• Investigative Magnetic Resonance Imaging
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• v.21 no.4
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• pp.242-251
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• 2017

Purpose: To investigate the association of carotid intraplaque hemorrhage (IPH) with acute cerebral ischemic events and progression of stenosis using magnetic resonance (MR) imaging. Materials and Methods: From April 2014 to December 2016, 53 patients underwent carotid plaque MR imaging, including magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) sequence. A total of 66 carotid arteries in 53 patients had carotid stenosis, and they were included in this study. Carotid arteries were classified according to the presence of IPH, the age of hemorrhage, and degree of stenosis. We assessed ipsilateral cerebrovascular event rates and progression of stenosis between the IPH and no-IPH groups. Results: Of the 61 carotid arteries assessed, 34 (56%) had IPH, and 27 (44%) had no IPH. Acute cerebral ischemic events were more frequent in the IPH group (47% vs. 22%, P = 0.045), especially in the < 30%-stenosis group (100% vs. 0%, P = 0.028). However, there was no significant difference in the incidence of ischemic events according to the age of hemorrhage (50% vs. 44%, P = 0.492). Among the 61 carotid arteries, 20 carotid arteries had previously undergone carotid artery imaging and were evaluated for plaque progression. The trend for progression of stenosis favored the IPH group versus the no-IPH group, with a marginal P-value ($20%{\pm}12.7$ vs. $9.6%{\pm}5.7$, P = 0.063). Conclusion: IPH was associated with an increased incidence of acute ischemic events, especially in the mild-stenosis group and it was also associated with progression of stenosis. Evaluation of the carotid IPH by carotid plaque MR could improve discrimination of carotid plaques that cause ischemic events and progression of stenosis.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.125-135
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• 2020

Purpose : Obesity indices are major predictive markers for coronary artery stenosis, but there are few studies about the relationship between obesity indices and coronary artery stenosis in the Korean population. Therefore, we analyzed the association between obesity indices and coronary artery stenosis among health-screen examinees. Methods : This study included 99 males and females who visited a health-examination center. The obesity indices included body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), visceral adipose tissue/subcutaneous adipose tissue ratio (V/S ratio). All subjects had their degree of coronary artery stenosis measured using coronary computed tomography angiography (CCTA). A multiple logistic regression test was conducted to analyze the association between obesity indices and coronary artery stenosis. Results : This study was taken by multiple logistic regression test adjusted by age, sex, smoking status, frequency of alcohol drinking/week and frequency of exercise/week. The adjusted odds ratio for the presence of coronary artery stenosis for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥ 90 cm in males; ≥ 85 cm in females) was 6.263 (95 % confidence interval (CI) 1.974-19.869), for subjects with visceral obesity by visceral adipose tissue (visceral obesity defined as a visceral adipose tissue ≥ 100) was 11.430 (95 % CI 3.044-42.928). Conclusion : In this study of adults, WC and VAT were independent predictors of coronary artery stenosis. These results suggest that WC and VAT may be useful markers of coronary artery stenosis.

• Korean Journal of Bronchoesophagology
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• v.11 no.1
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• pp.10-14
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• 2005

Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

• Korean Journal of Radiology
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• v.24 no.8
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• pp.784-794
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• 2023

