• Title/Summary/Keyword: 혈관 확장

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Heart-Lung Transplantation in a Patient with VSD, PDA and Eisenmenger′s Syndrome (심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 -1예 보고-)

  • 홍유선;김도형;함석진;이교준;이두연;권혁문;김형중;조상호;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.418-421
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    • 2003
  • Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.

Bidirectional Cavopulmonary Shunt for Isolated Right Ventricular Endomyocardial Fibrosis (우심실에 생긴 심근내막섬유증에서 시행한 양 방향성 상대정맥-폐동맥 단락 수술)

  • 서영준;이덕헌;박남희;최세영;유영선
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.523-526
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    • 2003
  • A 44-year-old man had been admitted for dyspnea on exertion and abdominal distension. The echocardiography revealed abnormal mass in right atrium and tricuspid valve stenosis with right ventricular obliteration. The operation was performed with mass removal, enlargement of tricuspid valve opening, and right ventricular endocardiectormy. And then, atrial septal defect was made due to inadequate right ventricular volume. The patient's symptom was improved and he discharged without events. The endomyocardial fibrosis was diagnosed with microscopic examination. Eighteen months later, the patient was readmitted due to aggravated dyspnea and cyanosis. The right ventricular obliteration was progressed and pulmonary blood flow was severely decreased in follow up echocardiography. Palliative bidirectional cave-pulmonary shunt was performed due to functional single ventricle. The dyspnea and cyanosis was markedly improved. Bidirectional cavo-pulmonary shunt for advanced and isolated right ventricular endomyocardial fibrosis provided effective palliation at early postoperative period, However, long-term follow up is mandatory.

Chronic Lhng Abscess Caused By Traumatic Bronchial Foreign Body(Wood) Persisting For 30 Years -A case report- (30년전 흉부외상에 의해 발생한 기관지내 이물(나무)과 이에 병발한 만성 폐농양 -1례 보고-)

  • Oh, Duck-Jin;Lee, Young;Lim, Seung-Pyeung;Yu, Jae-Hyun;Na, Myung-Hoon
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1040-1044
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    • 1996
  • A case with a bronchial foreign body(wood) which had an uncommon way of entry through a wound In the chest wall was described. A 41-year-old man was admitted to our hospital because of chronic cough and profuse purulent sputum. He had been injured by a fragment of wood which penetrated his anterolateral chest wall at 30 years ago. A chest x-ray film reavealed a calcific foreign body, measuring 3.0 by 1.0 cm, in the posterobasal segment of the left lung. Computed nomograp y of the chest demonstrated a calcific foreign body with bronchiectatic change near the diaphragmatic pleura In the left lower lobe. Left lower lobectomy was performed, and the patient remains well without any thoracic symptoms after the operation.

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Histopathological observation of the crucian carp Carassius auratus with infected leech Limnotrachelobdella sinensis by scanning electron microscope (주사전자현미경을 이용한 거머리, Limnotrachelobdella sinensis 감염 붕어, Carassius auratus의 조직병리학적 관찰)

  • Park, Jung-Jun;Byoun, Ju-Young;Kim, Jung-Ho;Choi, Hye-Sung;Park, Myoung-Ae;Kim, Seok-Ryel
    • Journal of fish pathology
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    • v.24 no.3
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    • pp.205-211
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    • 2011
  • All of the crucian carp, Carassius auratus and 50% of common carp. Cyprinus carpio examined in this study were infected with the leeches, Limnotrachelobdella sinensis. Especially, the infection of C. carpio with L. sinensis was the first report in Korea. The gill of C. auratus showed increased hydrophic degeneration of epithelial cell in the filament, blood congestion, hyperplasia of epithelial cell in the filament and lamellae. In the SEM observation, gill filament was transformed to the cylinder form by the lamellae fusion. The lamellae surface showed degeneration, fragmentation of microridges. The extracellular cartilaginous matrix of the filaments was exposed by the collapse of epidermal layer. In the 18S rRNA analysis of L. sinensis, the relationships among these groups are not clear and not concord with their morphological classification.

The First Successful Heart-Lung Transplantation in Korea (심장-폐이식 1례보고)

  • 박국양;김주이;박철현;김상익;김정철;현성열;심현자;정미진;권진형
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.610-614
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    • 1998
  • The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

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Clinical Analysis of Pulmonary Resection Using Staplers (자동 조직 봉합기를 사용한 폐절제술의 임상적 고찰)

  • 맹대현;곽영태
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.905-909
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    • 1996
  • From 1991 to 1994, We performed 75 cases of pulmonary resection. These were divided into two groups according to the method of bronchial stump closure : 51 cases automatic staplers were a plied in 49 patients (Group 1), 24 patients were closed with manual interrupted suture (Group II). Disease entities of the patients were malignant tumor in 33 patients(Group I: Group II, 22· II, bronchiectasis in 23(18:5), benign tumor in 5(3:2), aspergilloma in 5(2:3), tuberculosis(2:1) in 3, bronchogenic cyst in 2 (0 : 2) and so on. Surgical Procedure% for these Patients were 21 Pneumonectomies(18:3), 13 bilobectomies(11:2), 26 lobectomles (14:12), 11 segmentectomies (6:5) and 4 lobectomy with segmentectomies (4:0). In conclusion, the Amount of tube drainage was smaller and the removal of chest tube after surgery was shorter than manual bronchial closure group by means of statistical significance (p=0.047, p=0.005). Although there were no statistical significance, the duration of air leakage was reduced and incidence of bronchopleural rstula was reduced in the stapler used group compared with manual bronchial closure.

