• Journal of Chest Surgery
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• v.32 no.12
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• pp.1135-1139
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• 1999

Multistage unifocalization and complete repair have been performed for pulmonary atresia ventricular septal defect and major aortopulmonary collateral arteries. We reported a case that divided major aortopulmonary collateral artery was changed into an aneurysm that compressed the left main bronchus. A 1-year-8-month old boy was operated. The Rastelli operation with left pulmonary artery reconstructuion ligation of patent ductus arteriosus and take-down of right Blalock-Taussing shunt was performed on the patient who had pulmonary atreisia ventricular septal defect patent ductus arteriosus and MAPCA at 1 year and 8 months of his age. He previously underwent the unifocalization and right B-T shunt at 9 months of age,. He repeatedly had difficulty in weaning from the mechanical ventilator, After removing the aneurysm from the divided MAPCA that compressed the left main bronchus externally it was possible to wean him from the mechanical ventilator.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.201-208
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• 2019

Objective : In patients with internal carotid artery (ICA) occlusion, collateral middle cerebral artery (MCA) flow has a protective role against ischemia. However, some of these patients may experience initial major neurological deficits and major worsening on following days. Thus, we investigated the safety and efficacy of endovascular treatment (EVT) for ICA occlusion with collateral MCA flow by comparing clinical outcomes of medical treatment versus EVT. Methods : The inclusion criteria were as follows : 1) acute ischemic stroke with ICA occlusion and presence of collateral MCA flow on transfemoral cerebral angiography (TFCA) and 2) hospital arrival within 12 hours from symptom onset. The treatment strategy was made by the attending physician based on the patient's clinical status and results of TFCA. Results : Eighty-one patients were included (30 medical treatment, 51 EVT). The EVT group revealed a high incidence of intracranial ICA occlusion, longer ipsilesional MCA contrast filling time, and a similar rate of favorable clinical outcome despite a higher mean baseline the National Institutes of Health Stroke Scale (NIHSS) score. By binary logistic regression analysis, intravenous recombinant tissue plasminogen activator and EVT were independent predictors of favorable clinical outcome. In subgroup analysis based on stroke etiology, the non-atherosclerotic group showed a higher baseline NIHSS score, higher incidence of EVT, and a higher rate of distal embolization during EVT in comparison with the atherosclerotic group. Conclusion : In patients with ICA occlusion and collateral MCA flow, decisions regarding treatment strategy based on TFCA can help achieve favorable clinical outcomes. EVT strategy with respect to etiology of ICA occlusion might help achieve better angiographic outcomes.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.37-43
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• 1994

The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.31-41
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• 2024

Objective : Collateral circulation is associated with the differential treatment effect of endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to verify the ability of the collateral map to predict futile EVT in patients with acute anterior circulation ischemic stroke. Methods : This secondary analysis of a prospective observational study included data from participants underwent EVT for acute ischemic stroke due to occlusion of the internal carotid artery and/or the middle cerebral artery within 8 hours of symptom onset. Multiple logistic regression analyses were conducted to identify independent predictors of futile recanalization (modified Rankin scale score at 90 days of 4-6 despite of successful reperfusion). Results : In a total of 214 participants, older age (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.56 to 3.67; p<0.001), higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR, 1.12; 95% CI, 1.04 to 1.21; p=0.004), very poor collateral perfusion grade (OR, 35.09; 95% CI, 3.50 to 351.33; p=0.002), longer door-to-puncture time (OR, 1.08; 95% CI, 1.02 to 1.14; p=0.009), and failed reperfusion (OR, 3.73; 95% CI, 1.30 to 10.76; p=0.015) were associated with unfavorable functional outcomes. In 184 participants who achieved successful reperfusion, older age (OR, 2.30; 95% CI, 1.44 to 3.67; p<0.001), higher baseline NIHSS scores (OR, 1.12; 95% CI, 1.03 to 1.22; p=0.006), very poor collateral perfusion grade (OR, 4.96; 95% CI, 1.42 to 17.37; p=0.012), and longer door-to-reperfusion time (OR, 1.09; 95% CI, 1.03 to 1.15; p=0.003) were associated with unfavorable functional outcomes. Conclusion : The assessment of collateral perfusion status using the collateral map can predict futile EVT, which may help select ineligible patients for EVT, thereby potentially reducing the rate of futile EVT.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.49-54
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• 2005

Purpose: Complete rupture of metacarpophalangeal ulnar collateral ligament of thumb needs surgical exploration and repair, owing to the interposition of the adductor aponeurosis (Stener lesion) which interferes in healing process. We performed arthroscopic diagnosis and treatment on ulnar collateral ligament injury of thumb and evaluated it's efficiency. Materials and Methods: Arthroscopy was perfomed on 13 patients of whom injured on complete ruture of metacarpophalangeal ulnar collateral ligament. Follow-up period was over 1 year and mean age was 35.6 years old. Ulnar collateral ligament tears and Stener lesion were diagnosed and treated by arthroscopy procedure. Results were interpreted by joint instability, pinch power, grip power and range of motion on metacarpophalangeal joint of thumb. Results: We found 5 Stener lesions in 13 cases. There was no appreciable postoperative instability. Pinch and grip power were recovered to 92%, 94% of uninjured thumb respectively. Range of motion on metacarpophalangeal joint was mean $52^{\circ}$, almost equal to uninjured thumb. Conclusions: Arthroscopic treatment in metacapophalangeal ulnar collateral ligament injury of thumb is useful method that Stener lesion can be clearly comfirmed and treated. Also soft tissue injuries can be minimized, thereby early functional recovery can be expected.

