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1.
Neurointervention ; : 59-63, 2021.
Article in English | WPRIM | ID: wpr-875328

ABSTRACT

Purpose@#Three-dimensional (3D) measurement of intracranial aneurysms is important in planning endovascular treatment, and 3D rotational angiography (RA) is effective in accurate measurement. The purpose of this study was to evaluate the feasibility of low dose 3D RA (5 seconds 0.10 μGy/frame) in measuring an intracranial aneurysm using an in vitro phantom. @*Materials and Methods@#We investigated an in vitro 3D phantom of an intracranial aneurysm with 10 acquisitions of 3D RA with a conventional dose (5 seconds 0.36 μGy/frame) and 10 acquisitions with a low-dose (5 seconds 0.10 μGy/frame). 3D size and neck diameters of the aneurysm were measured and compared between the 2 groups (conventional and low-dose) using noninferiority statistics. @*Results@#The aneurysm measurements were well-correlated between the 2 readers, and noninferiority in the measurement of aneurysmal size of low-dose 3D RA was demonstrated, as the upper margin of the 1-sided 97.5% confidence interval did not cross the pre-defined noninferiority margin of 0.2 mm by the 2 readers. @*Conclusion@#Low-dose (5 seconds 0.10 μGy/frame) cerebral 3D RA is technically feasible and not inferior in in vitro 3D measurement of an intracranial aneurysm. Thus, low-dose 3D RA is promising and needs further evaluation for its clinical utility in the planning of endovascular treatment of an intracranial aneurysm.

2.
Article in English | WPRIM | ID: wpr-765301

ABSTRACT

OBJECTIVE: The purpose of this study was to compare the cosmetic outcome and complications after cranioplasty (CP) due to three different implant materials, and analyze the mean implant survival and cumulative survival rate based on these results. METHODS: We reviewed 108 patients retrospectively who underwent CP between January 2014 and November 2016. Autologous bone (AB; 45 patients) and synthetic materials with porous polyethylene (PP; 32 patients) and custom-made 3-dimensional printed titanium mesh (CT; 31 patients) were used as implants. RESULTS: Regardless of implanted materials, more than 89.8% of the CP patients were satisfied with the cosmetic outcome. No statistically significant difference was observed among the three groups. The overall postoperative complication rates of each group were 31.1% in the AB group, 15.6% in the PP group and 3.2% in the CT group. The CT group showed lower complication rates compared with AB and PP groups (χ2-test : AB vs. PP, p=0.34; AB vs. CT, p=0.00; PP vs. CT, p=0.03). The AB and PP groups demonstrated a higher post-CP infection rate (11.1% and 6.3%) than the CT group (3.2%). However, no significant difference in the incidence of post-CP infection was observed among the three groups. The PP and CT groups demonstrated a higher mean implant survival time and cumulative survival rate than the AB group at the last follow-up (p < 0.05). CONCLUSION: In comparison with AB and PP, cranioplasty with CT shows benefits in terms of lower post-CP complication, less intraoperative bleeding loss, shorter operation time and in-hospital stay. The PP and CT groups showed higher implant survival time and cumulative survival rate compared with the AB group.


Subject(s)
Bone Resorption , Follow-Up Studies , Hemorrhage , Humans , Incidence , Polyethylene , Postoperative Complications , Reconstructive Surgical Procedures , Retrospective Studies , Survival Rate , Titanium
3.
Article in English | WPRIM | ID: wpr-788731

