• 제목/요약/키워드: ascending syndrome

검색결과 92건 처리시간 0.023초

무봉합 혈관내 인조이식혈관을 이용한 박리성 대동맥류의 수술요법 (Surgical Treatment for Dissecting Aneurysm of the Aorta using Sutureless Intraluminal graft)

  • 이재원
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.305-313
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    • 1985
  • Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with an intraluminal graft that requires no end-to-end anastomosis has been developed. Of the four patients with dissecting aneurysm of the aorta treated by inserting sutureless ringed intraluminal graft at the Department of Thoracic and Cardiovascular Surgery, S.N.U.H., three were DeBakey type I [one with associated aortic insufficiency] and the other was DeBakey type III. Suspected etiology of the dissection was Marfan`s syndrome in one and hypertension in the others. Total cardiopulmonary bypass was utilized in repairing dissecting aneurysms of the ascending aorta [type A] and simple aortic crossclamping was used for the patient with dissecting aneurysm of the descending aorta. The basic technique consists of inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. The proximal ring of the graft effectively stabilized the flail aortic valve in patient with aortic insufficiency associated with dissection of the ascending aorta. There were no hospital deaths and one patient with type III dissecting aneurysm developed postoperative paraparesis and renal insufficiency which was resolved. Follow-up has been from 1 month to 16 months with no evidence of prosthetic problems, such as erosion, migration, or thrombosis.

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Annuloaortic ectasia의 외과적 치험 (Surgical Treatment of Annuloaortic Ectasia - Review of 4 cases -)

  • 이섭;안욱수;김병열;이정호;유회성
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.36-40
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    • 1991
  • Between November, 1981 and July, 1989, 4 patients, 3 male and 1 female patients ranging in age from 36 to 45 years, were operated on for aortic insufficiency associated with uncomplicated annuloaortic ectasia. All patients were in New York Heart Association class III. Two patients had clinical stigmata of the Marfan syndrome. The surgical treatment consisted of. supracoronary replacement of ascending aorta with vascular graft and replacement of the aortic valve in our first case. and composite graft replacement of the ascending aorta and aortic valve with reimplantation of the coronary arteries in subsequent 3 cases. Our first patient developed aneurysm of proximal aorta and pseudoaneurysm of distal aortic anastomosis 5 years postoperatively. One patient among the three patients with Ben-tall operation, died of ventricular fibrillation and myocardial failure during immediate postoperative period. Remaining 2 patients were in NYHA class I with follow-up of 16 months and 20 months respectively.

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소음인(少陰人) 병리론(病理論)에 관한 고찰(考察) (The Study on the Pathology of Soeumin in Sasang Constitutional Medicine (SCM))

  • 황민우;고병희
    • 사상체질의학회지
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    • 제21권2호
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    • pp.27-41
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    • 2009
  • 1. Objectives : This research was proposed to find our the pathology of Soeumin in Sasang Constitutional Medicine(SCM). 2. Methods : The related contents of the pathology of Soeumin were selected in Je-Ma Lee's literatures such as "Dongmu-YuGo(東武遺稿)"(DYG), "Donguisusebowon-SaSangchobongyun(東醫壽世保元四象草本卷)"(DSS), "Donguisusebowon-GabObon(東醫壽世保元甲午本)"(DGO), "Donguisusebowon-ShinChukbon(東醫壽世保元辛丑本)"(DSC), and the research was written in order to find out the physiology and pathology of Soeumin in SCM. 3. Results and Conclusions : The chronical change of pathologic concept in Soeumin diseases as follows: Pathology in Soeumin diseases was much Cold Qi(寒氣), and more descending Qi, less ascending Qi in DYG, DSS. In "Discourse on the viscera and bowels" of DGO and DSC, Soeumin has a circulation of Water-Food Hot Qi of Spleen Group(脾黨) and Water-Food Cold Qi of Kidney Group(腎黨). Exterior Disease(表病) was the injury of Exterior-Qi such as eye-shoulder Qi(目膂氣) by Pleasure-Nature-Qi(樂性氣), and Interior Disease(裏病) was the injury of Interior-Qi such as spleen-stomach Qi(脾胃氣) by Joy-Emotion-Qi(喜情氣). All diseases of Soeumin are caused by insufficient Warm Yang Qi(陽煖之氣) in Spleen Group(脾黨), so the pathology of Soeumin was focused on Requisite energy(保命之主) and each small viscera and bowels(偏小之臟). In this viewpoint, the schema of Soeumin diseases such as Ulkwang-syndrome(鬱狂證), Mangyang-syndrome(亡陽證), Taeum-syndrome(太陰證) and Soeum-syndrome(少陰證) were designed to explain the mechanism of each syndrome.