Objective: To determine whether dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) can be used to evaluate posterior cerebral circulation in pediatric patients with moyamoya disease (MMD) who underwent anterior revascularization. Materials and Methods: This study retrospectively included 73 patients with MMD who underwent DSC perfusion MRI (age, 12.2 ± 6.1 years) between January 2016 and December 2020, owing to recent-onset clinical symptoms during the follow-up period after completion of anterior revascularization. DSC perfusion images were analyzed using a dedicated software package (NordicICE; Nordic NeuroLab) for the middle cerebral artery (MCA), posterior cerebral artery (PCA), and posterior border zone between the two regions (PCA-MCA). Patients were divided into two groups; the PCA stenosis group included 30 patients with newly confirmed PCA involvement, while the no PCA stenosis group included 43 patients without PCA involvement. The relationship between DSC perfusion parameters and PCA stenosis, as well as the performance of the parameters in discriminating between groups, were analyzed. Results: In the PCA stenosis group, the mean follow-up duration was 5.3 years after anterior revascularization, and visual disturbances were a common symptom. Normalized cerebral blood volume was increased, and both the normalized time-topeak (nTTP) and mean transit time values were significantly delayed in the PCA stenosis group compared with those in the no PCA stenosis group in the PCA and PCA-MCA border zones. TTP_PCA (odds ratio [OR] = 6.745; 95% confidence interval [CI] = 2.665-17.074; P < 0.001) and CBV_PCA-MCA (OR = 1.567; 95% CI = 1.021-2.406; P = 0.040) were independently associated with PCA stenosis. TTP_PCA showed the highest receiver operating characteristic curve area in discriminating for PCA stenosis (0.895; 95% CI = 0.803-0.986). Conclusion: nTTP can be used to effectively diagnose PCA stenosis. Therefore, DSC perfusion MRI may be a valuable tool for monitoring PCA stenosis in patients with MMD.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.503-506
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• Journal of radiological science and technology
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• v.19 no.2
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• pp.45-49
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• 1996

To determine the utility of spiral computed tomography(CT) in the evaluation of carotid artery stenosis, spiral CT images of 10 patients were compared with both ones of conventional angiography and magnetic resonance(MR) angiography. The severeness of stenosis was determined for each Internal carotid artery on the basis of arterial narrowness : mild stenosis : 40 % or less, moderate stenosis = $40{\sim}70%$, severe stenosis = greater than 70 % of arterial narrowness. The short examination and clear depiction of the arterial lumen In areas of complex or low flow make CT angiography attractive alternative to MR angiography. Spiral CT angiography shows normal and abnormal carotid anatomy well when compared with conventional anglography.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.876-880
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• 1995

The optimal surgical approach to the patients with coronary artery disease combined with carotid artery stenosis is controversial. We report two cases of successful surgical management of the patients with combined obstructive coronary and carotid artery disease. The first case was a 69-year-old female who had unstable angina pectoris and a past medical history of left carotid endarterectomy. She was revealed to have triple vessel coronary disease and nearly total occlusion of right internal carotid artery. She was undergone staged right carotid endarterectomy 10 days before coronary bypass surgery. The second case, a 54-year-old male with a past medical history of left hemiparesis and dysarthria, was admitted due to unstable angina pectoris. He was revealed to have triple-vessel coronary disease and more than 90% stenosis of left internal carotid artery and 50% stenosis of right internal carotid artery. In the latter case, a combined coronary bypass surgery and left carotid endarterectomy was done. In both cases, postoperative neurologic complications were not observed.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.245-248
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• 2013

Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.710-714
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• 1987

Over the past 6 years, from July, 1981. through June, 1987., 14 consecutive patient with congenital aortic stenosis underwent corrective surgery in our department of Thoracic and Cardiovascular Surgery. The patient ranged in age from 1 to 20 years. There were 8 male and 6 female patients. According to the operative findings, stenotic site was valvular stenosis [5 cases], subvalvular stenosis [5 cases], supravalvular stenosis [2 cases], valvular and supra valvular stenosis [1 case]. We have performed valvotomy and commissurotomy [5 cases]. Resection of subvalvular membrane [3 cases], patch enlargement of Ascending aorta [2 cases], LV myotomy [2 cases], valvotomy and excision of membrane [1 case], patch enlargement of ascending aorta and valve ring [1 case]. There was one hospital mortality [7.1%]. He died of C-I bleeding and sepsis on the 25th postoperative day. All survivors showed improvement in NYHA functional class in the 160 patient/month follow up period.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.11-15
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• 2007

Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.