ABSTRACT

OBJECTIVE: The purpose of this study was to compare the cosmetic outcome and complications after cranioplasty (CP) due to three different implant materials, and analyze the mean implant survival and cumulative survival rate based on these results.METHODS: We reviewed 108 patients retrospectively who underwent CP between January 2014 and November 2016. Autologous bone (AB; 45 patients) and synthetic materials with porous polyethylene (PP; 32 patients) and custom-made 3-dimensional printed titanium mesh (CT; 31 patients) were used as implants.RESULTS: Regardless of implanted materials, more than 89.8% of the CP patients were satisfied with the cosmetic outcome. No statistically significant difference was observed among the three groups. The overall postoperative complication rates of each group were 31.1% in the AB group, 15.6% in the PP group and 3.2% in the CT group. The CT group showed lower complication rates compared with AB and PP groups (χ2-test : AB vs. PP, p=0.34; AB vs. CT, p=0.00; PP vs. CT, p=0.03). The AB and PP groups demonstrated a higher post-CP infection rate (11.1% and 6.3%) than the CT group (3.2%). However, no significant difference in the incidence of post-CP infection was observed among the three groups. The PP and CT groups demonstrated a higher mean implant survival time and cumulative survival rate than the AB group at the last follow-up (p < 0.05).CONCLUSION: In comparison with AB and PP, cranioplasty with CT shows benefits in terms of lower post-CP complication, less intraoperative bleeding loss, shorter operation time and in-hospital stay. The PP and CT groups showed higher implant survival time and cumulative survival rate compared with the AB group.


Subject(s)
Bone Resorption , Follow-Up Studies , Hemorrhage , Humans , Incidence , Polyethylene , Postoperative Complications , Reconstructive Surgical Procedures , Retrospective Studies , Survival Rate , Titanium
4.
Article in English | WPRIM | ID: wpr-740030

ABSTRACT

PURPOSE: To evaluate the therapeutic effect of human embryonic stem cell (hESC)-derived multipotent mesenchymal stem cells (M-MSCs) on ketamine-induced cystitis (KC) in rats. METHODS: To induce KC, 10-week-old female rats were injected with 25-mg/kg ketamine hydrochloride twice weekly for 12 weeks. In the sham group, phosphate buffered saline (PBS) was injected instead of ketamine. One week after the final injection of ketamine, the indicated doses (0.25, 0.5, and 1×106 cells) of M-MSCs (KC+M-MSC group) or PBS vehicle (KC group) were directly injected into the bladder wall. One week after M-MSC injection, the therapeutic outcomes were evaluated via cystometry, histological analyses, and measurement of gene expression. Next, we compared the efficacy of M-MSCs at a low dose (1×105 cells) to that of an identical dose of adult bone marrow (BM)-derived MSCs. RESULTS: Rats in the KC group exhibited increased voiding frequency and reduced bladder capacity compared to rats of the sham group. However, these parameters recovered after transplantation of M-MSCs at all doses tested. KC bladders exhibited markedly increased mast cell infiltration, apoptosis, and tissue fibrosis. Administration of M-MSCs significantly reversed these characteristic histological alterations. Gene expression analyses indicated that several genes associated with tissue fibrosis were markedly upregulated in KC bladders. However the expression of these genes was significantly suppressed by the administration of M-MSCs. Importantly, M-MSCs ameliorated bladder deterioration in KC rats after injection of a low dose (1×105) of cells, at which point BM-derived MSCs did not substantially improve bladder function. CONCLUSIONS: This study demonstrates for the first time the therapeutic efficacy of hESC-derived M-MSCs on KC in rats. M-MSCs restored bladder function more effectively than did BM-derived MSCs, protecting against abnormal changes including mast cell infiltration, apoptosis and fibrotic damage.


Subject(s)
Adult , Animals , Apoptosis , Bone Marrow , Cystitis , Female , Fibrosis , Gene Expression , Human Embryonic Stem Cells , Humans , Ketamine , Mast Cells , Mesenchymal Stem Cells , Multipotent Stem Cells , Pelvic Pain , Rats , Urinary Bladder
5.
Article in Korean | WPRIM | ID: wpr-53855

ABSTRACT

No abstract available.


Subject(s)
Adenoma , Ear
7.
Article in Korean | WPRIM | ID: wpr-73821

ABSTRACT

A 64-year-old female presented with a 1-year history of livedo-like erythematous patches and plaques around the surgical scar on the left knee. Examinations revealed poorly demarcated, erythematous, indurated patches and plaques, with mild tenderness overlying the medial and inferior portion of the surgical scar. Histopathology revealed a mixed dermal infiltrate with glomeruloid intravascular accumulation of histiocytes and neutrophils. Histiocytes were identified by immunostaining for CD68. Immunostains for CD31 and D2-40 confirmed the intra-lymphatic location of the histiocytes. Recently, there have been several case reports of erythematous patches around the joints, which histopathologically show histiocytic aggregations in dermal vessels. Intra-lymphatic histiocytosis is a rare group of skin diseases characterized by the proliferation of histiocytes in the vessel lumen. Although the pathogenesis of intra-lymphatic histiocytosis is unknown, a role for lymphatic stasis secondary to chronic inflammation or surgery has been suggested. We present the case of a 64-year-old female who developed a tender rash on her left knee 1 year after orthopedic metal implants. To our knowledge, this is the first case of intra-lymphatic histiocytosis reported in association with a metal implant in the Korean dermatologic literature.


