OBJECTIVE: Paraclinoid aneurysms are a group of aneurysms arising at the distal internal carotid artery. Due to a high incidence of small, wide-necked aneurysms in this zone, it is often challenging to achieve complete occlusion when solely using detachable coils, thus stent placement is often required. In the present study, we aimed to investigate the effect of stent placement in endovascular treatment of paraclinoid aneurysms. METHODS: Data of 98 paraclinoid aneurysms treated by endovascular approach in our center from August 2005 to June 2016 were retrospectively reviewed. They were divided into two groups: simple coiling and stent-assisted coiling. Differences in the recurrence and progressive occlusion between the two groups were mainly analyzed. The recurrence was defined as more than one grade worsening according to Raymond-Roy Classification or major recanalization that is large enough to permit retreatment in the follow-up study compared to the immediate post-operative results. RESULTS: Complete occlusion was achieved immediately after endovascular treatment in eight out of 37 patients (21.6%) in the stent-assisted group and 18 out of 61 (29.5%) in the simple coiling group. In the follow-up imaging studies, the recurrence rate was lower in the stent-assisted group (one out of 37, 2.7%) compared to the simple coiling group (13 out of 61, 21.3%) (p=0.011). Multivariate logistic regression model showed lower recurrence rate in the stent-assisted group than the simple coiling group (odds ratio [OR] 0.051, 95% confidence interval [CI] 0.005–0.527). Furthermore there was also a significant difference in the rate of progressive occlusion between the stent-assisted group (16 out of 29 patients, 55.2%) and the simple coiling group (10 out of 43 patients, 23.3%) (p=0.006). The stent-assisted group also exhibited a higher rate of progressive occlusion than the simple coiling group in the multivariate logistic regression model (OR 3.208, 95% CI 1.106–9.302). CONCLUSION: Use of stents results in good prognosis not only by reducing the recurrence rate but also by increasing the rate of progressive occlusion in wide-necked paraclinoid aneurysms. Stent-assisted coil embolization can be an important treatment strategy for paraclinoid aneurysms when considering the superiority of long term outcome.
Aneurysm* ; Carotid Artery, Internal ; Classification ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Aneurysm ; Logistic Models ; Prognosis ; Recurrence ; Retreatment ; Retrospective Studies ; Stents

OBJECTIVE: The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms. MATERIALS AND METHODS: From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms. Mini-mental state examinations (MMSE) were performed in 2 different periods. The statistical relationship between GR resection and MMSE results was evaluated, and further analysis of MMSE subgroup was performed. RESULTS: Twenty-five out of the 39 patients (64.19%) underwent GR resection. Mean initial and final MMSE scores in the GR resection group were 16.3 ± 9.8 and 20.8 ± 7.3, respectively. In the non-resection group, the mean initial and final MMSE scores were 17.1 ± 8.6 and 21.9 ± 4.5, respectively. Neither group's scores showed a significant change. Subgroup analysis of initial MMSE showed a significant difference in memory recall and language (p = 0.02) but not in the final MMSE scores. CONCLUSION: There was no significant relationship between the GR resection and cognitive outcomes in terms of total MMSE scores after surgery for ruptured ACoA aneurysm. However, subgroup analysis revealed a temporary negative effect of GR resection in the categories of language and memory recall. This study suggests that GR resection should be executed superficially, owing to its close anatomical relationship with the limbic system.
Aneurysm ; Arteries ; Cognition Disorders* ; Humans ; Intracranial Aneurysm* ; Limbic System ; Memory ; Prefrontal Cortex* ; Surgical Instruments

BACKGROUND: From January 1989 to December 1996, we analyzed 22 cases of ventricular septal defect associated(VSD) with aortic valvular prolapse. MATERIAL AND METHOD: The mean age of the patients was 7 years with a range of 6 months to 22 years . Thirteen patients were male and 9 were female. The types of VSD were Kirklin type I in 13 , Kirklin type II in 8 and Kirklin type I+II in one. RESULT: The preoperative echocardiographic findings were aortic valvular prolapse in 10 patients, aortic valvular prolapse associated with aortic regurgitation in 6, and only aortic regurgitation in 2. Aortic valvular prolapse were found in operation field in 4 that was not be in preoperative echcardiography. Preoperative mean Qp/Qs, systolic PAP, systolic RVP were 1.48+/-0.42, 27.9+/-9.87, 32.9+/-10.87 mmHg, respectively. Twenty patients underwent patch closure of VSD, and two patients with moderate aortic regurgitation and prolapsed of the aortic valve underwent patch closure of VSD and aortic valvuloplasty. Short and long term echocardiographic follow-up in 8 patients who had preoperative aortic regurgitation were found to have improved or not aggravated by performing VSD patch closure only and patch closure with valvuloplasty in 2. Twelve patients who had only preoperative aortic valvular prolapse had no change in prolapsed valve in postoperative echocardiography. CONCLUSION: Early closure of VSD with patch is necessary in VSD with aortic valvular prolapse even in associated with mild regurgitation. But in moderate regurgitation, VSD closure with valvuloplasty is recommended.
Aortic Valve ; Aortic Valve Insufficiency ; Echocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Male ; Prolapse*

