• Journal of Preventive Medicine and Public Health
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• 제42권5호
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• pp.298-304
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• 2009

Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

• 대한두경부종양학회지
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• 제33권1호
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• pp.53-56
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• 2017

Pharyngocutaneous fistula is one of the most common wound complications after total laryngectomy. The leakage of saliva may cause an erosion of greater vessels nearby and result in a life-threatening bleeding. 65-year-old male received laryngectomy and pharyngectomy followed by Latissimus dorsi flap reconstruction due to recurred laryngeal cancer with oropharyngeal extension after postoperative radiotherapy. Pharyngeal fistula was developed and an excessive fresh blood flowed through the oral and nasal cavity. The patient was transferred to the operating room immediately, and the causing artery was ligated. The rupture of the common carotid artery and its branches should be warned when the pharyngocutaneous fistula is developed. Prompt and proper therapy must be performed for the patients with impending or acute hemorrhage.

• Journal of health informatics and statistics
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• 제41권1호
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• pp.49-56
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• 2016

목적: 경동맥 내막-중막 두께와 경동맥 경화반의 존재유무는 죽상동맥경화증의 임상 전단계를 나타내는 지표로 널리 사용되고 있다. 경동맥 내막-중막 두께를 측정할 때의 측정자 의존성 때문에, 다기관 연구에서는 경동맥 내막-중막 두께와 경화반 측정의 기관간 신뢰도를 확인하는 것이 중요하다. 이 연구의 목적은 심뇌혈관 및 대사질환원인 연구센터에 속해 있는 세 임상기관 사이의 경동맥 내막-중막 두께와 경화반 측정의 측정자간 신뢰도를 평가하는 것이다. 방법: 심뇌혈관 질환 과거력이 없는 사람 20명이 2014-2015년 사이에 이 연구에 참여하였고(연령 37-64세), 미리 정해진 프로토콜에 따라 연구참여자의 좌, 우 경동맥을 세 임상기관에서 반복적으로 측정하였다. 총 경동맥의 원위부에서 측정한 경동맥 내막-중막 두께의 최대값과 평균값을 기록하였다. 경동맥에서의 경화반 존재유무는 측정자에 의해 확인되었다. 경동맥 내막-중막 두께와 경화반 존재유무의 신뢰도를 급내상관계수와 카파 통계량을 통해 각각 평가하였다. 결과: 계산된 급내상관계수는 최대 경동맥 내막-중막 두께를 평가하였을 때 0.647이었고 (95% CI: 0.487-0.779), 평균 경동맥 내막-중막 두께를 평가하였을 때 0.758 (95% CI: 0.632-0.854) 이었다. Bland Altman plot에서, 관측치의 대부분은 평균의 차이에서 ${\pm}1.96$ 표준편차 사이에 분포하였다. 각 기관 사이의 경화반 존재유무에 대한 카파 통계량은 0.304 (기관 1과 2), 0.507 (기관 1과 3), 0.606 (기관 2와 3)이었다. 전반적인 일치를 평가하는 Fleiss카파값은 0.445였다. 결론: 세 임상기관 사이의 경동맥 내막-중막 두께의 측정자간 신뢰도는 훌륭하였으며, 경화반 존재유무에 대한 신뢰도는 적정하였다.

• 대한임상검사과학회지
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• 제49권3호
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• pp.308-315
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• 2017