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Marfan 증후군에 동반된 우관상동맥 폐쇄증 - 1 례 보고 - (Right coronary artery atresia in Marfan's syndrome: A case report)

  • 이재원
    • Journal of Chest Surgery
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    • 제34권9호
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    • pp.720-723
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    • 2001
  • 우관상동맥 폐쇄증을 동반한 Marfan 증후군환자를 보고한다. 환자는 45세 여자로 약 1년 전에 Marfan 증후군으로 진단받고, 최근 흉통을 주소로 내원하였다. 환자는 손가락과 발가락이 긴 지주증과 돌출흉이 있고 몸통에 비해 사지가 긴 전형적인 외형을 갖고 있었다. 시력이 매우 약하고 수정체의 아탈구가 있었다. 심초음파상 대동맥판막 폐쇄부전증은 경도로 있었고, 좌심실의 중등도 확장과 심박출율의 중등도 저하가 있었다. 수술시에 우관상동맥의 폐쇄증을 발견하였다. 대동맥판막 폐쇄부전증과 대동맥 확장증에 대해서 SJM 27mm composite graft를 이용하여 좌관상동맥에는 Bentall 술식과 우관상동맥에는 PTFE 6mm를 이용하여 변형된 Piehler 식 방법으로 수술을 하였다. 원래의 우관상동맥구로 추정되는 부분부터 우관상동맥 원위부의 혈류가 있는 곳까지의 결손부위는 약 4cm 가량 되었다. 관상동맥 폐색증과 Marfan 증후군의 조합은 매우 드문 질환으로 양측 관상동맥의 혈류 재건을 위하여 각기 다른 술식으로 수술하였다.

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신생아에서 Berry 증후군의 자가동맥 피판을 이용한 일차 완전교정술 (One Stage Repair of Berry Syndrome in a Neonate Using an Autologous Arterial Flap)

  • 박진수;성시찬;장윤희;이형두;손봉수;김영규
    • Journal of Chest Surgery
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    • 제41권4호
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    • pp.499-503
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    • 2008
  • 원위부 대동맥-폐동맥창, 우폐동맥 대동맥기시, 온전한 심실중격결손, 개방성동맥관, 대동맥궁차단으로 구성된, 소위 Berry syndrome이라고 불리는 이 기형은 매우 드문 복잡 심기형이다. 생후 19일된 신생아에서 자가동맥 피판을 이용한 일차 완전교정술과 추적관찰에서 발생한 우폐동맥 협착 및 그의 풍선성형술에 의한 성공적 치료를 문헌고찰과 함께 보고한다.

Guillain-Barre Syndrome 환자의 한방 치험 1례 (A Case Report of Korean Traditional Medical Therapy about Patient with Guillain-Barre Syndrome)

  • 김종원;김민상;오병열;유병찬;조현경;김윤식;설인찬;심재철
    • 대한한방내과학회지
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    • 제25권4호
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    • pp.418-425
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    • 2004
  • The Guillain-Barre Syndrome(GBS), also called acute inflammatory demyelinating polyneuropathy and Landry's ascending paralysis, is an inflammatory disorder of the peripheral nerves - those outside the brain and spinal cord. It is characterized by the rapid onset of weakness and, often, paralysis of the legs, arms, breathing muscles and face. Finally, it leads to respiratory embarrassment and death. There is often a history of antecedent respiratory or gastrointestinal infection. Recently one patient was admitted with GBS. This patient was a 30 year-old man with quadriparesis, both facial palsy, numbness of hands and feet, and gait disturbance. After two weeks of oriental medicine and acupuncture treatment most symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

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상행 대동맥 동맥류를 동반한 Marfan씨증후군 환자에서 생긴 대동맥 박리(Aortic Dissection) 1례 (A Case of Dissection in Marfan Syndrome with Ascending Aortic Aneurysm)

  • 윤봉영;양창헌;김영조;심봉섭;이현우;류한영;정태은;박이태;한승세
    • Journal of Yeungnam Medical Science
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    • 제6권1호
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    • pp.179-184
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    • 1989
  • 본원에서는 Marfan씨증후군과 대동맥류, 대동맥판 역류로 진단받은 환자가 1년후 흉통을 주소로 내원하여 대동맥 박리로 이행한 것으로 밝혀져 응급수술을 성공적으로 치룬 1례를 경험하였기에 보고하는 바이다.

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소음인(少陰人) 보중익기탕(補中益氣湯)과 보중익기탕(補中益氣湯)에 대한 사상의학적(四象醫學的) 비교(比較) 연구(硏究) (A Comparative Study on Soumin Bojungyikgitang and Bojungyikgitang in the View of Constitution Medicine)

