1.Diagnosis and treatment of varicose veins and chronic venous insufficiency
Journal of the Korean Medical Association 2020;63(12):756-763
This study aimed to review the pathophysiology of varicose veins and chronic venous insufficiency and the recent surgical treatment trend. Varicose veins are tortuous, twisted, or lengthened veins in the lower extremities. It is part of the spectrum of chronic venous disease. Primary pathogenesis is increased chronic venous hypertension caused by valvular insufficiency, venous outflow obstruction, and calf muscle pump failure. Some patients complain of no symptoms, except report cosmetic concerns. If the varicose vein progresses to chronic venous insufficiency, it may cause edema of the lower limb. The skin lesion can present as hyperpigmentation of the median part of the ankle, congestive dermatitis, and even a skin ulcer. The varicose vein can be diagnosed easily by visual inspection after identifying the skin lesions. For non-surgical treatment, elastic stocking, Unna boots, and pneumatic compression devices are recommended to reduce venous pressure. High ligation with stripping has been the standard treatment for varicose veins to achieve symptom relief and improve cosmetic effects. Endovenous laser ablation, radiofrequency ablation, mechanochemical ablation, and the VenaSeal closure system have been introduced as surgical treatment methods. Recently, endovenous thermalon-thermal ablations are recommended for treatment because both are less invasive techniques. The appropriate therapy should be selected after considering the patients’ symptoms and signs, anatomical structure, and economic burden of the treatment.
2.Diagnosis and treatment of varicose veins and chronic venous insufficiency
Journal of the Korean Medical Association 2020;63(12):756-763
This study aimed to review the pathophysiology of varicose veins and chronic venous insufficiency and the recent surgical treatment trend. Varicose veins are tortuous, twisted, or lengthened veins in the lower extremities. It is part of the spectrum of chronic venous disease. Primary pathogenesis is increased chronic venous hypertension caused by valvular insufficiency, venous outflow obstruction, and calf muscle pump failure. Some patients complain of no symptoms, except report cosmetic concerns. If the varicose vein progresses to chronic venous insufficiency, it may cause edema of the lower limb. The skin lesion can present as hyperpigmentation of the median part of the ankle, congestive dermatitis, and even a skin ulcer. The varicose vein can be diagnosed easily by visual inspection after identifying the skin lesions. For non-surgical treatment, elastic stocking, Unna boots, and pneumatic compression devices are recommended to reduce venous pressure. High ligation with stripping has been the standard treatment for varicose veins to achieve symptom relief and improve cosmetic effects. Endovenous laser ablation, radiofrequency ablation, mechanochemical ablation, and the VenaSeal closure system have been introduced as surgical treatment methods. Recently, endovenous thermalon-thermal ablations are recommended for treatment because both are less invasive techniques. The appropriate therapy should be selected after considering the patients’ symptoms and signs, anatomical structure, and economic burden of the treatment.
3.Results of Open Surgical Repair of Chronic Juxtarenal Aortic Occlusion.
Shin Seok YANG ; Young Wook KIM ; Yang Jin PARK ; Dong Ik KIM ; Shin Young WOO ; Seung HUH ; Hyung Kee KIM
Vascular Specialist International 2014;30(3):81-86
PURPOSE: The aim of study was to review the results of open surgical repair (OSR) of chronic juxtarenal aortic occlusion (JRAO). MATERIALS AND METHODS: We retrospectively reviewed the results of OSR performed in 47 patients (male, 92%; mean age, 59.9+/-9.3 years [range, 44-79]) with chronic JRAO during the past 21 years. In order to reduce intraoperative renal ischemic time (RIT), we excised a portion of the occluded segment of the infrarenal aorta without proximal aortic clamping. We then performed suprarenal aortic clamping with both renal arteries clamped, removed the proximal aortic thrombus cap, confirmed both renal artery orifices, and moved the suprarenal aortic clamp to the infrarenal aorta to allow renal perfusion and standard aortoiliac reconstruction. We investigated early (<30 days) postoperative surgical morbidity (particularly renal function), operative mortality, and longterm patient survival. We conducted risk factor analysis for postoperative renal insufficiency. RESULTS: The mean intraoperative RIT was 10.7+/-5.5 minutes (range, 3-25), including 6 patients who underwent concomitant pararenal aortic thromboendarterectomy. Postoperatively, five (11%) patients had transient renal insufficiency, one had pneumonia, and one patient had an acute myocardial infarction. However, there was no operative mortality or newly developed dialysis-dependent renal failure. Postoperative follow up was available in 36 (77%) patients for a mean period of 6.3 years (range, 1 month-17 years). Kaplan Meier calculations of patient survival at 5 and 10 years after surgery were 91.2% and 83.6%, respectively. CONCLUSION: We have experienced short RIT, acceptable early postoperative results and long-term survival after OSR of chronic JRAO.
Aorta
;
Constriction
;
Endarterectomy
;
Follow-Up Studies
;
Humans
;
Mortality
;
Myocardial Infarction
;
Perfusion
;
Pneumonia
;
Renal Artery
;
Renal Insufficiency
;
Retrospective Studies
;
Risk Factors
;
Thrombosis
4.Analysis of Kinship Index Distributions in Koreans Using Simulated Autosomal STR Profiles.
