• Title/Summary/Keyword: 척추기저동맥부전

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Bow Hunter's Syndrome Caused by Bilateral Dynamic Occlusion of the Subaxial Vertebral Arteries during Neck Extension (경추 신전 시 축하 척추동맥의 양측성 동적 폐쇄로 인해 발생한 보우 헌터 증후군)

  • Yi, Jemin;Han, Ho Sung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.85-89
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    • 2020
  • Bow hunter's syndrome is a rare disease that shows the symptoms of vertebrobasilar insufficiency resulting from a dynamic obstruction or stenosis of the vertebral arteries during neck movement. This paper reports a case of a 59-year-old male who visited the emergency room with diplopia, tinnitus, and gait disturbance. Magnetic resonance imaging and angiography revealed a multiple cerebellar infarct, total obstruction of the right vertebral artery, and dynamic obstruction of the left vertebral artery during neck extension. As the infarction worsened, a thrombectomy was done. Posterior decompression and fusion at C5-6 were performed for the left vertebral artery. The left vertebral arterial patency was confirmed by intraoperative and postoperative angiography. No recurrence of the symptoms was observed for six months after surgery. Physicians need to pay attention to the diagnosis of vertebrobasilar insufficiency caused by an obstruction of the vertebral arteries during neck extension in cervical instability patients.

A case of the patient treated with Chunmagudung-um who was diagnosed with Vertebrobasilar insufficiency (척추기저동맥부전환자를 천마구등음(天麻鉤藤飮)으로 치료한 치험 1례)

  • Song, Cheol-Min;Chang, Tong-Young;Rhim, Eun-Kyung;Lee, Yun-Jae;Lee, Jung-Sub;Shin, Sun-Ho;Lee, In;Moon, Byung-Soon;Jeong, Hyun-Ae
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.699-707
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    • 2005
  • Vertebrobasilar insuffciency(VBI) is also refered to as vertebrobasilar transient ischemic attack(V-B TIA). Vertebrobasilar insufficiency is often undiagnosed or misdiagnosed due to complexity of the symptoms. Transcranial doppler(TCD) can be used to possible to record the blood flow velocities in the cerebral arteries through the intact cranium. Transcranial doppler and magnetic resonance angiography(MRA) are both noninvasive techniques that can be used in vertebrobasilar insufficiency, but transcranial doppler is more sensitive with respect to evaluating stenotic lesion of the arteries than magnetic resonance angiographv. Diagnostic values of transcranial doppler were assessed in patients with vertebrobasilar insufficiency. A case of vertebrobasilar insufficiency is here reported. A 62-year-old man with dizzness, nausea and tremor because of vertebrobasilar insufficiency was admitted at Wonkwang Oriental Medicine Hospital. He was treated with the herbal medicine Chunmagudung-um and with acupunture. Results showed improvement of symptoms and favorable transcranial doppler readings. The process used in this successful treatment is here described.

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Long-term oxygen therapy in patients with chronic respiratory failure in one university hospital (호흡부전환자의 재택산소치료 실태: 한 대학병원에서의 관찰)

  • Huh, Jin Won;Lee, Jung Yeon;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.160-166
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    • 2005
  • Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.