Subject(s)
Cicatrix , Exanthema , Female , Histiocytes , Histiocytosis , Humans , Inflammation , Joints , Knee , Middle Aged , Neutrophils , Orthopedics , Skin Diseases
8.
Article in Korean | WPRIM | ID: wpr-71361

ABSTRACT

BACKGROUND: Pityriasis lichenoides, an inflammatory skin condition of unknown etiology affecting both children and adults encompasses a clinical spectrum between pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). Although reported to follow a more self-limiting course in children compared with adults, there are a few studies comparing pityriasis lichenoides in both age groups in Korea. OBJECTIVE: The aim of this study was to evaluate the clinicopathological features, overall efficacy of treatments, and disease outcomes in children and adults diagnosed with pityriasis lichenoides. METHODS: This was a retrospective study of pityriasis lichenoides at our center between January 2003 and December 2013. Clinical manifestations and histopathological features of 54 patients with pityriasis lichenoides were analyzed. We also evaluated the clinical course in children and adults according to Gelmetti's classification. RESULTS: In this study, 36 patients were children (mean age 11.6 years, range 3approximately18 years) and 18 patients were adults (mean age 34.7 years, range 19approximately55 years). Lesions on the face were observed more commonly in children (n=18, 50%) compared with adults (n=1, 5.5%). Of the clinical features, vesiculation, crust and pigmentary changes were significantly more common in children than in adults. After treatment, 12 children (33.3%) and 10 adults (55.6%) went into complete remission. Histopathological features were not significantly different between children and adults. They just showed the difference between PLEVA and PLC. Dyskeratosis, epidermal necrosis, intraepidermal red blood cell (RBC) trapping, and RBC extravasati on in the dermis were more prominent in PLEVA than in PLC. By Gelmetti's classification, disease duration was longer in children with the peripheral type (38.5 months) than in children with the diffuse and central types. In adults, the diffuse type lasted longer (24.5 months) than the central and peripheral types. CONCLUSION: This study suggests that, compared with adults, pityriasis lichenoides in children is more likely to follow an unremitting course, with more facial/acral involvement and pigmentary changes and a poorer response to conventional treatment modalities. Applying the Gelmetti's classification, disease duration was longer in children with the peripheral type than other types. However, in adults, the duration was longer with the diffuse type.


Subject(s)
Adult , Child , Classification , Dermis , Erythrocytes , Humans , Korea , Necrosis , Pityriasis Lichenoides , Pityriasis , Retrospective Studies , Skin
9.
Article in Korean | WPRIM | ID: wpr-121651

ABSTRACT

A 9-year-old girl presented with a 2-year history of doughnut-shaped hair loss on the frontal scalp, resembling the symmetric distribution of Blaschko's lines. Physical examination showed an alopecic patch with mild scalp induration. Histopathology revealed lymphoplasmacytic infiltration of the perifollicular dermis and subcutaneous lobules with abundant mucin deposition, consistent with a diagnosis of lupus erythematosus panniculitis. Three cases of linear lupus erythematosus panniculitis of the scalp presenting as alopecia along Blaschko's lines have been documented in Korean dermatologic literature. However, there have been no reports of doughnut-shaped alopecia until now. Herein, we present an interesting case of a pediatric patient with a unique feature of doughnut-shaped alopecia along Blaschko's lines.


