1.Superselective embolization of brain arteriovenous malformations using microcatheter: Evaluation of success rate and complications.
Dae Soon KIM ; Hyung Jin SHIM ; Dae Sik RYU ; Yong Chul LEE ; Kun Sang KIM
Journal of the Korean Radiological Society 1993;29(4):634-640
Recently, accumulation of knowledge on cerebrovascular microanatomy and its hemodynamics and advances in interventional equipments, especially microcatheters, could make superselective embolization as well as for an adjunctive preoperative procedures The authors performed superselective angiography and embolization with Tracker microcatheter in 25 procedures out of 15 patients with brain arteriovenous malformations (AVMs). Complete embolization was done in 7 prtients (46.7%), nearly complete embolization in 6 patients(40.4%), and partial embolization in 2 patients (13.3%). The overall curative success rate of embolization was 86.7%. Five patients showed no complication at all. Mild complications, however, were observed in 7 patients (46.8%). Severe complications such as AVM or Tracker rupture were observed in 3 patients (20%). In conclusion, superselective embolization is and effective method for the treatment of brain AVMs, and multiple session embolizations could reduce the complication rate and increase the success rate.
Angiography
;
Arteriovenous Malformations*
;
Brain*
;
Hemodynamics
;
Humans
;
Methods
;
Preoperative Care
;
Rupture
2.A Case of Endovascular Stent-Graft Implantation in Aortic Dissection mimicking Intramural Hematoma in Descending Thoracic Aorta.
Dae Keun SHIM ; Byoung Kwon LEE ; Jong Won HA ; Do Yun LEE ; Byung Chul CHANG ; Won Heum SHIM
Korean Circulation Journal 2001;31(3):347-352
Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
Aged, 80 and over
;
Aorta, Thoracic*
;
Diagnosis
;
Hematoma*
;
Humans
;
Male
;
Pathology
;
Prognosis
;
Thrombosis
;
Ulcer
3.A Case of Complete Resolution of Aortic Dissection in the Descending Thoracic Aorta Treated with Endovascular Stent-Graft Implantation.
Dae Keun SHIM ; Hee Doo KYUNG ; Young Sup YOON ; Byung Chul CHANG ; Do Yun LEE ; Won Heum SHIM
Korean Circulation Journal 2000;30(12):1583-1588
The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult
;
Aorta
;
Aorta, Thoracic*
;
Blood Vessel Prosthesis
;
Humans
;
Male
;
Prognosis
4.Quantitation of C-reactive Protein Levels and Erythrocyte Sedimentation Rate after Spinal Surgery.
Dae Moo SHIM ; Tae Kyun KIM ; Ha Hun SONG ; Yong Suk SHIM ; Seong Ho LEE ; Jin Ho SONG
Journal of Korean Society of Spine Surgery 1998;5(1):33-39
OBJECTIVES: In order to standardize the CRP, ESR and WBC count after three types of spinal surgery and get clinical usefulness from these laboratory dadas after spinal surgery and clincal usefulness of laboratory datas. MATERIAL AND METHODS: Three groups of patients(microdisectomy, anterior and posterior fusion) were chosen for the study. CRP, ESR and WBC levels were prospectively determined before surgery and at days 1-5, 10, 14,21 and 42 after surgery. RESULTS: In all patients, preoperative normal CRP level(<10mg/L) increased, reaching peak levels on the second day after anterior fusion(84.6mg/L), and at the third day after microdiscectomy(54.5mg/L) and posterolateral intercorporal fusion(152.2mg/L), with normalization in 5-10 days. Preoperative normal ESR level increased to peak level on the forth day after microdiscectomy(33.0mm/hr), and increased double peak levels after anterior(postoperative days 2&5) and posterolateral intercorporal fusion(postoperative days 3&5). ESR followed by a slow and irregular decrease, and at 42 days after surgery often remained elevated. WBC increased to variable peak level within normal limit in all patients. CONCLUSIONS: The rapid decline in CRP will probably be interrupted by a second rise or persisting elevation if infection occurs. CRP is presumably a better test than ESR for early detection of postoperative infection.
Blood Sedimentation*
;
C-Reactive Protein*
;
Erythrocytes*
;
Humans
;
Prospective Studies
5.Aggressive Osteoblastoma.
