• 제목/요약/키워드: heart transplantation

검색결과 216건 처리시간 0.019초

정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고- (Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.364-368
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    • 2004
  • 선천성 폐정맥 협착증은 매우 드문 기형으로 진행성 폐동맥 고혈압 및 조기 심부전으로 사망률이 높아 적극적인 내외과적 치료가 요구된다 수술적 치료법으로는 품선 확장술, 스텐트 삽입술, 전폐절제술, 폐이식술, 패취 봉합술, 그리고 무봉합 교정술 등이 있다. 본원에서는 정상적인 해부학적 연결을 가진 폐정맥 협착증에서 무봉합 교정술 및 수술 후 Sildenafil, Iloprost 그리고 NO gas등의 폐혈관 확장제를 사용하여 성공적으로 치료한 1예를 경험하여 이를 보고하고자 한다.

Surgical Treatment of Dermatomal Capillary Malformations in the Adult Face

  • Kim, Yoo-Jeong;Oh, Suk-Joon;Lee, Jun-Sang;Yang, Ji-Hoon;Koh, Sung-Hoon;Jung, Sung-Won
    • Archives of Plastic Surgery
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    • 제39권2호
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    • pp.126-129
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    • 2012
  • Background : Facial capillary malformations (CMs) rarely recede; they often become darker and raised in proportion to their growth. These malformations may hypertrophy in adulthood, resulting in increased disfigurement and dysfunction. Laser treatment is considered a first-line therapy for focal CMs, but thick wide lesions, which are accompanied by hypertrophy and have a well-circumscribed nodularity, may be treated with surgical excision and reconstruction. Methods : We retrospectively reviewed the records of 25 consecutive patients who had undergone complete or partial excisions of facial capillary malformations in our unit. After the excisions, the defects that encompassed their facial aesthetic units were subsequently covered by various methods, including primary closures, local flaps, expanded flaps, split-thickness skin grafts, and full thickness skin grafts. Results : The data demonstrated satisfactory results and reliability. Our patients were treated without significant complications, and all of the patients were moderately or fully satisfied with the outcome of their surgeries. Conclusions : Among the many reconstructive options for adult patients with facial capillary malformations, thick split-thickness skin grafts can be a good choice for the coverage of widely excised wounds.

Case Reports of Adipose-derived Stem Cell Therapy for Nasal Skin Necrosis after Filler Injection

  • Sung, Ha-Min;Suh, In-Suck;Lee, Hoon-Bum;Tak, Kyoung-Seok;Moon, Kyung-Min;Jung, Min-Su
    • Archives of Plastic Surgery
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    • 제39권1호
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    • pp.51-54
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    • 2012
  • With the gradual increase of cases using fillers, cases of patients treated by non-medical professionals or inexperienced physicians resulting in complications are also increasing. We herein report 2 patients who experienced acute complications after receiving filler injections and were successfully treated with adipose-derived stem cell (ADSCs) therapy. Case 1 was a 23-year-old female patient who received a filler (Restylane) injection in her forehead, glabella, and nose by a non-medical professional. The day after her injection, inflammation was observed with a $3{\times}3cm$ skin necrosis. Case 2 was a 30-year-old woman who received a filler injection of hyaluronic acid gel (Juvederm) on her nasal dorsum and tip at a private clinic. She developed erythema and swelling in the filler-injected area A solution containing ADSCs harvested from each patient's abdominal subcutaneous tissue was injected into the lesion at the subcutaneous and dermis levels. The wounds healed without additional treatment. With continuous follow-up, both patients experienced only fine linear scars 6 months postoperatively. By using adipose-derived stem cells, we successfully treated the acute complications of skin necrosis after the filler injection, resulting in much less scarring, and more satisfactory results were achieved not only in wound healing, but also in esthetics.

