• 제목/요약/키워드: Intraluminal

검색결과 157건 처리시간 0.024초

혈전이 있는 축대칭 동맥류에서의 산소전달현상 (Oxygen Transport in Axisymmetric Thrombosed Aneurysm)

  • 김한일;태기식;김영호
    • 대한의용생체공학회:의공학회지
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    • 제23권4호
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    • pp.295-300
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    • 2002
  • 국부적 저산소증(localized hypoxia)은 산소공급의 저하로 인하여 조직세포를 파괴하고 관강압력에 대한 동맥류 벽의 저항을 현저하게 감소시킨다고 보고되고 있다. 본 연구에서는 동맥류 파열의 원인이 되는 저산소증의 기전을 이해하기 위하여 혈전의 두께에 따라 세 가지의 축대칭 동맥류 모델을 구성하여 동맥류 내 혈전을 통한 정상 층류유동 (steady laminar flow)에서의 산소전달현상(O$_2$transport phenomenon)을 유체-고체 열전달 현상과의 유사성을 이용하고 Fick의 법칙을 적용하여 해석하였다. 전산해석을 통해서 혈전이 형성된 혈관에서 산소농도는 혈관 벽에서 가장 낮게 나타났으며 혈전의 크기가 증가할수록 저산소농도(low $O_2$concentration) 영역이 혈관 벽 가까이 넓게 분포되어 저산소증의 가능성이 증가됨을 알 수 있었다 본 연구를 통해서 동맥류 내의 혈전은 구조와 크기에 따라 산소의 흐름에 주요한 영향을 미침을 확인할 수 있었다.

경부식도에 발생한 강내 육경성 평활근종의 수술 치험 (Intraluminal Pedunculated Leiomyoma in the Cervical Esophagus - Report of 1 Case -)

  • 이형렬;김흥수;박준호;조정수;강대환;이창훈
    • Journal of Chest Surgery
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    • 제35권8호
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    • pp.621-625
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    • 2002
  • 식도평활근종은 식도에 발생하는 양성종양 중에서 그 빈도가 가장 흔하지만, 식도에서 발생하는 모든 종양 중단지 1%를 차지할 정도로 비교적 흔치 않은 식도 질환이다. 식도평활근종은 식도근층에서 유래한 벽내 종양이 대부분을 차지하지만, 점막근층에서 유래하여 식도강내 육경을 가진 폴립과 유사한 형도 약 1%의 빈도로 드물게 보고된다. 최근에 30세 남자환자가 연하곤란을 주소로 본원에 입원하였다. 방사선학적 검사에서 직경 5cm의 강내 종양이 경부식도에서 발견되었다. 내시경검사에서 종양조직은 정상 점막으로 덮여 있음을 보였다. 좌측 경부절개를 통해 식도 전벽에 종절개를 가한 후 육경성 종양을 성공적으로 적출할 수 있었다. 조직학적 검사에서 식도 평활근종으로 확진되었다. 연하장애 등 합병증없이 술후 회복과정은 순조로웠다.

가묘악하선(家猫顎下腺)에 있어서 고색신경(鼓索神經) 및 경부교감신경자극(頸部交感神經刺戟)이 타액분필(唾液分泌) 및 배설관내압(排泄管內壓)에 미치는 영향(影響) (Effects of Stimulation of the Chords Tympani and Cervical Sympathetics on the Submaxillary Secretion and Intraluminal Pressure of the Submaxillary Duct in Cats)

  • 이종은
    • The Korean Journal of Physiology
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    • 제11권2호
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    • pp.51-56
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    • 1977
  • In Nembutal anesthetized cats, the sobmaxillary duct was cannulated with polyethylene tube, and effects of stimulation of the chorda tympani and cervical sympathetics on, the submaxillary secretion and intraluminal pressure of the submaxillary duct were observed. The stimulation of tile chorda tympani elicited a profuse salivary secretion. The stimulation of the cervical sympathetics evoked only a scanty flow, and on repeated stimulation of the nerve salivary flow response gradually diminished and finally the flow ceased. In this state the salivary flow by the sympathetic stimulation was resumed after the stimulation of the chorda tympani. Atropine abolished these responses to nerve stimulation. Intraluminal pressure of the submaxillary duct was abruptly increased and remained on a plateau during the stimulation of the chorda tympani, whereas sympathetic stimulation elicited moderate increase of the intraluminal pressure which did not remain in spite of continued stimulation. These results suggest that scanty salivary flow induced by cervical sympathetic stimulation is not real secretion but simple elimination of the saliva already present in the duct due to contraction of the contractile elements known to exist in the duct wall.

