• 제목/요약/키워드: Complete occlusion

검색결과 268건 처리시간 0.022초

Preparation of Reproducible and Responsive Scar Model and Histology Analysis

  • Kim, Sang-Cheol;ChoLee, Ae-Ri
    • Journal of Pharmaceutical Investigation
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    • 제40권1호
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    • pp.45-49
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    • 2010
  • Unlike human, with some exceptions, animals do not heal with excessive scar. The lack of suitable animal model has hindered the development of effective scar therapy. We previously reported that partial thickness rabbit ear wound model resembles human wound heal process. This study was designed to prepare a hypertropic scar wound model which can be employed for testing anti-scar therapy. Four wounds were created down to the bare cartilage on the anterior side of each rabbit ear using 8-mm dermal biopsy punch and histology analysis at post operation day (POD) 5, 28 and 48 were performed. As the outcome of scar formation is largely determined by the early inflammatory response to the wounding and the degree and the duration of occlusion, cephalodin(50 mg/kg) was injected daily and medical occlusive dressings were applied. Five micro wound and scar sections were stained with hematoxylin and eosin for quantification of epidermal regeneration and scar hypertrophy. Sections were also stained using Masson's trichrome and Sirius red to evaluate collagen organization and rete ridge formation. Wound closure process was assessed to 7wks post wounding. Complete removal of the epidermis, dermis and perichondrial layer caused delayed epithelialization, which results in hypertropic scarring. The inability of the wounds to contract and the delay in epithelialization in rabbit ear was likely due to cartilage and it created scar elevation. The results suggest that full thickness surgical punch wound model in rabbit ear could be employed as a reliable and reproducible scar wound model for testing anti-scar therapy.

Transcranial Direct Middle Meningeal Artery Puncture for the Onyx Embolization of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus

  • Oh, Jae-Sang;Yoon, Seok-Mann;Shim, Jai-Joon;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • 제57권1호
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    • pp.54-57
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    • 2015
  • A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx.

Experiences of Neuroform Stent Applications for Ruptured Anterior Communicating Artery Aneurysms with Small Parent Vessel

  • Yun, Jung-Ho;Cho, Chun-Sung
    • Journal of Korean Neurosurgical Society
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    • 제48권1호
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    • pp.53-58
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    • 2010
  • Objective : The purpose of this study was to review the safety and durability of aneurysms treated with stent-assisted coiling of ruptured anterior communicating artery aneurysms with small parent vessels (< 2.0 mm). Methods : Retrospective review of all ruptured aneurysm treated with stent assisted endovascular coiling between March 2005 and March 2009 at our institution was conducted. We report 11 cases of the Neuroform stent placement into cerebral vessels measuring less than 2.0 mm in diameter (range, 1.3-1.9 mm) in anterior cerebral artery. Clinical follow-up ranged from 3 to 12 months and imaging follow-up was performed with cerebral angiography at 6 months and 12 months after discharge. Results : Complete occlusion was achieved in 10 patients, and a remnant neck was evident in one. No stent displacement or no dislodgement occurred during stent placement. There was no evidence of thromboembolic complication, arterial dissection and spasm during procedure. We performed follow-up angiography in all patients at 6 months and/or 12 months from the first procedure. The follow-up angiographic data showed successfully results except one in-stent stenosis case. All patients improved clinical performances except one patient with severe vasospasm who showed poor clinical condition initially. Conclusion : We have safely and successfully treated 11 vessels smaller than 2.0 mm in diameter with self-expanding stents with good short and intermediate term results. More clinical data with longer follow-ups are needed to establish the role of stent-assisted coiling in ruptured aneurysms with small parent vessels.

동맥 흉곽 출구 증후군을 일으킨 쇄골하동맥 맥관 육종 -1례 보고- (Arterial Thoracic Outlet Syndrome due to Angiosarcoma of the Subclavian Artery a case report)

  • 이철범;함시영
    • Journal of Chest Surgery
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    • 제29권10호
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    • pp.1160-1165
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    • 1996
  • 저자들은 지금까지 발생보고 예가 없는 좌쇄골하동맥 맥관육종 1례 수술을 치험하였다. 제 1늑골의 기형이 있는 19세 여자 환자로, 1년 전부터 점진적으로 심해진 동맥 흉곽 출구 증후군의 증상을 나타냈다. 쇄골 중앙부를 절제한 후 폐쇄된 쇄골하 동맥 제 3부분과 상완 동맥 분절을 절제하고 대복재 정맥을 이용하여 우회로 조성술을 시행하였다. 쇄골하 동맥의 병리 조직 소견은 벽재성형 맥관 육종이었으며 혈액 응고 인자 WII과 관련되는 항원에 대한 조직 화학적 염색 소견도 양성이었다. 수술전 일상 생활을 할 수 없을 정도 심한 증상이 수술후 거의 소실되었으며, 수술후 4개월된 현재 직장 생활을 계속하고 있다.

