1.Cortical Infarction with Weakness of Individual Intrinsic Hand Muscles.
Phil Hyu LEE ; Sang Won HAN ; Ji Hoe HEO
Journal of the Korean Neurological Association 1998;16(5):697-700
With the development of electrophysiologic technique, a more detailed topographical organizations of motor cortex, especially hand area have been introduced in animal experiment. To the best our knowledge, in cerebral infarction, only one patient with isolated weakness of intrinsic hand muscles has been reported. We present two patients with cerebral infarction who showed isolated weakness in their intrinsic hand. Patient 1; A 76-year-old woman with coronary artery obstructive disease developed abrupt weakness in flexion of right thumb, index, middle finger and in adduction of thumb. Brain MRI showed a small discrete lesion in the posterior bank of left precentral gyrus. An angiography revealed an occlusion of left central sulcus artery. Prominent thumb adduction weakness was remained 11 days later. Patient 2; A 57-year-old hypertensive man was admitted because of recurrent TIA and decreased grasp power of right hand, especially flexion and adduction of thumb, index finger and middle finger. Brain MRI showed focal lamina necrosis in left precentral gyrus. An angiography revealed an occlusion of left internal carotid artery. Findings in our patients suggest that the similar arrangement of efferent zone for cortical hand area found in monkeys also may exist in human beings.
Aged
;
Angiography
;
Animal Experimentation
;
Arteries
;
Brain
;
Carotid Artery, Internal
;
Cerebral Infarction
;
Coronary Vessels
;
Female
;
Fingers
;
Hand Strength
;
Hand*
;
Haplorhini
;
Humans
;
Infarction*
;
Magnetic Resonance Imaging
;
Middle Aged
;
Motor Cortex
;
Muscles*
;
Necrosis
;
Thumb
2.An anesthetic experience in severe preeclampsia patient suspected HELLP syndrome with an intraperitoneal hemorrhage caused by a rapidly progressed liver rupture: A case report.
Hyun Joo HEO ; Hyungtae KIM ; Ji Hye LEE ; So Mang IM ; Ok Hyun KIM ; Han Gyeol LEE
Anesthesia and Pain Medicine 2018;13(4):401-404
The diagnosis of HELLP syndrome associated with preeclampsia-eclampsia during pregnancy uses three test results, including hemolysis, elevated liver enzyme, low platelets and their related clinical symptoms. Liver rupture is a life-threatening and rare complication related to HELLP syndrome. Early diagnosis and rapid treatment are very important for protecting the life of the patient and the fetus. We are reporting an anesthetic experience a sudden-onset suspicious HELLP syndrome with an intraperitoneal hemorrhage caused by a rapidly progressed liver rupture in a severe preeclampsia patient without any abnormalities during gestation.
Diagnosis
;
Early Diagnosis
;
Eclampsia
;
Female
;
Fetus
;
HELLP Syndrome*
;
Hemolysis
;
Hemorrhage*
;
Humans
;
Liver*
;
Pre-Eclampsia*
;
Pregnancy
;
Rupture*
3.Radiographic evaluation of marginal bone resorption around two types of external hex implants: preliminary study.
Ji Eun LEE ; Seong Joo HEO ; Jai Young KOAK ; Seong Kyun KIM ; Chong Hyun HAN
The Journal of Korean Academy of Prosthodontics 2008;46(2):169-174
STATEMENT OF PROBLEM: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. PURPOSE: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. MATERIAL AND METHODS: Twenty-four patients were included and randomly assigned to treatment with Branemark system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. RESULTS: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of 0.83+/-0.31mm; Group 2 had a mean crestal bone level changes of 0.44+/-0.36mm. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. CONCLUSION: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.
