• Title/Summary/Keyword: Intractable

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Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings

  • Cho, Sungsoo;Kang, Tae Soo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.121-126
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    • 2018
  • Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.

Cryptographic Protocols using Semidirect Products of Finite Groups

  • Lanel, G.H.J.;Jinasena, T.M.K.K.;Welihinda, B.A.K.
    • International Journal of Computer Science & Network Security
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    • v.21 no.8
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    • pp.17-27
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    • 2021
  • Non-abelian group based cryptosystems are a latest research inspiration, since they offer better security due to their non-abelian properties. In this paper, we propose a novel approach to non-abelian group based public-key cryptographic protocols using semidirect products of finite groups. An intractable problem of determining automorphisms and generating elements of a group is introduced as the underlying mathematical problem for the suggested protocols. Then, we show that the difficult problem of determining paths and cycles of Cayley graphs including Hamiltonian paths and cycles could be reduced to this intractable problem. The applicability of Hamiltonian paths, and in fact any random path in Cayley graphs in the above cryptographic schemes and an application of the same concept to two previous cryptographic protocols based on a Generalized Discrete Logarithm Problem is discussed. Moreover, an alternative method of improving the security is also presented.

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

A Case of Intractable Tracheitis Treated by Heat-Moisture Exchangers in a Total Laryngectomized Patient (열가습 여과기로 치료한 후두전적출 환자의 난치성 기관염 1예)

  • Koo, Beom Mo;Moon, Seong Kyu;Kim, Seung Woo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.87-91
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    • 2020
  • The tracheostomy directs external air into the airway tract. This process causes mucosal dryness, irritation and inflammation in the tracheo-bronchial tree. In order to prevent such problems, several methods are applied; ointment application, humidification and careful suction etc. The heat-moisture exchanger (HME) is commercially sold device that assists heating and humidification of the inhaled air. The authors experienced successful treatment outcome of intractable tracheitis caused by repetitive and vigorous intra-tracheal suction by applying HME in a total laryngectomized patient. We report an interesting and didactic case with a brief literature review.

Negative-Pressure Wound Therapy for Septic Ankle Arthritis Following Intractable Lateral Malleolar Bursitis: A Case Report (족관절 화농성 관절염이 동반된 난치성 외과 점액낭염의 음압 창상치료: 증례 보고)

  • Kim, Jiyoun;Jang, Jihoon;Chung, So Hak
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.190-194
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    • 2021
  • A bursa is an obstructive sac filled with synovial fluid and usually occurs in any area of the body exposed to friction. The bursa of the ankle is not a normal anatomical structure and is caused by repetitive trauma, constant friction, or inflammatory disease of the ankle. Bursitis can occur in any bursa in the human body; however it rarely progresses to septic arthritis. We report a rare case of septic ankle arthritis following intractable lateral malleolar bursitis successfully treated with negative-pressure wound therapy.

Involvement of TGF-β1 Signaling in Cardiomyocyte Differentiation from P19CL6 Cells

  • Lim, Joong-Yeon;Kim, Won Ho;Kim, Joon;Park, Sang Ick
    • Molecules and Cells
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    • v.24 no.3
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    • pp.431-436
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    • 2007
  • Stem cell-based therapy is being considered as an alternative treatment for cardiomyopathy. Hence understanding the basic molecular mechanisms of cardiomyocyte differentiation is important. Besides BMP or Wnt family proteins, $TGF-{\beta}$ family members are thought to play a role in cardiac development and differentiation. Although $TGF-{\beta}$ has been reported to induce cardiac differentiation in embryonic stem cells, the differential role of $TGF-{\beta}$ isoforms has not been elucidated. In this study, employing the DMSO-induced cardiomyocyte differentiation system using P19CL6 mouse embryonic teratocarcinoma stem cells, we investigated the $TGF-{\beta}$-induced signaling pathway in cardiomyocyte differentiation. $TGF-{\beta}1$, but not the other two isoforms of $TGF-{\beta}$, was induced at the mRNA and protein level at an early stage of differentiation, and Smad2 phosphorylation increased in parallel with $TGF-{\beta}1$ induction. Inhibition of $TGF-{\beta}1$ activity with $TGF-{\beta}1$-specific neutralizing antibody reduced cell cycle arrest as well as expression of the CDK inhibitor $p21^{WAF1}$. The antibody also inhibited induction of the cardiac transcription factor Nkx2.5. Taken together, these results suggest that $TGF-{\beta}1$ is involved in cardiomyocyte differentiation by regulating cell cycle progression and cardiac gene expression in an autocrine or paracrine manner.

The Outcome of Corpus Callosotomy for Intractable Epilepsy : 10 Years Experience of Corpus Callosotomy

  • Seo, Jeong-Suk;Lee, Jong-Ju;Lee, Jung-Kyo;Kang, Jung-Gu;Lee, Sang-Am;Ko, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.16-19
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    • 2006
  • Objective : The purpose of this study is to evaluate the effect of the corpus callosotomy and to elucidate possible prognostic factors. Methods : The cases of 39 patients who underwent corpus callosotomy were reviewed retrospectively. Clinical outcomes were analyzed using Engel's classification, with consideration of various presurgical conditions and the extent of the callosal resection during follow-up more than one year. Results : Satisfactory outcome [Engel's class I, II] was obtained in 20 patients [51%] of 39 patients. In 36 cases with drop attack seizures, the class I, II outcomes were 22 patients [61%]. When the patients were grouped according to the extent of callosal resection, the class I, II outcomes were 50% of the patients with anterior 1/2 or 2/3, 50% of those with anterior 4/5 callosotomy, and 57% of those with total callosotomy, respectively. The mean follow-up period was 34 months [24 to 58 months]. Conclusion : Although it is not statistically significant, the patients who had underwent total callosotomy show better outcomes than those with partial callosotomy. Corpus callosotomy is efficacious in controlling medically intractable epilepsy in appropriately selected patients.