Objective: : Endovascular treatment of intracranial aneurysms is challenging in case of wide-necked aneurysms because coils are prone to herniate into the parent artery, causing thromboembolic events or vessel occlusion. This study aims to compare long-term angiographic results of wide-necked aneurysms treated by stent-assisted, double-microcatheter, or single-microcatheter groups. Methods: : Between January 2003 and October 2016, 108 aneurysms that were treated with endovascular coil embolization with a neck size wider than 4 mm and a follow-up period of more than 3 years were selected. We performed coil embolization with singlemicrocatheter, double-microcatheter, and stent-assisted techniques. Angiographic results were evaluated using the Raymond-Roy occlusion classification (RROC). All medical and angiographic records were reviewed retrospectively. Results: : Clinical and angiographic analyses were conducted in 108 wide-necked aneurysms. The immediate post-procedural results revealed RROC class I (complete occlusion) in 66 cases (61.1%), class II (residual neck) in 36 cases (33.3%), and class III (residual sac) in six cases (5.6%). The final follow-up results revealed class I in 48 cases (44.4%), class II in 49 cases (45.4%), and class III in 11 cases (10.2%). Of a total of 45 (41.6%) radiologic recurrences, there were 21 cases (19.4%) of major recurrence that required additional treatment, and 24 cases (22.2%) of minor recurrence. The final follow-up angiographic results showed statistically significant differences between the stent-assisted group and the others (p<0.01). Conclusion : Long-term follow-up angiography demonstrated that the stent-assisted technique had a better complete occlusion rate than the other two techniques.

Objective: : Endovascular treatment of intracranial aneurysms is challenging in case of wide-necked aneurysms because coils are prone to herniate into the parent artery, causing thromboembolic events or vessel occlusion. This study aims to compare long-term angiographic results of wide-necked aneurysms treated by stent-assisted, double-microcatheter, or single-microcatheter groups. Methods: : Between January 2003 and October 2016, 108 aneurysms that were treated with endovascular coil embolization with a neck size wider than 4 mm and a follow-up period of more than 3 years were selected. We performed coil embolization with singlemicrocatheter, double-microcatheter, and stent-assisted techniques. Angiographic results were evaluated using the Raymond-Roy occlusion classification (RROC). All medical and angiographic records were reviewed retrospectively. Results: : Clinical and angiographic analyses were conducted in 108 wide-necked aneurysms. The immediate post-procedural results revealed RROC class I (complete occlusion) in 66 cases (61.1%), class II (residual neck) in 36 cases (33.3%), and class III (residual sac) in six cases (5.6%). The final follow-up results revealed class I in 48 cases (44.4%), class II in 49 cases (45.4%), and class III in 11 cases (10.2%). Of a total of 45 (41.6%) radiologic recurrences, there were 21 cases (19.4%) of major recurrence that required additional treatment, and 24 cases (22.2%) of minor recurrence. The final follow-up angiographic results showed statistically significant differences between the stent-assisted group and the others (p<0.01). Conclusion : Long-term follow-up angiography demonstrated that the stent-assisted technique had a better complete occlusion rate than the other two techniques.

This nationwide, prospective cohort study evaluated pulmonary function and radiological sequelae according to infection severity in 73 survivors from the 2015 Middle East respiratory syndrome (MERS) outbreak in Korea. Patients with severe pneumonia in MERS-coronavirus infection had more impaired pulmonary function than those with no or mild pneumonia at the 1-year follow-up, which was compatible with the radiological sequelae. Severe pneumonia significantly impairs pulmonary function and makes long radiological sequelae in MERS.
Cohort Studies ; Coronavirus ; Coronavirus Infections* ; Follow-Up Studies ; Humans ; Korea ; Middle East* ; Pneumonia* ; Prospective Studies ; Survivors

