• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.197-206
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• 2021

Subarachnoid hemorrhage (SAH) is a disease that causes bleeding in the subarachnoid space; 70%-80% of nontraumatic subarachnoid hemorrhages are caused by saccular aneurysms. If the patient has already experienced a ruptured aneurysm that causes subarachnoid bleeding, rebleeding can result in a high mortality rate and serious sequelae. Therefore, if the patient can undergo surgical or interventional treatment, it should always be performed. This patient was diagnosed with acute aneurysmal subarachnoid hemorrhage and hydrocephalus. The patient was hospitalized for uncontrolled headache and vertigo after aneurysm coil embolization and ventriculoperitoneal shunting. The patient was treated with Yangkyuksanwha-tang and acupuncture and was observed with a symptom checklist for 25 days. Headache improved, from a visual analog scale (VAS) score of 7 to 0. Vertigo also improved, from a numeric rating scale (NRS) of 6 to 2, and the vertigo pattern changed from rotational to nonrotational. This case suggests that Korean medicine treatment is helpful in managing subarachnoid hemorrhage sequelae.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.513-516
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• 2021

An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV⁶ Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

• Journal of Audiology & Otology
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• v.23 no.1
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• pp.49-52
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• 2019

Background and Objectives: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. Subjects and Methods: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. Results: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. Conclusions: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.49-52
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• 2019

Background and Objectives: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. Subjects and Methods: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. Results: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. Conclusions: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.769-773
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• 2010

Systemic hypotension has been traditionally used to facilitate deployment of thoracic stent grafts. Decreasing blood pressure with vasodilating agents further increases cardiac output and, consequently, the cardiac output-mediated windsock effect during deployment. Use of rapid ventricular pacing reduces the windsock effect during stent graft deployment and allows the graft to appose to the aortic wall under zero cardiac output, thus minimizing aortic wall shear stress. In this case we report the use of transvenous rapid ventricular pacing, a safe and reproducible technique to allow precise deployment of a Valiant Captivia stent graft in the distal thoracic arch for a saccular thoracic aneurysm.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.764-768
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• 2010

Phlebectasia of the venous system of the upper limb is very rare and it does not have a well-defined etiology. Phlebectasia means isolated fusiform or saccular dilatation of the venous system and isolated phlebectasia of the forearm may present as a painless cosmetic deformity or it may cause pain, decreased range of movement, compression on adjacent structures, bleeding, thrombosis and consumptive coagulopathy. We report here on a case of isolated phlebectasia of the forearm and we briefly review the relevant literature.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.257-261
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• 2011

Objective : Successful coil embolization of anterior communicating (A-com) artery aneurysms requires good visualization and understanding of the entire H complex. Bilateral carotid angiography may optimize anatomical understanding and visualization of the H complex. We therefore assessed the efficacy of simultaneous bilateral internal carotid angiography during coil embolization for A-com artery aneurysms. Methods : Of the 153 patients with intracranial saccular aneurysms who underwent embolization between July 2008 and December 2009, 12 had A-com artery aneurysms and were embolized under bilateral carotid angiography. Patients were evaluated angiographically, immediately and 6 months (n=11) after embolization, using a 3-point scale (complete, residual neck, residual aneurysm). The safety, performance and efficacy of this approach were retrospectively evaluated. Results: In all patients, bilateral internal carotid artery angiography provided more detailed anatomical information and understanding around the A-com artery, and, in complex situations, it allowed for more effective coil embolization through bilateral routes to the A-com artery. Angiography immediately after embolization showed occlusion of 11 of the 12 (92%) aneurysms, with none of these 11 showing evidence of recanalization at 6 months. Conclusion : These findings indicate that simultaneous bilateral carotid angiography during coil embolization of selected complex A-com artery aneurysms provided improved anatomical understanding, and resulted in more effective and safer procedures than typical unilateral angiography.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.74-78
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• 2006