부분 양심실 교정을 받은 엡스타인 기형에서 발생한 심실성 빈맥에 대해 체외막 산소화 장치를 이용한 성공적인 구출 (Successful Rescue of Refractory Ventricular Tachycardia after One and a Half Repair in Ebstein's Anomaly by Extracorporeal Membrane Oxygenation)

  • 서홍주;황성욱;이철;임홍국;유재근;이창하
    • Journal of Chest Surgery
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    • 제40권3호
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    • pp.220-224
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    • 2007
  • 소아에서 체외막 산소화 장치는 중증호흡부전, 약물에 반응하지 않는 심부전, 패혈증, 폐동맥고혈압에서 뿐만 아니라 심장이식의 가교로서도 기계적인 심폐보조를 제공한다. 그렇지만 소아에서 부정맥에 의해 생긴 저심박출증에 대해 체외막 산소화 장치를 이용하여 심장보조를 시행한 증례는 많지 않다. 본 저자들은 부분 양심실 교정을 받은 엡스타인 기형에서 심실성 부정맥 때문에 순환 부전에 빠진 15세 여자 환자를 체외막 산소화 장치를 이용하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

심장이식 수혜자의 삶의 질 관련 요인에 대한 메타분석 (A Meta-Analysis on Factors Related to Quality of Life in Heart Transplant Recipients)

  • 장미라;임세라;최모나
    • 임상간호연구
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    • 제25권3호
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    • pp.251-264
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    • 2019
  • Purpose: This study was a systematic review and meta-analysis to explore the factors related to quality of life in heart transplant recipients. Methods: To identify studies that suggested the factors related to the quality of life in heart transplant recipients, we searched the articles published from 1974 to November 2018 using Six databases, PubMed, CINAHL, EMBASE, Cochrane, KMBASE and RISS. A total of 22 studies were selected out of 5,234 for the systematic review and meta-analysis on the basis of the PRISMA flow. The quality of study was assessed by assessment tool form the NIH and meta-analysis was performed using the 'R 3.5.2' version to analyze the correlated effect sizes. Results: Factors related to quality of life in heart transplant recipients were categorized into six domains based on the health-related quality of life model introduced by Ferrans: individual, environmental, biological function, symptoms, functional status, and general health perception. In the meta-analysis, 34 factors were used and 17 factors having significant effect sizes were as follows: self-efficacy, demoralization, perceived control, current occupational status, age, marital status, health promotion life style in the individual characteristics; stress in environmental characteristics; physical function status, creatinine level, left ventricular ejection fraction (LVEF) in biological function; anxiety, depression, symptom frequency and distress in symptoms domain; coping, self-care compliance in functional status. Conclusion: The findings indicate that the multi-dimensional factors influencing the quality of life in heart transplant recipients and provide the evidence for developing effective interventions for improving the quality of life of recipients.

Major Clinical Issues in Hypertrophic Cardiomyopathy

  • Hyun-Jung Lee;Jihoon Kim;Sung-A Chang;Yong-Jin Kim;Hyung-Kwan Kim;Sang Chol Lee
    • Korean Circulation Journal
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    • 제52권8호
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    • pp.563-575
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    • 2022
  • Hypertrophic cardiomyopathy (HCM) is one of the most common inheritable cardiomyopathies. Contemporary management strategies, including the advent of implantable cardioverter-defibrillators and effective anticoagulation, have substantially improved the clinical course of HCM patients; however, the disease burden of HCM is still high in Korea. Sudden cardiac death (SCD), atrial fibrillation and thromboembolic risk, dynamic left ventricular outflow tract (LVOT) obstruction, and heart failure (HF) progression remain important issues in HCM. SCD in HCM can be effectively prevented with implantable cardioverter-defibrillators. However, appropriate patient selection is important for primary prevention, and the 5-year SCD risk score and the presence of major SCD risk factors should be considered. Anticoagulation should be initiated in all HCM patients with atrial fibrillation regardless of the CHA2DS2-VASc score, and non-vitamin K antagonist oral anticoagulants are the first option. Symptomatic dynamic LVOT obstruction is first treated medically with negative inotropes, and if symptoms persist, septal reduction therapy is considered. The recently approved myosin inhibitor mavacamten is promising. HF in HCM is usually related to diastolic dysfunction, while about 5% of HCM patients show reduced left ventricular ejection fraction <50%, also referred to as "end-stage" HCM. Myocardial fibrosis plays an important role in the progression to advanced HF in patients with HCM. Patients who do not respond to guideline-directed medical therapy can be considered for heart transplantation. The development of imaging techniques, such as myocardial deformation on echocardiography and late gadolinium enhancement on cardiac magnetic resonance, can provide better risk evaluation and decision-making for management strategies in HCM.