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원격전이의 증거가 없는 식도암의 방사선치료 성적 (Result of Radiotherapy in Non-metastatic Esophageal Cancer)

  • 채규영;장정순;이종석
    • Radiation Oncology Journal
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    • 제13권1호
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    • pp.27-31
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    • 1995
  • Purpose : This study was done to evaluate preliminarily the role of intraluminal brachytherapy in the radiation treatment of non-metastatic esophageal cancer, Materials and Methods: We analyzed follow-up result of 21 patients treated at the dept. of therapeutic radiology in Gyeongsang national university hospital between April, 1989 and August, 1992. All patients received neoadjuvant chemotherapy(5-FU, Cispl-atin). Fifteen Patients were treated with external beam alone, and in remaining 6 patients, the external beam radiotherapy followed by intraluminal brachytherapy was done. Results : Among 21 patients, 7 patients showed complete tumor regression after completion of radiotherapy. But 2 of these complete responder recurred at the site of primary disease, so ultimate local control rate was $23.8\%$(5/21). Local control rate according to radiation treatment modality was $6.7\%$(1/15) in patients treaed with external irradiation only, and $66.7\%$ in patients treated with combined external irradiation and intraluminal brachytherapy. The 2 year NED survival rate was $6.6.\%$ in the former and $66.7\%$ in the latter. Conclusion: Although there should be consideration about case selection for addition of intraluminal brachytherapy intraluminal brachytherapy may be considerded as one of the method to enhance the local control probability of esophageal cancer.

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재발한 간담도암 환자에서 시행 한 high-dose-rate intraluminal brachytherapy의 유용성 및 재현성 평가 (Availability and Reproducibility Evaluation of High-dose-rate Intraluminal Brachytherapy for Unresectable Recurrent Cholangiocarcinoma)

  • 박주경;이승훈;차석용;김양수;이선영
    • 한국방사선학회논문지
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    • 제6권2호
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    • pp.151-157
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    • 2012
  • 간담도암의 일차적 치료법은 수술적 제거이나, 초기 병기로 수술을 하여도 재발이 흔하며, 재발 후에는 근치적 목적이 아닌 주로 증상 완화 목적의 치료를 하고 있다. 이에 본 연구에서는 재발한 환자에서 자체 도입한 특수 관을 이용한 근치적 목적의 high-dose-rate intraluminal brachytherapy의 치료법과 치료 set-up 재현성 유지에 대하여 고찰하고 자 한다. 본 연구는 간담도암으로 수술 후, 6개월 간격으로 복부 자기 공명 영상을 이용한 추적 검사를 시행하여, 수술문합 부위의 재발이 확인된 임상 병기 rcT1N0M0인 환자를 대상으로 하였다. 근접 치료를 위하여 경피적 담도 배액관을 치료 전용관인 Arrow Sheath로 교체 후, intraluminal catheter를 삽입하여, 일회 치료당 3 Gy 씩 총 30 Gy 근접치료를 시행하였다. 협착 된 담도의 distal and proximal 그리고 central axis point로부터 1 cm 떨어진 지점을 선량표준화였으며, 5회에 걸쳐 치료 전 dummy seed 삽입 후, 치료 표적 용적 근위부와 말단부의 기준점에서 흉추 사이의 거리를 측정하여 set-up 재현성을 평가하였다. 매주 치료 전 근위부와 말단부위 치료 표적 용적 기준점에서 흉추 사이의 거리를 5회 측정한 값과 simulation image에서 측정된 거리를 비교한 결과 평균값과 표준편차가 오차율 5% 이내로 유의한 수준으로 측정되어 매회 치료시 재현성이 유지 되었다, 본 연구 환자의 추적 검사 상 1년 이상 무병 생존하고 있으며, 심각한 부작용 또한 관찰되지 않았다. 따라서, 수술이 불가능한 재발한 간담도암 환자에서 본원에서 자체 도입한 관으로 시행한 근접치료는 주변 인접 장기의 심각한 부작용 발생 없이, 매 회 치료 시 재현성이 유의한 수준으로 유지 되는 것으로 평가되었다.

다종(多種)의 태충(太衝)($LR_3$) 침척요법(鍼刺療法)이 Intraluminal Filament 삽입술로 유발된 백서(白鼠)의 허혈성 국소 뇌손상에 미치는 영향 (Anti-apoptotic and Neuroprotective Effects of Acupuncture at $LR_3$ on Focal Brain Ischemic Injury Induced by Intraluminal Filament Insertion in Rats)

