• 제목/요약/키워드: emboli

검색결과 77건 처리시간 0.025초

The Effects of Balloon-Guide Catheters on Outcomes after Mechanical Thrombectomy in Acute Ischemic Strokes : A Meta-Analysis

  • Ahn, Jun Hyong;Cho, Steve S.;Kim, Sung-Eun;Kim, Heung Cheol;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • 제62권4호
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    • pp.389-397
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    • 2019
  • Objective : Mechanical thrombectomies with balloon-guide catheters (BGC) are thought to improve successful recanalization rates and to decrease the incidence of distal emboli compared to thrombectomies without BGC. We aimed to assess the effects of BGC on the outcomes of mechanical thrombectomy in acute ischemic strokes. Methods : Studies from PubMed, EMBASE, and the Cochrane library database from January 2010 to February 2018 were reviewed. Random effect model for meta-analysis was used. Analyses such as meta-regression and the "trim-and-fill" method were additionally carried out. Results : A total of seven articles involving 2223 patients were analyzed. Mechanical thrombectomy with BGC was associated with higher rates of successful recanalization (odds ratio [OR], 1.632; 95% confidence interval [CI], 1.293-2.059). BGC did not significantly decrease distal emboli, both before (OR, 0.404; 95% CI, 0.108-1.505) and after correcting for bias (adjusted OR, 1.165; 95% CI, 0.310-4.382). Good outcomes were observed more frequently in the BGC group (OR, 1.886; 95% CI, 1.564-2.273). Symptomatic intracranial hemorrhage and mortality did not differ significantly with BGC use. Conclusion : Our meta-analysis demonstrates that BGC enhance recanalization rates. However, BGC use did not decrease distal emboli after mechanical thrombectomies. This should be interpreted with caution due to possible publication bias and heterogeneity. Additional meta-analyses based on individual patient data are needed to clarify the role of BGC in mechanical thrombectomies.

심내막염의 수술적 치료 성적에 관한 보고 (Result of Surgical Treatment for Infective Endocarditis)

  • 김성호;안혁;김종환
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.370-376
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    • 1990
  • From April, 1981, through March, 1989, 30 patients had received valve replacements and 1 patient had received foreign body removal for infective endocarditis at Seoul National University Hospital. There were 22 male and 9 female patients, ranged in age from 22 to 59 [mean 34.9] years. Twenty-three had native valve endocarditis, 7 had prosthetic valve endocarditis and 1 had infected transvenous permanent pacemaker electrode in right heart. Twenty-four required operation during active phase of disease and 7 during inactive phase. The infecting organism was Streptococcus in 10 patients, Staphylococcus in 5 patients, both Staphylococcus and Streptococcus in 1 patient, E. coli in 2 patients, and Candida in 1 patient. Indications for Surgery were congestive heart failure in 20, systemic emboli in 5, combination of both in 3, congestive heart failure with uncontrolled sepsis in 2, and complete heart block in 1 patient. Hospital mortality was 9.7% [3/31], and all were the patients who received emergency operation. There were 2 late mortality [7.7 %] due to acute myocardial infarction and recurrent endocarditis. This report suggests that the surgical treatment can be achieved with acceptable low mortality and morbidity in medically intractable congestive heart failure, emboli and sepsis.

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개에서 발생한 Inflammatory Mammary Carcinoma (Inflammatory Mammary Carcinoma in a Dog)

  • 이윤경;서국현;이채용
    • 한국임상수의학회지
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    • 제25권5호
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    • pp.405-407
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    • 2008
  • 13세의 miniature Poodle이 복부 피부의 자반을 주증으로 내원하였다. 자반은 전체 유선에 걸쳐 관찰되었으나 특히 복부유선과 서혜부 유선에서 심하게 관찰되었다. 유선을 덮고 있는 피부는 자줏빛으로 변해있었으며 비후되었고 황갈색의 분비물이 전흉부유선을 제외한 모든 유선에서 분비되었다. 조직학적 검사에서는 피부측 림프관들이 Cytokeratin에 양성반응을 보이는 종양세포 색전들로 차있었다. 본 증례는 임상검사와 조직학적 검사를 통해 inflammatory mammary carcinoma로 진단되었다.

폐색전 제거술 후 혈전에서 우연히 확인된 원발 미상 편평 상피 세포암 1예 (A Case of Primary Unknown Squamous Cell Carcinoma Incidentally Found in the Thrombus After Pulmonary Embolectomy)

  • 최창환;박영수;류동렬;박성하;고원기;안강현;박재민;김세규;장준;김성규;이원영
    • Tuberculosis and Respiratory Diseases
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    • 제47권1호
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    • pp.103-110
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    • 1999
  • 저자 등은 폐색전증이 확인된 환자에서 지속적인 경구 warfarin 항응고 치료에도 불구하고 색전에 의한 호흡곤란 증상이 악화하여 시행한 색전제거술 후 혈전에서 원발 미상의 미분화 편평 상피 세포암이 확인된 1예를 경험하여 보고하는 바이다.