총상으로 인한 하악골 결손 부위의 Tantalum plate 대치를 위한 장골이식에 관한 증례 (ILIAC BONE GRAFT REPLACING TANTALUM PLATE FOR GUNSHOT WOUND OF MANDIBLE)

  • 김수남;이봉재;한보균
    • 대한치과의사협회지
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    • 제15권5호
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    • pp.359-364
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    • 1977
  • Orthognathic surgery, ie, the surgical correction of congenital and acquaired anormalities of the jaws, is currently a field of vigorous activity among oral surgeons. Surgical correction of maxillofacial deformities benefits the patient both psychologically and functionally. Facial mutilation may precipitate adverse psychologic effects. Function is frequently impaired by malrelation of the jaws. In addition, speech, specifically articulation, is often handicapped in patient with severe jaw deformities. Therefore, in dealing with these patient, above mentioned problem should be considered deliberately. In this regard, the authors have treated 2 cases of mandible defect caused by gunshot and explosives with iliac bone graft. In both cases, the patient had Tantalum plate on defect area. But it became lose and gave functional disturbances. So, the authors have removed Tantalum plate and performed bone transplantation with autogenous soild iliac bone graft on that area with good results.

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전기-기계식 이식형 좌심실 보조 시스템의 개발 및 평가 (Development and Evaluation of a Novel Electro-mechanical Implantable Ventricular Assist System)

  • 조한상;김원곤;이원용;곽승민;김삼성;김재기;김준택;류문호;류은숙
    • 대한의용생체공학회:의공학회지
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    • 제22권4호
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    • pp.349-358
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    • 2001
  • A novel electro-mechanical implantable ventricular assist system is developed as a bridge to transplantation or recovery for patients with end-stage heart failure. The developed system is composed of an implanted blood pump, an external monitoring system which stores data, and a wearable system including a portable external driver and a portable power supply system. The blood pump is designed to be implanted into the left upper abdominal space and provides blood flow from the left ventricular apex to the aorta. The pulsatile blood flow is generated by a double cylindrical cam. There was mo excessive heat emission from the blood pump into the temperature-controlled chamber in the heat test and no stagnated flow within the blood sac by the observation in the flow visualization test. Animal experiments were performed using sheep and calves. The maximum assist flow rate reached 7.85L/min in the animal experiment. The evaluation results showed that the developed system was feasible for the implantable ventricular assist system. The long-term in vitro durability test and mid-term in vivo experiments are in progress and mow the modified next model is under development.

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성인용 공기구동식 심실보조장치의 모의순환실험 (In Vitro Test of an Adult-Sized Pneumatic Type Ventricular Assist Device)

  • 김상현;장병철;김원기;김남현;조범구
    • 대한의용생체공학회:의공학회지
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    • 제14권2호
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    • pp.163-167
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    • 1993
  • We developed a ventricular assist device(VAD) to be used as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial function after cardiac surgery. It is a pneumatic and diaphragm-type VAD and its stroke volume is 90 cc. The upper housing and diaphragm is made of a segmented polyurethane and the lower back plate is made of a polycarbonate. Two Carbomedics$^R$ mechanical valves are used as inlet and outlet valves. It was tested in vitro and the cardiac output of the VAD was 7 L/min at a heart rate of 70 bpm. The line pressure from a pressure transducer inserted in the pneumatic line was recorded and compared with the ideal pressure tracing.

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Cardiovascular Regeneration via Stem Cells and Direct Reprogramming: A Review

  • Choon-Soo Lee;Joonoh Kim;Hyun-Jai Cho;Hyo-Soo Kim
    • Korean Circulation Journal
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    • 제52권5호
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    • pp.341-353
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    • 2022
  • Cardiovascular disease (CVD) is the leading causes of morbidity and death globally. In particular, a heart failure remains a major problem that contributes to global mortality. Considerable advancements have been made in conventional pharmacological therapies and coronary intervention surgery for cardiac disorder treatment. However, more than 15% of patients continuously progress to end-stage heart failure and eventually require heart transplantation. Over the past year, numerous numbers of protocols to generate cardiomyocytes (CMCs) from human pluripotent stem cells (hPSCs) have been developed and applied in clinical settings. Number of studies have described the therapeutic effects of hPSCs in animal models and revealed the underlying repair mechanisms of cardiac regeneration. In addition, biomedical engineering technologies have improved the therapeutic potential of hPSC-derived CMCs in vivo. Recently substantial progress has been made in driving the direct differentiation of somatic cells into mature CMCs, wherein an intermediate cellular reprogramming stage can be bypassed. This review provides information on the role of hPSCs in cardiac regeneration and discusses the practical applications of hPSC-derived CMCs; furthermore, it outlines the relevance of directly reprogrammed CMCs in regenerative medicine.