• Title/Summary/Keyword: 관폐쇄

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Transcatheter Closure of Patent Ductus Arteriosus with a Amplatzer$^{(R)}$ Vascular Plug in Two Dogs (개에서 Amplatzer$^{(R)}$ vascular plug를 이용한 동맥관개존증의 폐쇄 2 증례)

  • Kang, Min-Hee;Kim, Jung-hyun;Moon, So-Jeung;Kim, Seung-gon;Yeo, Jung-Jin;Lee, Chang-Min;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.591-594
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    • 2011
  • A 9-month-old, intact female Maltese dog and one-year-old, intact female beagle dog were presented with continuous heart murmur. These 2 dogs were diagnosed as patent ductus arteriosus (PDA) based on the two-dimensional echocardiography and angiography. Due to the large shunt size, commercially available ductal occlude device was used for transcatheter occlusion of PDA. After Amplatzer$^{(R)}$ vascular plug placement, cardiac murmur was abruptly disappeared in Maltese dog and mildly decreased in beagle dog. Complications and safety after the procedure were evaluated regularly in these 2 dogs. This is first clinical application of Amplatzer$^{(R)}$ vascular plug for transcatheter closure of PDA in two dogs in Korea.

Transcatheter Closure of Patent Ductus Arteriosus with a Coil Embolization in a Dog (개에서 Coil색전술을 이용한 동맥관개존중의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Jung-Hyun;Moon, So-Jeung;Kim, Seung-Gon;Yeo, Jung-Jin;Lee, Chang-Min;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.236-239
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    • 2011
  • A 10 month-old female (intact) Maltese dog was presented due to continuous heart murmur. The dog was diagnosed with patent ductus arteriosus (PDA) based on two-dimensional echocardiography, computed tomography (CT) and angiography. Transarterial coil embolization was used for transcatheter occlusion of the PDA. A single coil was placed successfully and effectively occluded the blood flow through the ductus. Continuous heart murmur disappeared immediately the coil placement and no residual flow was detected. Complications and safety following the procedure were evaluated regularly based on clinical signs, cardiac examinations and serum troponin-I concentrations. This is the first clinical application of coil embolization for transcatheter closure of PDA in a dog in Korea.

Nasolacrimal Duct Obstruction after Radioactive Iodine Therapy for Thyroid Cancer (갑상선암에서 방사성 요오드 치료 후 발생한 코눈물길 폐쇄)

  • Hwang, Moon Won;Lee, Eung;Yang, Jae Wook
    • Journal of The Korean Ophthalmological Society
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    • v.55 no.1
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    • pp.1-6
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    • 2014
  • Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.

Effects of Ibuprofen and Indomethacin for Prophylaxis of Patent Ductus Arteriosus in Premature Infants (미숙아 동맥관 개존증의 예방적 치료로서 Indomethacin과 Ibuprofen의 효과)

  • Jeon, Bok-Seon;Kwon, Kyung-Ah;Park, Kyung-Hee;Byun, Shin-Yun;Kim, Myo-Jing
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.228-233
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    • 2011
  • Purpose: The aim of our study was to compare the efficacy and safety of ibuprofen and indomethacin in the prophylaxis of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen could be an alternative agent in prophylactic use. Methods: A retrospective study including 37 preterm infants <1,500 g of birth weight, <34 weeks of gestation, whom were administrated indomethacin (n=17; January 2009-December 2009) or ibuprofen (n=20; January 2010-February 2011) within 24 hr after birth was conducted. The rate of ductal closure, need for surgical ligation, clinical outcomes such as necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity (ROP) and death rate were compared. Results: There were no statistically significant differences between the two groups in mean gestational age, mean birth weight, Apgar score, sex, type of delivery, maternal dexamethasone treatment, frequency and duration of ventilator and surfactant treatment. The closure of PDA on day 7 of life was in 19 of 20 infants of the ibuprofen group and 13 of 17 infants of the indomethacin group (P=0.159). Between the two groups, there were no significant differences with respect to clinical outcomes. Conclusion: Ibuprofen has similar effects to indomethacin in the rate of PDA closure. Our study demonstrates that prophylactic ibuprofen is relatively effective without significant differences with respect to clinical outcomes compared with indomethacin. Therefore, ibuprofen may be used as an alternative agent in the prophylaxis of PDA in preterm infants.

Indication and Post-Procedural Management of Upper GI Stent Implantation (상부 위장관 스텐트 삽입술의 이해 -적응증 및 추적 관리-)

  • Joo, Moon-Kyung;Park, Jong-Jae
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.49-55
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    • 2009
  • Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

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Surgical Closure of Patent Ductus Arteriosus in Premature Infant -A report of two cases - (미숙아에서 동맥관 개존증 수술 2례)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.777-779
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    • 1996
  • Recently we operated on two cases of PDA in premature infant. In both cases, indomethacin therapy had failed to close the PDA. The extremely small baby(body weight 540gm) died 28hrs postoperatively by unexpe ted intrathoracic bleeding probably due to coagulopathy related to septic condition and thrombocytopenia. The clinical course of the second case(body weight 1395gm) was complicated by ileal perforation sec- ondary to necrotizing enterocolitis. The baby underwent segmental resection of ileum with ileostomy on the 8th hospital day. On the 34th hospital day surgical closure of the PDA was done and the ile'ostomy was repaired simultaneously. Ventilator weaning was possible on the postoperative 6th day. The baby discharged on the postoperative 33th day with the body weight of 2050gm.

