• Title/Summary/Keyword: duplex treatment

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Comparative Study of Cryostripping and Endovenous Laser Therapy for Varicose Veins: Mid-Term Results

  • Lee, Kwang Hyoung;Chung, Jae Ho;Kim, Kwang Taik;Lee, Sung Ho;Son, Ho Sung;Jung, Jae Seung;Kim, Hee Jung;Lee, Seung Hun
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.345-350
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    • 2015
  • Background: Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radiofrequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. Methods: Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. Results: A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. Conclusion: The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins.

Clinical Findings and Therapy of Ureteral Duplication in 61 Children (소아에서의 중복요관에 관한 임상적 고찰)

  • Yook Jin Won;Kim Ji Hong;Kim Pyung Kil;Han Sang Won
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.169-177
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    • 1998
  • Purpose : Renal duplication is a common occurrence, and the range of ureteral and renal anomalies draining the two poles of the duplex kidney leads to a variety of clinical presentations. Method : A series of 61 children with duplicated systems was studied retrospectively who were admitted during last 12years. Results : Of the children $60.6\%$ were accompanied with urologic anomalies that required surgical treatment, and most children initially were presented with urinary tract infection. $42.6\%$ of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : From our point view, children with history of abnormal antenatal renal sonogram, or with symptoms such as urinary tract infection, hematuria, abdominal pain should be evaluated radiologially fully to confirm further abnormality and accompanied complications. And routine follow-up using abdominal ultrasonogram, VCUG, and urine culture should be used to prevent and detect early treatable complications.

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Comparative Study of Conventional Phlebectomy and Transiliuminated Powered Phlebectomy in Varicose Veins (하지 정맥류의 고식적 수술 방법과 광투시 전동형 정맥제거술의 비교연구)

  • Lee Choong Won;Chung sung Woon
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.415-420
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    • 2005
  • Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). Material and Method: From March 200f to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. Result: Operative time was significantly shorter in the TIPP group than CP group (for one leg $108.4\pm27.6\;min\;vs\;83_4\pm24.4\;min,\;for\;both\;legs\;184.7\pm28.4\;min\;vs\; 137.8\pm24.4\;min)$. There was signifcant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group $(5.9\pm2.2\;vs\;4.2\pm1.6)$. Mean duration of hospitalization was Significantly shorter in the TIPP group than CP group $(4.4\pm1.0\;days\;vs\;5.8\pm1.9\;days)$. Complications were pain $(15.9\%)$, remnant lesion $(9.5\%)$, and ecchymosis $(4.8\%)$ in the CP group and ecchymosis $(19.6\%),\;pain\;(7.8\%),\;and\;remnant\;lesion\;(7.8\%)$ in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. Conclusion: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

The Research about the Classification System Improvement and Cord Development of Korean Classification of Disease on Oriental Internal Medicine (한국표준질병사인분류중 한방내과영역의 분류체계 개선 및 진단명 구성에 관한 연구)

  • Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.31 no.1
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    • pp.1-10
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    • 2010
  • Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.