• Title/Summary/Keyword: 협착증

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Repair of Complex Cardiac Anomaly Associated with Congenital Tracheal Stenosis -1 Case Report- (선천성 기관 협착증을 동반한 복잡 심기형의 완전 교정술 -1예 보고-)

  • Park, Jeong-Jun;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.88-91
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    • 1997
  • Congenital long-segment tracheal stenosis with complex cardiac anomaly has generally been regarded as a fatal disease This report described the successful concomitant repair of unexpected congenital tracheal stenosis and complex cardiac anomaly with the use of edrdiopulmonary bypass. The patient was a 3-month-old girl with coarctation of aorta, V D, and PDA. The presence of tracheal stenosis was not discovered until when difficulty with endotracheal intubation was encountered at operating room. Thus, we decided concomitant repair of both lesions and performed anterior pericardial tracheoplasty combined with one stage repair of coarctation of aorta, VSD, and PDA under the cardiopulmonary bypass. The patient is doing well without any signs of complication at present, 2 years and 1 month after the operation.

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The Effect of Cushion Insole on the Flexibility and Exercise Ability of Lumbar Spinal Stenosis (쿠션인솔이 요추 척추관협착증 환자의 유연성 및 운동능력에 미치는 영향)

  • Kim, Hyun Taeg;Moon, Sang Ho;Kim, Kyung Chul;Kwon, Byong An
    • Journal of Digital Convergence
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    • v.17 no.1
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    • pp.423-432
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    • 2019
  • The purpose of this study was to investigate the effect of cushion insole on lumbar flexibility and motor fitness in patients with lumbar spinal stenosis. 26 patients with lumbar spinal stenosis were randomly assigned to the experimental group 13 and the control group 13. Volunteers were allowed to wear cushioned insoles for two hours a day for six weeks. The experimental group was 8 mm and the control group was 4 mm, wearing a cushion insole as a blinded experiment. There was a significant increase(p<0.05) in the flexion test of the experimental group ($3.38{\pm}3.12$), but not statistically significant in the other tests(p>0.05). In conclusion, cushion insole was not suitable for intervention for lumbar spinal stenosis. There is a need to study the height and material of the insoles in the future.

A CLINICAL STUDY ON TRACHEAL STENOSIS (기관협착증에 관한 임상적 고찰)

  • 정무권;조진생;안회영;차창일;유세영;박주철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.13.1-13
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    • 1987
  • 저자들은 1984년 12월 17일부터 1987년 2월 26일까지 경희대학교 의과대학 부속병원 이비인후과 및 흉부외과에서 경험한 9례의 기관협착증환자를 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 연령 및 성별분포는 여자 3례, 남자 6례이었고, 10세이하 3례, 10대 2례, 20대 2례, 40대 이상이 2례 이었다. 2) 원인은 지속적 기관내삽입관에 의한 경우가 4례이었고 1례는 선천성 혈관기형인 double aortic arch에 의해 기관이 눌리어 기도협착증상이 있었던 경우이었다. 상기관절개술에 의한 경우가 2례, 경부외상 1례, 기관내 종양 2례이었다. 3) 협착부위의 길이는 1.5cm에서 2cm까지가 4례로 가장 많았고 3cm이내가 2례, 4cm이내 1례, 6cm이내 1례이었다. 4) 치료는 보존적인 방법으로 내시경하에서 육아조직 및 반흔조직을 laser를 이용하여 제거한 후 silastic stent 혹은 Montgomery T-tube 삽입후 4주에서 6주후 제거하여 치료한 경우가 2례이었고 협착부위절제 및 단단문합술을 시행한 경우가 6례이었다. 1례에서는 aortic arch division을 시행하였다. 5) 예후는 9례중 단단문합술을 시행한 6례 그리고 보존적 방법으로 laser를 이용한 육아조직의 제거 및 지지물삽입을 시행한 3례에서 모두 현재까지 재발은 보이지 않고 있다. 6) 기관협착의 길이가 1.5cm에서 4cm까지의 경우에는 supralaryngeal release procedure없이 단단문합술을 시행하였고 협착길이가 6cm인 1례에서는 supralaryngeal release를 하여 tension없이 문합술을 시행할 수 있었다.

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Tracheoplasty for Congenital Tracheal Stenosis-Two case reports- (선천성 기관 협착 환자의 기관성형술 2예)

  • Lim Hong Gook;Lee Chang-Ha;Hwang Seong Wook;Lee Cheul;Kim Jae Hyun;Seo Hong Joo;Jung Sung Chol
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.583-588
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    • 2005
  • Congenital tracheal stenosis can be a life-threatening disease, especially in cases involving the long-segment of the trachea. When patients are symptomatic immediately after birth or develop an accompanying complex cardiac anomaly, surgical repair can be a considerable challenge. We experienced a tracheoplasty in one early infant weighing 2.6 kg and one neonate who had ventilator dependency from long-segment congenital tracheal stenosis and congenital cardiac anomaly. One early infant, who had diffuse stenosis of distal trachea after ventricular septal defect closure, underwent resection and extended end to end anastomosis. One neonate who had diffuse stenosis of proximal trachea with tetralogy of Fallot (TOF), underwent slide tracheoplasty with total correction for TOF Postoperative chest computed tomography showed widely patent trachea. Both infants are now well without symptoms.

