• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.31-37
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• 2005

Purpose: To report our opinions of management about avascular necrosis following operative treatment of talar fracture and dislocation. Materials and Methods: We followed up 5 patients who were diagnosed as talar avascular necrosis after operation of talar fracture and dislocation. Clinical and radiological analysis were performed. The mean age of patients was 36 years. There were 4 males and 1 females. The average follow up was 51 months. Hawkins scoring system was used as clinical evaluation. Results: Regardless of radiological sclerotic finding, all patients showed satisfactory clinical result. Despite arthritic change in one patient, there were no further radiological and clinical deterioration to require salvage procedure. Conclusion: Most avascular necrosis after operative treatment of talar fracture and dislocation showed satisfactory result with conservative treatment. Thus, salvage operation such as talectomy or ankle fusion should be reserved in cases of intractable ankle pain and claudication.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.188-192
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• 2004

Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.711-715
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• 2001

Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.653-656
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• 2009

The entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities among young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomic relationships between vascular and musculo-tendinous structures in the popliteal fossa. An 18-year-old male visited our outpatient clinic with the chief complaint of claudication in his right calf. Three dimensional CT angiography showed an occlusion of the popliteal artery and less opacified arteries of the right leg. Intraoperatively, the popliteal artery was compressed by an accessory muscle band arising from the medial head of the gastrocnemius. After release of the muscle band, thrombectomy with endarterectomy was done. Three years after surgery, he is doing well without any problems.

• Journal of Chest Surgery
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• v.24 no.12
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• pp.1173-1184
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• 1991

This report is a review of 55 cases of peripheral arterial disease, who were treated at the department of thoracic and cardiovascular surgery, Masan Koryo General Hospital from January, 1986 to December, 1990. The result are summerized as follows ; 1. The incidence of peripheral arterial disease were as follows that : Arterial injury was in 21 cases(38.2%), arteriosclerosis oblitrans 18cases(32.7%), thromboembolism 9cases(16.4%), Buerger's disease was in 7cases(12.7%). 2. Overall male to female ratio was 6.8 : 1, the prevalent age was 3rd and 4th decade in arterial injury, 7th and 8th decade in atherosclerosis and thromboembolism and 5th and 6th decade in Buerger's disease. 3. The farmer was the first ranked occupation of these patients with chronic occlusive arterial disease, which was composed of 17 cases (68%). 4. 23 cases of patients with chronic occlusive disease has been smoking and most of them have been smoking over 10 years. 5. The clinical symptoms in acute and chronic arterial obstruction were pain, claudication, gangrene and coldness in order. 6. The duration of symptom of chronic arterial occlusive disease was less 1 years in 15 cases(60%). 7. The lower extremity were more affected than upper extremity in peripheral arterial disease. 8. The cause of arterial injury was traffic accident 9 cases(42.9%) stab wound 8 cases (38.1%), postangiography 2 cases(9.5%) and belt injury 1 case. 9. The etiologic factors of acute arterial occlusion was arterial fibrillation myocardial ischemia and postangiography in order. 10. Lumber sympathectomy in Buerger's disease, artificial bypass graft in atherosclerosis and thromboembolctomy in thromboembolism, end to end with vein graft in arterial injury were performed frequently. 11. Conclusively overall result was satis factory but 3 cases was below knee amputated after operation of chronic arterial occlusive disease.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.170-174
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• 1983

