1.Retrograde Tempofilter II(TM) Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head.
Nam Yeol YIM ; Nam Kyu CHANG ; Jae Hoon LIM ; Jae Kyu KIM
Korean Journal of Radiology 2011;12(1):140-143
The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofilter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis.
Aged
;
Female
;
Humans
;
Pulmonary Embolism/radiography
;
Tomography, X-Ray Computed
;
Upper Extremity Deep Vein Thrombosis/radiography/*therapy
;
*Vena Cava Filters
;
*Vena Cava, Superior
2.Endovascular Stent Placement for the Treatment of Superficial Femoral Artery Stenoses and Occlusions.
Seul Kee KIM ; Hee Sun YANG ; Jae Hee HAN ; Nam Kyu CHANG ; Nam Yeol YIM ; Woong YOON ; Jae Kyu KIM
Journal of the Korean Radiological Society 2008;58(4):365-373
PURPOSE: The aim of this study was to evaluate effectiveness of an endovascular stent placement in the treatment of superficial femoral artery stenoses and occlusions. MATERIALS AND METHODS: An angioplasty and stent placement was performed in forty four patients (42 men and 2 women; mean age: 71.2 years; age range: 50-82 years). A total of 27 patients were diagnosed with intermittent claudication, in addition to 8 patients with resting pain, and 9 patients with gangrene. A follow-up evaluation accompanied with a physical examination, catheter angiography, and a color Doppler sonography was performed. The patency rates were analyzed after 3 months, 6 months, 1 year and 2 years. The predictors of restenosis, according to the clinical and anatomical classification, risk factors, as well as the correlation of stent fracture and restenosis were analyzed. RESULTS: Initial technical success was achieved in all patients. The stent placement resulted in an initial improvement of the clinical category in more than one level for 95.5% of cases. Over the course of the follow-up period (mean: 17 months; range, 1-106 months), restenosis occurred in 16 patients (36.4%). The highest patency rates were 87.9% after 3 months, 81.5% after 6 months, 78.0% after 1 year, 54.2% after 2 years, and 46.0% after 3 years. No significant difference was found for the patency rates as a function of the clinical and anatomical classifications, or the risk factors. A stent fracture was identified on only two occasions; however, no clinical symptoms or good intra-stent blood flow was observed in a follow-up angiography. CONCLUSION: A mid-term patency after the stent placements for superficial femoral artery stenoses and occlusions was found to be unfavorable despite an initial success rate. Consequently, greater clinical experience and analysis is necessary.
Angiography
;
Angioplasty
;
Arteriosclerosis
;
Catheters
;
Constriction, Pathologic
;
Femoral Artery
;
Follow-Up Studies
;
Gangrene
;
Humans
;
Intermittent Claudication
;
Male
;
Physical Examination
;
Risk Factors
;
Stents
3.Increased Microfilaments in Hepatocytes and Biliary Ductular Cells in Cholestatic Liver Diseases.
Kyu Won CHUNG ; Nam Ik HAN ; Sang Wook CHOI ; Byung Min AHN ; Seung Kyu YOON ; Soon Woo NAM ; Young Sok LEE ; Jun Yeol HAN ; Hee Sik SUN
Journal of Korean Medical Science 2002;17(6):795-800
To assess the extent of microfilaments in cholestatic liver diseases we examined the cytoplasmic microfilaments in intrahepatic and extrahepatic cholestasis in man by electron microscopy. Study subjects were two patients with drug-induced intrahepatic cholestasis, three patients with intrahepatic cholestasis due to viral hepatitis, four patients with extrahepatic cholestasis due to stones of the common bile duct and two patients with primary biliary cirrhosis. Two biopsied specimens from patients without clinical or histological evidence of liver disease served as noncholestatic controls. The microfilaments in hepatocytes and biliary ductular cells were significantly increased in cholestasis compared with those in non-cholestatic controls. Well developed bundles of microfilaments were noted around the pericanalicular ectoplasm and seemed to be parallel to plasma membrane of the hepatocytes in cholestasis. In cholestasis, there were increased bundles of microfilaments around the periluminal region, lateral cell wall, and nucleus of biliary ductular cells. Two patterns of microfilaments bundles (fine microfilamentous network and spindle-shaped dense or clusters of microfilaments) were associated with cholestasis. The clustered form of microfilaments also seemed to be clearly associated with intracytoplasmic vacuoles containing bile salts. In conclusion, the increase of microfilaments in hepatocytes and biliary ductular cells may be the consequence of various forms of cholestasis. Further studies are needed to clarify the functional significance of increased microfilaments in cholestasis.
Bile Canaliculi/*pathology/ultrastructure
;
Biopsy
;
Cholestasis, Intrahepatic/*pathology
;
Hepatocytes/*pathology/ultrastructure
;
Humans
;
Microfilaments/*pathology/ultrastructure
;
Microscopy, Electron
4.Primary Cutaneous B Cell Lymphoma.
