1.Fusiform Superior Cerebellar Artery Aneurysm Treated with Endovascular Treatment.
Joon Bok JEON ; Se yang OH ; Dong Keun HYUN ; Yu Shik SHIM
Journal of Cerebrovascular and Endovascular Neurosurgery 2016;18(3):276-280
An aneurysm of the distal superior cerebellar artery (SCA) is a highly rare disease. Fusiform aneurysms of the distal SCA are particularly challenging to treat. Clipping, trapping with or without bypass using microsurgery or endovascular treatment (EVT) were used to treat this condition. We describe the case of fusiform distal SCA aneurysms treated successfully with endovascular coiling with a 3-month follow-up. A 39 year-old male was presented with subarachnoid hemorrhage (SAH) and a 15 mm fusiform aneurysm of the ambient segment of the left distal SCA. EVT for parent artery occlusion and packing of the aneurysm was done. Left sixth nerve palsy appeared after 1 day of EVT. The symptom completely recovered within 1 week of the post-procedural period. No neurological deficit was seen during the clinical 3-month follow-up. EVT of fusiform distal SCA aneurysms with coils is a safe and feasible option to manage this rare condition. However, the treatment options must be carefully selected depending on the neurologic condition, development of collateral circulation, and configuration of the dissection.
Abducens Nerve Diseases
;
Aneurysm*
;
Arteries*
;
Collateral Circulation
;
Endovascular Procedures
;
Follow-Up Studies
;
Humans
;
Intracranial Aneurysm
;
Male
;
Microsurgery
;
Parents
;
Rare Diseases
;
Subarachnoid Hemorrhage
2.A Case of Nasal T/NK-cell Lymphoma.
Jung Bok LEE ; In sang JEON ; Ho Joon IM ; Young Ha OH ; Ji Hye KIM
Journal of the Korean Pediatric Society 2003;46(12):1266-1270
The advance of the immunobiology clarifies the nature of non-Hodgkin's lymphoma(NHL). In addition the proceed in the immunophenotyping renders the classification of NHL. According to the Revised European American Lymphoma(REAL) classification, classified by the etiologic factors, molecular biological characteristics, immunophenotype, cytogenetics and histologic feature, nasal T/NK-cell lymphoma(=angiocentric lymphoma) belongs to the category of peripheral T-cell and natural killer cell lymphoma. Nasal T/NK-cell lymphoma is a distinct clinicopathologic entity characterized by progressive necrotic lesions in the nasal cavity, nasopharynx, and palate. The cellular origin of this tumor has been controversial. Although most nasal T/NK-cell lymphomas are of NK-cell lineage, being CD56+, negative for surface CD3(Leu4), and unassociated with rearrangements of the T-cell receptor genes, other minor variants have been reported. This lymphoma is a rare disease and usually experienced in adult. Recently, we experienced a rare type lymphoma, nasal T/NK-cell lymphoma, in 14 years old boy. His soft mass occupied the right nasal cavity including the nasal septum and turbinate. Pathologically this nasal mass showed the infiltration into the vascular wall, illustrating angiodestructive lesion. The cellular origin was NK-cell lineage, being CD56+ and negative to CD3. Now, we report the case with a brief review of related literatures.
Adolescent
;
Adult
;
Classification
;
Cytogenetics
;
Genes, T-Cell Receptor
;
Humans
;
Immunophenotyping
;
Killer Cells, Natural
;
Lymphoma*
;
Lymphoma, Non-Hodgkin
;
Male
;
Nasal Cavity
;
Nasal Septum
;
Nasopharynx
;
Palate
;
Population Characteristics
;
Rare Diseases
;
T-Lymphocytes
;
Turbinates
3.The Factors That Affect Improvement of Neurogenic Bladder by Severe Lumbar Disc Herniation in Operation.
