• Title/Summary/Keyword: Collateral

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Scintiangiographic Visualization of Systemic-Portal Venous Shunting as a Cause of "hot Spot" in Superior Vena Cava Obstruction (상대정맥폐쇄증에 의한 전신.문맥계 단락에 따른 국소성 간열소의 출현)

  • Park, Jeong-Mi;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.145-148
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    • 1985
  • A small number of pathologic entities such as Budd-Chiari Syndrome, cirrhosis, focal nodular hyperplasia, and superior and inferior vena cava obstruction has been reported to result in focal areas of increased uptake of radiocolloid on the hepatoscintigram. We recently studied a patient with focal accumulation of $^{99m}Tc-phytate$ at the inferior aspect of the liver, at the junction of the right and left lobe. The superior vena cava scintiangiogram was taken for the evaluation of the superior vena cava obstruction and collateral circulations. As a result of superior vena caval obstruction a considerable amount of blood flowed to the liver through the anterior parietal and periumblical venous channels. A certain fraction of radiocolloid delivered by the rete mirabile perfused to a localized area of the liver. This would explain the hot spot around the porta hepatis in this case.

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Paradigm Shift in Intra-Arterial Mechanical Thrombectomy for Acute Ischemic Stroke : A Review of Randomized Controlled Trials after 2015

  • Sheen, Jae Jon;Kim, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.427-432
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    • 2020
  • Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was effective and safe in acute ischemic stroke with anterior circulation occlusion when performed within 6 hours of stroke onset. There are four reasons underlying the different results observed between the trials conducted in 2013 and 2015. First, the three RCTs of 2013 used low-efficiency thrombectomy devices. Second, the three RCTs used insufficient image selection criteria. Third, following the initial presentation at the hospital, reperfusion treatment required a long time. Fourth, the three RCTs showed a low rate of successful recanalization. Time is the most important factor in the treatment of acute ischemic stroke. However, current trends utilize advanced imaging techniques, such as diffusion-weighted imaging and multi-channel computer tomographic perfusion, to facilitate the detection of core infarction, penumbra, and collateral flows. These efforts demonstrate that patient selection may overcome the barriers of time in specific cases.

An Interpretative Study on the Nam-Sa Village Space by Shamanistic Space Model (무속 공간모형에 의한 남사마을 공간 해석에 관한 연구)

  • 김동찬;이윤수;임상재
    • Journal of the Korean Institute of Landscape Architecture
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    • v.27 no.2
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    • pp.95-107
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    • 1999
  • Shamanism is an ancient culture that is also considered as a religious rite by most of people. So, shamanism is an important part of Korean tradition and should be a significant base to the Korean exterior space organization theme. However in the field of Landscape architecture th principle of exterior spacing has not yet clearly been identified as shamanistic. Therefore believe that this study can exhibit a model for the study of shaministic space language and its application to one of Korean's village Namsa. The results of this study are summarized below; 1. Extracted models are Unspecialized· Circular·Coninuous space. These are analyzed on the basis of the shaministic space language. Also shaministic space languages are based with Korean common belief of eternal human identify, circular view of the world. 2. Applying the shamanistic space models to Namsa village shows that shamanistic space models follow the Korean space organization principle. Some area of the village do not apply, because they were built on the structure of the social hierarchy between families or the difference between head households and collateral households. 3. Applying the shamanistic space model to Namsa village shows that the shamanistic space model follows the Korean space organization principle. Therefore can say that Namsa village was built by a shamanistic system that pursued eternal human identity.

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New Technique for Posterolateral Instability of The Knee: Posterolateral Reconstruction Using The Tibialis Posterior Tendon Allograft (슬관절 후외측 불안정성 치료의 새 기법: 동종 후경골건을 이용한 후외측 재건술)

  • Kim Sung-Jae;Ryu Sang-Wook;Cheon Yong-Min;Yong Suk-Won;Kim Bo-Ram
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.136-141
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    • 2003
  • Posterolateral instability of the knee is known as one of the most challenging injuries . Although several procedures have been designed for the posterolateral instability, there is no gold standard management yet. We present a technique for posterolateral instability of the knee using tibialis posterior tendon allograft, which reconstructed lateral collateral ligament and popliteal tendon.

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Reconstruction of Recurrent Posterolateral Rotatory Instability of the Elbow - A Case Report - (재발성 주관절 후외방 회전 불안정성의 재건술 - 증예보고 -)

  • Jeon In Ho;Kyung Hee Soo;Kim Poong Taek;Ihn Joo Chul
    • Clinics in Shoulder and Elbow
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    • v.4 no.2
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    • pp.191-195
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    • 2001
  • Posterolateral rotatory instability is the most common pattern of elbow instability especially which is recurrent, and is usually post-traumatic because of inadequate soft tissue healing. The lateral ulnar collateral ligament was reconstructed by using ipsilateral palmaris longus tendon. Functionally good result was obtained. This is a case report illustrating the posterolateral rotatory instability of the elbow and its reconstruction with palmaris longus.

