• Journal of Chest Surgery
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• v.21 no.6
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• pp.990-995
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• 1988

Seventeen cases of vascular injuries treated in Chungnam National University Hospital during the period from Apr. 1980 to Sep. 1988 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries. Of the 11 arterial injuries, 3 were femoral artery which was the commonest in frequency, the next was 2 cases of subclavian, common carotid, iliac artery. Of the 10 venous injuries, the subclavian vein and internal jugular vein were common in frequency. The most frequent type of injuries was laceration[13 cases in 21]. Vascular reconstruction was done by lateral suture repair in 8 cases, autogenous vein graft in 2, prosthetic vascular graft in 5, direct anastomosis in 1 case. Simple ligation was done in 5 cases. There was 1 case of visual field defect as a sequelae in right common carotid artery transaction and 1 case of mortality.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.90-97
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• 1977

This is a report of a. case in which a long narrow segment coarctation of the aorta was successfully corrected with Teflon graft. The patient was 30 year old man with hypertensive symptoms that occurred 7 years prior to operation. Blood pressure measured 230/110 mmHg in the arms and 110/80 mmHg in the legs. Pulses were strongly tensive in radial artery, but very weak in femoral artery and even absent in dorsal pedis artery. Final preoperative diagnosis was made by aortography which showed a long narrow segment between aortic arch and descending thoracic aorta and highly developed collateral circulations. A long hypoplastic narrow segment was located proximal to the ligament arteriosus, and diaphragmatic stenosis of the aorta was located just distal to the ligamentum arteriosus. After prosthetic correction of the coarctation of the aorta, blood pressure were measured 130/ 80 mmHg in the arms and 150/100 mmHg in the legs. Peripheral pulses were palpated normally, and the postoperative course was uneventful.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.808-811
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• 1993

Leriche syndrome ia a common entity which causes ischemia of the lower extremities. Since the introduction of aortic resection and homograft replacement by Oudot in 1951, reconstructive procedures to restore distal blood flow by either endarterectomy or, later, with prosthetic graft have become standardized. Recently we experienced a case of Leriche syndrome. A 50 year-old male patient admitted with intermittent claudication, impotence, and symmetrical atrophy at lower extremities. Aortogram revealed complete obstruction at infrarenal abdominal aorta and Doppler sonogram revealed only minimal blood flow at left femoral artery.Successful surgical treatment was accomplished with endarterectomy at proximal left renal artery and a bypass from abdominal aorta at the level of both renal arteries to both external iliac arteries with bifurcated Gore-tex vascular graft. After bypass operation, we did palpate with arterial pulse at both popliteal artery.He was recovered without complication.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.7-13
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• 2008

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.371-377
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• 2017

Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral-above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. Results: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. Conclusion: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.203-208
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• 2007

Purpose: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. Methods: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from $4{\times}6.5cm$ to $10{\times}13cm$. Results: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. Conclusion: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.133-136
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• 2017

A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency. The edema was relieved postoperatively and the graft was patent. During the second stage, which was performed 6 months later, the fistula was occluded by coil embolization. The staged procedure described herein provides an alternative for venous reconstruction when autologous vein is unavailable.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.151-157
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• 2014

Purpose: We report the surgical outcomes for femoral shaft fractures in polytrauma patients who were temporarily treated with external fixation and subsequently converted to internal fixation. Methods: From August 2008 to April 2012, we enrolled 13 patients with multiple traumas due to high-energy injuries and concurrent femoral shaft fractures in which temporary external fixation was carried out. The mean age was 39 years, with a range from 18 to 55 years. Ten were men and 3 were women. According to the AO/OTA classification of fractures, type A was found in 5 patients, type B in 6, and type C in 2, with open fractures being found in 6 patients and femoral artery rupture occurring in 2. For internal fixation, intramedullary nailing was performed in 7 patients, and minimally-invasive fixation of locking compression plates was used in 6. Results: Of the 7 patients converted to intramedullary nailing, 1 experienced delayed union. Of the 6 patients treated with minimally-invasive plate fixation, delayed union occurred in 5, and an auto-bone graft was performed within, on average, 8 months (range: 5~10 months), leading to bone union in all cases in the final follow-up. None of the patients experienced infections or complications involving other organs after having been converted to internal fixation. During the mean follow-up of 19 months, patients achieved satisfactory functional outcomes. Conclusion: In polytrauma patients with a femoral shaft fracture who have been treated with temporary external fixation and who may need internal fixation due to the occurrence of delayed union, an appropriate internal fixation method needs to be selected based on the patient's physical status, and the fracture type.

• Journal of Pharmaceutical Investigation
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• v.29 no.1
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• pp.47-53
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• 1999

Gastrodia elata (GE) is an oriental medicinal herb which has been used traditionally for the treatment of various brain diseases including convulsion and epilepsy. The purpose of this study was to determine pharmacokinetic parameters of 4-hydroxy-3-methoxybenzaldehyde (HMBA) and p-hydroxybenzaldehyde (PHBA), constituents of GE, in rats. Male rats were cannulated in the femoral vein, femoral artery, bile duct and ureter. They received a single i.v. bolus dose of either HMBA or PHBA through the femoral vein. The concentration of HMBA or PHBA in plasma, bile and urine samples were analyzed by reversed-phase HPLC. HMBA and PHBA have very short half-lives, i.e. 4.03 and 2.26 minutes respectively. Most of HMBA and PHBA were thought to be eliminated through metabolism as the metabolized fraction approaches unity. Derivatives of HMBA or PHBA with longer biological half-lives should be designed to develop better anticonvulsants and more complete qualitative and quantitative understanding of the overall pharmacokinetic fate of these compounds awaits further investigation.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.170-173
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• 2008

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.