1.Clinical Study of 12 Cases of Korean Hemorrhagic Fever in Childhood.
Dae Kyung KO ; Keyun Haeung CHO ; Ji Tae CHOUNG ; Pyung Hwa CHOE
Journal of the Korean Pediatric Society 1987;30(8):837-845
No abstract available.
Hemorrhagic Fever with Renal Syndrome*
2.Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage.
Beom Jin CHOI ; Tae Hong LEE ; Jae Il LEE ; Jun Kyeung KO ; Hwa Seung PARK ; Chang Hwa CHOI
Journal of Korean Neurosurgical Society 2011;49(3):157-162
OBJECTIVE: Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. METHODS: Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. RESULTS: TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. CONCLUSION: This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.
Aneurysm
;
Angiography, Digital Subtraction
;
Angioplasty, Balloon
;
Anterior Cerebral Artery
;
Arteries
;
Basilar Artery
;
Carotid Artery, Internal
;
Endovascular Procedures
;
Glycosaminoglycans
;
Humans
;
Middle Cerebral Artery
;
Rupture
;
Subarachnoid Hemorrhage
;
Vasospasm, Intracranial
;
Vertebral Artery
3.Early Rupture after Coiling of Unruptured Aneurysm.
Jun Kyeung KO ; Sang Weon LEE ; Tae Hong LEE ; Chang Hwa CHOI
Journal of Korean Neurosurgical Society 2007;42(3):235-237
We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.
Aneurysm*
;
Angiography
;
Female
;
Hemorrhage
;
Humans
;
Infarction
;
Intracranial Aneurysm
;
Middle Aged
;
Rehabilitation
;
Rupture*
;
Subarachnoid Hemorrhage
4.Endovascular Treatment Using Graft-Stent for Pseudoaneurysm of the Cavernous Internal Carotid Artery.
Jun Kyeung KO ; Tae Hong LEE ; Jae Il LEE ; Chang Hwa CHOI
Journal of Korean Neurosurgical Society 2011;50(1):48-50
A 57-year-old man presented with a 2-day history of left oculomotor palsy. Digital subtraction angiography revealed a pseudoaneurysm of the left cavernous internal carotid artery (ICA) measuring 37x32 mm. The pseudoaneurysm was treated with a balloon expandable graft-stent to occlude the aneurysmal neck and preserve the parent artery. A post-procedure angiogram confirmed normal patency of the ICA and complete sealing of the aneurysmal neck with no opacification of the sac. After the procedure, the oculomotor palsy improved gradually, and had completely resolved 3 months after the procedure. A graft-stent can be an effective treatment for a pseudoaneurysm of the cavernous ICA with preservation of the parent artery.
Aneurysm
;
Aneurysm, False
;
Angiography, Digital Subtraction
;
Arteries
;
Carotid Artery, Internal
;
Caves
;
Humans
;
Middle Aged
;
Neck
;
Paralysis
;
Parents
5.Radiologic Findings of Perforated Jejunal Diverticulitis: A Case Report.
Jeong Hwa KONG ; Dong Ho LEE ; Hyoung Jung KIM ; Joo Won LIM ; Young Tae KO ; Yong Koo PARK
Journal of the Korean Radiological Society 2006;54(4):289-292
We report a case of perforated jejunal diverticulitis in a 68-year-old man with iatrogenic Cushing's syndrome. The patient presented with right upper abdominal pain. Ultrasonography showed a hypoechoic structure connected to a small bowel loop, and subsequent CT examination showed multiple diverticula in proximal jejunal loops with free air trapped within the mesenteric leaf. Segmental resection of the jejunal loop confirmed jejunal diverticulitis with perforation.
Abdominal Pain
;
Aged
;
Cushing Syndrome
;
Diverticulitis*
;
Diverticulum
;
Humans
;
Ultrasonography
6.External Carotid Artery Angioplasty and Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis.
Jun Kyeung KO ; Sang Weon LEE ; Tae Hong LEE ; Chang Hwa CHOI
Journal of Korean Neurosurgical Society 2009;46(5):488-491
A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.
Adult
;
Angiography, Digital Subtraction
;
Angioplasty
;
Basal Ganglia
;
Carotid Artery, External
;
Carotid Artery, Internal
;
Constriction, Pathologic
;
Dietary Sucrose
;
Humans
;
Ischemic Attack, Transient
;
Magnetic Resonance Imaging
;
Middle Cerebral Artery
;
Paresis
;
Stents
;
Temporal Arteries
7.Endovascular Treatment with a Stent-Graft for Internal Carotid Artery Laceration during Trans Sphenoidal Surgery: A Case Report.
Eun Hwa CHOE ; Ji Ho KO ; Tae Hong LEE ; Myung Ho RHO
Journal of the Korean Radiological Society 2008;59(3):149-153
An internal carotid artery (ICA) tear during or after trans-sphenoidal surgery (TSS) is rare but may cause potentially lethal complications. A 23-year-old female patient visited our hospital for treatment of a Rathke's cleft cyst. The patient had massive hemorrhage during surgery and angiography performed after surgery showed laceration of the cavernous ICA. We successfully controlled the hemorrhage with emergency placement of an endovascular stent-graft.
