• 제목/요약/키워드: 혈관 확장

Search Result 451, Processing Time 0.028 seconds

Modification of the Cox-Maze Procedure for Atrial Fibrillation with Large Left Atrium ; Development of Surgical Technique to Increase the Left Atrial Contractility (좌심방 확장을 동반한 심방세동에 대한 Cox-Maze 수술법의 변형 -수술후 좌심방 수축력의 증진을 위한 수술법의 개량-)

  • 강창현;김기봉;손대원
    • Journal of Chest Surgery
    • /
    • v.32 no.3
    • /
    • pp.249-254
    • /
    • 1999
  • Background: Recovery of the left atrial contractile function after the Cox-Maze procedure is related to the size of the left atrium. We have postulated that if too wide area of the atrium were isolated electrically, then the atrial contractile function would be impaired postoperatively. We have modified the Cox-Maze procedure to dissect each pair of the pulmonary veins separately instead of the conventional pulmonary vein encircling incision, and compared the atrial contractile function after each procedure. Material and Method: From February 1995 to October 1997, 55 cases of the Cox-Maze procedure were performed in mitral valvular heart disease. We excluded the cases that did not covert to sinus rhythm. The patient groups were divided according to the interpulmonary vein distance(IPVD) and the procedure performed. Group I was IPVD under 6.5 cm(n=30), group II was IPVD over 6.5cm and the conventional Cox-Maze III procedure was performed(n=16), and group III was IPVD over 6.5cm and the modified Cox-Maze procedure was performed(n=9). Result: Atrial contractile function was evaluated by the echocardiography follow-up between 6 months to 12 months. The right atrial contractile function recovered gradually, the recovery rate after long-term follow-up was 90% in group I, 81% in group II, and 100% in group III(p>0/05). In the left atrium the recovery rate was 63% in group I, 31% in group II(p=0.03), and 66% in group III(p>0.05). Conclusion: The modified Cox-Maze procedure may have beneficial effects on the recovery of the left atrial contractile function, however, there are no statistically significant values. Therefore, further evaluation of this procedure is necessary.

  • PDF

Biliary Atresia in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담도폐색증 - 대한소아외과학회회원 대상 전국조사 -)

  • Choi, Kum-Ja;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.H.;Park, K.W.;Park, W.H.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Jhung, S.Y.;Jhung, S.E.;P.M., Jung;S.O., Choi;Choi, S.H.;Han, S.J.;Huh, Y.S.;Hong, C.;Hwbang, E.H.
    • Advances in pediatric surgery
    • /
    • v.8 no.2
    • /
    • pp.143-155
    • /
    • 2002
  • A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

  • PDF

Lateral Thoracic Expansion Surgery for Jeune's Syndrome (Jeune 증후군 환아에게 시행한 외측 흉벽 확장술)

  • Kim Joon Bum;Moon Il Hong;Choi Byung Min;Lee Kee Hyoung;Choi In Cheol;Park Seung Il
    • Journal of Chest Surgery
    • /
    • v.38 no.12 s.257
    • /
    • pp.873-877
    • /
    • 2005
  • Jeune's asphyxiating thoracic dystrophy is a rare, complex malformation with a broad spectrum of clinical expression. The degree of chest wall deformity is the most important prognostic factor and the only part which is correctable. A 11 month-old male infant was diagnosed as having Jeune's syndrome and received right side lateral thoracic expansion surgery. But because respiratory distress symptom was sustained postoperatively, we performed left side procedure 3 months after the initial operation. Respiratory distress symptom got worse after fracturing the left titanium plate which was inserted to fix the expanded thoracic wall and reimplantation was performed. The patient was discharged 6 months after the initial operation. He was readmitted and received ventilator care for respiratory failure and died 10 months after the initial operation.

