• Title/Summary/Keyword: Limb ischemia

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Management of Infected Axillo-bifemoral Graft; A Case Report (액와동맥-양측대퇴동맥우회술후 발생한 인조혈관 감염의 치료)

  • 정철하
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.552-556
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    • 1993
  • Infection after reconstructive surgery is one of the most catastrophic postoperative complication in vascular surgery. Mortality rates reported from a world-wide experience range between 25 and 88 percent. The surgeon faced with such a complication must choose among many diagnostic and management options to maximize limb salvage and survival based on the presentation and site of the infectiota the degree of ischemia of the lower extremities, and the overall medical condition of the patient. We successfully managed with descending thoracic aorta-to-bifemoral arteries bypass after the entire removal of the infected axillo-bifemoral graft because of bypass graft infection.

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The Iliac Fossa Transplant as an Acute Rejection Model in Porcine Kidney Transplantation: a Tool for the Safety Study of the Stem Cell- induced Humanized Tissue (돼지 장기이식에서 급성거부반응 연구에 효과적인 엉덩오목이식 동물모델: 줄기세포유래 Humanized 조직의 안전성 평가모델)

  • Kwak, Ho-Hyun;Nam, Hyun-Suk;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.63-70
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    • 2011
  • To consider the iliac fossa as the vascular anastomosis site of kidney transplantation for the short-term study of acute rejection in pigs. Twelve domestic pigs weighing 39~48 kg underwent heterotopic renal allgraft transplantation. The experimental animals were divided into 2 groups in terms of renal vascular anastomosis site; the external iliac artery and vein were used in iliac fossa model (n = 6), the abdominal aorta and the caudal vena cava inferior to the kidney were used in abdominal cavity model (n = 6). Renal function was evaluated by daily measurement of plasma creatinine and BUN concentrations. The experiments' health including postoperative complications was also assessed daily for 8 days after transplantation. After euthanazation gross and histopathologic analysis was performed. All six pigs in iliac fossa model developed neuropraxia and lameness of the ipsilateral pelvic limb. However, no necrosis was observed in any pigs. In the abdominal cavity model, durations of both the surgical operation and the vascular anastomosis were significantly longer than those in the iliac fossa model. Furthermore, ischemia injury of the transplanted kidney was increased in abdominal cavity model, which induced accelerated-acute immune response from day 4 after transplantation. Despite of pelvic limb complication, the iliac fossa model showed more advantages including not only less ischemia time related to easy vascular anastomosis, but also less immune response during the acute rejection period. The results indicate that the iliac fossa model may be appropriate to the study of acute rejection in porcine kidney transplantation.

Study on the Effect of KamiTongJonHaaATang Extracts on Thrombosis, Brain Ischemia and Brain damage (가미통전화어탕(加味通栓化瘀湯)이 혈전증(血栓症)과 뇌허혈증(腦虛血症) 및 뇌손상(腦損傷)에 미치는 영향(影響)에 대한 실험적(實驗的) 연구(硏究))

  • Ahn, Taek Won;Kim, Byeong Tak
    • Journal of Haehwa Medicine
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    • v.8 no.1
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    • pp.379-401
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    • 1999
  • The effect of KamiTongJonHaaATang extracts on hypercholesterolemia, platelet aggregation, pulm onary thrombosis, KCN-induced coma, forcal brain ischemia, cytotoxicity of PC12 cells induced by amyloid ${\beta}$ protein(25-35), and NO production in RAW cells stimulated lipopolysaccharide were investigated, respectively. The results were summarized as follows; 1. KTJHAT extracts showed a significant decrease of serum total cholesterol, triglyceride, phospholipid, LDL-cholesterol, and VLDL-cholesterol in hypercholesterolemia induced by 2% cholesterol diet in NZW rabbit. 2. KTJHAT extracts induced a significant inhibition of human platelet aggregation induced by thrombin and ADP but did not affect human platelet aggregation induced by collagen. 3. KTJHAT extracts showed a protective effect on pulmonary thrombosis induced by collagen and epinephrine. 4. KTJHAT extracts prolonged the duration of KCN-induced coma. 5. KTJHAT extracts showed a significant decrease of brain ischemic area and edema in MCA occlusion. Also, KTJHAT extracts showed a decrease of neurologic grade in hind limb but did not affect neurologic grade in fore limb. 6. KTJHAT extracts showed a protective effect on cytotoxicity of PC 12 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner. 7. KTJHAT extracts showed a significant decrease of NO production in RAW cells induced by lipopolysaccharide. These results suggested that KTJHAT extracts might be usefully applied for prevention and treatement of thrombosis and brain damage.

