1.Hemodynamic Properties of Portal Hypertansion in a Portal Vein Stenotic Rat Model.
Tae Nyeun KIM ; Jeong Ill SUH ; Byeong Ik JANG ; Moon Kwan CHUNG ; Hyun Woo LEE
Korean Journal of Medicine 1997;53(1):18-25
OBJECTIVES: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. METHODS: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. RESULTS: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7+/-0.6% in the portal stenosis group compared with 0.9+/-0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8+/-1.4 vs. 6.5+/-0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4+/-2.5 vs, 129.9+/-3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7+/-8.0 vs. 111.0+/-4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97+/-2.03 vs. 17.90+/-1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0+/-3.3 vs. 88.2+/-4.8 dyne sec/cm5 X 105; p<0.01) and splanchnic vascular resistance(2.54+/-0.20 vs. 5.47+/-0.33 dyne sec/cm5 X 105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57+/-0.31 vs. 3.03+/-0.38 dyne sec/cm5 X 105; p>0.05). CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.
Animals
;
Arterial Pressure
;
Cardiac Output
;
Collateral Circulation
;
Constriction, Pathologic
;
Hemodynamics*
;
Hypertension, Portal
;
Ligation
;
Liver
;
Microspheres
;
Models, Animal*
;
Portal Pressure
;
Portal Vein*
;
Rats*
;
Splanchnic Circulation
;
Spleen
;
Vascular Resistance
2.Clonorchiasis and its complications: cholangiogram revisited.
Jae Hoon LIM ; Young Tae KO ; Dong Ho LEE ; Kwan Sup LEE ; Soo Jhi SUH ; Seong Koo WOO
Journal of the Korean Radiological Society 1992;28(2):229-235
Clonorchiasis is known to be closely related with the development of recurrent pyogenic cholangitis and carcinoma of the bile ducts. In order to ascertain the cholangiographic signs for recurrent pyogenic cholangitis or carcinoma of the bile ducts arising in patients with clonorchiasis. we reviewed cholangiograms in 42 patients with proven clonorchiasis. The population consisted of 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone were intrahepatic multiple, oval, or elliptic filling defects measuring 2-10 mm in size, representing adult flukes (n=24). The peripheral bile duct were obstructed (n=18), and the margins were ragged (n=20) and hazy (n=12) the intrahepatic bile ducts were dilated diffusely (n=27), and the dilated peripheral small tributaries gave the impression of "too many ducts appearance" (n=7) and dilatation was mid (n=17) In six patients with clonorchiasis and recurrent pyogenic cholangitis, there were filling defects of stones, and the extrahepatic ducts and larger intrahepatic ducts were predominantly dilated. In seven patients with clonorchiasis and cholangiocarcinoma all the biliary tree proximal to the tumor was markedly and diffusely dilated In the latter two groups, filling defects of flukes and associated findings were less prominent, but there was disproportionately severe dilatation of too many intrahepatic ducts. In patients with recurrent pyogenic cholangitis or cholangiocarcinoma, clonorchiasis should be considered as a underlying cause when cholangiogram shows "disproportionately" severe dilatation of too many intrahepatic ducts. intrahepatic ducts.
Adult
;
Bile Ducts
;
Bile Ducts, Intrahepatic
;
Biliary Tract
;
Cholangiocarcinoma
;
Cholangitis
;
Clonorchiasis*
;
Dilatation
;
Humans
;
Trematoda
3.Using Blood Donating Set for the Treatment of Subgaleal Hematoma: Technical Note.
Dong Sang SUH ; Bum Tae KIM ; Sung Jin CHO ; Won Han SHIN ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 2000;29(11):1519-1522
No abstract available.
Hematoma*
4.Endoscopic Removal of Bile Duct Stones.