Surgical Treatment of Left Ventricular-Right Atrial Shunt (좌심실-우심방 단락의 외과적 치료)

  • 이응배;허동명
    • Journal of Chest Surgery
    • /
    • v.29 no.9
    • /
    • pp.945-950
    • /
    • 1996
  • Twelve patients with left ventricular-right atrial shunt (LV-RA shunt) underwent surgical correction be- tween April 1982 and March 1995. Seven patients were male and five patients were female. Age ranged from 3 to 26 years with mean age of 8.5 years. On the preoperative chest PA views, increased pulmonary vascularity was noted in 3 cases and enlargement of right atrium in 4 cases. The mean preoperative cardiothoracic ratio was 0.59. Echocardiographic studies were obtained in 9 patients and the preoperative echocardiographic diagnoses were LV-RA shunt in 2 cases, ventricular septal defect (VSD) in 6 casei, and atrial septal defect (ASD) in 1 case. The preoperative ngiographic diagnoses which were obtained in all patients were LV-RA shunt in 5 cases, VSD in 5 cases, ASD in 1 case, and VSD with ASD in 1 case. The descriptions of defect of LV-RA shunt according to intraoperative findings were supravalvular defect in 5 cases(42%), infravalvular defect in 4 cases (33%), and combined defect in 3 cases (25%). Associated anomalies of tricuspid valve in 4 cases of infravalvular defect were perforation (3 cases) and cleft (1 case). Primary closure of the septal defect was performed through the right atriotomy in all but one patient. There was no operative death. One patient underwent reoperation because of the residual interventricular shunt. All patients have been in good condition.

  • PDF

Clinical Evaluation of Pneumonectomy (전폐절제술의 임상적 연구)

  • Park, Jin-Gyu;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
    • /
    • v.29 no.9
    • /
    • pp.996-1002
    • /
    • 1996
  • From August 1979 to August 1995, 73 consecutive patients with various pulmonary diseases underwent pneumonectomy Underlying diseases were lung cancer(53 cases), pulmonary tuberculosis(10 cases), bronchiectasis(4 cases) and others(6 cases). Operative mortality and complication rate for 73 patients and respiratory capacity for 53 patients at postoperative 6 months were measured, and statistically analysed for the influencing factors. The influencing factors on prognosis included age, sex, pathologic finding (benign or malignant), associated diseases, preoperative pulmonary function test and operation time. The statistically significant factors for operative mortality were preoperative MW(% prep)(P=0.013) and operation time(P=0.009). The factors influencing operative complication was infectious disease (P=0. 015), and for respiratory capacity a postoperative 6 months, preoperative FVC(%. prod) (PED.0018), FEVI(%. prod)(P=0.0024), and MW(%. prod) (P=0.004)) were statistically significant factors. The preoperative FVC(%. tyred), FEVI(% . prod) and MW(%. prod) should be measured exactly. We conclude that preoperative lung function, cardiovascular and nutritional status, postoperative care and infection prevention were important factors to decrease the operative mortality and complication as well as to increase respiratory capacity.

  • PDF

Delayed Type Hypersensitivity on Abdominal Skim of Mouse by DNCB Sensitization (DNCB에 의한 생쥐 복강피부의 지연형 과민반응에 관한 연구)

  • Kim, Jin-Taek;Park, In-Sick;Ahn, Sang-Hyun
    • The Journal of Dong Guk Oriental Medicine
    • /
    • v.6 no.1
    • /
    • pp.117-128
    • /
    • 1997
  • Abdominal skin tissues of ICR mouse painted with Dinitrochlorobenzene (DNCB) were observed to investigate the delayed type hypersensitivity of skin by chemical allergen as hapten. The abdominal skin tissues were obtained at hour 48 after secondary DNCB sensitization that were stained by Luna's method for mast cell, and immunohistochemical stain method for IL-2 receptor. The superficial perivascular lymphocytic aggregation were shown in basement membrane after DNCB secondary painting and the large size capillaries in dermis were appeared. The infiltration of lymphocyte to epithelium, the vacuolation of epithelial cell and intercellular space were increased. The number of mast cell in dermis was increased and these shape is degranulation type. The number of IL-2 receptor positive cell was increased in dermis. As results indicated that the hypersensitivy of immune system were induced by DNCB, subsequently to damage evoke inflammation in skin.

  • PDF

Involvement of F-Actin Cytoskeleton for Microvilli Formation of Jurkat T Lymphocyte (F-actin cytoskeleton이 Jurkat T 림파구의 microvilli 형성에 미치는 영향)

