• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.999-1010
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• 2023

This case report shows the effect of Korean medicine treatment in a patient with deep vein thrombosis (DVT) after cerebral infarction who is suspected of having post-thrombotic syndrome (PTS) due to the loss of thrombus after receiving new oral anticoagulant (NOAC) treatment. The patient was treated with Korean medicine (Boyanghwano-tang and Hyulbuchuko-tang) three times a day. Acupuncture, moxibustion, infrared, and extra-physical therapy were given to the patient for 24 days. Clinical assessment - grading of edema and circumference of the left lower extremity were observed twice a week until the end of the treatment. NOAC treatment was continued for 24 days. After treatment, the patient's edema grade and circumference of the extremity improved. On the 24th day, the patient's chief complaints improved, and she requested termination of treatment. The results suggest that Korean medicine treatments, including Boyanghwano-tang, Hyulbuchuko-tang, and acupuncture therapy, can be effective in improving the clinical symptoms of DVT and PTS.

• Investigative Magnetic Resonance Imaging
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• v.4 no.2
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• pp.100-106
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• 2000

Purpose : To evaluate the usefulness of cerebral blood flow measurement applied to perfusion weighted image with short-scan time single shot gradient echo-planar technique in measuring cerebral blood volume(rCBV) of normal rabbits. Materials and methods : With 2.1-3.6 kg weighted rabbits, image is acquired when they are in supine position in children positioner. Perfusion weighted image is acquired to 44 seconds per 1 second successively. After 4 seconds later, Gd-DTPA 2ml are injected into int. jugular vein with 2 ml per second and normal saline is also injected after that. Same technique is applied 2 times per 30 minites in same rabbit. After Image is obtained in two part of cerebral cortex at vertex, convexity, in one of basal ganglia with choosing about $3-5{\textrm{mm}^2}$ areas. Curve of signal intensity changes in time sequence is drawn. After this images are transmitted by PC and software IDL, regional cerebral blood volume is measured with imaging processing program made by us. Results : With 22 of 24 rabbits, satisfactory 1-2 signal intensity versus time curve is made. Cerebral blood capacity and contrast media stay time (ST) is measured in two cerebral cortex and basal ganglia refering in parietal cerebral cortex. Mean focal cerebral blood flow capacity ratio in cortex was $0.97{\pm}0.35$ and in basal ganglia, $0.99{\pm}0.37$, mean contrast media stay time in cortex was $9.83{\pm}1.63$ sec and in basal gaiglia, $9.42{\pm}1.14$ sec, but there was no statistically significant difference between two areas ($\rho$=0.05). Conclusion : In cerebral cortex and basal ganglia, there is no difference in mean focal blood volume and mean contrast stay time. Therefore, PWI is useful in cerebral blood flow and early diagnosis, prognosis of cerebral ischemic disease. Hereafter, it is helpful in analysing cerebral blood flow changes with comparison difference in rCBV between normal tissue and ischemic tissue, and that with DWI finding in infarcted patient.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.485-493
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• 2018

Objective : Cerebral varices (CVs) without an arteriovenous shunt, so called nonfistulous CVs, are very rare, and their etiology and natural course are not well understood. The aim of this study is to evaluate the clinical outcomes of nonfistulous CVs by the analysis of 39 cases. Methods : From 2000 to 2015, 22 patients with 39 nonfistulous CVs (${\geq}5mm$) were found by searching the medical and radiologic records of our institute. Clinical data and radiological data including numbers, sizes and locations of CVs and associated anomalies were retrospectively collected and analyzed. Previously reported cases in literature were reviewed as well. Results : The mean age of the patients was 21 years (range, 0-78 years). On average, $1.8{\pm}1.2CVs$ were found per patient. CVs were categorized as either fusiform or saccular depending on their shapes. Two patients had saccular type CVs, seventeen patients had fusiform types, and three patients had both fusiform and saccular CVs. Eight patients had associated compromise of the vein of Galen and the straight sinus. Four of those patients had sinus pericranii, as well. Five patients had CVs that were distal draining veins of large developmental venous anomalies. One patient had associated migration anomaly, and two patients had Sturge-Weber syndrome. Six patients with an isolated cerebral varix were observed. Of the 39 CVs in 22 patients, 20 lesions in 14 patients were followed up in outpatient clinics with imaging studies. The average follow-up duration was 6.6 years. During this period, no neurological events occurred, and all the lesions were managed conservatively. Conclusion : Nonfistulous CVs seemed to be asymptomatic in most cases and remained clinically silent. Hence, we suggest conservative management.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.307-318
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• 2001