Subject(s)
Alopecia , Child , Dermis , Diagnosis , Female , Hair , Humans , Mucins , Panniculitis, Lupus Erythematosus , Physical Examination , Scalp
10.
Article in Korean | WPRIM | ID: wpr-84542

ABSTRACT

Epithelioid blue nevus is a rare variant of blue nevus that was first described in patients with Carney complex, a familial lentiginosis and multiorgan neoplasm (spotty cutaneous pigmentation, cutaneous/cardiac/mammary myxomas, endocrine overactivity, and psammomatous melanotic schwannomas). Epithelioid blue nevus is an intradermal melanocytic nevus composed of heavily pigmented globular and polygonal cells and lightly pigmented spindle and dendritic cells. Recently, cases of epithelioid blue nevi have been reported in patients without Carney complex. Herein, we describe a child who developed epithelioid blue nevus on her right foot without Carney complex symptoms and review the relevant literature.


Subject(s)
Carney Complex , Child , Dendritic Cells , Foot , Humans , Lentigo , Myxoma , Nevus, Blue , Nevus, Pigmented , Pigmentation
11.
Article in Korean | WPRIM | ID: wpr-124865

ABSTRACT

OBJECTIVES: This study investigated the clinical characteristics and functional magnetic resonance imaging (fMRI) findings of firefighters suffering from partial posttraumatic stress disorder (partial PTSD). They were treated by eye movement desensitization and reprocessing (EMDR) and the treatment effect was evaluated. METHODS: A total of 116 firefighters were screened and 15 of them were diagnosed as partial PTSD. 1) We compared sociodemographic and psychological characteristics between the firefighter partial PTSD group and the firefighter control group. 2) Subjects in the firefighter partial PTSD group (n=10), firefighter control group (n=8), and general control group (n=12) underwent fMRI with traumatic, negative, positive, and neutral picture stimuli. We compared clinical characteristics and fMRI findings among these three groups. 3) Seven firefighters in the partial PTSD group were treated by EMDR and the treatment effect was evaluated according to psychological scales. RESULTS: In fMRI analysis, there was a left middle temporal/occipital activation in the order of the general control group, firefighter control group, than the firefighter partial PTSD group for the Traumatic-Baseline contrast. For the Negative-Baseline contrast, there was an increased left middle temporal/occipital activation in the general control group versus decreased activation in the firefighter control group and the firefighter partial PTSD group. All firefighters in the partial PTSD group treated by EMDR showed significant improvement of Clinician-Administered PTSD Scale scores. CONCLUSION: These results show high incidence rate of partial PTSD in firefighters. In addition, partial PTSD firefighters exhibited distinct clinical characteristics and fMRI findings and showed significant improvement by EMDR treatment.


Subject(s)
Eye Movement Desensitization Reprocessing , Eye Movements , Firefighters , Humans , Incidence , Magnetic Resonance Imaging , Occipital Lobe , Stress Disorders, Post-Traumatic , Temporal Lobe , Weights and Measures
12.
Article in Korean | WPRIM | ID: wpr-122330

ABSTRACT

Hypereosinophilic syndrome is a multisystem disorder with unexplained persistent eosinophilia and marked preference for systemic organ involvement. More than half of all patients have cutaneous involvement, usually presenting as angioedema, urticarial lesions, and eczematous, pruriginous papules. Hypereosinophilic syndrome presenting with generalized cutaneous blisters is rare, and we report the findings of a patient who was successfully treated with interferon-alpha.


Subject(s)
Angioedema , Blister , Eosinophilia , Humans , Hypereosinophilic Syndrome , Interferon-alpha
13.
Article in Korean | WPRIM | ID: wpr-167124

ABSTRACT

Circumscribed acral hypokeratosis (CAH) is a rare disorder characterized by a well-circumscribed and erythematous depressed patch on the palm or sole. It usually presents as an asymptomatic, solitary, long-standing lesion in middle-aged to elderly women. Histologically, it has a characteristic stair-like configuration between normal and involved skin with an abrupt thinning of the horny layer and a decreased granular layer. Although the pathogenesis of CAH is not well established, several hypotheses were proposed. To our knowledge, there have been only two cases to document HPV in a single lesion of CAH. Herein, we report the third case of circumscribed acral hypokeratosis with expression of human papillomavirus, high-risk type 16, 18.