  • Lee, Jae-Seol;Kim, Hae-Young;Son, Gi-Ae;Kim, Ji-Eun;Moon, Kyoung-Mi;Kim, Kwang-Hyeon;Choi, Woo-Bong;Lee, Jong-Hwan
    • Journal of Life Science
    • /
    • v.21 no.10
    • /
    • pp.1401-1406
    • /
    • 2011
  • Morphological changes in immune cells occur due to pathogen infection and natural circulation. T cells produce uropod, filopodia, lamellipodia, and microvilli for inflammation, immunosurvelliance, migration, and diapedesis. Short finger-like microvilli cover the surfaces of circulating mammalian immune cells. The surface features of monocytes and neutrophils are quite different, containing membrane ruffles as their predominant structure. In this study, we present the involvement of actin cytoskeleton regarding T lymphocyte microvilli. From analysis of scanning electron micrographs, Jurkat T lymphocyte microvilli was observed to rapidly disassemble when exposed to the actin-sequestering molecule, cytochalasin D. In contrast to cytochalasin D treatment, we found that median microvillar thickness was enlarged on Jurkat T lymphocytes treated with PMA via Lin-11, Isl-1, Mec-3 Kinase (LIMK) and cofilin signaling. In addition, actin cytoskeleton was involved in polarity formation in EL4 T lymphocytes. These results suggest that microvilli formation or polarity of T lymphocytes are involved in actin cytoskeleton dynamics.

The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA) (관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가)

  • Jung, Kang-Kyo;Lee, Mi-Hwa;Cho, Pyong-Kon
    • Journal of radiological science and technology
    • /
    • v.37 no.4
    • /
    • pp.307-313
    • /
    • 2014
  • The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about $4.8{\pm}0.3bpm$ (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

Immunohistochemical c-fos Expression in Osteosarcoma (골육종의 c-fos 발현에 관한 면역조직화학적 검색)

  • Park, Yong-Koo;Park, Hye-Rim
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.5 no.3
    • /
    • pp.162-168
    • /
    • 1999
  • The products of c-fos and c-jun proto-oncogenes form the heterodimeric complex activator protein 1 (AP-1), which plays an important part in the control of bone cell proliferation and differentiation, as well as in the development of bone tumors. The expression of c-fos protein was examined in 35 cases of human osteosarcomas as formalin-fixed paraffin-embedded tissue sections using a monoclonal antibody. The expression of c-fos was restricted to bone-forming lesions, while low grade cartilaginous tumors were devoid of immunoreactivity. The highest levels of c-fos expression were detected in osteoblastic osteosarcoma (13 of 17 cases with grade one on two) while two chondroblastic osteosarcomas, one fibroblastic osteosarcoma, and two parosteal osteosarcomas were negative. Two cases of telangiectatic osteosarcomas were positive for c-fos protein. However, since there is a tendency of high c-fos protein expression at the higher histological grade, significant differences were not present in the expression of c-fos protein. Thus c-fos expression may be implicated in the development of osteosarcomas, but they appear to have little or no relevance in the development of low grade cartilaginous neoplasms.

  • PDF

Regression of Left Ventricular Hypertrophy after AVR in Aortic Valvular Stenosis (대동맥판막협착증 환자에서 판막치환 후 좌심실심근비후의 변화)

  • 이재원;최강주;송명근
    • Journal of Chest Surgery
    • /
    • v.31 no.6
    • /
    • pp.586-590
    • /
    • 1998
  • Background: The regression of the left ventricular hypertrophy after prosthetic valve replacement in patients with aortic valvular stenosis is an important factor to determine the appropriateness of the replaced prosthetic valvular size. Methods: To assess the regression of myocardial hypertrophy, a retrospective analysis of Doppler echocardiographic and electrocardiographic data was undertaken before, soon after(7.5$\pm$2.1 day), and late after(10.7$\pm$1.8 months) surgery in 36 patients(22 males, 14 female, mean age 54$\pm$12.1 years, mean BSA 1.61$\pm$0.15m2) with predominant aortic valvular stenosis. The patients underwent St. Jude Medical aortic valve replacement. By the size of the valves used, the patients were divided into three groups(19, 21 and 23+). Results: The mean body surface area(1.48$\pm$0.13) in the patients with the 19 mm valve was smaller than that in the other groups(1.63$\pm$0.12)(p<0.05). No significant changes of ejection fraction were detected in all groups over time. Left ventricular muscle mass index(gm/m2) was reduced significantly in the 21 and 23+ groups over time(p<0.05), but there were no significant changes in the 19 mm valve group. The electric voltage height on EKG at the period of late after surgery was reduced significantly in all groups(p<0.05). Conclusion: Despite clinical improvement, the LVH was not reduced significantly in 19 mm valve group. Thus we suggest that more attention and additional procedures such as annular enlargement should be taken in patients who will undergo the replacement of 19 mm prosthetic valve.

  • PDF