• 제목/요약/키워드: Buerger's disease

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"상한론"에 나타난 계(悸)와 관련된 처방들의 현대 질환 범위 고찰 (Study on Diseases Scope of Prescriptions Related with the Palpitation in "Shanghanlun")

  • 박미선;김영목
    • 동의생리병리학회지
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    • 제29권1호
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    • pp.1-10
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    • 2015
  • This article is a study on palpitation of which disease cause, disease mechanism and formulas were analyzed with reference to annotations on "Shanghanlun" and "Jinkuiyaolue". And the scope of modern diseases related with palpitation was drawn by research on clinical papers. The source books are "Zhujieshanghanlun" and "Jinkuiyaoluefanglun" and the clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). 13 clauses in "Shanghanlun" and 9 clauses in "Jinkuiyaolue" and 12 formulas are related with palpitation. Disease mechanisms of palpitation were classified as yang deficiency, yin deficiency, qi deficiency, blood deficiency, retained fluid, cold, etc and these days, qi stagnation, phlegm turbidity, blood stasis and fire heat are also considered as disease mechanisms. Modern diseases related with palpitation are arrhythmia(extrasystole, atrial fibrillation, bradycardia, tachycardia, sick sinus syndrome, atrioventricular block), vascular diseases(arterial occlusion, phlebothrombosis, Buerger's disease, coronary artery disease, vasculitis), blood pressure disorder(hypertension, hypotension) and heart diseases such as heart failure, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy, pericardial effusion. And diseases related with psychological change(cardiac neurosis, anxiety neurosis, neurosis, depression, hyperthyroidism, hypothyroidism), pyrexia, anemia, drug intoxication, etc are also related with palpitation. Zhen Wu Tang showing an efficacy in dilating blood vessels and strengthening cardiac function, Wuling Powder with diuretic effect and Fried Glycyrrhizae Decoction acting on the ${\beta}$ receptor are applied to heart failure in different ways. Fried Glycyrrhizae Decoction(308 cases), Zhen Wu Tang(154), Wuling Powder(54), Xiao Chaihu Tang(34), Sini San(20) are reported to have been clinically applied to cardiovascular diseases and Zhen Wu Tang and Wuling Powder mainly applied to heart failure, Fried Glycyrrhizae Decoction, Lizhong Wan, Sini San and Zhen Wu Tang chiefly applied to arrhythmia related diseases. This study focuses on the general research and consideration on clinical applications and is a preliminary study to understand relations between Korean Medicine's symptoms and categories of modern diseases.

혈관수술에 대한 임상적 고찰 (Clinical Experience with Vascular Surgery)

  • 김현경
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1570-1577
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    • 1992
  • The vascular surgery is the field that has developed in early 20 century and is progressing nowadays. Recent advance in surgical technique accompanying with excellent medical diagnosis and treatment, prompt angiographic usage, development of variable prosthetic material, and concomitant use of anti-coagulant have made remarkable results of vascular surgery. 83 cases of vascular surgery have been performed at Thoracic and Cardiovascular Surgery Department of Pusan National Unversity Hosaital since 1971 till 1990, for 20 years and their results are followed. Patient ductus arteriosus and Buerger`s disease were omited in this study. 1. The age distribution shows that the fifth and sixth decades are most frequently affected and mean age was 56.1 years old. Male to female ratio is 1: 2.32. 2. Among the 83 cases of all, number of occlusive vascular disease is 46 and that of aneurysmal disease is 33. 3. In clinical manifestation, most common symptom of occlusive disease is pulselessness and pain was next. Mass sensation is most commonly complained by patients of aneurysmal disease. 4. CT scan was more important in diagnosis of aneurysmal diseases and angiogram was more commonly used in occlusive diseases. 5. The common site of arterial occlusion was common iliac artery, femoral artery, aortic bifurcation, and external iliac artery, as its frequency rate. The most commonly affecting portion of aortic aneurysm was abdminal aorta, and descending thoracic aorta and femoral artery were next 6. Preoperative associated diseases were atherosclerosis[41 cases], hypertension[21 cases], valvular heart disease[11 cases], and diabetes mellitus[9 cases], etc, 7. Operative methods in ocllusive diseases were thrombectomy[36.9%], endarterectomy [10.9%], and bypass graft insertion[52.7%]. Among the bypass graft, Y-graft was used in 7 case, straight graft was used in 17 cases, and saphenous venous graft was used in 2 cases. 8. Postoperative complications were developed in 17 cases, and morbidity rate was 36. 9. Eleven patient were died within 1 month after operation, so operative mortality rate was 13.3%. 10. Duration of patency was beteween 7 and 58 months[average 27.5 months] in occlusive diseases and their 5-year patency rate was 56.3%. Duration of patency of aneurysmal disease was 20 months in aveage and their 5-year patency rate was 51.3%. 11. Patients of eleven cases of occlusive disease and two cases of aneurysmal disease required reoperation for variable reason. 12. 35 cases of patient have used anticoagulants: coumadin, ticlid, and persanthin-ASA combination.

