• Title/Summary/Keyword: Revascularization

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Regenerative Endodontic Procedure using Mineral Trioxide Aggregate (Mineral trioxide Aggregate를 이용한 근관치료재생술(Regenerative endodontic procedure))

  • Lee, Woo-Cheol
    • The Journal of the Korean dental association
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    • v.48 no.11
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    • pp.803-812
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    • 2010
  • Regenerative endodontic procedure (REP) is a treatment option to replace damaged pulp tissue with the viable tissue which restores the normal function of the pulp-dentin complex. Possible reason for doing REP is not clearly known, however, clinicians perform REP in order to recover the histological structure as well as function of the traumatized and diseased tooth so that this tooth can restore its original root shape and thickness. This REP can be explained by the concept of revascularization or revitalization after induction of blood clot formation in the canal space. For this purpose, several treatment strategies have been suggested. In this regard, the rationale for the application of triantibiotics, calcium hydroxide or mineral trioxide aggregate is discussed in this paper. As a result, we will try to find the best method for REP by reviewing each available technique and their advantages and disadvantages.

In Situ Intersegmental Anastomosis within a Single Artery for Treatment of an Aneurysm at the Posterior Inferior Cerebellar Artery : Closing Omega Bypass

  • Lee, Sung Ho;Choi, Seok Keun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.467-470
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    • 2015
  • A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.

Hyperperfusion Syndrome after Carotid Stent-Supported Angioplasty in Patients with Autonomic Dysfunction

  • Kim, Dong-Eun;Choi, Seong-Min;Yoon, Woong;Kim, Byeong C.
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.476-479
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    • 2012
  • Cerebral hyperperfusion syndrome (CHS) is a rare, serious complication of carotid revascularization either after carotid endarterectomy or carotid stent placement. Although extensive effort has been devoted to reducing the incidence of CHS, little is known about the prevention. Postprocedural hypertension is very rare due to autoregulation of carotid baroreceptors but may occur if presented with autonomic dysfunction. We present two cases of CHS after cerebral revascularization that presented autonomic dysfunction.

High Thoracic Epidural Analgesia for the Control of Pain in Unstable Angina Pectoris -A case report- (불안정형 협심증 환자의 고위 흉부 경막외 진통 효과 -증례보고-)

  • Lee, Bong Jae
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.271-274
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    • 2006
  • Unstable angina is a critical phase of coronary heart disease, with widely variable symptoms and prognoses. Recently, despite the advances in surgical revascularization, catheter-based revascularization and medical treatment, an increasing number of patients with angina pectoris are refractory to medical therapy and; therefore, can not be considered as candidates for coronary artery bypass grafting or interventional angioplasty. These patients are often treated with narcotics for pain relief, and forced to severely reduce their levels of activity and productivity. It has become clear that alleviating the pain caused by myocardial ischemia may be possible by altering the sympathetic afferent nerve fibers. Sympathetic blockade can be produced using high thoracic epidural analgesia. Herein, the case of a patient with intractable angina and poor ventricular function, who received high thoracic epidural analgesia to relieve ischemic chest pain, is reported.

Assessment of Myocardial Viability Using PET (PET을 이용한 심근생존능의 평가)

  • Yoon, Seok-Nam
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.133-140
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    • 2005
  • The potential for recovery of left ventricular dysfunction after myocardial revascularization represents a practical clinical definition for myocardial viability. The evaluation of viable myocardium in patients with severe global left ventricular dysfunction due to coronary artery disease and with regional dysfunction after acute myocardial infarction is an important issue whether left ventricular dysfunction may be reversible or irreversible after therapy. If the dysfunction is due to stunning or hibernation, functional improvement is observed. but stunned myocardium may recover of dysfunction with no revascularization. Hibernation is chronic process due to chronic reduction in the resting myocardial blood flow. There are two types of myocardial hibernation: "functional hibernation" with preserved contractile reserve and "structural hibernation" without contractile reserve in segments with preserved glucose metabolism. This review focus on the application of F-18 FDG and other radionuclides to evaluate myocardial viability. In addition the factors influencing predictive value of FDG imaging for evaluating viability and the different criteria for viability are also reviewed.

Cardiac Valve Replacement and Simultaneous Myocardial Revascularization (심장판막질환과 동반된 관상동맥질환의 수술)

  • Reiner, Korfer;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.164-168
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    • 1988
  • Between November, 1984, and May, 1986, 93 patients underwent combined valvular and coronary artery operation. They were 70 male and 23 female, the age ranging from 29 to 82. From this population 89 patients underwent single valve replacement and 4 patients underwent double valve replacement. Patients with mitral valve disease were in the majority present in the age group between 50 till 70, where as in the group after 60 years, patients with aortic valve disease were dominant. The main indication for aortic valve replacement was aortic stenosis and the indication for mitral valve replacement was equal between mitral stenosis and mitral incompetence, the later was due to papillary dysfunction after myocardial infarction. Dyspnea was a very frequent symptom and it was found in nearly all patients. 28 patients had a previous myocardial infarction and severe left ventricular dysfunction. The grafts were placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. It is our opinion that simultaneous valve replacement and myocardial revascularization does not increase the risk of cardiac valve replacement substantially.

