• Title/Summary/Keyword: double ligation

Search Result 36, Processing Time 0.022 seconds

A case of canine patent ductus arteriosus showed favorable therapeutic response by surgery combined with needle-acupuncture therapy

  • Kim, Kwang-Shik;Kim, Byung-Young;Kim, Tae-Hwa;Kim, Won-Bae;Liu, Jianzhu;Lee, Jung-Yeon;Kim, Duck-Hwan;Rogers, Philip A.M.
    • Korean Journal of Veterinary Research
    • /
    • v.45 no.4
    • /
    • pp.575-579
    • /
    • 2005
  • A 6-month-old male Poodle was referred with chief complaint of dysponea and cough. Cyanosis was not detected. This dog was diagnosed as a case of canine patent ductus arteriosus (PDA) by X-ray and ultrasonography. Diuretics and bronchodialators were administered for 4 weeks. Clinical symptoms were not improved. Thoracotomy was done at right recumbent position. The length of ductus arteriosus was 8 mm and the diameter was 6 mm, respectively. Double ligation was performed in surgery. Continuous cardiac murmur, cough and strong femoral pulsation were disappeared after surgery. The diameters of the pulmonary artery and vein found to normal by X-ray on 10 days after operation. The diameter of the aorta measured to be larger than that of the main pulmonary artery by ultrasonography. The fractional shortening (FS) on 10 days after surgery was 17.32% by ultrasonography. The needle-acupuncture therapy was used in acupoints BL-15 as local point plus PC-6, HT-7 and HT-5 as distant points for 3 days (15 min/once/a day). The FSs were increased to 21.31% and 29.44% at 1 and on 3 days after acupuncture, respectively. The present patient was a case of typical canine PDA that showed favorable therapeutic responses by surgery combined with needle-acupuncture treatment.

Clinic Analysis of Heart Surgery -110 cases- (심장수술 110례 임상고찰)

  • Chang, Hoon;Shin, Sung-Aia;No, Joong-Kee;Rho, Jun-Ryang
    • Journal of Chest Surgery
    • /
    • v.34 no.8
    • /
    • pp.597-603
    • /
    • 2001
  • Background: The purpose of writing this article is to get better clinical results and further clinical improvement based on subject to 110 cases of cardiac surgery which were performed and clinically analyzed. Material and Method: Since January 1995, the patent ductus arteriosus surgery had started in our hospital. In February 1999, an open heart surgery had started and up to September 2000, total of 110 cases were performed as of double ligation of patent ductus arteriosus(10 cases) and open heart surgery(100 cases). Result: Among the patients, Korean-Chines was 74(67.3%) and Han-Chinese was 35(31.8%). Congenital heart disease was 95 cases and acquired valvular heart disease was 15 cases. 83 cases of acyanotic congenital heart disease consisted of ventricular septal defect(VSD) with associated anomaly(45 cases), atrial septal defect(ASD) with associated anomaly(20 cases), patent ductus arteriosus(PDA) with associated anomaly(11 cases), cogenital aortic stenosis(5 cases), double chamber right ventrical(1 case) and Ebstein's anomaly(1 case). Among the 12 cases of cyanotic congenital heart disease, 11 cases of tetralogy of Fallot underwent total correction. Among the 15 cases of acquired valvular heart disease, valvular replacement(7 cases), double valve replacement (3 cases), mitral valve replacement(3 cases) and aortic valve replacement(1 case) were performed. And 8 cases of valvuloplasty were performed by using of commissurotomy, chordal plasty, plasty of papillary muscle, ring type annuloplasty, repair of leaflet. Conclusion: on cogenital heart disease, short term results of surgery for acyanotic cogenital heart disease was good. Among the cyanotic congenital heart disease, tetralogy of Fallot showed a little difference of recovery according to the surgery method so that further follow up observation was needed for long term result. On acquired valvular heart disease, especially, in terms of short term result of valvuloplasty, was relatively good, but further follow up observation was also needed for long term result. There wasn's any operative mortality.

  • PDF

Careful Approach for Ureteronephrectomy in a Dog with Hydronephrosis causing Dense Adhesion (치밀한 유착조직을 형성한 수신증을 가진 개에서 신요관절제술을 위한 세심한 접근)

