• Title/Summary/Keyword: Peripheral vascular disease

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Continuous Stellate Ganglion Block for Raynaud'S Disease -A case report- (Catheter를 이용한 지속적 성상신경절 차단 경험 -증례 보고-)

  • Lee, Sang-Ryull
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.278-280
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    • 1997
  • Stellate ganglion block has been used to treat diseases such as peripheral vascular disease, sympathetic dystrophy, and various pain syndromes involving the head or arm. Raynaud's disease is a syndrome manifested by attacks of pallor, cyanosis, numbness and pain of the digits in response to cold or emotional change. I report one case who was given Stellate ganglion block using 18G teflon Catheter(4.5 cm in length) for Raynaud's disease. Continuous stellate ganglion block is more convinient to inpatient than repeated needle punctures and may reduce major complications and more useful to patient who needs continuous sympathetic block about one week duration.

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Prognostic Factors in Patients Treated with DrugCoated Balloon Angioplasty for Symptomatic Peripheral Artery Disease

  • Sigala, Fragiska;Galyfos, George;Stavridis, Kyriakos;Tigkiropoulos, Konstantinos;Lazaridis, Ioannis;Karamanos, Dimitrios;Mpontinis, Vangelis;Melas, Nikolaos;Zournatzi, Ioulia;Filis, Konstantinos;Saratzis, Nikolaos
    • Vascular Specialist International
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    • v.34 no.4
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    • pp.94-102
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    • 2018
  • Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was $24.2{\pm}2.3$ months. Results: Overall, 149 patients (mean age: $68.6{\pm}8.3$ years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients (당뇨병 환자의 혈압 일주기 리듬에 관한 조사연구)

  • 김화순;서화숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.741-749
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    • 2000
  • This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( $^2$) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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Extravasation of Prostaglandin E1 during Bier Block for the Treatment of Occlusive Arterial Disease (폐쇄성 혈관 질환의 치료를 위한 Bier Block중에 발생한 Prostaglandin E1의 혈관의 유출)

  • Choe, Huhn;Lee, Yong-Tae;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.299-302
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    • 1994
  • Prostaglandin E1(PGE1) is a potent vasodilator and is a useful drug for the treatment of occlusive peripheral vascular disease. It has been used systemically via intravenous route or regionally via intraarterial route. We tried intravenous regional administration of PGE1 for the treatment of a patient with occlusive arterial disease involving left fingers. During the 13th injection, the patient complained of severe pain at the injection site during the drug administration. Thereafter, the patient developed painful and severe swelling with blebs on his left hand. Systemic antibiotics were given together with stellate ganglion block of the affected left side. PGE1 was substituted to reserpine, which is subcutaneously injectable, for the second term treatment.

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A study on post-formula instruction of Kyejitang(桂枝湯) (계지탕(桂枝湯) 방후주문(方後註文)에 관한 연구(硏究))

  • Kim, Kang;Meang, Woongjae
    • The Journal of Korean Medical History
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    • v.23 no.1
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    • pp.23-41
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    • 2010
  • Greater yang disease(太陽病) is a syndrome induced by peripheral obstruction. One of them is "wind stroke(中風)" with the obstruction in lymphatic system. The other obstruction appearing on circulatory system is called "cold damage(傷寒)." Kyejitang(桂枝湯) is the formula prescribed for greater yang wind stroke pattern(太陽中風證) which is caused by peripheral lymphatic duct obstruction. Ramulus Cinamoni acts as a vasodilator and Radix Paeoniae relieves the abdominal tension. They make blood move to the internal organ and this can remove the retention of peripheral lymphatic system. Covering the patient with a blanket and getting him/her to have hot and thin rice gruel causes slight Diaphoresis, contributing to relieving the retention of lymphatic system. Disharmony between nutrient and defense(營衛不和) means that pressure becomes different between lymphatic system and vascular system. Kyejitang(桂枝湯) is called releasing muscles formula(解肌劑) because it can resolve such pressure difference. Diaphoresis is not a means to eliminate pathogenic qi(邪氣) from the body. That is the syndrome proving that the body fluid has moved around when disordered fluid distribution is corrected. Therefore, diaphoresis should be induced weakly all the time. If diaphoresis is induced excessively, body fluid will move more than desired and then illness cannot be cured. In Sanghanlun(傷寒論), dispersing drugs aim at addressing the retention in the exterior field, but it actually applies to the entire exterior and interior to make body fluid move. Therefore, diaphoresis does not just act on exterior field, and freeing the stool does not only apply to interior field. Distribution of body fluid changed by pathogenic qi(邪氣) influences the whole body because the human body has a closed circulatory system. Sanghanlun(傷寒論) has included treatments for pathogenic disease. However, its value should not be limited to pathogenic disease. It is because controlling blood flow by sending body fluid to the place a doctor wants is certainly worth using for treatment of non-exogenous disease or chronic illnesses.

