• 제목/요약/키워드: Seoul National University Hospital

검색결과 7,282건 처리시간 0.045초

Characteristics and Treatment Outcome of Intracranial Aneurysms in Children and Adolescents

  • Nam, Sun Mo;Jang, Donghwan;Wang, Kyu-Chang;Kim, Seung-Ki;Phi, Ji Hoon;Lee, Ji Yeoun;Cho, Won-Sang;Kim, Jeong Eun;Kang, Hyun-Seung
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.551-560
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    • 2019
  • Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.

Trapping and A4-A4 end-to-side anastomosis for the treatment of a ruptured A3 fusiform aneurysm: Potential risk of in-situ bypass

  • Young Rak Kim;Sung Ho Lee;Jin Woo Bae;Young Hoon Choi;Eun Jin Ha;Kang Min Kim;Won-Sang Cho;Hyun-Seung Kang;Jeong Eun Kim
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권1호
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    • pp.62-68
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    • 2023
  • The treatment of complicated anterior cerebral artery aneurysms remains challenging. Here, the authors describe a case of ruptured complicated A3 aneurysm, which was treated with trapping and in-situ bypass. A 47-year-old man presented to the emergency department with severe headache and vomiting. Computed tomography illustrated acute intracerebral hemorrhage in the right frontal lobe. Digital subtraction angiography (DSA) confirmed a ruptured fusiform A3 aneurysm with lobulation and a daughter sac. Trapping of the ruptured fusiform A3 aneurysm and distal end-to-side A4 anastomosis was performed. DSA on postoperative day 7 showed mild vasospasm to the afferent artery. However, 2 months later, DSA demonstrated that the antegrade flow through the anastomosis site had recovered. Thus, surgeons should be aware of the possibility of postsurgical vasospasm of anastomosed arteries, especially in cases of ruptured aneurysms.

Two Cases of Unresectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgical Resection

  • Huh, Gunn;Chun, Jung Won;You, Min Su;Paik, Woo Hyun;Lee, Sang Hyub;Kim, Yong-Tae;Ryu, Ji Kon
    • Journal of Digestive Cancer Research
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    • 제7권2호
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    • pp.61-64
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    • 2019
  • We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.

Successful Surgical Treatment of Cardiac Complication of Graves Disease

  • Min, Jooncheol;Kim, Woong-Han;Jang, Woo Sung;Choi, Eun Seok;Cho, Sungkyu;Choi, Kwang Ho
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.294-297
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    • 2014
  • Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.

The Prevalence of Cerebral Microbleeds in Non-Demented Parkinson's Disease Patients

  • Kim, Kyeong Joon;Bae, Yun Jung;Kim, Jong-Min;Kim, Beom Joon;Oh, Eung Seok;Yun, Ji Young;Kim, Ji Seon;Kim, Han-Joon
    • Journal of Korean Medical Science
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    • 제33권46호
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    • pp.289.1-289.10
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    • 2018
  • Background: Cerebral microbleeds (CMBs) are associated with cerebrovascular risk factors and cognitive dysfunction among patients with Parkinson's disease (PD). However, whether CMBs themselves are associated with PD is to be elucidated. Methods: We analyzed the presence of CMBs using 3-Tesla brain magnetic resonance imaging in non-demented patients with PD and in age-, sex-, and hypertension-matched control subjects. PD patients were classified according to their motor subtypes: tremor-dominant, intermediate, and postural instability-gait disturbance (PIGD). Other cerebrovascular risk factors and small vessel disease (SVD) burdens were also evaluated. Results: Two-hundred and five patients with PD and 205 control subjects were included. The prevalence of CMBs was higher in PD patients than in controls (16.1% vs. 8.8%; odds ratio [OR], 2.126; P = 0.019); CMBs in the lobar area showed a significant difference between PD patients and controls (11.7% vs. 5.9%; OR, 2.234; P = 0.032). According to the motor subtype, CMBs in those with PIGD type showed significant difference from controls with respect to the overall brain area (21.1% vs. 8.9%; OR, 2.759; P = 0.010) and lobar area (14.6% vs. 4.9%; OR, 3.336; P = 0.016). Among PD patients, those with CMBs had higher age and more evidence of SVDs than those without CMBs. Conclusion: We found that CMBs are more frequent in PD patients than in controls, especially in those with the PIGD subtype and CMBs on the lobar area. Further study investigating the pathogenetic significance of CMBs is required.

전자간호기록에 사용된 간호과정 완성도 분석 - 위절제술 환자를 중심으로 - (Evaluation on the Record Completeness of the Nursing Process in Electronic Nursing Record for Patients Undertaken Gastrectomy)

  • 박인숙;유정숙;이순형;우경선;주영희;최완희;강현숙;정미라;김희진;박미옥;이수희;안선영
    • 임상간호연구
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    • 제15권3호
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    • pp.107-116
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    • 2009
  • Purpose: This study was conducted to evaluate the record completeness of the nursing process in the Electronic Nursing Record(ENR) in a university hospital. Methods: We compared nursing statements documented in 2004 with those from the year 2007, given the fact that the ENR system had been utilized since 2004. The ENRs of 35 gastrectomy patients in each year were selected for evaluation. The selected data were 11,822 nursing statements in 2004 and 27,870 in 2007. Results: The number of nursing records which documented the whole nursing process completely was 4,010 (48.3%) in 2007, whereas 513 (5.9%) in 2004 (p<.001). The number of incomplete records in 2004 was 8,142 (94.1%), while 4,300 (51.7%) in 2007 (p<.001). The number of nursing diagnoses was 846 in 2004 and 4,313 in 2007, which increased in number more than 5 times. The most frequently used diagnoses were 'pain', 'risk for infection' and 'risk for ileus' in both years. Conclusion: There was a significant increase in the record completeness on nursing process in 2007 compared to the records in 2004. The reasons for this increase are attributed to nurse training for encouraging to complete recording and nursing record auditing.