• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1188-1194
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• 2000

Objective : Internal carotid-posterior communicating artery(IC-PC) aneurysms can be clipped easily without any special preparations. Occasionally, however, it is difficult to clip the low-lying IC-PC aneurysms without some kinds of additional procedures. Clinical Material and Methods : We experienced four cases of low-lying IC-PC aneurysms, which the intradural anterior clinoidectomy and/or anterior petroclinoid fold(APF) resection was essential to expose the proximal side of the aneurysmal neck and/or proximal control. One patient harbored two low-lying IC-PC aneurysms bilaterally. The patients were divided into two groups according to the necessity of anterior clinoidectomy : Group I(n=4) that needed an intradural clinoidectomy and/or APF resection and Group II(n=29) that had IC-PC aneurysms, easily clipped without any special preparation. Also, various radiometric parameters were measured through the preoperative angiograms. Results : The incidence of such aneurysms was 12% among a total of thirty-three surgically treated IC-PC aneurysms during lasr 3 years. Among four cases, three cases presented with subarachnoid hemorrhage and all aneurysmal sac projected to postero-inferior direction. In our study, We initially considered the necessity of intraoperative anterior clinoid process(ACP) removal and/or resection of APF in cases of shorter distance less than 5.6mm between the proximal aneurysmal sac and tip of the ACP(p<0.001), and the proximal portion of aneurysmal neck has located below the interclinoid line(p=0.001). Conclusion : Through a careful preoperative evaluation, some radiometric parameters can be used to determine whether the ACP should be removed in clipping of the low-lying IC-PC aneurysms. Unlike to total removal of the ACP, the intradural partial anterior clinolidectomy and/or APF resection, which are more familiar to surgeons, reduce the risks of the premature rupture, operative time, and also contribute a more precise clip placement with proximal control than the extradural clinoidectomy.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.163-167
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• 2000

Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1584-1591
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• 2000

Objective : Until now, it has been little known about the biological mechanisms associated with the genesis, growth, and rupture of intracranial aneurysm. This study was performed to investigate and understand a part of these mechanisms. Materials and Methods : Immunohistochemical stains for angiogenesis growth factors(basic fibroblast growth factor (bFGF) and vascular endothelial growth factor(VEGF)) and selected vascular wall matrix proteins(alpha smooth muscle actin(${\alpha}SMA$) and collagen Type IV) were performed in fixed sections from a normal circle of Willis artery which was taken from the autopsy specimen as a control vessel and 17 aneurysmal wall specimens which was taken during surgical clipping of aneurysms. The staining intensity and distribution of immunoreactivity to angiogenesis growth factors and selected wall matrix proteins in control vessel and aneurysmal wall were examined and compared with each other. The difference of staining intensity according to the size of aneurysm was also investigated. Results : There was no immunoreactivity to bFGF and VEGF in the control vessel. bFGF immunoreactivity was exhibited in 15 of 17 aneurysm specimens around smooth muscle cells within the media of aneurysm. VEGF immunoreactivity was also exhibited in all aneurysm specimens in patches or diffusely affecting all layers of the aneurysmal wall. The degrees of intensity of bFGF and VEGF immunoexpression were proportionate roughly to the size of aneurysm. Strong immunoexpression of both factors were noticed in large aneurysm. A regularly arranged and defined band of immunoreactivity of ${\alpha}SMA$ was noticed in the media of the control vessel, whereas diffuse, faint, irregularly arranged ${\alpha}SMA$ was noticed in the aneurysmal wall. A regularly defined band of collagen Type IV immunoreactivity was also noticed in the subendothelium of the control vessel, whereas diffuse disorganized immunoreactivity of collagen Type IV was noticed in the entire wall of the aneurysm. Conclusion : These results indicate substantial evidences of abnormal expression of angiogenesis factors and changes of selected vascular wall matrix proteins in the wall of intracranial aneurysm. The unbalanced changes of angiogenesis factors and vascular wall matrix proteins in the wall of aneurysm may be one of the biological mechanisms for the growth and rupture of aneurysm.

