• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.223-229
• /
• 2010

Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.1
• /
• pp.67-71
• /
• 2000

Since its first description in 1951 by Mantz and Craig, pulmonary hypertension associated with portal hypertension has been observed more frequently. In a recent prospective study Hadengue et al. reported 2 % incidence of pulmonary hypertension in patients with portal hypertension. Thus this simultaneous occurrence can no longer be considered to be coincidental. The etiology remains unclear. It is most likely that vasoactive substances, normally metabolized by the liver, may have gained access to pulmonary circulation through portosystemic collaterals in portal hypertension. In genetically susceptible individuals, these substances could lead to pulmonary hypertension by inducing vasoconstriction or direct toxic damage to the wall of the small pulmonary arteries. A recent case of pulmonary hypertension in a 49-year-old woman with portal hypertension due to liver cirrhosis is reported as well as a review of the literature.

• Journal of the Korean Institute of Oriental Medical Informatics
• /
• v.17 no.2
• /
• pp.130-287
• /
• 2011

"zhenjiusunanyaozhi(鍼灸素難要旨)" is composed of three volumes and published in 1529 by Gao Wu(高武). Gao Wu(高武) is skillful in astronomy, the art of war and the law as well as a medical practitioner in Ming Dynasty. The books he wrote "zhenjiujuying(鍼灸聚英)", "zhizhi(直指)", "douzhenzhengzong(痘疹正宗)", "shexuezhinan(射學指南)", "zhenjiujieyao(鍼灸節要)". "zhenjiusunanyaozhi鍼灸素難要旨" is written by classifying the origin of acupuncture and moxibustion. In other words, it is edited by classifying the contents related to acupuncture and moxibustion out of the ancient Chinese medical book "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" in which are composed of 3 volumes as follows, Volume 1 says the main diseases on "the nine acupuncture needles figure" (九針圖), "the reinforcing and reducing the meridian" (補瀉), "the needle depth" (針刺深淺), "the five shu points - metal, wood, water, fire, earth" (正,滎,輸,經,合) based on 18 chapters in terms of acupuncture in "yellow emperor eighty-one Difficult "難經"", in which it quotes the annotation of "the difficulty by the original meaning "難經本義"" written by Hua Shou(滑壽) in Yuan Dynasty. Volume 2 is composed of 2 parts. Part 1 says the method of treatment on 36 Chapters, the method of acupuncture use in the Linshu "靈樞" and the Suwen "素問" such as "the rule of acupuncture use" (用針方宜), "the nine-pin method" (九針式) and "the nine-pin to only use the time appropriate to consider nature of Heaven, Earth and person" (九針應天地人時以起用) etc., Part 2 says "the five difficult acupuncture(五亂刺)", "the rise and fall of energy and blood(氣血盛衰)". "the pain tolerance(耐痛)" and ect., in which are in terms of method of treatment collected the original texts of 59 chapters on acupuncture to each disease and of 8 chapters on moxibustion in the Linshu "靈樞" and the Suwen "素問". Volume 3 includes 10 chapters in which consist of "the stabbing to disease in 12 meridians (十二經病刺)", "the eight extra meridian disease (寄經八脈病)", "the twelve meridians(十二經脈)", "the fifteen collaterals (十五絡脈), the twelve meridian muscles (十二經筋)", "the acupoint (孔穴)" and etc. This is the book edited comprehensively by classifying the contents on the theory of acupuncture and moxibustion and the circulations of meridians in "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" and there is no case story in particular except his comments in person. This study is for the purpose of helping researching and developing acupuncture and moxibustion and applying their clinical training.

• Korean Journal of Radiology
• /
• v.21 no.5
• /
• pp.582-587
• /
• 2020

Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1062-1068
• /
• 1997

From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.

• Journal of the Korean Society of Fisheries and Ocean Technology
• /
• v.21 no.2
• /
• pp.131-136
• /
• 1985

The calculation of the resulting fluid motion is an important problem of ship hydrodynamics. For a partially immersed body the condition of constant pressure at the free surface can be linearized. The resulting linear boundary-value problem for the velocity potential is the Neumann-Kelvin problem. The two-dimensional Neumann-Kelvin problem is studied for the half-immersed circular cylinder by Ursell. Maruo introduced a slender body approach to simplify the Neumann-Kelvin problem in such a way that the integral equation which determines the singularity distribution over the hull surface can be solved by a marching procedure of step by step integration starting at bow. In the present pater for the two-dimensional Neumann-Kelvin problem, it has been suggested that any solution of the problem must have singularities in the corners between the body surface and free surface. There can be infinitely many solutions depending on the singularities in the coroners.

