• Title/Summary/Keyword: vascular connection

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Microsurgical Reconstruction of Giant Cell Tumor of Distal Epiphysis of Radius (미세 수술을 이용한 광범위한 요골 원위 골단부 거대세포종의 재건술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.100-107
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    • 2007
  • Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

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Modified Fontan Procedure for Single or Dominant Right Ventricle (우세우심실 또는 우단심실증에서의 변형 Fontan 수술)

  • 백완기
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.310-321
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    • 1991
  • Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

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A Study on the DNA Polymorphisms at $\beta$fibrinogen Loci and Plasma Fibrinogen Concentration

  • Lee, Mi-Hwa;Ohrr, Hee-Choul;Song, Kyung-Soon
    • Biomedical Science Letters
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    • v.7 no.3
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    • pp.151-159
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    • 2001
  • Many prospective studies have confirmed the predictive value of plasma fibrinogen levels for vascular diseases, including ischemic heart disease. Several polymorphisms of the $\beta$fibrinogen gene have been investigated in relation to plasma fibrinogen levels. The blood samples for DNA were collected from 109 healthy Koreans who have no relationship by blood (67 males and 42 females) in due consideration of some other factors such as gender, age, and smoking status. Four polymorphisms of the $\beta$fibrinogen gene that consist of HaeIII, AluI, MaII and BcII restriction fragment length polymorphisms (RFLPs) were investigated to examine the associations between RFLPs and plasma fibrinogen levels. In conclusion, the significant associations between HaeIII, AluI, MnII RFLPs(H$_1$H$_2$, M$_1$M$_2$, $A_1$A$_2$) and the concentration of plasma fibrinogen were shown by the smokers as well as by the old people more than 50, whereas the association between BcII and plasma fibrinogen were shown no connection with the status of age and smoking. The concentration of plasma fibrinogen was significantly shown higher by the old people ($\geqq$50) by the younger people ($\leqq$49) in male and also higher by the smokers than by the nonsmokers.

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Double Outlet of Right Ventricle in Criss-Cross Heart -Surgical Experience of One Case (십자형심장에 동반된 양대혈관우심실기시증 -수술치험 1례)

  • Kim, Dae-Yeon;Jo, Seong-Rae;Park, Seong-Dal;Jeong, Hyeon-Gi
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1242-1246
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    • 1997
  • Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

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Anatomical Studies on Root Formation in Hypocotyl and Epicotyl Cuttings of Woody Plants (임목(林木)의 배축(胚軸) 및 유경삽수발근(幼茎揷穗発根)의 해부학적(解剖学的) 연구(研究))

  • Choi, Man Bong
    • Journal of Korean Society of Forest Science
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    • v.52 no.1
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    • pp.1-30
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    • 1981
  • The origin and development of adventitious roots was studied using hypocotyl and epicotyl cuttings of 34 species, 24 genus of woody plants. These cuttings obtained from young seedlings cultured in vials containing distilled water only. The several characteristics of cuttings materials studied are shown in Table 1. The results are summerized as follows: 1. The circumference shapes of cross-sections of hypocotyl and epicotyl cuttings can be divided into six categories, namely, round, irregular round, ellipse, irregular ellipse, square, and triangle. Species differences within a genus did not show any difference of hypocotyl and epicotyl cross-sections shape, however, a noticeable variation among genus or higher taxa. 2. The arrangements of vascular bundles in the cross-sections of hypocotyls or epicotyls were almost all collateral types and generally showed generic characteristics differing one to the other. However, there were some variations between species within the genus. Six models of vascular bundle arrangement were proposed for all the above speices. 3. The rooting portions of hypocotyl and epicotyl cuttings in this experimental materials can be grouped as follows: (1) Interfascicular parenchyma; (Thuja orientalis. T. orientalis for. sieboldii, Acer microsieboldianum, A. palmatum, A. saccharinum, Cercis chinensis, Lespedeza bicolor, Magnolia obovata, M. sieboldii, Mallotus japonicus, Staphylea bumalda) (2) Cambial and phloem parenchyma: (Chamaecyparis obtusa, C. pisifera, Albizzia julibrissin, Buxus microphylla var. Koreana, Cereis chinensis, Euonymus japonica, Firmiana platanifolia, Lagerstroemia indica, Ligustrum salicinum, L. obtusifolium, Magnolia kobus, M. obovata, Mallotus japonicus, Morus alba, Poncirus trifoliata, Quercus myrsinaefolia, Rosa polyantha, Styrax japonica, Styrax obassia) (3) Primary ray tissues; (Euonymus japonica, Styrax japonica) (4) Leaf traces; (Quercus acutissima, Q. aliena) (5) Cortex parenchyma; (Ailanthus altissima) (6) Callus tissues; (Castanea crenata, Quercus aliena, Q. myrsinaefolia, Q. serrata) 4. As a general tendency throughout the species studied, in hypocotyl cuttings, the adventitious root primordia were originated from the interfascicular parenchyma tissue, however, leaf traces and callus tissues were contributed to the root primordia formation in epicotyl cuttings. The hypocotyl cuttings of Ailanthus altissima exhibited a special performance in the root primordia formation, this means that cortex parenchyma was participated to the origin tissue. And in Firmiana platanifolia, differening from the other most species, the root primordia were formed at the phloem parenchyma adjacent outwardly to xylem tissue of vascular bundle system as shown photo. 48. 5. All the easy-to, or difficult-to root species developed adventitious roots in vials filled with distilled water. In the difficult-to-root species, however, root formations seemed to be delayed because they almost all had selerenchyma or phloem fiber which gave some mechanical hindrance to protrusion of root primordia. On the other hand, in the easy-to-root species they seemed to form them more easily because they did not have the said tissues. The rooting portions between easy-to-root and difficult-to-root species have not clearly been distinguished, and they have multitudinous variations. 6. The species structured with the more vascular bundles in number compared with the less vascular bundles exhibited delayed rooting. In the cuttings preparation, the proximal end of cuttings was closer to root-to-stem transition region, the adventitious root formation showed easier. 7. A different case occured however with the mature stem cuttings, in both the needle-leaved and the broad-leaved species. In the hypocotyl cuttings, parenchymatous tissues sited near the vascular bundles become the most frequent root forming portions in general and relevant distinctions between both species were hardly recognizable. 8. In the epicotyl cuttings, root primordia originated mainly in leaf traces in connection with cambial and phloems or callus tissues itself. In the hypocotyl cuttings, interfascicular parenchyma was the most frequent portion of the root primordia formation. The portions of root primordia had more connection with vascular cambium system, as the tissues were continuing to be developed.

