1.Neuromyelitis Optica Masquerading as Lumbosacral Radiculopathy: A Case Report.
Seungyeon KIM ; Bumsun KWON ; Jinwoo PARK ; Hojun LEE ; Hyojun KIM ; Dayun PARK ; Kiyeun NAM
Annals of Rehabilitation Medicine 2016;40(5):943-948
Neuromyelitis optica spectrum disorders (NMOSD) is a demyelinating syndrome of the central nervous system. This case report describes a 31-year-old woman whose electromyography revealed radiculopathy in the left L5-S1 spinal segment without anatomical abnormalities on lumbosacral magnetic resonance imaging (MRI). She was diagnosed with NMOSD based on gadolinium contrast whole spine and brain MRI and anti-aquaporin-4 antibody findings. Her peripheral nervous system might have been damaged during the early course of NMOSD. Therefore, it is necessary to consider NMOSD for patients who have radiculopathy in electromyography if lumbosacral MRI shows no abnormalities.
Adult
;
Brain
;
Central Nervous System
;
Electromyography
;
Female
;
Gadolinium
;
Humans
;
Magnetic Resonance Imaging
;
Neuromyelitis Optica*
;
Peripheral Nervous System
;
Peripheral Nervous System Diseases
;
Radiculopathy*
;
Spine
2.Sugammadex-induced bronchospasm: a case report
Saeyoung KIM ; Hyojun CHOO ; Hoon JUNG ; Ji Hyun KIM
Journal of Dental Anesthesia and Pain Medicine 2023;23(5):287-291
Sugammadex has shown faster reversal of steroidal neuromuscular blockade (NMB) than neostigmine, a traditional reversal agent for NMB, even in the intense block phase. This efficiency is possible because of the unique mechanism of action by encapsulating the NMB molecules. Therefore, with the use of sugammadex, we can also expect to avoid direct interactions with the cholinergic system and its subsequent side effects, which are disadvantages of traditional drugs. However, despite these benefits and US Food and Drug Administration (FDA) approval in 2015, rare adverse events associated with sugammadex have been reported. Herein, we report a case of bronchospasm that developed immediately after sugammadex administration.
3.The surgical approach for the inferior vena cava leiomyosarcoma including the confluence of right renal vein: A case report of patch venoplasty with right renal vein reimplantation after complete tumor resection
Chan Woo CHO ; Kyo Won LEE ; Hyojun PARK ; Jae Berm PARK ; Sungjoo KIM
Korean Journal of Clinical Oncology 2016;12(2):140-144
Surgical approaches for leiomyosarcoma of the inferior vena cava (IVC) are based on tumor location. Radical resection for the IVC leiomyosarcoma involving the renal vein has traditionally included nephrectomy with renal vein ligation or kidney autotransplantation. A 51-year-old woman was admitted for elective surgery for the tumor of IVC. At surgery, the tumor was located in front of IVC, abutted with right renal vein. After the tumor resection, IVC reconstruction involved the patch cavoplasty with cryopreserved cadaveric vein graft and the implantation of the right renal vein into the inferior IVC. The patient recovered fully without any postoperative complications including kidney function change. This technique could be adopted for tumors located in front of IVC involving renal veins, provided complete resection of the tumor with a comfortable resection margin is possible.
Autografts
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Cadaver
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Female
;
Humans
;
Kidney
;
Leiomyosarcoma
;
Ligation
;
Middle Aged
;
Nephrectomy
;
Postoperative Complications
;
Renal Veins
;
Replantation
;
Transplantation, Autologous
;
Transplants
;
Veins
;
Vena Cava, Inferior
4.Radical resection of intestinal blue rubber bleb nevus syndrome.
Kang Kook CHOI ; Jin Yong KIM ; Min Jung KIM ; Hyojun PARK ; Dong Wook CHOI ; Seong Ho CHOI ; Jin Seok HEO
Journal of the Korean Surgical Society 2012;83(5):316-320
Blue rubber bleb nevus syndrome (BRBNS) is a rare systemic vascular disorder characterized by multiple venous malformations involving many organs. BRBNS can occur in various organs, but the most frequently involved organs are the skin and gastrointestinal (GI) tract. GI lesions of BRBNS can cause acute or chronic bleeding, and treatment is challenging. Herein, we report a case of GI BRBNS that was successfully treated with a combination of intraoperative endoscopy and radical resection.
Blister
;
Endoscopy
;
Gastrointestinal Neoplasms
;
Hemorrhage
;
Intestines
;
Nevus
;
Nevus, Blue
;
Rubber
;
Skin
;
Skin Neoplasms
5.The Long-term Outcomes of Kidney Transplantation from Donation after Circulatory Death during Brain Death Donor Evaluation in a Single Center in Korea.
