• Title/Summary/Keyword: restenosis

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A Case of Biphasic Flow-volume Loop in Left Mainstem Bronchial Stenosis (이상성 기류유량곡선(biphasic flow-volume loop)을 보인 결핵에 기인한 좌주기관지협착 1예)

  • Choi, Soo-Jeon;Jo, Moon-Suk;Lee, Hyuk-Pyo;Kim, Joo-In;Yum, Ho-Kkee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.416-420
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    • 1998
  • Flow-volume loop is known to be useful in the diagnosis of upper airway obstruction. In cases of tracheal obstruction, characteristic features such as fixed or variable upper airway obstruction patterns give clue to the diagnosis. But the flow-volume loop of unilateral mainstem bronchial stenosis is not known well. There is controversy in patterns of flow-volume loop in unilateral mainstem bronchial stenosis (restrictive pattern or biphasic pattern). We report a case of biphasic flow-volume loop in left mainstem bronchial stenosis(4-5 mm in diameter) as a sequela of endobronchial tuberculosis, which recovered normal flow-volume loop after metallic stent insertion and 2 months later showed reappearance of biphasic pattern because of restenosis of left mainstem bronchus due to growth of granulation tissue at the stent site.

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Biodegradable PLGA Polymer Coating on Biomedical Metal Implants Using Electrospraying (전기분사를 이용한 의료용 금속 임플란트의 생분해성 PLGA 고분자 코팅)

  • Cho, Seong-Bae;Park, Chul-Ho;Park, Kwi-Deok;Chung, Dong-Jun;Han, Dong-Keun
    • Polymer(Korea)
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    • v.33 no.6
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    • pp.620-624
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    • 2009
  • Biomedical metal implants have been used clinically for replacement, restoration, or improvement of injury bodies based on high mechanical properties, but it has some risks such as the inflammatory, late thrombosis, or restenosis due to the low biocompatibility and toxicity. In various techniques of surface treatment developed to preserve these drawbacks, this study examined the electrospray coating technology with biodegradable poly (lactic-co-glycoic acid) (PLGA) on metal surface. Based on fundamental examination of electrospraying and solution parameters, the surface morphology of coated film was closely related to the boiling point of solvent, in-flight distance, and droplet size. The thickness of polymer film was linearly proportional to the emerged volume. This result exhibits that the polymeric droplets were continuously deposited on the polymer film. Therefore, the electrospray coating technology might be applied into the fabrication of single/multi-layered polymer film in nano-/micro-thickness and the control of the topology for biomedical metal implants including stents.

Results of Tracheal Resection with End-to-end Anastomosis (기관절제술후 기관 단단문합술 치험 결과)

  • Shin Dong-Jin;Cho Woo-Jin;Baek Sungkuk;Woo Jeong Su;Kwon Soon-Young;Jung Kwang-Yoon
    • Korean Journal of Bronchoesophagology
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    • v.10 no.1 s.19
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    • pp.41-45
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    • 2004
  • Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

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2 Cases of Bilateral Choanal Atresia (후비공 폐쇄 2례)

  • 심강석;이석용;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.18.3-19
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    • 1983
  • Choanal atresia, described first by Johann Roedere (1755) is an obstruction between the nasal cavity and nasopharyngeal vault, and the diagnosis and treatment were developed because of severity of the disease. Embryologically, incomplete development of olfactory pit, or failure of nasobuccal membrane to rupture, or persistent remaining of buccopharyngeal membrane, etc, all forms the congenital choanal atresia. And the acquired type was the result from syphilis or diphtheria with a resultant stenosing cicatrix and after the inexpert surgery and the trauma. Multiple abnormalities may be present particularly affecting the head, the heart and the alimentary system in the congenital type. The operative technique employed would depend upon the type of obstruction(whether membranous or bony), the age of the patient, and the presence or absence of any associated pathologic condition. Since Emmert (1853) first tried blind puncture of the atretic plate with the trocar, other surgical techniques have been introduced over the years for the correction of choanal atresia, which were the transnasal, transpalatal, transantral and the transseptal approach. Among them, transpalatal approach was proved to be a popular technique, that it provides a direct route, thus permitting an exact reconstruction and low restenosis rate. Recently, we have experienced two cases of choanal atresia and treated successfully with transpalatal approach, so authors report these cases with a review of the literature.