경동맥 내막-중막 두께(CIMT) 검사는 심장 질환의 증상이 없는 환자에서도 안전하고 비 침습적으로 죽상경화증을 검사하고 모니터 할 수 있는 표준화 된 초음파 절차이다. 본 연구의 목적은 초음파로 측정 한 경동맥 내막-중막 두께와 환자의 스트레스 정도를 측정하는 것이었다. 연구 대상자는 경기도 수원시에 있는 기타 질환이 없는 대학생 168 명(남자 46 명, 여자 122 명)이었다. 이 연구에서 참가자들의 연구 참여는 문서를 통하여 개인적으로 동의를 받았다. 경동맥 내막-중막 두께는 비 침습성 고 해상도 Medison Accuvix V20 초음파 장비를 사용하여 분기점 아래 1 cm의 좌우 총경동맥에서 측정되었고, 스트레스 인지정도는 10 가지 항목의 PSS (Perceived Stress Scale)설문지를 이용하였다. 이 연구는 PSS가 인지된 스트레스 수준과 체중을 추정하는데 적절함을 나타냈다. 스트레스 유무에 따라 좌측 CIMT와 체중 간에 통계적으로 유의 한 차이가 있었다(p<0.05). 이 연구의 결과는 체중 측정이 부분적으로는 일반화 된 스트레스에 영향을 받는다는 것을 시사합니다. CIMT에 대한 인지된 스트레스와 일반화 된 불안의 영향을 테스트하기 위해서는 다양한 연구가 지속적으로 이루어져야 할 것으로 사료된다.

• The Korean Journal of Physiology
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• 제21권2호
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• pp.211-223
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• 1987

Head-down tilt (HDT) at $-6^{\circ}$ has been commonly used as the experimental model in both man and animals to induce the blood shift toward the head or central protion of the body, demonstrating similar physiological effect encountered in the weightlessness in the orbital flight. There are few reports about the physiological response upon the cardiovascular regulatory system or the tolerance to the $(-6^{\circ})$ HDT within a relatively short period less than 1 hour. Therefore, the purpose of this study way to observe the effects of $-6^{\circ}$ HDT on cardiovascular system within 30 minutes and to evaluate early regulatory mechanism for simulated hypogravity. Ten mongrel dogs weighing 8-12 kg were anesthetized with the infusion of 1% ${\alpha}-chloralose$ (100 mg/kg) intravenously, and the postural changes were performed from the supine to the $-6^{\circ}$ head-down Position, then from the head-down to the supine (SUP), and each posture was maintained for 30 minutes. Blood flow $({\dot{Q}})$ through common carotid and femoral arteries were determined by the electromagnetic flowmeter. Mean arterial pressure (MAP), heart rate (HR), respiratory rate , and pH, $P_{O_2}$, $P_{CO_2}$ and hematocrit (Hct) of arterial and venous blood were also measured. The peripheral vascular resistance was calculated by dividing respective MAP values by ${\dot{Q}}$ through both sides of common carotid or femoral arteries. The concentration of plasma epinephrine and norepinephrine was determined by Peuler & Johnson's radioenzymatic method. The results are summarized as follows: In the initial 5 minutes in $-6^{\circ}$ HDT, HR was significantly (p<0.05) increased and MAP slightly decreased. Although ${\dot{Q}}$ and carotid peripheral artery resistance were not significantly changed, ${\dot{Q}}$ through femoral artery was diminished and femoral peripheral artery resistance was elevated. In the SUP, the initial changes of MAP and HR were increased (p<0.05), but those of ${\dot{Q}}$ and peripheral vascular resistance through both common carotid and femoral arteries were not significant. After 10 minutes of each postural change in both HDT and SUP, MAP was maintained almost equal to that of the level of pretilting control. During 60 minutes of both postural changes of HDT and SUP, $P_{O_2}$ and Hct were not changed significantly. However pH tended to increase slowly and $P_{CO_2}$ was gradually decreased. The pH and $P_{CO_2}$ seemed to be related to the increased respiratory rate. Plasma epinephrine concentration was not changed significantly and plasma norepinephrine concentration was slightly decreased in the course of HDT and also at 10 minutes of SUP. However these concentration changes were statistically insignificant. From these results, it may be concluded that the effect of $-6^{\circ}$ HDT for 30 minutes on the cardiovascular system and plasma catecholamine levels of the dog is minimum and it is suggestive that the cardiovascular regulatory mechanism, possibly mediated by so called gravity receptors including baroreceptor and volume receptor, has been properly and adequately operated.