Objective : We examined the incidence of fenestration in the proximal segment of the anterior cerebral artery[ACA] and reviewed its clinical significance. Methods : Cerebral angiography was performed in 843 patients and magnetic resonance angiography[MRA] in 1,787; all patients had, or were suspected to have, cerebrovascular disease. We subsequently reviewed the angiography and MRA data. Results : Fourteen patients [six men and eight women, $35{\sim}81$ years of age, median age = 67 years] had proximal ACA fenestrations. Three of the 843 patients [0.36%] undergoing cerebral angiography had fenestrations of proximal ACA as did eleven of the 1,787 MRA patients [0.62%]. Seven fenestrations were located on the right side and seven fenestrations were located on the left side. The fenestrated ACA in one patient was associated with a saccular aneurysm at its proximal end. None of the 120 patients who underwent both conventional cerebral angiography and cranial MRA showed fenestration of proximal ACA. Conclusion : Although fenestration of ACA has little clinical significance, knowledge and recognition of this condition is important in the interpretation of cerebral images, especially during neurosurgical procedures.

• Parasites, Hosts and Diseases
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• v.49 no.4
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• pp.449-455
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• 2011

We detected metacercariae of Echinostoma revolutum in Filopaludina sp. snails purchased from a local market in Nam Dinh Province for the first time in Vietnam. Adult flukes were harvested from experimentally infected hamsters at days 14 and 17 post-infection. The metacercariae were round, $170-190{\mu}m$ (n=15) in diameter, with a cyst wall thickness of about $12{\mu}m$. A total of 37 collar spines were arranged around the head collar, and large excretory granules were seen in 2 canals of the excretory bladder. The 14-day old adult flukes were elongated, ventrally curved, and $5.0-7.2{\times}0.8-1.3mm$ (n=20). The head collar had a total of 37 collar spines arranged in 2 alternating rows, including 5 corner spines on each side. The cirrus sac contained a saccular seminal vesicle, a prostatic gland, and an unarmed cirrus. Two tandem testes were smooth or slightly lobed. Eggs were ovoid to elliptical, $110-118{\times}70-75{\mu}m$. These morphological characters were similar to those of E. revolutum and E. jurini. We tentatively identified it as E. revolutum because the validity of E. jurini remains to be elucidated. The taxonomic relationship of E. revolutum and E. jurini is discussed.

• Parasites, Hosts and Diseases
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• v.55 no.5
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• pp.541-548
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• 2017

A survey was performed to know the infection status of echinostome metacercariae in Cipangopaludina chinensis malleata snails from Korea. Total 75 snails collected in 5 localities, i.e., Imsil-gun, Jeollabuk-do, Hwasun-gun and Shinan-gun (Aphae and Jido), Jeollanam-do, and Jinju-si, Gyeongsangnam-do, were examined for metacercariae by the artificial digestion method. Infection rates of metacercariae were 80.0%, 66.7%, 100%, 60.0%, and 73.3%, and their densities were 39, 32, 183, 19, and 30 per snail infected, respectively. The metacercariae were round, $105-118{\times}105-118{\mu}m$ in size, with a thin cyst wall, collar spines on the head collar, and excretory granules in 2 canals of excretory tube. Adult flukes were elongated, ventrally curved, and $5,167{\times}939{\mu}m$ in average size. Head collar distinct, bearing 45 collar spines with 5 end groups on each side. Oral sucker subterminal, pharynx well developed, and esophagus somewhat short. Cirrus sac well developed, with a saccular seminal vesicle, and ventral sucker very large. Ovary elliptical and on the median line of the body. Testes tandem and slightly lobed. Eggs operculated, elliptical, and $90-103{\times}55-60{\mu}m$ in size. By scanning electron microscopy, the head collar was prominent with 45 collar spines resembling horns of younger stags. Scale-like tegumental spines were densely distributed on the body surface between the head collar and ventral sucker. Conclusively, it has been first confirmed that the life cycle of E. macrorchis is indigenously maintained in Korea, and C. chinensis malleata snails are popularly infected with the metacercariae of this echinostome.