• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.1
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• pp.371-375
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• 2019

The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) in hemodynamically unstable pancreatic trauma is unclear. We report here a case of traumatic pancreatic bleeding controlled with REBOA and angioembolization of the splenic artery before surgery. A 65-year old man experienced blunt trauma upon falling from a height of 20 m. Computed tomography (CT) revealed distal pancreatic trauma (grade III) and contrast extravasation around the splenic artery. Shortly after CT, his systolic blood pressure was 60 mmHg and REBOA was performed for hemodynamic stability. His systolic pressure increased to 130 mmHg after balloon inflation and angioembolization of the splenic artery was performed. On angiography, no further arterial bleeding was identified and the balloon was removed. Subsequently, the patient underwent emergent laparotomy with distal pancreatectomy. There was no active bleeding during surgery and distal main pancreatic duct injury was identified. After surgery, the patient recovered without complication. In this case, hemodynamically unstable hemorrhagic pancreatic trauma was treated effectively and safely with distal pancreatectomy after REBOA with angioembolization.

• Progress in Medical Physics
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• v.10 no.2
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• pp.89-94
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• 1999

We developed a sterotactic radiosurgery system which is comprised of 1) collimators with small circular aperture, 2) an angiographic target localizer, 3) a target localizer used for alignment of planned target position with isocenter of treatment machine, and 4) a treatment planning system named LinaPel. In this study, we performed a series of treatment simulations to specify and analyze geometrical errors contained our in-house radiosurgery system. As results, 1) using Geometrical Phantom(Radionics,USA), the accuracy of target localization by LinaPel was determined as Avg. =(equation omitted) the accuracy of mechanical isocenter was found out to be 0.6 $\pm$ 0.2 mm, 3) the positional difference of target localization which determined by CT and angiography was 0.8 mm, and their size difference was 1.5 mm, and 4) the positional error during whole treatment was found out to be 0.9 $\pm$ 0.3 mm. With these results, we concluded that our in-house radiosurgery system can be used clinically. However, these range of accuracies need periodical quality assurance strongly.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.735-745
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• 1994

The incidence data (1991. 7. 1$\sim$1992. 6. 30) from the Implementation Study of Seoul Cancer Registry (ISSCR) were evaluated in terms of its completeness and validity. Two indicators for the completeness, Mortality/Incidence ratio (M/I ratio) and Age-specific Incidence Curve, showed fairy good registration throughout the age-sex specific strata, except the strata aged over 75 years old. The strata had very high M/I ratio (over 100%) and decreasing pattern of incidence, which suggested incomplete registration of cancer in this group. The active surveillance by a ISSCR staff improved the registration rate especially among elderlies. From the site specific M/I ratio, we found that liver cancer had oddly high M/I ratio. Since this high M/I ratio of liver cancer appears consistently in other reliable cancer registries, it is more like to be due to the high fatality of it rather than incomplete registration. The validity of the incidence data was assessed by three indicators; Histological Verification (HV%), Primary Site Unknown (PSU%), and Age Unknown (Age UNK%). The average HV% were 77% for men and 85% for women, which were slightly lower than those of other reliable cancer registries. This low HV% might be due to the considerable size of relative frequency of liver cancer in Korea, regarding the fact that the diagnosis of liver cancer is made mostly by non-biopsical radiologic methods (CT, Ultrasono, Angiography, MRI etc.). The level of PSU% and Age UNK% were in acceptable range, but not low enough, especially in terms of Age UNK%. Although ISSCR data had acceptable quality in general, it is needed to have more hospitals participate in the registry surveillance, to make registery data merged with death certificate data regulary, and educate the registration stans to be more competent and dedicated.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.144-148
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• 2015

Purpose: Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture isn't an easy task. There have been many trials finding indicators of embolization for patients with pelvic bone fracture. Although Young and Burgess classification is useful in decision making of treatment, it is reported to have little value as indicator of embolization in major trauma patients. The aim of this study is to find out Young and burgess classification on predicting vessel injury by analzyng pelvic radiograph taken from major trauma patients with pelvic bone fracture. Methods: Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 200 patients were found with pelvic bone fracture in trauma series and thus pelvic CT angiography was taken. Setting aside patients with exclusion criteria, 153 patients were enrolled in this study for analysis of Young and Burgess classification. Results: The most common mechanism of injury was lateral compression in both groups. There was no statistical significant difference in Young and Burgess classification (p=0.397). The obturator artery was the most commonly injured artery in both groups. Six patients had more than one site of bleeding. Conclusion: Prediction of transcatheter angiographic embolization using Young and Burgess classification in severe trauma patients is difficult and requires additional studies.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.139-144
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• 2010

Objective : We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department. Methods : We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients. Results : Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues : by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures. Conclusion : The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.

• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.729-738
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• 2000

Objective : We examined patients admitted to Dong Eui University Oriental Medical Hospital from 1st January to 31st December in 2000. We studied 110 cases of patients who were diagnosed as Brain stem(pons, mid brain, medullar) infarction with brain CT, MRI scan, MR Angiography. Methods : We analyzed patients into sex, age, onset time, invasion lesion, past and family history, risk factor, abnormal vital sign for early 2 weeks, prodromal symptoms, symptoms at entry, progress and incidental symptoms at acute stage, complications, the state of condition at discharge, demonstrations, herb medications, western and oriental medical cooperation and admission period. Results : Our study was similar to existing studies in the distribution of sex, age, past and family history and risk factors. But there was some differences in the prodromal symptoms, symptoms at entry progress and incidental symptoms at acute stage, and the state of condition at discharge. Conclusions : Our study shows the brain stem infarction patients differed from other cerebrovascular accident patients in the symptoms. We hoped that our study would be further studied in western and oriental medicine.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.99-104
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• 2001

We present two cases of deep cerebral venous thrombosis(DCVT) with the totally occluded straight sinus. A 42-year-old female received with altered mentality . She has taken antihistamine for six years to treat the paranasal sinusitis. Another 34-year-old female who used the oral contraceptive for 11 months presented with acute behavior change . Both of these patients were diagnosed by computed tomography(CT), magnetic resonance(MR) imaging, and cerebral angiography. They were fully recovered with systemic urokinase thrombolysis followed by heparin therapy. We report that the intravenous thrombolysis was potentially effective management strategy in our cases of DCVT with the totally occluded straight sinus.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.527-530
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• 2014

Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.

• Journal of The Korea Institute of Healthcare Architecture
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• v.12 no.3
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• pp.27-34
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• 2006

Planning for the space of the Media Medical Department requires the details about the efficiency of the equipment and the operation in professional sector. For that, as designing, it is necessary to keep communicating with the experts on the technology and the officials from the company producing the equipment. One of the common concerns is not only how to insure enough room for the future extension and the upgrade of the equipment, as concerning the scale of the hospital, but the plan to cover movie cameras. As technology has been developed, despite the fact that machinery tend to be small, it can be possible to require continuously about the concerns of the scale because the camera taking body-picture tend to be much bigger and more complicated than before. Currently used diagnostic media techniques are divided by the method and the feature of the equipment such as Diagnostic X-ray, Ultrasound, CT, MRI, Angiography. The general and special photographing units which are used more than the other diagnostic parts, must be planned not for experiencing any inconvenience and unnecessary risks for the patients and must accept technical requirements. Also, it must be designed not to be seen as a clinic zone, as concerning the psychological stability of the patients. However, study of the general and special photographing units among the domestic general hospitals is insufficient. Also, as there is shortage of the material considering the development of the equipment, when planning, it's involving a lot of difficulties. Thus, this study has got a purpose on giving the basic material which is essential for further study, as suggesting the planning guidelines and the alternative plans for the general and special photographing units in a general hospital.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.181-189
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• 1988

Insulinoma is the most frequent endocrine tumor of the pancreas and the first of the endocrine-secreting tumor of the gut to be recognized by Nicholls in 1902. Recurrent episodes of hypoglycemia is the main cause of the symptoms and signs which were sweating, pallor, dizziness, habitual change, convulsion and coma. In 1935, Whipple and Frants were described so-called "Whipple's triad" : the patient's symptoms occur with fasting or exercise; at the time of symptoms, the serum glucose in 50mg/dl or less; and the symptoms are relieved by the administration of glucose. While these criteria were timely, they proved to be rather nonspecific and may be found in other conditions that result in fasting hypoglycemia. We experienced a 44-year-old female patient who had repeated attacks of convulsion, unconsciousness and coma for 3 years. Although she has been treated with anticonvulsant, the symptoms and signs were not disappeared. At the time of administration, she was a full coma state due to hypoglycemia and was dramatically reversed by intravenous administration of the glucose solution. The preoperative test such as provocative test, abdominal CT and celiac angiography revealed insulinoma and after enucleation the pathologic diagnosis was the same. We like to report a adult female patient with insulinoma and the review of literatures briefly.