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권굉보,서보양,손대호 대한혈관외과학회 1996 Vascular Specialist International Vol.12 No.1
Most current articles on venous thromboembolism begin with the statement that pulmonary embolism(PE) is a common problem and remains a significant cause of mortality in the western countries in spite of recent development in diagnostic and therapeutic mordality. In korea clinically apparent PE was reported infrequently probably due to rare incidence and small mumber of autopsy. Authors evaluated clinical symptoms,diagnostic modality and therapeutic results of clinical PE which was associated with Deep Vein Thrombosis(DVT) in 6 cases at Department of Surgery, Yeungnam University Hospital. For diagnosis of PE, chest x-ray, EKG, lung perfusion scan and pulmonary angiography were performed and reviewed literatures. Mean age was 41.5 years old with range of 21∼64. Male to female ratio was 3: 3 and mean hospital stay was 29 days. EKG and chest abnormality were found in 3 cases respectively. According to classification of lung perfusion scan in PE,moderate probability in 5 cases and intermediate probability in I case were noted. Treatment modalities were heparin and coumadin in all cases, Inferior Vena Cava(IVC) plication in 1 case of recurrent PE, and IVC ligation in 1 case of septic PE. All patients were recovered without any complication. In conclusion,although incidence of PE associated with DVT is uncertain and rare in korea, major concern and meticulous inspection are required to detect PE and to decrease mortality.
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폐혈증성 색전에 의한 폐동맥 색전증시 하대정맥 결찰 1예
권굉보,서보양,송광렬 대한혈관외과학회 1990 Vascular Specialist International Vol.6 No.1
The most serious complication of venous thrombosis is pulmonary embolism. Septic emboli unresponsive to antibiotic and anticoagulant therapy pose a significant threat to life. Complete ligation of the inferior vena cava is now a relatively uncommon procedure. It causes an acute decrease in venous return to the heart, and the associated hemodynamic consequences result in a significant operative mortality rate. It entails also a greater likehood of postoperative sequelae. Recently authors experienced a case of successful result after inferior vena caval ligation of septic pulmonary embolism. 47 years old female patient complained of painful swelling on right leg with fever due to Moxa cautery for 4 weeks. Dyspnea, chest pain and hemoptysis have developed since 5 days ago. Laboratory findings were WBC 16,600/mm³, Pa0₂,65.2mmHg, PaCO₂,35mmHg, SGOT 53 IU/L, LDH 329 IU/L and bilirubin 2.2mg/dl. The diagnosis was established with impedance plethysmography, B-mode duplex scan, venography, perfusion lung scan and pulmonary arteriography. After complete vena caval ligation, systemic anticoagulant and antibiotic therapy had continued. Patient was recovered without any significant sequelae after 2 weeks. In conclusion, complete vena caval ligation may induce more operative mortality and postoperative sequelae than plication. In case of septic pulmonary emboli, early ligation will prevent further disastrous results.
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권굉보,서보양,도병수,권우형 대한혈관외과학회 1993 Vascular Specialist International Vol.9 No.1
Current radical stripping technique for treating primary varicose vein has some disadvantages, in which the vein is no longer available for coronary and peripheral graft surgery. The valvuloplasty is a new, safe and advanced vascular surgical technique, and can also preserve great saphenous vein for further vascular bypass grafts. Two hemodynamic tests of Duplex scan and photophlethysmography were performed pre-and postoperatively in 12 among 15 patients who underwent valvuloplasty. The results were as follows: The male and female ratio was 5 to 7 and average age was 38.5 years with a range of 21-52 years. The clinical symptoms of calf pain(n=6) and tortuous veins(n=12) were all improved after valvuloplasty, but in l case, the heaviness of leg, venous engorgement and swelling were not improved. The reflux on Duplex scan was not found postoperatively except 1 case. The venous refilling times with PPG were 9.41±0.69 second preoperatively and 18.83±0.90 second postoperatively. In conclusion, treatment of the primary varicose vein using valvuloplasty is a new, and effective method that can preserve the valvular competence.
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權宏保,芮旻海 최신의학사 1970 最新醫學 Vol.13 No.2
In order to observe some possible relationships between the growth of organs, which show enormous growth in the later stage of the intrauterine life, and the growth of the vertebral column, the relative growth of the weight of the body, heart, liver, pancreas and the kidney to the vertebral column were observed in 109 cases of the Korean fetus from 5th month to 10th month. The relative growthes of the various organs to vertebral column were analysed by Huxley-Teissiet' s method. The results were as follows; 1) The relative growth of .the weight of the body, heart, liver, pancreas and the kidney to the whole vertebral length showed "positive allometry." The coefficient of the relative growth was largest in the pancreas, and then it was decreased as heart, the weight of the body, the kidney and' the liver in decreasing order. 2) The relative growth of the organs to the length of cervical, thoracic, lumbar, and sacrococcygeal vertebrae showed "positive allometry". The coefficient of the relative growth was largest in the pancreas, and then it was decreased as heart, the weight of the body, the kidney and the liver in decreasing order. 3) The growthes of the weight of various organs were nearly paralleled to the cubic of the vertebral column.
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Axillo-axillary Artery bypass Graft for the Treatment of Subclavian Steal Syndrome 3예 체험
권굉보,서보양,도병수 대한혈관외과학회 1991 Vascular Specialist International Vol.7 No.1
Subclavian steal syndrome is congenital or aquired occlusive disease at the origin of the subclavian artery. It is difficult to differenciate from Raynaud phenomenon, Burgers disease and non specific arteritis because the upper extremity symptoms of these diseases are similar to the subclavian steal syndrome. Subclavian steal syndrome can be diagnosed with both brachial artery pressure difference and aortogram. Therapy for this condition is essentially surgical. Recommendable surgical technique is axilloaxillary extraanatomical bypass graft. This procedure shows lower morbidity and mortality than transthoracic approch and it is the most commonly used technique recently. Our experience demonstrate that axillo-axillary bypass provides significant relief of symptoms related to obstructive disease of the origin of the subclavian artery.
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