• Journal of Yeungnam Medical Science
• /
• v.17 no.2
• /
• pp.137-145
• /
• 2000

Background: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and Methods: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. Results: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. Conclusions: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

• Journal of Chest Surgery
• /
• v.37 no.1
• /
• pp.35-42
• /
• 2004

Background: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were peformed. This study was performed to investigate whether V-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. Material and Method: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. Result: left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizations by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal blanches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. Conclusion: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.

• Korean Journal of Acupuncture
• /
• v.24 no.1
• /
• pp.65-77
• /
• 2007

목 적 : 본 연구(硏究)는 수소양삼초경근(手少陽三焦頸筋)의 이론적(理綸的) 근거(根據)를 해부학적(解剖學的)으로 제공(提供)하고 임상(臨床)에 경근(經筋)의 정확(正確)한 적용(適用)을 위함이다. 방 법 : Cadaver에 경근(經筋)을 표시(表示)하고 각각(各各)의경 경혈부위(經穴部位)에 표식(標識)와 pore 작업을 수행하고 각 경혈부(經穴部)를 피부(皮膚), 근막(筋膜), 그리고 근육(筋肉)의 천층(淺層), 중문층(中問層), 그리고 심층부(深層部)를 순서적(順序的)으로 해부(解剖)하여 근육(筋肉), 신경(神經), 혈관(血管) 등을 관찰(觀察)한다. 결 과 및 결 론 : 수소양삼초경근(手少陽三焦經筋)의 해부학적(解剖學的) 고찰(考察) 결과(結果)는 다음과 같다. 1) 근(筋) 육(肉) : 천층에 근막(TE1), 근막확장대(TE2), 근막과 근간결합(TE3), 근막과 신근지대(TE4), 근막과총지신근건(TE5), 근막및 총지신근과 소지신근간(TE6), 근막과 소지신근(TE7), 총지신근(TE8), 척측수근신근과 소지신근간(TE9), 상완삼두근건(TE10, 11), 상완삼두근(TE12), 삼각근(TE13), 삼각근및 극하근과 극상근간(TE14). 승모근(TE15), 흉쇄유돌근(TE-16, 17, 18), 후이개근(TE19, 22), 상이개근(TE20), 전이개근및 이하선근막(TE21), 안륜근(TE23), 중층에 소지신근건과 총지신근건간(TE4), 측두근막과 측두근(TE2O, 22, 23), 심층에 배측골간근(TE3), 시지신근과 골간막(TE5) 장모지신근(TE6), 시지신근(TE7), 장지신근과 장모지외전근간(TE8, 9), 상완삼두근(TE13), 견갑거근(TE15), 두판상근(TE16), 경상설골근과 하악이복근간(TE17) , 이복근(TE18) .2) 신(神) 경(經) : 천층에 척골신경의 배측지(TE1, 2, 3), 후전완피신경(TE4, 5, 6, 8, 9, 10, 11), 내측전완피신경(TE5, 6, 7, 8, 9, 10, 11), 후상완피신경(TE12, 13), 상외측상완피신경(TE13), 외측쇄골상신경(TE14, 15),대이개신경(TE16, 17, 18, 19), 소후두신경(TE19, 20), 이개측두신경(TE20, 21, 22), 안면신경측두지(TE22, 23), 관골측두신경(TE23), 중층에 견갑상신경(TE15), 견갑배신경(TE15), 경상설골근신경(TE17), 후이개신경(TE18, 19, 20), 안면신경측두지(TE20, 21, 22), 심층에 후골간신경(TE5, 6, 7), 요골신경심지(TE8, 9, 12, 13), 견갑상신경(TE14), 액와신경가지(TE14), 부신경(TE16), 안면신경과 부신경가지(TE17), 설인신경(TE17), 설하신경(TE17), 경신경고리(TE17), 미주신경(TE17), 안면신경 (TE18). 3) 혈(血) 관(管) : 천층에 척측정맥배측지(TE1, 2), 고유수장지동맥배측지(TE1), 배측중수골동맥배측지(TE2), 배측중수골정맥(TE3), 척측피정맥(TE4, 5, 6, 7, 8, 9, 10, 11), 배측정맥궁(TE4), 부요측피정맥(TE6, 8, 9),요측피정맥(TE10, 11), 후견봉정맥가지(TE13, 14), 후이개동 ${\cdot}$ 정맥(TE16, 17, 18, 19, 20), 전이개동 ${\cdot}$ 정맥(TE20), 천측두동 ${\cdot}$ 정맥(TE22, 23), 중층에 후상완회선동맥(TE14), 견갑배동맥(TE15), 견갑상동맥(TE15),천측두동 ${\cdot}$ 정맥(TE21), 관골측두동 ${\cdot}$ 정맥(TE23), 심층에 배측중수골동맥(TE3), 배측수근동맥궁(TE4), 후골간동맥(TE4, 5, 6, 7, 8, 9), 전골간동맥(TE6, 7, 9), 심상완동맥(TE10, 11), 상완동맥측부지(TE10, 11), 중간 측부동맥(TE12), 요측측부동맥(TE12), 심상완동맥가지(TE13), 후상완회선동맥(TE13), 견갑상동맥(TE14), 후두동 ${\cdot}$ 정맥(TE16, 17), 내경정맥(TE17). 결 론 : 1. 수소양삼초경근(手少陽三焦經筋)은 근육(筋肉), 그리고 관련(關聯) 신경(神經), 혈관(血管)으로 구성된다. 2. 본 연구(硏究)는 경근(經筋)에 관한 기존(旣存)의 연구(硏究)와 비교(比較)하여 볼 때에 경근(經筋)의 구성요소(構成要素)에 있어서 약간(若干)의 차이(差異)를 보여준다. 3. 해부학적(解剖學的) 연구결동(硏究結東), 경근(經筋) 근육(筋肉)을 지배(支配)하는 신경(神經)${\cdot}$혈관(血管)의 개념(槪念)과 경근(經筋)을 스쳐 지나가는 신경(神經)${\cdot}$혈관(血管)의 개념(槪念)은 구분(區分)된다.