• Korean Circulation Journal
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• v.52 no.6
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• pp.478-480
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• 2022

• Journal of Chest Surgery
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• v.36 no.6
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• pp.427-430
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• 2003

The surgical managements for the complicated aortic disease is still one of most challenging fields for the cardiac surgeons. The endovascular stent graft procedure has been tried recently to avoid serious complications caused by traditional graft replacement technique. However, indications for the procedures or management methods for the complications have not been clearly elucidated so far. We report a case of successful management for the newly-onset aneurysmal dilation of the distal aorta after an endovascular stent graft procedure in a patient with acute aortic dissection type IIIB.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.167-170
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• 2014

Herein, we present a case of a successful treatment of persistent type 2 endoleaks associated with aneurysmal sac enlargement after endovascular aneurysm repair in an elderly patient. We confirmed the diagnosis by abdominal computed tomography and selective angiography revealing an 11.0-cm aneurysm sac with type 2 endoleaks. An attempt for the endovascular embolization of collateral arteries was unsuccessful due to anatomic variations and their multiple complex communications. Instead, transperitoneal sacotomy and direct suturing on the feeding target vessels was successfully performed without any endograft damage. In conclusion, sacotomy appears to be a feasible therapeutic substitute where endovascular or other techniques have a high risk of failure and lead to unsuccessful results.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.222-229
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• 1982

The aneurysmal dilatation of ascending aorta with the aortic regurgitation presents typical surgical problems. Over the years, various surgical procedures had been used for the management of the dilated segment of sending aorta and the aortic regurgitation. The surgical technique Is still in the state of evolution. The one method is the super coronary replacement of the ascending aorta with vascular graft and replacement of the aortic valve with preservation of the coronary ostia as advocated by Miller and his colleague at Stanford University, so called conventional technique". The other is the replacement of aortic valve and the dilated segment of the ascending aorta using a composite graft and transplantation of the coronary ostia as described by Bentall and DeBono in 1968. The controversy appears to evolve around 3 technical problems. One is bleeding from the grafted area. Two is later development of the aneurysmal dilatation of the subcoronary aortic wall when non-composite graft is employed. Three is a management of the coronary arteries. The purpose of this article is to present our experience with 7 cases of annuloaortic ectasia in whom both of these surgical techniques at that employed and to review some of the problems that encountered during the management of these patients .

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.63-66
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• 2008

Objective : The purpose of this study is to investigate the correlation between various transcranial Doppler (TCD) ultrasonography parameters and clinical vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Methods : This study enrolled 40 patients presented with aneurysmal SAH between September 2006 and August 2007. We measured differences of mean blood flow velocity (BFVm), highest systolic blood flow velocity (BFVh), and Lindegaard ratio (LR) in the middle cerebral artery on TCD examination. These parameters were evaluated for correlation with clinical vasospasm by univariate analysis and the receiver operating characteristic analysis. Results : Twelve patients (30%) developed clinical vasospasm. The best TCD parameters for the detection of clinical vasospasm were revealed to be differences of BFVm, BFVh, and LR values between $1^{st}$ TCD test and $3^{rd}$ TCD (7 cm/s. 11.5 cm/s, 0.45 respectively). The positive predictive value of anyone of three parameters was 60% and the negative predictive value was 100%. Conclusion : TCD is still considered a useful tool for screening clinical vasospasm. To confirm the predictive value of the above parameters. further prospective study will be needed.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1363-1366
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• 2006

Aneurysmal dilatation of the ductus arteriosis has been considered a rare but potentially fatal abnormality. The mechanism of ductal aneurysmal formation remains uncertain. Plain chest radiography has proven helpful in the diagnosis of ductus arteriosus aneurysm (DAA), before the application of transthoracic echocardiography. The transthoracic echocardiography is an important tool for the diagnosis and follow-up of DAA. We present a case of congenital ductus arteriosus aneurysm in a newborn, that was an incidental discovery. The diagnosis was made by echocardiography, three-dimensional surface rendering computed tomography (CT), and spontaneous regression after four weeks of follow-up.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.753-761
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• 1984

Most patients having annuloaortic ectasia are associated with marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. A 19 year old male patient complaining of tightness on left posterior chest wall underwent cardiac angiography in which demonstrated annuloaortic ectasia with ascending aortic aneurysm and aortic insufficiency. The patient had corrective operation replacing the ascending aorta and aortic valve with a composite graft[Dacron prosthesis containing a Bjork-Shiley aortic valve] within the aneurysmal sac. The coronary orifices were anastomosed to the tubular Dacron prosthesis [30 mm in diameter] by means of a second smaller Gore-Tex tube [8mm in diameter]. The aneurysmal sac was trimmed by removing the redundant wall and then wrapped outer wall of the Dacron prosthesis. Postoperatively, mediastinal bleeding was temporarily observed in the operative day and satisfactory blood pressure was maintained with small dose of dopamine. One week later, large amount of serous effusion was drained out of the retrosternal space making partial disruption of the skin which was healed well by daily local dressing. The patient discharged in good condition on postoperative 29th day with no residual complications and is doing very well on the 4 months follow-up.