• Journal of Chest Surgery
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• v.20 no.2
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• pp.342-347
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• 1987

Complete occlusion of the main LCA is associated with a poor prognosis if the RCA becomes severely occluded. The functional role of collateral circulation is critical in this situation. This study lends support to the hypothesis that coronary collateral circulation can provide critically needed myocardial blood flow via right to left collaterals. Not surprisingly, left ventricular function was maintained in 4 of the 5 patients studied who had main LCA occlusion and well-developed collateral circulation.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.174-182
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• 1979

This is a report on four cases of successful surgical correction of coarctation of the aorta [COA] in Department of the Thoracic & Cardiovascular Surgery, Hanyang University Hospital. The first case was a postductal type of coarctation of the aorta associated with Patent ductus arteriosus [PDA], Persistent left superior vena cava [LSVC] and richly developed collateral circulation. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. The coarctation of the aorta was corrected with following procedure: Partial resection of the aortic wall with diaphragmatic structure lust above and below the coarctating line of the aorta, and then the defect of the aortic wall was closed by lateral aortographic suture. PDA was closed by ligation procedure. The second case a preductal type of coarctation of the aorta associated with PDA, LSVC, ventricular septal defect [VSD] and poorly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Correction of coarctation of the aorta was performed under the establishment of tube bypass because of poor collateral circulation. After resection of coarctating short segment, end to end anastomosis was performed without any tension. PDA was closed by division procedure. Simple suture closure of VSD was performed by open heart surgery two weeks after correction of COA. The third case was a long segment COA without any other anomaly. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.5 cm] of the aorta. The fourth case was a long segment COA associated with aortic insufficiency and richly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.0 cm] of the aorta. Both blood pressure and peripheral pulse on the arm and the legs returned to normal postoperatively in all patients.

• 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 Acupuncture Research
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• v.21 no.1
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• pp.168-175
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• 2004

Objective: This report was designed to investigate characteristic of ankle sprain due to cause, degree of injury, treatment process, sex, age etc Methods: We selected 36 patients who visited our clinic at last over two times complaining of ankle-sprain since 8th, March, 2002. Results: The results were summarized as follows. 1. The major cause of ankle-sprain was injury of lateral collateral ligament. 2. Ankle-sprain was distinguished three degree, and generally presented pain, regional tenderness, swelling, limited movement, muscle spasm, redness, deformity. 3. In early stage of ankle-sprain, ice massage, compression, elevation, rest were very important. 4. In oriental medicine, the principle of treatment were promoting blood circulation to remove blood stasis, relaxing muscles and tendons and activating the flow of Gi and blood in the channels and collaterals, reducing edema or swelling, and alleviating pain. 5. There were more effective result to using three-edged needle with acupuncture. Conclusions: Ankle-sprain were treated successfully using acupuncture and three-edged needle.

• Restorative Dentistry and Endodontics
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• v.34 no.3
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• pp.169-176
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• 2009

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type land 2 DM are most common form and the prevalence of the latter is recently increasing, The aim of this article was to assess whet her Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction w as larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 D M itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered, The function of polymorphonuclear leukocyte is also impair ed and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process, Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.488-491
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• 2009

A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.834-840
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• 2020

Objective : Carotid endarterectomy (CEA) is an effective surgical procedure for treating symptomatic or asymptomatic patients with carotid stenosis. Many neurosurgeons use a shunt to reduce perioperative ischemic complications. However, the use of shunting is still controversial, and the shunt procedure can cause several complications. In our institution, we used two types of modified arteriotomy suture techniques instead of using a shunt. Methods : In technique 1, to prevent ischemic complications, we sutured a third of the arteriotomy site from both ends after removing the plaque. Afterward, the unsutured middle third was isolated from the arterial lumen by placing a curved Satinsky clamp. And then, we opened all the clamped carotid arteries before finishing the suture. In technique 2, we sutured the arteriotomy site at the common carotid artery (CCA). We then placed a curved Satinsky clamp crossing from the sutured site to the carotid bifurcation, isolating the unsutured site at the internal carotid artery (ICA). After placing the Satinsky clamp, the CCA and external carotid artery (ECA) were opened to allow blood flow from CCA to ECA. By opening the ECA, ECA collateral flow via ECA-ICA anastomoses could help to reduce cerebral ischemia. Results : The modified suture methods can reduce the cerebral ischemia directly (technique 1) or via using collaterals (technique 2). The modified arteriotomy suture techniques are simple, safe, and applicable to almost all cases of CEA. Conclusion : Two modified arteriotomy suture techniques could reduce perioperative ischemic complications by reducing the cerebral ischemic time.

