• Radiation Oncology Journal
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• v.20 no.2
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• pp.123-129
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• 2002

Purpose : The purpose of this study 띤as to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Materials and Methods : Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from $36\~60\;Gy$ (median; 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at $4\~8$ weeks following the completion of treatment. The acute and subacute toxicities were monitored. Results : An objective response was observed in 11 out of 17 patients, giving a response rate of $64.7\%$. The actuarial survival rate at 2 years was $21.2\%$ from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 30-CRT were gastro-duodenitis $(\geq\;grade\;2)$ in 2 patients. There were no treatment related deaths and radiation induced hepatitis. Conclusion : The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.39-42
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• 2015

Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.96-101
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• 1996

Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behçet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocytoclastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.224-229
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• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.702-706
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• 2004

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.119-124
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• 1999

Right atrial metastasis occurs in 1 to 4% of patients with hepatoma, and the extension to intracavitary or metastasis of a tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographies findings. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating a massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.119-124
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• 2005

This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) and sclerotherapy of renal pelvis using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis. Experimental hydronephrosis was induced by unilateral ureter ligation for 20 days in five Beagle dogs. Renal artery embolization with iohexol-ethanol solution was performed using selective catheterization technique in the hydronephrotic kidney and sclerotherapy was done by injection of the iohexol-ethanol solution through percutaneously placed pig-tail catheter. EKG, $SpO_2$ body temperature, pulse, and respiratory rate were within normal ranges during procedures. Average pure ethanol dose for renal artery embolization was $1.1\pm0.3ml/kg$. Renal artery embolization was confirmed by the detection of no blood flow signal at the interlobar and arcuate artery using color Doppler ultrasonography. There were no dogs expired after TAE-RA and sclerotherapy and no side effects associated with regurgitation of iohexol-ethanol solution. The value of BUN, creatinine, ALT, AST, Ca, P in five dogs were within normal range during the experiment period. Ultrasonographically, the mean longitudinal and transverse length and the depth of the embolized kidney significantly decreased at 28 days after TAE-RA. We may conclude that TAE-RA and sclerotherapy with iohexol-ethanol solution is an effective methods for the treatment of unilateral hydronephrosis in dogs.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.535-539
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• 2021

Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9^th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16^th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.10a
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• pp.309-313
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• 2022

This study was attempted to analyze the status of emergency room use of severe trauma patients using the health insurance system and to understand their characteristics. This study used data from the 'Community-based Severe Trauma Surveillance' investigated from January 1, 2018 to December 31, 2019. As a result, there were differences in the degree of disability after injury and whether treatment(surgery, trauma embolism, transfusion) was performed according to the type of medical insurance (p< .001), it was found that there was a statistically significant difference between the degree of disability before and after damage depending on the type of medical insurance (p< .001). Reviews of the health insurance system located for the well-being of the people should be continued from various angles, and specific improvement plans should be proposed.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1216-1221
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• 2020

Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.