Treatment of Facial Palsy in Hyangsang Medicine (구안와사(口眼喎斜)의 형상의학적 치료)

  • Kang Kyung Hwa;yeon Jong Won;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1585-1597
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    • 2004
  • Facial palsy is a common disease in clinic, which can be classified into central and peripheral according to the causes. The central facial palsy is caused by cerebral vascular accident, brain tumor, etc. The peripheral facial palsy comes from cold stimulus on face, regional infection of virus, suppurative tympanitis, inflammation on mastoid process, pathological teeth, trauma like cranial fracture, and so forth, They have distinctive features in diagnosis. While the central facial palsy is followed by hemiplegia and articulation disorder, the peripheral one by the disappearance of wrinkles on the forehead and rising of eyeball on paralyzed side when closing the eyes. Most of the cases in this thesis are peripheral palsy. The social classes and ages of the patients are so various that the treatments must be applied from various standpoints. The statistical data shows that the functional weakness of the whole body is the fundamental condition of the facial palsy. Therefore it is very important to find and the exact pathology and treatment appropriate for Hyungsang of the patients.

Angiofollicular Lymph Node Hyperplasia (= Castleman's Disease) -Report of A Case - (혈관여포양 임파선 증식증 -1예 보고-)

  • Gil, Hak-Jun;Oh, Yoon-Kyung;Yoon, Sei-Chul;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • Radiation Oncology Journal
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    • v.5 no.1
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    • pp.37-41
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    • 1987
  • Angiofollicular lymph node hyperplasia (AFLNH) with well marginated lymphoid masses, is a rare benign disease of unknown etiology. The majority of the disease develop intrathoracically. Histologically this disease can be divided into the hyaline-vascular and the plasma cell types with the hyaline-vascular type prevailing. The plasma cell variant has been associated with nephrotic syndrome, anemia, growth failure, fever, hyperglobulinemia, peripheral neuropathy, and hypoalbuminemia. Surgical resection is known to be treatment of choice in most cases, and radiotherapy is reserved for advanced, unresectable lesions. We report a complete remission of AFLNH in a case treated by sugical excision followed by irradiation.

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Adventitial Cystic Disease of the Common Femoral Artery: A Case Report and Literature Review

  • Kim, Sung Hwan;Lee, Chung Eun;Park, Hyun Oh;Kim, Jong Woo;Choi, Jun Young;Lee, Jeong Hee
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.150-152
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    • 2013
  • Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.

Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong;Choi, Jung-Kyu;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.2
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    • pp.92-102
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    • 2018
  • Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

A Giant Popliteal Artery Aneurysm Treated with Exclusion and Bypass Using a Saphenous Vein

  • Kim, Su Wan;Chang, Jee Won
    • Journal of Chest Surgery
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    • v.46 no.5
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    • pp.369-372
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    • 2013
  • While popliteal artery aneurysm is the most common form of peripheral artery aneurysm, it is a rare condition in the general population. Furthermore, a giant popliteal artery aneurysm has not previously been reported in Korea. A 67-year-old male presented with left thigh pain that had begun 4 months earlier and was aggravated when in a sitting position. We found a giant aneurysm on the left popliteal artery and performed a bypass from the common femoral artery to the distal popliteal artery below the knee, using the autologous greater saphenous vein, and excluded the aneurysm at the sites of anastomoses.