• 한국임상수의학회지
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• 제36권6호
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• pp.314-318
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• 2019

The purpose of this study was to compare the results of complete blood cell count (CBC) of blood samples collected from the jugular vein, cephalic vein and lateral saphenous vein and to find out if there were clinically significant differences. Total of 40 dogs were tested. CBC tests were conducted with blood samples obtained from the jugular vein, cephalic vein and lateral saphenous vein and manual differential count was performed to accurately distinguish the white blood cell (WBC) types. The results were analyzed using Repeated Measures ANOVA and posthoc test was conducted using the least significant difference method. As a result, there was a statistically significant difference (P < 0.05) in the total WBC and monocyte count. The post-hoc test of total WBC counts revealed a significant difference between the jugular vein and cephalic vein, and the jugular vein and lateral saphenous vein. For monocyte counts, a significant difference was observed between the jugular vein and lateral saphenous vein.

• Journal of Chest Surgery
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• 제50권2호
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• pp.99-104
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• 2017

Background: We observed several cases of rare vascular anomalies within the femoral triangle during varicose vein operations. Methods: From among 2,093 patients who underwent stripping operations of the great saphenous vein between January 2002 and June 2016, 14 cases of rare vascular anomalies were enrolled in this study. Results: Twelve cases of femoral artery and vein transposition (0.57%), 1 case of separate entrance of the great saphenous vein trunk and its tributaries (0.05%), and 1 case of separate entrance with femoral artery and vein transposition (0.05%) were observed. The preoperative diagnosis rate was 71% (10 of 14) using duplex ultrasound. In all cases of femoral artery and vein transposition, the saphenofemoral junction was located at the lateral or posterolateral side of the superficial femoral artery, corresponding to complete or incomplete transposition, respectively. Among the 12 cases of femoral artery and vein transposition, 5 cases were complete transposition and 7 cases were incomplete transposition. In 2 cases of separate entrance of the great saphenous vein trunk and its tributaries, the separated tributaries formed a common trunk before connecting to the femoral vein. Conclusion: The anatomy of the saphenofemoral junction may infrequently be altered in some individuals. Detailed preoperative sonographic examinations and meticulous groin dissection during the operation are necessary to prepare for unexpected anatomical variations.

• Journal of Chest Surgery
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• 제19권2호
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• pp.288-294
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• 1986

During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.184-191
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• 1999

Reconstruction of soft tissue defect of the foot, ankle and distal tibial area has been and remains a challenging problem for reconstructive surgeons. We treated 19 patients who showed soft tissue defect in these area with distally based superficial sural artery flaps, including four adipofascial flaps, two sensate flaps. The size of the soft tissue defect was from $4{\times}5cm\;to\;8{\times}10cm$. In nine cases, we preserved sural nerve. Seventeen flaps survived completely, but one flap failed and another flap showed partial skin necrosis at the distal half. In failed cases, lesser saphenous vein was ruptured at initial injury. The advantage of this flap is a constant and reliable blood supply without sacrifice of major artery or sensory nerve. Elevation of the flap is technically easy and quick. The pedicle is long and the island flap can be transffered as far as to the instep area. It also has the potential for sensate flap, innervated by the lateral sural cutaneous nerve. But for appropriate venous drainage small saphenous vein must be preserved.

• Journal of Chest Surgery
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• 제7권1호
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• pp.109-116
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• 1974

Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.208-213
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• 2008

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.709-715
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• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• Journal of Chest Surgery
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• 제40권2호
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• pp.136-139
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• 2007

양측성 슬와동맥 포착증후군은 주로 젊은 남자에게서 슬와동맥과 비복근, 섬유대, 슬와근과의 비정상적인 주행관계에 의한 혈류장애로 허혈성 파행을 유발하는 드문 말초 혈관질환이다. 58세 남자환자가 내원 1개월 전부터 시작된 좌측 하지의 허혈성 파행, 냉감, 3번 발가락 괴사로 입원하였다. 발목-상완 지수 감소 소견을 보여 대퇴동맥 혈관조영술을 시행하였고 좌측 하지 천부 대퇴동맥 원 위부 이하 부위 완전폐쇄소견 보였다. 심전도상 심방세동 보여서 슬와동맥 혈전증을 의심하고 유로키나제 혈전용해술을 시행하기로 결정하였다. 혈전용해술 후 좌측 슬와동맥 포착증후군이 진단되었고 해부학적 확진을 위하여 자기공명촬영를 시행하였다. 슬와동맥이 비복근 내측으로 주행하는 제1형으로 진단되었고, 슬와동맥류를 완전 제거하고 반대측 대복제정맥를 이용하여 대치술을 시행하였다. 경미한 우측 슬와동맥류는 수술하지 않고 관찰 중에 있으며 현재까지 합병증 없이 개통성이 유지되고 있다. 이에 심하게 이환된 하지는 수술적 치료를 시행하고, 경미하게 이환된 하지는 보존적 치료로 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제41권1호
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• pp.34-40
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• 2008