Nayoon HUR ; Hyojun PARK ; Kyowon LEE ; Gyuseong CHOI ; Jong Man KIM ; Jae Berm PARK ; Choon Hyuck KWON ; Sung Joo KIM ; Jae Won JOH ; Suk Koo LEE
The Journal of the Korean Society for Transplantation 2015;29(4):216-226
BACKGROUND: While the number of deceased donor donations has increased in Korea, the organ shortage remains a major limitation for kidney transplantation. Donation after circulatory death (DCD) can be an option to expand the donor pool. In this study we evaluated the short and long term survival of grafts and patients and assessed the risk factors for graft failure. METHODS: In a single center, from August 1997 to December 2013, 28 cases of recipients who received kidney transplantation from DCD were enrolled. Information about donor and recipient factors, graft conditions, and transplant outcomes was collected through review of medical records. We calculated overall graft and patient survival rates and the risk factors for graft failure according to donor criteria and whether or not delayed graft function (DGF) occurred. RESULTS: There was no primary non-function, but DGF developed in 67.9% (19/28). Graft losses occurred in five patients during a median follow-up period of 68.2 months (4~204). There was no significant difference in graft survival rates depending on the donor criteria and the occurrence of DGF. In addition, there were no noteworthy risk factors for graft failure among donor age, donor creatinine, extended criteria donor, recipient age, warm ischemic time, cold ischemic time, and DGF. CONCLUSIONS: In this study, despite the high incidence of DGF, the long-term graft and patient survival in kidney transplantation from DCD were acceptable. Therefore, DCD can be an alternative to expand the donor pool and to shorten the waiting time.
Brain Death*
;
Brain*
;
Cold Ischemia
;
Creatinine
;
Delayed Graft Function
;
Follow-Up Studies
;
Graft Survival
;
Humans
;
Incidence
;
Kidney Transplantation*
;
Kidney*
;
Korea*
;
Medical Records
;
Risk Factors
;
Survival Rate
;
Tissue Donors*
;
Transplants
;
Warm Ischemia
6.High pretransplant HBV level predicts HBV reactivation after kidney transplantation in HBV infected recipients.
Jong Man KIM ; Hyojun PARK ; Hye Ryoun JANG ; Jae Berm PARK ; Choon Hyuck David KWON ; Wooseong HUH ; Joon Hyeok LEE ; Sung Joo KIM ; Jae Won JOH
Annals of Surgical Treatment and Research 2014;86(5):256-263
PURPOSE: HBsAg-positive kidney recipients are at increased risk for mortality and graft failure. The aims of this study were to identify the outcomes of HBsAg-positive recipients who received preemptive antiviral agents after successful kidney transplantation and to analyze risk factors for HBV reactivation. METHODS: We retrospectively reviewed the medical records of 944 patients performed kidney transplantation between 1999 and 2010. RESULTS: HBsAg-negative recipients were 902 patients and HBsAg-positive recipients, 42. Among HBsAg-positive recipients, HBV reactivation was detected in 7 patients and well controlled by switch or combination therapy. Graft failure developed in only one patient due to chronic rejection regardless of HBV reactivation but no deaths occurred. All patients were alive at the end of follow-up and none developed end-stage liver disease or hepatocellular carcinoma. There was statistically significant difference in graft survival between HBsAg-positive recipients and HBsAg-negative. Multivariate analysis identified increased HBV DNA levels (>5 x 10(4) IU/mL) in the HBsAg-positive kidney transplant recipients as a risk factor for HBV reactivation (P = 0.007). CONCLUSION: Effective viral suppression with antiviral agents in HBsAg-positive renal transplant recipients improves patient outcome and allograft survival. Antiviral therapy may be especially beneficial in patients with high HBV DNA levels prior to transplantation.
Allografts
;
Antiviral Agents
;
Carcinoma, Hepatocellular
;
DNA
;
Follow-Up Studies
;
Graft Survival
;
Hepatitis B virus
;
Humans
;
Kidney
;
Kidney Transplantation*
;
Liver Diseases
;
Medical Records
;
Mortality
;
Multivariate Analysis
;
Retrospective Studies
;
Risk Factors
;
Transplantation
;
Transplants
7.The Effect and Safety of Steroid Injection in Lumbar Spinal Stenosis: With or Without Local Anesthetics.
Sung Hyuk SONG ; Gi Hyeong RYU ; Jin Woo PARK ; Ho Jun LEE ; Ki Yeun NAM ; Hyojun KIM ; Seung Yeon KIM ; Bum Sun KWON
Annals of Rehabilitation Medicine 2016;40(1):14-20
OBJECTIVE: To compare the long-term effect and safety of an epidural steroid injection in spinal stenosis patients, with or without local anesthetics. METHODS: Twenty-nine patients diagnosed with spinal stenosis were included and randomly divided into two groups. Translaminar epidural and selective nerve root spinal injection procedures were performed using steroids mixed with local anesthetics or normal saline. The effects of spinal injection procedures were measured with visual analogue scale (VAS) and functional rate index (FRI). These measurements were performed before injection, at 1 month after injection and at 3 months after injection. The occurrence of side effects was investigated each time. RESULTS: The VAS and FRI scores were significantly reduced in both the local anesthetics group and normal saline group at 1 and 3 months after the injection. However, there was no significant difference in VAS and FRI score reduction between the two groups each time. Side effects are not noted in both groups. CONCLUSION: The spinal injection procedures using steroids mixed either with local anesthetics or normal saline have an effect in reducing pain and improving functional activities. However, there was no significant difference between the two groups in relation to side effects and the long-term effects of pain and function.
