• 제목/요약/키워드: Graft dysfunction

검색결과 65건 처리시간 0.022초

네비게이션을 이용한 비밸브 기능저하의 원인 규명과 치료 1예 (A Case of Identification of the Cause Using Navigation System and Treatment in the Patient with Nasal Valve Compromise)

  • 김호찬;조용태;김지선
    • 임상이비인후과
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    • 제29권2호
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    • pp.269-275
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    • 2018
  • Nasal valve compromise (NVC) is a distinct cause of symptomatic nasal obstruction, yet there are several ambiguities surrounding the diagnosis and management of this disease. Understanding of nasal valve anatomy with critical assessment of the site of obstruction is essential to effective nasal valve management. Technique selection should be individualized to the type of valve dysfunction. This case report presents a 56 year old man with nasal valve dysfunction due to narrow middle vault, concave lower lateral cartilage and swollen septal body which was diagnosed by various techniques including navigation system and treated by spreader graft, alar batten graft and reduction of septal body.

Paclitaxel Coating Inhibits Inflammation Surrounding Subcutaneously Implanted Expanded Polytetrafluoroethylene (ePTFE) Hemodialysis Grafts in Rabbit Model

  • Baek, In-Su;Lee, Yu-Ji;Park, Soo-Jin;Bai, Cheng Zhe;Park, Jong-Sang;Kim, Dae-Joong
    • Bulletin of the Korean Chemical Society
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    • 제31권2호
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    • pp.281-285
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    • 2010
  • Hemodialysis vascular access dysfunction (HVAD) due to the aggressive development of venous neointimal hyperplasia remains a major complication for patients with synthetic arteriovenous grafts. Paclitaxel-coated expanded polytetrafluoroethylene (ePTFE) grafts effectively prevent neointimal hyperplasia and stenosis. However, perigraft inflammation or edema can be another complication of ePTFE grafts, preventing early cannulation. Three different types of ePTFE grafts, including grafts without paclitaxel coating (control group, n = 12), grafts with paclitaxel coating at a dose density of $0.61ug/mm^2$ (low concentration group, n = 12), and grafts with paclitaxel coating at a dose density of $1.15ug/mm^2$ (high concentration group, n = 12) were placed in the backs of 12 rabbits, simultaneously. Six rabbits were euthanized after one week and the remaining six were euthanized two weeks after implantation. Perigraft inflammation, graft wall inflammation, stromal cell proliferation, blood vessel formation, tissue necrosis and edema were analyzed for the grafts in each animal. Inflammation surrounding the paclitaxel-coated grafts was significantly reduced compared to the control group. Stromal cell layers were detected at the interface between the graft and the surrounding tissue in the control group, infiltrated into the graft interstices, and differentiated into myofibroblasts for graft healing. Paclitaxel-coated grafts inhibited stromal cell proliferation and infiltration into the graft wall. Tissue necrosis and edema were not detected in either of the paclitaxel-coated graft groups.

Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction

  • Kim, Il-Kyu;Cho, Hyun-Young;Pae, Sang-Pill;Jung, Bum-Sang;Cho, Hyun-Woo;Seo, Ji-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권6호
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    • pp.257-262
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    • 2013
  • Objectives: Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. Materials and Methods: An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Results: Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Conclusion: Patients who undergo tibial grafts must be careful of excessive external force after the operation.

Hepatic ischemia-reperfusion injury with respect to oxidative stress and inflammatory response: a narrative review

  • Eun Kyung Choi;Dong Gun Lim
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.115-122
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    • 2023
  • Hepatic ischemia-reperfusion injury is a major complication of liver transplantation, trauma, and shock. This pathological condition can lead to graft dysfunction and rejection in the field of liver transplantation and clinical hepatic dysfunction with increased mortality. Although the pathological mechanisms of hepatic ischemia-reperfusion injury are very complex, and several intermediators and cells are involved in this phenomenon, oxidative stress and inflammatory responses are the key processes that aggravate hepatic injury. This review summarizes the current understanding of oxidative stress and inflammatory responses and, in that respect, addresses the therapeutic approaches to attenuate hepatic ischemia-reperfusion injury.

