• 제목/요약/키워드: ascending syndrome

검색결과 91건 처리시간 0.033초

대동맥판부전이 동반된 상행대동맥류의 외과적 치험 (Surgical Management of Aneurysm of the Ascending Aorta with Aortic Insufficiency)

  • 박만실
    • Journal of Chest Surgery
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    • 제26권6호
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    • pp.457-462
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    • 1993
  • We retrospectively studied 34 patients who underwent operations of ascending aortic aneurysm and aortic valve replacement from August 1979 to July 1992 at the Yonsei Cardiovascular Center. Eight patients underwent supracoroanry non-composite graft replacement and separate aortic valve replacement[group I]. Twenty six patients underwent valved composite graft replacement with reimplantation of coronary arteries[group II]. Two cases in group II died within 1 month after the operation. Among the 32 survivors 28 patients have been followed up for an average of 59 months ranging from 1 months to 159 months. During the follow up periods, a pseudoaneurysm around the ascending aorta and a newly developed dissecting aneurysm in remaining aorta were noted in group II. There were 6 late deaths: 2 cases in group I and 4 cases in group II. Three cases among the 6 late deaths have stigmata of Marfan`s syndrome[1 cases in group I and 2 case in group II]. There was no statistically significant difference in actuarial survival rates between group I and group II[p > 0.05]. This study suggests that non-composite supracoronary graft interposition with separate aortic valve replacement is a safe surgical technique in patients who have normal aortic annulus and normal position of coronary ostia. However in degenerative disease such as cystic medial necrosis, composite graft replacement is recommended because this procedure eliminates entire abnormal tissue.But it seems to be important that the suture technique and strict follow-up in patients with diseased aortic wall.

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태아기에 좌심형성부전증후군으로 잘못 진단되었던 1례 (A False Diagnosis of Hypoplastic Left Heart Syndrome in a Fetus)

  • 신윤정;장성희;최정연;한은숙
    • Clinical and Experimental Pediatrics
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    • 제45권2호
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    • pp.267-272
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    • 2002
  • 저자들은 재태 $31^{+5}$주 산전 심초음파검사에서 좌심형성부전 및 대동맥축삭으로 진단되어 추적 관찰한 태아가 출생 후 전부하의 증가에 의해 단기간 내에 좌심실 용적의 증가를 보임으로 생후 최소 며칠은 심근세포 증식의 가능성이 있음을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

이동원(李東垣) 내외상변(內外傷辨)의 의사학적(醫史學的) 고찰(考察) (Research of discrimination of internal injury from external by Lee Dong-won from medical historical point of view)

  • 진주표;김남일
    • 한국의사학회지
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    • 제14권1호
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    • pp.153-166
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    • 2001
  • Lee Dong-won based on the machanism of internal disease founded on Umhwa and Wonki in discriminating internal injury from external. His general idea of discrimination of internal injury from external could be thought as an reinterpretation of the concept from "Neijing", to Triple heater Wonki and ascending and descending of stomach qi. He distinguished between Yin disease and Yang disease and classified into internal and external injury. "Insufficiency of yang brings about cold syndrome." and "An excess of yang brings about heat syndrome." are considered as external infection, and "Insufficiency of yin brings about heat syndrome." and "An excess of yin brings about cold syndrome." as internal injury.

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Valve-Sparing Root Replacement in a Turner Syndrome Patient with Bicuspid Aortic Valve and Juxtacommissural Origin of the Right Coronary Artery: A Case Report

  • Son, Dong Hyeon;Cho, Sungkyu;Song, Mi Kyoung
    • Journal of Chest Surgery
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    • 제55권5호
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    • pp.413-416
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    • 2022
  • A 32-year-old woman diagnosed with Turner syndrome presented to the hospital for an evaluation of cardiovascular complications. Preoperative computed tomography (CT) and echocardiography showed progression of aortic root and ascending aorta dilatation, as well as a bicuspid aortic valve. There was no evidence of aortic regurgitation. We planned valve-sparing aortic root replacement and ascending aorta replacement with a high risk of aortic rupture. Intraoperatively, we incidentally found a juxtacommissural origin of the right coronary artery (RCA). We performed aortic valve reimplantation using a graft designed with a key-shaped hole to wrap the juxtacommissural-origin RCA by modifying the Florida sleeve technique. Coronary blood flow was patent on postoperative CT angiography, and there was no evidence of aortic regurgitation on postoperative echocardiography. The patient was discharged from the hospital on postoperative day 7 without any complications.