Joon Bok JEON ; Seung Hwan YOON ; Do Keun KIM ; Ji Yong KIM
Korean Journal of Spine 2016;13(3):124-128
OBJECTIVE: This study analyzed retrospectively the bladder function of patients after early surgery for cauda equina syndrome (CES) performed within 24 or 48 hours, or after 48 hours of the onset of autonomic symptoms. METHODS: We retrospectively reviewed the clinical data of 31 patients after decompression surgery for lumbar disc herniation (LDH) who had been diagnosed with CES between January 2001 and December 2014 at Inha University Hospital. The following factors were assessed to evaluate the influence of time to surgery: bladder function, rectal incontinence, sexual dysfunction, LDH level, and degree of spinal canal compression. RESULTS: After decompression, the outcome group was categorized into normal bladder function and abnormal bladder function. The patients operated on within 48 hours showed an improved postoperative outcome. Among 16 patients operated on within 48 hours, 13 (81%) recovered normal bladder function. In contrast, among 15 patients with decompression after 48 hours, 6 (40%) recovered normal bladder function. Among 21 patients with mild bladder dysfunction at admission, 16 (76%) recovered normal bladder function after decompression. CONCLUSION: Our study suggests that patients who have decompression surgery within 48 hours of the onset of bladder dysfunction, improve their chances of recovering bladder function than those who have a late operation (>48 hours). Also, patients with mild bladder dysfunction are more likely to recover bladder function after decompression, than patients with severe bladder dysfunction.
Decompression
;
Humans
;
Intervertebral Disc Displacement
;
Polyradiculopathy
;
Retrospective Studies
;
Spinal Canal
;
Spinal Cord Compression
;
Treatment Outcome
;
Urinary Bladder
;
Urinary Bladder, Neurogenic*
4.Antibiotic Resistance Patterns and Serotypes of Salmonella spp. Isolated at Jeollanam-do in Korea.
Ki Bok YOON ; Byung Joon SONG ; Mi Yeong SHIN ; Hyun Cheol LIM ; Yeon Hee YOON ; Doo Young JEON ; Hoon HA ; Soo In YANG ; Jung Beom KIM
Osong Public Health and Research Perspectives 2017;8(3):211-219
OBJECTIVES: Few long-term studies have been conducted on the serotype and antibiotic resistance patterns of Salmonella speices (spp.) The aim of this study was to determine the serotypes and antibiotic resistance patterns of Salmonella spp. isolated at Jeollanam-do in Korea from 2004 to 2014. METHODS: A total of 276 Salmonella samples were evaluated. Serotyping was carried out according to the Kauffmann–White scheme. Antibiotic susceptibility was determined using the Vitek II system with an AST-N169 card. RESULTS: A total of 22 different serotypes were identified, and the major serotypes were Salmonella Enteritidis (116 strains, 42.0%) and Salmonella Typhimurium (60 strains, 21.7%). The highest resistance was observed in response to nalidixic acid (43.4%), followed by ampicillin (40.5%) and tetracycline (31.6%). Resistance to nalidixic acid was detected in 81.0% of S. Enteritidis. Multidrug resistance was detected in 43.3% of Salmonella spp. S. Enteritidis and S. Typhimurium presented the highest resistance (98.3%) and multidrug resistance rate (73.3%), respectively. The most highly observed antibiotic resistance pattern among Salmonella spp. in this study was ampicillin-chloramphenicol (14 strains, 5.7%). CONCLUSION: Overall, S. Enteritidis and S. Typhimurium showed higher antibiotic resistance than the other Salmonella serotypes tested in this study. Our study will provide useful information for investigating the sources of Salmonella infections, as well as selecting effective antibiotics for treatment.
Ampicillin
;
Anti-Bacterial Agents
;
Drug Resistance, Microbial*
;
Drug Resistance, Multiple
;
Jeollanam-do*
;
Korea*
;
Nalidixic Acid
;
Salmonella enteritidis
;
Salmonella Infections
;
Salmonella typhimurium
;
Salmonella*
;
Serogroup*
;
Serotyping
;
Tetracycline
5.Low Frequency and Variability of FLT3 Mutations in Korean Patients with Acute Myeloid Leukemia.
