• Title/Summary/Keyword: 협착증

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Clinical Application of Balloon Valvuloplasty in a Boxer Dog with Subaortic Stenosis (대동맥 판막하 협착증에 이환된 박서견의 풍선 확장술 적용예)

  • Choi, Ran;Nam, So-Jeong;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.160-165
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    • 2009
  • A 4-month-old intact male Boxer dog(9 kg of body weight) was presented with the primary complaints of heart murmur and exercise intolerance. Diagnostic studies revealed severe subaortic stenosis. Since the pressure gradient(PG) in stenotic aortic valve area was higher than ${\sim}120mmHg$(5.4 m/s of peak velocity), the dog was underwent balloon valvuloplasty. With this procedure, the peak aortic velocity was reduced to 3.9 m/s(${\sim}60mmHg$ of PG) and the clinical condition of dog was markedly improved. Periodic re-evaluations performed at monthly interval revealed no further deterioration. This is the first case report of subaortic stenosis treated by non-surgical palliative balloon valvuloplasty in Korea.

The Efficacy of Ultrasonography-guided S1 Selective Nerve Root Block (초음파를 이용한 제 1천추 선택적 신경근 차단술의 유용성)

  • Jeon, Young Dae;Kim, Tae Gyun;Shim, Dae Moo;Kim, Chang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.113-119
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    • 2014
  • Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

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Tracheomalacia Associated with Esophageal Atresia - A case report - (식도폐쇄증과 동반된 기관연화증 - 1예 보고 -)

  • Song Seung-Hwan;Chang Yun-Hee;Lee Chang-Hun;Shin Dong-Hoon;Sung Si-Chan
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.643-647
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    • 2006
  • Congenital tracheomalacia associated esophageal atresia is a rare foregut anomaly. We report a case of 40-day old male infant with tracheomalacia who has undergone repair of esophageal atresia at his age of 1 day. The patient had progressive dyspnea and stridor after repair of esophageal atresia. His 3-dimensional chest computed tomography showed severe stenosis at the middle of trachea. We underwent resection and end-to-end anastomosis under cardiopulmonary bypass. Histologic examination revealed esophageal tissues indicating congenital origin as well as no cartilage.

Design of the Interspinous Process Fixator Using Biomechanical Analysis for the Treament of Degenerative Lumbar Spinal Stenosis (퇴행성 요추부 척추관 협착증 치료를 위한 극돌기간 고정기구의 설계 및 생체역학적 분석)

  • Heo S.;Son K.;Lee S.J.;Moon B.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1963-1966
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    • 2005
  • Degenerative lumbar spinal stenosis(DLSS) is a disease inducing low back pain, leg pain, convulsion, numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degenerative of neighbor region after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design of the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified fixators using the finite element analysis(FEA). Displacement, stiffness and Von-Mises stress were found to have similar values to those obtained from the mechanical test and the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator.

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Modified Tracheostomy for Severe Tracheal Stenosis (고도의 기관협착증에서 변형된 기관절개술의 적용)

  • Sa Young-Jo;Nam Sang-Yong;Wang Young-Pil;Park Jae-Kil
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.415-418
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    • 2006
  • When tracheal invasion of a malignant tumor or tracheal stenosis of a benign origin exists at the lower or anterior part of the trachea, tracheal intubation or conventional tracheostomy may be difficult, and in these cases a modified tracheostomy through the lower or lateral part of the trachea would be necessary. We present 6 cases of modified tracheostomy performed with satisfactory results in severe tracheal stenosis that developed in the lower or anterior part of the trachea.

Lumbar Spinal Stenosis Cases Managed by Yinyang Balance Appliance of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System (FCST의 음양균형장치를 활용한 요추 척추관 협착증의 증례보고)

  • Lee, Sang Bae;Park, Sang Gil;O, Se Chang;Lee, Young Jun;Yin, Chang Shik
    • Journal of TMJ Balancing Medicine
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    • v.5 no.sup
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    • pp.25-30
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    • 2015
  • Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in a lumbar spinal stenosis case. One lumbar spinal stenosis case was managed with the Yinyang Balancing Appliance on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. further clinical and biological research on FCST is expected.