Seven Cases of Severe Esophageal Stricture (고도의 식도 협착증 7 예)

  • 김기주;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.2-5
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    • 1982
  • With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

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Preoperative Risk Factors for the Prognosis of Mitral Regurgitation in Patients with Coronary Artery Stenosis and Mitral Regurgitation Who Underwent Coronary Artery Bypass Surgery Alone (승모판폐쇄부전증을 동반한 관상동맥협착증 환자에서 시행한 단독 관상동맥우회술 후 승모판폐쇄부전증의 예후에 영향을 미치는 수술 전 요인)

  • Jin, Ung;Park, Chan-Beom;Choi, Si-Young;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.410-415
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    • 2004
  • Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.

A Case Report of Restrictive Ventricular Septal Defect & Left Ventricular Out Flow Tract Stenosis Caused by Fibrotic Tissue in Tetralogy of Fallot (섬유성 조직으로 인한 제한적 심실 중격 결손과 좌심실 유출로 협착을 보인 활로씨 4증 1예 보고)

  • Hwang, Ui-Dong;Jung, Sung-Ho;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.850-853
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    • 2006
  • The VSD in TOF is usually large and unrestrictive with an equal to or greater than that of the aortic annulus. Typically shunting through the VSD is bidirectional or right-to-left component. Restrictive VSD in TOF caused by ingrowing fibrotic tissue is very rare. We report a case of restrictive VSD and LVOTO in TOF caused by ingrowing fibrotic tissue with the review of literature.

Correlation of the External Otic Diseases and the Ear Canal Length in Dogs (개에서 외이도의 길이와 외이도 질환과의 연관성)

  • 엄기동;윤정회
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.263-266
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    • 1998
  • 외이도의 직경 및 길이와 외이도 질환과의 연관성을 알아보고자 73두 성견을 실 험에 이웅하였다. 임상중상, 배양 및 도말 검사를 통하여 외이 질환이 얼는 정상군 57개의 이 관과, 질환이 있는 비정상군 89개의 이관에 직경과 길이를 평가하기 위한 간접적인 방법으로 이관내 조영술을 실시하였다. 비정상군은 정상군에 비하여 윤상연골 및 귓바퀴 연골의 직경 이 더 넓었다. 수직외이도를 구성하는 귓바퀴 연골의 길이는 비정상군4(12.79{\pm} 3.08)이 정상 군(12.79{\pm}5.87 mm)$에서 보다 유의성 있게 길게 나타났다(p<0.001). 심한 외이도 협착증을 보이는 21개의 귀에서는 외이도 질환을 발견할 수 없었으며, 외이도 질환이 심한 귀에 있어 서 그 직경과 길이가 정상군에 비하여 넝고 길게 나타났다(p<0.05). 본 실험의 결과로 보아 외이도관의 협착증과 외이도 질환과는 연관성이 발견되지 않았으나, 환기와 귀내 분비물의 배출을 방해하는 긴 수직외이도를 갖는 귀가 외이도 질환과 밀접한 관계가 있는 것으로 생각 되었다.

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A Case Report of Nasopharyngeal Stenosis Corrected by Velopharyngoplasty (구개인두성형술로 교정한 비인두 협착증)

  • 최홍식;임재열;신승호;남태욱
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.1
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    • pp.59-62
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    • 2002
  • We present a case of nasopharyngeal stenosis which developed after adenotonsillectomy. A 11-year-old boy underwent adenotonsillectomy because of snoring at a local clinic using a $CO_2$ LASER. After the operation, he cannot breathe via nose due to severe cicatrical nasopharyngeal stenosis. Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We treated the patient with velopharyngoplasty using two separate rotational mucosal flaps.

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A Case of Acquired Nasopharyngeal Stenosis (후천성 비인두 협착증 1례)

  • Chung, Young-Jun;Lim, Eun-Seok
    • Korean Journal of Bronchoesophagology
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    • v.13 no.1
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    • pp.43-46
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    • 2007
  • Nasopharyngeal stenosis is an obliteration of the normal communication between the nasopharynx and the oropharynx resulting from the fusion of the tonsillar pillars and soft palate to the posterior pharyngeal wall. It is a rare but serious problem. The most common etiology is currently the surgical trauma associated with uvulopalatopharyngoplasty or adenotonsillectomy. It can range in severity from a thin band to a complete obstructing cicatrix, Symptoms vary from mild hyponasal speech to almost complete nasal obstruction with oral breathing, We present a case of a 16 year-old male with nasopharyngeal stenosis after radiofrequency-assisted adenoidectomy in this paper. This patient was managed by synechiolysis, obturator and buccal mucosal graft.

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