BACKGROUND: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. METHODS: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (≤2 weeks), early (≤1 year, 4.6±3.8 months), and late (>1 year, 3.5±1.1 years) postoperative stages. RESULTS: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of 9.6±2.4 seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5–68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). CONCLUSION: The absence of AC may be associated with a subsequent risk of PPM implantation.
Atrial Fibrillation ; Atrioventricular Block ; Bradycardia ; Cryosurgery* ; Dilatation ; Follow-Up Studies ; Humans ; Proportional Hazards Models ; Risk Factors ; Sick Sinus Syndrome ; Stroke

In order to examine the prevalence of Cryptosporidium infection in wild rodents and insectivores of South Korea and to assess their potential role as a source of human cryptosporidiosis, a total of 199 wild rodents and insectivore specimens were collected from 10 regions of South Korea and screened for Cryptosporidium infection over a period of 2 years (2012-2013). A nested-PCR amplification of Cryptosporidium oocyst wall protein (COWP) gene fragment revealed an overall prevalence of 34.2% (68/199). The sequence analysis of 18S rRNA gene locus of Cryptosporidium was performed from the fecal and cecum samples that tested positive by COWP amplification PCR. As a result, we identified 4 species/genotypes; chipmunk genotype I, cervine genotype I, C. muris, and a new genotype which is closely related to the bear genotype. The new genotype isolated from 12 Apodemus agrarius and 2 Apodemus chejuensis was not previously identified as known species or genotype, and therefore, it is supposed to be a novel genotype. In addition, the host spectrum of Cryptosporidium was extended to A. agrarius and Crosidura lasiura, which had not been reported before. In this study, we found that the Korean wild rodents and insectivores were infected with various Cryptosporidium spp. with large intra-genotypic variationa, indicating that they may function as potential reservoirs transmitting zoonotic Cryptosporidium to livestock and humans.
Animals ; Animals, Wild/*parasitology ; Cryptosporidiosis/*parasitology ; Cryptosporidium/classification/*genetics/*isolation & purification ; Feces/parasitology ; Genotype ; Insectivora/*parasitology ; Molecular Sequence Data ; Murinae ; Phylogeny ; Republic of Korea ; Rodent Diseases/*parasitology

PURPOSE: To identify the modes of failure after total knee arthroplasty (TKA) in patients >55 years of age and to compare with those >55 years of age in patients who underwent revision TKA. MATERIALS AND METHODS: We retrospectively reviewed 256 revision TKAs among patients who underwent TKA for knee osteoarthritis between January 1992 and December 2012. The causes of TKA failure were analyzed and compared between the groups. RESULTS: Thirty-one revision TKAs were performed in patients < or =55 years of age at the time of primary TKA, whereas 225 cases were in those >55 years of age at primary TKA. In the < or =55 years of age group, the most common cause of TKA failure was polyethylene wear (45%) followed by infection (26%) and loosening (17%). The interval from primary TKA to revision was 8.6 years (range, 1 to 17 years). There were relatively lower infection rate and higher loosening rate in patients < or =55 years of age, but the difference was not statistically significant. CONCLUSIONS: The main causes of failure after TKA in patients < or =55 years of age were polyethylene wear, infection and loosening, and there was no significant difference in the modes of failure after TKA between the two groups.
Arthroplasty ; Humans ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Polyethylene ; Retrospective Studies

We report on a case involving total en bloc uncinatectomy of C7 without removal of the previously inserted cage, performed on a patient with a history of previous anterior cervical discectomy and fusion without uncoforaminotomy at C5-6-7 who had persistent pain radiating to the upper extremity along with progressive weakness. Satisfactory results were achieved. This procedure should be regarded as an effective option for surgical treatment of persistent or recurrent radiculopathy caused by remaining foraminal stenosis following anterior cervical fusion, and we suggest it as a new indication for this procedure.
Constriction, Pathologic ; Diskectomy* ; Humans ; Radiculopathy* ; Upper Extremity