Bone Resorption
;
Dental Implants
;
Follow-Up Studies
;
Humans
;
Neck
;
Phenothiazines
;
Statistics as Topic
4.Factors Affecting Suicide Attempters Visiting Emergency Departments: Through a Focus on Acquired Capability with Rehearsal for Suicide, Negative Urgency, and Social Support
SohRee HAN ; YeongSuk LEE ; EunJee KIM ; Ji Sun KIM ; Insoo HEO ; JooYoung LEE ; Hee Jung YOON ; Se-Hoon SHIM
Mood and Emotion 2020;18(2):49-56
This study examines how acquired capability for suicide, negative urgency, and social support effectuate a suicide attempt. Sixty-three adults having visited an emergency room due to a suicide attempt were studied. The results can be summarized as follows. First, there were no significant sex differences in acquired capability for suicide, negative urgency, and social support. Second, the correlation among suicidal ideation, acquired capability for suicide, negative urgency, social support, and suicide attempts was examined. Results showed that suicide attempts were significantly and positively correlated with suicide ideation, acquired capability for suicide, and negative urgency. However, social support and suicide attempts did not significantly correlate. Third, results of hierarchical regression analysis indicated that acquired capability for suicide and negative urgency significantly predicted suicide attempts even when suicide ideation was controlled, but social support did not significantly explain attempts. In other words, study results imply that suicide attempts increase when acquired capability for suicide and negative urgency are high. Study results offer empirical data for understanding the intrinsic characteristics of individuals attempting suicide.
6.Selective Temporary Stent-Assisted Coil Embolization for Intracranial Wide-Necked Small Aneurysms Using Solitaire AB Retrievable Stent
Han Yong HEO ; Jae Guen AHN ; Cheol JI ; Won Ki YOON
Journal of Korean Neurosurgical Society 2019;62(1):27-34
OBJECTIVE: Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety.METHODS: Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated.RESULTS: The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0.CONCLUSION: Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.
Aneurysm
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Angiography
;
Embolization, Therapeutic
;
Follow-Up Studies
;
Humans
;
Intracranial Aneurysm
;
Neck
;
Platelet Aggregation Inhibitors
;
Recurrence
;
Retrospective Studies
;
Stents
;
Thrombosis
7.Prediction of Stent Failure for Malignant Ureteral Obstruction in Non-Urological Cancer
Ji Eun HEO ; Dae Young JEON ; Jongsoo LEE ; Hyun Ho HAN ; Won Sik JANG
Yonsei Medical Journal 2023;64(11):665-669
Purpose:
To analyze prognostic factors associated with ureteral stent failure and to develop a prediction model for malignant ureteral obstruction (MUO) in patients with non-urological cancers.
Materials and Methods:
We retrospectively reviewed patients with non-urological cancers who underwent ureteral stenting or percutaneous nephrostomy (PCN) for MUO between 2006 and 2014. Variables predicting stent failure were identified using Cox regression analysis.
Results:
Of the 743 patients, 468 (63.0%) underwent ureteral stenting only, and 275 (37.0%) underwent PCN owing to technical (n=215) or functional (n=60) stent failure. The median overall survival was 4 [interquartile range (IQR) 1–11] months, and the median interval duration to stent failure was 2 (IQR 0–7) months. In univariate analysis, lower gastrointestinal cancer, previous radiotherapy to the pelvis, bladder invasion, lower ureteral obstruction, and low previous estimated glomerular filtration rate (eGFR) (<30 mL/min/1.73 m2 ) were significantly associated with a decreased survival rate. In multivariate analysis, bladder invasion and previous eGFR were significant predictors. With these two predictors, we divided patients into three groups based on their presence: low-risk (neither factor; n=516), intermediate-risk (one factor; n=206), and high-risk (both factors; n=21). The median stent failure-free survival rates of patients in the low-, intermediate-, and high-risk groups were 26 (8-unreached), 1 (0–18), and 0 (0–0) months, respectively (p<0.001).
Conclusion
In cases of ureteral obstruction caused by non-urological cancers, patients with bladder invasion and a low eGFR showed poor stent failure-free survival. Therefore, PCN should be considered the primary procedure for these patients.
