• Archives of Plastic Surgery
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• 제38권4호
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• pp.508-511
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• 2011

Purpose: Blue toe syndrome consists of blue or purplish toes in the absence of a history of obvious trauma, serious cold exposure, or disorders producing generalized cyanosis. It is a life-threatening and still underrecognized disease. It can be commonly occurred by vascular surgery, invasive cutaneous procedures or anticoagulant therapy. Our case is presented of blue toe syndrome related to atheromatous embolization that was presumably triggered by angio CT. Methods: A 69-year-old man presented with the suddenly developed pain, cyanosis and livedo reticularis of the toes in right foot. Dorsalis pedis pulses were palpable. He had been performed a diagnostic angio CT 1 month earlier. Angio CT revealed diffuse aortic atheromatous plaque in lower abdominal aorta and both common iliac artery. One month after angio CT, he visited our clinic. There was no visible distal first dorsal metatarsal artery and digital artery of right first toe in lower extremity arteriography. A diagnosis was established of blue toe syndrome. Because his symptom was aggravated, we performed the exploration of the right foot. After exposure of first dorsal metatarsal artery, microsurgical atheroembolectomy was done. Results: There were no postoperative complications. After three months the patient had no clinically demonstrable problems. Conclusion: Patient with blue toe syndrome is at high risk of limb loss and mortality despite treatment. Blue toe syndrome produces painful, cyanosed toes with preserved pedal pulses. It needs to be aware of blue toe syndrome. Careful history should reveal the diagnosis. Treatment is controversial, however, most believe that anticoagulation therapy should be avoided.

• Tuberculosis and Respiratory Diseases
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• 제64권6호
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• pp.451-455
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• 2008

저자들은 잘 조절되지 않는 당뇨병을 가진 75세 환자에서 혈관을 침범한 폐 모균증으로 인해 항진균제와 수술적 치료를 시행하였으나 진행되는 다발성 괴사로 인한 객혈로 사망한 폐 모균증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제47권2호
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• pp.106-110
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• 2014

Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

• Journal of Hospice and Palliative Care
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• 제12권1호
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• pp.27-31
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• 2009

목적: 림프부종은 림프계 이상으로 림프액 이동이 원활하지 못하여 생기는 팔다리 조직의 팽창을 의미한다. 현재 가장 효과적인 치료법은 복합적인 림프부종 치료법이지만 이 치료는 수술적 치료가 요구되는 환자에게는 효과가 없다. 이번 연구에서는 물리 치료법에 실패한 환자의 피하 지방조직에 비침습적 바늘 흡인술을 실시하여 그 효과를 알아보고자 하였다. 방법: 2003년 8월 1일부터 2004년 2월 28일까지 일개대학 병원 림프부종 클리닉에 방문하여 상하지 림프부종 2${\sim}$3기를 진단받은 환자를 대상으로 실시하였다. 모든 환자는 1년 이상 복합적인 림프부종 치료법을 실시하였으나 치료에 반응이 없었으며 9명의 환자는 유방암, 12명의 환자는 자궁경부암 환자였다. 치료 전 자기공명영상(MRI)을 실시하여 부종이 가장 심한 부위를 찾아 바늘 흡인술을 실시한 후 3개월 동안 추적 관찰하였다. 치료의 효과는 치료 전과 치료 3개월 후 부종 부피를 계산하여 Wilcoxon signed rank-test를 통해 비교하였다. 결과: 치료 전과 치료 3개월 후의 평균 부종 감소율은 29.1%였다(P=0.001). 국소적 출혈 이외 다른 특별한 부작용은 없었다. 결론: 바늘 흡인술은 복합적인 림프부종 치료법에 반응이 없는 림프부종 2, 3기 환자에게 수술에 앞서 고려해볼 수 있는 안전하고 효과적인 방법이다.