• Journal of the Korean Society of Radiology
• /
• v.81 no.1
• /
• pp.166-175
• /
• 2020

Purpose This study aimed to compare the image quality and adverse events between Iopamidol 250 and Ioversol 320 usage during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Materials and Methods Medical records and hepatic angiography from 113 patients who underwent TACE with Iopamidol 250 (44 patients) and Ioversol 320 (69 patients) were retrospectively reviewed. Vessel perception on hepatic angiography was graded into three categories by two radiologists for hepatic subsegmental arteries, the right gastroepiploic artery, right gastric artery, and pancreaticoduodenal artery. Imaging concordance was assessed by comparing the number of detected HCCs on hepatic angiography and CT. The adverse events before and after hepatic angiography were evaluated. Results The mean vessel perception scores were 2.92 and 2.94 for Iopamidol 250 and Ioversol 320, respectively. The imaging concordance was 31 (70.5%) and 46 (66.7%) patients for Iopamidol 250 and Ioversol 320, respectively. There were no statistical differences in vessel perception or imaging concordance (p > 0.05). One and six patients experienced nausea for Iopamidol 250 and Ioversol 320, respectively. There was no statistical difference in adverse events (p = 0.24). Conclusion Iopamidol 250 can be used in hepatic angiography for TACE without significant difference in image quality or occurrence of adverse events from Ioversol 320.

• Advances in pediatric surgery
• /
• v.8 no.2
• /
• pp.143-155
• /
• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.4
• /
• pp.914-921
• /
• 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.

• The Korean Journal of Nuclear Medicine
• /
• v.37 no.5
• /
• pp.301-307
• /
• 2003

Purpose: Lipiodol is used for targeting liver cancers by administrating through the hepatic artery. In the present study, feasibility of Re-188-sulfur colloid suspension in lipiodol as a liver cancer targeting agent was investigated. Materials and Methods: Re-188-sulfur colloid was prepared, harvested by centrifugation, washed with organic solvent and then suspended into lipiodol. Biodistribution of Re-188-sulfur colloid in normal saline and its suspension in lipiodol in mice after 1 hr of injection through the tail vein were investigated. Biodistribution and autoradiography of tumor-hearing liver was acquired after 5 min post-injection into left ventricle of the tumor-inoculated rats. Results: After 1 hr of injection with Re-188-sulfur colloid suspensiob in lipiodol through the tail vein in normal mice (n=3), the uptakes in the liver and lung were $5.2{\pm}0.7\;and\;91.0{\pm}1.7%$ ID/organ, respectively. After 5 min of injection with Re-188-sulfur colloid suspention in lipiodol through the left ventricle in the tumor-inoculated rats (n=4), uptakes in the normal liver, hepatoma, and lung were $0.41{\pm}0.28,\;1.88{\pm}1.57,\;and\;1.65{\pm}1.54%$ ID/organ, respectively. And autoradiography of hepatoma showed increased uptake than normal liver tissues. Conclusion: Re-188-sulfur colloid suspension in lipiodol injected through the artery shows higher uptake in the hepatoma than normal liver tissue that indicates the feasibility as a new radiopharmaceutical for therapy of hepatoma.

