• Title/Summary/Keyword: Nidus

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Coil-Protected Technique for Liquid Embolization in Neurovascular Malformations

  • Keun Young Park;Jin Woo Kim;Byung Moon Kim;Dong Joon Kim;Joonho Chung;Chang Ki Jang;Jun-Hwee Kim
    • Korean Journal of Radiology
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    • v.20 no.8
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    • pp.1285-1292
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    • 2019
  • Objective: To evaluate the safety and efficacy of the coil-protected technique for liquid embolization in neurovascular malformations. Materials and Methods: Twenty-two patients who underwent coil-protected liquid embolization for symptomatic cranial (n = 13) and spinal (n = 9) arteriovenous fistula (AVF) or arteriovenous malformations (AVMs) were identified. A total of 36 target feeder vessels were embolized with N-butyl cyanoacrylate and/or Onyx (Medtronic). This technique was used to promote delivery of a sufficient amount of liquid embolic agent into the target shunt or nidus in cases where tortuous feeding arteries preclude a microcatheter wedging techniqu and/or to prevent reflux of the liquid embolic agent in cases with a short safety margin. The procedure was considered technically successful if the target lesion was sufficiently filled with liquid embolic agent without unintentional reflux. Angiographic and clinical outcomes were retrospectively evaluated. Results: Technical success was achieved for all 36 target feeders. Post-embolization angiographies revealed complete occlusion in 16 patients and near-complete and partial occlusion in three patients each. There were no treatment-related complications. Of the six patients who showed near-complete or partial occlusion, five received additional treatments: two received stereotactic radiosurgery for cerebral AVM, two underwent surgical removal of cerebral AVM, and one underwent additional embolization by direct puncture for a mandibular AVM. Finally, all patients showed complete (n = 19) or near-complete (n = 3) occlusion of the target AVF or AVM on follow-up angiographies. The presenting neurological symptoms improved completely in 15 patients (68.2%) and partially in seven patients (31.8%). Conclusion: The coil-protected technique is a safe and effective method for liquid embolization, especially in patients with various neurovascular shunts or malformations who could not be successfully treated with conventional techniques.

CT-guided Percutaneous Thermoablation for the Treatment of Osteoid Osteoma (경피적 고주파 열 치료를 이용한 유골 골종의 치료)

  • Sung, Ki-Sun;Seo, Jai-Gon;Ha, Hae-Chan
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.88-95
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    • 2004
  • Purpose: Current treatment for osteoid osteomas is usually surgical excision of the nidus. Various minimal invasive techniques have been reported to overcome the invasiveness of the surgical excision. We treated 22 patients with osteoid osteoma by percutaneous thermoablation of the nidus under computed-tomography guidance. Materials and Methods: Twenty two consecutive patients underwent CT-guided percutaneous radio-frequency thermoablation between April 1999 and May 2004. The mean age was 26.5(7~55) years. In three cases, the diagnosis was confirmed pathologically before the prodedure while the others clinically and radiologically. Computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 80 or 90 degrees C for 6(3~8) minutes. Clinical success was assessed at a mean of 30(4~62) months after the procedure at out patient clinic or by telephone interview. Results: The procedure was technically successful in all cases except a complication. Patients were discharged on 1.9 days after the procedure and resumed normal activities immediately. All patients but three (86%) remained pain free during follow-up (range 4~62 months). A second thermoablation treatment relieved the recurrent symptoms in 2 patients and the remained had persistent pain without a second prodedure. Conclusion: Percutaneous thermoablation appears to be safe and effective for osteoid osteomas, and is a minimally invasive procedure alternative to surgical resection.

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Linac Based Radiosurgery for Cerebral Arteriovenous Malformations (선형가속기 방사선 수술을 이용한 뇌동정맥기형의 치료)

  • Lee, Sung Yeal;Son, Eun Ik;Kim, Ok Bae;Choi, Tae Jin;Kim, Dong Won;Yim, Man Bin;Kim, In Hong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1030-1036
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    • 2000
  • Objective : The aim of this study was to retrospectively analyze the safety and effect of Linac based Photon Knife Radiosugery System(PKRS) for treatment of cerebral arteriovenous malformation. Patients and Methods : The authors analyzed the clinical method and results of ten patients who were followed up more than two years, among the 18 patients who had radiosurgery on arteriovenous malformation from June, 1992, to Dec. 1997, with Linac based Photon knife radiosurgery system(PKRS) which was developed in our hospital. Results : The average age of the patients was 30.4(with the range of 13-49), and the sex was seven males and three females. For the initial clinical symptoms, there were five patients with headache, three with seizure, one with hemiparesis, and one with vomiting. Before the radiosurgery, computed tomography, MRI, and cerebral angiogram were done. For the location of arteriovenous malformation, it was found on six patients of cerebral hemisphere, two of thalamus, one of brainstem, and one of corpus callosum. Regarding the size of nidus, there were seven patients of smaller than 3cm, and three patients of larger than 3cm. Computed tomography, MRI, and cerebral angiogram were done periodically for sixth months, first year, and second year after the radiosurgery of PKRS for the completeness of obliteration. Six cases showed complete obliteration, and four partial obliterations were observed among ten cases, and interestingly, six cases of complete obliteration were observed among seven cases of small AVM of smaller than 3cm(the rate of complete obliteration : 85.7%). All patients tolerated the treatment and no significant complication were seen. Conclusion : In this study, linac based radiosurgery using PKRS onto arteriovenous malformation showed excellent effects, therefore authors believe that it is an ideal method for small sized or deep seated AVM.