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Effects of Luteolin on Fetal Bovine Serum-induced Events in Cultured Rat Vascular Smooth Muscle Cells (소태아혈청으로 유도된 흰쥐 혈관평활근세포의 luteolin 효과)

  • Lim, Yong
    • Journal of Life Science
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    • v.22 no.12
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    • pp.1595-1599
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    • 2012
  • Cell cycle activation and progression in vascular proliferative disease represent potent therapeutic targets. Luteolin, which occurs as glycosylated forms in celery, green pepper, perilla leaf, and camomile tea, has demonstrated antimutagenic, antitumorigenic, antioxidant, and antiinflammatory properties. In this study, we investigated the effect of luteolin on the proliferation of primary cultured rat aortic vascular smooth muscle cells induced by 5% fetal bovine serum. Luteolin at concentrations of 5, 20, and $50{\mu}M$ significantly inhibited this proliferation by 29.6, 50.8, and 83.1%, respectively. The incorporation of $[^3H]$-thymidine into DNA was also inhibited by 25.8, 57.6, and 81.0%, respectively. Flow cytometry analysis of DNA content revealed that FBS-inducible cell cycle progression was blocked by luteolin. Luteolin showed no cytotoxicity in VSMCs in this experimental condition according to WST-1 assays. Luteolin may represent a potential anti-proliferative agent for treatment of angioplasty restenosis and atherosclerosis.

Material Design and Analysis of Coronary Artery Stents (관상동맥혈관용 스텐트의 구조해석과 재료설계)

  • Park, Joong-Gwun;Kang, Tae-Won;Lee, Kee-Sung;Kim, Tae-Woo
    • Journal of the Korean Ceramic Society
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    • v.44 no.7
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    • pp.362-367
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    • 2007
  • Stent is a tiny structure made with either ceramic coating and/or bare metal. Being approximately $1{\sim}2 mm$ in diameter, it consists of holes, slots, or void space and is designed to cover entire medical lesions. Stent implantation into patients' arteries has been practiced for a little more than a decade in order to widen the blocked artery. The adoption of the stent has significantly improved the efficacy when compared with the previous medical practice by balloon angioplasty alone. Yet better biomedical performance of the stent is being demanded in order to eliminate the still existing problem of artery restenosis, which means the artery becomes narrowed again. Recent literature survey shows researches on ceramic coatings onto the stent surface, or material design to improve the mechanical response of the stent. This study focuses more on the material design and mechanical analysis. The results showed that the void configuration within the stent affects the mechanical response significantly. The rectangular shape was found to yield expansion at a relatively lower pressure than the elliptical slot for a slotted tube stent. The present results, when combined with research on coating at the stent surface, may provide stents with improved bio-medical performance.

Anti-apoptotic effects of autophagy via ROS regulation in microtubule-targeted and PDGF-stimulated vascular smooth muscle cells

  • Park, Hyun-Soo;Han, Joo-Hui;Jung, Sang-Hyuk;Lee, Do-Hyung;Heo, Kyung-Sun;Myung, Chang-Seon
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.3
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    • pp.349-360
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    • 2018
  • Autophagy has been studied as a therapeutic strategy for cardiovascular diseases. However, insufficient studies have been reported concerning the influence of vascular smooth muscle cells (VSMCs) through autophagy regulation. The aim of the present study was to determine the effects of VSMCs on the regulation of autophagy under in vitro conditions similar to vascular status of the equipped micro-tubule target agent-eluting stent and increased release of platelet-derived growth factor-BB (PDGF-BB). Cell viability and proliferation were measured using MTT and cell counting assays. Immunofluorescence using an $anti-{\alpha}-tubulin$ antibody was performed to determine microtubule dynamic formation. Cell apoptosis was measured by cleavage of caspase-3 using western blot analysis, and by nuclear fragmentation using a fluorescence assay. Autophagy activity was assessed by microtubule-associated protein light chain 3-II (LC-II) using western blot analysis. Levels of intracellular reactive oxygen species (ROS) were measured using $H_2DCFDA$. The proliferation and viability of VSMCs were inhibited by microtubule regulation. Additionally, microtubule-regulated and PDGF-BB-stimulated VSMCs increased the cleavage of caspase-3 more than only the microtubule-regulated condition, similar to that of LC3-II, implying autophagy. Inhibitory autophagy of microtubule-regulated and PDGF-BB-stimulated VSMCs resulted in low viability. However, enhancement of autophagy maintained survival through the reduction of ROS. These results suggest that the apoptosis of conditioned VSMCs is decreased by the blocking generation of ROS via the promotion of autophagy, and proliferation is also inhibited. Thus, promoting autophagy as a therapeutic target for vascular restenosis and atherosclerosis may be a good strategy.