• Journal of Pharmacopuncture
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• v.17 no.4
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• pp.50-54
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• 2014

Objectives: Digital infrared thermographic imaging (DITI) has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient's with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient's who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient's knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient's were composed of 14 women (70%) and 6 men (30%), with a mean age of $62.15{\pm}15.71$ (mean${\pm}$standard deviation (SD)) years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05). The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.9-22
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• 2020

Objectives: The purpose of this study is to consider the concept of Meridian Points(經穴) and to establish the directions in further research. Methods: First, based on the latest results from the researches of Meridian and Collateral(經絡), it was to infer the original concept of Meridian Points(經穴). Second, the meaning of Meridian Points(經穴) has been investigated and its directions in further research was studied founded upon Symbolic Mathematical Study(象數學). Results ＆ Conclusions : Firstly, Meridian Points(經穴) are considered to be the source of information that contains 365 numbers of human physiological information which includes physiological information of Viscera and Bowels(藏府) and Meridian and Collateral(經絡). Secondly, advanced researches are required further to clarify the meaning of Meridian Points(經穴) as Symbolic Mathematical Study(象數學) has established the systems of Meridian Points(經穴). In addition, the efficacy of each Meridian Points(經穴) needs to be revised through literature studies. Clinical studies are essential to practically verify the results from the former theoretical research. Thirdly, the contention to oppose the presence of Meridian and Collateral(經絡) and Meridian Points(經穴) was acknowledged to be incorrect. Lastly, for broadening the theoretical systems of Korean Medicine(韓醫學) with integration of Western scientific knowledge, a paradigm shift is necessary to revise the concepts of Viscera and Bowls(藏府), Meridian and Collateral (經絡) and Meridian Points(經穴) in Korean Medicine(韓醫學). In order to accomplish the shift, the ambiguity in theories of Korean Medicine(韓醫學) should be clarified through the study of Symbolic Mathematical Study(象數學).

• Journal of Haehwa Medicine
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• v.20 no.1
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• pp.1-10
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• 2011

By studying the portions and layers(分部), left and right, superior and inferior, location of yin and yang, and beginning and end of diseases of skin, which is the core point of the theory of cutaneous region(皮部論) in "Naejing(內經)", in the physiological and pathological perspective, based on opinion of historic memorial doctors, arrived to the conclusion as below. Cutaneous region means not only the distribution of three yin and three yang(三陰三陽) of the surface, but also inside and outside, shallowness and depth, and it is the system which unites meridians, networks, and vessels. It is divided into portions and layers. The origin and beginning of diseases and the rule of favorable pattern and unfavorable pattern can be known through it. The portion of skin is not only the area that meridian vessels belongs to skin, but also the area that activation of twelve meridian vessels are expressed in the surface. The layer of skin is consisted in order of skin-tertiary collateral vessel-collateral vessel-meridian vessel-bone. In "Naejing", there are two preconditions to divide three yin and three yang into yin and yang. The first is standing while looking the south, and second is the quotation "outside is side of yang(外者爲陽 內者爲陰)." According to this preconditions, yang of outside of yang brightness, lesser yang, and greater yang is the whole body, except inside of hand and foot which yin of lesser yin, pericardium, and greater yin. Superior and inferior of the portions and the layers is designated as hand and foot, theological basis of which superior and inferior work in same diagnostic method can be found in the root and the basis(標本) and the origin and the insertion(根結). In conclusion, cutaneous region not only manages layer of the skin, but also it is divided into layers and portions, so it has close relations between meridian vessels and collateral vessels. The in-depth study of cutaneous region and meridians should be progress, in order to practice of diagnosis and acupuncture and moxibustion more.

• Korean Journal of Digital Imaging in Medicine
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• v.11 no.2
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• pp.69-77
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• 2009

This study gives an account of the collateral standards in IEC 60601-1-3: 2008 specifying the general requirements for basic safety and essential performance of diagnostic X-ray equipment regarding radiation protection as it pertains to the production of X-rays. The collateral standards establish general requirements for safety regarding ionization radiation in diagnostic radiation systems and describe a verifiable evaluation method of suitable requirements regarding control over the lowest possible dose equivalent for patients, radiologic technologists, and others. The particular standards for each equipment can be determined by the general requirements in the collateral standard and the particular standard is followed in the risk management file. The guidelines for radiation safety of diagnostic radiation systems is written up in ISO 13485, ISO 14971, IEC 60601-1-3(2002)1st edition, medical electric equipment part 1-3, and the general requirements for safety-collateral standards: programmable electrical medical systems. Therefore the diagnostic radiation system protects citizens' health rights with the establishment and revisions of laws and standards for diagnostic radiation systems as a background for the general requirements of radiation safe guards applies, as an international trend, standards regarding the medical radiation safety management. The diagnostic radiation system will also assure competitive power through a conforming evaluation unifying the differing standards, technical specifications, and recognized processes.