8.Herpes zoster in the ophthalmic branch of the trigeminal ganglia obscuring cavernous sinus thrombosis due to Streptococcus constellatus ssp. constellatus
Ji Hye LEE ; Hyun Joo HEO ; Ki Man KIM ; Han Gyeol LEE ; Seung Min BAEK ; Da Wa JUNG
Anesthesia and Pain Medicine 2020;15(2):205-208
Herpes zoster ophthalmicus (HZO) is an infectious disease that results from the reactivation of latent varicella zoster virus in the ophthalmic branch of the trigeminal ganglia. HZO manifests with herpes zoster-like symptoms such as rash with or without signs of ocular involvement. Cavernous sinus thrombosis (CST) is a life-threatening condition accompanied by signs and symptoms involving the eyes and the cranial nerves. Case: We report a case of septic cavernous sinus thrombosis (caused by Streptococcus constellatus ssp. constellatus) which was masked by the simultaneous occurrence of HZO in this patient, resulting in delayed diagnosis. Conclusions: CST may be obscured by HZO, prompt diagnosis and treatment is necessary when such case arrive.
9.Comparison of chemical pregnancy rates according to the anesthetic method during ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization: a retrospective study
Hyun Joo HEO ; Yu Yil KIM ; Ji Hye LEE ; Han Gyeol LEE ; Seung Min BAEK ; Ki Man KIM
Anesthesia and Pain Medicine 2020;15(1):49-52
Background:
Oocyte retrieval is the most important procedure in in vitro fertilization (IVF). Various anesthetic methods are used to control a patient’s anxiety and pain during IVF; however, there are no recommended anesthetic methods at present. In this study, we retrospectively investigated chemical pregnancy rates according to the anesthetic method used for oocyte retrieval.
Methods:
We reviewed records of patients who underwent oocyte retrieval between January 1, 2012 and December 31, 2017. Patients were divided into the spinal anesthesia (SA) and monitored anesthesia care (MAC) groups. The primary outcome was chemical pregnancy rate after IVF.
Results:
The study included 95 patients. SA was administered in 77 (81%) and MAC in 18 (19%). The overall chemical pregnancy rate was 32.6% (31/95). According to the anesthetic method, the pregnancy rate was 32.5% (25/77) in the SA group and 33.3% (6/18) in the MAC group. There was no statistical difference in the pregnancy rate between the groups (P = 0.575). The procedural time was significantly shorter in the SA group than in the MAC group (P < 0.001).
Conclusions
Chemical pregnancy rates were not significantly different between the SA and MAC groups. However, the procedure duration was shorter in the SA group than in the MAC group.
10.Increased Pulsatility Index in Acute Lacunar Infarction with Type II Diabetes.
Kee Oog LEE ; Ji Hyung PARK ; Young Chul CHOI ; Sang Won HAN ; Hyo Suk NAM ; Ji Hoe HEO ; Kyung Yul LEE
Journal of the Korean Neurological Association 2005;23(4):457-462
BACKGROUND: The pulsatility index (PI) measured by a transcranial Doppler (TCD) has been postulated to reflect the vascular resistance that is distal to the artery being examined. Therefore, pathologies of small perforating arteries may affect the PI of the proximal artery. Microangiopathy is a common vascular complication of diabetes mellitus (DM), which may contribute to the development of small infarctions involving the perforating artery, and may be reflected on the PI. METHODS: We enrolled patients with acute cerebral infarctions who were examined by TCD, MRI, and MRA and fulfilled the following criteria: 1)an infarction of less than 2 cm size involving a single perforating arterial territory; 2)no significant arterial stenosis on MRA; and 3)no cardioembolic sources. Patients were divided into either a group with DM, or without and TCD findings were compared. RESULTS: The DM group showed higher PI than non-DM (0.99 v.s. 0.85 for the right middle cerebral artery; 1.02 v.s. 0.85 for the left middle cerebral artery; and 0.94 v.s. 0.78 for the basilar artery). The mean flow velocity was comparable between the groups. Multivariate linear regression analysis revealed that the duration of DM was a significant predictor of elevated PI of the bilateral MCA and basilar artery and that age was another significant predictor in the case of basilar artery. CONCLUSIONS: The elevated PIs in DM patients suggest the possible role of diabetic microvascular complications in the development of the lacunar infarction. The PI measurement using TCD may be a useful marker of the lacunar infarction, especially in DM patients.
Arteries
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Basilar Artery
;
Cerebral Infarction
;
Constriction, Pathologic
;
Diabetes Mellitus
;
Humans
;
Infarction
;
Linear Models
;
Magnetic Resonance Imaging
;
Middle Cerebral Artery
;
Pathology
;
Stroke, Lacunar*
;
Vascular Resistance