• 제목/요약/키워드: small vessel disease

검색결과 65건 처리시간 0.031초

최소침습적 관상동맥우회술의 발전단계와 경험에 대한 고찰 (Clinical Experiences of MIDCAB - Developmental Stage and Early Short-term Results -)

  • 이영탁;정철현
    • Journal of Chest Surgery
    • /
    • 제32권11호
    • /
    • pp.1009-1016
    • /
    • 1999
  • Background: Minimally invasive direct coronary artery bypass surgery(MIDCAB) has been increasing in interest along with the new techniques in myocardial immobilization for easier and safer procedures. Until the opening of the era of new techniques, adequate accuracy and good patency of grafts were debatable. Our experiences of MIDCAB were studied according to the stages of technical developments. Material and Methods: Since March 1996, 55 patients have undergone MIDCAB procedures. The patients of off-pump CABG(no cardiopulmonary bypass under full sternotomy) were excluded from the study. In the early experience(Stage I), a left anterior small thoracotomy through the left parasternal incision was performed(n=6); then an approach through the lower partial sternotomy was used(Stage II, n=33); and recently, a chest wall elevator for harvesting the internal thoracic artery and the foot plate for myocardial immobilization have been used(USSC, Norwalk, CT)(Stage III, n=16). Result: The surgical procedures of four patients in the Stage II group have been converted to conventional bypass because of the deeply seated left anterior descending coronary artery in two patients, fracture of the calcific lesion in the right coronary artery in one patient, and a cardiogenic shock during hypothermia in the other patient with ventricular dysfunction. Two patients in stage II experienced symptomatic recurrences after surgery and restenosis was verified on angiocardiography. They were managed by interventional procedures. All the other patients were doing well without symptoms, except one patients in Stage II who underwent PTCA procedure for a lesion in the circumflex artery during the follow up period. Conclusion: The new and specialized devices are essential to the development of MIDCAB surgery. MIDCAB and the hybrid procedures in multi-vessel disease are on the way to further development. So far, our experience is limited only to a single device among the many new devices for the purpose.

  • PDF

Seasonal Variation of Acute Stroke;Hospital Based Study

  • Yun, Sang-Pil;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • 대한한의학회지
    • /
    • 제29권2호
    • /
    • pp.1-6
    • /
    • 2008
  • Objectives: This study aimed to investigate the seasonal variation in stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions. Methods: 226 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from November 2005 to October 2006. The year was subdivided into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions in the four groups were examined. Results: Ischemic stroke was most frequent in summer, whereas hemorrhagic stroke was most frequent in winter. There was no significant difference in seasonal variation of stroke. The frequency of ischemic heart disease among stroke risk factors was significantly high in spring (p=0.031). The frequency of hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia did not differ among seasons. There was no significant difference in Sasang constitution among seasons. Frequency of small vessel occlusion was highest in summer. Large artery atherosclerosis was frequent in spring and summer,but seasonal variation of ischemic stroke subtypes did not show statistical difference. Conclusion: Acute stroke demonstrates seasonal characteristics according to stroke types, ischemic stroke subtypes, risk factors for stroke, and Sasang constitutions. These results have important clinical implications in stroke prevention.

  • PDF

급성기 중풍환자에서 음주습관이 중풍의 발생양상에 미치는 임상적 영향 (The Clinical Effect of Drinking Habit in Acute Stroke Patients)

  • 최동준;현진오;신원용;김용형;강아미;이원철;전찬용;조기호;한창호
    • 대한한방내과학회지
    • /
    • 제28권1호
    • /
    • pp.92-96
    • /
    • 2007
  • Objectives : This study investigated the clinical effect of a drinking habit in acute stroke patients. Methods : 409 acute stroke patients were included from October 2005 to October 2006. Patients were hospitalized within 14 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, or Department of Cardiovascular and Neurologic Diseases (Stroke Center), Kyung Hee University Oriental Hospital. We investigated general characteristics, drinking habit, and stroke subtype by TOAST classification. Results : Among drinking subjects, hemorrhagic stroke was more frequent than ischemic stroke (odds ratio 3.04), and less in small vessel occlusion than others (odds ratio 1.84). Ischemic stroke was associated with a longer (30 yrs) drinking habit than hemorrhagic stroke. Conclusions : To acquire more concrete conclusions on this theme, we need further and larger scale research.