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Simultaneous Revascularization for Coronary Artery Stenosis and Peripheral Vascular Disease. (관상동맥 우회술과 말초 혈관 협착의 동맥 우회술의 동시 수술)

  • Song, Hyun; Lee, Eun-Sang;Yoo, Dong-Gon
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.943-946
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    • 1999
  • There was no significant difference in morbidity and mortality between those that received simultaneous operation for coronary artery disease and peripheral vascular disease versus those that received coronary artery bypass graft alone. Simultaneous operation is also cost effective. A 46 year-old patient with resting chest pain and intermittent claudication was diagnosed as unstable angina and Leriche's syndrome. We performed simultaneous revascularization for coronary artery stenosis with internal mammary artery and right gastroepiploic artery and a bifurcated vascular graft interposition between in the aorta, left common iliac and right femoral arteries for Leriche's syndrome. The postoperative coronary angiogram and aortogram revealed a good patency of the arterial conduits and vascular graft. He has been followed for 12 months without any problem.

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THE TREATMENT OF TOOTH AVULSION (치아탈구 시 처치)

  • Lee, Se-Joon
    • Restorative Dentistry and Endodontics
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    • v.24 no.2
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    • pp.426-429
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    • 1999
  • When the tooth avulsion occur in accidents the drying damage to the periodontal ligament has extremely detrimental effects on healing. Pulp necrosis always occurs after an avulsion injury, but revascularization can only take place in teeth with immature apexes. Therefore complications after avulsion injuries are common, and treatment must be carried out in a timely and correct fashion to prevent or limit these complications. Every effort should be made to replant the tooth within the first 15 to 20 minutes. If doubt exists that the tooth can be replanted adequately, the tooth should quickly be stored in an appropriate medium until the patient can get to the dental office for replantation. A complication of inflammatory root resorption is occurred by bacterial infection of periodontal ligament and dental pulp. Therefore aseptic endodontic treatment must be carried out in a timely and systemic antibiotics given at the time of replantation and before endodontic treatment are effective in preventing bacterial invasion. Further studies are needed to establish the clinical importance of preparation of the socket and root.

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Revascularization of immature permanent teeth with apical periodontitis

  • Iwaya, Shin-Ichi;Ikawa, Motohide;Kubota, Minoru
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.586-586
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    • 2003
  • In the infected immature tooth with periapical involvement, the pulp is considered to hardly exist in the canal and periapical area. Such a tooth receives apexification procedure, because revascularization of the pulp chamber is in principle not expected. Apexification is beneficial to induce further development of an apex to close the foramina, but does not promote the thickness of the entire canal wall dentin. It may be possible for the pulp to be only partially necrotic and infected when an extremely large communication from the pulp space to the periapical tissues exists with a very young tooth. If this were the case, vital pulp in the apical part of the canal could proliferate new pulp into the coronal pulp space by the successful removal and disinfection of the necrotic infected coronal pulp.(omitted)

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Myocardial Perfusion Scoring System in Coronary Bypass Grafting - Estimation of Completeness - (관상동맥우회술 환자에서의 심근관류점수제에 대한 연구: 완전혈관재생술의 평가)

  • Chae, Hurn;Baek,Wan-Ki;Ahn, Hyuk;Kim, Yong-Jin;Rho, Joon-Ryang;Kim, Chong-Whan;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.881-889
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    • 1991
  • The ideal goal of the coronary artery bypass surgery is complete revascularization. To estimate the numerical degree of completeness of revascularization, the following formula was used in 50 patients having aorta-coronary bypass grafting for the treatment of unstable angina. myocardial perfusion score of revascularized area Degree of Completeness = ----------------------------------------------------------------------------- x100[%] preoperative myocardial perfusion score Randomized patients who underwent revascularization procedures in 19Hb were compared with the patients who received similar elective operation each year from 1988 through 1991. To obtain these data, the patients aged 38 ~ 75[mean 54$\pm$9.1years], composed of 31 males and 19 females were randomly sampled. The number of grafts per patient increased from 2.30 in 1986, to 3.07 in 1988 - 89, to 3.21 in 1990, and to 3.50 in 1991. [0.05 The degree of completeness improved from 75.4% to 81.4%, 91.6% and 88.6% respectively. It improved significantly in the last two years, [P<0.05, Mann-Whitney U test] At a follow-up of three months, 90 percent[45/50] of patients remained angina, free, 6 percent[3/50] had residual angina, and 4 percent[2/50] died. The last two patients degree of completeness corresponded to 43% and 30% respectively As a conclusion, the degree of completeness seems to improve year by year, and to have close relationship with the clinical results.

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