Soo Mee BANG ; Jeong Yeal AHN ; Jiyoon PARK ; Se Hoon PARK ; Jinny PARK ; Eun Kyung CHO ; Dong Bok SHIN ; Jae Hoon LEE ; Sook Jin YOO ; In Sang JEON ; Yeo Kyeoung KIM ; Hyeoung Joon KIM ; Hee Nam KIM ; Il Kwon LEE ; Hyoung Jin KANG ; Hee Young SHIN ; Hyo Seop AHN
Journal of Korean Medical Science 2008;23(5):833-837
FLT3 mutations are common genetic changes, and are reported to have prognostic significance in acute myeloid leukemia (AML). The FLT3 internal tandem duplication (ITD) and the D835 activating mutation in the tyrosine kinase domain (TKD) were analyzed by polymerase chain reaction (PCR) in the genomic DNA of Korean patients with AML at diagnosis and during follow-up. There were 226 patients with AML enrolled between March 1996 and August 2005. The incidence of ITD and TKD at diagnosis was 13% (29/226) and 3% (6/226). When compared to Western and other Asian patients with AML, Korean patients had a lower frequency by about two-thirds of ITD and TKD. Among the non-M3 cases (N=203), the patients with an ITD had a significantly shorter event-free survival when compared with those without an ITD (p=0.0079). Among 54 relapsed patients, 9 patients had the FLT3 ITD at diagnosis. Six patients demonstrated a reappearance of the ITD and 3 patients remained negative at relapse. One patient, among 45 patients who relapsed, had a negative baseline ITD but acquired a de novo ITD at relapse. There were 101 samples from 93 patients in remission; they were all negative for an ITD. Among 34 patients who failed to achieve a remission, five patients had a persistent ITD and one patient had a de novo ITD. These results support the concept of resistance of FLT3 ITD leukemic clones to chemotherapy. Therefore, effective therapy with FLT3 targeting agents may improve the prognosis of non-M3 AML patients with the FLT3 mutation.
Adolescent
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Adult
;
Aged
;
Aged, 80 and over
;
Child
;
Child, Preschool
;
Disease-Free Survival
;
Female
;
*Gene Expression Regulation, Neoplastic
;
Humans
;
Infant
;
Infant, Newborn
;
Korea
;
Leukemia, Myeloid, Acute/*genetics
;
Male
;
Middle Aged
;
*Mutation
;
Prognosis
;
Recurrence
;
Remission Induction
;
fms-Like Tyrosine Kinase 3/*genetics
6.High-resolution Impedance Manometry Criteria in the Sitting Position Indicative of Incomplete Bolus Clearance.
Eui Ju PARK ; Joon Seong LEE ; Tae Hee LEE ; Gene Hyun BOK ; Su Jin HONG ; Hyun Gun KIM ; Seong Ran JEON ; Jin Oh KIM
Journal of Neurogastroenterology and Motility 2014;20(4):491-496
BACKGROUND/AIMS: We used high-resolution impedance manometry (HRIM) to determine the length of breaks on the isobaric contour which would predict incomplete bolus clearance in patients in the sitting position. METHODS: In total, 651 swallows in 71 patients with esophageal symptoms were studied using a solid-state HRIM system in the sitting position. Each swallow was classified as complete or incomplete bolus clearance by impedance criteria and peristaltic integrity was evaluated using 20- and 30-mmHg pressure topography isobaric contours. Correlations between the lengths of the breaks for 20- and 30-mmHg were analyzed. RESULTS: Complete bolus clearance was observed in 83.3% (542/651) of swallows. Breaks of 3 and 7 cm or less were associated with a bolus clearance of 96.8% on the 20-mmHg and 94.7% on the 30-mmHg isobaric contour, respectively (P < 0.001). The areas under the ROC curves for the 20 and 30 mmHg isobaric contours were 0.900 and 0.950, respectively. The sensitivity and specificity for complete bolus clearance were 75.6% and 89.3% for breaks 3 cm or less on the 20-mmHg isobaric contour and 87.9% and 78.7% for breaks 7 cm or less on the 30-mmHg contour (P < 0.001). CONCLUSIONS: Breaks of < 3 cm in the 20-mmHg isobaric contour or < 7 cm in the 30-mmHg isobaric contour were associated with com -plete bolus clearance. The threshold for breaks in the sitting position was greater than previous reports using the supine position and longer breaks predicted incomplete bolus clearance.
