1.Intermittent Claudication due to Cystic Adventitial Disease of the Popliteal Artery: Importance of Multiple Imaging Modalities
Sul Ki HAN ; Sang Wook PARK ; Jun Won LEE ; Sung Gyun AHN ; Young Jin YOUN ; Jin Rok OH ; Il Hwan PARK
Korean Circulation Journal 2018;48(4):334-335
No abstract available.
Intermittent Claudication
;
Popliteal Artery
2.A Case of Intermittent Claudication and Skin Ulcers of Lower Limb due to Arteriosclerosis Obliterans Successfully Treated with Prepared in the Hospital Keishibukuryogan and Daisaikoto
Masaki RAIMURA ; Katsutoshi TERASAWA ; Nobuyasu SEKIYA ; Atsushi CHINO ; Sumire HASHIMOTO ; Takao NAMIKI ; Takeshi OJI ; Keiko OGAWA ; Kenji OHNO ; Yoshiro HIRASAKI ; Yuji KASAHARA ; Katsumi HAYASHI
Kampo Medicine 2009;60(3):365-369
Lower limb skin ulcers due to arteriosclerosis obliterans are severe ischemic lesions, and if preservation therapies such as antiplatelet and anticoagulant treatments are not effective, lower limb amputation may be necessary.We report the case of 73 year-old male patient suffering from intermittent claudication and skin ulcers on the heel of the left foot, who was successfully treated with keishibukuryogan and daisaikoto prepared in hospital. This case suggests that improvement of micro circulation with the addition of keishibukuryogan and daisaikoto to anticoagulant and antiplatelet therapies, safely promoted an improvement of ischemic lesions due to arteriosclerosis obliterans.
Skin Ulcer
;
Intermittent Claudication
;
Hospitals
;
seconds
;
Lower
3.Phenol Lumbar Sympathetic Block for Buerger's Disease.
Hwa Young MOON ; Chang Young JEONG ; Chan Jin PARK
Korean Journal of Anesthesiology 1985;18(4):458-462
Phenol sympathetic block is valuable for the treatment of ischemic pain, gangrene, intermittent claudication, Pager's disease of the bone and pain associated with pancreatitis, pancreatic cacinoma, etc. The author has experienced a case of successful lumber sympathetic block using 7% phenol under fluroscopy and given to a patient with Buerger's disease who had severe pain and ulceration of the right great toe for several years. After the sympathetic block, 2 epidural blocks with 2.5% bupivacaine were done in order to augment the effects of this sympathetic block. Subsidence of rest pain, increase in walking distance from under 100M to over 500M and circulatory improvement of the affected limb were observed. Imporvement of circulation was confirmed by strain gauge plethysomgraphy.
Bupivacaine
;
Extremities
;
Gangrene
;
Humans
;
Intermittent Claudication
;
Pancreatitis
;
Phenol*
;
Thromboangiitis Obliterans*
;
Toes
;
Ulcer
;
Walking
4.Sacral Perineural Cyst: Another Cause of Sciatica.
Keun Wook KIM ; Jae Won DOH ; Hack Gun BAE ; Kyeong Seok LEE ; Il Gyu YOON ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 1999;28(11):1644-1648
About 25% of intrasacral perineural cyst cause sciatica resembling lumbar disc herniation or lumbar stenosis. We report a case of sacral perineural cyst in a 38-year-old female who complained of sciatica and neurogenic intermittent claudication. Delayed X-ray after 3 hours from initial myelogram revealed round cyst at the sacral canal. CT and MRI revealed a cystic mass which has cerebrospinal fluid(CSF) signal intensity. The patient underwent surgery via sacral laminotomy and ligation of cyst including S2 nerve root. The patient returned to work with complete relief of symptoms.
Adult
;
Constriction, Pathologic
;
Female
;
Humans
;
Intermittent Claudication
;
Laminectomy
;
Ligation
;
Magnetic Resonance Imaging
;
Sacrum
;
Sciatica*
;
Tarlov Cysts*
5.Evaluation of Clinical Result of Transpedicular Screw Fixation and Modified Posterior Fusion for Lumbar Spondylolisthesis.
