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      • 선천성 좌내경동맥 부재 1예

        김응규,김동선,김종환,김성은,허경 인제대학교 1998 仁濟醫學 Vol.19 No.1

        선천성 내경동맥부전 및 발육부전은 매우 희귀한 질환으로 전세계적으로 약 100예가 보고되고 있다. 이 질환은 뇌의 동맥류도 같이 동반하는 경우도 있으며 증상이 없이 지내는 경우도 있다. 본 저자 등은 두통을 주소로 내원한 43세 여자 환자에서 좌내경동맥의 선천적 부전을 전산화단층촬영을 통하여 확진하였기에 보고하는 바이다. Congenital absence of the internal carotid artery is a rare anomaly. When the internal carotid artery is congenitally absent, collateral circulation develops through the circle of Willis from basilar and the opposite internal carotid to supply the involved hemisphere. Absence or hypoplasia of the carotid canal on a computed tomography through the skull base should suggest a congenital ICA abnormality and prompt a search for associated intracranial vascular abnormalities because of high association with circle of Willis aneurysmal formation. A 43-year-old female patient listed to our hospital because of headache. There was no definite abnormal findings on neurologic examination. MRI did not show left intracranial portion of ICA, so we studied 4 vessel angiography. Angiography showed left ICA was not present and left MCA and left ACA was supplied by left posterior communicating artery and right AComA, respectively. Computed Tomography confirmed the absence of left carotid canal.

      • KCI등재

        관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

        이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

        목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

      • 관상동맥 질환에서 SDF-1α의 농도

        김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

        Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

      • 원발성 폐암 환자의 생존율에 관한 보고

        김현태,이상무,어수택,박춘식,정성환,허승재,남충희,강창희,김용훈 순천향대학교 1994 논문집 Vol.17 No.4

        We analysed 404 patients with primary lung carcinoma who were treated at Soonchunhyang University Hospital from July, 1985 to september, 1993 in order to investigate the survival rate and epidemiolgical properties of primary lung cancer. They were 330 males and 74 females. The most prevalent decade was seventh. In terms of cell type, the squamous cell was 225 patients (55%), and adenocarcinoma, small cell, mixed type was 21%, 19%, 4%, respectively. Among non-small cell lung carcinoma, stage Ⅲa was the most prevalent one(92%). In case of small cell carcinoma, the limited stage was 64%. The 12-, 24-, 36- month survival rate of total patients was 57%, 31%, 22%, respectivley and median sruvival time was 15 months. The 36-month survival rate tended to be longer in non-small cell lung carcinoma than that of small cell lung cancer, but there was no difference between two groups, statistically. In non-small cell carcinoma, The 36-month survival rate and meidan survival time were longer in the stage Ⅰ and Ⅱ than those of Ⅲa, Ⅲb, Ⅳ (80% versus 38%, 22%, 0%, p<0.05). According to involvement of lymph node, the 36-month survival rate was longer in NO and N1 than those of N2, N3 (61.9%, 48.7% versus 17.7%, 17.3%, p<0.05). In small cell carcinoma, The 36-month survival rate and median survival rate were higher and longer in limited stage than those of extensive stage(16.1% and 13 month vs 10% and 8 month, p<0.05). In conclusion, we report here the incidence of primary lung carcinoma and the survival rate of paients with primary lung carcinoma who were treated in Soonchunhyang University Hospital.

      • SCIESCOPUSKCI등재
      • SCIESCOPUSKCI등재

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