• Archives of Plastic Surgery
• /
• v.36 no.1
• /
• pp.33-37
• /
• 2009

Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed between February 2005 and May 2008. Male to female ratio of the liver transplantation recipients was 3.4 : 1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92 mm and mean artery length was 24.25 mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re - anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

• Korean Journal of Veterinary Research
• /
• v.32 no.4
• /
• pp.511-521
• /
• 1992

The distribution of the hepatic arteries within the liver in 30 Korean native cattle were observed. Vinylite solution was injected into the hepatic arteries of 10 livers for cast preparation. The angiography was prepared in 20 livers by injected 30% barium sulfate solution into the hepatic arteries and then radiographed on X-ray apparatus. The results were summarized as follow ; 1. The hepatic arteries were divided into the Ramus (R.) sinister, R. dexter and R. intermedius. The intrahepatic arteries were derived from the R. sinister and R. dexter. The R. intermedius divided into the Arteria(A.) gastrica dextra, A. gastroduodenalis and A. cystica. 2. The right branch (ramus dexter) of the hepatic artery supplies the right lobe and caudate process. It consisted of the A. dorsalis lobi dextri, A. ventralis lobi dextri and A. lobi caudati. They formed one common trunk with three arteries(6 cases, 20%), and two arteries formed common trunk with the A. ventralis lobi dextri and A. lobi caudati (16 cases, 52.8%), or with A. dorsalis lobi dextri and A. lobi caudati (5 cases, 16.5%). The three arteries arose from the A. hepatia independently(3 cases, 10%). 3. The left branch (ramus sinister), larger than the right and often double (6 cases, 20%), supplies the caudate, quadrate and left lobes, and often gives origin to the A. gastrica dextra. 4. The branches of hepatic artery in the left lobe were derived from A. dorsalis lobi sinistri, A. ventralis lobi sinistri and A. intermedius lobi sinistri. The A. intermedius lobi sinistri were absent in some cases (3 cases, 10%). They almostly originated a single branch and often two branches. 5. The A. cystica arose from the R. intermedius(27 cases, 90%) and A. hepaica(3 cases, 10%). 6. The Rami processus papillarum arose from dorsal border of the Pars transversa of the left branch(19 cases, 62.7%), the left branch and right branch (9 cases, 30%) or A. hepatica(2 cases, 6.6%). 7. The A. lobi quadrata arose from either the Pars transversa of left branch (12 cases, 40%) or A. hepatica(4 cases, 13.2%). It also arose from both Pars transversa of left branch and A. ventralis lobi sinistri (3 cases, 10%). 8. The anastomosis on the branches of A. hepatica was observed in intrahepatic and cystic arteries. The left and right branches ramified several secondary radiating branches within the liver. 9. The hepatic arteries formed a very short common trunk of the right branch ($18.75{\pm}11.89$ : 2.20~44.8mm) and a long Pars transversa of the left branch($72.85{\pm}20.04$ : 28.2~104.1mm). 10. The ramified angles at the A. dorsalis lobi dextri, A. ventralis lobi dextri, A. lobi sinistri, A. ventralis lobi sinistri, A. lobi quadrata, A. cystica and Rami processus papillarum were 50-80, 270-300, 340-20, 120-160, 160-290, 200-230, 250~290, 230~280 and 80~120 degrees, respectively.

• Journal of radiological science and technology
• /
• v.36 no.2
• /
• pp.131-139
• /
• 2013

The aim of this study was to evaluate the variation which based on Celiac axis and SMA using by CT volume rendering images. 613 patients underwent abdominal CTA, there were 552 patients (99.05%, TypeI, II) with normal anatomical form and 61 (9.95%, Type III~XII) with variation. TypeI was 339(55.31%), Type II was 213 (34.74%), Type III was 18 (2.93%), Type IV was 12 patients (1.95%), Type V was 11 patient (1.79%), Type VI was 9 patients (1.46%), Type VII was 6 patients (0.97%), Type VIII was 1 patient (0.16%), Type IX was 1 patient (0.16%), Type X was 1 patient (0.16%), Type XI was 1 patient (0.16%), and Type XII was 1 patient (0.16%) into totally new types of variation. In conclusion, we could found 9 new types of variation by classifying based on celiac axis and superior mesenteric artery. These results were considered to be an important opportunity for a new vessel map.