• Journal of Yeungnam Medical Science
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• v.28 no.1
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• pp.99-104
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• 2011

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.

• Clinical and Experimental Reproductive Medicine
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• v.13 no.2
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• pp.175-180
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• 1986

It has been reported that oral kallikrein therapy exerts a favourable effect on sperm motility in asthenozoospermic patients. In order to evaluate the efficacy of kallikrein on asthenozoospermia, a total of 20 subfertile male patients with varicocele, whose sperm counts were less than $40{\times}10^6/ml$ and sperm motility was less than 30%, was subjected to this clinical study (Table 1). They were divided into 2 study groups: 1) Varicocelectomy group consisted of 10 patients with varicocele (grade II-III) who underwent varicocelectomy. 2) Kallikrein group was composed of 10 patients with varicocele (grade I) who were given kallikrein orally 600 KU (kallikrein unit) daily divided 3 times after meal for 3 to 9 months. Semen analyses were repeated twice before the study, once a month during the study and twice after the study. Effective results designate that sperm parameters improved more than 30% from the basical levels after varicocelectomy or kallikrein exposure. Sperm counts increased from $32.5{\times}10^5/ml$ to $45.5{\times}10^6/ml$ after varicocelectomy in 3 patients and sperm motility increased from 25% to 38.5% after varicocelectomy in 3 patients. Pregnancy occurred in 2 patients of 3 responders and 1 patient of 7 non-responders 3 to 6 months after varicocelectomy in Varicocelectomy group. Sperm motility increased from 28% to 40.2% after kallikrein treatment in 3 patients. Pregnancy occurred in 2 patients of the 3 responders in Kallikrein group (Tables 2-3). There were no significant changes in volume and morphology in Varicocelectomy group before after varicocelectomy and no significant changes in volume, counts, and morphology before and after kallikrein exposure. No remarkable side effects were noted with kallikrein treatment.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.760-766
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• 2021

Objectives: This study investigated the effectiveness of Dong's acupuncture for pain associated with a varicocele. Methods: A 23-year-old male patient visited for pain due to varicocele that occurred on March 2 and was treated with acupuncture and moxibustion three times on March 16, 17, and 19. The Numerical Rating Scale (NRS) was used to evaluate the patient's pain. Results: After the three treatments, the NRS scores decreased, and the patient's subjective symptoms improved. Also, the patient required no medication for a week from the date of treatment start. Conclusions: These findings demonstrate that Korean medicine may be an option for treating a painful varicocele, but further research is required for confirmation.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.916-922
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• 2021

Objectives: This study aimed to determine whether Korean medicine could improve unilateral testicular pain caused by recurrent varicocele without unfavorable side effects. Methods: A 46-year-old man diagnosed with varicocele, identified with a scrotal ultrasound scan, had right-side testicular pain. We administered Banchong-san and Eunhoebanchong-san to observe changes in the degree of pain. Results: After one month of taking Banchong-san and Eunhoebanchong-san, testicular pain improved. Conclusion: This study suggests that Korean medicine might be effective for managing testicular pain caused by varicocele.

• Proceedings of the Korea Water Resources Association Conference
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• 2005.05b
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• pp.1148-1153
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• 2005