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A Case of Enterolithiasis in a Grant's Zebra (Equus burchelli boehmi) and Analysis of the Enterolith (그랜트얼룩말에서 발생한 장결석증과 결석의 분석)

  • Kim, Ji-Yong;Kim, Yang-Beom;Kwon, Soo-Whan;Lee, Wang-Hee;Choi, Yoon-Ju;Lee, Won-Jung;Yoo, Han-Sang;Shin, Nam-Shik
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.93-96
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    • 2010
  • We describe a case of enterolithiasis in an eight-year-old male Grant's zebra (Equus burchelli boehmi) that died after a 10-day history of depression, anorexia, dehydration and colic. On necropsy, an enterolith was discovered at the conjunction of the descending colon and the rectum. The spherical enterolith weighed 1,660 g and was $13.5cm{\times}8cm$ in size. According to scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), the nidus consisted primarily of $SiO_2$ with outer layers of magnesium and phosphate. The formation of enteroliths is closely related to diet. We suggest that this captive zebra's diet, which consisted primarily of alfalfa hay with mineral supplements, was the cause of enterolithiasis in this case. This is the first report of enterolithiasis in a captive equid in Korea. Our findings provide information valuable for the development of dietary guidelines to prevent enterolithiasis in captive wild equids.

Semen Properties of a Hanwoo bull persistently infected by BVDV (한우에서 BVDV 지속감염우의 정액 성상에 관한 연구)

  • Kim, Chan-Lan;Kim, Min Su;Kim, Namtea;Jeon, Ik Soo;Kim, Sung Woo
    • Korean Journal of Veterinary Service
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    • v.40 no.3
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    • pp.201-208
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    • 2017
  • BVDV causes significant infections in ruminants, resulting in reproductive disorders, diarrhea, reduced milk production and enormous damage to farms. In particular, identification and culling of persistent infectious calf is an important task to eliminate infectious nidus in cattle households. However, studies on physiological characteristics of PI bull are still insufficient to understand reproductive effects of BVDV. In this study, one PI bull was confirmed in herd and complete blood analysis was performed. The lymphocyte count of PI at age 4 was below the normal range and the number of WBCs was also in the lower level of normal range in blood. The sperm number produced by PI male becomes lower and the viability of fresh sperm comes to poor with ages (P<0.05). The sperm abnormality was also increased, especially in nuclear vacuoles of head and droplets of midpeace (P<0.05). The PI male becomes infertile due to poor semen quality at age 4. With these results, we concluded that BVDV in PI bull cause decreased sperm cell and abnormality in semen so causes infertility. However, it appears that BVDV could not be transmitted by indirect contact of PI bull, because there was no evidence of BVDV infection in the herd, when regular vaccination program was applied.

Results of Stereotactic Radiosurgerv with Linear Accelerator for Intracranial Arteriovenous Malformation (두개강내 동정맥기형에서 선형가속기를 이용한 방사선수술의 결과)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Lee Yong Ha
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.215-224
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    • 1997
  • Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

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A Study on an Effective Decellularization Technique for a Xenograft Cardiac Valve: the Effect of Osmotic Treatment with Hypotonic Solution (이종 심장 판막 이식편에서 효과적인 탈세포화 방법에 관한 연구; 저장성 용액(hypotonic solution)의 삼투압 처치법 효과)

  • Sung, Si-Chan;Kim, Yong-Jin;Choi, Sun-Young;Park, Ji-Eun;Kim, Kyung-Hwan;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.679-686
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    • 2008
  • Background: Cellular remnants in the bioprosthetic heart valve are known to be related to a host's immunologic response and they can form the nidus for calcification. The extracellular matrix of the decellularized valve tissue can also be used as a biological scaffold for cell attachment, endothelialization and tissue reconstitution. Thus, decellularization is the most important part in making a bioprosthetic valve and biological caffold. Many protocols and agents have been suggested for decellularization, yet there ave been few reports about the effect of a treatment with hypotonic solution prior to chemical or enzymatic treatment. This study investigated the effect of a treatment with hypotonic solution and the appropriate environments such as temperature, the treatment duration and the concentration of sodium dodecylsulfate (SDS) for achieving proper decellularization. Material and Method: Porcine aortic valves were decellularized with odium dodecylsulfate at various concentrations (0.25%, 0.5%), time durations (6, 12, 24 hours) and temperatures ($4^{\circ}C$, $20^{\circ}C$)(Group B). Same the number of porcine aortic valves (group A) was treated with hypotonic solution prior to SDS treatment at the same conditions. The duration of exposure to the hypotonic solution was 4, 7 and 14 hours and he temperature was $4^{\circ}C$ and $20^{\circ}C$, respectively. The degree of decellularization was analyzed by performing hematoxylin and eosin staining. Result: There were no differences in the degree of decellularization between the two concentrations (0.25% 0.5%) of SDS. Twenty four hours treatment with SDS revealed the best decellularization effect for both roups A and B at the temperature of $4^{\circ}C$, but there was no differences between the roups at $20^{\circ}C$. Treatment with hypotonic solution (group A) showed a better ecellularization effect at all the matched conditions. Fourteen hours treatment at $4^{\circ}C$ ith ypotonic solution prior to 80S treatment revealed the best decellularization effect. The treatment with hypotonic solution at $20^{\circ}C$ revealed a good decellularization effect, but his showed significant extracellular matrix destruction. Conclusion: The exposure of porcine heart valves to hypotonic solution prior to SDS treatment is highly effective for achieving decellularization. Osmotic treatment with hypotonic solution should be considered or achieving decellularization of porcine aortic valves. Further study should be carried out to see whether the treatment with hypotonic solution could reduce the exposure duration and concentration of chemical detergents, and also to evaluate how the structure of the extracellular matrix of the porcine valve is affected by the exposure to hypotonic solution.