• Title/Summary/Keyword: Malformations

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Pediatric Cerebral Vascular Malformations : Current and Future Perspectives

  • Edward R. Smith
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.326-332
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    • 2024
  • Intracranial vascular malformations typically encountered by pediatric neurosurgeons include arteriovenous malformations, vein of Galen malformations and cavernous malformations. While these remain amongst some of the most challenging lesions faced by patients and caregivers, the past decade has produced marked advances in the understanding of the pathophysiology of these conditions, with concomitant innovations in treatment. This article will highlight present and future perspectives relevant to these diseases, with a focus on an emerging approach utilizing disease-specific mutations to develop a novel taxonomy for these conditions.

A Review of the Current State and Future Directions for Management of Scalp and Facial Vascular Malformations

  • Emma Hartman;Daniel M. Balkin;Alfred Pokmeng See
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.315-325
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    • 2024
  • Vascular malformations are structural abnormalities that are thought to result from errors in vasculogenesis and angiogenesis during embryogenesis. Vascular malformations of the scalp present unique management challenges due to aesthetic and functional implications. This review examines the pathophysiology, clinical presentation, and management techniques for six common types of vascular malformations of the face and scalp : infantile hemangioma, capillary malformations, venous malformations, lymphatic malformations, arteriovenous malformations, and arteriovenous fistulas. These lesions range from common to rare, and have very different natural histories and management paradigms. There has been increasing understanding of the molecular pathways that are altered in association with these vascular lesions and these molecular targets may represent novel strategies of treating lesions that have historically been approached from a structural perspective only.

Surgical treatement of complex cardiac malformations (복잡심기형의 외과적 치료)

  • 조형곤
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.122-133
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    • 1986
  • Thirteen patients with cyanotic cardiac malformations having more complex intracardiac defects, hemodynamics and operative procedures than ones in Tetralogy of Fallot undertaken total surgical corrections from July 1981 to August 1985. The cases of corrective surgery for complex cardiac malformations were 3.9% of all congenital cardiac malformations and 12.6% of cyanotic cardiac malformations. Six patients died within 30 days after surgery. So operative mortality was 46%; Transposition of the great arteries, two of 4 patients, due to low cardiac output syndrome and tracheal bleeding ; Univentricular heart, one of 3 patients, due to bleeding; Corrected transposition of the great arteries, one of 2 patients, due to acute heart failure; Tricuspid atresia, one of 2 patients, due to low cardiac output syndrome; Double outlet right ventricle, one of single patient, due to respiratory failure. The cases of surgical correction for complex cardiac malformations are progressively increasing in numbers. The more accurate evaluation of anatomical condition and hemodynamics in preoperative diagnosis, studies on applicable surgical procedure and perioperative care of patients are necessary in the improvement of clinical and surgical results.

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Congenital Intracranial Vascular Malformations in Children : Radiological Overview

  • Jung-Eun Cheon;Ji Hye Kim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.270-279
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    • 2024
  • Prompt medical attention is crucial for congenital intracranial vascular malformations in children and newborns due to potential severe outcomes. Imaging is pivotal for accurate identification, given the diverse risks and treatment strategies. This article aims to enhance the identification and understanding of congenital intracranial vascular abnormalities including arteriovenous malformation, arteriovenous fistula, cavernous malformation, capillary telangiectasia, developmental venous anomaly, and sinus pericranii in pediatric patients.

Pediatric Central Nervous System Vascular Malformation : Pathological Review with Diagram

  • Se Hoon Kim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.265-269
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    • 2024
  • Pediatric central nervous system (CNS) vascular malformations are a group of abnormal blood vessel formations within the brain or spinal cord in children. The most crucial point of pediatric CNS vascular malformation is that no golden standard classifications exist. In addition, there is a big gap in knowledge and the viewpoint of clinicians, radiologists, and pathologists. In addition, many genes associated with pediatric CNS vascular malformation, such as Sturge-Weber-Dimitri syndrome with guanine nucleotide-binding protein G(q) subunit alpha (GNAQ) gene mutation, and cavernous malformations with cerebral cavernous malformations 1 (CCM1), CCM2, and CCM3 gene mutation, were recently revealed. For proper therapeutic approaches, we must understand the lesions' characterizations in anatomical, morphological, and functional views. In this review, the author would like to provide basic pediatric CNS vascular malformation concepts with understandable diagrams. Thus, the author hopes that it might be helpful for the proper diagnosis and treatment of CNS pediatric vascular malformations.