Subject(s)
Aged , Female , Humans , Skin
14.
Article in Korean | WPRIM | ID: wpr-177706

ABSTRACT

Lichen amyloidosis is composed of firm, yellowish to brownish papules, usually found on the pretibial area. Amyloidosis of the auricular concha is a rare variant of primary cutaneous amyloidosis, presenting papules or plaques localized to the ear. Histopathologically, it is characterized by hyperkeratosis, acanthosis and deposition of eosinophilic materials in the papillary dermis similar to the presentation of lichen amyloidosis. Herein, We report a case of lichen amyloidosis occurring on the auricular concha of a 48-year-old Korean woman, presented with a 3-years history of asymptomatic monomorphous papules on her both ears.


Subject(s)
Amyloidosis , Dermis , Ear , Eosinophils , Female , Humans , Lichens , Middle Aged
15.
Article in Korean | WPRIM | ID: wpr-177989

ABSTRACT

Histiocytoid Sweet syndrome (HSS) is a rare inflammatory disease that has recently been described as a variant of Sweet syndrome. Histopathologically, HSS is characterized by papillary dermal edema with infiltration of histiocytoid cells into the upper dermis. The histiocytoid cells are easily misinterpreted as histiocyte, but in fact, they are immature myeloid cells. To demonstrate cells of myeloid lineage, specific staining must be performed, such as myeloperoxidase (MPO). To date, there are several HSS cases associated with hematological malignancy, drugs, and chronic inflammatory diseases. But, in Korea, only one case has been reported so far. Herein, we report a case of HSS developed in the patient with pure white cell aplasia and review the relevant literature.


Subject(s)
Dermis , Edema , Hematologic Neoplasms , Histiocytes , Humans , Korea , Myeloid Cells , Peroxidase , Sweet Syndrome
16.
Annals of Coloproctology ; : 248-251, 2013.
Article in English | WPRIM | ID: wpr-42224

ABSTRACT

PURPOSE: We aimed to examine the effect of gum chewing after laparoscopic colorectal cancer surgery. METHODS: We reviewed the medical records of patients who underwent laparoscopic colorectal cancer surgery in Incheon St. Mary's Hospital, The Catholic University of Korea School of Medicine. We divided the patients into 2 groups: group A consisted of 67 patients who did not chew gum; group B consisted of 65 patients who chewed gum. We analyzed the short-term clinical outcomes between the two groups to evaluate the effect of gum chewing. RESULTS: The first passage of gas was slightly earlier in group B, but the difference was not significant. However, the length of hospital stay was 6.7 days in group B, which was significantly shorter than that in group A (7.3 days, P = 0.018). CONCLUSION: This study showed that length of postoperative hospital stay was shorter in the gum-chewing group. In future studies, we expect to elucidate the effect of gum chewing on the postoperative recovery more clearly.


Subject(s)
Chewing Gum , Colorectal Neoplasms , Gingiva , Humans , Korea , Laparoscopy , Length of Stay , Mastication , Medical Records
17.
Article in Korean | WPRIM | ID: wpr-222671

ABSTRACT

Laparoscopic surgery is popular and widely accepted method for colorectal cancer today. Especially in rectal cancer, laparoscopic TME made surgery safe and feasible with good outcome. But there are still some limits and difficulties in resection and anastomosis of low rectal cancer. We combined laparoscopic TME and posterior approach. Surgery was performed in three low rectal cancer patients. They were prepared in supine position and laparoscopic TME to pelvic floor muscles was performed. After changing the patient to Jack-knife position, post-anal median incision (between the external sphincter and coccyx) and distal rectal resection was done. Through this surgical window, proximal stump was retrieved and resected with the safety margin, and anastomosis with leak test was performed. After a drain keeping, patient's position was changed back to supine again and laparoscopic irrigation and inspection of operation field was done finally. In the course of recovery, two patients were uneventful, but the rest with FAP experienced postoperative anastomotic leakage and got perineal resection and permanent ileostomy. According to our experience, posterior approach after laparoscopic TME permit right angle resection of distal rectum which is difficult in laparoscopic transabdominal approach. In addition, manual anastomosis with various instruments, Lembert suture, easy drain keeping, accurate fibrin glue apply can also be achieved. No incision on abdomen adds cosmetic advantage. But frequent position changes, need of patience-demanding intracorporeal mesenteric dissection to anastomotic site, and wound discomfort during sitting position right after the operation remain as challenges to consider and solve.