Autosomal dominant hypocalcemia with Bartter syndrome due to a novel activating mutation of calcium sensing receptor, Y829C

  • Choi, Keun Hee;Shin, Choong Ho;Yang, Sei Won;Cheong, Hae Il
    • Clinical and Experimental Pediatrics
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    • 제58권4호
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    • pp.148-153
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    • 2015
  • The calcium sensing receptor (CaSR) plays an important role in calcium homeostasis. Activating mutations of CaSR cause autosomal dominant hypocalcemia by affecting parathyroid hormone secretion in parathyroid gland and calcium resorption in kidney. They can also cause a type 5 Bartter syndrome by inhibiting the apical potassium channel in the thick ascending limb of the loop of Henle in the kidney. This study presents a patient who had autosomal dominant hypocalcemia with Bartter syndrome due to an activating mutation Y829C in the transmembrane domain of the CaSR. Symptoms of hypocalcemia occurred 12 days after birth and medication was started immediately. Medullary nephrocalcinosis and basal ganglia calcification were found at 7 years old and at 17 years old. Three hypercalcemic episodes occurred, one at 14 years old and two at 17 years old. The Bartter syndrome was not severe while the serum calcium concentration was controlled, but during hypercalcemic periods, the symptoms of Bartter syndrome were aggravated.

하지마목으로 진단된 환자 치험 1례(例) (Treatment of Acute Transverse Myelitis : a case report)

  • 강형원;류영수;김태헌;이수정
    • 동의신경정신과학회지
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    • 제16권2호
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    • pp.213-221
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    • 2005
  • Acute Transverse Myelitis is a syndrome, not a disease, in which acute inflammation affects gray and white matter in one or more adjacent thoracic segments. Almost all patients will develope ascending weakness and numbness of feet and leg, difficulty voiding, urinary retention, and loss of bowel control. We concluded this case to MAMOK( 마목) due to Qi ascent, Qi deficiency, Qi stoppage(상기, 기허, 기체). So we used herbal medication, acupuncture, and homeopuncture according to oriental medical theory. Weakness and numbness of feet and leg, difficulty voiding, urinary retention, and loss of bowel control are reduced. Herbal medication, acupuncture, and homeopuncture helped the care of this syndrome and further study will be investigated in oriental medicine for this syndrome.

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쯔쯔가무시병에 의한 길랑-바레 증후군의 신경병성 통증 (Neuropathic Pain in Guillain-Barre Syndrome Associated with Scrub Typhus)

  • 강새롬;이숙정;최은석
    • Clinical Pain
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    • 제18권2호
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    • pp.111-114
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    • 2019
  • Guillain-Barre syndrome (GBS) is usually characterized by acute areflexic ascending paralysis with minimal sensory involvement. Only a few cases of GBS associated with scrub typhus have been reported. Previous case reports focused on the laboratory findings, pathogenesis, and clinical manifestation. Unlike the previous case, neuropathic pain was a prominent symptom of GBS in our case. We report scrub-typhus-related GBS with a detailed description of the clinical manifestations, especially neuropathic pain, along with results of serial follow-up electrodiagnostic studies.

"청기재하(淸氣在下), 탁기재상(濁氣在上)"에 대한 고찰(考察) - 『상한론(傷寒論)』 병증(病症)과의 비교 - (Understanding the Phenomenon of "Clear Qi Below, Turbid Qi Above" with Reference to Symptom Patterns of the Sanghallon (Treatise on Cold Damage 傷寒論))