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소폐동맥 내피세포를 이용한 인조혈액접촉표면의 혈액 접합성 (Blood Compatibility of Artificial Blood-Contacting Surface Seeded with Cultured Bovine Endothelial Cells)

  • 김원곤;곽영태;유세영
    • Journal of Chest Surgery
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    • 제26권2호
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    • pp.80-85
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    • 1993
  • Synthetic and biosynthetic vascular grafts of small diameter have long been considered to be prone to thrombosis, ultimately leading to the complete graft occlusion. Endothelial cell seeding onto synthetic blood-contacting surfaces has been suggested to be an ideal means to solve this problem. This study described a culture method of bovine endothelial cells and evaluated blood-compatibility and seeding efficiency of cultured endothelial cells. Bovine pulmonary artery endothelial cells were harvested enzymatically and grown to confluence on polystyrene culture flask surfaces using established techniques. The identification of endothelial cells was made through the demonstration of expression of factor VIII R:Ag by immunofluorescent technique. To quantitate the effect of improvement in blood-compatibility of viable endothelial cells, endothelial monolayers were exposed to blood containing $\^$111/In-oxine labeled platelets. Viable endothelial monolayers retained less labeled platelets than control surfaces. The Indium-labeled endothelial cells were seeded onto three different blood-contacting surfaces of Dacron vascular graft immobilized in specially equipped wells and incubated for specific time intervals (t=15, 30, 60, 120 minutes). Longer incubation times showed improved cell adherence in collagen-coated and fibrin-coated Dacron vascular graft groups. However in untreated Dacron grafts, no direct relationship was observed between incubation time and endothelial cell seeding efficiency. This may be due to leakage of endothelial cells through porosity of Dacron grafts in this in-vitro experimental condition.

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심하게 마모된 치열의 전악 수복에 대한 임상적 고찰 (Rehabilitation of the Worn Dentition)

  • 김유리
    • 구강회복응용과학지
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    • 제26권4호
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    • pp.455-462
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    • 2010
  • 치아의 마모를 보이는 환자가 진료실을 찾는 이유는 보통 심미적인 이유, 기능적인 이유, 지각 과민증의 증가 때문이다. 이때 먼저 병인 요소들의 조절이 필요하고, 환자의 나이가 고려되어야 한다. 전반적인 치아 마모를 보이는 환자의 치료를 위하여 때때로 전악을 보철로 수복해야 할 경우가 있고, 이때에는 보철물의 공간 확보를 위한 교합거상이 필요하다. 전악 수복을 할 때 장기적인 좋은 결과를 얻기 위해서는 정확한 진단, 적절한 수직고경 확립, 최적의 수복재료 선정을 바탕으로 지속적인 교합조정 및 구강 위생 관리가 필수적이다. 본 증례에서는 과도한 마모를 보여 심미적인 이유로 병원을 찾아온 환자로, 보철수복 공간을 위하여 교합고경을 증가시켜 중심위를 이용하여 수복한 치험례를 문헌고찰과 함께 보고하고자 한다.

Endovascular Treatment of Symptomatic High-Flow Vertebral Arteriovenous Fistula as a Complication after C1 Screw Insertion

  • Jang, Hyun Jun;Oh, Se-Yang;Shim, Yu Shik;Yoon, Seung Hwan
    • Journal of Korean Neurosurgical Society
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    • 제56권4호
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    • pp.348-352
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    • 2014
  • High-flow vertebral arteriovenous fistulas (VAVF) are rare complications of cervical spine surgery and characterized by iatrogenic direct-communication of the extracranial vertebral artery (VA) to the surrounding venous plexuses. The authors describe two patients with VAVF presenting with ischemic presentation after C1 pedicle screw insertion for a treatment of C2 fracture and nontraumatic atlatoaxial subluxation. The first patient presented with drowsy consciousness with blurred vision. The diffusion MRI showed an acute infarction on bilateral cerebellum and occipital lobes. The second patient presented with pulsatile tinnitus, dysarthria and a subjective weakness and numbness of extremities. In both cases, digital subtraction angiography demonstrated high-flow direct VAVFs adjacent to C1 screws. The VAVF of the second case occurred near the left posterior inferior cerebellar artery originated from the persistent first intersegmental artery of the left VA. Both cases were successfully treated by complete occlusion of the fistulous portion and the involved segment of the left VA using endovascular coil embolization. The authors reviewed the VAVFs after the upper-cervical spine surgery including C1 screw insertion and the feasibility with the attention notes of its endovascular treatment.

