• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1029-1034
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• 2009

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15-year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.86-91
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• 2002

A bronchial artery aneurysm(BAA) is rare, and has an unclear etiology. However, it may be caused by congenital abnormalities and acquired diseases like as bronchiectasis, tuberculosis, and other infections. The pathogenesis of a bronchial artery dilatation and the formation of an aneurysm results in an increase in the systemic blood flow to the chronic inflammatory pathologic lungs such as bronchiectasis or tuberculosis. It can be divided into the mediastinal and intrapulmonary BAA according to their location. The most common symptom is hemoptysis. Chest computed tomography and bronchial artery angiography may be used for a diagnosis. Treatment is mainly by a surgical resection of the aneurysmal artery. However, when patient is unstable due to massive hemoptysis or recurrent hemoptysis, bronchial artery embolization is useful. Here, we experienced a case of a bronchial artery aneurysm presenting as a massive hemoptysis.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.102-107
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• 2017

Purpose: Coronary arterial lesions (CALs) were reported to have developed in children with systemic inflammatory diseases, as well as those with Kawasaki disease (KD). The purpose of this study was to confirm that the CAL development in children with KD occurs in a mouse model of sepsis presenting typical systemic inflammatory response syndrome (SIRS). Methods: To induce the sepsis mouse model with SIRS, 6-week-old C57BL/6 mice were intraperitoneally injected with endotoxin. We compared histological findings of the major organs between the control and the sepsis groups and examined CAL in the heart of the septic mice. Results: Infiltrating inflammatory cells were relatively increased in the heart, liver, and kidneys of the sepsis group, compared with those of the control group. We confirmed lymphocytic infiltration in the myocardium (myocarditis) and the pericardial soft tissue of the heart. Furthermore, coronary artery of the septic mouse was identified, but CAL was not observed. Conclusions: In this study, we failed to confirm the existence of CAL in a mouse model of sepsis. However, it is well-known that CALs are seen in many kinds of diseases that cause SIRS. Our findings suggest further investigation into the clinical significance of CAL in various systemic inflammatory diseases, including KD.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.96-104
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• 1995

The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1418-1425
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• 2022

Elderly patients with a history of chronic alcoholism presented to our hospital with episodes of melena, abdominal pain, and anemia. During admission, hemorrhagic cystic lesion at the pancreas was observed on abdominal CT. Transcatheter angiography confirmed active bleeding foci and arterial embolization was performed. After the procedure, the bleeding was resolved. The authors report two cases of hemosuccus pancreaticus and pancreaticocolic fistula associated with pancreatitis, a rare cause of gastrointestinal bleeding, treated with vascular intervention.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.826-837
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• 2021

Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1296-1307
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• 1997

Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.265-269
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• 2000

Traumatic aneurysm is a rare complication of head trauma. Unfortunately, it is rarely recognized until their presence is heralded by delayed deterioration or intracranial hematoma, etc,. Early diagnosis and surgical treatment are most important for good outcome. We recently encountered a patient who developed a pericallosal aneurysm after major trauma. With a high index of suspicion about traumatic aneurysm, brain MRI and MRA were performed. Definitive diagnosis was made by transfemoral carotid angiography, revealing a aneurysm of the right proximal pericallosal artery. The aneurysm was explored through right interhemispheric approch. A $15{\times}15mm$ sized traumatic aneurysmal sac, located in proximal portion of right pericallosal artery was noted. It was dissected from the falx of cerebri and its neck was clipped. The postoperative course was uneventful. Traumatic intracranial aneurysm should be suspected in any patient who deteriorates after the trauma. Early recognition and prompt treatment are warranted in this setting. Definitive surgical treatment of all traumatic intracranial aneurysm is recommended.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1038-1043
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• 2009

Two adolescent cases of Fitz-Hugh-Curtis syndrome, which has not been previously reported in Korean girls, presenting with right upper-quadrant abdominal pain, nausea, vomiting, and fever are reported here. A careful and thorough inquiry into the sexual history of the first patient, which was not done upon admission, led to a careful reassessment of the dynamic abdominal computed tomography scan revealing hepatic capsular enhancement without evidence of gallbladder or liver disease. Both cases were diagnosed noninvasively and were treated successfully by medical intervention. A high index of suspicion of Fitz-Hugh-Curtis syndrome should be implemented in the differential diagnosis of right upper quadrant pain, particularly in sexually active girls, for a prompt diagnosis and rapid cure.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1048-1051
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• 2002

Toxic shock syndrome(TSS) is clinically similar to Kawasaki disease(KD) in that both of them are characterized by fever, desquamating rash and mucous membrane erythema. In contrast the main feature of TSS is hypotension, whereas the complication of KD is coronary vasculitis. We report an 8-year-old boy who fulfilled the crireria for TSS and KD. Initially he showed clinical features of TSS, so he was treated with intravenous antibiotics and supportive management. But the fever sustained, and the coronary aneurysm that is the main complication of Kawasaki disease was shown by echocardiogram on Day 14. He was treated with intravenous immunoglobulin twice and the fever subsided and general condition was improved.