Effects of Butylated Hydroxyanisole on Glutathione S-Transferases Activity and Cyclophosphamide-Induced Teratogenicity in Rats (랫드에서 Butylated Hydroxyanisole에 의한 Glutathione S-Transferases 유도 및 Cyclophosphamide로 유발된 기형에 대한 예방효과)

  • 강현구;이창희;이기창;이지은;김하정;최은경;윤영원;김윤배
    • Toxicological Research
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    • v.19 no.3
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    • pp.181-187
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    • 2003
  • Effects of repeated treatment with butylated hydroxyanisole (BHA) on the induction of glutathione S-transferases (GSTs) and teratogenicity of cyclophosphamide were investigated in rats. Pregnant rats were orally treated with BHA (50 mg/kg) for 7 days, from days 6 to 12 of gestation, and intraperitoneally challenged with cyclophosphamide (15 mg/kg) 2 hr after the final treatment. On day 20 of gestation, the maternal and fetal abnormalities were examined. Separately, a part of rats was sacrificed for the assay of hepatic and placental GSTs activities on day 12 of gestation following 7-day treatment with BHA. Cyclophosphamide, administered on day 12 of gestation, induced 43.2% of fetal death and resorption, and 100% of malformations in live fetuses, in contrast to low fetal resorption (8.7%) and malformations (8%) in control group. The malformations include cranial defect and exencephaly (100%), micrognathia and tongue extrusion (100%), limb defects (40%), renal pelvic dilatation (39%), and cleft palate (15%). Interestingly, BHA induced GSTs activities by 62% and 46% over the control in liver and placenta, respectively, and remarkably reduced the fetal resorption (13.9%) and malformations, resulting in 62% of cranial defect and exencephaly, 68% of micrognathia and tongue extrusion, 29% of limb defects, and 14% of renal pelvic dilatation. Taken together, it is suggested that a long-term pretreatment with BHA could substantially prevent fetuses from abortion and malformations following intrauterine exposure to teratogens including cyclophosphamide by inducing phase II antioxidant enzymes such as GSTs.

Intraosseous Arteriovenous Malformation in a Pediatric Patient - A Case Report - (소아 환아의 경골 내에 발생한 동정맥 기형 - 1예 보고 -)

  • Park, Soo-Sung;Lee, Jong-Seok;Yoon, Hyun-Ki;Chung, Ho-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.56-61
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    • 2008
  • More than half of the reported cases of congenital arteriovenous malformations involve the extremities. However, these are predominantly arteriovenous malformations of soft tissues. There are few studies on intraosseous arteriovenous malformations. The clinical features of vascular malformations are not well defined, but are likely to be extremely diverse. So, it is not easy to diagnose exactly and treat intraosseous arteriovenous malformations. The authors noted intraosseous arteriovenous malformation of tibia in a child and had a good result by the use of ethanol embolization. Therefore we include those results along with the literature review.

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Surgical Teatment of Congenital Cardiac Malformations in the Adult -A Report of 1389 Surical Cases- (성인에서의 서천성 심장기형의 외과적 치료)

  • Kyu
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.747-753
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    • 1995
  • Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

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Management of Pediatric Intracranial Arteriovenous Malformations

  • Alfred Pokmeng See;Edward R. Smith
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.289-298
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    • 2024
  • Pediatric intracranial arteriovenous malformations (AVMs) are challenging lesions managed by pediatric neurosurgeons. The high risk of hemorrhage and neurologic injury is compounded by the unique anatomy of each malformation that requires individualizing treatment options. This article reviews the current status of pediatric AVM epidemiology, pathophysiology and clinical care, with a specific focus on the rationale and methodology of surgical resection.