Moon Kwan CHUNG ; Hyun Woo LEE ; Byeong Ik JANG ; Tae Nyeun KIM ; Ki Duk KIM ; Jeong Ill SUH
Korean Journal of Gastrointestinal Endoscopy 1995;15(4):697-703
From January 1988 to December 1994, endoscopic sphincterotomy with stone extraction was attempted in 395 patients with common duct stones at Yeungnam University Hospital. Endoscopic sphincterotomy was successful in 389 patients(98.5 %), and clearance of the duct was achieved in 364 patients with an overall success rate of 92.2%. After sphincterotomy, stone extraction by basket or balloon was undertaken in 298 patients without lithotripsy, and stones could be extracted after fragmentation of stones in 19 patients. In 47 patients, stones were passed into duo denum spontaneously. There were 6 cases of sphincterotomy failure due to large periampullary diverticulum or previous gastrojejunostomy. In patients with success ful sphincterotomy, endoscopic stone extraction was failed in 25 cases due to 14 large stones, 5 bile duct strictures, 4 impacted stones, and 2 cases of technical fail ure. Complications were developed in 13 patients(3.3%); 8 pancreatitis and 5 bleedings. All of them were improved with medical therapy only. Despite relatively high success rate and low complications of the endoscopic management of choledocholithiasis, there were significant difficulties in removing large stones. Developement of more effective and inexpensive methods of lithotripsy, and the search for rapidly effective solvent dissolving stones were needed.
Bile Ducts*
;
Bile*
;
Cholangiopancreatography, Endoscopic Retrograde
;
Choledocholithiasis
;
Constriction, Pathologic
;
Diverticulum
;
Gastric Bypass
;
Humans
;
Lithotripsy
;
Pancreatitis
;
Sphincterotomy, Endoscopic
5.Treatment outcome of the patients with small hepatoma (5 cm in diameter) in relation to treatment modalities and underlying liver function.
Kun Hoon SONG ; Kwang Hyub HAN ; Young Myung MOON ; Chae Yoon CHON ; Won CHOI ; Kwan Sik LEE ; In Suh PARK ; Byong Ro KIM ; Jong Tae LEE
The Korean Journal of Hepatology 1996;2(2):186-197
BACKGROUND/AIMS: To compare treatment outcome of hepatocellular carcinoma(HCC) under the size of 5 cm in relation to underlying liver function and treatment modalities, analysis of data from 145 patients was performed. METHODS: In this study, the records of 145 patients with small HCC (< 5 cm in diameter determined by hepatic angiography) were reviewed. Clinical parameters were analyzed and survival rate, recurrence rate were calculated. RESULTS: There were 107(73.8%) men and 38 women. Mean age at diagnosis was 55.1(range .' 25 83 year-old). HBsAg was detected in 97(66.9%) patients. Seventy two(50.0%) patients showed markedly elevated(>40 ng/mL) serum alpha-fetoprotein(AFP) level. Liver cirrhosis was associated in 109(75.2%) patients. Sixty five(44.8%) patients underwent surge, 63(43.5%) underwent transarterial therapy(TAT), 8(5.5%) underwent other modalities of therapy and the remaining 9(6.2% ) patients did not receive any specific treatment for HCC. In relation to the underlying liver function, 119(82.1% ) patients belonged to the non-cirrhotic or Child-Pugh class A, 20(13.8%) to class B and 6(4.1%) to class C. The median follow-up duration was 21 months. When analyzed with respect to treatment modalities alone, median survival was 43 months for all patients, 60 months for surgery, 29 months for TAT, 20 months for other treatment and 18 months for patients who received no specific treatment. Without considering liver function, cumulative 3 year survival rate was 68.6% for surgery, 43.9% for TAT, 29.2% for other treatment and 0% for no treatment. The survival rate for the patients who underwent surgery was significantly higher than for any other treatment modalities without considering the underlying liver function or in the non-cirrhotic/Child-Pugh class A(p<0.001). In patients whose tumor size was equal to or less than 3 cm, there was no difference in survival rate in relation to the treatment modalities when not considering the underlying liver function of each patient(p>0.05). But in patients classified as the non-cirrhotic/Child-Pugh class A, better survival was observed in the surgep group than the TAT group(p<0.05). The only factor influencing survival was the pre-treatment serum AFP level(p<0.05). The overall recurrence rate was 30.3%. For the entire patients, the factor significantly influencing the recurrence rate was the presence of underlying cirrhosis. When considering only the patients in the surgery group, the different types of surgical procedures significantly influenced the recurrence rate. CONCLUSION: Surgery is the treatment of choice for patients with HCC equal to or smaller than 5 cm. But for those patients whose tumor size is less than 3 cm, TAT may be a reasonable alternative to surgep when the liver function is not adequate for hepatic resection. Because overall recurrence rate exceeded 30% and median time of recurrence was only 9.5 months after definitive treatment, careful follow-up is required for all patients who undergo treatment for small HCC.
