• Title/Summary/Keyword: dilatation

Search Result 607, Processing Time 0.022 seconds

Impact of Pulmonary Arterial Elastance on Right Ventricular Mechanics and Exercise Capacity in Repaired Tetralogy of Fallot

  • Soo-Jin Kim;Mei Hua Li;Chung Il Noh;Seong-Ho Kim;Chang-Ha Lee;Ja-Kyoung Yoon
    • Korean Circulation Journal
    • /
    • v.53 no.6
    • /
    • pp.406-417
    • /
    • 2023
  • Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO2] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO2 was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

Bilateral Persistent Sciatic Arteries Complicated with Aneurysmal Dilatation and Thrombotic Occlusion: A Case Report (동맥류와 혈전성 폐색이 동반된 양측 잔류좌골동맥: 증례 보고)

  • Seo Jin Jang;Yoonhee Han;Jae Hyun Kwon
    • Journal of the Korean Society of Radiology
    • /
    • v.81 no.6
    • /
    • pp.1517-1522
    • /
    • 2020
  • Persistent sciatic artery (PSA), a rare congenital vascular anomaly, increases susceptibility to aneurysms and accounts for 40-61% of the cases. Here, we describe a case of PSA in a 70-yearold man with a history of alcoholic liver cirrhosis. Bilateral complete PSAs were detected incidentally on computed tomography angiography during evaluation for spontaneous intramuscular bleeding in the thigh due to cirrhosis-related coagulopathy. Selective angiography of the left PSA revealed aneurysmal dilatation and thrombotic occlusion of the PSA, which was partially removed with aspiration thrombectomy. Intramuscular bleeding was succesfully managed with empirical embolization of the deep femoral artery.

Peroral Pancreatoscopy with Videoscopy and Narrow-Band Imaging in Intraductal Papillary Mucinous Neoplasms with Dilatation of the Main Pancreatic Duct

  • Yui Kishimoto;Naoki Okano;Ken Ito;Kensuke Takuma;Seiichi Hara;Susumu Iwasaki;Kensuke Yoshimoto;Yuto Yamada;Koji Watanabe;Yusuke Kimura;Hiroki Nakagawa;Yoshinori Igarashi
    • Clinical Endoscopy
    • /
    • v.55 no.2
    • /
    • pp.270-278
    • /
    • 2022
  • Background/Aims: Endoscopic evaluation of intraductal papillary mucinous neoplasms (IPMNs) is useful in determining whether the lesions are benign or malignant. This study aimed to examine the usefulness of peroral pancreatoscopy (POPS) in determining the prognosis of IPMNs. Methods: POPS with videoscopy was performed using the mother-baby scope technique. After surgery, computed tomography/magnetic resonance cholangiopancreatography or ultrasonography and blood tests were performed every 6 months during the follow-up. Results: A total of 39 patients with main pancreatic duct (MPD)-type IPMNs underwent POPS using a videoscope, and the protrusions in the MPD were observed in 36 patients. The sensitivity and specificity of cytology/biopsy performed at the time of POPS were 85% and 87.5%, respectively. Of 19 patients who underwent surgery, 18 (95%) patients had negative surgical margins and 1 (5%) patient had a positive margin. Conclusions: In IPMNs with dilatation of the MPD, POPS is considered effective if the lesions can be directly observed. The diagnosis of benign and malignant lesions is possible depending on the degree of lesion elevation. However, in some cases, slightly elevated lesions may increase in size during the follow-up or multiple lesions may be simultaneously present; therefore, careful follow-up is necessary.