하수관거는 국민의 정맥이라고 할 수 있을 정도로 도시의 환경관리와 치수, 쾌적한 환경조성에 있어서 매우 중요한 시설이며 그 규모가 광범위하고 복잡한 네트워크로 구성되어 있다. 이러한 하수관망을 통해 이송되는 물은 지저분하고 냄새가 심하기 때문에 지하에 관의 형태로 대부분 시공되어 왔으며, 상수관망처럼 압력관이 아니라 대부분 중력에 의한 이송방식을 채택하고 있어 문제 발생 시 원인파악과 대처를 힘들게 하는 요인을 가지고 있다. 특히 하수관거의 관리 소홀은 곧바로 토양오염과 인근 환경오염으로 직결되며 장기적으로는 상수를 오염시키는 요인으로 작용하므로 체계적인 방법과 장기적인 안목을 가지고 명확한 분석을 시행할 수 있는 시스템을 가지고 최적으로 유지관리 되어야 한다. 최근 들어 이러한 하수도 시설을 효율적으로 관리 및 개선하기 위해 대도시를 중심으로 근거 조사와 정비 사업이 활발히 시행되고 있다. 그러나, 사업효과를 검증하거나 관로의 유지관리를 위하여 국내 실정에 맞지 않는 외국하수관망 흐름 해석 프로그램을 그대로 사용하고 있고 정확한 해석이 이루어지지 않고 있어 효율적인 유지관리가 어렵다. 이와 같은 문제점을 해결하기 위하여 하수관망해석이나 하수관망 정비시 필요한 불명수산정이 가능하고 국내실정에 맞는 프로그램 개발이 시급한 실정이며, 아울러 프로그램을 효율적 운영하고 관리하는 제어관리 기술을 개발, 진행하고 있다. 본 논문에서는 개발된 프로그램의 부정류 해석 기능을 활용하여 대상구역의 해석을 실시하여 기존분석방법의 I/I결과와 비교하였으며 최적관리를 위한 방안을 제시하였다.준편차가 증가하고 있음을 알 수 있다. 본 연구에서는 상용 CFD모형인 FLOW-3D를 계획 중인 하수처리장의 침전지 유입부 설계에 적용하였으며 저류벽의 위치와 폭, 유공정류벽의 유공율에 따른 유입하수의 분배효과를 분석하였다. 실험을 수행하여 보다 정밀한 공식으로 개선할 수 있었다.$10,924m^3/s$ 및 $10,075m^3/s$로서 실험 I의 $2,757m^3/s$에 비해 통수능이 많이 개선되었음을 알 수 있다.함을 알 수 있다. 상수관로 설계 기준에서는 관로내 수압을 $1.5\~4.0kg/cm^2$으로 나타내고 있는데 $6kg/cm^2$보다 과수압을 나타내는 경우가 $100\%$로 밸브를 개방하였을 때보다 $60\%,\;80\%$ 개방하였을 때가 더 빈번히 발생하고 있으므로 대상지역의 밸브 개폐는 $100\%$ 개방하는 것이 선계기준에 적합한 것으로 나타났다. 밸브 개폐에 따른 수압 변화를 모의한 결과 밸브 개폐도를 적절히 유지하여 필요수량의 확보 및 누수방지대책에 활용할 수 있을 것으로 판단된다.8R(mm)(r^2=0.84)$로 지수적으로 증가하는 경향을 나타내었다. 유거수량은 토성별로 양토를 1.0으로 기준할 때 사양토가 0.86으로 가장 작았고, 식양토 1.09, 식토 1.15로 평가되어 침투수에 비해 토성별 차이가 크게 나타났다. 이는 토성이 세립질일 수록 유거수의 저항이 작기 때문으로 생각된다. 경사에 따라서는

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.901-906
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• 2005

Kawasaki disease (KD) is a leading cause of acquired heart disease in children. Yet the etiology of KD is still unknown and diagnosis depends on the exclusion of other diseases and the clinical manifestations meeting the defined criteria. Young infants frequently show atypical clinical courses and are frequently complicated with coronary aneurysms. Some cases show thrombocytopenia, which is known as one of the risk factors for complications with coronary aneurysms. So, a high index of suspicion is the most important factor for the diagnosis of KD in very young infants or adolescents whose clinical courses are equivocal. We report herein on a case of KD in an 80-day-old female infant with fever and seizure with bloody stool; laboratory findings were those of sepsis with disseminated intravascular coagulopathy. In spite of aggressive treatments, fever and thrombocytopenia persisted for two weeks and huge coronary aneurysms developed at the third week in all three major coronary arteries; the diameter of the right one was as large as the aortic annulus. Three months later, huge pulsatile masses developed in both axillas; these were found to be huge axillary aneurysms defined very clearly on multi-detector CT scan. She has been under follow up with antiplatelets and anticoagulation therapy with poor regression of the aneurysms.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.609-615
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• 2005

Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.44-53
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• 1992

We compared the efficacy of each modality of treatment group in reducing the frequency of coronary artery abnormalities and changes of clinical courses in children with kawasaki disease in the children of 81 cases who were admitted in pediatric department of Yeungnam University Hospital from September 1985 to August 1990, Group A(37 cases)-aspirin alone, Group B(44 cases)-intravenous gammaglobulin(400mmg/kg/day) for 5 consecutive days, plus aspirin. We studied the frequency of echocardiographic abnormalities, the duration of fever, and changes in the total white blood cell counts, platelet counts, ESR and CRP value at 1, 2 and 3 weeks of the illness and compared the results between the two groups. The results were as follows, 1) There as no significant intergroup difference in age and sex ratio. 2) The duration of the febrile period after the initiation of the therapy was significant shorter in group B($2.5{\pm}1.2$ days) than in group A:($5.2{\pm}3.5$ days)(p<0.01). 3) No significant difference was noticed in the WBC and platelet counts in two groups as measured at admission day, 1 and 2 weeks of the illness. However, at 3weeks of illness significant difference was noted. 4) The CRP values measured at 1, 2 and 3 weeks after treatment were significantly lower in group B($2.42{\pm}1.8$, $2.00{\pm}1.2$, $1.16{\pm}1.0$) than in group A($7.22{\pm}5.3$, $5.25{\pm}3.9$, $1.85{\pm}1.2$) respectively(p<0.01). 5) In 2D- Echocardiogram, coronary artery dilataton was more frequent in Group A than in Group B at 6month of illness(p<0.01). In conclusion, intravenous gammaglobulin therapy was effective in the shortening of the duration of fever and in the antiinflammatory action and somewhat effective in prevention of coronary artery aneurysm.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.480-484
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• 2007

Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.760-769
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• 1997

This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.