In Seok YANG ; Hwan Young LEE ; Su Jeong PARK ; Woo Ick YANG ; Kyoung Jin SHIN
Korean Journal of Legal Medicine 2013;37(2):57-65
Kinship testing in forensic casework is largely based on a likelihood ratio (LR) approach with short tandem repeat (STR) markers; however, in order to efficiently identify potential relatives in a specific population, the threshold values for kinship prediction should be determined by analyzing the kinship index distributions of the population in question. In this study, 250,000 DNA profiles were simulated using allele frequencies at 20 autosomal STR loci in Koreans, then the LRs were calculated for true close relatives and unrelated pairs. The LR distributions in related and unrelated pairs under a given relationship were compared in 2 sets of 13 Combined DNA Index System (CODIS) and 20 STR profiles. Using 13 CODIS STRs, true relatives in parent/child and full-sibling relationships were sufficiently discriminated from unrelated pairs with LR thresholds of 1,000 and 100, respectively. However, the CODIS STRs lacked the discriminatory power to differentiate between related and unrelated pairs in uncle/nephew and first cousin relationships due to high false-positive and false-negative rates with a LR threshold of 10. Increasing the number of STR loci to 20 increased discrimination of close relatives, but high false results remained in uncle/nephew and first cousin relationships. The kinship index data from this study will help make decisions on various kinship testing and familial searching in Koreans.
Asian Continental Ancestry Group
;
Discrimination (Psychology)
;
DNA
;
Gene Frequency
;
Humans
;
Microsatellite Repeats
5.Sequence Generation and Genotyping of 15 Autosomal STR Markers Using Next Generation Sequencing.
Eun Hye KIM ; Sang Eun JUNG ; Kyoung Jin SHIN ; Woo Ick YANG ; In Seok YANG
Korean Journal of Legal Medicine 2014;38(2):48-58
Recently, next generation sequencing (NGS) has received attention as the ultimate genotyping method to overcome the limitations of capillary electrophoresis (CE)-based short tandem repeat (STR) analysis, such as the limited number of STR loci that can be measured simultaneously using fluorescent-labeled primers and the maximum size of STR amplicons. In this study, we analyzed 15 autosomal STR markers via the NGS method and evaluated their effectiveness in STR analysis. Using male and female standard DNA as single-sources and their 1:1 mixture, we sequentially generated sample amplicons by the multiplex polymerase chain reaction (PCR) method, constructed DNA libraries by ligation of adapters with a multiplex identifier (MID), and sequenced DNA using the Roche GS Junior Platform. Sequencing data for each sample were analyzed via alignment with pre-built reference sequences. Most STR alleles could be determined by applying a coverage threshold of 20% for the two single-sources and 10% for the 1:1 mixture. The structure of the STR in each allele was accurately determined by examining the sequences of the target STR region. The mixture ratio of the mixed sample was estimated by analyzing the coverage ratios between assigned alleles at each locus and the reference/variant ratios from the observed sequence variations. In conclusion, the experimental method used in this study allowed the successful generation of NGS data. In addition, the NGS data analysis protocol enables accurate STR allele call and repeat structure determination at each locus. Therefore, this approach using the NGS system will be helpful to interpret and analysis the STR profiles from singe-source and even mixed samples in forensic investigation.
Alleles
;
DNA
;
Electrophoresis, Capillary
;
Female
;
Gene Library
;
Humans
;
Ligation
;
Male
;
Microsatellite Repeats
;
Multiplex Polymerase Chain Reaction
;
Statistics as Topic
6.A Inflammed Plantar Epidermal Cyst Misdiagnosed as Secondary Infection of Calluses.
Yoon Seok YANG ; Soeun PARK ; Soo Jung SHIN ; Chang Sun YOO ; Chul Woo KIM ; Sang Seok KIM
Korean Journal of Dermatology 2014;52(2):153-154
No abstract available.
Bony Callus*
;
Coinfection*
;
Epidermal Cyst*
7.A Case of Trichobezoar.
Ue Chong YANG ; Bong Sik KONG ; Sang kyu PARK ; Ho Jin PARK ; Mi Ja SHIN ; Seok Hwan SHIN
Journal of the Korean Pediatric Society 1989;32(5):700-704
No abstract available.
Bezoars*
8.The etiologies and the clinical manifestations of hypoglycemia in infancy and childhood.
Nam Seon BECK ; Dong Joo SHIN ; Heon Seok HAN ; Sei Won YANG ; Hyung Ro MOON
Journal of the Korean Pediatric Society 1991;34(4):480-486
No abstract available.
Hypoglycemia*
9.Ectopic Implantation of Chorionic Villi presenting as Hemorrhagic Vaginal Mass associated with Second Trimester of Normal Pregnancy.
Jin Woo SHIN ; Yong Ho LEE ; Yang Seok CHAE ; Young Tae KIM ; Kyu Wan LEE
Korean Journal of Obstetrics and Gynecology 2000;43(7):1243-1245
Although a lot of articles examining concomitant intrauterine and ectopic pregnancy have been presented, we have not found any reports on ectopic implantation of chorionic villi in the vagina with normal intrauterine pregnancy. We experienced a case of chorionic villi on the vaginal wall as a hemorrhagic mass during the second trimester of pregnancy. A pregnant woman (gestational age of 16 weeks and 1 day) visited our hospital due to vaginal bleeding. There was no abnormal finding except vaginal hemorrhagic mass, and the mass revealed a product of conception.
Chorion*
;
Chorionic Villi*
;
Female
;
Fertilization
;
Humans
;
Pregnancy
;
Pregnancy Trimester, Second*
;
Pregnancy*
;
Pregnancy, Ectopic
;
Pregnant Women
;
Uterine Hemorrhage
;
Vagina
10.DNA ploidy as a predictive index of therapeutic response in lung cancer.
In Seon CHOI ; Shin Seok LEE ; Jae Beom YANG ; Kyung Ok PARK ; Sang Woo JUNG
Tuberculosis and Respiratory Diseases 1992;39(2):150-158
No abstract available.
DNA*
;
Lung Neoplasms*
;
Lung*
;
Ploidies*