Ki Ho KIM ; Jong Taik NAM ; Gwang Yeol JOH ; Young Ho LEE ; Sook Hee HONG ; Chul Woo KIM ; Kyu Won KIM
Annals of Dermatology 1994;6(2):249-255
We report a case of B-cell lymphoma primarily involving the skin in a 12-year-old boy. The histopathologic findings were compatible with those of small lymphocytic type of non-Hodgkin's lymphoma. A cutaneous lesion was the sole manifestation of his disease without any other organ involvement. Immunophenotypic studies and immunoglobulin gene rearrangement with Southern blot analysis determined its lineages and monoclonality with result of B-cell lineage neoplasm, i. d. CD20⁺, C1323⁺, CD35⁻ and rearranged band on JH probe. We treated him with surgical excision and CVP regimen of chemotherapy (cyclophosphamide, vincristine, prednisolone). There is no recurrence or metastasis during the last six months.
B-Lymphocytes
;
Blotting, Southern
;
Child
;
Drug Therapy
;
Genes, Immunoglobulin
;
Humans
;
Immunophenotyping
;
Lymphoma, B-Cell*
;
Lymphoma, Non-Hodgkin
;
Male
;
Neoplasm Metastasis
;
Recurrence
;
Skin
;
Vincristine
5.Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Comprehensive Review
Hyoung Ook KIM ; Nam Yeol YIM ; Jae Kyu KIM ; Yang Jun KANG ; Byung Chan LEE
Korean Journal of Radiology 2019;20(8):1247-1265
Abdominal aortic aneurysm (AAA) can be defined as an abnormal, progressive dilatation of the abdominal aorta, carrying a substantial risk for fatal aneurysmal rupture. Endovascular aneurysmal repair (EVAR) for AAA is a minimally invasive endovascular procedure that involves the placement of a bifurcated or tubular stent-graft over the AAA to exclude the aneurysm from arterial circulation. In contrast to open surgical repair, EVAR only requires a stab incision, shorter procedure time, and early recovery. Although EVAR seems to be an attractive solution with many advantages for AAA repair, there are detailed requirements and many important aspects should be understood before the procedure. In this comprehensive review, fundamental information regarding AAA and EVAR is presented.
Aneurysm
;
Aorta, Abdominal
;
Aortic Aneurysm, Abdominal
;
Dilatation
;
Endovascular Procedures
;
Rupture
6.Hepatic Perfusion Disorders: A Pictorial Review of CT and MR Imaging.
Nam Yeol YIM ; Yong Yeon JEONG ; Sang Soo SHIN ; Sang Gook SONG ; Hyo Soon LIM ; Suk Hee HEO ; Nam Kyu CHANG ; Shen Yu LAN ; Woong YOON ; Heoung Keun KANG
Journal of the Korean Radiological Society 2005;53(3):199-213
The liver has a unique dual blood supply through the portal vein and the hepatic artery. There are several communications between these two vessels under various conditions such as in hepatic tumors, trauma and liver cirrhosis, vascular compromise, among others. When vascular compromise occurs, this dual blood supply system can cause changes in the volume of blood flow in individual vessels or even in the direction of blood flow. With rapid image acquisition and increased resolution available in multislice CT and MR imaging, hepatic perfusion disorders are now more frequently encountered than in the past. Familiarity with imaging findings of these perfusion disorders will be helpful in characterizing focal hepatic lesions and will also help to avoid false positive diagnoses.
Diagnosis
;
Hepatic Artery
;
Liver
;
Liver Cirrhosis
;
Magnetic Resonance Imaging*
;
Perfusion*
;
Portal Vein
;
Recognition (Psychology)
7.A case of recurred malignant melanoma of the stomach and peritoneum.
Sang Woo NAM ; Na Ri LEE ; Tae Hwan LEE ; Eun Kee SONG ; Jae Yong KWAK ; Chang Yeol YIM ; Kyu Yun JANG
Korean Journal of Medicine 2007;72(2):213-216
Malignant melanoma may spread through the lymphatic channels or via the bloodstream. The lung, liver, bone and brain are common sites of hematogenous metastases. Malignant melanoma that has recurred to the stomach or peritoneum is not common. An 83-year old male patient was admitted to the Department of Oncology due to abdominal distension; 13 years ago, the patient had previously received a complete surgical resection for malignant melanoma of the right heel. According to a computed tomography (CT) scan of the abdomen, peritoneal carcinomatosis was suggested. Under a gastrofiberoscopic examination, two small sized polyps with central umbilication were found on the midbody of the stomach. The gastric polyps were histopathologically confirmed as metastatic melanoma. We report a rare case of metastatic malignant melanoma that has recurred to the stomach and peritoneum 13years after its initial diagnosis.