Aortic arch syndrome is an unusual disease entity characterized by the narrowing or obliteration of major branches of the arch of the aorta regardless of etiology. We have experienced 2 cases. One of them was 22 years old office girl with 3 months history of headache, intermittent syncope and weakness and claudication on left arm especially during her physical exercise. On physical examination, pulseless on left antecubital and radial artery and blood pressure on left arm was inable to check and coldness with weakness were noted on the same side. Aortic angiography reealed 34% narrowing of left subclavian artery as that of right. But both common carotid artery and both axillary arterial patency were relatively good. Through right supraclavicular and left axillary incision, bypass graft with Gore-tex prosthesis (I.D. 6mm, Length 25 cm) was implanted from right subclavian artery on 2cm distal to origin of right common carotid arery to left axillary artery distal to axillary fossa. End to side anastomosis with preservation of left subclavian artery was done. Postoperative state was stable with blood pressure of 110/70 mmHg on left arm and palpable antecubital and radial pulsation. Another one was 41 year old male patient with 8 months history of pain and numbness on right upper arm and shoulder. On admission, right arm blood pressure was 110/80 mmHg, left arm was 160/110 mmHg, but other physical findings had no abnormalities. Angiography revealed segmental narrowing of right axillary artery on the beginning with 2 cm in length. Operative treatment with right wupraclavicular and right axillary incision, bypass graft with great saphenous vein (Length; 15 cm) from right subclavian artery between scalenus anticus and medius to axillary artery at distal end of axillary fossa was done. The authors report two cases of Aortic arch syndrome treated with bypass graft using Autograft or Gore-tex with good result.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.371-374
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• 2003

Atherosclerosis has more than 60% of the causes of arterial occlusive diseases. The abdominal aorta and lower extremity arteries are the most common sites of occlusion. We have treated surgically 2 cases who had intermittent claudication and were diagnosed as simultaneous aortobifemoral and bilateral femoropopliteal obstruction by angiography, but had ineffective results from medical treatment or angioplasty. Simultaneously aortobifemoral bypass using Hemashield Y graft and bilateral femoropopliteal bypass using autologous greater saphenous vein were done. After operations, the symptom disappeared and there were no specific post-operative complications except abdominal wound dehiscence. In postoperative angiography, we had obtained good patency of bypass graft. We are following up patients through the out patient department without recurrence up to 16 months.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.120-124
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• 1988

Phenol sympathetic block is valuable for the treatment of ischemic pain, gangrene, intermittent claudication, Paget's disease of the bone and pain associated with pancreatitis, pancreatic carcinoma, etc. The author has experienced a case of successful lumber sympathetic block using 7% phenol under fluoroscopy and given to a patient with Buerger's disease who had severe pain and ulceration of the right great toe for several years. After the sympathetic block, 2 epidural blocks with 2.5% bupivacaine were done in order to augment the effects of this sympathetic block. Subsidence of rest pain, increase in walking distance from under 100 M to over 500 M and circulatory improvement of the affected limb were observed, Improvement of circulation was confirmed by strain gauge plethysmography.

• Journal of Acupuncture Research
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• v.17 no.3
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• pp.116-124
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• 2000

This clinical study was carried out 15 cases with lumbar spinal stenosis patients, who had been admitted and diagnosed by Computed Tomography from June, 1999 to May, 2000, in the department of acupuncture and moxibustion. Hanseo University Oriental Medical Nospital. The results obtained from this study were as follows; 1. We investigated 10 female and 5 male patients. The age distribution was from early 20's to 70's, among which 30's and 50's were most common. 2. The most common duration of symptom was less than a year(46.7%). 3. Regarding to the number of the involved levels, one was 12 cases(80%), two was 3 cases(20.0%). In the one level cases, L4~5 was the most common involved site. 4. Regarding to the clinical symptoms, low back pain was the most common, followed by lower extremity radiating pain, intermittent claudication, lower extremity paresthesia. 5. In orthopaedic examinations, positive sign in Milgram test was 80.0%, positive sign in straight leg raising test was 40.0%, and positive sign in Braggard test was 33.3%. Inneurologic examinations, sensory loss was seen in 60.0%, motor weakness and decreased deep tendon reflex were 26.7% in each. 6. According to clinical symptom scale proposed by Chae(1989), grade I1I was the most common (53.3%), followed by grade II, grade IV, grade I . 7. According to treatment outcome scale proposed by Chae(1989), Good was the most common (73.3%), followed by Excelleat, Fair and Poor.

• Journal of Acupuncture Research
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• v.18 no.2
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• pp.237-244
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• 2001

Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.