• Title/Summary/Keyword: Ischemic disease

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Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Aortic Valve Replacement in a Patient with Aortic Arch Syndrome Secondary to Takayasu's Arteritis -One case - (Takayasu씨 동맥염에 의한 대동맥궁 증후군 환자에서 대동맥판막 치환술 - 1예 보고 -)

  • 최종범;양현웅;이삼윤
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.88-91
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    • 2004
  • Aortic regurgitation is not a rare complication of Takayasu's disease. Aortic regurgitation may aggravate cerebral ischemic syndrome like syncope in patients with stenotic or occlusive lesions in cerebral branches of aorta secondary to acute or progressive inflammation. In a 34-yrs-old male patient who complained of syncope and exertional dyspnea with occlusion of both carotid arteries and severe stenoses of both subclavian arteries, occlusion of right coronary artery, and aortic regurgitation, his symptom was improved with perioperative aggressive steroid therapy, stent insertion in both subclavian arteries, and aortic valve replacement.

Left Ventricular Volume Measurement by Count Method with Attenuation Correction in Gated Blood Pool scan (심장풀스캔에서 방사능 계측법에 의한 좌심실 용적의 측정 -조직 감쇄의 보정에 의한 연구-)

  • Bom, Hee-Seung;Chung, June-Key;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.33-37
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    • 1987
  • Attenuated end-diastolic and end-systolic left ventricular counts which obtained from cardiac gated blood pool scan were corrected using experimentally calculated attenuation coefficient $(\mu=0.13/cm)$ and depth of center of left ventricle. This method was confirmed to be correct experimentally using phantom balloon. To compare the accuracy of attenuated and attenuation-corrected left ventricular volume measurement, authors studied 10 patients with ischemic heart disease who underwent both gated blood pool scan and X-ray contrast ventriculography within a week. The attenuated and attenuation-corrected left ventricular volume measured by count method correlated with contrast ventriculographic volumes; however, attenuation corrected measurement was correlated more closely.

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Left ventricular aneurysm (Two cases report) (좌심실에 발생한 진성심실류 (2례 보고))

  • 이철세
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.175-183
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    • 1983
  • Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

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Neonatal Gastrointestinal Perforation (신생아 위장관천공)

  • Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.41-46
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    • 1997
  • Perforation of the gastrointestinal tract in neonatal period has been associated with a grim prognosis. Recently there has been some improvement in survival. To evaluate the remaining pitfalls in management, 19 neonatal gastrointestinal perforation cases from May 1989 to July 1996 were analysed retrospectively. Seven patients were premature and low birth weight infants. Perforation was most common in the ileum(56.3%). Mechanical or functional obstruction distal to the perforation site was identified in 7 cases; Hirschsprung's disease 3, small bowel atresia 3, and anorectal malformation 1. These lesions were often not diagnosed until operation. Five cases of necrotizing enterocolitis and 1 of muscular defect were the other causes of perforation. In six cases, the cause of the perforation was not identified. Perinatal ischemic episodes were associated in five cases. Overall mortality was 15.1%. Because a considerable number of gastrointestinal perforations resulted from distal obstruction, pediatric surgeon should be alert for early identification and intervention of gastrointestinal obstruction, particularly in patients that are premature and have a history of ischemia.

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Neuroprotective Effects of Berberine in Neurodegeneration Model Rats Induced by Ibotenic Acid

  • Lim, Jung-Su;Kim, Hyo-Sup;Choi, Yoon-Seok;Kwon, Hyock-Man;Shin, Ki-Soon;Joung, In-Sil;Shin, Mi-Jung;Kim, Yun-Hee
    • Animal cells and systems
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    • v.12 no.4
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    • pp.203-209
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    • 2008
  • Berberine, an isoquinoline alkaloid found in Coptidis Rhizoma(goldenthread) extract, has multiple pharmacological effects such as anti-inflammatory, antimicrobial and anti-ischemic effects. In the present study, we examined the effects of berberine on neuronal survival and differentiation in a hippocampal precursor cell line and in the memory deficient rat model. Berberine increased in a dose dependent manner the survival of hippocampal precursor cells as well as differentiated cells. In addition, berberine promoted neuronal differentiation of hippocampal precursor cells. In the memory deficient rat model induced by stereotaxic injection of ibotenic acid into entorhinal cortex(Ibo model), hippocampal cells were increased about 2.7 fold in the pyramidal layer of CA1 region and about 2 fold in the dentate gyrus by administration of berberine after 2 weeks of ibotenic acid injection. Furthermore, neuronal cells immunoreactive to calbindin were increased in the hippocampus and entorhinal cortex area by administration of berberine. Taken together, these results suggest that berberine has neuroprotective effect in the Ibo model rat brain by promoting the neuronal survival and differentiation.