  • 김일환;김경요
    • 사상체질의학회지
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    • 제8권2호
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    • pp.69-94
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    • 1996
  • The main purpose of this work is comparing the difference between Soumin Bojungyikgitang of constitutional medicine and Li Dongyuan's Bojungyikgitang Bojungyikgitang, the prescription originated from the Pi-Wei theory(脾胃論) of Li Dongyuan who was a medical man in the Jin Yuan dynasty, had been used widely for many kinds of disease caused by the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the end of Choseon dynasty Li Je Ma, the creator of the constitutional medicine, modified the Bojungyikgitang and applied to Soumin's disease. In this paper, the difference between the two prescription were investigated from the viewpoint of chinese herb pharmacology and purpose of prescription. Additionally the problems which could be brought out by applying Bojungyikgitang to the Soyangin and the Taeumin were studied. And the conclusion could be summarized as follows: 1. The prescription of the Li Dongyuan's Bojungyikgitang is based on the deficiency of vital energy due to internal damage and the Soumin Bojungyikgitang is useful to only a certain stage of progressing disease on the basis of Shanghanlun(傷寒論). 2. In the Li Dongyuan's Bojungyikgitang, Cimicifugae Rhizoma and Bupleuri Radix were used for emphasizing the ascending action and have the antipyretic action and the effect of elavating of yangqi as they are bitter in taste and cold in nature. 3. In the Soumin Bojungyikgitang, Pogostemonis Herba and Perillae Folium have the ascending-descending action and strengthen the stomach with the effect of mild sweating by pungent taste and warm nature. 4. The effect of elavating of yangqi in the Li Dongyuan's Bojungyikgitang offers the pathway where vital qi go up by eleminating the pathogenic fire with the action of Cimicifugae Rhizoma and Bupleuri Radix in the triple energizer and yangming muscular striae. On the other hand, the Soumin Bojungyikgitang depends on the effect of reinforcing qi and elavating yangqi by Astrgalli Radix entirely and supply vital qi by reinforcing yangqi with Ginseng Rsdix. 5. The exahausion of yin(亡陰證) in the Soyangin exterior syndrome and cold limbs(寒厥證) in Taeumin exterior syndrome are similar to the indication of Li Dongyuan's Bojungyikgitang. As the causes of the disease are fundamentally different in the view of constitutional medicine, the diseases could be aggravated by applying Li's Bojungyikgitang. These results suggest that Li Dongyuan's Bojungyikgitang is proper to the exterior syndrome of Soumin and Soumin Bojungyikgitang seems to be appropriate to the Soumin's disease.

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대동맥판상부협착증: 치험 3례 (Supravalvular Aortic Stenosis - Report of 3 cases -)

  • 전예지
    • Journal of Chest Surgery
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    • 제24권3호
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    • pp.280-286
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    • 1991
  • Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries It may be localized or diffuse. Enlargement of the aorta with a diamond-shaped patch of the noncoronary sinus of Valsalva was reported in 1961 by McGoon and associates But this reconstruction is asymmetric and the aortic obstruction may remain. In 1977, Dotty and associates reported the extended aortoplasty, the supravalvular ring was incised at two points in the noncoronary and in the right coronary sinuses of Valsalva closed with a tubular Dacron prosthesis of inverted Y-shape tailored to reconstruct the aorta We experienced three cases of the supravalvular aortic stenosis. The 11-year-old female and 4-year-old male with localized supravalvular aortic stenosis in William`s syndrome were operated with an inverted Y-shaped aortotomy toward the non-coronary sinus and the right coronary sinus and closed with "Hemashield`s collagen impregnated Dacron" tube graft, fashioned into "pantaloon" form patch. The 12-year-old male with localized supravalvular aortic stenosis and mitral insufficiency in William`s syndrome were operated with same procedure as two other patient above-mentioned for relief of supravalvular aortic stenosis and with mitral valve replacement. Postoperative course has been good.ourse has been good.

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Loeys-Dietz 증후군으로 진단된 젊은 여자 환자의 상행 대동맥 파열: 국내 첫 번째 증례 보고 (Ascending Aortic Rupture in a Young Woman with Loeys-Dietz Syndrome: The First Case Report in Korea)

  • 김환욱;이택연;문덕환;주석중;정철현;이재원
    • Journal of Chest Surgery
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    • 제42권5호
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    • pp.639-644
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    • 2009
  • 대동맥 동맥류/대동맥 박리증, 두눈먼거리증, 목젖갈림증/입천장갈림증, 그리고 동맥혈관계의 이상과다 뒤틀림 등을 독특한 표현형으로 하는 Loeys-Dietz 증후군은 새로이 기술된 공격적 성향의 결체 조직 질환으로, transforming growth factor-$\beta$ receptor type 1 또는 type 2를 encoding 하는 유전자 돌연 변이가 발병 원인이다. Loeys-Dietz 증후군은 Marfan 증후군, Ehlers-Danlos 증후군 4형 등의 표현형과 일부 비슷한 형태를 공유한다. 그러나, Loeys-Dietz 증후군은 다른 질환보다 더 심한 병태생리적 특성을 가지고 있기 때문에, 임상의들은 이들 결체 조직 질환들을 감별하여야 한다. 강한 의심, 조기 진단, 예방적 수술, 그리고 지속적 영상 검사가 적절한 Loeys-Dietz 증후군 치료를 위해 실행되어야 한다. 저자들은 대동맥 파열, 목젖갈림증, 그리고 두눈먼거리증의 3징후를 가진 Loeys-Dietz 증후군의 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.