Central venous catheterization through subclavian vein has been used for central venous pressure monitoring, hyperalimentation, and fluid therapy. Its complications are air embolism, infection, vascular injury, pneumothorax, hemothorax and thrombosis that is the most serious complication. At the department of Thoracic and Cardiovascular surgery Chonbuk University Hospital, authors experienced superior vena cava syndrome due to thrombosis of the superior vena cava, internal jugular (left), subclavian(left), and innominate vein. Patients was a 21 years old female who had central venous catheterization through subclavian vein for hyperalimentation and fluid therapy because of enterocutaneous fistula. Thrombectomy on superior vena cava was performed, and pre and postoperative anticoagulation therapy was given. Symptoms were relieved after operation. From the venography, performed 6 weeks after the operation, restenosis was seen at the thrombectomy site of the superior vena cava. S anticoagulant and conservative treatment were done that symptoms relieved by the development of collateral venous channel.
Brachiocephalic Veins ; Catheterization, Central Venous ; Central Venous Catheters* ; Central Venous Pressure ; Embolism, Air ; Female ; Fluid Therapy ; Hemothorax ; Humans ; Intestinal Fistula ; Jeollabuk-do ; Phlebography ; Pneumothorax ; Subclavian Vein ; Superior Vena Cava Syndrome ; Thrombectomy ; Thrombosis ; Vascular System Injuries ; Vena Cava, Superior* ; Young Adult

This study was taken to measure the serum aminotransferase level and its correlation with clinical symptoms from Human Rotavirus gastroenteritis. This report is based on analysis of 434 patients who were admitted to the Pediatric department at Wonju Christian Hospital because of watery diarrhea and vomiting during 2-year period from July, 1991 to June 1993. The stool specimen on admission was tested for Rotavirus Ag by Rotazyme test. And then serum aminotransferase were checked. The result are as follows: 1) Rotavirus Antigens were detected in 194 cases (44.7%) among total 434 patients with gastroenteritis 2) The number of patients with AST elevation above the normal value in RTZ+group was 126 cases(64.9%) and, in RTZ-group was 65 cases(27.0%). 3) The mean value of AST in RTZ+ group was 41.7U/L and, in RTZ-group was 31.1U/L. The mean value of AST between the two groups were significantly different. 4) The mean value of ALT and GGT in the two groups were not different. 5) The patients with AST elevation above normal level in the RTZ+group was significantly increased in frequency and duration of diarrhea than RTZ+ group with normal AST level.
Diarrhea ; Gangwon-do ; Gastroenteritis* ; Humans* ; Reference Values ; Rotavirus* ; Vomiting

Congenital anomalies occur in 2-3% of neonates and have unknown and variable causes. It's occurance rate is higher in twin gestations than in singleton gestations, especially in monozygotic twins. In most cases of twin anomalies, one fetus is normal and the other fetus is not. When an anomaly is found in one fetus, various tests, such as chorionic villus sampling, amniocentesis, and umbilical cord aspiration are strongly recommended in high risk groups of chromosmal anomaly for accurate diagnosis and proper treatments. A case of congenital anomalies in both twins diagnosed in a 35 year old multiparous woman is presented with brief review of literatures.
Adult ; Amniocentesis ; Anencephaly ; Chorionic Villi Sampling ; Diagnosis ; Down Syndrome ; Female ; Fetus ; Humans ; Infant, Newborn ; Pregnancy ; Twins* ; Twins, Monozygotic ; Umbilical Cord

OBJECTIVE: The purpose of this study is to investigate the clinical characteristics of cerebral venous thrombosis (CVT) in a single center in Korea. METHODS: A total of 36 patients were diagnosed with CVT from August 2005 to May 2013. The patient data regarding age, sex, disease stage, pathogenesis, location, laboratory findings, radiological findings, and treatment modalities were retrospectively collected. The results were compared with those of previous studies in other countries. RESULTS: The patient group comprised 21 men and 15 women with a mean age of 46.9 years (ranging from three months to 77 years). The most common cause was a prothrombotic condition (8 patients, 22.2%). Within the patient group, 13 patients (36.1%) had a hemorrhagic infarction, whereas 23 (63.9%) had a venous infarction without hemorrhage. By location, the incidence of hemorrhagic infarction was the highest in the group with a transverse and/or sigmoid sinus thrombosis (n=9); however, the proportion of hemorrhagic infarction was higher in the cortical venous thrombosis group (75%) and the deep venous thrombosis group (100%). By pathogenesis, the incidence of hemorrhagic infarction was the highest in the prothrombotic group (n=6), which was statistically significant (p=0.016). CONCLUSION: According to this study, CVT was more prevalent in men, and the peak age group comprised patients in the sixth decade. The most common cause was a prothrombotic condition. This finding was comparable with reports from Europe or America, in which CVT was more common in younger women. Hemorrhagic infarction was more common in the prothrombotic group (p=0.016) than in the non-prothrombotic group in this study.
Americas ; Colon, Sigmoid ; Europe ; Female ; Hemorrhage ; Humans ; Incidence ; Infarction ; Korea ; Male ; Retrospective Studies ; Sinus Thrombosis, Intracranial ; Venous Thrombosis*