Jae Sung KIM ; Tae Sun KIM ; Soo Han KIM ; Shin JUNG ; Jae Hyoo KIM ; Sam Suk KANG ; Jae Hyuk LEE
Journal of Korean Neurosurgical Society 1996;25(7):1389-1394
During the past five years(1990. 7-1995. 6,) eighteen patients with symptomatic lumbar spondylolisthesis whose neurogenic intermittent claudication appeared within fifteen minutes of walking, but otherwise suffered from no significant disc herniation at the involved level, underwent operation. The lumbar spine was stabilized by transpedicular screw fixation and modified posterior fusion instead of posterior lumbar interbody fusion(PLIF). There were three males and fifteen females and the average age was fourty-seven years(range, thirty-six to sixty-four years). After an average follow-up period of thirty-one months(range, fifteen to fifty-two months), the result were excellent in eight, good in seven, moderate in two, and poor in one patients. The satisfactory result of 83.3 percent of the patients suggested that the modified posterior fusion, instead of posterior lumbar interbody fusion, in which the spinous process, the lamina, the facet joint, and only the base of the transverse process were included, after transpedicular screw fixation in lumbar spondylolis thetic patients would be enough when there is no significant disc herniation at the involved level.
Female
;
Follow-Up Studies
;
Humans
;
Intermittent Claudication
;
Male
;
Spine
;
Spondylolisthesis*
;
Walking
;
Zygapophyseal Joint
6.Cilostazol for Secondary Prevention of Stroke: Should the Guidelines Perhaps Be Extended?.
George GALYFOS ; Argyri SIANOU
Vascular Specialist International 2017;33(3):89-92
Cilostazol belongs to the new generation antiplatelet agents that have been introduced and studied regarding a potential role in cardiovascular disease prevention or treatment. Although data on peripheral artery disease are sufficient, and the drug has been recommended as first line treatment for intermittent claudication, it has not been approved nor recommended as far as cerebrovascular events are concerned. However, a great volume of randomized as well as pooled data has been published during the last years. Therefore, this review aims to describe the basic mechanisms of cilostazol’s action as well as to present all recent clinical data in order to conclude on whether official guidelines should be extended.
Cardiovascular Diseases
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Intermittent Claudication
;
Peripheral Arterial Disease
;
Platelet Aggregation Inhibitors
;
Secondary Prevention*
;
Stroke*
7.A Clinical Analysis of Degenerative Supondylolisthesis.
Myun SEO ; Seong Hoon OH ; Young Soo KIM ; Yong KO ; Suck Jun OH ; Nam Kyu KIM ; Hwan Yung CHUNG ; Kwang Myung KIM
Journal of Korean Neurosurgical Society 1993;22(3):339-349
The auther has studied 60 patients of degenerative spondylolisthesis diagnosed and operatively treated at Hanyang University Hospital from January 1987 to June 1992, and analized the outcome. The results were summarized as followings: 1) Male to female ratio was 1:4, showing female predominance. Average peak ages were 5th and 6th decades. 2) "Pedicle-Facet Angle" and the degree of slipping had directly proportional relationship(Y=0.58X+110). The wider the angle is, the more slipping develops. 3) The significant symptom and sign were neurogenic intermittent claudication and negative straight-leg-raising test. 4) The degenerative spondylolisthesis developed most frequently at L4-5 level(74%), L5-S1(15%), L3-4(8%), 57 cases(95%) fell into Grade by Meyerding classification. 5) Complete or incomplete block on myelogram was present in 59%, and pseudodisc and lumbar spinal stenosis were noticed on CT. 6) Laminectomy with P.L.I.F. were done in 50 cases(83%) and total laminectomy and medial facetectomy and foraminotomy were done in only 4 cases(7%). In the comparision on the slipping degree before & after operation, in 55 cases(92%), slipping degrees showed no great change less than 2mm, but the almost showed exellent & good results. So we considered decom pression & fusion without excessive reduction was sufficient. 7) Threaded fusion cage(T.F.C) had the several benefits that 1) stability was good, 2) osteosynthesis through threaded was possible and 3) postoperative ambulation was possible earlier. Therefore recently, P.L.I.F. using T.F.C in the treatment of degenerative spondylolisthesis were used in many cases and further evaluation for T.F.C. should be considered.
Classification
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Female
;
Foraminotomy
;
Humans
;
Intermittent Claudication
;
Laminectomy
;
Male
;
Spinal Stenosis
;
Spondylolisthesis
;
Walking
8.Usefulness of PTFE Graft in Above-Knee Femoropopliteal Artery Bypass.
