1.Repair of Spontaneous Cerebrospinal Fluid Otorrhea from Defect of Middle Cranial Fossa.
Sung Hyun BOO ; Young Bum GOH ; Chi Sung HAN
Korean Journal of Audiology 2013;17(3):148-151
Spontaneous cerebrospinal fluid (CSF) otorrhea is defined as CSF otorrhea where there are no identifiable causes including previous trauma, surgery, infection, neoplasm or congenital anomaly. The condition is rare. The origin of CSF leak is commonly a defect in the tegmen of the middle cranial fossa. The pathophysiology of spontaneous CSF otorrhea is unclear. Two theories of the etiology of bony defects of the temporal bone are the congenital bony defect theory and arachnoid granulation theory. The authors experienced a case of a 49-year-old female patient admitted with the complaint of persistent right ear fullness. Computed tomography revealed a large defect of the middle fossa and suspicious CSF otorrhea through the defect of tegmen tympani. Repair was successful with multiple bone chips using the transmastoid approach. The postoperative course was good and there has been no recurrence of the CSF leakage.
Arachnoid
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Cerebrospinal Fluid
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Cerebrospinal Fluid Otorrhea*
;
Cranial Fossa, Middle*
;
Ear
;
Female
;
Humans
;
Middle Aged
;
Recurrence
;
Temporal Bone
2.Evaluation of Treatment Response after Endoscopic Variceal Obturation with Abdominal Computed Tomography
Han Ah LEE ; Hyun Gil GOH ; Tae Hyung KIM ; Young-Sun LEE ; Sang Jun SUH ; Young Kul JUNG ; Hyuk Soon CHOI ; Eun Sun KIM ; Ji Hoon KIM ; Hyunggin AN ; Yeon Seok SEO ; Hyung Joon YIM ; Sung Bum CHO ; Yoon Tae JEEN ; Jong Eun YEON ; Hoon Jai CHUN ; Kwan Soo BYUN ; Soon Ho UM ; Chang Duck KIM
Gut and Liver 2020;14(1):117-124
Background:
s/Aims: Rebleeding of gastric varices (GVs) after endoscopic variceal obturation (EVO) can be fatal. This study was performed to evaluate the usefulness of computed tomography (CT) for the prediction of rebleeding after EVO GV bleeding.
Methods:
Patients who were treated with EVO for GV bleeding and underwent CT before and after EVO were included. CT images of the portal phase showing pretreatment GVs and feeding vessels, and nonenhanced images showing posttreatment cyanoacrylate impaction were reviewed.
Results:
Fifty-three patients were included. Their mean age was 60.6±11.6 years, and 40 patients (75.5%) were men. Alcoholic liver disease was the most frequent underlying liver disease (45.3%). Complete impaction of cyanoacrylate in GVs and feeding vessels were achieved in 40 (75.5%) and 24 (45.3%) of patients, respectively. During the follow-up, GV rebleeding occurred in nine patients, and the cumulative incidences of GV rebleeding at 3, 6, and 12 months were 11.8%, 18.9%, and 18.9%, respectively. The GV rebleeding rate did not differ significantly according to the complete cyanoacrylate impaction in the GV, while it differed significantly according to complete cyanoacrylate impaction in the feeding vessels. The cumulative incidences of GV rebleeding at 3, 6, and 12 months were 22.3%, 35.2%, and 35.2%, respectively, in patients with incomplete impaction in feeding vessels, and there was no rebleeding during the follow-up period in patients with complete impaction in the feeding vessels (p=0.002).
Conclusions
Abdominal CT is useful in the evaluation of the treatment response after EVO for GV bleeding. Incomplete cyanoacrylate impaction in feeding vessels is a risk factor for GV rebleeding.
3.A Case of Cystic Duct Carcinoma with Hepatic Duct Invasion.
Chang Hyun LEE ; Youn Joo KIM ; Woo Hyun PAIK ; Jae Kyung LEE ; Goh Eun CHUNG ; Sang Hyup LEE ; Ji Kon RYU ; Yong Tae KIM ; Yong Bum YOON ; Dong Chul KIM ; Se Hyung KIM ; Jin Young JANG
Korean Journal of Gastrointestinal Endoscopy 2006;33(3):178-182
A primary carcinoma of the cystic duct is extremely rare, accounting for 2.6% of all biliary carcinomas. However, the prognosis is better than other biliary carcinomas. The median survival is 20.4 months. In Korea, three cases have been reported and there is no case where a pre-operative MRI has been performed. We report a case of a primary carcinoma of the cystic duct with hepatic duct invasion, which presented as a painless right upper quadrant mass, that was diagnosed by MRCP in a pre-operative situation.