OBJECTIVE: To evaluate the accuracy and effect of ultrasonography guided subacromial subdeltoid (SASD) bursa injection on the shoulder pain and function compared to blind technique. METHOD: Twenty-eight patients diagnosed as SASD bursitis were administered with SASD injection of corticosteroids randomly by either blind or US guided technique and then assessed by ultrasonography to confirm the accuracy. Shoulder pain and function were evaluated by visual analog scale with Hawkin's impingement test, active range of motion (ROM) of the shoulder, University of California-Los Angeles (UCLA) shoulder rating scale before and 1 week after the injection. RESULTS: The accuracy of SASD injection using blind technique was 42.8%, however, US-guided injection showed 100% accuracy, significantly higher than blind technique (p<0.05). We could find significant improvement in pain with Hawkin's impingement test, active ROM of the shoulder, UCLA shoulder rating scale 1 week after injection in both groups. But there were no significant differences between the groups. In eight patients, failure was observed: four in the suprascapularis tendon, three in the deltoid muscle, and one in the subcutaneous tissue without side effects. CONCLUSION: Ultasonography guided injection into SASD bursa improved the accuracy of injection. However the injection method and the success of injection did not affect to the pain and shoulder function.
Adrenal Cortex Hormones ; Bursitis ; Deltoid Muscle ; Humans ; Range of Motion, Articular ; Shoulder ; Shoulder Pain ; Subcutaneous Tissue ; Tendons

Hepatosplenic gamma delta-cell lymphoma is a rare histologic type of peripheral T-cell lymphomas, clinically characterized by predominant involvement of liver and spleen, no or little adenopathy, and an often aggressive course. We report a case of bone marrow involvement of hepatosplenicgamma delta-cell lymphoma in a 21- year-old woman who presented with fever, anemia, thrombocytopenia, and hepatosplenomegaly. A lymphoma was found subsequently by bone marrow biopsy and computed tomography scan of the abdomen and pelvis. Immunologic characterization of lymphoma cells in bone marrow revealed positivity for CD2, CD3, and CD16/56, and negativity for CD4, CD5, CD7, CD8, CD34, and terminal deoxynucleotidyl transferase (TdT). Conventional cytogenetic studies revealed the presence of isochromosome 7q. Using the PCR-SSCP technique, monoclonal gene rearrangement of the T-cell receptor gamma chain was demonstrated. Thus, we could make a confirmatory diagnosis as hepatosplenic gamma delta-cell lymphoma.
Abdomen ; Anemia ; Biopsy ; Bone Marrow* ; Cytogenetics ; Diagnosis ; DNA Nucleotidylexotransferase ; Female ; Fever ; Gene Rearrangement ; Humans ; Isochromosomes ; Liver ; Lymphoma* ; Lymphoma, T-Cell, Peripheral ; Pelvis ; Receptors, Antigen, T-Cell ; Spleen ; Thrombocytopenia

PURPOSE: To evaluate the usefulness of MR imaging for the follow-up of vessels in which a stainless steel ornitinol stent has been placed. MATERIALS AND METHODS: Stents were made with either stainless steel or nitinol,and inserted in a vascular-shaped rubber tube; this was then placed in an acryl bath. MR images of stainless steeland nitinol stents in the water-filled tube, both with and without flow, were obtained. As MRI pulse sequences, SET1WI, FSE T2WI, heavily T2WI, SE EPI, FMPSPGR, GRASS, FLAIR, 3D SSFP, 2D PC MRA and 2D TOF MRA were used. The MRimages obtained with each pulse sequence were compared, with special attention to the presence and location ofartifact and the ability to discriminate the stent from the wall of the vascular phantom or water. RESULTS: Inour study without water flowing, the stainless steel stent produced images with severe artifacts in all pulsesequences, but the nitinol stent produced excellent images without artifact in SE T1WI, FSE T2WI and heavily T2WI.With water flowing, the stainless steel stent produced a less severe artifact at the distal end of the stent on SET1WI, FSE T2WI, heavily T2WI, GRASS and FLAIR ; the nitinol stent produced excellent images without artifact in SET1WI, FSE T2WI, GRASS, FLAIR and 2D TOF MRA. CONCLUSION: For follow-up study of Patients with a nitinol stent,MRI can be useful.
Artifacts ; Baths ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Poaceae ; Rubber ; Stainless Steel* ; Stents* ; Water