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통증치료실 환자의 임상통계적 고찰 (A Clinical Survey of Patients of Pain Clinic)

  • 장영호;이정구;전재규;정정길
    • The Korean Journal of Pain
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    • 제8권1호
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    • pp.103-109
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    • 1995
  • The pain clinic in our institution opened on of June, 1984. since then until December 1994, we have had 1,741 patients who had been treated on an out-patient basis. The patients were analysed retrospectively according to their sex, age, and retrospective disease. There were 969 male(55.7%) and 772 female patients(44.3%) In the age distribution of the patients, the highest incidence was in the forties with 463 patients(26.6%). The second highest age incidence was in the thirties with 357 patients(20.5%), and the third highest age incidence was in the sixties with 341 patients(19.6%). In this figure, there were 203(26.6%) stomach cancer patients, 135(17.7%) cervix and uterine cencer patients, 81(10.6%) colorectal cancer patients, 74(9.7%) hepatoma patients, and 68 (8.9%) pancreatic cancer patients. The patients with non malignant chronic pain numbered 977(56.1%). In this figure, there were low back pain of 188(19.2%), sudden deafness of 17.5%, Buerger's disease of 63(6.5%) and postherpetic neuralgia of 56(5.7%).

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하지동맥 폐쇄질환의 외과적 고찰 (Results of Revascularization in Ischemic Lower Extremities)

  • 이두연
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.58-67
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    • 1986
  • Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.

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하지 혈행장애의 임상적 고찰 (Clinical Analysis of Arterial Occlusive Disease in the Lower Extremity)

  • 서정욱;조은희
    • Journal of Chest Surgery
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    • 제29권8호
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    • pp.889-896
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    • 1996
  • 하지 동맥 혈관의 폐쇄로 인한 급,만성적인 하지 허혈은 혈관우회술이나 혈전제거술등의 적극적인 수술을 시행함으로 점차 좋은 경과를 얻고있다. 동아대학교 병원 흉부외과학 교실에서는 하지 허혈의 임상적 양상과 수술 결과를 살펴보고자 1990년 3월부터 1995년 8월까지 5년 5개월동안 101명의 환자를 대상으로 수술을 하여 이를 분석하였다. 연령 및 성별 분포는 25세에서 87세이고 남자가 92례, 여자가 9례로써 약 101로 남자에서 많았다. 이들 환자의 동맥폐쇄질환에 관계있는 병인에는 동맥경화성 협착이 54례, 혈전색전증이 21례. 버거씨병이 20례, 외상에 의한 동맥 폐쇄가 3례, 가성동맥류가 3례였다. 동맥경화성 협착에서 주 폐쇄부위는 대퇴동맥 폐쇄가 30례, 장골동맥 폐쇄 23례, 슬와 동맥 폐쇄 10례, 대동맥 분지부 6례. 경골동맥 폐쇄였고, 버거씨 병에서는 후경골동맥 폐쇄 14례, 전 경골동맥 폐쇄 8례. 슬와동맥 폐쇄 5례. 대퇴동맥과 비골동맥이 각각 2례 였다. 혈관 폐쇄로 인한 하지 혈행장애의 수술은 동맥경화성 협착에서 혈관우회술이 61례. 혈전 제거술 24 례, 교감 신경절제술 20례였다. 동맥경화성 협착 환자에서 혈관우회술을 시행한 苛\ulcorner61례로써 이중 대퇴동맥과 슬와 동맥간의 우회술이 21례, 대퇴동맥과 반대편 대퇴동맥간의 우회술이 15례. 맥와 동맥과 양측 대퇴동맥간의 우회술이 7례, 하복부 대동맥과 양측 대퇴동맥간에 Y graft를 이용한 우회술이 3례였 4술후 이식혈관에 대한 개존율은 전체적으로 술 후 1년에 83.6%. 2년에 77.1%. 3년에 75.5%의 결과를 보였고 하지 보존율은 86.8 %였다. 하지혈행장애의 모든 환자에서 수술후 사망은 6명이었는데 사망 원인은 급성 신부전증, 다장긴 기능 부전, 그리고 패혈중이었다.

