• Childhood Kidney Diseases
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• 제2권2호
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• pp.138-144
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• 1998

Purpose : The use of cyclosporine and mitomycin in various immunologic or neoplastic disorders has been known to cause wide-ranged nephrotoxic effects including thrombotic microangiopathy. However, the mechanism of nephrotoxicity of these drugs has not been studied adequately, so that present experimental study has been undertaken to find out whether these drugs can cause direct damage to the kidney and to clarify the pathogenetic mechanism of nephrotoxic effect of these drugs. Materials and methods : Sprague-Dawley rats weighing 250-300 gm were used for experimental animals and unilateral renal perfusion technique, modified from the method described by Hoyer et al was used. Isolation of left kidney from systemic circulation was made by clamping aorta and left renal vein and a hole was punctured in the anterior wall of the left renal vein. Cyclosporine (2.5 mg in 4 ml solution) and mitomycin (1.6 mg in 4ml solution) were infused through left renal artery and normal saline was used in control rats. Forty-eight hours after infusion of the drugs, animals were sacrificed and left kidney removed and processed for histologic examination. Total ischemic time of left kidney was less than 15 minutes: Results : Cyclosporine-perfused group showed severe swelling of glomerular endothelial ceil along with swelling of glomerular epithelial cell and interstitial vascular endothelial cell. Mitomycin-perfused group also showed severe swelling of glomerular endothelial and epithelial cells. And in addition to these findings, they demonstrated platelets aggregation, swelling and degranulation of platelets and fibrin accumulation in some of the capillaries, indicating occurrance of thrombotic microangiopathy. Conclusion : present experiment indicates that cyclosporine and mitomycin can cause direct toxic injury to renal endothelial cell. And this direct toxic damage to endothelial cell seems to be an important initiating event for the development of thrombotic microangiopathy.

• Journal of Chest Surgery
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• 제29권9호
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• pp.1028-1030
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• 1996

Arteriovenous fistula Is the most widely used mean of vascular access for long-term hemodialysis in patients with end-stage renal disease. Lymphangioma associated with arteriovenous fistula is very rare, seemed to be developed from Iymphatic fluid accumulation. Lymphangioma is benign neoplasm, arises de hobo or secondary to surge y or irradiation, and affects almost any part of the body served by the Lwphasic system. Treatment of choise for Iymphangioma Is surgical excision. We repo$\ulcorner$t a case of procedure using Gore-Tex graft between left brachial artery and cephalic vein for vascular access of hemodialysis in 59 year old female, with successful surgical removal.

• The Korean Journal of Physiology
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• 제30권2호
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• pp.269-278
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• 1996

The mechanism of impaired endothelium-dependent relaxation in the aorta of one-kidney, one clip Goldblatt hypertensive (1K,1C-GBH) rats was investigated. 8 week-old Wistar-Kyoto (WKY) rats were made hypertensive by left renal artery stenosis with contralateral nephrectomy. Endothelium-dependent relaxation was significantly reduced in 1K,1C-GBH rats as compared with WKY rats. However, the relaxation by sodium nitroprusside in 1K,1C-GBH rats was not reduced as compared with WKY rats. The impairment of endothelium-dependent relaxation in 1K,1C-GBH rats was partially restored by the pretreatment of indomethacin or SQ29548. When the nitric oxide production was inhibited by L-nitroarginine methyl ester, acetylcholine (ACh) induced a endothelium-dependent contraction that was greater in 1K,1C-GBH rats than in WKY rats. Endothelium-dependent contraction by ACh was completely abolished by indomethacin or SQ29548. However, imidazole, tranylcypromine and superoxide dismutase did not affect the endothelium-dependent contraction in 1K,1C-GBH rats. These results suggest that impaired endothelium-dependent relaxation in the 1K,1C-GBH rats might be due to the simultaneous release of EDCF, and that prostaglandin B2 may be involved as a mediator of endothelium-dependent contraction.

• Journal of Chest Surgery
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• 제41권6호
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• pp.799-802
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• 2008

Infection occurs very rarely in the sternoclavicular joint compared to other joints in the body. It occurs mainly in IV drug abusers, diabetics, chronic renal failure patients, septic patients and those with central vein catheters. In the early phase, it can be treated simply by antibiotics or incision, and drainage. However, when proper treatment is not begun. early, bone destruction can occur, and only en-bloc resection of the involved bone can cure it. To reduce the risk of recurrence, we advanced a pectoralis major flap into the resected area based on the feeding artery. We report a case of a patient with sternoclavicular osteomyelitis who was successfully treated using en-bloc resection and a pectoral advancement flap.