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Acute Lower Limb Ischemia Associated with COVID-19 (코로나바이러스감염증-19 이후 발생한 급성 하지허혈증)

  • Kim, Hyung Suh;Suh, Jin Soo;Choi, Jun Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.450-454
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    • 2021
  • A 75-year-old male patient without any significant medical and habitual risk factors for acute atherosclerosis obliterans except for hypertension was diagnosed with coronavirus disease 2019 with dyspnea, coughing, and mild fever. After a week of hospitalization, he complained of right foot pain and numbness. The symptoms were aggravated during the next week, resulting in a complete toe color change and loss of dorsalis artery pulse. Enhanced 3-dimensional computed tomography angiography revealed thrombus formation in the right common iliac artery and a loss of blood flow below the popliteal artery on both sides. The patient underwent percutaneous balloon angioplasty with stent insertion followed by medical therapy for anticoagulation. The clinical symptoms immediately were improved after the intervention, but the great toe necrosis was not recovered. Finally, amputation of the great toe was performed.

The Effects of Swim Training on Neurogenesis in the Hippocampal Dentate Gyrus and Functional Ability After Focal Ischemic Stroke in Rats (수영 훈련이 뇌허혈 유발 흰쥐의 해마 치아이랑에서 뇌신경생성과 기능적 능력에 미치는 영향)

  • Kim, Ho-Sung;Kim, Deuk-Ho;Lee, Jeong-Pil;Kim, Young-Joo;Shin, Young-Oh;Kim, Sang-Hoon;Kwon, Ki-Wook;Oh, Jae-Keun
    • Physical Therapy Korea
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    • v.12 no.3
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    • pp.11-21
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    • 2005
  • The present study was aimed at investigating the effect of swimming training on brain function after focal cerebral ischemia in rats. Therefore, this study was examined on neurogenesis in dentate gyrus of hippocampus using 5-bromo-2'-deoxyuridine (BrdU) to label proliferating cells and assessed the neurological response following focal cerebral ischemia in rats using neurological motor behavioral test. In an observer-blinded fashion, twenty male Sprague-Dawley (280~310 g, 7 weeks old) rats were divided into four groups: MCAO plus swimming group (ME, $n_1$=5), MCAO plus control group (MC, $n_2$=5), SHAM plus swimming group (SE, $n_3$=5), SHAM plus control group (SC, $n_4$=5). The results of this study were as follows: 1) The limb placing time before and after swimming in the ME group were significantly longer than the MC group (p<.05), the SE group were significantly longer than the SC group (p<.01). 2) The balance beam scores before and after swimming in the ME group was higher than the SE group, the MC group was higher than the SC group but was not significantly different (p>.001). 3) The foot fault index before and after swimming training in ME group was significantly lower (i.e., improved) than the MC group (p<.001) and the SE group (p<.001), the SE group was significantly lower (i.e., improved) than the SC group (p<.001). 4) The mean number of BrdU-positive cells in the dentate gyrus in the ME group was significantly higher than the MC group (p<.001) and the SE group (p<.01). The MC group and the SE group was significantly higher than the SC group (p<.001). 5) There was significantly correlation between limb placing time and number of BrdU-positive cells on swimming training, there was positive correlation (r=.807, p<.0001) and between foot fault index and BrdU-positive cells number, there was negative correlation (r=-.503, p<.05). However, between balance beam scores and BrdU-positive cells number, there was no correlation. In conclusion, the present study demonstrates that the role of swimming training improves behavioral motor function probably by enhancing cell proliferation in that hippocampus. This study provides a model for investigating the stroke rehabilitation that underlies neurogenesis and functional ability.

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Extra-anatomic Bypass in Lower Limb Ischemia (하지동맥 폐쇄환자에서 실시한 Extra-anatomic bypass술의 임상적 고찰)

  • Kim, Gyu-Man;Kim, Jong-Won
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.920-925
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    • 1993
  • Extra-anatomic bypass was proposed by Freeman in 1952 and has been used for patient with lower extremity arterial occlusion who had very high operative risk, especially elderly or severly illed patient.We had performed 14 cases of extra-anatomic bypasses from Jan. 1991 till July 1993 and having been following up them. Their results were summarized as follow. Among total 14 patients, 13 was male. Their mean age was 64.8 years old, ranged from 48 to 80. The most common complaint was pain on lower limb and they visited hospital 6.1 months in average after onset of symptom. Frequently, they were associated with systemic diseases such as generalized atherosclersis, hypertension, diabetes mellius, etc. Axillary artery was used as donor artery in 8 cases and crossover femoro-femoral or femoro-popliteal bypass was performed in 6 cases. Postoperative complications were notedd in 8 cases so their morbidity rate was 42.8%. Except for two contraindicated cases, one or more anticoagulants were used routinely . Among them, combined use of aspirin and persantine was most commonly applied.After bypass graft, nine cases were occluded beteween 10 and 53 months. So their average duration of freedom from reocclusion was 35.7 months and 3-year patency rate was 63%.

