• Title/Summary/Keyword: 석회화부전증

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Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age (경증의 폐동맥 고혈압을 동반한 고령에서의 심내막상 결손 환자 치험 1예)

  • Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.633-636
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    • 2006
  • The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

DEVELOPMENTAL DISTURBANCES OF SUCCESSIVE PERMANENT TEETH BY TRAUMA TO THE PRIMARY TEETH (유치의 외상에 의한 계승 영구치의 발육 장애)

  • Kim, Ji-Young;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.260-266
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    • 2010
  • Trauma to the primary teeth may have an effect on the successive permanent teeth. Thus, the treatment plans should be focused on safety of their permanent teeth. The degree of developmental disturbances in those permanent teeth depends upon many factors including the age of the children, developmental conditions of the affected teeth, types and severities of trauma and time interval from the moment of trauma to the initial treatment the patients received. The complications of the effected permanent teeth vary from the mild enamel hypoplasia to the premature finishing of teeth development. In this study, children whose ages were 33 months, 5 years, and 26 months presented the developmental disturbances to their permanent teeth, which resulted from the trauma to the primary teeth: the intrusion, the avulsion, and the subluxation. There showed a mild complication in the case of subluxation resulting in enamel hypoplasia, but, the more severe complication of the root dilacerations occurred in the case of intrusion. Furthermore, the 5-year-old patient whose primary dentition was near in transition period to the permanent one, the more complicated problem such as stop of root development of the permanent teeth was resulted from the avulsion. Thus, one should assume that the types of trauma and the age of the children at the moment of trauma have different effects on those successive permanent teeth. In conclusion, when the trauma that causes changes in the position of primary teeth happened, it is important to arrange an appropriate treatment procedure considering the types of trauma and the developmental conditions of the permanent teeth.

Evaluation of the Surgical Treatment for Mitral Stenosis (승모판협착증의 외과적 치료에 대한 평가)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1095-1101
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    • 1996
  • From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

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DENS INVAGINATUS IN MANDIBULAR CENTRAL INCISORS (하악 중절치에 발생한 치내치)

  • Lee, Jung-Jin;Choi, Byung-Jai;Lee, Jae-Ho;Choi, Hyung-Jun;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.313-318
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    • 2008
  • Dens invaginatus is a rare malformation resulting from invagination of the enamel before calcification has occurred. It is mostly found in permanent maxillary lateral incisors and mandibular teeth are rarely affected by this anomaly. The malformation is estimated to affect between 0.04 % and 10 % of people and has been associated with other abnormalities such as taurodontism, microdontia, gemination and dentinogenesis imperfecta. Dens invaginatus is classified in three types with respect to the depth of invaginatus and has a broad spectrum of morphologic variations. Invagination frequently allows the entry of irritants and microorganism, which usually lead to caries, pulp infection and pulp necrosis. Root canal treatment on such invaginatus tooth may present severe problems because of its complex anatomy of the tooth. Therefore, the early diagnosis of such malformation is crucial and preventive approach is strongly recommended.

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Mid-term Follow-Up Results of Cryopreserved Valved Conduit in RVOT Reconstruction (우심실 유출로에 사용된 냉동 동종 판막도관의 중기성적)

  • 장윤희;전태국;민호기;한일용;성기익;이영탁;박계현;박표원
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.384-390
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    • 2003
  • Background: Since Ross and Sormeville first reported the use of aortic homograft valve for correction of pulmonary atresia in 1966, homograft valves are widely used in the repair of congenital anomalies as conduits between the pulmonary ventricle and pulmonary arteries. On the basis of these results, we have used it actively. In this report, we describe our experience with the use of cryopreserved valved homograft conduits for infants and children requiring right ventricle to pulmonary artery connection in various congenital cardiac anomalies. Material and Method: Between January, 1996 and December 2001, 27 infants or children with a median age of 16 months(range 9days to 18years) underwent repair of RVOTO using homograft valved conduit by two surgeons. We studied 22 patients who have been followed up at least more than one year. The diagnosis at operation included pulmonary atresia with ventricular septal defect (n=13), truncus arteriosus (n=3), TGA or corrected TGA with RVOTO (n=6). Homograft valved conduits varied in size from 15 to 26 mm (mean, 183.82 mm). The follow-up period ranged from 12 to 80.4 months (median, 48.4 months). Result: There was no re-operation due to graft failure itself. However, early progressive pulmonary homograft valve insufficiency developed in one patient, that was caused by dilatation secondary to the presence of residual distal pulmonary artery stenosis and hypoplasia after repair of pulmonary atresia with ventricular septal defect. This patient was required reoperation (conduit replacement). During follow-up period, there were significant pulmonary stenosis in one, and pulmonary regurgitation more than moderate degree in 3. And there were mild calcifications at distal anastomotic site in 2 patients. All the calcified homografts were aortic in origin. Conclusion: We observed that cryopreserved homograft conduits used in infant and children functioned satisfactorily in the pulmonic position at mid-term follow-up. To enhance the homograft function, ongoing investigation is required to re-establish the optimal strategy for the harvest, preservation and the use of it.