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Dorsal Mini-thoracotomy for PDA Closure in Premature Neonates (후방 소개흉술을 통한 미숙아 동맥관 개존증의 수술요법)

  • Lee, Hyang-Lim;Choi, Chang-Hyu;Son, Dong-Woo;Shim, So-Yeon;Park, Kook-Yang;Park, Chul-Hyun
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.434-440
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    • 2009
  • Background: Surgical closure of a patent ductus arteriosus (PDA) can be considered when conservative medical treatment is ineffective or contraindicated. Low weight and earlier gestational age neonates who are treated with conservative medical therapy generally showed a higher failure rate. The morbidity of surgical PDA closure in such extremely low birth weight (ELBW) neonates is also high. Here we present the early results of a new technique for approaching the PDA through a dorsal minithoracotomy. Material and Method: From March 2006 to November 2008, 24 premature neonates underwent surgical PDA closure. The procedures were performed in the newborn intensive care unit via a 2 cm long dorsal minithoracotomy with the baby in the prone position with the left hemithorax elevated 30$^{\circ}$. Bimanual cotton swab blunt dissection completed the extrapleural accesstothe PDA and then two clips were applied. Tube thoracostomy was avoided if there was no meaningful pleural laceration. Result: The infants mean gestational age was 26.5$\pm$2.1 weeks (range: 23 to 30 weeks) and the average age at operation was 11$\pm$11 days. The mean body weight at operation was 933$\pm$271 grams (range: 570 to 1,700 grams). Eight patients expired, but there was no procedure-related death. Postoperative echocardiography revealed two cases of residual shunt but none of these shunts were detected on the follow up echocardiogram that was performed on the post operative 5 and 59 days. Conclusion: We concluded that the technique described here is an effective procedure in view of the satisfactory operative exposure and the low rate of complications.

Morphological characteristics of the upper airway and pressure drop analysis using 3D CFD in OSA patients (폐쇄성 수면무호흡 환자의 상기도 형태의 특징과 압력강하에 관한 3차원 전산유체역학해석)

  • Mo, Sung-Seo;Ahn, Hyung-Taek;Lee, Jeong-Seon;Chung, Yoo-Sam;Moon, Yoon-Shik;Pae, Eung-Kwon;Sung, Sang-Jin
    • The korean journal of orthodontics
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    • v.40 no.2
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    • pp.66-76
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    • 2010
  • Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

Pyloric Obstruction with Advanced Gastric Cancer: Stent vs. Bypass (악성 위출구 폐쇄 치료의 선택: 스텐트 삽입술 혹은 수술적 우회술?)

  • Lee, Beom-Jae;Park, Jong-Jae
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.1-5
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    • 2009
  • In the past, conservative bypass surgery was usually performed for palliation of malignant obstruction of the gastrointestinal tract. However, endoscopic stenting was developed recently, and technical advances and clinical experience have made it possible to establish stent implantation as one of the main treatment options. There are several advantages in stent implantation over bypass surgery, such as high feasibility and technical success rate, non-invasiveness, rapid symptomatic response, short hospitalization, and cost-effect benefits. Complications, such as stent ingrowth, stent injury by bile or acid, and migration, may occur and early re-insertion is frequently needed. Recently, diverse novel stents which are powered to predict stent migration or ingrowth have been developed and are being used in the clinical setting. In general, stent implantation is known to be beneficial in patients who are expected to survive <6 months, and surgical bypass may be more effective in patients who can survive >6 months. In this review, we have compared the technical feasibility, clinical outcomes, complications, and cost-benefit between stent implantation and bypass surgery, and determined the optimal treatment strategy in malignant upper gastrointestinal obstruction.

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Analysis of Water Balance by Relative Humidity in Closed Transplants Production System (폐쇄형 묘생산 시스템의 상대습도에 따른 수분 수지 분석)

  • 김진국;김용현;최유화;이명규
    • Proceedings of the Korean Society for Bio-Environment Control Conference
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    • 2003.04a
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    • pp.58-63
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    • 2003
  • 폐쇄형 묘생산 시스템(closed system for transplants production)은 자연광이 투과되지 않도록 단열재로 구성되어 있어 시스템 내부와 외부의 공기, 물, 열 등의 교환이 기본적으로 제한된다. 또한 식물 생육에 필요한 관수량, 내부에 적절한 습도를 유지시켜 주기 위한 가습량 및 공조기구에 의한 제습량 등이 시스템 내에서 평형을 이루며 순환한다. (중략)

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