  • PDF

아나필락시스양(樣) 자반증(紫班症) 치험례 보고 (A case report of Henoch-Schonlein purpura)

  • 김현희;박영주;소기숙;조영기;박은정;나원경
    • 대한한방소아과학회지
    • /
    • 제17권2호
    • /
    • pp.75-83
    • /
    • 2003
  • Background : Henoch-Schonlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria, and arthalgia. The exact etiology remain unknown despite a long and intensive research, but the findings showes immune mechanism is involved in the pathogenesis of this disease. The main clinical manifestations are skin rash, abdominal symptoms, joint symptoms, and renal involvement. And the existence of renal involvement influences on the course and prognosis of the Henoch-Schonlein purpura Objective : To demonstrate the therapeutic effect of herbal medicine(Kamiguibiondamtang) on parents with Henoch-Schonlein purpura Method : We treated two cases of Henoch-Schonlein purpura in a nine-year old male and a twenty-year old female, who showed multiple petechiae and ecchymoses on both extrimities with Kamiguibiondamtang. Result : A nine-year old male recovered completely and a twenty-year old female improved. Conclusion : We repert that we had good effects of herbal medicine treatment on two cases of Henoch-Schonlein purpura.

  • PDF

비바이러스 In Ovo 직접주입법에 의한 메추리 형질전환 시스템 (Non-Viral Transgenesis via Direct In Ovo Lipofection in Quail)

  • 박태섭;한재용
    • 한국가금학회지
    • /
    • 제42권3호
    • /
    • pp.239-245
    • /
    • 2015
  • Transgenic animals have been widely used for developmental biology studies, as disease models, and even in industry such as transgenic bioreactor animals. For transgenic birds, quail has the great advantages of small body size, short generation time, and frequent egg production. To date, retroviral or lentiviral transduction has been used to generate transgenic quail for various purposes. However, the efficiency of transgenic offspring production with these methods is relatively low and viral vector usage has safety issues. Unfortunately, non-viral transgenesis has not been established in quail due to a deficiency of stem cell and germ cell culture systems. In this study, we established a direct in ovo lipofection method that could be used to create transgenic quail without germline-competent cells or viruses. To optimize the injection stage during embryo development, the liposome complex (containing piggyBacCMV-GFP and transposase plasmids) was introduced into an embryonic blood vessel at 50 hr, 55 hr or 60 hr. GFP expression was detected in various tissues (heart, kidney, liver and stomach) on day 12 of incubation under a fluorescence microscope. Additionally, GFP-positive cells were detected in the recipient embryonic gonads. In conclusion, the direct in ovo lipofection method with the piggyBac transposon could be an efficient and useful tool for generating transgenic quail.

An Alternative Surgical Technique for Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

  • Kim, Young-Su;Lee, Mina;Cho, Yang Hyun;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
    • /
    • 제47권3호
    • /
    • pp.220-224
    • /
    • 2014
  • Background: For the surgical management of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), there have been various techniques that reduce the tension and kinking of the coronary artery during reimplantation to the aorta. The aim of this study is to describe the results of our modified technique of coronary reimplantation for the treatment of ALCAPA. Methods: Between October 2003 and February 2011, seven patients underwent coronary reimplantation with the modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta). The median follow-up duration was 52 months (range, 4 to 72 months). Clinical outcomes and serial echocardiographic data were reviewed. Results: There was no mortality. One patient had a small amount of cerebral hemorrhage postoperatively and improved without any sequelae. Another patient had left diaphragm palsy and underwent diaphragm plication. Follow-up echocardiogram showed that all patients had normal ventricular function without chamber enlargement. Conclusion: Our modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta) demonstrated successful clinical outcomes. We conclude that this surgical technique can be a potential alternative for the treatment of ALCAPA.

소아에서 출혈성 수포를 동반한 $Henoch-Sch{\"{o}}nlein$ 자반병 1례 (A Case of $Henoch-Sch{\"{o}}nlein$ Purpura with Hemorrhagic Bullae in a Child)

  • 오연미;정미림;최혜정;차희정;정진영
    • Childhood Kidney Diseases
    • /
    • 제10권1호
    • /
    • pp.40-44
    • /
    • 2006
  • [ $Henoch-Sch{\"{o}}nlein$ ] 자반증은 소혈관의 혈관염으로 오는 전신적 혈관 장애로 자반, 위장 증세, 관절 증세, 신 증세를 주 증세로 하는 질환이다. HSP의 흔한 피부증상은 주로 궁둥이와 하지의 자반 증상이며 성인에서는 출혈성 수포를 동반하는 경우가 흔하나 소아에서는 드문 것으로 알려져 있다. 저자들은 관절통과 복통을 호소하는 환아에서 출혈성 수포가 동반되어 있어 피부조직 검사를 하였고 진피의 leukocytoclastic vasculitis와 면역 형광법상 소혈관의 IgA와 fibrinogen의 침착을 관찰하였다. HSP로 진단하여 스테로이드 치료를 하였고 수일 내로 관절통과 복통이 호전되어 문헌고찰과 함께 보고하는 바이다.

