• Title/Summary/Keyword: Iliac Vein

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Surgical Treatment of Patients with Abdominal Aortic Aneurysm (복부 대동맥류에 대한 수술)

  • Ryu, Kyoung-Min;Seo, Pil-Won;Park, Seong-Sik;Ryu, Jae-Wook;Kim, Seok-Kon;Lee, Wook-Ki
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.331-336
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    • 2009
  • Background: Open surgical repair of abdominal aortic aneurysms was initiated by Dubost in 1952. Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized for curative intent. We retrospectively analyzed surgical outcome, complications, and mortality-related factors for patients with abdominal aortic aneurysms over a 6 year period. Material and Method: We analyzed 18 patients who underwent surgery for abdominal aortic aneurysms between March 2002 and March 2008. The indications for surgery were rupture, a maximal aortic diameter >60 mm, medically intractable hypertension, or pain. Result: The mean age was $66.6{\pm}9.3$ years (range, $49\sim81$ years). Twelve patients (66.7%) were males a 6 patients were females. Extension of the aneurysm superior to the renal artery existed in 6 patients (33.3%), and extension to the iliac artery existed in 13 patients (72.2%). Five patients (27.8%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $72.2{\pm}12.9$ mm (range, $58\sim109$ mm). Surgery was performed by a midline laparotomy, and 6 patients underwent emergency surgery. The mean total ischemic time from aorta clamping to revascularization was $82{\pm}42$ minutes (range, $35\sim180$ minutes). The mortality rate was 16.7%; the mortality rate for patients with ruptured aneurysms was 60%, and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included one each of renal failure, femoral artery and vein occlusion, and wound infection. The patients who were discharged had a long-term survival of $34{\pm}26$ months (range, $4\sim90$ months). Rupture and emergency surgery had a statistically significant mortality-related factor (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have a high mortality, but unruptured cases are repaired with relative safety. Successfully operated patients had long-term survival. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, aggressive application should be determined with care. Experience and systemic support of each center is important in the treatment plan.

Comparison Radiation Dose of Z-Axis Automatic Tube Current Modulation Technique with Fixed Tube Current Multi-Detector Row CT Scanning of Lower Extremity Venography (하지 정맥조영술 MDCT에서 고정 관전류 기법과 Z-축 자동 관전류 변동 제어에 의한 선량 비교)

  • Yoo, Beong-Gyu;Lee, Jong-Seok;Jang, Keun-Jo;Jeon, Sang-Hwan;Kim, Yong-Soo;Kweon, Dae-Cheol
    • Journal of Radiation Protection and Research
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    • v.32 no.3
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    • pp.123-133
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    • 2007
  • Z-axis automatic tube current modulation technique automatically adjusts tube current based on size of body region scanned. The purpose of the current study was to compare noise, and radiation dose of multi-detector row CT (MDCT) of lower extremity performed with Z-axis modulation technique of automatic tube current modulation with manual selection fixed tube current. Fifty consecutive underwent MDCT venography of lower extremity with use of a MDCT scanner fixed tube current and Z-axis automatic tube current modulation technique (10, 11 and 12 HU noise index, $70{\sim}450\;mA$). Scanning parameters included 120 kVp, 0.5 second gantry rotation time, 1.35:1 beam pitch, and 1 mm reconstructed section thickness. For each subject, images obtained with Z-axis modulation were compared with previous images obtained with fixed tube current (200, 250, 300 mA) and with other parameters identical. Images were compared for noise at five levels: iliac, femoral, popliteal, tibial, and peroneal vein of lower extremity. Tube current and gantry rotation time used for acquisitions at these levels were recorded. All CT examinations of study and control groups were diagnostically acceptable, though objective noise was significantly more with Z-axis automatic tube current modulation. Compared with fixed tube current, 2-axis modulation resulted in reduction of CTDIvol (range, $-6.5%{\sim}-35.6%$) and DLP (range, $-0.2%{\sim}-20.2%$). Compared with manually selected fixed tube current, 2-axis automatic tube current modulation resulted in reduced radiation dose at MDCT of lower extremity venography.