Subject(s)
Abdomen , Anastomotic Leak , Colorectal Neoplasms , Cosmetics , Fibrin Tissue Adhesive , Humans , Ileostomy , Imidazoles , Laparoscopy , Muscles , Nitro Compounds , Pelvic Floor , Rectal Neoplasms , Rectum , Supine Position , Sutures
18.
Article in Korean | WPRIM | ID: wpr-202815

ABSTRACT

Background : Preoperative radiochemotherapy (RCT) has been administered for locally advanced rectal cancer to increase the therapeutic benefits, and to preserve the sphincter in low-lying tumors, however, tumor responses after RCT are variable. Methods : Apoptotic index (AI), and expressions of Ki-67, p53 and bcl-2 were analyzed in pretreatment biopsies from 69 patients with rectal cancer by immunohistochemistry. Tumor response was graded in surgically resected specimens by using a three-scale grading system: no response (NR), partial remission (PR) and complete remission (CR). Results : CR was identified in 19 cases (28%), PR in 24 cases (35%), and NR in 26 cases (38%) of 69 cases. p53 protein was expressed in 49 cases (71%), whereas bcl-2 was in 42 cases (61%). The pretreatment Ki-67 labeling index was 65.4+/-3.4%. The tumor response was not associated with any of these markers. Tumors with CR/PR showed a higher AI (0.84+/-.84%/0.66+/-.52%) than that of tumors with NR (0.58+/-0.54%). There was a significant correlation between tumor response and the histologic differentiation (p=0.008) or recurrence (p=0.039). Conclusions : The AI revealed a tendency to increase in tumors with CR/PR, while expressions of p53 and bcl-2, and Ki-67 labeling index had little direct association with tumor response.


Subject(s)
Apoptosis , Biopsy , Chemoradiotherapy , Humans , Immunohistochemistry , Rectal Neoplasms , Recurrence
19.
Article in Korean | WPRIM | ID: wpr-166799

ABSTRACT

Multiple carcinoid tumors in stomach are very rare tumors and associated with pernicious anemia, chronic atrophic gastritis and Zollinger-Ellison syndrome. These are believed to be due to hypergastrinemia, resulting in chronic stimulation of enterochromaffine-like (ECL) cells, leading to hyperplasia, metaplasia and ultimately neoplasia. The carcinoid tumor is potentially malignant, even though it may grow slowly, so the treatment of choice must be endoscopic lumpectomy or surgical gastrectomy. The prognosis depends on the site of the tumor and its size. Most carcinoid tumors are less than 1 cm in size and metastasis is uncommon but metastasis in tumors with size over 2 cm is common. A case of multiple carcinoid tumors in stomach, which was successfully removed by endoscopy, is herein reported.


Subject(s)
Anemia, Pernicious , Carcinoid Tumor , Endoscopy , Gastrectomy , Gastrins , Gastritis, Atrophic , Hyperplasia , Mastectomy, Segmental , Metaplasia , Neoplasm Metastasis , Prognosis , Stomach , Zollinger-Ellison Syndrome
20.
Article in Korean | WPRIM | ID: wpr-218551

ABSTRACT

Laminar flow within large vessels or organs can cause artifact that may simulate thrombus during computed tomographic study. The degree of venous enhancement depends on the size of blood pool and cardiac output in relation to the time of scanning. When venous structures are scanned too fast after injection of contrast material, poor mixing of enhanced and unenhanced blood creates flow artifact that gives an appearance of deep venous thrombosis. As compared with dynamic computed tomography (CT), because of a shorter acquisition time of spiral CT, vascular and organ enhancement on spiral CT scan are more dependent on factor that affect delivery of contrast material into the blood stream. Differentiation from true thrombus can be made by use of delayed scan as well as increased density and finding of relatively poor margination of artifact. In addition, both angiography and echocardiography could complement CT to assure that false-positive results are minimized. We experienced a case of artifact mistaken for intracardiac mass on spiral CT, but it was not noted on echocardiography.


Subject(s)
Angiography , Artifacts , Cardiac Output , Complement System Proteins , Echocardiography , Heart Neoplasms , Rivers , Thrombosis , Tomography, Spiral Computed , Venous Thrombosis
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