Abdomen
;
Aged, 80 and over
;
Brain
;
Carcinoma
;
Diagnosis
;
Heel
;
Humans
;
Liver
;
Lung
;
Male
;
Melanoma*
;
Neoplasm Metastasis
;
Peritoneum*
;
Polyps
;
Stomach*
8.Insulin pump therapy in transient neonatal diabetes mellitus.
Joong Heum PARK ; Jeong Hee KANG ; Kyu Hyung LEE ; Nam Hyo KIM ; Han Wook YOO ; Dae Yeol LEE ; Eun Gyong YOO
Annals of Pediatric Endocrinology & Metabolism 2013;18(3):148-151
Neonatal diabetes mellitus (NDM) is a rare disease requiring insulin treatment. Its treatment is primarily focused on maintaining adequate glycemic control and avoiding hypoglycemia. Although insulin pump therapy is frequently administered to adults and children, there is no consensus on the use of insulin pumps in NDM. A 10 day-old female infant was referred to us with intrauterine growth retardation and poor weight gain. Hyperglycemia was noted, and continuous intravenous insulin infusion was initiated. However, the patient's serum glucose levels fluctuated widely, and maintaining the intravenous route became difficult within the following weeks. Continuous subcutaneous insulin infusion with an insulin pump was introduced on the twenty-fifth day of life, and good glycemic control was achieved without any notable adverse effects including hypoglycemia. We suggest that the insulin pump is a safe and effective mode for treating NDM and its early adoption may shorten the length of hospital stays in patients with NDM.
Blood Glucose
;
Diabetes Mellitus*
;
Female
;
Fetal Growth Retardation
;
Humans
;
Hyperglycemia
;
Hypoglycemia
;
Infant
;
Infant, Newborn
;
Insulin Infusion Systems*
;
Insulin
;
Length of Stay
;
Rare Diseases
;
Weight Gain
9.The Role of Three-Dimensional Multidetector CT Gastrography in the Preoperative Imaging of Stomach Cancer: Emphasis on Detection and Localization of the Tumor.
Jin Woong KIM ; Sang Soo SHIN ; Suk Hee HEO ; Hyo Soon LIM ; Nam Yeol LIM ; Young Kyu PARK ; Yong Yeon JEONG ; Heoung Keun KANG
Korean Journal of Radiology 2015;16(1):80-89
Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.
Humans
;
Image Processing, Computer-Assisted
;
Imaging, Three-Dimensional
;
Neoplasm Staging
;
Stomach Neoplasms/pathology/*radiography/surgery
;
Tomography, X-Ray Computed
10.A Case of Iodine-induced Thyrotoxicosis with Acromegaly.
Kwang Hyun KIM ; Kyu Hong KIM ; Ho Yoel RYU ; Su Min NAM ; Mi Young LEE ; Jang Hyun KOH ; Jang Yeol SIN ; Choon Hee CHUNG
Journal of Korean Society of Endocrinology 2006;21(1):63-67
Hyperthyroidism is seen in 3.5-26% of subjects with acromegaly. Hyperthyroidism can be developed by thyroid stimulating hormone (TSH) dependent mechanism in TSH-secreting adenomas with acromegaly or by TSH independent mechanism through the stimulation of thyroid cells by growth hormone (GH). So, confirming the cause of hyperthyroidism is important to treat that. We report a case of a 56-year-old man who had acromegaly with iodine-induced thyrotoxicosis. He took the sea tangle for 4 years because he had constipation. His face and hands indicated acromegaly. Thyroid function test showed that T3 and free T4 were increased and TSH was decreased. Ultrasonography of neck showed diffuse enlargement of thyroid gland and thyroid scan showed decreased uptake of thyroid gland. So we could confirm iodine-induced thyrotoxicosis due to excessive iodine intake. Serum GH and insulin-like growth factor (IGF)-1 were markedly increased and brain MRI showed heterogenous 1 cm sized pituitary mass in right side. Acromegaly was confirmed by brain MRI, pituitary stimulation test and increased level of GH, IGF-1. He stopped iodine intake. After 6 months, T3, free T4 and TSH were normalized and he is waiting for the surgical removal of pituitary adenoma.
Acromegaly*
;
Adenoma
;
Brain
;
Constipation
;
Growth Hormone
;
Hand
;
Humans
;
Hyperthyroidism
;
Insulin-Like Growth Factor I
;
Iodine
;
Magnetic Resonance Imaging
;
Middle Aged
;
Neck
;
Pituitary Neoplasms
;
Thyroid Function Tests
;
Thyroid Gland
;
Thyrotoxicosis*
;
Thyrotropin
;
Ultrasonography