Anatomy of Spleen Meridian Muscle in human (족태음비경근(足太陰脾經筋)의 해부학적(解剖學的) 고찰(考察))

  • Park Kyoung-Sik
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.65-75
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    • 2003
  • This study was carried to identify the component of Spleen Meridian Muscle in human, dividing into outer, middle, and inner part. Lower extremity and trunk were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Spleen Meridian Muscle. We obtained the results as follows; 1. Spleen Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle; ext. hallucis longus tend., flex. hallucis longus tend.(Sp-1), abd. hallucis tend., flex. hallucis brevis tend., flex. hallucis longus tend.(Sp-2, 3), ant. tibial m. tend., abd. hallucis, flex. hallucis longus tend.(Sp-4), flex. retinaculum, ant. tibiotalar lig.(Sp-5), flex. digitorum longus m., tibialis post. m.(Sp-6), soleus m., flex. digitorum longus m., tibialis post. m.(Sp-7, 8), gastrocnemius m., soleus m.(Sp-9), vastus medialis m.(Sp-10), sartorius m., vastus medialis m., add. longus m.(Sp-11), inguinal lig., iliopsoas m.(Sp-12), ext. abdominal oblique m. aponeurosis, int. abd. ob. m., transversus abd. m.(Sp-13, 14, 15, 16), ant. serratus m., intercostalis m.(Sp-17), pectoralis major m., pectoralis minor m., intercostalis m.(Sp-18, 19, 20), ant. serratus m., intercostalis m.(Sp-21) 2) Nerve; deep peroneal n. br.(Sp-1), med. plantar br. of post. tibial n.(Sp-2, 3, 4), saphenous n., deep peroneal n. br.(Sp-5), sural cutan. n., tibial. n.(Sp-6, 7, 8), tibial. n.(Sp-9), saphenous br. of femoral n.(Sp-10, 11), femoral n.(Sp-12), subcostal n. cut. br., iliohypogastric n., genitofemoral. n.(Sp-13), 11th. intercostal n. and its cut. br.(Sp-14), 10th. intercostal n. and its cut. br.(Sp-15), long thoracic n. br., 8th. intercostal n. and its cut. br.(Sp-16), long thoracic n. br., 5th. intercostal n. and its cut. br.(Sp-17), long thoracic n. br., 4th. intercostal n. and its cut. br.(Sp-18), long thoracic n. br., 3th. intercostal n. and its cut. br.(Sp-19), long thoracic n. br., 2th. intercostal n. and its cut. br.(Sp-20), long thoracic n. br., 6th. intercostal n. and its cut. br.(Sp-21) 3) Blood vessels; digital a. br. of dorsalis pedis a., post. tibial a. br.(Sp-1), med. plantar br. of post. tibial a.(Sp-2, 3, 4), saphenous vein, Ant. Med. malleolar a.(Sp-5), small saphenous v. br., post. tibial a.(Sp-6, 7), small saphenous v. br., post. tibial a., peroneal a.(Sp-8), post. tibial a.(Sp-9), long saphenose v. br., saphenous br. of femoral a.(Sp-10), deep femoral a. br.(Sp-11), femoral a.(Sp-12), supf. thoracoepigastric v., musculophrenic a.(Sp-16), thoracoepigastric v., lat. thoracic a. and v., 5th epigastric v., deep circumflex iliac a.(Sp-13, 14), supf. epigastric v., subcostal a., lumbar a.(Sp-15), intercostal a. v.(Sp-17), lat. thoracic a. and v., 4th intercostal a. v.(Sp-18), lat. thoracic a. and v., 3th intercostal a. v., axillary v. br.(Sp-19), lat. thoracic a. and v., 2th intercostal a. v., axillary v. br.(Sp-20), thoracoepigastric v., subscapular a. br., 6th intercostal a. v.(Sp-21)

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