• The Journal of the Society of Stroke on Korean Medicine
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• v.18 no.1
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• pp.55-65
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• 2017

■ Objectives Atrial fibrillation is the most common cause of cardioembolic stroke. Of the 44 ischemic stroke patients with atrial fibrillation who were hospitalized in hospital of Korean Medicine from July 1, 2014 to June 30, 2017, we selected 39 patients who have had Magnetic Resonance Angiography. We divided them into Atrial Fibrillation group with no stenosis or less than 50% stenosis in the ipsilateral artery of the lesion and Artery to Artery Embolism group with more than 50% stenosis or occlusion in the ipsilateral artery of the lesion. ■ Methods Clinical characteristics, examination and evaluation tools were collected from the patient's electronic medical records. CHADS2, Initial National Institutes of Health Stroke Scale, 8-item Stroke Scale and Improved 8-item Stroke Scale Number were checked. ■ Results & Atrial Fibrillation group showed differences in age, brain lesion location, vascular lesion, Conclusion initial National Institutes of Health Stroke Scale, initial 8-item Stroke Scale and progress compared to Artery to Artery Embolism group.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.184-192
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• 2009

Purpose: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. Methods: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. Results: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was $84.53{\pm}66.92$ minutes, and the CTA-to-embolization time was $147.65{\pm}99.97$ minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. Conclusion: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.86-90
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• 2014

Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.384-388
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• 2001

A 51-year-old woman presented with sudden severe headache, vomiting, and right hemiparesis at first admission. Computed tomography(CT) scans revealed an hemorrhagic density at left basal ganglia. Preoperative cerebral angiography showed no vascular lesion. Under the diagnosis of hypertensive intracerebral hemorrhage(ICH), total extirpation of hematoma was done. The postoperative neurological condition improved gradually and discharged without any neurological sequelae. Two months later, she revisited with headache, vomiting and progressive right hemiparesis. CT scans at second admission showed an irregular rim enhanced mass with central low density with surrounding edema at the initial bleeding area. Repeated craniotomy was performed and the mass was partially removed. The histopathological diagnosis of the specimen was confirmed as glioblastoma. The authors report a glioblastoma, which occurred at initial ICH site and regarded as a brain abscess with literature review.

• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.89-89
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• 2002

Purpose： To report initial experience and evaluate feasibility of cervical carotid artery contrast-enhanced MR angiography (CEMRA) using whole body coil at 3.0T Method： Twenty-eight patients (14 male, ages 41-80, mean age 63) underwent CEMRA at the 3.0T using whole body coil and 3D-FSPGR (TR/TE 6.6/l.3 msec, FA 30, thickness 1.3mm), and thirty patients (17 male, ages 30-80, mean age 57) underwent CEMRA at the 1.5T using Helmholtz neck coil and 3D FLASH sequence (TR/TE 3.8/l.4msec, FA 35, thickness 1mm). At both 1.5 and 3.0T, a power injector (Spectris) injected 20m1 of gadolinium to the right or left antecubital vein at a rate of 3mL/s. All CEMRA cases were accepted by one neuroradiologiest. We measured the signal intensities at the bifurcation of common carotid artery (CCA), vertebral artery (V2) and two surrounding tissues (ST) and noise at the background in all patients, and also compared contras-to-noise ratios (CNR) of CCA/ST and V2/ST at 3.0 and 1.5T

• Journal of Chest Surgery
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• v.15 no.2
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• pp.254-258
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• 1982

We have experienced one case of Redo AVR which was performed 13 months after initial operation. The patient had received AVR [Bjork-Shiley disc valve] and MVR [Ionescu-Shiley tissue valve] because of ASI and MSI at March, 1981. During follow up through the OPD, he complained exertional dyspnea and progressive jaundice with hemolytic anemia was also noticed since 1 month prior to readmission. Cardiac catheterization and angiography revealed periaortic valvular leakage due to partial detachment of previously replaced prosthetic aortic valve. Re-replacement of prosthetic aortic valve with Ionescu-Shiley valve was performed and the patient was discharged at 17th POD without any complications.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.235-237
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• 2007

We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.251-253
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• 2012

We report a redo coronary artery bypass grafting (CABG) in a 55-year-old man. Angina recurred 7 years after the initial surgery. Coronary angiography showed all patent grafts except a faint visualization of the in situ right gastroepiploic artery (RGEA) graft, which was anastomosed to the posterior descending coronary artery, associated with celiac axis stenosis. Redo-CABG was performed at postoperative 10 years because of aggravated angina and decreased perfusion of the inferior wall in the myocardial single photon emission computed tomography. The saphenous vein graft was interposed between the 2 in situ grafts used previously; the right internal thoracic artery and RGEA grafts. Angina was relieved and myocardial perfusion was improved.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.98-98
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• 2003

We will present various MR findings of hyperacute ischemic stroke with our own experiences in the management of the patients according to the findings. 대상 및 방법： A total of 441 patients were underwent 'acute stroke MR' imaging protocol between Mar. 2001 and Jun. 2003. The protocol included initial T2-weighted image (WI), diffusion WI (DWI, b=2000), time-of-flight (TOF) MR angiography (MRA), and pefusion WI(PWI), and follow-up T2WI, DWI, TOF MRA, and neck vessel contrast-enhanced MRA obtained three to five days after the insult. Among them, we retrospectively reviewed the MR findings and clinical courses of 193 patients with anterior circulation territorial infarction. Those ICA and MCA lesions were divided into six and five groups respectively according to the level and mechanism of the occlusion. PWI findings can be another factor in the management planning.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.431-434
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• 2023

Severe blunt injuries to isolated solid abdominal viscera have been previously managed nonoperatively; however, management algorithms for simultaneous visceral injuries are less well defined. We report a polytrauma case of a 33-year-old man involved in a motorbike collision who presented with left-sided chest and abdominal pain. Initial imaging demonstrated multiple solid organ injuries with American Association for the Surgery of Trauma (AAST) grade V splenic injury and complete devascularization of the left kidney. The patient underwent urgent angioembolic coiling of the distal splenic artery with successful nonoperative management of simultaneous grade V solid organ injuries.