  • Kim, Young-Ki;Uhm, Mi-Young;Lee, Scott-S.;Wang, Ji-Hwan;Park, Kee-Tae;Jin, Yeung-Bae;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
    • /
    • v.26 no.4
    • /
    • pp.353-358
    • /
    • 2009
  • Unilateral ureteronephrectomy was performed in a dog presented with unilateral hydroureter and hydronephrosis. On laparotomy, severe adhesion of the dorsomedial border of the affected kidney to the abdominal aorta longitudinally and caudal pole of the kidney firmly to the ipsilateral ovary were observed. Since it was not possible to ligate the renal artery and vein separately due to severe adhesion tissue, two mass ligations were applied in the medial border of kidney, and the adhesion tissue was transected distal to each ligature. Then, blunt and sharp dissections were performed to isolate dorsomedial border of the kidney from the abdominal aorta, but they brought out unexpected hemorrhage caused by incision of renal artery and it has been suspected that two mass ligations could not include renal artery, which was adhered to dorsomedial border of the kidney. The hemorrhage was controlled by double ligations and electrocautery. In this case report, we recommend that if isolation of renal vessels is impossible due to strict adhesion of kidney to adjacent tissue, the mass ligation could be chosen to isolate and exteriorize the kidney and placed carefully not only at medial border of the kidney, where the renal vessels come into the kidney anatomically but also additional border of the kidney where adhesion tissues are formed.

The pharmacological treatment of patent ductus arteriosus in premature infants with respiratory distress syndrome: oral ibuprofen vs. indomethacin (호흡곤란 증후군 미숙아에서 동맥관 개존증의 약물 치료 : 경구용 ibuprofen과 indomethacin의 비교)

  • Lee, Soo Jin;Kim, Ji Young;Park, Eun Ae;Sohn, Sejung
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.9
    • /
    • pp.956-963
    • /
    • 2008
  • Purpose : Indomethacin is widely used for the prophylaxis and treatment of patent ductus arteriosus (PDA); however, it is associated with side effects such as renal failure, intraventricular hemorrhage, and gastrointestinal bleeding. Intravenous ibuprofen has been shown to be as effective as indomethacin in prompting PDA closure. If treatment with oral ibuprofen is as effective as indomethacin, it would have the advantages of greater availability, simpler administration, and lower cost. We conducted this study to compare the efficacy and side effects of indomethacin with those of oral ibuprofen, vis-$\grave{a}$-vis on the pharmacological closure of PDA. Methods : As a randomized double-blind study, 34 preterm infants with respiratory distress syndrome and hemodynamically significant PDA were treated with either intravenous indomethacin or oral ibuprofen. Echocardiography was performed by one cardiologist who was blind to the treatment that any given infant received. The rate of ductal closure, the need for additional drug treatment or surgical ligation, clinical outcome, and the side effects of drug treatment were compared. Results : Ductal closure occurred in 16 of 18 patients (88.9%) from the indomethacin group and in 14 of 16 patients (87.5%) from the ibuprofen group (P>0.05). Three patients in the indomethacin group and four in the ibuprofen group required a second drug treatment (P>0.05). Three patients (i.e., one patient in the indomethacin group and two in the ibuprofen group) underwent surgical ligation (P>0.05). Between the two groups, there was no significant difference vis-$\grave{a}$-vis in side effects or clinical outcome. Conclusion : Compared to indomethacin, oral ibuprofen has the advantages of simpler administration and lower cost, while being as effective; in addition, there are no differences between the two drug treatments with regards to side effects or clinical outcomes. Therefore, the widespread use of oral ibuprofen should be considered in treating PDA in preterm infants.

Acquisition of Thermotolerance in the Transgenic Plants with BcHSP17.6 cDNA (BcHSP17.6 cDNA의 도입에 의한 형질전환된 식물의 내열성 획득)

  • Ki Yong Kim;Min Sup Chung;Jin Ki Jo
    • Journal of The Korean Society of Grassland and Forage Science
    • /
    • v.17 no.4
    • /
    • pp.379-386
    • /
    • 1997
  • Recombinant plasmid, pBKH4, containing NPT II and P35S-BcHSP17.6 was constructed by ligation of Bum H I -digested pBKSl-l and BcHSP 17.6 (thermotolerance gene) 6om pBLH4. The tobacco leaf disc was cocultivated with transformed Agmbacterium tumefaciens bearing pBKH4 for 24 hours and transformed shoots were selected on MS-n/B medium containing $100\;{\mu\textrm{g}}/ml$ of kanamycin. Heat-killing temperature of Nicotima tabacum was $50^{\circ}$ for >15min, and transformed tobacco plants with BcHSP17.6 cDNA exhibited thermotolerance at the heat-killing temperature. The transgenic plants were analyzed by Southern blot hybridization with the probe of ${\alpha}^{_32}P$ labelled BcHSP17.6 cDNA. Transcription and expression level of BcHSP17.6 cDNA were also continued by Northern blot analysis and Ouchterlony double immunodiffusion assay. In this study, we suggest that the BcHSP17.6 cDNA introduced to tobacco plant is related to thenuoto-lerance and 17.6-kD LMW HSP acts as a protector from heat damage in plants.

  • PDF

Open Heart Surgery after Pulmonary Artery Banding in Children (소아에서 폐동맥밴딩술후의 개심술 치료)

  • 김근직;천종록;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
    • /
    • v.32 no.9
    • /
    • pp.781-789
    • /
    • 1999
  • Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

  • PDF