• Title/Summary/Keyword: Collateral

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Traumatic Dynamic Hallux Varus (A Case Report) (외상성 역동적 무지 내반증(1예 보고))

  • Yim, Soo-Jae;Lee, Young-Koo;Kim, Jin-Su;Kim, Chan-Ho;Kang, Hee-Kyung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.193-196
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    • 2009
  • The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

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Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow

  • Chung, Joon-Ho;Shin, Yong-Sam;Lim, Yong-Cheol;Park, Min-Jung
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.260-263
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    • 2009
  • Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.

External Carotid Artery Angioplasty and Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis

  • Ko, Jun-Kyeung;Lee, Sang-Weon;Lee, Tae-Hong;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.488-491
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    • 2009
  • A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.

The Clinical Study on Abnormal Liver Function Patients Caused by Obesity (비만증(肥滿症)과 간기능(肝機能) 이상(異常)을 동반(同伴)한 환자(患者) 11례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Choon-Woo;Kim, Kyung-Hoon;Park, Young-Jun;Park, Jou-Han;Yun, Bo-Hyeon
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.547-555
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    • 2001
  • Objectives: Obesity is regarded as the aggregation of needless risk factors, for instance, cardiovascular disease, joint disease, induce cancer. We studied on interrelation between abnormal liver function and obesity. Methods: We analyzed liver function, T.Cholesterol, Triglyceride before and after lose weight treatment. The collateral condition is over 6 weeks period on obesity treatment, no liver injury and no complicated another disease on personal past history and found out abnormal impression on biochemical liver function blood test. Results: The improvement rate of LFT, compare with before treatment is 10.6% in T.Bilirubin, 11.1% in ALP, 21% in AST, 38% in ALT, 37.3% in r-GTP, 9.2% in LDH and decreased 2.7% in T.Protein, increased 2.3% in Albumin. Hyperlipidemia is 19.4% in T.Cholesterol, 42.5% in Triglyceride. Conclusions: LFT and Hyperlipidemia of abnormal liver function patients, caused by obesity, is improved to normal limit in proportion to reduce patient's weight.

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Osborne-Cotterill Lesion a Forgotten Injury: Review Article and Case Report

  • Vargas, Daniel Gaitan;Woodcock, Santiago;Porto, Guido Fierro;Gonzalez, Juan Carlos
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.27-30
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    • 2020
  • Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

A Case of Infantile Hemangioendothelioma of the Liver Treated with Hepatic Embolization and Lobectomy (간동맥 색전술과 간엽 절제술로 치료한 영아 간내 혈관내피종 1례)

  • Kim, Jae Seon;Moon, Soo Kyung;Yoon, Hye Seon;Lee, Tae Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.660-664
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    • 2005
  • Infantile hemangioendothelioma(IHE) of the liver is the most common vascular tumor in infants before the age of 6 months. It is a histologically benign tumor with potentially life-threatening complications. The clinical manifestations are variable, ranging from asymptomatic forms to intractable high-output heart failure. In addition, abdominal mass, intraperitoneal hemorrhage due to rupture of mass, respiratory distress, hematologic abnormalities and jaundice can occur. Diagnostic work-up is through doppler ultrasound sonography, computed tomography scan, magnetic resonance imaging and angiography. Treatment consists of medical treatment, interventional therapy, surgical resection and liver transplantation. We experienced symptomatic IHE in a premature neonate who presented with high output heart failure and respiratory distress. Initial medical treatment and steroid therapy failed to improve his condition. Coil embolization of left hepatic artery resulted in improvement of respiratory symptoms. However, a left lobectomy was performed because the mass size was not decreased with development of collateral vessels. The infant was well, after a successful discharge from the hospital.

A study on the Ke-qin's recognition about Reverting yin disease pattern in Shanghanlun(傷寒論) (가금(柯琴)이 인식(認識)한 "상한론(傷寒論)" 궐음병(厥陰病)에 관한 연구(硏究))

  • Lee, Sang-Hyup
    • Journal of Korean Medical classics
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    • v.25 no.4
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    • pp.23-38
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    • 2012
  • Objective : Generally speaking Reverting yin disease pattern(厥陰病) is the last step in cold damage(傷寒). Therefore recognized Yin cold disease(陰寒病) is increasing, and resist action One Yang qi(一陽) began to creep into body. But Ke Qin(柯琴) have a different way of thinking that Reverting yin disease pattern connected with the loss of Liver's function. Liver qi depression(肝鬱) make a ministerial fire(相火), and it make a nutrient and blood insufficiency(營血不足). Method : I will try to describe the Sanghanlun's Reverting yin disease pattern through the Ke-qin's JueyinbingJie(厥陰病解), and I would like to point out that the exact meaning of Reverting yin(厥陰) is connected with Liver's ministerial fire. Result : Ke Qin's JueyinbingJie explained the Reverting yin disease pattern was connected with Liver(肝), and according to Six qi theory(六氣學說) connected with ministerial fire, and according to meridian and Collateral theory(經絡學說) connected with closing referring to inward actions(闔) among the Opening closing and pivot(關闔樞). Conclusion : Ke Qin was recognized that Reverting yin disease pattern have relevance to the loss of Liver's function. In other world, It is connect with soothe the liver and purge fire(疏肝瀉火) and nutrient and blood insufficiency(營血不足).

