 상행대동맥 치환술 8명(26.7%), 대동맥판-승모판 연속의 섬유체 및 판륜 재건을 이용한 이중판막치환술 2명, 패취를 이용한 상행대동맥 성형술 2명, Bentall 술식 후 이중판막 치환술 1명이었다. 수술은 7명에서 체외순환하에 흉골절개를 하였고 16명(53.3%)에서 완전순환정지를 이용하였다. 평균 순환정지 시간은 20$\pm$12분, 체외순환 및 대동맥차단 시간은 각각 228$\pm$56분과 143$\pm$64분이었다. 결과 조기 사망은 3명(10%)에서 있었다. 합병증으로는 재수술이 필요했던 출혈이 7명(23.3%), 심장 합병증 5명(16.7%), 일과성 급성 신부전 2명, 간질 발작 2명, 그리고 기타가 5명이었다. 술후 생존자 27명에서 평균 22.8$\pm$20.5개월을 추적조사한 결과: 만기사망은 2명(7.4%)에서 있었으며 술후 6년 actuarial survival rate는 92.6$\pm$5.0%였다. 대동맥근부 혹은 상행대동맥 재수술 후 다시 재수술이 필요하였던 경우는 1명이었고(3.7%), 술후 1년과 6년 재수술로부터의 actuarial freedom rate는 각각 100%와 83.3$\pm$15.2%이었다. Behce씨 질환이 있는 1명이 동종이식편으로 근부치환술 후 가성동맥류가 발생하여 재수술이 필요한 상태이다. 혈전색전증이나 항응고제 관련 합병증은 없었다. 결론: 본 연구 결과 대동맥근부 혹은 상행대동맥의 재수술은 비교적 낮은 사망률과 이환율을 보이며 또한 재수술을 예방하기 위해서는 선행수술 및 재수술시 원인질환에 따른 적절한 수술 방법의 선택이 매우 중요할 것으로 사료된다

A Case of Guillain Barre Syndrome

  • 백선호
    • 대한간호
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    • 제6권5호통권31호
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    • pp.33-41
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    • 1967
  • Guillain Barre Syndrome, rather rarely occuring nerve disease and its causes are usually obscure, was seriously studied through a patient admitted recently to our hospital. Bilateral ascending paralysis on both extremities without sensory loss and the exc

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