Late aortic root dilatation and aortic regurgitation in repaired tetralogy of fallot (팔로 4징의 완전 교정술 후 장기 추적 관찰상 나타나는 대동맥근의 확장과 대동맥판 폐쇄부전)

  • Kim, Jeong Eun;Hur, Kyong;Kwon, Hae Sik;Yoo, Byung Won;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.10
    • /
    • pp.976-981
    • /
    • 2007
  • Purpose : Aortic valve or aortic root (AoRo) replacement is occasionally required because of AoRo dilatation and aortic regurgitation (AR) in repaired tetralogy of Fallot (TOF). We evaluated AoRo size and possible factors associated with its hemodynamic nature in patients with repaired TOF. Methods : We investigated 130 repaired TOF patients more than 15 years of age who followed-up by echocardiography from January 2002 to December 2003. Of 130 patients, we identified 17 patients with AoRo dilatation, which was defined as ratio of expected AoRo size by standard nomogram (AoRo ratio) >1.5 (dilator group), and 113 TOF controls, with AoRo ratio <1.5 (non-dilator group). Results : Mean indexed AoRo size ($mm/m^2$) in the first echo was $24{\pm}3.2$ in the dilator group and $18{\pm}3.4$ in the non-dilator group (P<0.0001). AoRo rate of change (mm/year) from the first to latest echo study was $1.6{\pm}3.8$ in dilator group and $0.05{\pm}1.6$ in the non dilator group (P=0.0021). Patients from the dilator group showed a higher prevalence of pulmonary atresia (P=0.031) and a history of aortopulmonary shunt before repair (P=0.048), moderate to severe AR (P=0.0065), and increased left ventricular end-diastolic dimensions (P=0.003). Conclusions : A subset of patients late after TOF repair may show progressive dilatation of AoRo. To identify and prevent long-term sequelae in this patient group, regular follow-up and speculation about AoRo after TOF repair is recommended.

Pathological Studies on the Experimentally Induced Rodenticide Poisoning in Ruminant (반추수(反芻獸)의 살서제중독(殺鼠劑中毒)에 관한 병리학적(病理學的) 연구(硏究))

  • Lee, Cha-Soo;Park, Cheong-Kyu;Cho, Yong-Joon;Kwak, Soo-Dong
    • Korean Journal of Veterinary Research
    • /
    • v.22 no.2
    • /
    • pp.221-232
    • /
    • 1982
  • This paper dealt with the pathological and clinical findings on the experimentally induced rodenticide (fluoroacetate, zinc phosphide, thallium sulfate, coumarin) and NaCN poisoning of ruminants (Holstein cattle and/or Korean native goat) for the purpose of the diagnosis in the accidental rodenticide poisoning of cattle. The results observed are summarized as follows: Fluoroacetate poisoning (cattle and goat): in the clinical signs, there were depression, convulsion, dyspnea, groan, grinding of the teeth, vomiting, opisthotonus and post-mortem tympany. In the macroscopical findings, the blood was more or less poor coagulative and dark red, bloody fluid with foam in the trachea, hyperemia and hemorrhage of tracheal mucosa and lung, cloudy swelling and hyperemia of kidney, epicardial hemorrhage(cattle), and hyperemia of abomasum, intestine and brain were observed. In the microscopical findings, there were pulmonary edema and hemorrhage, necrosis of convoluted tubular epithelium and interstitial hemorrhage of kidney, focal coagulative necrosis of myocardium, hemorrhage of pancreas and spleen, dilatation of Virchow-Robin space and hyperemia of brain, and necrosis with desquamation of mucosal epithelia of abomasum and upper small intestine. In the histological lesions of the liver, lobular peripheral hyperemia, centrilobular necrosis and cytoplasmic inclusion bodies of the hetatic cells were observed. The cytoplasmic inclusion body of the hepatic cells was not seen in the affected goat, but hydropic degeneration of the hepatic cells was marked. Zinc phosphide poisoning (cattle and goat): clinically, the affected animals died in recumbent position after ataxia, dyspnea and convulsion. In the macroscopical findings, hyperemia and hemorrhage of lung, cloudy swelling and hyperemia of liver and kidney, hemorrhage of spleen (cattle), and catarrh of abomasum and small intestine were observed. In the microscopical findings, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hemorrhage of spleen, hyperemia of lung, hyperemia or hemorrhage of heart, cloudy. swelling and fatty changes of hepatic cells, dilatation of hepatic central vein, hyperemia of brain, and catarrh of abomasal and small intestinal mucosae were observed. Thallium sulfate poisoning (cattle): in the macroscopical findings dark red color of blood, hyperemia and hemorrhage of lung, bloody fluid with foam in the tracheal mucosa, petechiae of tracheal mucosa, cloudy swelling and hemorrhage of liver, necrotic lesions and hemorrhage of renal cortex and epicardial hemorrhage were observed. In the microscopical findings, severe hemorrhages of the lung, cloudy swelling and necrosis of hepatic cells, hyperemia and hemorrhage of liver, focal coagulative necrosis of mycordium, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hyperemia and hemorrhage of spleen and dilatation of Virchow-Robin apace in brain were observed. Coumarin poisoning (goat): the poisoned animals died in the state of groan and depression. In the macroscopical findings, poor coagulation of blood, hemorrhage of lung, cloudy swelling and severe hemorrhages of liver, cloudy swelling and hemorrhage of kidney, abomasal hemorrhage, catarrh of small intestine, and hyperemia and hemorrhage of the other organs were observed, In the microscopical findings, hyperemia and hemorrhage of lung and kidney, cloudy swelling of the convoluted tubular epithelium of kidney, severe hepatic hyperemia, cloudy swelling and hydropic degeneration of heptatic cell, and hyperemia and hemorrhage of brain and spleen were observed. NaCN poisoning (cattle and goat): clinically, there were convulsion, severe dyspnea, paresis of hind limb, depression and then rigor of four limbs. In the macroscopical findings, bright red color of blood, hyperemia and bright and red tinge of lung cloudy swelling of kidney and liver, and hyperemia of abomasum were observed. In the microscopical findings, cloudy swelling and hydropic degeneration of hepatic cell, hyperemia and edema of lung, necrosis and degeneration of the convoluted tubular epithelium and hemorrhage in kidney, dilatation of Virchow-Robin space of brain and hemorrhage of spleen were observed.