The VR1-Positive Primary Afferent-Mediated Expression of pERK in the Lumbosacral Neurons in Response to Mechanical and Chemical Stimulation of the Urinary Bladder in Rats

  • Yoo, Chan-Jong;Hwang, Se-Jin
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.462-469
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    • 2007
  • Objective : This study characterized the neurons in the lumbosacral cord that express phospho ERK (pERK) after distension or irritation of the bladder, and their relation to the vanilloid receptor 1 (VR1) positive primary afferents. Methods : Mechanical distension and chemical irritation of the bladder were induced by intravesical injection of the saline and mustard oil, respectively. Spinal neurons expressing pERK and the primary afferent fibers were characterized using multiple immunofluorescence for neurokinin 1 (NK1), neuronal nitric oxide synthetase (nNOS) and VR1. Results : Neurons in lamina I, medial dorsal horn (MDH), dorsal gray commissure (DGC) and sacral parasympathetic nucleus (SPN) were immunoreactive for pERK after either mechanical or chemical stimulation. The majority of pERK positive cells were positive for NK1 in lamina I and SPN, but not in the DGC. Most of pERK positive cells are not stained for nNOS except in a small population of the cells in the SPN and DGC. Contacts between perikarya and dendrites of pERK-positive cells and terminals of primary afferents expressing VR1 were identified in lamina I. lateral collateral path (LCP) and SPN. Conclusion : In this study, the lumbosacral neurons activated by mechanical and chemical stimulation of the urinary bladder were identified with expression of the pERK, and also provided the evidence that VR1-positive primary afferents may mediate the activation of these neurons.

Treatment of Tibial Condyle Fracture (경골과 골절의 치료)

  • Lee, Dong-Chul;Shon, Oog-Jin;Park, Sung-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.177-186
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    • 2003
  • Background: Clinical and radiological results based on fracture types and associated injuries after the treatment of tibial plateau fracture were evaluated for analyzing prognostic factors. Materials and Methods: From June 1997 to June 2002, 50 cases were followed for at least 1 year. Mean age was 47.4 years, and mean follow period was 30.0 months. Fracture classification was performed by the Schatzker method. Clinical and radiological evaluation were performed by the Porter and Rasmussen method. Evaluation was based on degree of reduction and associated injuries, etc. Results: The most common cause of injury was traffic accident (37 cases, 74%), The common fracture types by Schatzker classification were type II (14 cases) and VI (12 cases). Methods of treatment were screw fixation (15 cases), plate and screw (21 cases), external fixator (5 cases), and conservative treatment (9 cases). The most common associated injuries were ipsilateral fibular fracture (18 cases) and MCL (medial collateral ligament) injury (8 cases). Conclusion: Acceptable results after treatment of tibial plateau fracture were obtained from the anatomical reduction group, non-associated injury group, the young age group, and the early ROM (range of motion) beginning group.

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Overview of the PCL Reconstruction (후방 십자 인대 손상 치료의 개관(over view))

  • Jung, Young Bok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.1-3
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    • 1998
  • The PCL reconstruction in chronic isolate PCL reconstruction was still controversy. 1) In isolate PCL deficient knee, functionally not so bad as like ACL deficient knee. 2) The result of the PCL reconstruction was not as good as ACL reconstruction. Therefore, isolate PCL injuries has been treated as nonoperatively. Hey Grovere, who was the first to attempt an intra-articular reconstruction of the PCL, utilized the semi-tendinous tendon other static procedures have been described in only a few cases with very limited follow-up. Dynamic procedures utilizing the medial head of the gastrocnemius has been reported by Hugston and Degenhardt, Kennedy and Grainger, and Insall and Hood. These procedures did not improve static stability. Dr Clancy, who was introduce the use of BPTB for the PCL reconstruction transtibial and femoral tunnel. From 1995, untill early 1990 PCL reconstruction was done as tend as placement of the isometric point. Physiometic placement of Anatomical placement of the femoral tunnel in PCL reconstruction were introduced in 1995. Tibial Inlay Technique was reported by Dr Berg in 1995. The main advantage of the tibial Inlay Technique was to avoid fraying of the graft at the posterior tibial tunnel orifice. In complete PCL ruptured and severely posterior unstable knee, dual femoral tunnel technique will be to get better result than one bundle technique. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the posterolateral structures. Futher research is necessary to evaluate new surgical approches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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