No abstract available.
May-Thurner Syndrome ; Venous Thrombosis

The presently used impairment rating guidelines in Korea do not accurately reflect the injury in various lung diseases. Therefore, they need to be made more objective and quantitative with new measurements, using indicators to more precisely represent impairment in the major respiratory diseases. We develop a respiratory impairment rating guideline to ensure that the same grade or impairment rating would be obtained regardless of surgeons who determinate it. Specialists in respiratory medicine and thoracic surgeons determined the impairment grades. Moreover, the impairment should be irreversible for more than 6 months. The impairment rating depends on the level of forced vital capacity, forced expiratory volume 1 second, diffusion capacity of carbon monoxide, arterial oxygen pressure, and arterial carbon dioxide pressure. The degree of whole body impairment is defined by each grade: first 81-95%, second 66-80%, third 51-65%, fourth 36-50%, and fifth 21-35%. In conclusion, we develop a respiratory impairment rating guideline for Koreans. Any qualified specialist can easily use it and judge objective scoring.
*Disability Evaluation ; Humans ; Korea ; Lung Diseases/classification/diagnosis ; Program Development ; Pulmonary Ventilation/physiology ; Respiratory Insufficiency/classification/*diagnosis ; Severity of Illness Index

Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
Aneurysm* ; Angiography ; Blood Vessel Prosthesis* ; Buttocks ; Embolization, Therapeutic ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery* ; Middle Aged

PURPOSE: To evaluate the beveled, full thickness astigmatic keratotomy. METHODS: This study included 185 eyes of 112 patients treated with beveled, full thickness astigmatic keratotomy. Treated eyes were divided into 3 groups: beveled, full thickness astigmatic keratotomy after implantable collamer lens (ICL) implantation (group A), beveled, full thickness astigmatic keratotomy after cataract surgery (group B) and beveled, full thickness astigmatic keratotomy alone (group C). Follow-up visits were at 1 week, 1 month, 3 months and 6 months. The outcome measures included uncorrected distance visual acuity, astigmatism, efficacy, safety and predictability. RESULTS: At 6 months postoperatively, astigmatism was significantly reduced: 68.9 +/- 18.24% in total, 69.24 +/- 20.76%, in the group A, 67.84 +/- 17.56% in the group B and 67.82 +/- 13.97% in the group C. The proportion of eyes with astigmatism 1.0 or less was 88.65% in total, 91.49% in the group A, 87.5% in the group B and 70.0% in the group C. Mean improvement in corrected distance visual acuity (CDVA) was 0.56 lines; no eyes lost 2 lines of CDVA after 6 months postoperatively. Postoperative complications were not observed. CONCLUSIONS: This study showed the beveled, full thickness astigmatic keratotomy is effective and safe for correcting astigmatism alone as well as correcting astigmatism after ICL implantation or cataract surgery.
Astigmatism ; Cataract ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Postoperative Complications ; Visual Acuity

PURPOSE: To evaluate the clinical outcomes of a combined procedure of astigmatic keratotomy (AK) and laser in situ keratomileusis (LASIK) for the correction of high astigmatism. METHODS: Thirty-five eyes of 19 patients who had astigmatic keratotomy were studied. The patients had a secondary procedure, LASIK, to correct the residual refractive error. Follow-up visits were at 1 week, 1 month, 3 months, and 6 months. The outcome measures included uncorrected distance visual acuity, refractive error, efficacy, safety, and predictability. We compared preoperative and post-AK expected corneal ablation depth using an Amaris Ablation depth table. RESULTS: After astigmatic keratotomy, astigmatism was reduced by 61.43 ± 14.62%, and after LASIK, astigmatism was reduced by 91.65 ± 8.68%. Expected corneal ablation depth was reduced by 18.72 ± 11.77% after astigmatic keratotomy. The proportion of eyes with spherical equivalent 0.5 D or less was 85.71% at 6 months after the combined procedure of astigmatic keratotomy and LASIK. No intraoperative or postoperative complications were observed. CONCLUSIONS: This study showed the combined procedure of astigmatic keratotomy and LASIK is effective for visual acuity, refraction, and reduction in corneal ablation depth.
Astigmatism ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Refractive Errors ; Visual Acuity

This study was designed to clarify the dependency of hypoxic coronary vasodilation (HCD) on the endothelium and the role of the K+ channels on HCD in the rabbit coronary artery. HCD was investigated in an isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit (KH) solution. Hypoxia was induced by gassing the chamber with 95% N2 + 5% CO2 and was maintained for 15 approximately 25 min. Hypoxia elicited a vasodilation in the precontracted coronary artery with and without endothelium. There was no difference between the amplitude of the HCD induced by two consecutive hypoxic challenges and the effects of 20% O2 + 5% CO2 + 75% N2 and 95% O2 + 5% CO2 control K-H solution of subsequent responses to hypoxia. Inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HCD. Blockades of the tetraethylammonium chloride-sensitive K+ channel abolished HCD. Apamin, a blocker of the small conductance Ca(2+)-activated K+ (KCa) channel, and iberiotoxin, a blocker of the large conductance KCa channel had no effect on HCD, respectively. Glibenclamide, a blocker of the ATP-sensitive K+ (K+ATP) channel, reduced HCD. Cromakalim, an opener of the K+ATP channel, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia while glibenclamide reduced both hypoxia- and cromakalim-induced vasodilatations. In conclusion, these results suggest that HCD is independent on endothelium and HCD is considered to be induced by activation of K+ATP channel.
Animal ; Anoxia/physiopathology* ; Coronary Vessels/physiopathology* ; Coronary Vessels/drug effects ; Cyclooxygenase Inhibitors/pharmacology ; Enzyme Inhibitors/pharmacology ; Female ; Indomethacin/pharmacology ; Male ; Nitroarginine/pharmacology ; Rabbits ; Tetraethylammonium/pharmacology ; Vasodilation/physiology*

PURPOSE: To report a case of suction loss during small incision lenticule extraction (SMILE) and a good visual outcome after switching to femtosecond laser-assisted in-situ keratomileusis (LASIK). CASE SUMMARY: A 20-year-old female was admitted to receive refractive surgery. During SMILE in the left eye, suction loss occurred at 65% of posterior cut completion. We switched to LASIK and SMILE was performed in the right eye as planned. The uncorrected distance visual acuity was 1.2 with a manifest refraction of +0.25 Dsph with 0 Dcyl. The patient had no complications at 3 months postoperatively. CONCLUSIONS: Suction loss during SMILE is a rare complication. Good visual outcome was achieved by switching to LASIK.
Female ; Humans ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures ; Suction* ; Visual Acuity ; Young Adult

Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.
Aged ; Aneurysm ; Cardiopulmonary Bypass ; Endocardium ; Follow-Up Studies ; Heart Aneurysm ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Neck ; Rare Diseases ; Recurrence ; Tachycardia, Ventricular

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Brachiocephalic Trunk ; Carotid Arteries ; Chimera ; Humans ; Stents ; Transplants

Spontaneous resolution of the arterial obstruction in Takayasu's arteritis is rarely reported. We reported a case of spontaneous resolution of an obstruction of the left subclavian artery in a young female. The patient underwent a bilateral coronary patch ostioplasty for both coronary ostial lesions complicated by Takayasu's arteritis at the age of 28. Concomitant left subclavian obstruction was seen at that time but left untreated. Surprisingly, the 10-year follow-up angiogram revealed complete resolution of the left subclavian artery obstruction. Meanwhile, no specific medical treatment was administered.
Arteritis ; Female ; Follow-Up Studies ; Humans ; Subclavian Artery* ; Takayasu Arteritis*