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오행진,김송이 대한의사협회 2022 대한의사협회지 Vol.65 No.4
Background: Varicose veins refer to tortuous engorged veins on the lower extremities. Although this is a common condition observed in clinical practice, objective diagnosis is important for optimal treatment. Current Concepts: Thorough physical examination is the first key step for diagnosis of varicose veins. Both legs should be examined between the inguinal region and the feet with the patient in an erect position. The presence and location of venous reflux should be confirmed using duplex ultrasonography (DUS), which serves as a simple, non-invasive modality to assess both the anatomy and physiology of leg veins. Reflux is defined as duration of retrograde flow greater than 0.5 seconds in superficial veins, 0.35 seconds in perforating veins, and 1.0 seconds in deep veins. Computed tomography venography can be used in selective cases as a complementary tool to obtain objective images of all varicose veins; however, this imaging modality cannot confirm venous reflux. Discussion and Conclusion: DUS is a key diagnostic tool for varicose veins. However, DUS results are operator dependent; therefore, this procedure should be performed by experienced technologists or clinicians, based on guidelines. The location and duration of reflux should be recorded.
오행진,황대현,박인근,이민기,이준구 대한골절학회 2020 대한골절학회지 Vol.33 No.4
Traumatic shoulder dislocations are one of the most common major dislocations in the general population. Injury to major vessels is rarely reported as a complication of shoulder dislocations. This case report presents the traumatic dissection of the axillary artery after a simple shoulder dislocation that was managed successfully with the placement of a self-expanding stent. With the clinical manifestations of a brachial plexus injury and progressive vascular compromise in the affected arm, a major vascular injury was detected on an angiogram, and a self-expanding stent was deployed. Through immediate diagnosis and prompt intervention, serious complications, such as hypovolemic shock and even death, were averted, ultimately achieving a favorable patient outcome.
유두상 갑상선 암 환자에서 수술 전 혈청 호중구-림프구 비의 임상적 의의
오행진,장여구,홍성우,이우용,이병모,HaengJin Ohe,Yeo Goo Chang,Seong Woo Hong,Woo Yong Lee,Byungmo Lee 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4
Purpose: Papillary thyroid cancer (PTC) is known to have a favorable prognosis and low mortality. However, some PTC has aggressive propensity with loco-regional recurrence or distant metastasis, and it could cause poor quality of life. Many studies for predicting high-risk group in papillary thyroid cancer have been reported, however, more study is needed. The objective of this study is to assess the efficiency of inflammation indices including the Neutrophil-Lymphocyte Ratio (NLR) as a predictor for high-risk group in papillary thyroid cancer patients. Methods: From January 2006 to November 2012, this study enrolled consecutive 164 patients who underwent total thyroidectomy and were confirmed with papillary thyroid cancer by histopathology. Among 164 patients, 23 were excluded because they had co-morbidities which could confound the inflammation related variables. We reviewed the medical records of 141 patients and assessed the correlation between inflammation indices including preoperative serum NLR and clinical prognostic parameters, including age at presentation, tumor size, extra-thyroidal extension, lymph node metastasis, TNM stage, and MACIS score. Results: In the papillary thyroid cancer patients, preoperative value of NLR, ESR, CRP, platelet, and albumin showed no significant correlation with the risk factors. Conclusion: In this study, preoperative inflammatory parameters such as NLR had uncertain efficacy as risk factors for papillary thyroid cancer.
Aortoiliac Occlusive Disease as a Cause of Allograft Kidney Dysfunction and Refractory Hypertension
오행진 고신대학교(의대) 고신대학교 의과대학 학술지 2019 고신대학교 의과대학 학술지 Vol.34 No.2
Aortoiliac occlusive disease (AIOD), especially proximal to the transplant artery, in kidney transplant patient activates the renin-angiotensin-aldosterone system by limiting graft renal perfusion and causes symptoms that can occur with transplant renal artery stenosis (TRAS) such as refractory hypertension, water retention, and graft renal dysfunction. Immediate clinical suspicion is difficult due to the nature of the progressive disease unlike TRAS. Herein, we present an interesting case of bilateral common iliac artery occlusion (AIOD, TASC II, type C) that manifested as uncontrolled blood pressure and decreased allograft function in a patient who had kidney transplant 17 years ago. The patient was successfully diagnosed with duplex scan, ankle-brachial index (ABI) and computed tomography angiography and treated with percutaneous luminal angioplasty and stent graft insertion.