Journal of the Korean Surgical Society 2009;77(6):410-416
PURPOSE: Which graft material is appropriate for the above-knee femoropopliteal (AK fem-pop) bypass has been a controversy. We were to evaluate the usefulness of PTFE graft in AK fem-pop bypass by comparing the results of autogenous vein graft in below-knee femoropopliteal bypass. METHODS: This was a retrospective study of data for Fem-Pop bypass from August 1999 to August 2008. The median follow-up was 59.9+/-27.3 months. The demographic data, patency rate, secondary procedures, and amputation rate were compared, and statistical comparison was performed by Kaplan-Meier method, Log-rank test, and Chi-square test. RESULTS: Seventy-three bypasses were performed in 63 patients: PTFE graft in 48 cases (Group A), autogenous vein in 25 cases (Group B). Sixty-one patients (96.81%) were men. The mean age was 67.3+/-8.0 years. The indication for surgery was intermittent claudication in 27 cases (37.0%), critical limb in 46 cases (63.0%). The 6-yr primary patency rates were 28.1%; 60.3%, the 6-yr secondary patency rates were 37.2+/-8.4%, 67.0+/-14.7% in Group A and Group B, respectively (P<0.05). The number of secondary procedures was 31 and 3, respectively (P<0.05). Major amputation at later periods was not needed in Group B, but there were 9 cases in group A (P<0.05). CONCLUSION: PTFE graft for above-knee femoropopliteal bypass shows poor long-term patency with a large number of secondary procedures and a higher amputation rate than vein graft in BK Fem-Pop bypass. PTFE graft should be limited to patients with high operative risk, or poor venous graft.
Amputation
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Arteries
;
Extremities
;
Follow-Up Studies
;
Humans
;
Intermittent Claudication
;
Male
;
Polytetrafluoroethylene
;
Retrospective Studies
;
Transplants
;
Veins
9.The Effect of Lumbar Spinal Stenosis on Results of Treatment in Peripheral Arterial Disease.
Chung Shik SHIN ; Byeong Yeol CHOI ; Seung Bum PARK ; Kyung Tae KIM ; Tae Ho KIM ; Chul Seung KIM ; Kyu Dam HAN
The Journal of the Korean Orthopaedic Association 2016;51(5):357-364
PURPOSE: The purpose of this study was to evaluate the result of percutaneous transluminal angioplasty (PTA) in patients with concurrent lumbar spinal stenosis (LSS) and peripheral arterial disease (PAD). MATERIALS AND METHODS: Patients who underwent PTA for intermittent claudication were evaluated retrospectively. Twenty-two patients with severe LSS were included in group A and 23 patients with no or mild LSS in group B. The symptomatic improvement after PTA was comparatively evaluated. RESULTS: Visual analogue scale (VAS) and Walking Impairment Questionnaire (WIQ) scores showed significant improvement after PTA in both groups (p<0.001, <0.001). However, according to VAS, WIQ and modified MacNab scores, results of group A were less satisfactory (p<0.001, <0.001, p=0.03). Only 2 patients underwent additional spine surgery. CONCLUSION: In results of PTA, the PAD associated LSS group showed less improvement than the PAD only group, but most patients showed symptomatic improvement with conservative treatment.
Angioplasty
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Humans
;
Intermittent Claudication
;
Lumbar Vertebrae
;
Peripheral Arterial Disease*
;
Retrospective Studies
;
Spinal Stenosis*
;
Spine
;
Walking
10.Population pharmacodynamics of cilostazol in healthy Korean subjects
Yun Seob JUNG ; Dongwoo CHAE ; Kyungsoo PARK
Translational and Clinical Pharmacology 2018;26(2):93-98
Cilostazol is used for the treatment of intermittent claudication, ulceration and pain. This study was conducted to develop a population pharmacodynamic (PD) model for cilostazol's closure time (CT) prolongation effect in healthy Korean subjects based on a pharmacokinetic (PK) model previously developed. PD data were obtained from 29 healthy subjects who participated in a study conducted in 2009 at Severance Hospital. The PK model used was a two-compartment model with first order absorption. CT data were best described by a turnover model with a fractional turnover rate constant (K(out)) inhibited by drug effects (Eff), which were represented by a sigmoid E(max) model [Eff = E(max) · C(γ) / (EC₅₀(γ)+C(γ))] with E(max) being maximum drug effect, EC₅₀ drug plasma concentration at 50% of E(max), C drug plasma concentrations, and γ the Hill coefficient. For the selected PD model, parameter estimates were 0.613 hr⁻¹ for K(out), 0.192 for E(max), 730 ng/ml for EC₅₀ and 5.137 for γ. Sex and caffeine drinking status significantly influenced the baseline CT, which was 85.36 seconds in male non-caffeine drinkers and increased by 15.5% and 16.4% in females and caffeine drinkers, respectively. The model adequately described the time course of CT. This was the first population PD study for cilostazol's CT prolongation effect in a Korean population.
Absorption
;
Caffeine
;
Colon, Sigmoid
;
Drinking
;
Female
;
Healthy Volunteers
;
Humans
;
Intermittent Claudication
;
Male
;
Plasma
;
Ulcer