PURPOSE: We propose an equation that predicts graft function after kidney transplantation by using donated kidney volume and recipient body surface area (BSA). MATERIALS AND METHODS: Included were 261 cases of living kidney transplantation between 2007 and 2009. Preoperative computed tomography scans were performed and the donated kidney volume was measured by use of a three-dimensional reconstruction program (Ripidia). The estimated glomerular filtration rate (eGFR) was calculated by using the modification of diet in renal disease formula. Donated kidney volume, preoperative renal function, and demographic factors of both donors and recipients were evaluated as predictors. RESULTS: The mean ages of the donors and recipients were 40.8 and 41.6 years, respectively. The mean donated kidney volume and donated kidney volume/recipient BSA ratio were 153.4 mL and 96.9 mL/m2, respectively. Mean preoperative and postoperative 12-month eGFR of recipients were 7.1 and 59.7 mL/min, respectively, and the mean preoperative eGFR of donors was 92.2 mL/min. Donated kidney volume/recipient BSA ratio, donor age, and recipient gender were the significant predictors of eGFR level (p<0.001) and eGFR<45 mL/min at postoperative 12 months (p=0.005, p<0.001, and p=0.006). From the multiple linear regression equation and predicted probability from logistic regression, we could calculate the equation for the ratio of living donor kidney volume to recipient BSA on graft function. CONCLUSIONS: Graft kidney volume/recipient BSA ratio, donor age, and recipient gender were predictors of graft function 12 months after kidney transplantation. Although we are concerned only with the preoperative, this equation model could help physicians to counsel patients concerning their postoperative prognosis and to avoid insufficient volume donations.
Body Surface Area* ; Delayed Graft Function ; Demography ; Diet ; Glomerular Filtration Rate ; Humans ; Kidney Transplantation ; Kidney* ; Linear Models ; Living Donors* ; Logistic Models ; Organ Size ; Prognosis ; Tissue Donors ; Transplantation ; Transplants*

PURPOSE: To compare and analyze length change of patella tendon after intramedullary nailing of tibial shaft fracture using transtendinous approach. MATERIALS AND METHODS: Thirty-two cases were analyzed from December, 1999 to December, 2005. Insall Salvati ratios were estimated. Severity of initial trauma, duration of nail retension, knee function and pain on change of length of patellar tendon was evaluated. RESULTS: Mean duration of nail retention was twenty-two months. The shortening of patella tendon was observed in 25 cases (p<0.001). The effect of AO type and the duration of nail retension on the decrease of Insall Salvati ratio was not significant (p>0.05, p=0.778). Lysholom score decrease to 89.5. There was no significant difference between the shortening of patellar tendon length and knee pain (p=0.058). CONCLUSION: After intramedullary nailing for closed tibia fracture, shortening of patellar tendon length is observed. That is irrelevant to the fracture type and the duration of nail retension. The shortening of patella tendon length may contribute to decreasing of knee function, but it was no significance of knee pain after intramedullary nailing.
Fracture Fixation, Intramedullary ; Knee ; Nails ; Patella ; Patellar Ligament ; Retention (Psychology) ; Tibia ; Tibial Fractures

Adiaspiromycosis is caused by pulmonary infection with Emmonsia. Inhalated spores of Emmonsia cause asymptomatic infection to necrogranulomatous pneumonia, depending on the burden of adiaspore and host immunity. For disease monitoring of wild rodents captured on Jeju Island in Korea, we examined the lung tissue of wild rodents histopathologically. Spores composed of thick three-layered walls were found following histopathological examination and were diagnosed as adiaspiromycosis. Adiaspiromycosis has been found in mammals in many parts of the world. To our knowledge, this is the first report of adiaspiromycosis of an Apodemus agrarius captured in Korea.
Animals ; Asymptomatic Infections ; Chrysosporium ; Korea ; Lung ; Mammals ; Murinae ; Pneumonia ; Rodentia ; Spores