• Journal of Chest Surgery
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• v.48 no.6
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• pp.398-403
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• 2015

Background: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2533-2539
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• 2014

Aim: To take a deeper insight into the relationship between the root of the inferior mesenteric artery (IMA) and the autonomic nerve plexuses around it by cadaveric anatomy and explore anatomical evidence of autonomic nerve preservation in high ligation of the IMA in laparoscopic surgery for colorectal cancer. Methods: Anatomical dissection was performed on 11 formalin-fixed cadavers and 12 fresh cadavers. Anatomical evidence-based autonomic nerve preservation in high ligation of the IMA was performed in 22 laparoscopic curative resections of colorectal cancer. Results: As the upward continuation of the presacral nerves, the bilateral trunks of SHP had close but different relationships with the root of the IMA. The right trunk of SHP ran relatively far away from the root of IMA. When the apical lymph nodes were dissected close to the root of the IMA along the fascia space in front of the anterior renal fascia, the right trunk of SHP could be kept in suit under the anterior renal fascia. The left descending branches to SHP constituted a natural and constant anatomical landmark of the relationship between the root of IMA and the left autonomic nerves. Proximal to this, the left autonomic nerves surrounded the root of the IMA. Distally, the left trunk of the SHP departed from the root of IMA under the anterior renal fascia. When high ligation of the IMA was performed distal to it, the left trunk of SHP could be preserved. The distance between the left descending branches to SHP and the origin of IMA varied widely from 1.3 cm to 2.3 cm. Conclusions: The divergences of the bilateral autonomic nerve preservation around the root of the IMA may contribute to provide anatomical evidence for more precise evaluation of the optimal position of high ligation of the IMA in the future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.367-370
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• 1999

While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.

• The korean journal of orthodontics
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• v.20 no.2
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• pp.409-417
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• 1990

Tooth movement would be impeded by frictional force arised between archwire and tube, bracket or elastics in the fixed orthodontic appliances, which could be changed variably by such several factors as the contact area, normal (perpendicular) force and the condition of contact surface. There were many literatures about frictional force in the orthodontic region, but different results were obtained from little controlled research so that was very difficult in clinical application. Therefore we have reviewed comprehensively previous literatures about frictional force and thus several results were obtained as follows: 1. For use species of the orthodontic wire, frictional force was influenced mainly by surface roughness of wire in the absence of binding, while that was influenced mainly by normal force in high binding angulation. 2. For the cross-section and diameter of the wire, the contact area influenced mainly on frictional force in the absence of binding, while wire stiffness influenced mainly on frictional force in high binding angulation. 3. The greater the bracket width, the greater frictional force, and frictional force of the plastic bracket was larger than that of the metal bracket. 4. For ligation type, frictional force of the stainless steel ligation was larger than that of the elastic ligation, and frictional force was directly proportional to ligation force. 5. Variable frictional force were occured from the saliva combined with such another factors as normal force and mode of surface oxide et al.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.209-212
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• 1973

Because of the. rise in the incidence of high speed automobile accident and various gun shot wound, complicated vascular injuries are becoming more frequent. Inferior vena caval injury seems to be also in high incidence, but reports in the literature were rare. because of potentially lethal. Recently we have experienced a case of inferior vena caval injury due to stab wound on the posterior aspect of the right abdomen. This was successfully treated with inferior caval ligation on the both, proximal and distal of the injured infrarenal vena cava.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.1-10
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• 2002

Background: Despite the relatively high mortality rates in the chronic heart failure model induced by coronary artery ligation are relatively high, this model has been a subject of continuos research because of its clinical correlation. Chronic heart failure model of large-sized animals is very useful to analyse mechanical or biological effects on circulatory system which is difficult in small-sized animals. The purpose of this study is to establish the heart failure model by coronary artery ligation in sheep. Material and Method: Among 9 Corridale sheep, the homonymous artery and the diagonal branch were ligated simultaneously in 2 sheep and remaining 7 sheep were assigned to successive ligation of both arteries at an interval of 1 hour. Both coronary arteries were ligated from the point 40% proximal to the apex of the heart. Hemodynamic and echocardiographic parameters were analyzed before the ligation of the coronary artery, after the ligation of the homonymous artery, and after additional ligation of the diagonal branch. The experimental animals were sacrificed after 2 or 3 months of growth and histopathologic studies were performed Result: Immediate postoperative death occurred in the 2 sheep that had received simultaneous ligation of the homonymous artery and diagonal branch. On the other hand, all the 7 sheep that were lifated in succession were survived up to 3 months. Arterial pressure was sifnificantly decreased immediately after ligation of the homonymous artery(p<0.05), and the cardiac output was decreased and pulmonary capillary wedge pressure was increased after further ligation of the diagonal branch(p<0.05). Central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, left ventricular end-diastolic dimension and end-systolic dimension were markedly increased 3 months after ligation of coronary arteries. Anteroseptal akinesia or dyskinesia was developed after the ligation of coronary arteries. Histopathologic study revealed we]1-demarcated ischemic area of fibrosis. Conclusion: Using methods of successive ligation of the homonymous artery and diagonal branch, chronic heart failure model could be reliably established in sheep.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.390-396
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• 1991

