• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.206-211
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• 2022

Stenosis of the central veins is a common complication in hemodialysis patients. However, cerebral venous hypertension and neurological symptoms caused by central vein stenosis are relatively rare. We present a rare case of cerebral venous hypertension in a 63-year-old male who showed venous reflux into the dural sinuses due to central venous stenosis on time-of-flight MR angiography. After management for central venous stenosis, the venous reflux disappeared.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.318-324
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• 1992

Acquired tracheobronchial stenosis has resulted from vehicular accidents, prolonged tracheal intubation, sleeve resection, tuberculosis and sarcodosis. Various modalities of therapy for the relief of such stenosis included surgery, cryotherapy, laser photoresection, and sometimes balloon dilatation. Several recent reports have described the use of self-expandable metal stents for the dilatation of stenotic areas in the tracheobronchial tree. Three patients of benign acquired tracheobronchial stenosis were treated with self-expandable metal stents, who had shown little response to several times of balloon dilatations; One patient had a tracheal stenosis caused by intubation, one a right main bronchial stenosis developed after reconstructive surgery of traumatic bronchial rupture, and the other a left main bronchial stenosis caused by longstanding endobronchial tuberculosis. We found that the using stent in benign acquired tracheobronchial stenosis can be effectively performed with alleviation of clinical symptoms and lung function. And even in longstanding localized stenosis of main bronchus without distal bronchial destruction, lung perfusion also improved.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.1-10
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• 1977

Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.427-435
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• 2009

We surveyed 586 patients who had been examined CCTA. Out of those patients, 299 (52%) has stenosis of coronary arteries; 166 males (28%) and 133 females (23%). Among them 246 stenosis patients (82.6%) are in 50's to 70's. The number of patients with 50% or more stenosis in more than 1 coronary artery is 299 including 43 males (33.9%) in their 60's and 39 females (37.5%) in their 70's. When a vessel score is higher than 2 points, 70 patients (50.1%) among 139 have 70% or more stenosis; 32 males (39.5%) in their 60's and 27 females (46.6%) in their 70's. It is noted that 14 patients in their 70's show more cases compared to other ages up to 2 or even 5 times when a vessel score is 3 points. LAD shows 77.6% of stenosis, LCX 47.5% and RCA 60.5%. Frequency of a triple vessel disease is high for patients in their 70's; 15 males (36.6%) and 13 females (56.5%) for both. 196 people (33.4%) in the group with stenosis have calcification, while only 40 (6.8%) in the group without stenosis have it. It means that calcification has a significant, if not absolute, correlation with stenosis of coronary arteries.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.761-768
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• 2001

Objective : To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed Materials & Method : Twenty-eight patients(male, 15 ; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with $SPSS^{(R)}$ was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. Result : Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). Conclusion : Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.65-71
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• 2015

Objective : Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods : Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results : Twenty-five patients were included. The mean preoperative VAS score was $6.6{\pm}1.6$ and $4.6{\pm}3.1$ for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, $1.32{\pm}1.2$) and the back (VAS score, $1.75{\pm}1.73$) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively ($6.60{\pm}6.5$; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion : Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.499-503
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• 1995

Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.284-294
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• 2001

Objective : Stroke is leading cause of death and more importantly it is cause of serious disability. The effective treatment of acute ischemic stroke still remains a challenge to modern medicine. Recent clinical trials have shown that carotid endareterctomy(CEA) provide overwhelming benefits compared with medical therapy in preventing subsequent stroke for symptomatic carotid stenosis. For the asymptomatic ones, the data are less compelling, but highly suggestive that CEA do have benefits in properly selected patients. Materials and Methods : To investigate the clinical manifestations of carotid stenosis and results of CEAs, authors analyzed retrospectively 19 CEAs in 16 patients from June 1986 to June 1999. Age of patients ranged from 55 to 76 years(median, 66) and male to female ratio was 14 to 2. The duration of follow-up was 1 to 144 months (median, 26). All of CEAs were done on the side of stenosis more than 80% and bilateral CEAs were done in three. Six CEAs were performed in asymptomatic patients. Results : Seventeen of 19 CEAs showed excellent results and complication rate was low although ipsilateral ischemic stroke occurred in two. Conclusion : CEA may be a valuable surgical treatment for ischemic stroke caused by carotid stenosis and also for prevention of stroke of asymptomatic patients with carotid stenosis.

• Advances in pediatric surgery
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• v.7 no.1
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• pp.54-58
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• 2001

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.156-161
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• 1995

Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.