  • PDF

Small bowel obstruction caused by an anomalous congenital band in an infant (신생아에서 발생한 선천성 밴드에 의한 장폐색증 1예)

  • Sung, Tae-Jung;Cho, Ji-Woong
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.2
    • /
    • pp.219-221
    • /
    • 2008
  • Intestinal obstruction is not uncommon in infants. The common causes of intestinal obstruction in the neonatal period are Hirschsprung disease, intestinal atresia, meconium ileus, and intussusception. However, small bowel obstruction caused by a congenital band is very rare. We report a 27-day-old baby who was admitted with abdominal distension and fever. The abdominal X-ray revealed massive bowel dilatation and the contrast gastrografin enema suggested a distal small bowel obstruction. The explolaparotomy showed small bowel entrapment due to an unusual anomalous congenital band.

Advanced Finite Element Analysis for Linear Viscoelastic Problems of a Hereditary-Type Constitutive Law (유전적분형 선형 점탄성문제의 유한요소법에 의한 효율적 해석)

  • 심우진;이성희
    • Computational Structural Engineering
    • /
    • v.6 no.2
    • /
    • pp.103-114
    • /
    • 1993
  • An advanced time-domain finite element formulation is presented for the displacement and stress analysis of isotropic, linear viscoelastic problems of a hereditary-type constitutive law. The semidiscrete finite element method with linear time-stepping scheme and an elastic-viscoelastic correspondence principle are used in the theoretical development. An efficient treatment of hereditary integral is introduced to improve the numerical accuracy, to reduce the computation time, and to avoid the use of large memory storage. Two-dimensional numerical examples of plane strain and plane stress are solved under the assumption on the material property of being elastic in dilatation and like three-element Voigt model in distorsion, and compared with the analytical solutions and the past numerical results to show the versatility and efficiency of the proposed method.