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Mid-term results of IntracardiacLateral Tunnel Fontan Procedure in the Treatment of Patients with a Functional Single Ventricle (기능적 단심실 환자에 대한 심장내 외측통로 폰탄술식의 중기 수술성적)

  • 이정렬;김용진;노준량
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.472-480
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    • 1998
  • We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

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A Study of Influences Caused by Far Infrared and Anion on Human Body (원적외선과 음이온이 인체에 미치는 효과)

  • Kim, Wan-Gyeom;Kim, Seong-Sam;You, Seung-Hyun;Kil, In-Ho;Kwon, So-Hee;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.9 no.2
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    • pp.93-106
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    • 2005
  • A survey was performed for 2 weeks in October 2004 in order to examine the effects and changes of far infrared and anion of office workers aged 40 and older before and after wearing the underwear. In the survey, questionnaires and photoplethysmography were used to measure the difference between the two tests conducted with one week interval. The findings could be summed up as follows: 1. There was no statistically significant difference in changes of vascular aging points and photoplethysmogram wave form before and after wearing the far infrared and anion underwear but the points showed the increasing tendency(p>0.05). 2. A statistically significant difference was confirmed since the total points of each item in the questionnaires increased after wearing the underwear(p<0.001). 3. In connection with the systemic symptoms, a significant difference was found with increased points in all items except for no. 6 after wearing the underwear(p<0.05). 4. With regard to the difference before and after wearing the underwear depending on the Kidney symptoms, there was a significant difference with increased points in all items except for item no. 1 after wearing the underwear(p<0.05). In conclusion, to put on the underwear with effect of far infrared and anion is believed to smooth metabolism and blood circulation, contributing by thus to promoting health and preventing disease. Further studies with wider sampling of subjects are requested to diversify and refine the findings from this sectional study.

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Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome (Osler-Rendu-Weber 증후군 환자에서 색전요법을 이용한 다발성 폐동정맥루 치험 1예)

  • Kim, Jae-Hag;Choi, Taek-Hee;Nam, Seung-Mo;Chang, Jae-Jin;Park, Yeon-Hee;Hur, Nam-Hyun;Choe, Du-Hwan;Lee, Byung-Hee;Kim, You-Cheoul;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.914-921
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    • 1997
  • Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blood in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II). clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization. significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she had the improvement of symptoms and iron deficiency anemia.

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Effect of Relative Humidity on Physiology and Antioxidant Metabolism of Grafted Watermelon Seedlings (상대습도가 수박 접목묘의 생리 및 항산화 대사에 미치는 영향)

  • Wei, Hao;Manivannan, Abinaya;Muneer, Sowbiya;Kim, SooHoon;Ya, Liu;Park, Ji Eun;Jeong, Byoung Ryong
    • Journal of Bio-Environment Control
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    • v.25 no.4
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    • pp.351-358
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    • 2016
  • This study investigated the effect of different relative humidity (RH) regimes on graft healing of grafted seedlings of watermelon (Citrullus vulgaris Schrad.). Two watermelon cultivars ('Speed' and 'Sambok Honey') were grafted onto the 'RS-Dongjanggun' bottle gourd rootstock (Lagenaria siceraria Stanld.) and the grafted seedlings were maintained under one of three relative humidity regimes, 95-96% [1.1-0.8 (day) or $0.8-0.6(night)\;g{\cdot}m^{-3}$ vapor pressure deficit (VPD)], 97-98% [ 0.7-0.4 (day) or $0.5-0.3(night)\;g{\cdot}m^{-3}$ (VPD)], or 99-100% [0.3-0.0 (day) or $0.2-0.0(night)\;g{\cdot}m^{-3}$ (VPD)] according to the Mollier diagram based on the air temperature of $25^{\circ}C\;day/18^{\circ}C\;night$ with 16 h photoperiod per day. Among the RH treatments, 97-98% significantly increased plant height and fresh weight of the rootstock and scion of the 'Speed' and it also enhanced the graft union connection of both cultivars after two days of grafting. However, plant height and thickness of the scion of 'Sambok Honey' was increased by the 99-100% RH treatment. Furthermore, both cultivars grown in the 95-96 and 97-98% RH treatments consisted of lower levels of endogenous $H_2O_2$ and less activities of antioxidant enzymes which illustrated the occurrence of less oxidative stress. Hence, the results of this study identified the optimal RH level for the graft healing of watermelon seedlings.