Physical Therapy Following Arthroscopic Rotator Cuff Repair with Graft Augmentation: A Case Report with Magnetic Resonance Imaging

  • Kim, Hyun-Joong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • 제10권4호
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    • pp.463-469
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    • 2021
  • Objective: If non-surgical treatment fails, arthroscopic rotator cuff repair (ARCR) is recommended, and ARCR considers graft augmentation in consideration of size, direction, and re-tear. It is reported to have potential benefits by improving the healing rate as it can fill the gaps that have been left behind. The purpose of this study is to investigate the effect of structural changes observed after ARCR on muscle action through magnetic resonance imaging and to investigate the effect of appropriate physical therapy required for graft augmentation in the general ARCR rehabilitation protocol. Case presentation: A 47-year-old male hospitalized for postoperative rehabilitation following ARCR participated in a 5-week physical therapy intervention. The postoperative day was 6 months, but due to shooting pain and shoulder dysfunction,and the movement of the shoulder was compensatory motion, not normal motion. Physical agents, manual therapy, and supervised exercise for 110 minutes per session were performed 3 times a week, and pain intensity, range of motion, function, and strength were evaluated. Results: As a result of the study, the patient showed positive improvement in pain intensity, range of motion, function, and strength. In addition, normal scapulohumeral rhythm movement was observed. Conclusions: According to the results of this case, appropriate physical therapy according to the compensatory motion shown in the structural changes after ARCR can positively improve the pain intensity, range of motion, function, and strength of ARCR patients.

Rehabilitative goals for patients undergoing lung retransplantation

  • Massimiliano Polastri;Robert M. Reed
    • Journal of Yeungnam Medical Science
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    • 제41권2호
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    • pp.134-138
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    • 2024
  • Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

중년 여자 환자에서 비전형적 Middle Aortic Syndrome의 수술치험 1예 (Atypical Middle Aortic Syndrome in a Middle Aged Woman -A case report-)

  • 김우식;배윤숙;정성철;신용철;유환국;김병열
    • Journal of Chest Surgery
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    • 제37권1호
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    • pp.80-83
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    • 2004
  • 원위 흉부 대동맥이나 복부 대동맥 혹은 두 부위가 좁아져 있는 Middle aortic syndrome (이하 MAS) 또는 mid aortic dysplastic syndrome은 매우 드물게 발생한다. 원인이 불분명하고 흔히 젊은 여성에게서 잘 나타나는 이 질환은 뇌출혈뿐만 아니라 심장, 신장의 손상을 초래할 수 있으므로 적극적인 수술적 치료로 혈류를 개선하여 효과를 볼 수 있으나 대동맥 혈관의 섬유화로 인한 수술 술기의 어려움이 따른다. 최근 국립의료원 흉부외과에서는 광범위한 석회화 병변을 동반한 하부 대동맥협착을 가진 51세 여자 환자에서 6.0-mmPTFE (polytetrafluoroethylene) 인조혈관을 이용하여 양측 액와-대퇴 동맥간 우회로술을 시행함으로써 우수한 수술 결과를 보였기에 보고하는 바이다.

Hemifacial Microsomia의 외과적 교정 1례 (SURGICAL CORRECTION OF HEMIFACIAL MICROSOMIA REPORT OF A CASE)

  • 양동규;김종렬;최갑림;박상준;김병민
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권2호
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    • pp.19-27
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    • 1989
  • Hemifacial microsomia는 편측의 측두 하악 관절과 하악지의 발육장애 및 저작근의 발육장애를 특징으로 하며 종종 상악골과 협골의 발육장애도 동반한다. 또한 관련된 외이의 발육장애 및 외이도의 부재, 이하선 및 도관의 부재, 안면 신경 및 안면 표정근의 기능 저하를 보이기도 한다. 전형적인 것은 출생시에 이미 알 수 있는데 이러한 변형은 주로 편측에 나타나며 하악골의 후퇴, 안면 비대칭, 부정 교합등이 존재하게 된다. 이 선천성 기형의 원인은 불명이며 그 치료로는 외과적으로 변형을 교정하는 것이다. 저자들은 22세된 여자 환자에서 hemifacial microsomia를 관찰하고 악교정 수술에 의해 만족할 만한 안면의 대칭 및 기능의 회복을 얻을 수 있었기에 문헌고찰과 함께 보고하는 바이다.

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관상동맥협측증의 외과적 요법 (Aortocoronary bypass surgery in the management of coronary artery disease)

  • 이재원
    • Journal of Chest Surgery
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    • 제19권4호
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    • pp.606-617
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    • 1986
  • During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.

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