• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.246-250
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• 2019

Recently, there is a growing interest of hyperbaric oxygen therapy in many fields of medicine. We had a 43-year-old female patient presented with severe necrosis of the nose, philtrum, and upper lip due to retrograde arterial occlusion after nasolabial fold hyaluronic acid filler injection. Our patient went through 43 sessions of systemic hyperbaric oxygen therapy from December 2, 2017 to January 18, 2018. We administered 2.8 atmosphere absolute (ATA) for 135 minutes in the first session and the remaining sessions consisted of 2.0 ATA for 110 minutes. In reporting this case, we wish to provide a warning regarding the latent risk of filler injections and share our experience about minimizing soft tissue damage in the early stages with systemic hyperbaric oxygen therapy.

• Journal of Korean Neurosurgical Society
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• 제65권2호
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• pp.180-185
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• 2022

Objective : Drug-eluting stents and balloons are occasionally used to reduce restenosis in medically intractable intracranial atherosclerotic stenosis. The authors aimed to determine whether such drugs can cause neurotoxicity due to local effects in a rat model. Methods : Intra-arterial catheters were placed in the right common carotid artery of rats. Mannitol was injected to transiently open the brain-blood barrier (BBB), followed by high-dose drug (paclitaxel and rapamycin) injection. The optimal time interval of transient BBB opening for maximal drug penetration was determined to be 10 minutes. Paclitaxel and rapamycin were intra-arterially administered in various doses. All the rats were neurologically evaluated, and their brain tissues were histologically examined. Results : Neither neurological deficits nor histological abnormalities were observed in all the rats. Conclusion : Paclitaxel and rapamycin did not cause neurotoxicity in a rat model with transient BBB opening.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.199-202
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• 2009

We report the case of a 64-year-old man with dural arteriovenous fistula (DAVF) at right jugular foramen, presented as subarachnoid and intraventricular hemorrhage. The malformation was fed by only the neuromeningeal trunk of the right ascending pharyngeal artery and drained into the right lateral medullary veins craniopetally. Complete embolization was attained by selective transarterial glue injection, but patient showed lower cranial neuropathies. A 3-month follow-up angiogram still showed persistent fistula occlusion. Transarterial glue embolization is a feasible method, only if a transvenous access is not possible in case of single channel fistula.

• Asian-Australasian Journal of Animal Sciences
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• 제16권1호
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• pp.88-95
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• 2003

The objective of the present study was to determine the effect of exogenous bovine somatotropin on the mammary function in late lactating crossbred Holstein cows. Twelve 87.5% late lactating Holstein cows, approximately 30 weeks postpartum, were divided into two groups of 6 animals each. Animals in the control group were given sodium bicarbonate buffer by subcutaneous injection, while animals in the treated group were given recombinant bovine somatotropin (bST) by subcutaneous injection with 500 mg of bST (14 day prolonged-release bST). After bST injection, milk yield significantly increased from the control level on day 8 to day 20 (p<0.05) with a concomitant increase in mammary blood flow (p<0.01). An increase in mammary blood flow in response to bST treatment was greater than an increase in milk production. An increased plasma concentration of IGF-I coincided with an increase in mammary blood flow in animals treated with bST. There were no significant changes in the concentration of arterial plasma glucose concentration, the arteriovenous concentration difference (A-V difference) and mammary extraction ratio while the mammary glucose uptake increased when compared to the control group. The concentration of arterial plasma triglyceride decreased throughout the experimental period in animals give bST. The plasma concentration of acetate, and the mammary uptake for acetate significantly increased (p<0.05) after bST treatment. The action of bST did not affect the plasma concentration, A-V difference and extraction ratio across the mammary gland for $\beta$-hydroxybutyrate. The concentrations of milk fat and lactose tended to increase during bST treatment. Milk protein concentration initially increased in the first few days and decreased after bST injection when compared to the pretreated period. The present results indicated that bST could affect the mammary function in late lactating cows by increase in milk yield involving changes in both extra-mammary and intra-mammary mechanisms. The exogenous bST exerted its galactopoietic action through an increase in circulating IGF-I of the late lactating Crossbred Holstein cattle.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.251-255
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• 2013

We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.58-64
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• 2013

Alpha-fetoprotein-producing gastric cancer is associated with poor prognosis because of frequent liver and lymph node metastasis. We present a case with synchronous liver metastasis who survived for 5 years. A 69-year-old man with upper abdominal pain was referred to our hospital. Gastrointestinal endoscopy revealed a Borrmann II-like tumor in the lower part of the stomach. Computed tomography revealed a tumor in the left lobe of the liver. Serum alpha-fetoprotein levels were markedly increased. We performed distal gastrectomy after administering oral tegafur/gimeracil/oteracil potassium and administered hepatic intra-arterial cisplatin injection. Liver metastasis showed partial response on computed tomography. Despite left hepatic lobectomy, further metastases to the liver and mediastinal lymph nodes became difficult to control. After sorafenib tosylate administration, stabilization of the disease was observed for 4 months. We conclude that hepatic intra-arterial chemotherapy and oral administration of sorafenib tosylate may potentially improve the prognosis in such cases.

• 대한핵의학회지
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• 제20권2호
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• pp.61-71
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• 1986

An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.

• Clinical Pain
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• 제19권2호
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• pp.116-119
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• 2020

Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

• Korean Journal of Radiology
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• 제21권11호
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• pp.1230-1238
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• 2020

Objective: We aimed to assess the effects of remote ischemic pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy (CIN) after an intravenous (IV) or intra-arterial injection of contrast medium (CM) in patient and control groups. Materials and Methods: This prospective, randomized, single-blinded, controlled trial included 26 patients who were hospitalized for the evaluation of the feasibility of transcatheter aortic valve implantation and underwent investigations including contrast-enhanced computed tomography (CT), with Mehran risk scores greater than or equal to six. All the patients underwent four cycles of five minute-blood pressure cuff inflation followed by five minutes of total deflation. In the RIPC group (n = 13), the cuff was inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in the control group (n = 13), it was inflated to 10 mm Hg below the patient's SBP. The primary endpoint was the occurrence of CIN. Additionally, variation in the serum levels of cystatin C was assessed. Results: One case of CIN was observed in the control group, whereas no cases were detected in the RIPC group (p = 0.48, analysis of 25 patients). Mean creatinine values at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 88 ± 32 μmol/L, 91 ± 28 μmol/L and 82 ± 29 μmol/L, respectively (p = 0.73) in the RIPC group, whereas in the control group, they were 100 ± 36 μmol/L, 110 ± 36 μmol/L, and 105 ± 34 μmol/L, respectively (p = 0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18] mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p = 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13 [1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in the control group. Conclusion: The risk of CIN after an IV injection of CM is very low in patients with Mehran risk score greater than or equal to six and even in the patients who are unable to receive preventive hyperhydration. Hence, the Mehran risk score may not be an appropriate method for the estimation of the risk of CIN after IV CM injection.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.49-66
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• 2014

지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.