Solitaire AB Stent-Assisted Coiling of Wide-Neck Micro Aneurysms

  • Li, Xue-dong;Qin, Jun;Xiao, Zhen-yong;Feng, Yi;Chen, Jia-kang
    • Journal of Korean Neurosurgical Society
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    • 제59권4호
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    • pp.341-345
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    • 2016
  • Objective : Solitaire AB stent-assisted coiling facilitates the endovascular treatment of wide-necked intracranial aneurysms. We present our experience of coiling the micro-aneurysms of wide-neck with Solitaire AB stent assisting in a single center. Methods : Thirty-one Solitaire AB stents were used to treat via endovascular approach patients with 31 wide-neck micro aneurysms in a single center in China. Technical and clinical complications were recorded. Modified Rankin Scale was used to evaluate the patients' conditions via clinic and telephone follow-up. Results : The mean width of aneurysm sac was $2.30{\pm}0.42mm$, and the mean diameter of aneurysm neck was $2.83{\pm}.48mm$. Complete occlusion was achieved in 28 aneurysms (90.32%); neck remnant was seen in 3 aneurysms (9.68%). Technical and clinical complications related to the procedure were encountered in four patients (12.5%). Two patients died (6.25%). No patient had a permanent deficit. Conclusion : Solitaire AB stent was a safe and efficiency tool in assisting coiling of micro aneurysms with wide neck, but may be not suitable for a blaster-like one. Mid- and long-term follow-up will be required to elucidate the impact of the Solitaire AB stent on recanalization rate.

청색심기형환자에서 PTFE 인조혈관을 이용한 쇄골하-폐동맥 단락술의 임상적 적용과 그 결과 (Clinical Application and its Result of Modified Blalock-Taussig Shunt Using Polytetrafluoroethylene in Congenital Cyanotic Heart Disease)

  • 나명훈
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.55-61
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    • 1988
  • This report provides follow-up data on 116 patients with congenital cyanotic heart disease, aging 1 month to 13 years [median: 1.8 years], who underwent the modified Blalock-Taussig shunt using polytetrafluoroethylene graft at Seoul National University Hospital between September, 1984 and June, 1987. Among 116 patients complete follow-up studies were done on 95 patients. The mean preoperative arterial oxygen tension was 36 torr. Thirty-Six patients [38%] underwent operation in infancy. Conduit diameters included 4mm [15 cases], 5mm [47 cases], and 6mm [33 cases] sizes. The mean postoperative arterial oxygen tension was 52 torr [P<0.001]. The effectiveness of shunts was evaluated clinically and by shunt murmur, echocardiography and cardiac catheterization with angiography 1 to 31 months after operation. The incidence of shunt occlusion was 9.5% and the mortality was 14.8%. The actuarial patency rate was 83.1 * 6.4% and the actuarial survival rate was 82.5 * 4.5% at 30 months` follow-up for all patients. The effectiveness of the 4mm diameter conduit may be limited. Blalock-Taussig procedure is an effective alternative to the classic B-T shunt in congenital cyanotic heart disease.

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완전 무치악 환자에서 Locator® system을 이용한 임플란트 피개의치 수복 증례 (Implant Supported Overdenture using Locator® System on Edentulous Patient)

  • 이상엽;신수연
    • 구강회복응용과학지
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    • 제24권4호
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    • pp.351-359
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    • 2008
  • 임플란트의 도입으로 악골이 흡수된 무치악 환자의 보철 치료에 획기적인 변화가 가능해졌다. 특히 하악 무치악 환자의 경우 2개의 임플란트에 의해 유지를 얻는 피개의치가 일반적인 총의치의 대안으로 자리잡았으며 첫 번째로 고려되어야 할 치료 방법으로 받아들여지고 있다. 본 증례는 상하악 완전 무치악 환자로서 상악에는 일반적인 총의치, 하악에는 2개의 임플란트를 식립하고 $Locator^{(R)}$ Attachment를 사용하여 수복한 임상과정 및 결과에 관하여 보고하고자 한다.