• Journal of Chest Surgery
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• 제53권6호
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• pp.381-386
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• 2020

Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.18-23
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• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.394-399
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• 1999

저자들은 갑작스런 흉통을 주소로 내원한 젊은 남자에서 AT III 결핍증에 의한 폐색전증을 진단하고 세 자녀 모두에서도 AT III 결핍이 확인됨으로써 폐색전증을 동반한 선천성, 가족성 AT III 결핍증을 경험하였기에 문헌고찰과 함께 보고한다.

• Journal of Chest Surgery
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• 제43권3호
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• pp.266-272
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• 2010

배경: 심부정맥 혈전증은 폐색전증이나 만성 심부정맥 부전증을 일으킬 수 있는 질환으로 기본적인 치료로 항응고요법이 사용되어 왔다. 그러나 고식적인 항응고요법은 치료 이후 재발과 혈전후 증후군의 빈도가 높은 것으로 드러나 최근에는 중재적 시술을 이용한 치료가 적극적으로 이루어지고 있다. 이에 저자들은 하지 심부정맥 혈전증을 가진 환자들을 대상으로 중재적 치료의 유용성을 조사하였다. 대상 및 방법: 2006년 12월부터 2008년 7월까지 심부정맥 혈전증으로 중재적 시술을 시행한 29명의 환자를 대상으로 임상양상 및 치료 방법, 치료 경과를 후향적으로 조사하고 이전에 항응고제만으로 치료한 45명의 환자들을 대조군으로 하여 결과를 비교 하였다. 결과: 환자의 평균연령은 중재적 치료의 경우 55.4세, 대조군의 경우 53.7세로 두 군 모두 여자에서 더 많이 발생하였다. 도관을 이용한 혈전 용해제를 투여한 환자는 총 22명(78.5%)이었고 흡입 혈전제거술을 시행한 환자가 18명(62.0%), 스텐트를 삽입한 환자가 25명(86.2%)이었다. 폐색전증의 위험이 있어 하대정맥 내 필터를 삽입한 환자가 15명(51.7%)있었다. 대조군의 경우 저분자량 헤파린으로 치료한 경우가 39명(86.7%), 와파린을 사용할 수 없어 아스피린만으로 치료한 경우가 7명(15.6%), 헤파린으로 치료한 경우가 6명(17.8%) 있었다. 혈전용해제 또는 항응고제 사용 후 출혈로 인한 합병증은 발생하지 않았다. 추적 관찰 기간 동안 중재적 치료의 경우에 대조군과 비교하여 혈전증의 재발에는 유의한 차이가 없었으나 혈전후 증후군은 통계학적으로 유의하게 적게 나타났고(p-value=0.008) 사망한 경우가 없어 임상적으로 더 양호한 결과를 보였다. 결론: 중재적 치료는 고식적 항응고요법과 비교하여 안전하며 빠른 증상 호전과 낮은 합병증 발생률을 보이지만 아직까지 장기적인 유용성과 그 효과에 대한 연구는 이루어지지 않았으므로 향후 이 부분에 대한 연구가 필요할 것으로 생각된다.

• Vascular Specialist International
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• 제34권4호
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.57-62
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• 2005

Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

• Journal of Chest Surgery
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• 제45권1호
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• pp.69-71
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• 2012

The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.303-307
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• 2006

No one technique provides an optimal outcome for all body contouring patients. There are many surgical options for abdominoplasty. Among these, this abdominoplasty without undermining consists of liposuction around abdominal subcutaneous fatty tissue, excision of lower abdominal flap. The procedure allows aggressive thinning and sculpting of abdominal flap. This operation minimizes the dead space, which often leads to postoperative complications, and preserves neurovascular supply to the abdominal skin. From 1999 to 2004, 18 patients underwent the abdominoplasty without undermining, resulting in high satisfaction rates with no significant complications, such as, pulmonary embolism and deep vein thrombosis. Patients could return to normal activity within a week. This abdominoplasty without undermining is an effective and safe alternative with low complication rate and enhances aesthetic results compared to traditional abdominal surgery.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.48-52
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• 2006

Background: Intravenous immunoglobulin (IVIg) has been administered for various immune-mediated neurological diseases such as autoimmune neuropathy, inflammatory myopathies, and other autoimmune neuromuscular disorders. The purpose of this study is to investigate side effects and complications of IVIg therapy in neuromuscular disorders. Methods: We enrolled 29 patients (age 8~63 years) with IVIg therapy for various neurological diseases including Guillain-Barre syndrome, myasthenia gravis, dermatomyositis, polymyositis, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. IVIg therapy was used at a dose of 0.4 g/kg body weight/day for 5 consecutive days. Results: 10 patients (34%) had adverse events. There are adverse events in 16 courses (11%) among total 145 courses. The majority of patients presented with mild side effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 3 patients. One patient showed a serious side effect of deep vein thrombosis. Conclusions: IVIg therapy is safe for a variety of immune-mediated neurological diseases in our study.

• Journal of Chest Surgery
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• 제47권1호
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• pp.43-46
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• 2014

Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.