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Stellate Ganglion Block for the Treatment of Sudden Sensoryneural Hearing Impairment (돌발성 난청의 치료를 위한 성상신경절 차단)

  • Choe, Huhn;Choi, Young-Soon;Kim, Dong-Chan;Han, Young-Jin;Lee, Ki-Nam
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.234-238
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    • 1992
  • We compared the effectiveness of vasodilator therapy with histamine and stellate ganglion block(SGB) for the treatment of sudden sensoryneural hearing impairment retrospctively. 24 patients were treated with histamine and nicotinic acid(histamine group), and 30 patients were treated with SGB(SGB group). Corticosteroids and low molecular weight dextran($Rheomacrodex^{(R)}$) were given to all patients. The degree of hearing impairment and the evidence of improvement were checked with audiogram. 52.8%(10 out of l9 follow-up ckecked patients) of patients in histamine group and 56.7%(17 out of 30) of patients in SGB group had improved within three weeks of treatment, which means both histamine and SGB are equally effective. As a consequence, we concluded that SGB ia a good substitute for histamine as a vasodilator therapy for sudden sensoryneural hearing impairment with minimal complication, few absolute contraindications, and simple and safe technique.

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A case of Rothmund-Thomson syndrome (Rothmund-Thomson 증후군 1례)

  • Kim, Seung Hyo;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.565-569
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    • 2006
  • Rothmund-Thomson syndrome (RTS), is a rare autosomal recessive disorder, characterized by : skin photosensitivity, poikiloderma, sparse hair, sparse eyebrows/lashes, short stature, skeletal abnormalities, cataracts, and an increased risk of malignancy. Skeletal abnormalities include : dysplasia, absent or malformed bones, such as absent radii, osteopenia, and delayed bone formation. RTS is thought to result from chromosomal instability, and children with RTS are at risk of cancer. Reported cancers in children with RTS include : basal cell carcinoma, squamous cell carcinoma of the skin and osteosarcoma of bone. We report an 11 year-old boy, who presented to our institution with poikilodermatous skin change with telangiectasia and hyperpigmentation, absence of radius and thumb, and the development of osteosarcoma of the left tibia. The patient is now receiving supportive care and is receiving maintenance chemotherapy after surgery for osteosarcoma.

A Case of Sigmoid Volvulus in a Child (소아에서 발생한 S상 결장 염전증 1예)

  • Lee, Dong-Han;We, Ju-Hee;Park, Hyun-Seok;Kim, Hae-Young;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.199-203
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    • 2010
  • Sigmoid volvulus may cause acute or subacute colonic obstruction. Excessive length of the sigmoid colon may be a contributing factor. Typically, the patient develops bilious vomiting and marked gaseous abdominal distension. We report a case of sigmoid volvulus in a 9-year-old boy who presented with recurrent, sudden onset abdominal pain, abdominal distension, and vomiting for 1 year, which was diagnosed by simple abdominal X-ray, barium enema, computed tomography, and colonoscopic examination. Colonoscopic reduction failed and a sigmoid colectomy with primary repair was performed. The intra-operative findings showed that the sigmoid colon was noted to be dilated, and redundant with a lax mesentery. Two clear areas of compression (proximal and distal) were present. After sigmoidectomy, the symptoms resolved. After 5 years of follow-up, he had no new symptoms.

Internal Mammary Artery Grafting Without Intraluminal Dilatation - Measurement of Internal Mammary Artery Flow and Clinical Results - (내경 확장을 시행하지 않은 내유동맥을 이용한 관상동맥 우회로술의 임상적 결과[내유동맥 혈류량과 그임상적 결과])

  • 최종범
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.307-314
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    • 1992
  • The internal mammary artery has been advocated for use in bypass grafting owing to its superior long-term patency when compared to saphenous vein grafts. Concern exists that the flow through internal mammary artery may be inadequate during periods of peak myocardial demand when the internal mammary artery graft was used for proximal left anterior descending artery stenosis. This flow adequacy was investigated in 13 consecutive patients with a mean proximal left anterior descending artery stenosis of 84.2% who were selected for coronary bypass using internal mammary artery. We checked flow and diameter of left internal mammary artery without intraluminal dilatation just before anastomosis to left anterior descending artery during cardiopulmonary bypass. Clinical results were evaluated postoperatively with clinical symptoms, echocardiographies, stress tests, and coronary angiographies. The mean internal mammary artery flow measured just before anastomosis was 38ml/ min[range of 20 to 80ml /min] and its mean internal diameter 1.4mm. Maximal workload was improved from preoperative value of 6.3$\pm$2.5METS to postoperative value of 9.1$\pm$1.4 METS in 9 patients who Paired-test can be used. Cardiac symptoms recurred in two patients after bypass surgery, but they were not related to left internal mammary artery grafts. All patients were discharged in postoperatively 9.3 days[range of 7 to 20 days] after operation without mortality. Thus, on the basis of these findings, the internal mammary artery is a reasonable graft that we can routinely use for proximal left descending artery stenosis if internal diameter of the internal mammary artery is more than 1.0mm and its flow is more than 20ml /min at mean arterial pressure of 50 to 60mmHg during cardiopulmonary bypass.

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