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Study on the Effect of Gamisihotang(GSHT) on Glutamate Receptor, Free Radical and Brain Damage in Rats Subjected to Brain Ischemia (가미시호탕이 뇌허혈시 Glutamate receptor, free radical 및 뇌손상 보호에 미치는 영향)

  • Oh Byung-Yul;Kim Min-Sang;Yu Byeong-Chan;Choi Young;Seol In-Chan
    • The Journal of Korean Medicine
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    • v.25 no.3
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    • pp.32-44
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    • 2004
  • Objectives : This study was undertaken to prove the effect of GSHT on the glutamate receptor, free radical and brain damage in rats subjected to brain ischemia Methods : Levels of cultured cortical neuron death caused by toxic chemicals were measured by LDH release assay. Neuroprotective effects of GSHT on brain tissues were examined in vivo by ischemic model of middle cerebral artery (MCA) occlusion. Results : GSHT showed significant inhibitory effect on LDH release induced by NMDA-kinate-Fe/sup 2+/. GSHT remarkably decreased coma duration time in a nonfatal dose of KCN and showed higher survival rate in a fatal dose. GSHT remarkably decreased ischemic area and edema induced by the MCA blood flow block. GSHT showed high improvement of forelimb and hind limb test after MCA occlusion in neurological examination. GSHT showed no significant change after MCA occlusion in pathological observation of the normal group. Conclusions : These results indicate that GSHT can be used to treat the brain damage caused by brain ischemia. Further study will be needed about the functional mechanism, etc.

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Endovascular Revascularization for the Obstruction after Patch Angioplasty in Buerger's Disease

  • Jun, Hee Jae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.174-177
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    • 2014
  • Surgical revascularization for patients with Buerger's disease is possible only in a few cases, due to the diffuse segmental involvement and the lack of distal runoff vessels available for bypass surgery. We encountered a case of resting pain in the right foot, coldness with dysesthesia, and cyanosis on the right 1st toe. The patient was treated with an endovascular intervention after vein patch angioplasty failed due to an inflammatory reaction of Buerger's disease. We suggest that an endovascular procedure can be an effective treatment, even in addition to more conservative and surgical management, in patients with Buerger's disease and critical limb ischemia.

The Subclavian Artery Thrombosis after Open Reduction and Internal Fixation of Clavicular Fracture - A Case Report - (쇄골 골절의 관혈적 정복 및 내 고정술 후 발생한 쇄골하 동맥의 혈전증 - 증례 보고 -)

  • Moon, Eun-Sun;Kim, Myung-Sun;Jeong, Kwang-Cheul;Lim, Keun-Young
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.211-215
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    • 2006
  • Reported in this article is a case report of a patients who developed limb threatening ischemia as a consequence of a subclavian artery thrombosis resulting from screws. The subclavian artery thrombosis after open reduction and internal fixation of clavicle fracture, when it occurs, should be treated promptly by plate removal and claviculectomy. It can be prevented by placing screws in locations away from the underlying neurovascular structures.

Clinical Analysis of Vascular Bypass Graft in Aortoiliac Occlusive Disease (대동맥 장골동맥 폐쇄성 질환에서 혈관 우회술의 임상적 고찰)

  • Jeong, Seong-Un;Lee, Hyeong-Ryeol;Kim, Jong-Won
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.900-905
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    • 1995
  • Between Jan.1990 and Mar.1994, twenty-three patients[Male:20, Female:3 with aortoilac occlusive disease had underwent reconstruction [bypass garft . Two main causes of occlusion were atherosclerosis [21 patients and chronic thromboembolism[2 patients . Indications for operation were disabling claudication in 20 patients and critical limb ischemia in 12 patients. The procedures of operation included femorofemoral[8 , axillobifemoral[6 , aorto-bifemoral[6 , axillounifemoral[2 , aortoiliac[1 bypass graft. Postoperatively one patient died for sepsis and the operative mortality was 4.3%. Various anticoagulant therapy were maintained for at least six months. The 1year, 2year, 3year and 4year patency rates of bypass graft after operation were 91.3%, 80.8%, 71.4% and 58.4% respectively.

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