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A Case of Renovascular Hypertension Controlled by Renal Artery Embolization (신동맥 색전술로 치료한 신혈관 고혈압증 1례)

  • Yew, Jung Hun;Kim, Young Deuk;Shin, Byung Seok;Gil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.212-215
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    • 2005
  • Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

A Case of Pseudo-Bartter's Syndrome Due to Hypertrophic Pyloric Stenosis (비후성 유문 협착증에 의한 가성 Bartter 증후군 1례)

  • Kim, Yoon Hee;Lee, Tae Ho;Kim, Hong Bae
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1430-1434
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    • 2002
  • We report a 3-month old boy admitted to our hospital with Bartter's syndrome like symptoms and laboratory findings, which were vomiting, failure to thrive, hypochloremic and hypokalemic metabolic alkalosis associated with hyperreninemia, hyperaldosteronism and normal blood pressure. However, the urine chloride level was low. Hypertrophic pyloric stenosis was diagnosed through abdominal ultrasonography. Fredet-Ramstedt operation was done after electrolyte correction. After surgery he made a good recovery and gained body weight. The electrolytes maintained within a normal limit without any potassium supplementations after surgery. Differential diagnosis from Bartter's syndrome was made on the basis of a decrease in urine chloride and the non-necessity for potassium supplementation after surgery. It is relatively rare for hypertrophic pyloric stenosis to induce pseudo-Bartter's syndrome. The importance of considering this diagnosis in such cases is discussed.

Airway Narrowing Patterns during Obstructive Sleep Apnea : Airway CT and Multi-level Airway Pressure Monitoring (수면무호흡 중에 관찰된 다양한 기도협착의 형태:상기도 CT 및 상기도 압력 측정법)

  • Jeong, Seung-Cheol;Hong, Seung-Bong;Kyung, Seung-Hyun;Kim, Hoo-Won
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.18-26
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    • 2000
  • Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.

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Causes and Clinical Outcomes of Congenital Hydronephrosis (신생아 수신증의 원인과 임상 경과에 대한 고찰)

  • Kang Hyun-Young;Chang Mea-Young;Lee Jae-Ho
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.69-75
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    • 2005
  • Purpose : The most important management of congenital hydronephrosis consists of the early diagnosis and evaluation of the pathologic abnormalities of congenital hydronephrosis. This study was conducted to investigate the different causes of hydronephrosis and its clinical outcome. Methods : 54 live neonates who were hospitalized and diagnosed with congenital hydronephrosis at Chungnam National University Hospital from Aug. 1998 to Aug. 2003 were retrospectively analyzed. Results : Hydronephrosis(renal pelvic AP diameter $gt;5 mm) was postnatally detected in 54 cases(2.1%) among 2,539 neonates who were hospitalized from Aug. 1998 to Aug. 2003. There were three times more males than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis(48.7%), followed by multicystic dysplastic kidney, vesicoureteral reflux and duplication kidney with ureterocele. Spontaneous regression of hydronephrosis was revealed in 25 renal units(75.8% ) of mild hydronephrosis, 14 renal units of moderate hydronephrosis and 1 renal unit of severe hydronephrosis. Operative correction were carried out in 14 renal units(70%) of severe hydronephrosls. Conclusion : The most common established cause of congenital hydronephrosis in this study was ureteropelvic junction obstruction. There are many cases of spontaneous regression in mild to moderate congenital hydronephrosis. Urinary tract infections occur in many neonates with hydronephrosis. Therefore, early detection and evaluation of congenital hydronephrosis and continuous follow-up at regular intervals are necessary for conservation of renal function. (J Korean Soc Pediatr Nephrol 2005;9:69-75)

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