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경막외 카테테르 거치후 발생한 척수경막외 농양 -증례 보고- (Epidural Abscess Following Epidural Catheterization -Two cases-)

  • 박장훈;강승관;한영진;최훈
    • The Korean Journal of Pain
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    • 제9권2호
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    • pp.434-438
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    • 1996
  • Epidural abscess is associated with placement of epidural catheter is very rare. We experienced two cases of epidural abscess formation after placement of epidural catheter for pain management. A 63 years old female patient received thoracic epidural catheterization for management of pain due to herpes zoster on right T4 dermatome. Two weeks after catheterization, she complained of paraparesis and anesthesia below $T_4$ dermatome. Four weeks later magnetic resonance images was performed and revealed epidural abscess on $T_2-T_5$. Emergent decompressive laminectomy was performed but neurologic symptoms were not improved. In other case, a 75 years old male patient received lumbar epidural catheterization for management of Buerger's disease. About on month later, pus was aspirated from lumbar epidural space. But further evaluation could not be achieved because he wanted to discharge against advice. We emphasize that epidural abscess results sequele serious and prompt diagnosis and treatment is important.

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Searching for Hidden, Painful Osteochondral Lesions of the Ankle in Patients with Chronic Lower Limb Pain - Two Case Reports -

  • Ri, Hyun Su;Lee, Dong Heon;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • 제26권2호
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    • pp.164-168
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    • 2013
  • It is easy to overlook osteochondral lesions (OCLs) of the ankle in patients with chronic lower limb pain, such as complex regional pain syndrome (CRPS) or thromboangiitis obliterans (TAO, Buerger's disease). A 57-year-old woman diagnosed with type 1 CRPS, and a 58-year-old man, diagnosed with TAO, complained of tactile and cold allodynia in their lower legs. After neurolytic lumbar sympathethic ganglion block and titration of medications for neuropathic pain, each subject could walk without the aid of crutches. However, they both complained of constant pain on the left ankle during walking. Focal tenderness was noted; subsequent imaging studies revealed OCLs of her talus and his distal tibia, respectively. Immediately after percutaneous osteoplasties, the patients could walk without ankle pain. It is important to consider the presence of a hidden OCL in chronic pain patients that develop weight-bearing pain and complain of localized tenderness on the ankle.

