• The Journal of Internal Korean Medicine
• /
• v.37 no.5
• /
• pp.741-749
• /
• 2016

Objective: To evaluate the effect of Sukjihwangbogan-tang-gagam (熟地黃補肝湯加減) in a patient with delayed vascular chorea. Methods: A vascular chorea patient was treated with acupuncture, moxibustion, and herbal medicine (Sukjihwangbogan-tang-gagam). Results: Improvements in the Unified Huntington’s Disease Rating Scale (UHDRS), UFMG Sydenham’s Chorea Rating Scale (USCRS) (especially the scale of Activity of Daily Living (ADL)) (dysarthria 2→0, tongue protrusion 3→1, chorea 3→1, handwriting 3→1), and a Visual Analogue Scale (VAS) (8→2) were observed after the Sukjihwangbogan-tang-gagam treatment. Conclusions: Sukjihwangbogan-tang-gagam may be an effective treatment for patients with delayed vascular chorea.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.650-659
• /
• 1998

Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.