The Clinical Outcomes of 75 Consecutive Patients with Cervical Carotid Artery Stenosis Treated by Carotid Artery Stenting

  • Chung, Joon-Ho;Shin, Yong-Sam;Lim, Yong-Cheol;Park, Sang-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.350-354
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    • 2009
  • Objective : The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only. Methods : From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis ${\geq}70%$, and 6 patients had asymptomatic stenosis ${\geq}80%$. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months. Results : The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better. Conclusion : Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.

Improving Smoothness of Hydrophilic Natural Polymer Coating Layer by Optimizing Composition of Coating Solution and Modifying Chemical Properties of Cobalt-Chrome Stent Surface (코팅 용액의 조성 최적화 및 코발트-크롬 금속스텐트의 화학적 표면개질을 통한 친수성 천연 고분자 코팅층의 표면 거칠기 개선)

  • Kim, Dae Hwan;Kum, Chang Hun
    • Journal of Chitin and Chitosan
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    • v.23 no.4
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    • pp.256-261
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    • 2018
  • Recently, the number of cardiovascular disease-related deaths worldwide has increased. Therefore, the importance of percutaneous cardiovascular intervention and drug-eluting stents (DES) has been highlighted. Despite the great clinical success of DES, the re-endothelialization at the site of stent implantation is retarded owing to the anti-proliferative effect from the coated drug, resulting in late thrombosis or very late restenosis. In order to solve this problem, studies have been actively carried out to excavate new drugs that promote rapid re-endothelialization. In this study, we introduced hydrophilic drug, tauroursodeoxycholate (TUDCA), that improves the proliferation of endothelial progenitor cells and promotes apoptosis of vascular smooth muscle cells. In addition, we utilized shellac, which is a natural resin from lac bug to coat TUDCA on the surface of the metal. When using conventional coating method including biodegradable polymers and organic solvents, phase separation between polymer and drug occurred in the coating layer that caused incomplete incorporation of drug into the polymer layer. However, when using shellac as a coating polymer, no phase separation was observed and drug was fully covered with the polymer matrix. In addition, by adjusting the composition of coating solution and modifying the hydrophilicity of the metal surface using oxygen plasma, the surface roughness decreased due to the increased affinity between coating solution and metal surface. This result provides a method of depositing a hydrophilic drug layer on the stent.

Improved Biocompatibility of Intra-Arterial Poly-L-Lactic Acid Stent by Tantalum Ion Implantation : 3-Month Results in a Swine Model

  • Kim, Kangmin;Park, Suhyung;Park, Jeong Hwan;Cho, Won-Sang;Kim, Hyoun-Ee;Lee, Sung-Mi;Kim, Jeong Eun;Kang, Hyun-Seung;Jang, Tae-Sik
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.853-863
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    • 2021
  • Objective : Biodegradable poly-L-lactic acid (PLLA) with a highly biocompatible surface via tantalum (Ta) ion implantation can be an innovative solution for the problems associated with current biodegradable stents. The purpose of this study is to develop a Taimplanted PLLA stent for clinical use and to investigate its biological performance capabilities. Methods : A series of in vitro and in vivo tests were used to assess the biological performance of bare and Ta-implanted PLLA stents. The re-endothelialization ability and thrombogenicity were examined through in vitro endothelial cell and platelet adhesion tests. An in vivo swine model was used to evaluate the effects of Ta ion implantation on subacute restenosis and thrombosis. Angiographic and histologic evaluations were conducted at one, two and three months post-treatment. Results : The Ta-implanted PLLA stent was successfully fabricated, exhibiting a smooth surface morphology and modified layer integration. After Ta ion implantation, the surface properties were more favorable for rapid endothelialization and for less platelet attachment compared to the bare PLLA stent. In an in vivo animal test, follow-up angiography showed no evidence of in-stent stenosis in either group. In a microscopic histologic examination, luminal thrombus formation was significantly suppressed in the Ta-implanted PLLA stent group according to the 2-month follow-up assessment (21.2% vs. 63.9%, p=0.005). Cells positive for CD 68, a marker for the monocyte lineage, were less frequently identified around the Ta-implanted PLLA stent in the 1-month follow-up assessments. Conclusion : The use of a Ta-implanted PLLA stent appears to promote re-endothelialization and anti-thrombogenicity.