Cystic Duct*
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Hepatic Duct, Common*
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Korea
;
Magnetic Resonance Imaging
;
Prognosis
4.Clinical Features and Treatment Pattern of Migrainous Vertigo in Korea: A Nationwide Prospective Multicenter Study
Seong Ki AHN ; Kyusik KANG ; Ja Won KOO ; Kyu Sung KIM ; Beom Gyu KIM ; Byung Kun KIM ; Ji Soo KIM ; Kyoung Ho PARK ; Shi Nae PARK ; Eun Ho PARK ; Hong Ju PARK ; Jae Yong BYUN ; Myung Whan SUH ; Ki Bum SUNG ; Sun Young OH ; Chung Ku RHEE ; Tae Kyeong LEE ; Seong Hae JEONG ; Won Ho CHUNG ; Chang Il CHA ; Sung Won CHAE ; Eui Kyung GOH
Journal of the Korean Balance Society 2009;8(2):122-131
BACKGROUND AND OBJECTIVES It is being increasing recognized that the morbidities of migraine and balance disorders are interrelated. In fact, migrainous vertigo (MV) is one of frequent causes of recurrent vertigo in patients presenting to specialized dizziness clinics. Nevertheless, not many studies have reported clinical manifestations and treatment. Therefore, the aim of study was designed to assess clinical features and treatment patterns by a nationwide multicenter study. MATERIALS AND METHODS Patients between 9 and 74 years of age who visited 17 Korean tertiary referral centers and 1 clinic from February to March 2009 were investigated using two forms of questionnaires. RESULTS Overall, 318 patients with MV were enrolled. MV was responsible for ~8.45% of visits to the specialized dizziness clinics. One hundred seventy-five of these patients had definite MV and were included in assessing the clinical features. Vertigo characteristics of patients with definite MV were various. Vertigo was regularly as sociated with headache in 87% of the patients. The duration of vertigo ranged from seconds to days. For the treatment patterns, an acute and prophylactic therapies were carried in most clinics. There were no differences in either acute or prophylactic therapies between department of neurology and otorhinolaryngology. CONCLUSIONS The results of this study suggest that MV the clinical features of MV also varies in Korea. In addition, most clinics provide similar patterns of practice in treatment for MV. The syndrome of MV deserves further research activity as it is relatively common and clinically relevant.
Dizziness
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Headache
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Humans
;
Korea
;
Migraine Disorders
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Neurology
;
Prospective Studies
;
Tertiary Care Centers
;
Vertigo
5.Multicenter Study on the Clinician's Diagnostic and Therapeutic Approaches for Benign Paroxysmal Positional Vertigo in Korea
Eun Ju JEON ; Won Ho CHUNG ; Jeong Hwan CHOI ; Eui Cheol NAM ; Hong Ju PARK ; Jong Dae LEE ; Won Sang LEE ; Kyu Sung KIM ; Eui Kyung GOH ; Ja Won KOO ; Min Bum KIM ; Min Beom KIM ; Se Hyung KIM ; Young Jin KIM ; Chang Hee KIM ; Sung Il NAM ; Seog Kyun MUN ; Ga Young PARK ; Sang Yoo PARK ; Shi Nae PARK ; Chang Hoon BAE ; Sung Hyun BOO ; Myung Whan SUH ; Jae Hyun SEO ; Eun Jin SON ; Jae Jun SONG ; Jae Jin SONG ; Joong Wook SHIN ; Dae Bo SHIM ; Seong Ki AHN ; Hye Youn YOUM ; Shin Young YOO ; Dong Hee LEE ; Seung Hwan LEE ; Chang Ho LEE ; Hyun Seok LEE ; Hwan Ho LEE ; Hyo Jeong LEE ; Yun Hoon CHOUNG ; Seung Hyo CHOI ; Jee Sun CHOI ; Seok Min HONG ; Sung Kwang HONG
Journal of the Korean Balance Society 2013;12(3):79-92
BACKGROUND AND OBJECTIVES: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician's diagnostic and therapeutic approaches for BPPV. MATERIALS AND METHODS: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. RESULTS: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). CONCLUSION: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.
Surveys and Questionnaires
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Delivery of Health Care
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Dizziness
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Electronic Mail
;
Korea
;
Otolaryngology
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Otolithic Membrane
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Public Opinion
;
Vertigo