• Title/Summary/Keyword: stenosis

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Early Manifestation of Supravalvular Aortic and Pulmonary Artery Stenosis in a Patient with Williams Syndrome

  • Lee, Jong Uk;Jang, Woo Sung;Lee, Young Ok;Cho, Joon Yong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.115-118
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    • 2016
  • Williams syndrome (WS) is a developmental disorder characterized by vascular abnormalities such as thickening of the vascular media layer in medium- and large-sized arteries. Supravalvular aortic stenosis (SVAS) and peripheral pulmonary artery stenosis (PPAS) are common vascular abnormalities in WS. The natural course of SVAS and PPAS is variable, and the timing of surgery or intervention is determined according to the progression of vascular stenosis. In our patient, SVAS and PPAS showed rapid concurrent progression within two weeks after birth. We report the early manifestation of SVAS and PPAS in the neonatal period and describe the surgical treatment for stenosis relief.

Laryngotracheal Stenosis (후두-기관 협착)

  • Ryu, In-Sun;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.1
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    • pp.21-27
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    • 2012
  • Laryngotracheal stenosis is a congenital or acquired narrowing of the airway, representing a continuum of disease that may affect the glottis, subglottis, and/or trachea. The larynx and trachea are semirigid tubular structures in which concentric scar contraction - a normal wound healing process - tends to narrow the lumen. The diversity of causes, severity, location of stenosis, and association with swallowing and phonation make this disease difficult to compare across patient populations and treating otolaryngologists. The wide array of surgical techniques for any given stenosis attests to the complexity and less than perfect results of the treatment. This review will address the etiology, diagnosis, and management of laryngotracheal stenosis.

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Clinical Analysis of Cases of Laryngotracheal Reconstruction Treated with End to End Anastomasis (단단문합술에 의한 기관재건의 임상적 고찰)

  • 김광현;윤자복;안순현
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.101-108
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    • 1995
  • From 1988 to 1995, 59 patients with laryngotracheal stenosis were operated with resection of stenotic segment and end to end anastomosis in Seoul national university. Among these patients, 36 were tracheal stenosis, 17 were combined lesion of subglottis and trachea and 5 were subglottic stenosis. The success of procedure was determined by stoma closure or decannulation and an overall 89.8% success rate was achieved following 165 procedures. The success rate showed correlation with severity of stenosis and the number of procedures done was related to the site of stenosis. There was no mortality and granulation formation, unilateral vocal cord palsy were the common complication of end to end procedures.

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Laryngotracheal Reconstruction Using The Vascularized Clavicle (혈관화된 쇄골을 이용한 기관재건술)

  • 정동학;송승용;윤정선;정영석
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.327-331
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    • 1997
  • One of the most difficult airway problems is a subglottic stenosis combined with a tracheal stenosis. Laryngotracheal stenosis has not been completely solved with classic methods like cricotracheal split with autogenous cartilage graft, thyrotracheal anastomosis, and free hyoid or hyoid-sternohyoid myo-osseous flap reconstruction. A 28-near-old male patient who had had laryngotracheal stenosis was successfully treated by laryngotracheal reconstruction using vascularized clavicle. This method has a several advantages: the vascularized clavicle harvesting in the same operative fields, one stage operation, less restenosis due to plentyful blood supply, md prevention of airway collapse due to a clavicle provided framework. It is too early to make a definite conclusion, but the authors suggested that this method could become one of the most effective methods of laryngotracheal stenosis.

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Acquired pulmonary stenosis secondary to tuberculosis -A case report- (결핵성 폐동맥 협착증 치험 1 례)

  • 조광조;우종수;성시찬;최필조;손춘희
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1140-1143
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    • 1999
  • Acquired pulmonary artery stenosis which is secondary to tuberculosis is so rare that only a few scattered cases have been reported. We report one case of pulmonary stenosis caused by pulmonary tuberculosis.l A 50 year old man who gradually developed dyspnea was diagnosed as bilateral pulmonary stenosis, he underwent bypass surgery between the main diagnosed as bilateral pulmonary stenosis. he underwent bypass surgery between the main pulmonary artery and the right pulomonary artery with a 13mm Gortex ringed straight graft. The left pulmonary artery was too small to restore the perfusion. The patient was discharged on the 33rd day after the operation. Acquired pulmonary stenosis could be treated successfully with one-side pulmonary arery reconstruction.