배경: 심폐바이패스 없는 관상동맥우회술의 개발은 심폐바이패스로 일어나는 부작용을 피함으로써 관상동맥우회술의 적용범위를 더 확대할 수 있게 하였다. 특히 심폐바이페스 없는 관상동맥우회술은 심근보호 폐 및 신기능의 보호, 혈액응고 장애 예방, 전신 염증 반응 및 인지기능의 예방 등에서 이점이 있는 것으로 알려져 있다. 저자들은 관상동맥우회수술을 좀 더 작대 적용할 수 있는지를 알기 위하여 심폐바이패스 없는 관상동맥우회술의 임상성적을 분석하였다. 대상 및 방법: 1999년 5월부터 2007년 8월까지 관상동맥우회술을 시행한 310예의 한자 중 심폐바이패스 없이 시행한 100명을 대상으로 하였다. 남자가 63명, 여자가 37명이었으며 평균연령은 $62{\pm}10$세($29{\sim}82$세)이었다. 수술 전 진단은 불안정성 협심증이 77예, 안정성 협심증이 16예이었으며 급성심근경색증인 경우가 7예이었다. 동반된 질병은 고혈압이 48예, 당뇨병 42예, 신부전증의 경우가 10예이었고 만성폐쇄성폐질환이 5예, 경동맥질환이 동반된 경우가 6예이었다. 수슬 전 평균 심박출률은 $56.7{\pm}11.6%$ ($26{\sim}74%$)였다. 관상동맥조영술에서 심혈관질환이 47예, 이혈관질환이 25예이었고 단일혈관질환이 24예였으며, 이 중 좌주관상동맥협착이 있는 경우가 23예이었다. 내흉동맥은 97예에서 경상이식편으로 획득하였고 요골동맥과 대복재정맥은 각각 70예, 45예이었으며 이 중 내시경을 사용한 혈관 확보는 각각 53예, 41예 이었다. 결과: 평균 $2.7{\pm}1.2$개의 문합을 하였다. 일측 내흉동맥은 95예(95%)에서 사용되었으며 요골동맥이 62예, 대복재정맥이 39예였고 양측 내흉동맥은 2예에서 시행되었으며, 100예 중 연속문합은 46예가 있었다. 각각의 관상동맥별 문합 수는 좌전하행지가 97개소, 둔각변연지가 63개소, 대각지가 53개소, 우관상동맥이 30개소, 중간분지가 11개소, 후하행동맥이 9개소, 그리고 후측방분지가 3개소였다. 수술 중 심폐바이패스로 전환한 경우는 4예 있었다. 전체 100예 중 72예에서 퇴원 전 관상동맥조영술 혹은 다중절편 컴퓨터 단층촬영술을 이용한 관상동맥영상술로 확인하였는데 198문합 중에 184문합(92.9%)에서 개통성이 유지되었다. 수술 후 1예에서 패혈증으로 사망하였으며, 뇌경색 1예와 창상 감염 1예가 있었고 술 후 부정맥과 심근경색증은 없었다. 수술 후 평균 인공호흡기보조시간은 $20{\pm}35$시간이었으며 중환자실 체류시간은 $68{\pm}47$시간이었다. 수술 중 평균 수혈양은 $4.0{\pm}2.6\;pack$이었다. 결론: 저자들은 100예의 심폐바이패스 없는 관상동맥우회술을 시행하여 좋은 성적을 얻었기에 관상동맥우회수술의 범위를 확대하기 위해 사용할 수 있는 수술이라 제시할 수 있겠다.