• The Journal of Dong Guk Oriental Medicine
• /
• v.8 no.2
• /
• pp.131-154
• /
• 2000

Nan Jing(Difficult Classic), as a catechism, describes in detail and deeply the ideas in Nei Jing(Huangdi's Internal Classic). The description of Nan Jing is focused on basic theories including theories about some disease and is excellent in identification and analysis. The contents of Nan Jing are as follows: 1-23 Nan-pulse and pulse condition, 24~29 Nan-channels and collaterals, 30~47 Nan-viscera and bowels(Zang Fu organs), 48~61 Nan-disease, 62~68 Nan-acupuncture points, 69~91 Nan-acupuncture. Especially, diagnosis techniques in Nan Jing make 'Only method of cunkou pulse taking' that is a technique for feeling the pulse widely applied in these days in Oriental medicine clear. Thus, this book adjusts the theory of pulse and pulse condition given in 1~23 Nan of 'The Study of Nan Jing' in order to enhance an understanding about the theory of pulse and pulse condition. The text of 1~23 Nan about pulse lore centers on all pulse of human body interconnected each other and cunkou, both ends of the pulse, and contrasts regular pulse with irregular pulse. 1. 10 Nan describes the theory about five kinds of evils and hardness and softness, and unique pulse condition of each bowels. 2. 13 Nan explains that the relative difficulty of medical treatment is determined by the degree of balance or unbalance among three factors-colors, pulse and pulse condition, flesh shape. 3. 14 Nan divides pulse and pulse condition into slow pulse and rapid pulse, and explains separately abnormality, great loss of semen, death caused by slow pulse, and abnormality, great loss of semen, death caused by rapid pulse. 4. 15 Nan about taut pulse(弦), full pulse(鉤), floating pulse(毛), deep pulse(石脈) describes that pulse and pulse condition differs according to four seasons. Therefore, Nan Jing establishes clearly techniques of feeling the pulse in 'Only method of cunkou pulse taking(獨取寸口)' and advances the theory of Nei Jing. Futhermore, Nan Jing is more valuable in that it suggests unique theory different with Nei Jing.

• The Journal of Dong Guk Oriental Medicine
• /
• v.8 no.2
• /
• pp.155-173
• /
• 2000

The diagnosis in Oriental medicine is done by inspection, auscultation and olfaction, interrogation, four diagnostics of pulse feeling and palpation, and various system of identification like identification according to Qi(vital energy), Xue and body fluids, identification according to fair principles, identification according to principles of Wei, Qi, Ying and Xue, identification according to Sanjiao(the triple heater), identification according to four type physical constitution. Sometimes, symptoms and diagnosis techniques according to symptoms is selectively applied for the diagnosis. Among them the pulse feeling and palpation diagnosis technique using the sense of finger and palm of the hand is divided into feeling of pulse and palpation and pressing maneuver. Pressing maneuver is a diagnosis technique pressing and rubbing the affected part in order to attain data of identification including inside and outside condition of the body with regard to the nature, condition and relative seriousness of disease. There are palpation of the skin, palpation the hand and foot, palpation the chest and the abdomen, palpation shu points in pressing maneuver. The diagnosis of the Back Shu points is a technique to examine the change of disease condition from pressure ache, spontaneous ache, tension, relaxation, solidification revealed through channels and collaterals. I investigates starting disease and an attack of disease of twelve pulse and pulse condition through the study relative to the substance and technique of pressing maneuver, and adjusts diagnosis techniques of a region for acupuncture and matters to be attended. The conclusions are as follows. 1. The Shu or stream points in which pathogenic factors go are important to medical treatment of dormant diseases like bowels disease, cold symptom complex and insufficiency symptom complex. 2. Disease classified by system is diagnosed by the condition of process part like pro-trusion, cave-in, tension, relaxation, pressure ache through palpating the Shu or stream points, that is pressing upward or downward left and right sides of the backbone process by hands. 3. In real clinic pressing maneuver of one's back side is very important to patient's diagnosis treatment. Thus, pressing maneuver of one's back side have to be done without omission. 4. Diagnosis must be accomplished through the perception about the diversity of diagnosis technique of bowels disease, the exact knowledge about pressing maneuver of one's back side for enlargement of treatment range and rising of treatment rate, and pressing maneuver of the Shu or the stream points.