• 제목/요약/키워드: Extracorporeal

검색결과 485건 처리시간 0.026초

프롤로테라피와 체외충격파에 반응 없는 요각통(腰脚痛) 환자 1례 (A case of sciatica; did not respond to prolotherapy and extracorporeal shock wave therapy)

  • 이혜윤;황만석
    • 척추신경추나의학회지
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    • 제11권2호
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    • pp.57-64
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    • 2016
  • This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.

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체외순환후 혈청내 Immunoglobulin 과 보체의 변화에 관한 연구 - 막형 인공산화기와 기포형 인공산화기의 비교 - (Changes of Plasma Immunoglobulins and Complements after Extracorporeal Circulation)

  • 이철주
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.613-618
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    • 1988
  • The exposure of blood to foreign materials can cause the denaturation of plasma protein components such as immunoglobulins and complements. And those phenomena increase the morbidity and mortality after intracardiac operations through the cardiopulmonary bypass. From April, 1987 to September, 1987, we had observed the serial changes of plasma total protein IgG, IgA, IgM, complements[C3, C4] in bubble oxygenator group[n=5] and membrane oxygenator group[n=5]. Statistically significant difference between two groups were present in total protein and C3. We conclude that using membrane oxygenator in long extracorporeal circulation can reduce the activation of alternative pathway of complement system, and which can reduce post-perfusion complications of the lung though we can`t prove it in mass populations.

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Adrenal incidentaloma: a case of asymptomatic pheochromocytoma

  • Park, Sang Yoong;Rim, Jong Cheol;Cho, Hyun Chul;Lee, Yoon Chan;Kim, Jung A;Choi, So Ron
    • 고신대학교 의과대학 학술지
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    • 제33권2호
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    • pp.215-222
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    • 2018
  • An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

Validation of Nafamostat Mesilate as an Anticoagulant in Extracorporeal Membrane Oxygenation: A Large-Animal Experiment

  • Han, Sung Joon;Han, Woosik;Song, Hee-Jung;Kim, Cuk-Seong;Jeong, Seong-Mok;Kang, Min Woong
    • Journal of Chest Surgery
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    • 제51권2호
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    • pp.114-121
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    • 2018
  • Background: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. Methods: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels. Results: In both groups, the aPTT was longer than the baseline value. Although the aPTT in the NM group was shorter than in the heparin group, the TEG parameters were similar between the 2 groups. Hemoglobin levels decreased in both groups, but the decrease was less with NM than with heparin (p=0.049). Interleukin $(IL)-1{\beta}$ levels significantly decreased in the NM group (p=0.01), but there was no difference in the levels of tumor necrosis factor alpha or IL-10 between the 2 groups. Conclusion: NM showed a similar anticoagulant effect to that of unfractionated heparin, with fewer bleeding complications. NM also had anti-inflammatory properties during ECMO. Based on this preclinical study, NM may be a good alternative candidate for anticoagulation in ECMO.

인공심폐기를 이용한 개심술후 혈청효소 변화에 관한 연구 (A Clinical Study on the Changes of Serum Enzymes after Open heart Surgery under Cardiopulmonary Bypass)

  • 고재웅
    • Journal of Chest Surgery
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    • 제22권4호
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    • pp.562-572
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    • 1989
  • The changes of serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT], serum lactic dehydrogenase [LDH] and serum creatine phosphokinase [CPK] were examined during and after the open heart surgery. In the total of 52 patients with heart diseases including 40 cases of congenital heart anomalies and 12 cases of acquired valvular heart diseases who undergone open heart surgery under cardiopulmonary bypass. The results obtained are as follows: 1. The average value of SGOT before surgery was 30.27 [ 18:86 units. The enzyme was reached to the maximum of 139.88 [ 89.43 units on the 1st day after the operation [p< 0.05], the enzyme activity was gradually decreased from the 3rd day after the operation, returned to the normal range on the 7th day after the operation. 2. The average value of SGPT before surgery was 14.36 [ 7.45 units. The enzyme was reached to the maximum of 34.67 [ 27.64 units on the 2nd day after the operation, but it was valueless statistically, the enzyme activity was gradually decreased from the 3rd day after the operation, returned to the normal range on the 5th day after the operation. 3. The average value of LDH before surgery was 263.07 * 86.66 units. The enzyme was reached to the maximum of 662.29 * 303.60 units on the 2nd day after the operation [p < 0.05], the enzyme activity was gradually decreased from the 5th day after the operation, returned to the normal range on the 7th day after the operation. 4. The average value of CPK before surgery was 141.35 * 43.44 units. The enzyme was reached to the maximum of 377.42 [ 222.02 units on the 1st day after the operation [p < 0.05], the enzyme activity was gradually decreased from the 5th day after the operation, returned to the normal range on the 7th day after the operation. 5. In the relationships of the serum enzymes and duration of the extracorporeal circulation, the values on the group over 90 minute of the extracorporeal circulation were increased than on the group below 90 minute of the extracorporeal circulation, but it was valueless statistically.

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Results of Extracorporeal Membrane Oxygenation (ECMO) Support before Coronary Reperfusion in Cardiogenic Shock with Acute Myocardial Infarction

  • Chung, Eui-Suk;Lim, Cheong;Lee, Hae-Young;Choi, Jin-Ho;Lee, Jeong-Sang;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • 제44권4호
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    • pp.273-278
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    • 2011
  • Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.

중둔건 석회화 건염의 초음파 유도하 정확한 조준에 의한 체외충격파치료 -증례 보고- (Ultrasound-guided Exact Focusing of Extracorporeal Shock Wave Therapy for the Calcific Tendinitis of Gluteus Medius - A Case Report -)

  • 문상호;이송;김광해;정종필;홍성원
    • 대한정형외과 초음파학회지
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    • 제5권2호
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    • pp.94-98
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    • 2012
  • 석회화 건염은 건-골 부착부에 침착된 칼슘 수산화 인회석 결정 주위로 염증이 생기는 질환인데 체외충격파치료가 석회화 건염에 대한 비침습적 치료로써 효과적으로 많이 사용되고 있다. 실제 임상에서는 병변 부위에 정확히 체외충격파를 시행하기보다는 주로 촉진과 압통 부위 확인만으로 충격파 시행범위를 정하고 있다. 방사선 투시하에 석회 침착부위에 정확히 체외충격파를 시행하는 것이 임상 결과가 월등히 우수하다는 것은 알려져 있다. 초음파는 간편하고 비싸지 않으며 방사선 피폭이 없으면서 건 질환을 진단하는데 아주 효과적인 진단 기기이지만 체외충격파 치료의 조준에 있어서의 역할은 확립되어 있지 않다. 저자들은 중둔건에 발생한 거대 석회화 건염을 초음파를 이용하여 병변 부위의 위치를 정확히 조준하면서 체외충격파치료를 시행함으로써 석회 침착의 완전 소실을 얻은 증례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

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