Angiography
;
Carotid Artery Injuries
;
Carotid Artery, Internal
;
Caves
;
Emergencies
;
Female
;
Hemorrhage
;
Humans
;
Lacerations
;
Stents
;
Young Adult
8.Peribiliary Cysts with Intrahepatic Bile Duct Obstruction: A Case Report.
Ji Seon PARK ; Dong Ho LEE ; Joo Won LIM ; Young Tae KO ; Sang Mok LEE ; Yoon Hwa KIM
Journal of the Korean Radiological Society 2001;45(6):615-619
Peribiliary cysts involve cystic dilatation and necroinflammatory change in the peribiliary glandular tissue of the larger biliary tree in association with portal hypertension or severe hepatobiliary disease. They are usually asymptomatic and found incidentally. However, rare cases causing symptoms or the mass effect of bile duct compression require differential diagnosis. They may be benign or malignant lesions resulting from narrowing of the bile duct and involving dilatation of the proximal intrahepatic bile duct. We recently encountered a case of peribiliary cysts associated with intrahepatic duct dilatation, and confirmed by surgery, and present the imaging and pathologic findings. Sonography and CT revealed the presence of multiple cystic lesions along the hepatic hilum, and the larger left portal tract and left intrahepatic ducts were dilated. Histopathologic examination indicated that the cysts were compressing the central bile duct.
Bile Ducts
;
Bile Ducts, Intrahepatic*
;
Biliary Tract
;
Diagnosis, Differential
;
Dilatation
;
Hypertension, Portal
9.A young child of anti-NMDA receptor encephalitis presenting with epilepsia partialis continua: the first pediatric case in Korea.
Eun Hee KIM ; Yeo Jin KIM ; Tae Sung KO ; Mi Sun YUM ; Jun Hwa LEE
Korean Journal of Pediatrics 2016;59(Suppl 1):S133-S138
Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis*
;
Antibodies
;
Anticonvulsants
;
Antihypertensive Agents
;
Cerebrospinal Fluid
;
Child*
;
Child, Preschool
;
Cognition
;
Consciousness
;
D-Aspartic Acid
;
Diagnosis
;
Dyskinesias
;
Encephalitis
;
Epilepsia Partialis Continua*
;
Female
;
Fever
;
Humans
;
Immunoglobulins
;
Immunotherapy
;
Korea*
;
Methylprednisolone
;
Rituximab
;
Seizures
;
Virus Diseases
10.Coiling of Middle Cerebral Artery Bifurcation Aneurysms : Clinical and Angiographic Outcomes.
Jung Hwan LEE ; Jun Kyeung KO ; Sang Weon LEE ; Tae Hong LEE ; Chang Hwa CHOI
Korean Journal of Cerebrovascular Surgery 2008;10(3):411-418
OBJECTIVE: The anatomy of middle cerebral artery (MCA) bifurcation aneurysms has been noted to be unfavorable for endovascular treatment. Our purpose was to analyze the clinical and angiographic results of coiling of the MCA bifurcation aneurysms. METHODS: From January 2004 to April 2007, 26 patients harboring 29 MCA bifurcation aneurysms were treated with coils. Of these patients, 16 had subarachnoid hemorrhages (SAH). The bleeding source was a ruptured MCA bifurcation aneurysm in 11 patients and a ruptured aneurysm in a different location in 5 patients, respectively. Treatment-related complications, clinical outcomes, and postprocedural and follow-up angiography results were retrospectively evaluated. RESULTS: 29 MCA bifurcation aneurysms (11 ruptured, 18 unruptured) were occluded with coils in 26 patients. Occlusion was complete for 24 (82.8%) of the 29 aneurysms, incomplete for 3 (10.3%), and partial for 2 (6.9%) aneurysms. Procedural complications included thromboembolism in 6, a small nonocclusive thrombus formation in 1, and intraprocedural aneurysmal rupture in 1. All of symptomatic complications were thromboembolic events that occurred 3 patients with unruptured aneurysm and they discharged with moderate disability state. Follow-up angiograms were available on 16 patients with 18 aneurysms and 1 patient with an initial complete occlusion had a slight neck recanalization. CONCLUSION: Coiling of MCA bifurcation aneurysm could be achieved without treatment-induced neurologic deficit in 88.5% (23/26) of the patients while at the same time obtaining favorable anatomic results. Improvements in device technology and technique will certainly greatly increase the safety of coiling of MCA bifurcation aneurysm, widening its indications.
Aneurysm
;
Aneurysm, Ruptured
;
Angiography
;
Follow-Up Studies
;
Hemorrhage
;
Humans
;
Intracranial Aneurysm
;
Middle Cerebral Artery
;
Neck
;
Neurologic Manifestations
;
Retrospective Studies
;
Rupture
;
Subarachnoid Hemorrhage
;
Thromboembolism
;
Thrombosis