  • PDF

급성기 중풍환자에서 중풍전조증과 중풍유형간의 상관성에 대한 임상연구 (A Clinical Study on the Relationship between Warning Signs and Stroke Subtype in Acute Stroke Patients.)

  • 최동준;한창호;현진오;신원용;김용형;강아미;이원철;전찬용;조기호
    • 대한중풍순환신경학회지
    • /
    • 제7권1호
    • /
    • pp.54-58
    • /
    • 2006
  • Objectives : This study was aimed to investigated the relationship between warning signs and stroke subtype in acute stroke patients. Methods : From Oct. in 2005 to Oct. in 2006, 409 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke in DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, Department Cardiovascular and Neurologic Diseases(Stroke center) Kyung Hee University Oriental hospital. We investigated general characteristics, stroke subtype, and warning signs(facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke. (odds ratio 3.60) Small vessel occlusion had more neck stiffness than others. (odds ratio 2.03) Conclusion : To acquire more concrete conclusions on warning signs, we need further and large scale of prospective researches.

  • PDF

요통에 관한 침구임상 진료지침 프로토콜 개발을 위한 전자우편 설문조사 (E-mail Survey for Developing Clinical Guideline Protocol on Acupuncture Treatment for Low Back Pain)

  • 이승훈;남동우;강중원;김은정;김현욱;송호섭;김선웅;김갑성;이건목;이재동
    • Journal of Acupuncture Research
    • /
    • 제26권3호
    • /
    • pp.115-131
    • /
    • 2009
  • Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

  • PDF

$Henoch-Sch\ddot{o}nlein$ 자반증에서 스테로이드 사용이 신장 침범에 미치는 영향 (The Effect of Steroid on Renal Involvement in $Henoch-Sch\ddot{o}nlein$ Purpura)

  • 홍은정;하태선
    • Childhood Kidney Diseases
    • /
    • 제11권2호
    • /
    • pp.185-194
    • /
    • 2007
  • 목 적 : HSP는 주로 소혈관을 침범하는 혈관염으로 대개 자연적으로 치유되지만 장기적 예후는 신장 침범의 정도에 달려 있으므로 신장 침범의 위험인자를 예측하고 예방하는 것이 중요하다. 이에 본 연구는 증상을 완화하기 위해 사용한 스테로이드가 HSP에서 신장 침범을 줄일 수 있는지를 알아보고자 하였다. 방 법 : 1993년 1월부터 2006년 12월까지 충북대학교병원 소아과에서 HSP로 진단 받은 환아를 대상으로 하여 스테로이드 사용 유무와 사용 기간, 지속성 자반의 유무에 따른 신장 침범의 유무와 정도를 분석하였다. 결 과 : 스테로이드 사용 유무와 사용 기간에 따른 신장 침범 빈도와 신장 침범 기간에는 유의한 차이가 없었다. 스테로이드의 사용 여부에 따른 신장 침범 양상을 보았을 때, 스테로이드를 사용한 경우에는 혈뇨가 많이 나타나고 사용하지 않은 경우에는 단백뇨가 많이 나타나는 경향을 보였으나 통계적으로는 유의한 차이가 없었다. 스테로이드의 사용과 자반의 지속성과는 유의한 관계가 없었다. 반면에 10일 이상의 지속성 자반이 있는 경우에 신장 침범이 유의하게 많은 것으로 나타났으며, 신장 침범의 기간도 지속성 자반이 있는 경우에 증가하는 것으로 나타났다. 결 론 : HSP로 진단받은 환아들에게 복통이나 관절통 등으로 스테로이드를 사용한 후 신장 침범의 유무를 비교해 본 결과, 스테로이드의 사용 여부와 사용 기간과는 유의한 결과를 보이지 않으므로 신장 침범에 대한 스테로이드의 예방효과는 없는 것으로 생각된다. 또한, 스테로이드 치료의 적응증이 아닌 자반의 지속성이 오히려 신장 침범의 유무와 기간과 관계있다는 사실은, 스테로이드가 신장 침범의 예방효과가 없음을 뒷받침해 주고 있다.

  • PDF