• The Journal of Internal Korean Medicine
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• v.17 no.1
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• pp.107-122
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• 1996

Apoplexy is a disease of a morbid condition manifested as sudden syncope, unconciousness, distortion of face, hemiplegia and dysphasia, usually seen in the middle-aged. The symptoms and signs before sudden onset are headache, dizziness, numbness of extremities, palpitation, etc. This study was performed to investige causes of disease, therapies and prescriptions by insect medicine through the successive medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows; 1. The treatment of apoplexy is divided into stage of attack and sequela. In stage of attack, the principal therapies of apoplexy are calming the liver, suppressed Yang, dissipate phlegm and elimination weatness. In sequela, the principal therapies of apoplexy are invigorating Qi, promote blood circulation and dredge collateral. 2. Insects medicine have more strong effect than herbal medicine, because apoplexy is a kind of critically desease. 3. Insects medicine is effective in a convalscent stage and sequela of apoplexy. The proper dosage for stage of attack is a small dose of insects medicine(about 2-4g), increse gradually. In convalscent stage, about 4g, in sequela, patients need a large dose of insects medicine(about 8g). 4. Hirudo used to remove stagnated blood and to disperse swelling for the treatment of severe cases of blood stasis, such as cerebral infarction, sequela of cerebrovascular accident, contused wounds. Lumbricus used to for the treatment of convulsions due to high fever, and for hemiplegia and hypertension. Scolopendra used to subdue the endogenous wind for the treatment of various kinds of tics, convulsions and tetanus, and it's character is strong because it will be effective Sthenia-Syndrome of apoplexy. Scorpio used to subdue the endogenous wind for the treatment of various kind of tics, convulsions, tetanus and sequela of cerebrovascular accident.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.823-828
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• 1989

Aortoenteric fistula is an uncommon important complication of aortic reconstruction with a prosthetic graft. The complication often is difficult to diagnose and is associated with poor prognosis. Aortoenteric fistula could be divided into true aortoenteric fistula and paraprosthetic-enteric fistula. In case of true aortoenteric fistula, an actual communication between the gastrointestinal tract and the aortic lumen is present. So, massive gastrointestinal hemorrhage is the presenting manifestation. In paraprosthetic-enteric fistula, characterized by communication between the gastrointestinal tract and the external surface of synthetic vascular prosthesis without actual fistularization into the vascular lumen, the predominant clinical manifestation were sepsis, fever and anemia. We experienced one case of paraprosthetic-enteric fistula in a 16 years old male after abdominal aortic reconstruction with a prosthetic graft. The interval from the operation to onset of symptoms was 40 months. The initial clinical manifestation was sepsis, fever and anemia without massive gastrointestinal hemorrhage. Surgical treatment consists of complete excision of infected graft, two layers closure of jejunal wall defect and pledgets suture of aortic stump with surrounding health tissue. Anatomic revascularization was not able to be done: because of extensive retroperitoneal inflammation and extraanatomic revascularization did not performed due to adequate distal blood supply through rich collateral circulation. After operation, he complained numbness on left foot on moderate exertion and felt coldness on left leg compared with right leg but not showed skin color change. 43 days after operation, he discharged without gait disturbance except numbness on left foot on moderate exertion.

• Korean Journal of Digital Imaging in Medicine
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• v.12 no.1
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• pp.27-31
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• 2010

The purpose of this study was to investigated the usefulness of MR perfusion image comparing with SPECT image. A total of pediatric 30 patients(average age : 7.8) with Moyamoya disease were performed MR Perfusion with 32 channel body coil at 3T from March 01, 2010 to June 10, 2010. The MRI sequences and parameters were as followed : gradient Echo-planar imaging(EPI), TR/TE : 2000ms/50ms, FA : $90^{\circ}$, FOV : $240{\times}240$, Matrix : $128{\times}128$, Thickness : 5mm, Gap : 1.5mm. Images were obtained contrast agent administrated at a rate of 1mL/sec after scan start 10s with a total of slice 1000 images(50 phase/1 slice). It was measured with visual color image and digitize data using MRDx software(IDL version 6.2) and also, it was compared of measurement with values of normal and abnormal ratio to analyze hemodynamic change, and a comparison between perfusion MR with technique using Warm Color at SPECT examination. On MR perfusion examination, the color images from abnormal region to the red collar with rCBV(relative cerebral blood volume) and rCBF(relative cerebral blood flow) caused by increase cerebral blood flow with brain vascular occlusion in surrounding collateral circulation advancement, the blood speed relatively was depicted slowly with blue in MTT(Mean Transit Time) and TTP(Time to Peak) images. The region which was visible abnormally from MR perfusion examination visually were detected as comparison with the same SPECT examination region, would be able to confirm the identical results in MMD(Moyamoya disease)judgments. Hymo-dynamic change in MR perfusion examination produced by increase and delay cerebral blood flow. This change with digitize data and being color imaging makes enable to distinguish between normal and abnormal area. Relatively, MR perfusion examination compared with SPECT examination could bring an excellent image with spatial resolution without radiation expose.