From July 1984 to September 1990, 316 patients of congenital heart diseases were operated and 15 patients died. Hospital mortality was 4.75%. Five patients of 73 PDA had residual shunt after operation: 4 were ligated under support of Dacron patch, 1 was closed through the pulmonary arteriotomy under CPB. 3 patients were reoperated. No patient had residual shunt or reopening among the patients of simple ligation or division and suture. During the ligation of PDA, Dacron patch for protection from tearing may disturb the complete interruption of shunt. If the tissue around the ductus arteriosus looks weak or fragile, division and suture may be more reliable other than ligation with supporting patch. If the septal leaflet of tricuspid valve is adherent around the VSD, remained opening of VSD may be closed with simple suture directly. In these cases, the incidence of postoperative residual shunt is as high as the incidence of more large VSD closed with patch [10.9%: 9.6%]. During the direct closure of remained opening of VSD, another leaking route should be looked for carefully beneath the septal leaflet of tricuspid valve.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.150-155
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• 2010

Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.

• Advances in pediatric surgery
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• v.19 no.1
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• pp.32-38
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• 2013

The purpose of this study is to analyze the early experience of the laparoscopic adhesiolysis for the intestinal obstruction due to postoperative adhesion. Seven patients were included in this study. The median age of those patients was 13, and there were 3 males and 4 females. Previous diagnosis and surgical procedure were various in seven cases, including small bowel resection with tapering enteroplasty, Boix-Ochoa fundoplication, Ladd's procedure with appendectomy, mesenteric tumor resection with small bowel anastomosis, ileocecal resection and anastomosis, primary gastric repair, and both high ligation. A successful laparoscopic adhesiolysis was performed in one who had high ligation for inguinal hernia and had a single band adhesion. Six out of 7 (86%) cases needed to convert open surgery due to multiple and dense type of adhesion. In conclusion, laparoscopic approach with postoperative small bowel adhesion seems safe. However, it might be prudently considered because of high rates of conversion in children.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.101-107
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• 2010

Herniorrhaphy of Indirect inguinal hernia (IIH) is one of the most frequently performed surgical procedures in children. The overall incidence of inguinal hernias in childhood ranges from 0.8 to 4.4 %. The incidence is up to 10 times higher in boys than girls, especially much higher in premature infants. IIHs in children are basically an arrest of embryologic development rather than an acquired weakness, which explains the increased incidence in premature infants. In normal development, the processus vaginalis closes, obliterating the peritoneal opening of the internal ring between 36th and 40th week of gestation. This process is often incomplete, leaving a small patent processus in many newborns. However, closure continues postnatally, and the rate of patency is inversely proportional to age of the child. The presence of a patent processus vaginalis is a necessary but not sufficient variable in developing a congenital IIH. In other words, all congenital IIHs are preceded by a patent processus vaginalis, but not all patent processus vaginalis go on to become IIHs. The overall incidence of IIH in population is approximately 1 to 2 % and the incidence of a processus vaginalis is approximately 12 to 14%, clinically appreciable IIH should develop in approximately 8 to 12 % of patients with a patent processus vaginalis. Although the classic open inguinal hernia repair remains the gold standard for most pediatric surgeons, laparoscopic repair is being performed in many centers. Like open technique, laparoscopic technique is fundamentally a high ligation of the indirect hernia sac with or without internal ring ligation. The advantages of laparoscopic approach include the ease of examining the contralateral internal ring, the avoidance of access damage to vas and vessels during mobilization of cord, decreased operative time, and an ability to identify unsuspected direct or femoral hernias. Almost all groin hernias in children are IIHs and occur as a result of incomplete closure of processus vaginalis. The treatment is repair by high ligation of hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone, open exploration is no longer indicated due to potential risk of infertility.