Carcinoma, Hepatocellular*
;
Diagnosis
;
Female
;
Fibrosis
;
Follow-Up Studies
;
Hepatitis B Surface Antigens
;
Humans
;
Liver Cirrhosis
;
Liver*
;
Male
;
Recurrence
;
Survival Rate
;
Treatment Outcome*
6.Endoscopic Sclerotherapy in Bleeding Gastric Varices.
Moon Kwan CHUNG ; Hyun Woo LEE ; Byeong Ik JANG ; Tae Nyeun KIM ; Jeong Ill SUH ; Chan Woo PARK ; Keyong Hee LEE
Korean Journal of Gastrointestinal Endoscopy 1996;16(3):435-442
A study carried out to evaluate the bleeding control and prophylactic effect of rebleeding using emergency endoseopic sclerotherapy in patients with hleeding gastric varices. 42 patients with gastric variceal bleeding were admitted to the Yeungnam University Hospital from May, 1983 to August, 1992. Patients were randomly classified into control group, 20 patients treated with conservative management, and sclerotherapy group, 22 patients treated with emergency endoscopic sclerotherapy. The two group were analysed with age, sex, etiology of liver cirrhosis, nature of bleeding episode, hematocrit on admitting day, amount of sclercsants used, rebleeding episodes, complications, and mortality. There were no significant differences in the severity of underlying liver disease and hematocrit on admission between two groups. Blood transfusion were performed in 19 cases of control group and 21 cases in sclerotherapy group(p>0.05). The amounts of transfusion were 7. 7units in control group and 6.1 units in sclerotherapy group(p<0,05). Rebleeding were developed in 65% and 18% of the patiehts with control and sclerotherapy group, respectively(p<0.05). Chest pain and mild fever were observed after endoscopic sclerotherapy. These results suggest that the endoscopic sclerotherapy is effective method in hemostasis of bleeding gastric varices and short-term prevention of rebleeding, but mortality rate was not decreased compared to control group. Development of more effective methods to treat gastric variceal bleeding is required.
Blood Transfusion
;
Chest Pain
;
Emergencies
;
Esophageal and Gastric Varices*
;
Fever
;
Hematocrit
;
Hemorrhage*
;
Hemostasis
;
Humans
;
Liver Cirrhosis
;
Liver Diseases
;
Mortality
;
Sclerotherapy*
7.anterior Spinal Epidural Hematoma after posterior Approach in Cervical Meningioma.
Dong Sang SUH ; Bum Tae KIM ; Sung Jin CHO ; Jae Chil CHANG ; Won Han SHIN ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 2000;29(2):261-264
No abstract available.
Hematoma, Epidural, Spinal*
;
Meningioma*
8.Correlation between Angiographic Vasospasm and Clinical Vasospasm following Aneurysmal Subarachnoid Hemorrhage.
Dong Sang SUH ; Bum Tae KIM ; Soo Bin IM ; Sung Jin CHO ; Won Han SHIN ; Soon Kwan CHOI ; Bark Jang BYUN
Journal of Korean Neurosurgical Society 2000;29(12):1563-1569
No abstract available.
Aneurysm*
;
Subarachnoid Hemorrhage*
9.High Cervical Chordoma Removed via Median Labiomandibular Glossotomy Approach.
Seung Min LEE ; Mun Bae JU ; Chun Sik CHOI ; Jung Keun SUH ; Tae Hyung CHO
Journal of Korean Neurosurgical Society 1997;26(10):1462-1470
The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma*
;
Deglutition Disorders
;
Dyspnea
;
Female
;
Humans
;
Middle Aged
;
Spine
10.A Case of Reticulum Cell Sarcoma of the Brain.
Jin Young YOUM ; Whan Whae KOO ; Shi Hun SONG ; Kwan Tae KIM ; Youn KIM ; Kwang Sun SUH
Journal of Korean Neurosurgical Society 1986;15(3):539-544
A rare case of primary reticulum cell sarcoma of the brain in a 56-year-old male is reported. The tumor was located in the left temporoparietal lobe. Brain CT scan revealed well enhanced mass with surrounding brain edema in left temporoparietal area. Osteoplastic craniotomy was performed for removal of tumor. Then the patient received radiation therapy with a good result.
Brain Edema
;
Brain*
;
Craniotomy
;
Humans
;
Lymphoma, Non-Hodgkin*
;
Male
;
Middle Aged
;
Reticulum*
;
Tomography, X-Ray Computed