• Journal of Korean Neurosurgical Society
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• 제63권4호
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• pp.532-538
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• 2020

Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

• 대한치과의사협회지
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• 제49권9호
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• pp.527-534
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• 2011

Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy.

• 대한임상검사과학회지
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• 제49권3호
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• pp.316-321
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• 2017

빗장밑혈류빼앗김증후군은 좌측 몸쪽부분 빗장밑동맥 혹은 팔머리동맥에 심한 혈관 협착이나 폐색이 원인이 되어 발생한다. 병변이 있는 부위에서는 제한적이며, 불충분한 혈류가 발생하여 반대쪽으로부터 연결혈관을 통해 일부 혈액이 유입될 수 있다. 이러한 현상을 빗장밑혈류빼앗김현상이라고 한다. 이중초음파검사는 빗장밑혈류빼앗김현상을 측정하는데 유용한다. 빗장밑혈류빼앗김현상을 보이는 일부 환자에서는 척추뇌바닥혈류부전 혹은 허혈성 말초동맥질환 증상을 호소한다. 빗장밑혈류빼앗김증후군은 빗장밑혈류빼앗김현상과 더불어 신경학적 증상이 반드시 동반될 경우로 정의할 수 있다. 저자는 팔머리동맥의 심한 협착을 보이는 환자에서 척추동맥과 더불어 바깥목동맥과 전방순환계를 담당하는 온목동맥 및 속목동맥에서 이중초음파검사를 이용한 혈류빼앗김현상이 관찰된 증례를 보고하고자 한다.

• Advances in pediatric surgery
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• 제2권1호
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• pp.64-67
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• 1996

1세된 남아에서 세열낭종을 의심한 좌측 경부 종양이 수술을 시행한 결과 고형종양이였고, 조직검사상 이소성 흉선으로 판명되었다. 술후 초음파상 흉선은 정상적으로 있었고, 현재 환자의 면역기능은 아무 이상없이 정상으로 자라고 있다.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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• pp.345-345
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• 1994

BBB opening 에 의란 수용성 약물 및 지용성 약물의 뇌혈관 투과 패턴을 알아보기 위해 모델약물로서 수용성 약물인 $^{99}$Tc-DTPA, 지용성 약물인 Pherlytoin을 선택하여 뇌혈관 투과성(PA)의 증가율을 검토하고자 하였다. 랫트의 좌측 외경동맥(left external carotid artery)에 혈류의 역방향으로 PE-50 catheter를 분지점에서 1-2mm 전까지 삽입하고, 1.6 molal L-(+)-arabinosg 고장액 (1580 mOsm)을 0. 12ml/sec의 일정한 속도로 30초간 infusion 한 후. $^{99}$Tc-DTPA 혹은 phenytoin 약물 용액을 대뢰정맥으로 주사하고, 대뢰동맥으로부터 약물 투여전 및 투여후 10, 30초, 1, 1.5, 2, 3. 4, 5. 7, 10분 간격으르 혈액을 채취하였으며. 마지막 채혈후 즉시 단두하여 뇌조직을 취하였다. 채취한 뇌를 좌, 우반구 및 각 부위별로 분리하고 감마 카운터와 HPLC를 이용하여 뇌증농도를 정량하였다. 또한 뇌 실질 조직내 약물량을 구하기 위해 뇌 혈관내에 존재하는 약물양을 보정하였는데, 이때 계산에 필요한 뇌증 혈액부피의 측정은 $^{99}$Tc-albumin을 이용하여 구하였다.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.296-301
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• 2016

Dural arteriovenous fistula (DAVF) of the transverse sinus with ophthalmic manifestations in young children are rare. We reviewed two cases of direct AVF of the transverse sinus with ocular manifestations managed at our institution. The first, a 2.5 years old male child presented with left exophthalmos. Angiography revealed AVF between the occipital artery and the transverse sinus. The second, a 2 years old female child, complained of left exophthalmos. Imaging studies showed bilateral direct AVFs of the transverse sinus with bilateral dysmaturation of the sigmoid sinus. Transarterial embolization was done in both cases. Clinical and radiological follow up revealed complete cure. This report suggests that DAVF of the transverse sinus supplied by the external carotid branches can present with ophthalmic manifestations especially if there is distal venous stenosis or obliteration involving sigmoid sinus. Transarterial embolization using coils and liquid embolic agents could be safe and feasible to obliterate the fistula.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.7-16
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• 2018

Oronasal bleeding that continues despite oronasal packs or recurs after removal of the oronasal packs is referred to as intractable oronasal bleeding, which is refractory to conventional treatments. Severe craniofacial injury or tumor in the nasal or paranasal cavity may cause intractable oronasal bleeding. These intractable cases are subsequently treated with surgical ligation or endovascular embolization of the bleeding arteries. While endovascular embolization has several merits compared to surgical ligation, the procedure needs attention because severe complications such as visual disturbance or cerebral infarction can occur. Therefore, comprehensive understanding of the head and neck vascular anatomy is essential for a more effective and safer endovascular treatment of intractable oronasal bleeding.

• 대한두경부종양학회지
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• 제27권2호
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• pp.226-229
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• 2011

Knowledge of variations of veins of head and neck in relation to internal jugular, external jugular, anterior jugular and facial veins is important to surgeons doing head and neck surgery as well as to radiologists doing catheterization and to clinicians in general. In the current case, congenital atresia of the left internal jugular vein is reported. During neck dissection, superficial veins of neck and left external jugular vein was engorged and the left internal jugular vein was look like a fibrotic band. The left common carotid artery and vagus nerve was normal.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.550-553
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• 2017

Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture.

• Journal of Acupuncture Research
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• 제18권4호
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• pp.161-177
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• 2001

Objective : We have studied the part, definition, diagnostic generaliztion and pathological viewpoint of Qi mouth and Renying by refering literatures Methods : I refered to records from anciant to modern. The results are followings : 1. Qi mouth and Renying is ancient diagnostic method and the origin of diagnostic method through the pulsation of radial artery. And Qi mouth is recognized as the right and left Qi mouth and Renying is located on pulsation points of both common carotid arteries. 2. The yin of five viscera, nutritional blood and viscous liquid are diagnosed by Qi mouth which is inclued lung meridian. And the yang of six organs, guarding Qi and the rise and fall of stomach energy are diagnosed by Renying which is inclued stomach meridian. 3. It is possible that the position, process and transformational condition of disease are decided by comparing and examining Qi mouth and Renying.