Yong Koo PARK ; Hyung Bae MOON ; Dong Kyuen LEE ; Dae Moo SHIM ; Jung Dal LEE
Korean Journal of Pathology 1986;20(2):235-239
Osteoblastomas were originally thought to be lesions that could be controlled with minimal local therapy, including curettage. However, at least some of the osteoblastomas with an unexpectedly active clinical course had histologic features which differed from ordinary osteoblastomas, and the term aggressive osteoblastoma was given to these lesions. In the aggressive osteoblastoma the osteoblasts are cytologically atypical. In addition, the well organized trabecular patterns of typical osteoblastoma is partly lacking, especially in the areas that are rich in atypical osteoblasts. The case report deals a case of aggressive osteoblastoma of the left iliac wing in a 44 year old male. The interesting radiologic manifestationa(plain x-ray CAT and radionuclide bone scan) and characteristic histologic findings are presented along with review of pertinent literatures.
6.Left Atrial Enlargement: Echocardiographic Assessment of Electrocardiographic Criteria.
Uoo Eak SHIM ; Seung Hoon LEE ; Nam Joon LEE ; Dae Ha KIM
Korean Circulation Journal 1982;12(1):139-143
A comparison betwen electrocardiographic and echocardiographic criteria of Lt. atrial enlargement was made in 40 cases who demonstrated left atrial enlargement either electrocardiographically or echocardiographically. 1) There were 20 cases with Lt. atrial enlargement by electrocardiographic criteria and echocardiographic criteria and 30 cases by echocardiographic criteria 2) Of 40 subjects, 19 cases were found to satisfy both electrocardiographic and echocardiographic critera of Lt. atrial enlargement at the same time. 3) 10 cases were consistent only with electrocardiographic criteria of Lt. atrial enlargement, but not with echocardiographic criteria 4) On the other hand, 11 cases of Lt. atrial enlargement consistent with echocardiographic criteria did not meet the electrocardiographic criteria 5) The respective predictive indices of electrocardiographic and echocardiographic criteria of Lt. atrial enlargement were: Electrocardiographic criteria; positive: 65.52%, Negative: 79.9%. Echocardiographic criteria; Positive: 63.3%, Negative: 89.13%.
Echocardiography*
;
Electrocardiography*
;
Hand
7.Studies on the Development of Lung and Distribution of Elastic and Reticular Fibers during Fetal Period Proper.
Dae Joong KIM ; Ho Dirk KIM ; Bong Jin RAH ; Jin Mo LEE ; Tae Sub SHIM
Korean Journal of Physical Anthropology 1990;3(2):131-144
To investigate the human lung development and the distribution of elastic and reticular fibers during the fetal period proper, lung tissues taken from the periphery of the right lower lobes of Korean fetuses (n=49) of both sex were studied. The fetuses were the prodocts of spontaneous or therapeutic abortions and were found to have no associated lesions or anomalies at autopsy. The fetal age were estimated from crown-rump length or foot length. Paraffin sections, cut at 5-7 µm, were stained with routine hematoxylin and eosin for general structure, acid orcein and a1dehyde fuchsin for elastic fiber, and with Gomori's silver technique for reticular fiber, respectively. The lung development during fetal period proper, could be subdivided into three continuous periods according to the relation between airspaces, surrounding mesenchymal tissue, their structural changes and distribution, i.e., an early stage of the formation of conductive airways (pseudoglandular period, before 16th week of gestation), a middle stage of the development of lung parenchyma and new blood vessels (canalicular period, between 16th and 28th week of gestation), and a late stage of transition of respiratory portion to vascular organ (terminal sac stage, after 28th week of gestation). In places, secondary septa of sac or saccule formed by capillaries, capillary connective tissue, elastic and reticular fuel could be identified by the 33rd week of gestation. Elastic fibers could be noted in pleura, subepithelial areas of bronchioles and the wall of blood vessels in the late stage of pseudoglandular period. By the 28th week of gestation, elastic fibers were seen in the wall of small blood vessels or capillaries in the septal wall among the airspaces. And these fibers were observed in the tip of the secondary septa by the 33rd week of gestation but were not still completely developed in the walls of primary or secondary septa. Reticular fibers were already developed and widely distributed in fetal lung by the 10th week of gestation. These fibers were concentrated particular around the subepithelial area of bronchicoles, the airspaces and the blood vessel wall in the canalicular period. By the late stage of terminal sac period, reticular fibers formed a network along the small blood vessels in the septum of airspaces. These results indicate that primitive alveoli might be formed by the late stage of fetal period proper. The fibrous framework could partially formed by collagenous and reticular fibers during the pseudoglandular period, by addition of elastic fiber to the preformed network, and incompletely still finally by the three kinds of connective tissue fiber.