  • 임현진;조명래;윤대환;나창수;류충열
    • Journal of Acupuncture Research
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    • 제24권2호
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    • pp.125-140
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    • 2007
  • Objectives: This study was performed to investigate the effects of acupuncture therapy(AT, AT-9), electro-acupuncture therapy(EAT) and low level laser acupuncture therapy(LAT) at LRJ on the focal ischemia-induced by intraluminal filament insertion in rats. Methods : In the present syudy, the focal ischemia was induced by Intraluminal filament insertion into left middle cerebral artery. The subjects were divided into five groups after focal brain ischemia. (n=15, in each group) : Control with no treatment, AT with acupuncture at $LR_3$, AT-9 with acupuncture at $LR_3$ and rotating 9 times in a clockwise direction, EAT with electro-acupuncture at $LR_3$ and LAT with invasive laser acupuncture at $LR_3$. Anti-apoptotic and neuroprotective effects of acupuncture were observed by mGluR5 mRNA, Bax mRNA, Bcl-2 mRNA, Cytochrome C protein, Cresyl violet-stain and Choline acetyltransferase (ChAT)-stain in the hippocampus. Results: 1. In LAT, mGluR5, Cresyl violet-stain and ChAT-stain were increased. 2. In LAT, Cytochrome C protein was decreased. 3. In AT-9, Bax, Cytochrome C protein and the Bax/Bcl-2 ratio were decreased. 4. In AT-9, Bcl-2, Cresyl violet-stain and ChAT-stain were increased. 5. In EAT, Bcl-2 and Cresyl violet-stain were increased. Conclusions: These results suggests that LAT and AT-9 show anti-apoptotic and neuro-protective effects and that LAT and AT-9 may be useful for managing stroke by focal brain ischemia.

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경부의 주정맥 침범과 암성 혈전을 보인 여포상 갑상선암 2예 (Follicular Thyroid Carcinoma Associated with Macroscopic Vascular Invaion and Intraluminal Tumor Thrombosis in Great Cervical Veins : Two Case Reports)

  • 임준섭;이잔디;윤지섭;임치영;남기현;장항석;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제22권1호
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    • pp.58-61
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    • 2006
  • Differentiated thyroid carcinomas are rarely associated with macroscopic vascular invasion and intraluminal tumor thrombus in great cervical veins. The best treatment for such cases appears to be a total thyroidectomy with en-block resection of the involved vessels, followed by postoperative radioiodine therapy(RI). We report two cases of follicular thyroid carcinoma with vascular invasion and intraluminal tumor thrombosis in great cervical veins that were successfully treated using complete surgical resection and postoperative RI.

무봉합 혈관내 인조이식혈관을 이용한 박리성 대동맥류의 수술요법 (Surgical Treatment for Dissecting Aneurysm of the Aorta using Sutureless Intraluminal graft)

  • 이재원
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.305-313
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    • 1985
  • Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with an intraluminal graft that requires no end-to-end anastomosis has been developed. Of the four patients with dissecting aneurysm of the aorta treated by inserting sutureless ringed intraluminal graft at the Department of Thoracic and Cardiovascular Surgery, S.N.U.H., three were DeBakey type I [one with associated aortic insufficiency] and the other was DeBakey type III. Suspected etiology of the dissection was Marfan`s syndrome in one and hypertension in the others. Total cardiopulmonary bypass was utilized in repairing dissecting aneurysms of the ascending aorta [type A] and simple aortic crossclamping was used for the patient with dissecting aneurysm of the descending aorta. The basic technique consists of inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. The proximal ring of the graft effectively stabilized the flail aortic valve in patient with aortic insufficiency associated with dissection of the ascending aorta. There were no hospital deaths and one patient with type III dissecting aneurysm developed postoperative paraparesis and renal insufficiency which was resolved. Follow-up has been from 1 month to 16 months with no evidence of prosthetic problems, such as erosion, migration, or thrombosis.

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무봉합 혈관내 인조혈관을 사용한 박리성 하행흉부대동맥류의 치료 -2례 보고- (Use of Intraluminal Sutureless Graft in the Surgical Treatment of Dissecting Aneurysm(Debakey type III) of the Thoracic Aorta)

  • 홍순필
    • Journal of Chest Surgery
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    • 제27권10호
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    • pp.862-867
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    • 1994
  • We experienced two cases of dissecting aneurysm[DeBakey type III] of the thoracic aorta treated using intraluminal sutureless graft. Controversy still exists about the exact timing of surgical intervention for dissection of the descending thoracic aorta. The surgical indication of dissecting aneurysm[DeBakey type III] is continuous flow in the false lumen, continuous chest pain, compromise of arterial supply to a specific organ or limb, or extension of the dissection while the patient is receiving satisfactory medical treatment. Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with a intraluminal sutureless graft that requires no end-to-end anastomosis has been developed. In our cases, cardiopulmonary bypass and circulatory arrest was utilized in repairing dissecting aneurysm of descending aorta[DeBakey type III] in order to avoid the aortic cross clamping because of friable aortic intima. The basic technique consists of vertical incision of descending aorta in the area of intimal tear and inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. Postoperative course was uneventful.

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