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Experimental Study on Flow Characteristics in a Micro-stenosis Inside a Microchannel (마이크로 채널내부 미세 협착 부위의 유동특성에 대한 실험적 연구)

  • Ji Ho-Seong;Lee Sang-Joon
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.30 no.3 s.246
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    • pp.255-261
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    • 2006
  • Flow characteristics of DI water in a microchannel with a stenosis were investigated using .a micro PIV system with varying flow rate. The width and depth of the PDMS micro-channel were $100{\mu}m\;and\;50{\mu}m$, respectively. To Investigate flow characteristics in the micro-stenosis, the same experiment was carried out in a straight microchannel under the same flow rate. The measured mean velocity fields were almost symmetric with respect to the channel centerline. The experimental results are well agreed with the theoretical Hagen-Poiseuille profile. In the contraction part of the micro-stenosis, the oncoming flow is accelerated rapidly and the maximum velocity occurs at the throat, almost 4.99 time faster than that without the stenosis.

Management of Pediatric Laryngotracheal Stenosis (소아 후두기관 협착의 치료)

  • Yoon Se, Lee
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.3
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    • pp.123-129
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    • 2022
  • Pediatric laryngotracheal stenosis occurs by either congenital or acquired causes and usually indicates subglottic stenosis. The main goals of treatment are decannulation, preserving phonation, and normal swallowing function. Various types and degrees of stenosis and combined anomalies would be the main barriers to reaching successful treatment results unless comprehensive understanding of stenosis. Multidisciplinary team approaches encompassing initial assessment, treatment, and postoperative care, are also necessary to achieve the best treatment outcome. Therapeutic approaches are divided into conservative, endoscopic, and open surgical approaches at length, which are not exclusive to each other. Here, an adequate selection of each therapeutic option and postoperative management will be introduced to achieve decannulation without leaving phonatory or swallowing complications.

Endoscopic Management of Supraglottic Stenosis with KTP-532 Laser (KTP-532 레이저에 의한 성문상부 협착증 치험)

  • Choi, Jong-Ouck;Jun, Byung-Sun;Kang, Hee-Joon;Baek, Seung-Kuk;Choi, Geun;Jung, Kwang-Yoon;Chu, Hyung-Ro
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.153-158
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    • 1999
  • Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

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THE INFLUENCES OF SWIRL FLOW ON FRACTIONAL FLOW RESERVE IN MILD/MODERATE/SEVERE STENOTIC CORONARY ARTERIAL MODELS (관상동맥 내의 나선형 유동이 협착도에 따라 분획 혈류 예비능에 미치는 영향에 관한 수치해석)

  • Lee, Kyung Eun;Kim, Gook Tae;Ryu, Ah-Jin;Shim, Eun Bo
    • Journal of computational fluids engineering
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    • v.22 no.1
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    • pp.15-25
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    • 2017
  • Swirl flow is often found in proximal coronary arteries, because the aortic valves can induce swirl flows in the coronary artery due to vortex formation. In addition, the curvature and tortuosity of arterial configurations can also produce swirl flows. The present study was performed to investigate fractional flow reserve alterations in a post-stenotic distal part due to the presence of pre-stenotic swirl flow by computational fluid dynamics analysis for virtual stenotic models by quantifying fractional flow reserve(FFR). Simplified stenotic coronary models were divided into those with and without pre-stenotic swirl flow. Various degrees of virtual stenosis were grouped into three grades: mild, moderate, and severe, with degree of stenosis of 0 ~ 40%, 50 ~ 60%, and 70 ~ 90%, respectively. In this study, three-dimensional computational hemodynamic simulations were performed under hyperemic conditions in virtual stenotic coronary models by coupling with a zero-dimensional lumped parameter model. The results showed that the influence of pre-stenotic swirl inflow is dominant on FFR alteration in mild stenosis, whereas stenosis is dominant on FFR alteration in moderate/severe stenosis. The decrease in FFR caused by swirl flow is more significant in mild stenosis than moderate/severe stenosis. Biomechanical modeling is useful for clinicians to provide insight for medical intervention strategies. This hemodynamic-based parameter study could play a critical role in the development of a non-invasive imaging-based strategy-support system for percutaneous transluminal angioplasty in cases of mild/moderate stenosis.

Circunferential resection and direct end to end anastomosis of mediastinal trachea on a post tracheostomy stenosis (기관절개술후 종격동기관 협착증에 대한 기관절제 단단 문합술)

  • Kim, Se-Wha;Park, Hee-Chul;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.495-502
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    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

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