1.Delayed Vasospasm after Aneurysmal Subarachnoid Hemorrhage in Behcet Syndrome.
Jun Hak KIM ; Si Un LEE ; Choonwoong HUH ; Chang Wan OH ; Jae Seung BANG ; Tackeun KIM
Journal of Cerebrovascular and Endovascular Neurosurgery 2016;18(1):27-31
A man visited the emergency room with a headache. Brain computed tomography showed aneurysmal subarachnoid hemorrhage (SAH) and multiple aneurysms. After aneurysm clipping surgery, the patient was discharged. After 5 days, he was admitted to the hospital with skin ulceration and was diagnosed with Behcet syndrome. An angiogram taken 7 weeks after aneurysmal SAH showed intracranial vasospasm. Because inflammation in Behcet syndrome may aggravate intracranial vasospasm, intracranial vasospasm after aneurysmal SAH in Behcet syndrome should be monitored for longer compared to general aneurysmal SAH.
Aneurysm*
;
Behcet Syndrome*
;
Brain
;
Emergency Service, Hospital
;
Headache
;
Humans
;
Inflammation
;
Skin Ulcer
;
Subarachnoid Hemorrhage*
;
Vasospasm, Intracranial
2.A Rapidly Growing Gastric Squamous Cell Carcinoma Presenting as a Subepithelial Tumor.
Tae Un KIM ; Su Jin KIM ; Si Hak LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2017;17(4):224-227
Squamous cell carcinoma (SCC) of the stomach is a very rare disease, comprising less than 1% of all stomach cancers. Primary SCC of the stomach was first reported in 1895, and about 100 cases have been reported worldwide since then. Although there are several theories regarding its pathogenesis in the stomach, the process of development of SCC remains unclear. The prognosis of SCC of the stomach is poor compared to adenocarcinoma because it is often diagnosed at late stages and is more prone to lymphovascular invasion. We report a case of rapidly growing SCC of the stomach presenting as a subepithelial tumor on the cardia during screening endoscopy.
Adenocarcinoma
;
Carcinoma, Squamous Cell*
;
Cardia
;
Endoscopy
;
Epithelial Cells*
;
Mass Screening
;
Prognosis
;
Rare Diseases
;
Stomach
;
Stomach Neoplasms
3.Intravenous Fluid Selection for Unruptured Intracranial Aneurysm Clipping : Balanced Crystalloid versus Normal Saline
Jian KANG ; Young Joo SONG ; Sujeong JEON ; Junghwa LEE ; Eunsook LEE ; Ju-Yeun LEE ; Euni LEE ; Jae Seung BANG ; Si Un LEE ; Moon-Ku HAN ; Chang Wan OH ; Tackeun KIM
Journal of Korean Neurosurgical Society 2021;64(4):534-542
Objective:
: While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA.
Methods:
: This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation.
Results:
: A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results.
Conclusion
: This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.
4.Intravenous Fluid Selection for Unruptured Intracranial Aneurysm Clipping : Balanced Crystalloid versus Normal Saline
Jian KANG ; Young Joo SONG ; Sujeong JEON ; Junghwa LEE ; Eunsook LEE ; Ju-Yeun LEE ; Euni LEE ; Jae Seung BANG ; Si Un LEE ; Moon-Ku HAN ; Chang Wan OH ; Tackeun KIM
Journal of Korean Neurosurgical Society 2021;64(4):534-542
Objective:
: While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA.
Methods:
: This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation.
Results:
: A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results.
Conclusion
: This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.
5.A Clinical observation on Skin Disease of Elderly patients.
Woo Seok KOH ; Ho Chel CHOI ; Byung Su KIM ; Si Won LEE ; Seung Chul LEE ; Jae Hak YOO ; Kae Jeung KIM ; Seung Young JUNG ; Un Cheol YEO ; Eil Soo LEE ; Young Gull KIM ; Hee Chul EUN
Korean Journal of Dermatology 1999;37(5):614-619
BACKGROUND: It is a trend that the average life span is prolonged in proportion to the advance of socio-economy and medical science. Consequently, the number of elderly patients with skin diseases is increasing. OBJECTIVE: This study was performed to see the change of patterns of skin diseases in elderly patients. METHODS: One thousand four hundred and twenty elderly patients, over the age of 65, who visited the departments of dermatology and in five hospitals, from January 1, 1997 to December 31, 1997 were selected. We surveyed the frequeney of skin disease by types and the distributions by month, season and age.
Aged*
;
Dermatology
;
Epidemiologic Studies
;
Humans
;
Seasons
;
Skin Diseases*
;
Skin*
6.Skin-directed radiotherapy for primary cutaneous T-cell lymphomas
Ha Un KIM ; Yeon Joo KIM ; Mi Woo LEE ; Woo Jin LEE ; Sang-wook LEE ; Youngju SONG ; Byungchul CHO ; Si Yeol SONG
Radiation Oncology Journal 2024;42(3):228-236
Purpose:
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
Materials and Methods:
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Results:
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Conclusion
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.
7.Skin-directed radiotherapy for primary cutaneous T-cell lymphomas
Ha Un KIM ; Yeon Joo KIM ; Mi Woo LEE ; Woo Jin LEE ; Sang-wook LEE ; Youngju SONG ; Byungchul CHO ; Si Yeol SONG
Radiation Oncology Journal 2024;42(3):228-236
Purpose:
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
Materials and Methods:
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Results:
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Conclusion
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.
8.Skin-directed radiotherapy for primary cutaneous T-cell lymphomas
Ha Un KIM ; Yeon Joo KIM ; Mi Woo LEE ; Woo Jin LEE ; Sang-wook LEE ; Youngju SONG ; Byungchul CHO ; Si Yeol SONG
Radiation Oncology Journal 2024;42(3):228-236
Purpose:
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
Materials and Methods:
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Results:
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Conclusion
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.
9.Skin-directed radiotherapy for primary cutaneous T-cell lymphomas
Ha Un KIM ; Yeon Joo KIM ; Mi Woo LEE ; Woo Jin LEE ; Sang-wook LEE ; Youngju SONG ; Byungchul CHO ; Si Yeol SONG
Radiation Oncology Journal 2024;42(3):228-236
Purpose:
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
Materials and Methods:
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Results:
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Conclusion
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.
10.Skin-directed radiotherapy for primary cutaneous T-cell lymphomas
Ha Un KIM ; Yeon Joo KIM ; Mi Woo LEE ; Woo Jin LEE ; Sang-wook LEE ; Youngju SONG ; Byungchul CHO ; Si Yeol SONG
Radiation Oncology Journal 2024;42(3):228-236
Purpose:
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
Materials and Methods:
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Results:
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Conclusion
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.