• Journal of Chest Surgery
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• 제39권12호
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• pp.943-945
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• 2006

수유 곤란과 반복적인 흡인성 폐렴을 주소로 내원한 11개월 된 여아가 우대동맥궁, Kommerell 게실, 식도 후방의 좌쇄골하 및 동맥관 인대로 형성된 완전 혈관륜을 진단 받고 수술적 교정을 받았다. 수술은 좌측 후측 개흉 후 동맥관 인대를 분리하여 식도 압박 요인을 제거하고, Kommerell 게실을 하행대동맥으로부터 분리, 절제한 후 좌쇄골하 동맥을 좌측 총경동맥으로 단측 문합하였다. 환아의 수술 경과는 양호하였으며, 현재 외래 관찰 중이다.

• Journal of Korean Neurosurgical Society
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• 제63권4호
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• pp.532-538
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• 2020

Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

• 대한한의학회지
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• 제18권1호
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• pp.337-343
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• 1997

With the purpose of producing easily the basal ganglia infarction into Chen's, scerebral ischemic model which is almost cortical infarct made by the ligation of distal part of MCA and 1 hr obliteration of both common carotid arteries in rat, the MCA obstruction was extended between rhinal fissure and olfactory tract with electrocauterization in place of 10-0 silk suture ligation of distal part of MCA. Both original Chen's model and modified Chen's have shown the cortical infarction in dorsolateral & lateral frontoparietal cortex, but not any infarction in basal ganglia. However, the modified Chen's model have shown the effect of average 12% increase in cortical infarct than that of original Chen's model. This experimental results suggest the modified Chen's model can not reduce the blood flow of the lateral lenticulostriatal artery enough to make the basal ganglia infarction and that blood circulation of basal gagglia under its condition is probably being kept partly through the posterior cerebral artery via vertebral artery. Therefore, The follow-up observation on ischemic time lapse would be needed.

• Journal of Chest Surgery
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• 제49권1호
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• pp.54-58
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• 2016

A 49-year-old male presented with chills and a fever. Five years previously, he underwent ascending aorta and aortic arch replacement using the elephant trunk technique for DeBakey type 1 aortic dissection. The preoperative evaluation found an esophago-paraprosthetic fistula between the prosthetic graft and the esophagus. Multiple-stage surgery was performed with appropriate antibiotic and antifungal management. First, we performed esophageal exclusion and drainage of the perigraft abscess. Second, we removed the previous graft, debrided the abscess, and performed an in situ re-replacement of the ascending aorta, aortic arch, and proximal descending thoracic aorta, with separate replacement of the innominate artery, left common carotid artery, and extra-anatomical bypass of the left subclavian artery. Finally, staged esophageal reconstruction was performed via transthoracic anastomosis. The patient's postoperative course was unremarkable and the patient has done well without dietary problems or recurrent infections over one and a half years of follow-up.

• Journal of Chest Surgery
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• 제40권12호
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• pp.871-873
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• 2007

무명동맥은 길이가 짧고 가슴 골격에 의해 보호되기 때문에 외상에 의한 무명동맥의 파열은 드문 질환으로 알려져 있다. 본 증례는 자동차 사고로 내원한 25세 남자로 흉부 전산화 단층촬영 및 혈관 조영술로 무명동맥 파열이 진단되어 우측 쇄골하 절개를 동반한 정중 흉골 절개술을 이용하여 응급 수술을 시행하였다. 다른 동반 손상이 많아 인공 심폐기를 사용하지 않고 수술을 하였으며, 손상은 무명동맥의 중위부부터 우측 쇄골하 동맥 및 총경동맥의 기시부까지 약 3 cm 정도로 동맥 내막까지 완전히 찢어져 있었다. 복제정맥을 이용하여 첩포 혈관 성형술을 시행하였으며, 수술 후 환자는 별 다른 이상 없이 외래 추적 관찰 중이다.