Anesthetics
;
Anesthetics, Local*
;
Humans
;
Injections, Epidural
;
Injections, Spinal
;
Spinal Stenosis*
;
Steroids
8.Intra-abdominal bronchogenic cyst: report of five cases.
Kang Kook CHOI ; Ji Youn SUNG ; Jung Sun KIM ; Min Jung KIM ; Hyojun PARK ; Dong Wook CHOI ; Seong Ho CHOI ; Jin Seok HEO
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2012;16(2):75-79
An intra-abdominal bronchogenic cyst (BC) is a very rare congenital anomaly caused by abnormal budding of the developing tracheobronchial tree. Intra-abdominal BCs are reported as retroperitoneal masses in most cases, many of which are located on the left side of the midline, the perigastric area, the left adrenal gland, or the superior body of the pancreas. Intra-abdominal BCs are frequently misdiagnosed due to the rarity, location, and variable cystic content. We report five patients with intra-abdominal BCs who underwent surgery in a single institution.
Adrenal Glands
;
Bronchogenic Cyst
;
Humans
;
Pancreas
;
Pancreatic Neoplasms
;
Retroperitoneal Neoplasms
9.Case Report of Kidney Paired Donation (KPD) with Desensitization: the Strategy and Experience of 3-Way KPD in Samsung Medical Center
Dongkyu OH ; Eun Suk KANG ; Shinae YU ; Kyoungsuk CHUN ; Wooseong HUH ; Hye Ryoun JANG ; Chan Woo CHO ; Nuri LEE ; Kyo Won LEE ; Hyojun PARK ; Jae Berm PARK ; Sung Joo KIM
Journal of Korean Medical Science 2018;33(5):e39-
As the need for the organ donation increases, strategies to increase kidney transplantation (KT) through expanded living donation have become essential. These include kidney paired donation (KPD) programs and desensitization in incompatible transplantations. KPD enables kidney transplant candidates with incompatible living donors to join a registry with other incompatible pairs in order to find potentially compatible living donor. Positive cross match and ABO incompatible transplantation has been successfully accomplished in selective cases with several pre-conditionings. Patients who are both difficult-to-match due to broad sensitization and hard-to-desensitize because of donor conditions can often be successfully transplanted through a combination of KPD and desensitization. According to the existing data, KPD can increase the number of KTs from living donors with excellent clinical results. This is also a cost-effective treatment as compared with dialysis and desensitization protocols. We carried out 3-way KPD transplantation with one highly sensitized, positive cross match pair and with two ABO incompatible pairs. Herein we report our first successful 3-way KPD transplantation in a single center. To maximize donor-recipient matching and minimize immunologic risk, KPD programs should use proper algorithms with desensitization to identify optimal donor with simultaneous two-, three- or more complex multi-way exchanges.
Dialysis
;
Humans
;
Kidney Transplantation
;
Kidney
;
Living Donors
;
Tissue and Organ Procurement
;
Tissue Donors
10.Technique for orthotopic liver transplantation in cynomolgus monkeys (Macaca fascicularis)
Kyo Won LEE ; Chan Woo CHO ; Hyojun PARK ; Gyu Seong CHOI ; Jae Berm PARK ; Sung Joo KIM
Annals of Surgical Treatment and Research 2018;94(1):8-12
PURPOSE: Recent studies investigating new strategies to modulate the immune system have utilized animal models of liver transplantation (LT). However, the anhepatic phase (AHP) remains a crucial problem in LT. The aim of the present study is to introduce a technique for successful orthotopic LT in cynomolgus monkeys using an early-reperfusion strategy. METHODS: Orthotopicallo-LT was performed with seven donor/recipient pairs of cynomolgus monkeys. RESULTS: In 2 recipients, liver allografts were perfused after suprahepatic inferior vena cava (SHIVC), portal vein (PV), and infrahepatic inferior vena cava (IHIVC) anastomosis. To reduce the time of AHP in five recipients, liver allografts ware perfused after SHIVC and PV anastomosis while the IHIVC was not anastomosed. In the latter strategy, the AHP was reduced from 46 minutes to 31 minutes and a 24-hour survival rate of 80% was achieved. CONCLUSION: Our results indicate that an early-reperfusion strategy can be successfully used to establish a LT model in cynomolgus monkeys with a consistently high rate of animal survival.
Allografts
;
Animals
;
Immune System
;
Liver Transplantation
;
Liver
;
Macaca fascicularis
;
Models, Animal
;
Portal Vein
;
Primates
;
Reperfusion
;
Survival Rate
;
Vena Cava, Inferior