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Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm

  • Cho, Jae Ik;Cho, Jae Hoon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.496-499
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    • 2014
  • Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

Isolated pulmonary cryptococcosis in an immunocompetent boy

  • Bauer, Siegfried;Kim, Ji-Eun;La, Kyong-Suk;Yoo, Young;Lee, Kee-Hyoung;Park, Sang-Hee;Choung, Ji-Tae;Kim, Chul-Whan
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.971-974
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    • 2010
  • Pulmonary cryptococcosis is rare in immunocompetent subjects. Here, we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.

Free jejunal graft for replacement of cervical esophagus (유리 장 이식편을 이용한 식도 재건)

  • Lee, Hong-Seop;Lee, In-Seong;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.775-779
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    • 1984
  • Reconstruction of the pharynx and cervical esophagus is a difficult surgical problem. A successful case of reconstruction of cervical esophagus by free jejunal graft upon a 23-year-old female who had stricture in the pharynx and cervical esophagus after ingestion of hydrochloric acid is presented. This procedure was done after the primary traditional reconstruction with right sided colon had resulted in restenosis due to necrosis of the cervical portion of the graft. A proximal jejunal segment, about 12 cm in length was isolated for free graft preserving its vascular arcade. Both superior thyroid artery and vein were anastomosed to the graft vessels in end to end by continuous suture of 8-0 monophil. Nylon. The postoperative course was uneventful. The patient has been followed for 4 months after operation and she can eat every kind of food without dysphagia. We think free jejunal graft offers an excellent and safe method of reconstructing cervical esophagus and pharynx with definitive advantages over other traditional techniques.

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MATHEMATICAL UNDERSTANDING OF CONSCIOUSNESS AND UNCONCIOUSNESS

  • LEE, NAMI;KIM, EUN YOUNG;SHIN, CHANGSOO
    • Journal of the Korean Society for Industrial and Applied Mathematics
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    • v.21 no.2
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    • pp.75-79
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    • 2017
  • This paper approaches the subject of consciousness and unconsciousness from a mathematical point of view. It sets up a hypothesis that when unconscious state becomes conscious state, high density energy is released. We argue that the process of transformation of unconsciousness into consciousness can be expressed using the infinite recursive Heaviside step function. We claim that differentiation of the potential of unconsciousness with respect to time is the process of being conscious in a world where only time exists, since the thinking process never have any concrete space. We try to attribute our unconsciousness to a special solution of the multi-dimensional advection partial differential equation which can be represented by the finite recursive Heaviside step function. Mathematical language explains how the infinitive neural process is perceived and understood by consciousness in a definitive time.

Contralateral Juxtafacet Cyst Development after the Spontaneous Resolution of a Previous Facet Cyst

  • Kim, Hyeun Sung;Ju, Chang Il;Kim, Seok Won;Kim, Sung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.563-565
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    • 2015
  • Juxtafacet cysts are implicated in neural compression. Thus far, it is known that surgical removal is the definitive treatment for symptomatic juxtafacet cyst because spontaneous regression is rare, and the failure rate of conservative treatment is high. We have reported a rare case of right-sided juxtafacet cyst development after the spontaneous resolution of contralateral left-sided facet cyst. The left-sided facet cyst resolved spontaneously without surgical treatment, but a juxtacyst developed on the contralateral facet on the right side, as illustrated on 4-year follow-up magnetic resonance images. To the best of our knowledge, this is the first report of newly developed contralateral juxtafacet cyst after spontaneous regression. Herein, we have discussed the natural history and the management of this rare case.

Clinical Features in 9 Dogs with Immune-Mediated Polyarthritis

  • Lim, Seula;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.434-436
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    • 2017
  • Nine dogs with history of lameness and anorexia were presented. On physical examination, all dogs had gait abnormality and six dogs had high body temperature. Their clinical signs were mostly episodic, and only non-specific symptoms were occasionally observed. Arthrocentesis was performed in all dogs, and immune-mediated polyarthritis (IMPA) was diagnosed. Definitive rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) were diagnosed in one dogs, one each. Prednisolone (PDS) was chosen as the first-line therapy for all dogs, except for the one with RA. Most cases responded to PDS but some cases including those of SLE and RA were refractory to PDS. IMPA can be challenging to diagnose due to its vague symptom and is commonly implicated in 'fever of unknown origin'. Therefore, clinicians should consider IMPA as a differential diagnosis when the patient has fever with systemic, non-specific signs, such as anorexia and depression, but does not respond to antibiotics.

Bilateral Osteoarthritis of Coxofemoral Joint in a Thoroughbred Horse

  • Jeong, Hyohoon
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.247-249
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    • 2018
  • A 3-year-old black Thoroughbred colt weighing 500 kg was admitted to the Equine Hospital of Korea Racing Authority (KRA) due to the chronic gait abnormality of the hindlimbs. The history revealed that the patient had run and fallen onto the fence of the farm about at the age of 1 year old and the lameness had been worsening insidiously since the accident. The degree of lameness was 2/5 in accordance with the AAEP lameness grading system in both hindlimbs at hand walking and trot. The lameness was exacerbated at lunging clockwise and counterclockwise on both hindlimbs. The definitive diagnosis of the bilateral osteoarthritis of coxofemoral joint was established using radiography under general inhalation anesthesia. The prognosis was considered to be poor with low expectancy for racing and the colt was expelled from the racecourse eventually. The clinicians are required to consider the possibility of osteoarthritis of coxofemoral joint presented with chronic hindlimb lameness although it is rare. This is the first report on the bilateral osteoarthritis coxofemoral joint in Republic of Korea.

Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta in Neurotrauma: Three Cases

  • Kim, Dong Hun;Chang, Ye Rim;Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.175-180
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

Positioning of Resuscitative Endovascular Balloon Occlusion of the Aorta Catheter: A Case of an Elderly Patient with Concomitant Chest and Pelvic Injury after Blunt Trauma

  • Noh, Dongsub;Yun, Jeongseok;Chang, Ye Rim
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.186-190
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as a resuscitative adjunct for trauma patients with life-threatening non-compressible torso hemorrhage. By blocking the aorta temporarily with an inflated balloon, REBOA preserves cerebral and coronary perfusion while diminishing exsanguination below the balloon, thereby providing time for resuscitation and definitive bleeding control. When determining the occlusion zone during the REBOA procedure, factors such tortuosity of the aorta, co-occurring minor chest injuries, and the severity of shock must be considered, as well as the main injury site. This paper describes a case of high Zone I REBOA in an elderly patient with a tortuous aorta who had concomitant injuries of the chest and pelvis.

Less is more: role of additional chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal cancer management

  • Ahn, Yong Chan
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.67-72
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    • 2019
  • Concurrent chemoradiation therapy (CCRT) has played the most important and central role in the definitive therapy for the patients with locoregionally advanced stage nasopharynx cancer. The addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) to CCRT have been widely accepted with the rationale of improving distant control in the clinical practices. This review article investigated the role of IC and AC based on 11 recent meta-analysis publications, and found that the clinical benefits obtained by the additional IC or AC to CCRT, at the cost of the increased risks of more frequent and more severe side effects, seemed not big enough. More intervention is not always better, however, less seems frequently good enough. The author would speculate that 'less is more' and would advocate CCRT alone as the current standard.