Electric Impedance*
;
Humans
;
Manometry*
;
ROC Curve
;
Sensitivity and Specificity
;
Supine Position
;
Swallows
7.A Case of Primary Aldosteronism after Renal Transplantation.
Joon Chang SONG ; Hyeon Seok HWANG ; Bok Jin HYOUNG ; Yeon Joo JEON ; So Young LEE ; Se Na CHANG ; Hye Eun YOON ; Bum Soon CHOI ; Yong Soo KIM ; Chul Woo YANG
Korean Journal of Nephrology 2009;28(1):77-81
After renal transplantation, we are more likely to encounter hyperkalemia rather than hypokalemia. We report a case of kidney transplantation recipient with hypokalemia and hypertension secondary to primary aldosteronism. A 48 year-old woman was presented with fatigue and weight loss that had lasted for 3 months. She was diagnosed as autosomal dominant polycystic kidney disease that ultimately progressed to end-stage renal disease. She was operated for renal transplantation before 6 months. She had hypokalemia and hypertension at that time. The ratio of plasma aldosterone over plasma renin activity was 851.7. The computed tomography (CT) revealed 2.4x1.7 cm sized adrenal mass on the right side. The pre-transplantation CT also showed that there had been adrenal mass in the same location even before the transplantation. Right adrenalectomy was performed. After she got discharged, she was again presented with nausea and vomiting. She developed hyperkalemia and was diagnosed as hyporeninemic hypoaldosteronism. She was prescribed with fludrocortisones and recovered from the disease, and resumed the state of normokalemia and normotension.
Adrenalectomy
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Aldosterone
;
Fatigue
;
Female
;
Humans
;
Hyperaldosteronism
;
Hyperkalemia
;
Hypertension
;
Hypoaldosteronism
;
Hypokalemia
;
Kidney Failure, Chronic
;
Kidney Transplantation
;
Nausea
;
Plasma
;
Polycystic Kidney, Autosomal Dominant
;
Renin
;
Transplants
;
Vomiting
;
Weight Loss
8.Successful Renal Transplantation with Desensitization in Highly Sensitized Patients: A Single Center Experience.
Hye Eun YOON ; Bok Jin HYOUNG ; Hyeon Seok HWANG ; So Young LEE ; Youn Joo JEON ; Joon Chang SONG ; Eun Jee OH ; Sun Cheol PARK ; Bum Soon CHOI ; In Sung MOON ; Yong Soo KIM ; Chul Woo YANG
Journal of Korean Medical Science 2009;24(Suppl 1):S148-S155
Intravenous immunoglobulin (IVIG) and/or plasmapheresis (PP) are effective in preventing antibody-mediated rejection (AMR) of kidney allografts, but AMR is still a problem. This study reports our experience in living donor renal transplantation in highly sensitized patients. Ten patients with positive crossmatch tests or high levels of panel-reactive antibody (PRA) were included. Eight patients were desensitized with pretransplant PP and low dose IVIG, and two were additionally treated with rituximab. Allograft function, number of acute rejection (AR) episodes, protocol biopsy findings, and the presence of donor-specific antibody (DSA) were evaluated. With PP/IVIG, six out of eight patients showed good graft function without AR episodes. Protocol biopsies revealed no evidence of tissue injury or C4d deposits. Of two patients with AR, one was successfully treated with PP/IVIG, but the other lost graft function due to de novo production of DSA. Thereafter, rituximab was added to PP/IVIG in two cases. Rituximab gradually decreased PRA levels and the percentage of peripheral CD20+ cells. DSA was undetectable and protocol biopsy showed no C4d deposits. The graft function was stable and there were no AR episodes. Conclusively, desensitization using PP/IVIG with or without rituximab increases the likelihood of successful living donor renal transplantation in sensitized recipients.