Objective : Surgical experiences of pseudoaneurysms such as traumatic, mycotic and ill-defined unknown causes of aneurysms are rare. The authors have studied the results of surgical management from such cases in our series. Patients and Method : In the last 17 years, 1320 patients with cerebrovascular aneurysms were managed surgically. Among these, 16 patients showed the pseudoaneurysms. The authors analyzed retrospectively the clinical characteristics, treatment methods, management outcomes and problems in the managements. Results : There were 6 patients with traumatic aneurysm, 4 mycotic aneurysms and 6 ill-defined unknown causes of aneurysm. The sites of traumatic aneurysms were cavernous portion of the internal carotid artery(n=3), distal portion of the anterior cerebral artery (n=2) and vertebral artery(VA : n=1). Good outcomes in 5 cases could be obtained by extracranial - intracranial bypass followed by parent vessel occlusion or resection of aneurysm followed by re-anastomosis of parent vessel. The sites of mycotic aneurysm were peripheral portions of middle cerebral artery(MCA : n=3) and posterior cerebral artery(PCA : n=1). The outcomes of the patients with a mycotic aneurysm were relatively poor. It was partially due to the development of new aneurysm after treatment in one. The sites of ill-defined unknown causes of aneurysm were extracranial carotid artery(n=3), V2 portion of the VA(n=1), peripheral portion of the PCA (n=1) and MCA(n=1). Good outcome in all cases could be obtained by resection of aneurysm with or without saphenous vein graft. Conclusion : For the treatments of cerebrovascular pseudoaneurysm, combinations of aggressive medical, endovascular and surgical managements seem mandatory. Insertion of stent for a extracranial carotid artery aneurysm and coiling for a peripheral mycotic aneurysm can be option in future.

• Progress in Medical Physics
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• v.21 no.3
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• pp.274-280
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• 2010

The purpose of this study was to analyze the effect of single-fraction stereotactic radiosurgery (SRS) for the treatment of 15 cases of cerebral arteriovenous malformations (AVMs). Between 2002 and 2009, of the 25 patients who had SRS for the treatment of cerebral AVM, 15 patients (6 men, 9 women) taken a digital subtraction angiography (DSA) over 12 months after SRS were included. We retrospectively evaluated the size, location, hemorrhage of nidus, angiographic changes on follow-up on the MR angiography and DSA, and clinical complications during follow-up periods. At a median follow-up of 24 months (range 12-89), complete obliteration of nidus was observed in all patients (100%) while residual draining veins was observed in 3 patients (20%). There was no clinical complication during the follow-up period except seizure in 1 patient. The mean nidus volume was 4.7cc (0.5~11.7 cc, SD 3.7 cc). The locations of nidus were in cerebral hemisphere in 11 patients, cerebellum in 2 patients, basal ganglia in 1 patient, and pons in 1 patient respectively. 9 cases were hemorrhagic, and 6 cases were non-hemorrhagic AVMs. The SRS with LINAC is a safe and effective treatment for cerebral AVMs when the follow up period is over 4 years. However, it is recommended to continue to follow up until the draining vein on arterial phase of follow up DSA disappears completely.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.357-359
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• 2010

While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

• Korean Journal of Veterinary Service
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• v.16 no.1
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• pp.57-64
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• 1993

This survey was performed to report rare outbreak of liver cirrhosis in Korean native goat (KNG) which was died of Yangpyeong's goat farm on Feb. 1992. The examination for the KNG was carried out by clinical signs, necropsy and various lab-oratory test including parasitic, bacterial and histological test. The KNG looked jaundice, ascite, hemorrhage of lumen, abomasum and intestine, and brownish smooth cirrhotic liver at necropsy. Histological examination for liver revealed considerable proliferation of connective tissue and piecemeal necrosis which was caused by chronic active inflammation in interlobules and intralobules. There were atrophic micro and macro nodules which were sur-rounded by connective tissue. The lobular structure lack almost all central vein. The portal areas appearred proliferation of bile ducts, blood vessels and connective tissues. These connective tissue infiltrated heavily with plasma cells, Iymphocytes and histocytes. Histological examination for brain proved to be hepatic encephalopathy by virture of congestion and edema in cerebral medullary. From these results were demonstrated miked nodular, active, postnecrotic liver cirrhosis.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.755-759
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• 2002

A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1200-1209
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• 2001

Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1619-1627
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• 2021

Central venous stenosis is a relatively common complication in hemodialysis patients; however, jugular venous reflux (JVR) and increased intracranial pressure are rare, and associated progressive visual disturbance was reported in only a few cases. Here, we report a case of JVR with visual disturbance and increased intracranial pressure. Notably, the MRI was accompanied by a dilatation of the superior ophthalmic vein, which was mistaken for a cavernous sinus dural arteriovenous fistula (CSdAVF). The patient had JVR on time-of-flight MR angiography (TOF-MRA) and severe stenosis of the left brachiocephalic vein on conventional angiography. After balloon angioplasty for central venous stenosis, he was discharged after improvement of his visual disturbance. Although JVR due to central venous stenosis and CSdAVF might show similar symptoms, treatment plans are different. Therefore, it is important to distinguish radiologically based on a thorough review of MRI and TOF-MRA and confirm the central venous stenosis on cerebral angiography for the accurate diagnosis.