• The Korea Journal of Herbology
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• 제21권2호
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• pp.143-150
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• 2006

Oriental pear was used as treatment of asthma, control of blood pressure tonic medicine diabetes in oriental medicine, Pear Pectin was effective on control of blood pressure in previous report. In this study, it was investigated that Woohwang with pear extractions effects on cardiovascular system as blood pressure and renin and Atrial natriuretic peptide(ANP) in plasma. The 2K1C hypertension model was prepared by constricting the left renal artery with a sliver dip. Animals were then divided into three groups, control, Woowhang:Pear Phenolic compound(1:1), Woowhang:Pear Phenolic compound(2:1),Woowhang:Pear Phenolic compound(1:2) were supplied with them. Direct-blood pressure was measured at femoral vein, Indirect-blood pressure was measured at rodent tail. The results are as follows. The blood pressure was more significantly decreased at 1:2(woohwang:pear phenolic compound)group than other groups. On 6,9,12,15days, the blood pressure was significantly decreased in 1:2(woohwang:pear phenolic compound)group. The plasma ANP was significantly increased in 1:2(woohwang:pear phenolic compound)group. It tenders to decrease in 1:2(woohwang:pear phenolic compound)group on plasma renin. Based on the above results it is assumed that oral administration of Woohwang with Pear Phenolic compound(1:2) can help the treatment of hypertension.

• Herbal Formula Science
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• 제21권1호
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• pp.1-15
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• 2013

Objectives : This article is a study on to which categories of modern diseases blood stasis patterns are assigned and the meaning of blood stasis interpreted with perspectives of Korean Medicine and modern medicine. Methods : We reviewed "Neijing", "Shanghanlun", "Yilingaicuo", "Xuezhenglun" and other books and modern clinical papers related with blood stasis. Results : 1. Blood stasis patterns are related with disorders of hemorrheology, hemodynamics, platelet function, microcirculation, microelements and endothelial damage. 2. From the types of syndrome differentiation, diverse diseases classified in type of qi deficiency with blood stasis and type of blood stasis due to qi stagnation are reported, which reflects qi and blood are closely connected. And many diseases are classified in type of kidney deficiency with blood stasis, which has something in common with chronic diseases can achieve effect from treatment considering blood stasis. 3. Diseases related with kidney involve menopausal disorder, mazoplasia, prostatitis, erectile dysfunction, chronic nephritis, renal calculus, osteoporosis and bursitis. Diseases related with heart involve coronary artery disease, arrhythmia and cerebral thrombosis. Diseases related with spleen involve gastritis, colonitis and digestive organ ulcer. Diseases related with liver involve hepatitis, hyperthyroidism and stroke. Diseases related with lung involve neurodermatitis, bronchitis and paranasal sinusitis. Conclusions : Blood stasis pattern which is one of the areas to draw medicine's attention has broad clinical application.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.84-87
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• 2016

Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit. The clinical symptoms are variable, and recognition in children with hypertension can aid early diagnosis and optimal treatment. Hypertension with MAS is malignant and often refractory to several antihypertensive drugs. Recently, radiologic modalities have been developed and have led to numerous interventional procedures. We describe the case of a 3-year-old boy presenting with left ventricular hypertrophy whose severely elevated blood pressure led to the diagnosis of idiopathic MAS. This case highlights the importance of measuring blood pressure and conducting a detailed physical examination to diagnose MAS. This is the first reported case of idiopathic MAS diagnosed in childhood in Korea.

• Journal of Chest Surgery
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• 제37권1호
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• pp.80-83
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• 2004

The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called ‘middle aortic syndrome’ or ‘mid-aortic dyspastic syndrome’. Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.

• Journal of Chest Surgery
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• 제16권3호
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• pp.301-309
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• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.190-195
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• 2005

Objective : This study is performed to evaluate the procedural complications, aneurysm occlusion rate, and mid-term outcome of endovascular treatments in intracranial aneurysms. Methods : We retrospectively investigated 135 patients with 161 cerebral aneurysms who were treated by endovascular means at our institute from March 1999 to December 2004. We statistically analyzed overall outcome, occlusion rate, and occurrence of complications according to the location, size, rupture history, and neck size of aneurysms. Results : Forty-nine patients [36.3%] had experienced acute intracranial or extracranial complications related to the procedure. Among these, there were 13cases of perforation of the aneurysm, 9 of local vasospasm, 8 of thromboembolism, 4 of coil migration, 3 of occlusion of parent vessels due to coil protrusion, and 1 of seizure. Extracranial complications occurred in 14cases including alopecia [9cases], femoral artery thrombosis [2cases], acute renal failure [2cases], and hypovolemic shock [1case]. One hundred twenty-six aneurysms [78.3%] had complete occlusion of the aneurysm and 35 [21.7%] incomplete occlusion at 6months angiographic follow-up. Postembolization clinical follow-up ranged from 1 to 60months [mean, 14.2months]. Seven of the 161 aneurysms underwent additional embolization and 2 incomplete embolized aneurysms required subsequent surgery. Conclusion : The procedural complications and incomplete occlusion rates are substantial. Therefore, endovascular treatment needs close and continued neurosurgical and neuroradiological concerns for the therapy of intracranial aneurysms.