Adult
;
Antibodies, Monoclonal/therapeutic use
;
Antigens, CD20/biosynthesis
;
Female
;
Humans
;
Immunoglobulins/metabolism
;
Immunophenotyping
;
Immunosuppressive Agents/therapeutic use
;
Isoantibodies/chemistry
;
Kidney Failure, Chronic/therapy
;
Kidney Transplantation/*methods
;
Lymphocytes/metabolism
;
Male
;
Middle Aged
;
Retrospective Studies
9.Mandibular Enlargement, Metastatic Pulmonary Calcification and Gastric Mucosal Calcinosis in a Patient with Chronic Kidney Disease-mineral Bone Disorder.
Jeong Yup KIM ; Jeong Seon KIM ; Joon Kwang WANG ; Sang Won PARK ; Young Mo LEE ; Ji Eun LEE ; Eun Sil JEON ; Heui Jung PYO ; Young Joo KWON ; Jae Bok LEE
Korean Journal of Nephrology 2010;29(2):270-275
Secondary hyperparathyroidism is one of the most common complications of patients with chronic kidney disease (CKD). Mandibular enlargement, metastatic pulmonary calcification, and gastric mucosal calcinosis are rare complications in these patients. The defect of calcium and phosphorus metabolism may precipitate pathologic calcification at diverse organs and soft tissue, and change bone architecture. In case of involving periarticular area, patients usually present with localized swelling, pain, and reduced mobility in affected sites. However, in case of organ involvement, except in an advanced stage of disease, there are no specific symptoms. Among these patients, treatment strategies include tight control of calcium and phosphate levels, parathyroidectomy for hyperparathyroidism, renal transplantation, and local excision of calcific lesions. We report a case of mandibular enlargement, metastatic pulmonary calcification, and gastric mucosal calcinosis due to CKD with improvement 3 months after medical and surgical treatment.
Calcinosis
;
Calcium
;
Humans
;
Hyperparathyroidism
;
Hyperparathyroidism, Secondary
;
Kidney
;
Kidney Transplantation
;
Parathyroidectomy
;
Phosphorus
;
Renal Insufficiency, Chronic
10.The Efficacy and Safety of Ezetimibe and Low-Dose Simvastatin as a Primary Treatment for Dyslipidemia in Renal Transplant Recipients.
Hye Eun YOON ; Joon Chang SONG ; Bok Jin HYOUNG ; Hyeon Seok HWANG ; So Young LEE ; Youn Joo JEON ; Bum Soon CHOI ; Yong Soo KIM ; Chul Woo YANG
The Korean Journal of Internal Medicine 2009;24(3):233-237
BACKGROUND/AIMS: The efficacy and safety of a combination of ezetimibe and low-dose statin as primary treatment for dyslipidemia in renal transplant patients were evaluated prospectively. METHODS: The study enrolled 77 renal transplant recipients with dyslipidemia. They were given ezetimibe (10 mg) and simvastatin (10 mg) for 6 months as the initial treatment for dyslipidemia. Efficacy and safety were evaluated using lipid profiles, trough calcineurin inhibitor levels, allograft function, and adverse effects. The effects on proteinuria and high sensitivity C-reactive protein (hsCRP) levels were also evaluated. RESULTS: Ezetimibe and low-dose simvastatin significantly decreased the levels of total cholesterol (34.6%), triglyceride (16.0%), and low-density lipoprotein cholesterol (LDL-C) (47.6%), and 82.5% of the patients reached the target LDL-C level of <100 mg/dL. No significant change in the trough calcineurin inhibitor levels or allograft function occurred, and no serious adverse effects were observed. Fourteen patients (18.2%) discontinued treatment; eight patients (11.7%) developed muscle pain or weakness without an increase in creatinine kinase levels, and two patients (2.6%) developed elevated liver transaminase levels. The proteinuria and hsCRP levels did not change significantly. CONCLUSIONS: Ezetimibe and low-dose statin treatment is safe and effective as a primary treatment for dyslipidemia in renal transplant patients.
Adult
;
Azetidines/*administration & dosage/adverse effects
;
C-Reactive Protein/analysis
;
Cholesterol, LDL/blood
;
Dyslipidemias/blood/*drug therapy
;
Female
;
Humans
;
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage
;
*Kidney Transplantation
;
Male
;
Middle Aged
;
Prospective Studies
;
Simvastatin/*administration & dosage/adverse effects