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Mycotic Aneurysm of the Superior Mesenteric Artery -Report of 2 Cases- (상간장막동맥에 발생한 감염성 동맥류의 외과적 치료 - 2례 보고 -)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.97-102
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    • 1997
  • We have experienced two cases of mycotic aneurysms of the superior mesenteric artery The first case originated from septic embolism of Infective endocarditis and the second case originated from salmonella enteritis eight months before The aneurysms were diagnosed by abdominal ultrasonography and comflrmed by computed tomogram and dngiography but the blood culture was negative in both cases at the time of the surgery. Both patient ere successfully treated by resection only and the restorations of vdsculdr continuity were not neccesary because of adequate collateral circulations to the intestine. Both pd.tient's postoperative courses were uneventful after the follow up of one year and nine months, respectively.

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Replacement Operation for Occlusion of Great Vein with Dacron Prosthesis: 3 Cases Report (대정맥 폐쇄증에 대한 인조혈관 대치술[치험 3예])

  • Lee, Jung-Ho;Kim, Byeong-Yeol;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.274-279
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    • 1981
  • We performed three replacement operations of great venous obstruction with Dacron prosthesis from July, 1980 to Nov. 1980. Summary of 3 cases as belows: 1) Inferior vena cava obstruction . 43 years old male was admitted because of abdominal distension and marked superficial collateral circulation on chest and abdomen. Inferior vena cavogram showed complete obstruction of I. V .C. just below hepatic vein. Bypass operation was done between Rt atrium '||'&'||' I. V.C. (just above renal vein) with Woven Dacron prosthesis (22mm in Diameter) under ex tracorporeal ci rculation. 2) Superior vena cava obstruction . 21 years old male was admitted because of facial edema and irritative cough. Well circumscribed lobulated mass was located at ant. superior mediastinum and extended to Rt. thorax in chest P-A view. Woven Dacron prosthesis (10mm in Diameter) was replaced at involved S.V.C. segment after Rt. upper '||'&'||' middle lobectomy with tumor resection. 3) Common iliac vein obstruction (Lt) . 64 years old female was admitted because of generalized edema and tenderness of Lt. lower extremity. Venography of Lt leg showed complete obstruction of common iliac vein. Woven Dacron prosthesis (10mm in Diameter) was replaced at obstruction site.eplaced at obstruction site.

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Surgical treatment of pulmonary atresia -2 cases- (폐동맥 폐쇄증 (Pulmonary atresia)의 외과적 치료 -2예 보고-)

  • 강경훈
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.464-469
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    • 1986
  • Pulmonary atresia with intact ventricular septum, and with VSD were uncommon congenital anomalies with high mortality in the neonatal period. Those survivals depend on an adequate interatrial communication or interventricular communication and pulmonary flow via large aortopulmonary collateral including PDA. Recently we experienced surgical correction of 2 cases pulmonary atresia with intact ventricular septum and with VSD. On case 1, 10-years old male patient was confirmed as pulmonary valvular membranous atresia with intact ventricular septum combined with large functioning PFO and mild tricuspid incompetence. So we performed total correction under the E.C.C, that was PDA ligation, RVOT reconstruction with monocusp valved outflow patch [16mm], repair of tricuspid insufficiency and closure of PFO. Post-operative hemodynamic result was good and there was no event during hospital course. On case 2, 16-years old female patient was diagnosed as pulmonary atresia with VSD and PDA. MPA was absent, remained fibrous cord like remnant and type of VSD was subaortic defect [3cm by 3cm in the size]. PDA was located at the usual site. Under the E.C.C. VSD patch closure through the right ventriculotomy, anastomosis between the right ventricular outflow tract and the pulmonary bifurcated site with the extra-cardiac Hancock valved conduit [22cm] and PDA ligation were performed.

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Epicondylitis (상과염)

  • Chung Sun-Gun
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.81-87
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    • 2005
  • Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.

Rainfall induced instability of mechanically stabilized earth embankments

  • Roy, Debasis;Chiranjeevi, K.;Singh, Raghvendra;Baidya, Dilip K.
    • Geomechanics and Engineering
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    • v.1 no.3
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    • pp.193-204
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    • 2009
  • A 10.4-m high highway embankment retained behind mechanically stabilized earth (MSE) walls is under construction in the northeastern part of the Indian state of Bihar. The structure is constructed with compacted, micaceous, grey, silty sand, reinforced with polyester (PET) geogrids, and faced with reinforced cement concrete fascia panels. The connections between the fascia panels and the geogrids failed on several occasions during the monsoon seasons of 2007 and 2008 following episodes of heavy rainfall, when the embankment was still under construction. However, during these incidents the MSE embankment itself remained by and large stable and the collateral damages were minimal. The observational data during these incidents presented an opportunity to develop and calibrate a simple procedure for estimating rainfall induced pore water pressure development within MSE embankments constructed with backfill materials that do not allow unimpeded seepage. A simple analytical finite element model was developed for the purpose. The modeling results were found to agree with the observational and meteorological records from the site. These results also indicated that the threshold rainwater infiltration flux needed for the development of pore water pressure within an MSE embankment is a monotonically increasing function of the hydraulic conductivity of backfill. Specifically for the MSE embankment upon which this study is based, the analytical results indicated that the instabilities could have been avoided by having in place a chimney drain immediately behind the fascia panels.