  • 박상균;방정균
    • 한국의사학회지
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    • 제32권1호
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    • pp.33-42
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    • 2019
  • Objective : Describe the phenomenon of "clear qi below, turbid qi above" as found in the Somun Eumyangeungsangdaelon (Major Essay on Yinyang Resonances and Appearances 素問 陰陽應象大論) and compare this pattern with water-grain dysentery and flatulence symptom patterns in the Sanghallon (Treatise on Cold Damage). Method : Study the annotation of the Hwangjenaegyeong (Yellow Emperor's Internal Classic 黃帝內經) and compare the results with the Sanghallon's water-grain dysentery and flatulence. Conclusions and Results : The causes of water-grain dysentery and flatulence are associated with the ascending and descending properties of Yin and Yang. Additionally, these symptoms can also be caused by pathogenic heat, turbid pathogenic factors, and interruption of the movement of clear and turbid qi. Aspects of water-grain dysentery resemble several patterns found in the Sanghallon. If caused by a weakness of yang qi, it resembles Sayeoktang (四逆湯) syndrome. Weakness of spleen qi resembles Ijungtang (理中湯) syndrome. Flatulence is similar to fullness in the chest syndrome, which in the Sanghallon is caused by an obstruction of cold qi. If there is excessive cold, water-grain dysentery is similar to the syndrome of Gyeolhyung (結胸). If the qi is not scattered, deficiency syndrome is similar to Gyejigejagyaktang (桂枝去芍藥湯) syndrome and excess syndrome is similar to Mahwangtang (麻黃湯) syndrome. When flatulence is caused by fever in chest, it is similar to Chijasitang (梔子?湯) syndrome. When caused by heat and phlegm build up in chest, it is similar to Sipjotang (十棗湯) syndrome.

요추부 최소침습적 시술 후 길랑-바레 증후군: 증례보고 (Guillain-Barre Syndrome after Minimally Invasive Lumbar Procedure: A Case Report)

  • 이봉연;윤서라;류수라;최유리
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.159-163
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    • 2018
  • Guillain-Barre syndrome (GBS) after trauma and general orthopedic surgery is rare. A 74-year-old woman showed ascending paralysis symmetrically, dysarthria, dysphagia and areflexia on 14 days after minimally invasive endoscopic thermoannuloplasty on L4-5 level. Brain and lumbar magnetic resonance imaging demonstrate no abnormal findings. The electrodiagnostic study showed prolonged distal motor, sensory latencies and F-wave latencies and reduced amplitude of compound muscle action potential in nerves of upper and lower extremities. In the cerebrospinal fluid (CSF) examination, total protein and IgG were increased. We diagnosed Guillain-Barre Syndrome based on clinical features, electrodiagnostic study and CSF examination and the patient improved symptoms after immunoglobulin injection and rehabilitation. Because the occurrence of GBS after minimally invasive procedure has not been reported, we report a case of GBS after minimally invasive procedure with literature review.

A형 대동맥 박리 수술 후 재발성 박리의 재수술 (Redo Opeations for Recurrent Dissection After Operation for Type A Aortic Dissection)

  • 홍유선;강정한;윤치순;이현성;박형동
    • Journal of Chest Surgery
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    • 제34권8호
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    • pp.604-610
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    • 2001
  • 배경: Stanford 제A형(type A) 대동맥 박리증은 상행대동맥이나 대동맥궁의 인조혈관 치환 수술 후에도 남은 대동맥의 가강이 확장되거나 파열의 가능성이 있기 때문에 철저한 추적관리가 필요하다. 연세대학교 세브란스병원에서는 1984년 6월부터 2000년 3월까지 Stanford 제A형의 대동맥박리 수술이 124예 있었다. 수술 후 가강의 확장이나 파열로 재수술한 6예에서 Marfan 증후군과의 관련성 등 원인을 조사하고 재수술의 방법과 결과, 재수술의 위험을 줄일 수 있는 방법 등을 알아보고자 한다. 대상 및 방법: 처음 대동맥 박리로 수술시급성인 경우가 4예 만성이 2예였으며 이중 3예가 Marfan 증후군이였다. 1예를 제외한 모든 환자에서 상행대동맥내에 내막파열이 있어 대동맥판막의 폐쇄부전의 정도에 따라 상행대동맥 인조혈관 치한수술(2례) 또는 Bentall 수술을 시행하였으며(3례) 1예는 여러 개의 가강과의 연결부위가 있는 만성 박리 환자로 Bentall 수술과 더불어 대동맥궁까지 인조혈관으로 치환을 하였다. 재수술은 평균 67.6개월(4개월-14년4개월) 후에 시행하였는데 1예는 만성 하행대동맥 박리 및 동맥류로 1예는 염증성 가성동맥류로 나머지 4예는 급성대동맥 박리로 재수술을 시행하였다. 수술은 하행흉부대동맥만을 치환한 경우가 1예, Hemiarch로 시행한 경우가 1예 그리고 나머지 4예는 원위부 상행대동맥에서 대동맥궁을 포함하여 근위부 또는 중간부위의 하행 흉부대동맥까지 인조혈관으로 치환하였다. 결과: 전체 124예 중 Marfan 증후군이 동반된 경우는 18예였다.

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