폐쇄성 혈관 질환을 가진 환자의 고식적 치료에 관한 임상적 고찰 (Clinical Analysis of Palliative Treatments in Occlusive Vascular Disease)

  • 김학제;조원민;류세민;황재준;송영상;최영호
    • Journal of Chest Surgery
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    • 제35권4호
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    • pp.283-289
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    • 2002
  • 배경: 폐쇄성 혈관 질환을 가진 환자에서 폐쇄된 혈관 자체의 문제를 해부학적으로 해결하기에는 환자의 상태나 병변의 종류, 수술 위험도 등이 문제가 된다. 이때 환자의 연령이나 상태에 따라 선택할 수 있는 고식적인 치료 방법으로 extra-anatomic bypass나 교감신경 절제술 등이 있다. 우리는 이러한 고식적 치료의 장기 성적과 적응증에 관하여 관찰하고자 하였다. 방법: 1996년부터 2000년까지 고식적 치료가 필요했던 폐쇄성 혈관 질환을 가진 38명의 환자를 대상으로 수술의 결과를 후향적으로 고찰하였다. 남자가 32명, 여자가 6명 이었으며 평균 연령은 60.37$\pm$17.65세이다. 이 중 원인 질환으로는 동맥경화증이 32명으로 가장 많았으며, Buerger씨 병이 4명, Raynaud씨 증후군과 상대정맥 증후군이 각각 1명씩이었다. 결과: 수술은 extra-anatomic bypass가 40회, 요추 교감신경 절제술이 17회, 혈전제거술이 7회, 대퇴동맥 혈관 간치술이 1회 등이었고, 혈관 우회술 없이 요추 교감신경 절제술 혹은 혈전 제거술만을 시행한 환자는 7명이었다. 수술 후 6명에서 재수술이 필요하였는데, 이 중 5명은 원위부 혈류 폐쇄 혹은 약화로 발목 관절이나 족지 절단 혹은 요추 교감신경 절제술을 시행한 경우이었고, 1명은 혈관 우회술 1달 후에 인조혈관 원위부의 동맥류가 발생하여 다시 우회술이 필요한 경우였다. 폐쇄성 혈관 질환에 대한 고식적 치료 3년 후의 1차 혈관 개통률은 78.29 $\pm$ 3.81%이었으며, 수술 방법과 혈관 개통률 사이의 통계적 유의성은 없었다. 결론: 여러 논란에도 불구하고 폐쇄성 혈관 질환 환자의 일부에서는 여러 고식적 수술이 이루어지는데, 적절한 환자의 선택과 수술 전후의 적절한 환자 교육, 추적 관찰이 이루어진다면 좋은 결과를 얻을 수 있을 것으로 생각된다.

거머리 요법에 대한 연구동향 (The literature review of Leech therapy)

  • 장효길;허동석
    • 대한약침학회지
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    • 제13권1호
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    • pp.103-120
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    • 2010
  • Objective : To review the trend of the study related to Leech therapy and to establish the hereafter direction for the study on Leech therapy. Methods : I reviewed and analyzed all the theses published in Domestic and Foreign research institution from 1990 to 2009. Results : The following results were obtained in this study. 1. Analyzed number of theses published, there was no significance per year. 2. Classified by theme of journal, journals related to surgery were most(41 journals, 75.92%) among 54 kinds. 3. Classified by theses by research method and thesis types, case report accounted for nearly twothirds (52 pieces, 68.42%) of all theses and consideration of document was next(9 pieces, 11.84%). 4. With the most case of venous congestion after plastic and reconstructive surgery(33 pieces, 63.46%), leech therapy was effective on illnesses such as haematoma, macroglossia, purpura, varicous vein, avulsion injury, neurovascular compression, diabetic neuropathy, penoscrotal oedema, buerger's disease, rheumatoid arthritis. 5. Two most appeared adverse effects were anemia and infection. Immediate blood transfusion was done for recovering anemia and prophylactic 3rd generation antibiotics to infection were emphasized in more than half of case reports. 6. All of consideration of documents was retrospective study of cases related leech therapy and 3 pieces of them emphasized prophyratic antibiotic treatment for preventing infection. 7. The study of clinical trail type started first in 2002 and osteoarthritis of knee and carpometacarpal joint were main target. As see above result, Leech therapy was effective cure and could be used in disease induced by venous congestion. And I think that it is necessary to perform additional study related to solution of problems about leech therapy and protocol for using in clinical practice.