  • PDF

The effect of coking property on combustion reactivity of weak caking coals and ash-free coal (점결특성이 무회분탄과 약점결탄의 연소반응성에 미치는 영향)

  • Lee, Soonho;Eom, Soohyun;Kim, Gyubo;Jeon, Chunghwan
    • 한국연소학회:학술대회논문집
    • /
    • 2014.11a
    • /
    • pp.47-49
    • /
    • 2014
  • 발전소에서 설계 규격을 벗어나는 저등급 석탄을 사용하기 시작하면서, 보일러에서의 연소특성을 예측하기 어려운 다양한 성질의 석탄이 들어오게 되어 각종 연소 문제가 증가하고 있다. 이 중 약 점결 특성을 가지는 저등급 석탄의 사용은 대형 클링커로 인한 보일러 하부의 튜브 손상 사고, 재열증기온도 상승으로 인한 출력감발 등의 문제를 발생시켰다. 또한 현재 개발 중인 무회분석탄 역시 점결 특성을 가지고 있는 것으로 알려져 있어 보일러 내부의 다양한 문제를 일으킬 것으로 예상되고 있다. 발전소에서는 강점결탄 수입 규제를 위해 CSN(Crucible Swelling Number)를 이용하여 제철용으로 사용되는 강점결 석탄의 도입을 규제해왔으나, 발전소 운영에 악 영향을 미치는 약 점결탄에 대한 규제 및 대응으로는 그 효과가 미미한 실정이다. 따라서 본 연구에서는 석탄의 점결 특성 중 팽창 특성을 분석할 수 있는 Microdilatometer와 TGA를 이용한 연소반응성 분석을 통해 석탄의 점결 특성이 연소반응성에 미치는 영향을 분석하였다.

  • PDF

Numerical Computation of the Stress Itensity Factor of A Cracked Viscoelastic Body Under the Impact Load (충격하중을 받는 점탄성 균열의 응력확대계수 계산)

  • Lee Sung-Hee;Sim Woo-Jin
    • Transactions of the Korean Society of Mechanical Engineers A
    • /
    • v.28 no.10
    • /
    • pp.1583-1589
    • /
    • 2004
  • In this paper, A new finite element method for the time domain analysis of the dynamic stress intensity factor of two-dimensional viscoelastic body with a stationary central crack under the transient dynamic load is presented, which is based on the intergrodifferential equations of motion in the isotropic linear viscoelasticity and the Galerkin's method. The vlscoelastic material is assumed to be elastic in dilatation and behaves like a standard linear solid in shear. As a numerical example, the Chen's problem in viscoelastodynamic version is solved for the parametric study about the effect of viscosity and relaxation time on the dynamic stress intensity factor.

Effects of San-Yin-Jiao(SP6) Acupressure on Labor Pain, Delivery Time in Women during Labor (삼음교(SP6)지압이 산부의 분만통증, 분만소요시간에 미치는 효과)

  • 이미경
    • Journal of Korean Academy of Nursing
    • /
    • v.33 no.6
    • /
    • pp.753-761
    • /
    • 2003
  • Purpose: The study was done to examine the effects of San- Yin-Jiao(SP6) acupressure treatment on subjective labor pain, length of delivery time in women during labor. Method: The study design was a randomized controlled clinical trial study using a double-blinded method. Data were collected using a structured questionnaire, a subjective labor pain scale and measurement of delivery time. The experimental group(n=29) was received SP6 acupressure and control group(n=29), SP6 touch for the duration of each uterine contraction, during 30 minutes after 3cm dilatation of cervical os. Result: The subjective labor pain scores was significantly different between the two groups(p=0.042). The total length of delivery time in the group which had the SP6 acupressure was shorter than SP6 touch group (p=0.036). Conclusion: These findings showed that SP6 acupressure was effective related to labor pain, length of time for delivery. SP6 acupressure during labor could be applied as an effective nursing treatment.