• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.257-260
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• 2009

Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis (EDAS) is very rare. The effect of revascularization surgery for preventing hemorrhagic event of moyamoya disease remains controversial. We report a 17-year-old female with intracerebral hemorrhage and intraventricular hemorrahge 10 years after successful EDAS. Even though cerebral vessels angiography showed good collateral circulations without specific weak points, a cerebral hemorrhage could occur in patient with ischemic type of moyamoya disease long after successful indirect bypass operations. Good collateralization of cerebral angiography or magnetic resonance perfusion image after indirect bypass surgery would ensure against ischemic symptoms, not a hemorrhage. And, thus a life-time follow-up strategy might be necessary even if a good collateral circulation has been established.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.210-217
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• 1993

To compare the myocardial viability in patients suffering from total occlusion of the right coronry artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) ($300{\sim}350{\mu}Ci$) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA ($200{\sim}250{\mu}Ci$) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar & SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 injection. Intravenous T1-201 reinjection (six pts) or $^{99m}Tc-MIBI$ (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201 (IV T1-201) images, ECG, and ventriculography. Intracoronary T1-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

• Journal of Korean Medical classics
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• v.26 no.4
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• pp.71-87
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• 2013

Subject : The physiological characteristic of Eight Extra Meridians. Objective : This study research physiological characteristic of Eight Extra Meridians that differentiate from the physiological characteristic of Twelve Regular Meridians. Method : First, we researched the meaning of "There are Eight Extra Meridians and they don't be arrested by Twelve Regular Meridians" in Nanjing 27Nan compared with the contents of regular Meridians circulation in Huangdineijing. Second, we studied on the origin of Eight Extra Meridians and researched their route. Third, from these researches we drew some physiological characteristics of Eight Extra Meridians. Conclusion : In Huangdineijing, the regular Meridians circulation include the route of Governor Meridian, Conception Meridian, and Heel Meridian. So the sentence in Nanjing 27Nan is contradictory to the contents of Huangdineijing. The origin of Eight Extra Meridians could be found in Huangdineijing. The collateral Meridians of the Uterus and Epiglottis Meridian are specifically formulated to supplying for the Uterus or Epiglottis. Eight Extra Meridians have third qualities of Meridian, collateral Meridian, and the solid viscera keep the Essence Gi, so named 'Extra'. And they have an intimate association with Extraordinary Organs. They place at the middle axis of human body, thus do higher physiological function that control and regulate the function of Twelve Regular Meridians and Five Viscera & six Bowels for adaptation to the environment.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.109-116
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• 1974

Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.13-18
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• 2001

Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

• Journal of Korean Medical classics
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• v.19 no.2 s.33
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• pp.30-45
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• 2006

Analyzed the subject of ‘To heart' meridian system(向心服系), and 'Circulating' meridian system(備環服系), and considered relativity between the circulating pattern of the channels, the collaterals and the circulating distinction YoungGi (營氣), WiGi(衛氣). The subject of 'To heart' meridian system is WiGi, and this system is similiar to the moving pattern of the fifteen major collaterals(十五絡服). The subject of 'Circulating' meridian system is YoungGi, and this system is same with the moving pattern of the twelve regular channels(十二經脈). YoungGi and WiGi have the same origin, and they are intrinsic one thing with functional ambivalency. It is WiGi, the subject of the movement of Collateral, because it is identical the moving pattern of Collaterals(絡服) and that of WiGi as the subject of the movement of Collateral. It is YoungGi, the subject of movement of Channel because it is identical the moving pattern of Channels(經服) and that of YoungGi. It can be defined that Wigi as the subject of the movement of Collateral, also YoungGi as the subject of movement of Channel, but that is from i 염 function and action, there's no need to be separated within the framework of going through Meridian. YoungSuBosa(迎隨補鴻) in acupuncture, defines its basis not only on the moving direction of YoungGi, but on combinated difference between the directions, moments, and sex. Until now it is under discussion the rights and wrongs, It's not contradictory concept between two basis of YoungSuBoSa, from the thought the distinct movement of WiGi and the circulation pattern of Collaterals have no specified directions.

• Korean Journal of Acupuncture
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• v.31 no.1
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• pp.1-4
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• 2014

Objectives : The capillary destruction has frequently been used to treat telangiectasia in Korean Medicine. The objective of this study was to review of related literature concerning the capillary destruction as treatment for telangiectasia, and to discuss the clinical application of medical devices in accordance with the principles of Korean Medicine. Methods and Results : An extensive traditional literature including Huangdi Neijing were reviewed for identification of relevant evidence for treating telangiectasia. The telangiectasia is simply defined as a dilated, superficial blood vessel. It is called as the tertiary collateral vessel, superficial collateral vessel or Hyulrak(small superficial collateral vessel). The telangiectasia could be due to disturbances in the circulation of qi and blood. According to Huangdi Neijing, one of the oldest traditional literature published in 4th century B.C. through the first century A.D., it is needed to get rid of the vessel by the capillary destruction for treating telangiectasia using lance needle, shear needle, stiletto needle or moxibustion. Several studies have examined that intense pulsed light or laser as new therapeutic tools could have an sufficiently impact on aspects of improving the effectiveness of the capillary destruction. Conclusions : The capillary destruction for the treatment of telangiectasia has been used since two thousand years ago. We suggested that medical devices, such as intense pulsed light or laser, should be used to treat telangiectasia as a safe and convenient intervention in clinical practice of Korean Medicine.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.409-412
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• 1998

This is a case report of an operation for the pulmonary arteriovenous fistula supplied from the systemic arteries instead of the pulmonary artery. The operation of systemic arteriovenous pulmonary fistula has formidable technical challenges due to its extensive collateral circulations. A 16 year-old female patient, diagnosed as systemic arteriovenous fistula with multiple tortuous feeding vessels and with hereditary hemorrhagic telangiectasia, was initially managed with arterial embolization before the operation. A 15${\times}$8cm sized huge vascular malformation was removed by RML and RLL bilobectomy. During the operation, we encountered annoying massive bleeding and pulmonary congestion originated in its extensive collateral circulation. The patient was discharged after conservative management without specific problem on the 15th postoperative day. For the safe operation as well as good operative result, it seemed that meticulous ligation of the multiple collateral vessels should be performed prior to that of pulmonary veins.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.582-587
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• 2020

Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.905-910
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• 1988

Anomalous origin of the coronary artery from the pulmonary artery is a rare congenital coronary artery disease and the origin of the left coronary artery from the pulmonary artery represents the commonest form of these unusual lesions. Because of differences in symptomatology, clinical course and prognosis, this malformation has been divided into infant type[Bl-and-White-Garland syndrome] and adult type on the basis of the absence or presence of collateral circulation between the right and left coronary artery. The latter type has been reported relatively few cases. A 21-year-old male was admitted to the Yeungnam University Hospital, due to study of incidentally noticed heart murmur. At that time he was asymptomatic and past medical history was noncontributory. Chest roentgenogram was within normal limit and electrocardiogram was consistent with hypertrophy of left ventricle. Echocardiogram and aortogram demonstrated markedly dilated and tortuous right coronary artery and anomalous origin of the left coronary artery from the pulmonary artery. To prevent arteriosclerosis, progressive myocardial infarction, infection and aneurysmal rupture, Takeuchi operation which establish a two coronary system by transpulmonary arterial reconnection of the anomalous left coronary artery was done. Postoperative course was uneventful.