Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).
Aneurysm* ; Carotid Artery, Internal* ; Mortality ; Subarachnoid Hemorrhage ; Transplants*

No abstract available.
Humans ; Siblings*

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the weight bearing articular surface. This fracture often presents some problems in treatment and prognosis, because it is frequently accompanied by soft tissue injuries such as collateral ligament, cruciate ligament and menisci. During a period of 3 1/2 years, from Febuary 1980 to July 1983, We observed 78 cases of tibial plateau fractures at Gang Nam Sacred Heart Hospital. Of the above cases, 40 could be followed for a period of anywhere from 3 months to 3 years. They have been analysed according to the cause, classification, method of treatment and final result of treatment. Among these 21(52.5%) were treated by cast immobilization, 3(7.5%) by skeletal traction, 16 (40%) by open reduction and internal fixation. Thirty two cases (80% ) out of 40 indicated the result of the Acceptable group according to Hohl and Lucks criteria.
Classification ; Clinical Study ; Collateral Ligaments ; Heart ; Immobilization ; Ligaments ; Methods ; Prognosis ; Soft Tissue Injuries ; Tibia ; Traction ; Weight-Bearing

The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

Intraspinal cavernous malformation (CM) accounts for 5% to 16% of all spinal vascular abnormalities. Multiple spinal cord CMs are very rare and only a few cases have been described. We report a patient presented with right chest paresthesia and seizure, and diagnosed as multiple spinal intramedullary CM and intracranial involvement.
Humans ; Paresthesia ; Seizures ; Spinal Cord ; Spine ; Thorax

Cleidocranial dysplasia is a well-documented rare autosomal dominant skeletal dysplasia characterized by hypoplastic/aplastic clavicles, brachycephalic skull, patent sutures and fontanelles, midface hypoplasia, and abnormalities of dentition. Patients with cleidocranial dysplasia often complain about undesirable esthetic appearance of their forehead and skull. Notwithstanding many studies of molecular, genetics and skeletal abnormalities of this congenial disorder, there have been very few written reports of cranioplasty involving cleidocranial dysplasia. Thus, we report a rare case of successful cranioplasty using a modified split calvarial graft technique in patient with cleidocranial dysplasia.
Clavicle ; Cleidocranial Dysplasia* ; Dentition ; Forehead ; Genetics ; Humans ; Skull ; Sutures ; Transplants*

BACKGROUND: Although current dietary guidelines recommend to increase the consumption of whole grain, these recommendations are mainly derived from the belief that replacing fats with carbohydrate may reduce risk of coronary artery disease (CAD) by improving serum lipids. Our objective was to evaluate whether the isocalorical replacement of refined rice with whole grain reduce CAD risk factors such as insulin demand and lipid peroxidation in CAD patients. METHODS: Thirty-eight male patients with CAD were provided with 70 g powder of whole grain (220 kcal) for 16 weeks, replacing cooked refined rice as a carbohydrate source of breakfast. An oral glucose tolerance test (OGTT) was performed in all subjects to determine the effect of whole grain consumption on serum concentrations of insulin and glucose in CAD patients with different degree of glucose tolerance. RESULTS: With the substitution of whole grain for refined rice, serum glucose concentrations decreased by 24% without altering body weight and energy intake. Estimates of daily fiber and vitamin E intakes increased by 24% and 50%, respectively. Whole grain consumption in CAD patients without diabetes decreased fasting glucose (22%) and the area under the curve (AUC) for insulin (26%) and glucose (19%) during an OGTT. CAD patients with diabetes also showed reductions in fasting glucose (27%) and AUC for glucose (25%) during the OGTT, compared with baseline values. Whole grain consumption reduced plasma malondialdehyde and homocysteine and urinary 8-epi-prostaglandin F 2alpha concentrations by about 30%. Lipid-corrected concentrations of alpha-carotene, retinol, alpha- and gamma-tocopherol and lycopene increased by 22-46%, compared with baseline values. Whole grain consumption decreased the percentage composition of w6 fatty acids of serum phospholipid increased by 14%. CONCLUSION: The replacement of refined rice with whole grain as a carbohydrate source of a meal showed significant beneficial effects on glucose, insulin and homocysteine concentrations and lipid peroxidation in CAD patients. These effects are likely to substantially reduce the risk factors of CAD and diabetes in CAD patients.
Area Under Curve ; Blood Glucose ; Body Weight ; Breakfast ; Edible Grain* ; Coronary Artery Disease* ; Coronary Vessels* ; Energy Intake ; Fasting ; Fats ; Fatty Acids ; gamma-Tocopherol ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Insulin* ; Lipid Peroxidation* ; Male ; Malondialdehyde ; Meals ; Nutrition Policy ; Plasma* ; Risk Factors ; Vitamin A ; Vitamin E ; Vitamins