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안장 색전증을 유발한 좌심방 점액종 -수술 치험 1례- (Saddle Embolism Caused by Left Atrial Myxoma -A Case Report-)

  • 송정근
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.316-319
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    • 1995
  • Systemic emboli occur in approximately one-third of patients with cardiac myxoma. Embolization is common because of the friability of the tumor and intracardiac location. Embolic episodes in young patients with normal sinus rhythm should arouse suspicions of cardiac myxoma in the absence of active endocarditis. We present one case of 17 years old girl having saddle embolism combined with left atrial myxoma. We planned staged operation. First, the emergency thromboembolectomy of aortic bifurcation was performed through bilateral transfemoral approach with use of Forgaty catheter. One week later, the extirpation of myxoma was successfully done with ECC.

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꽃사슴에서 자연발생한 림프육종 (Spontaneous Lymphosarcoma in a Formosan Sika Deer (Cervus nippon taiouanus))

  • 한정희;진희경;김종택
    • 한국임상수의학회지
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    • 제11권2호
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    • pp.573-578
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    • 1994
  • A lymphosarcoma was diagnosed in a 4-year-old female Formosan sika deer presented with persistent reproductive failure, anorexia, depression and diarrhea. Characteristic pathological findings were infiltration of neoplastic lymphoid cells and cancer emboli in the lymph nodes, heart, lung, kidney, urinary bladder, ovary, uterus and peritoneal fat tissue.

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개에서 발생한 유선 면포암종 (Mammary Comedocarcinoma in a Dog)

  • 김재훈;김재훈
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.486-489
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    • 2013
  • 18세령 중성화 암컷 요크셔테리어종 개가 우측 4번 및 5번 유선 부위에 위치한 대형 복부 종괴로 내원하였다. 외과적으로 적출한 유선 종괴가 병리학적 진단을 위하여 의뢰되었다. 병리조직학적 소견으로 종괴는 표피에서 피하조직에 걸쳐 다발성 및 융합된 종양성 집락들로 구성되어 있었다. 종양성 집락들은 면포상, 고형상, 사상 및 미세유두상 등의 매우 다양한 형태를 나타내었으며, 큰 종양성 유선 도관은 주변조직으로의 강한 침습성을 나타내고 있었다. 진피표층에 위치한 다수의 림프관 얼기들과 진피의 림프관에는 무수히 많은 종양세포의 색전을 가지고 있었다. 종양을 구성하고 있는 세포들의 약 50%이상이 면포상의 형태를 띠고 있기 때문에, 본 증례는 최근의 개 유선 종양의 분류에 근거하여 개의 유선에서 발생한 유선 면포 암종으로 진단하였다.

급성 입인두 감염 후에 발열과 경부 강직을 주소로 내원한 Lemierre 증후군 1례 (A Case of Lemierre Syndrome Manifests with Persistent Fever and Neck Stiffness Following Acute Oropharyngeal Infection)

  • 이예나;홍예슬;김성수
    • Pediatric Infection and Vaccine
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    • 제23권2호
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    • pp.143-148
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    • 2016
  • Lemierre 증후군은 급성 입인두 감염의 합병증으로 생기는 질환으로, 이차적인 혈전 정맥염과 여러 장기를 침범하는 전이성 색전이 특징이다. 1940년대 이후 항생제가 도입되면서 "잊혀진" 질환이었지만, 영상의학 검사가 발달하면서 Lemierre 증후군의 보고가 많아지고 있다. 건강한 16세 남자 환자가 입인두 감염 후에 5일간 지속된 발열과 경부 강직으로 응급실에 내원하였다. 입원 초기에는 뇌수막염에 준하여 치료를 시작하였으나 추후 경부 전산화 단층촬영에서 오른쪽 속목정맥 안의 혈전이 발견되어 Lemierre 증후군으로 진단하였다. 환자는 입원 2일째 갑자기 복시를 호소하였으나 곧 증상이 호전되었으며, 그 외 전이성 색전에 의한 증상은 발견되지 않았다. 총 3주간의 항생제 치료 후 정맥 내 혈전이 소실된 것을 경부 초음파로 확인하고 치료를 종료하였다.

Differential Diagnosis of CT Images in Children with Neuroblastomas and Ganglioneuroblastomas

  • Zhuang, Bo;Lv, Deng-Kun;Gao, Si-Ju;Meng, Jing-Jing
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10509-10512
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    • 2015
  • Objective: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). Materials and Methods: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. Results: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). Conclusions: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.

응급 페동맥 색전 제거술로 진단 및 치유된 폐동맥내 융모막 암종 (Choriocarcinorma in the Pulmonary Artery Diagnosed and Treated by Emergency Pulmonary Embolectomy)

  • 조봉균;김종인;이해영;박성달;김송명;김영옥
    • Journal of Chest Surgery
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    • 제36권7호
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    • pp.531-534
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    • 2003
  • 5년 전 침윤기태(invasive mole)로 진단받았던 43세 여자가 심폐 바이패스 하에 응급 폐색전 제거술을 시행 받았다. 우측 주폐동맥뿐 아니라 좌하엽 폐동맥에도 종양이 침범되어 완전절제는 얻을 수 없었다. 종양 조직검사에서 융모막 암종으로 확진된 후 환자는 6개월 동안 항암치료를 받았고 완전관해 되었다. 드물지만 가임기 여성에서 폐색전이 있을 때 감별진단으로 융모막 암종을 고려해야 한다.