Nontraumatic Extracranial Carotid Artery Aneurysm (비외상성 경동맥류)

  • Kim Bum-Joon;Choi Jong-Ouck;Chung Keun;Kim Yong-Whoan;Choi Geon
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.90-93
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    • 1997
  • Aneurysm of extracranial carotid artery which usually originated from trauma, but it can be developed by atheroscrelosis, infection and congenital vascular disease, is defined as abnormal dilatation of intimal wall of carotid artery. The proper management should not be delayed due to occurrence of high neulorogic complication. Recently the authors experienced a case of nontraumatic extracranial internal carotid artery aneurysm, which was successfully resected using intraoperative EEG monitoring for the prevention of ischemic attack and was reconstructed with end to end anastomosis using nylon 9 - 0. On postoperative day #13, we could confirm well healed aneurysmal site and normal blood flow in the view of arteriography.

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A Case of Systemic Lupus Erythematosus Presenting with Amaurosis Fugax without Antiphospholipid Antibodies Syndrome (항인지질항체증후군을 동반하지 않은 일과성 단안 실명으로 발현된 전신성 홍반성 루푸스 1 예)

  • Kim, Jung-Hyun;Hah, Jung-Sang;Park, Mee-Young;Lee, Se-Jin;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.113-117
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    • 2006
  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect many organ systems including the nervous system. The immune response in patients with SLE can cause inflammation and other damage that can cause significant injury to the arteries and tissues. A 48-year-old woman was admitted to the hospital because of transient monocular blindness. Magnetic resonance imaging and conventional angiography showed severe stenosis of the distal intracranial internal carotid artery. The patient was diagnosed as having SLE but the antiphospholipid antibodies were negative. Amaurosis fugax has not been previously reported as an initial manifestation of SLE in Korea. We report a patient with a retinal transient ischemic attack as the first manifestation of SLE.

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Successful treatment of central retinal artery occlusion using hyperbaric oxygen therapy

  • Kim, Soo Han;Cha, Yong Sung;Lee, Yoonsuk;Kim, Hyun;Yoon, Ie Na
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.278-281
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    • 2018
  • Central retinal artery occlusion (CRAO) is considered an ophthalmologic emergency. The prognosis of this disease is very poor. Currently, there is no generally effective therapy available to treat CRAO. Hyperbaric oxygen therapy (HBOT) can increase the volume of oxygen delivered to the ischemic retinal tissue until spontaneous or assisted reperfusion occurs. We report the case of a patient who experienced sudden visual loss due to CRAO that was treated with HBOT. The patient was an 81-year-old woman who presented with CRAO in her right eye (OD). She exhibited "hand motion" visual acuity before treatment. She underwent three sessions of HBOT at a pressure of 2.8 atmospheres absolute, performed over 3 days. After 4 days in hospital, her visual acuity improved to 0.4 (OD) for far vision and 0.5 (OD) for near vision. Her vision was stable without the supply of oxygen; therefore, she was discharged.

Advances in Fast Vessel-Wall Magnetic Resonance Imaging Using High-Density Coil Arrays

  • Yin, Xuetong;Li, Nan;Jia, Sen;Zhang, Xiaoliang;Li, Ye
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.229-251
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    • 2021
  • Arteriosclerosis is the leading cause of stroke, with a fatality rate surpassing that of ischemic heart disease. High-resolution vessel wall magnetic resonance imaging is generally recognized as a non-invasive and panoramic method for the evaluation of arterial plaque; however, this method requires improved signal-to-noise ratio and scanning speed. Recent advances in high-density head and neck coil arrays are characterized by broad coverage, multiple channels, and closefitting designs. This review analyzes fast magnetic resonance imaging from the perspective of accelerated algorithms for vessel wall imaging and demonstrates the need for effective algorithms for signal acquisition using advanced radiofrequency system. We summarize different phased-array structures under various experimental objectives and equipment conditions, introduce current research results, and propose prospective research studies in the future.