Abortion, Therapeutic
;
Autopsy
;
Blood Vessels
;
Bronchioles
;
Capillaries
;
Collagen
;
Connective Tissue
;
Crown-Rump Length
;
Elastic Tissue
;
Eosine Yellowish-(YS)
;
Female
;
Fetus
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Foot
;
Gestational Age
;
Hematoxylin
;
Humans
;
Lung*
;
Paraffin
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Pleura
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Pregnancy
;
Reticulin*
;
Rosaniline Dyes
;
Saccule and Utricle
;
Silver
8.Retrospective Study of Protruded and Extruded type in the Lumbar Intervertebral Disc.
Dae Moo SHIM ; Tae Kyun KIM ; Ha Heon SONG ; Han Sol LEE
Journal of Korean Society of Spine Surgery 1997;4(1):136-142
No abstract available.
Intervertebral Disc*
;
Retrospective Studies*
9.Effect of Preconditioning on Postischemic Reperfused Rabbit Heart.
Ho Dirk KIM ; Dae Joong KIM ; Jae Kyoug LEE ; Tae Sub SHIM ; Bong Jin RAH
Korean Circulation Journal 1992;22(3):418-430
BACKGROUND: It has been reported that one or more intermittent reperfusion(s) during ischemia may be beneficial to the myocardium by washing out catabolites that have accumlated during ischemia. We evaluated the effect of four cycles of ichemia (2 minutes) and reperfusion (3 miutes), i.e., preconditioning on sustained ischemia (20 minutes) and reperfusion (60 minutes) using isolated Langendorff-perfused rabbit hearts. METHODS: After a fifty-minutes recovery phase, LVP , dLVP/dt and ECG were simultaneously recorded and ultrastructure of the stunned(or risk) area of the left ventricle was examined with conventional methods. RESULTS: In the preconditioned hearts, functional parameters such as LVPP(peak pressure), LVPP recovery rate and LVEDP(end-diastolic pressure) reached to 99.6+/-4.38mmHg, 98.0+/-4.67% and 14.0+/-2.90mmHg (109.3+/-2.91mmHg, 109.4+/-1.29mmHg and 10.7+/-2.67mmHg for the controls), respectively, after 30 minutes from the onset of reperfusion and maintained as in the controls(p>0.01). In contrast, in the ischemia-reperfusion hearts, LVPP and LVPP recovery rate were significantly reduced(81.6+/-6.83mmHg and 85.7+/-5.30%;p<0.05) and LVEDP elevated(21.2+/-3.00mmHg) but dP/dtmax, heart rate and ECG patterns were not significantly different between the preconditioned and the ischemia-refusion hearts during reperfusion. Furthermore, irreversible myocardial injury was homogeneous(both subendo- and subepicardial) in the ischmia-reperfusion hearts but only focal(subendocardial) in preconditioned hearts. CONCLUSION: These results suggest that preconditioning induced by very short periods of ischemia and reperfusion may enhance recovery of the left ventricular function and delay ultrastructhral changes to a certain extent during reperfusion.
Electrocardiography
;
Heart Rate
;
Heart Ventricles
;
Heart*
;
Ischemia
;
Myocardium
;
Reperfusion
;
Ventricular Function, Left
10.Clinical and Histopathological Observation on Benign Melanocytic Tumor and Malignant Melanoma ( 1974 ~ 1984 ).
Dae Sung LEE ; Baik Kee CHO ; Won HOUH ; Sang In SHIM ; Soo Il CHUNG
Korean Journal of Dermatology 1986;24(3):364-372
This clinical and histopathological study was performed with 147 cases of benign mielanocytic tumors and 19 cases of malignant melanomas, which were obtained as surgical specimens from 1974 to 1984 at Department of Clinical Pathology, Catholic Medical College. The results were as follows: 1, In 89 cases of acquired benign melanocytic nevi, the average age of intradermal type(64 cases) was 34. 7 years and that of compound type(24 cases) was 24. 6 years. 2. In 30 cases of congenital nevus, nevus cells were present in the lower two thirds of reticular layer of the dermis in 93. 3% and in the subcutis as well in 3.3%. A case of giant congenital nevus with balloon cell appearance was found. 3. Of the 147 benign melanocytic tumors, a pigmented spindle cell nevus and a desmoplastic nevus were observed. 4. Blue nevi were 11 in number and excised from the face in 7, buttock in 2, shoulder in 1, upper arm in 1, and all were common type histopathologically. 5. Twelve malignant melanornas which were possible to be re-examined histopathologically were composed of 5 nodular type, 3 acral lentiginous type, 1 superficial spreading type and 3 metastatic malignant melanoma.
Arm
;
Buttocks
;
Dermis
;
Melanoma*
;
Nevus
;
Nevus, Blue
;
Nevus, Pigmented
;
Nevus, Spindle Cell
;
Pathology, Clinical
;
Shoulder