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Leriche Syndrome -A case report- (Leriche 증후군 1예)

  • Lee, Won-Jong;Kim, Hong-Jin;Shim, Min-Chul;Song, Sun-Kyo;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.319-323
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    • 1986
  • Leriche syndrome is a chronic disorder mostly in male and is a specific symptom complex due to thrombotic obliteration of the aortic bifurcation as result of a atherosclerotic change. The symptoms include 1) extreme liability to fatigu of both lower limbs; 2) symmetric atrophy of both lower limbs; 3) pallor of the legs and feets; 4) inability to maintain stable erection. There are several methods for surgical management of this disorder; 1) thromboendarterectomy with or without sympathectomy; 2) aortoiliac bypass graft; 3) aortofemoral bypass graft. Here we report a case of Leriche syndrome which was successfully managed with arotobifemoral bypass graft with Dacron and reviewed literatures on it briefly.

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Treatment for Giant Fusiform Aneurysm Located in the Cavernous Segment of the Internal Carotid Artery Using the Pipeline Embolization Device

  • Oh, Se-Yang;Kim, Myeong Jin;Kim, Bum-Soo;Shin, Yong Sam
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.32-35
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    • 2014
  • The pipeline embolization device (PED) is a new endovascular device for treatment of complex, fusiform and wide-neck intracranial aneurysms. The main mechanism of this stent is to divert the flow in the parent artery with reduction of inflow in the aneurysm leading to thrombosis. We treated a 40-year-old woman who had left facial pain and orbit discomfort. Angiography showed a giant fusiform aneurysm located in the cavernous segment of the left internal carotid artery. A PED was successfully deployed across the aneurysm. The procedure and post-procedural course were uneventful. After 3 months, angiography showed complete obliteration of the aneurysm with good patency of the branching vessels originating from the deployed segment. The patient's symptoms improved completely without complications.

Glue Embolization of Ruptured Anterior Thalamoperforating Artery Aneurysm in Patient with Both Internal Carotid Arteries Occlusion

  • Lee, Jae-Il;Choi, Chang-Hwa;Ko, Jun-Kyeung;Lee, Tae-Hong
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.287-289
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    • 2011
  • Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.

Technical Consideration for Coiling of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm

  • Kim, Jong Hoon;Jeon, Ik Chan;Chang, Chul Hoon;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.653-659
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    • 2018
  • Objective : Surgical obliteration of ruptured aneurysm of the proximal posterior inferior cerebellar artery (PICA) is challenging because of limited surgical accessibility. In recent years, coil embolization is the first-choice treatment for these lesions. However, coil embolization is not always easy in ruptured PICA aneurysm owing to the variable anatomical diversity of its shapes, its relationship to the parent artery, its low incidence, and accordingly, lesser neurointerventionist experience. Methods : The parent artery and microcatheter for easier navigation and the embolization technique for stable coiling were identified. Results : This study aimed to identify the more appropriate approach route, microcatheter, and strategies for an easier and safer, and more durable coil embolization in the treatment of lesions in the proximal PICA. Conclusion : Coil embolization for aneurysmal subarachnoid hemorrhage due to a ruptured proximal PICA remains a challenge, but with the appropriate coiling plan, it can be treated successfully.

Favorable Aortic Remodeling Following Serial False Lumen Procedures in a Case of Chronic Type IIIb Dissection

  • Eleshra, Ahmed Sameh;Heo, Woon;Lee, Kwang-Hun;Lee, Shin-Young;Lee, Ha;Song, Suk-Won
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.286-289
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    • 2018
  • We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol.

THE STUDY OF THE MALIGNANT TUMORS OF THE MAXILLARY SINUS BY COMPUTED TOMOGRAPHY (전산화 단층 촬영상에 의한 상악동 악성종양에 관한 연구)

  • Dan Jung-Bae;Park Tae-Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.19 no.1
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    • pp.137-147
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    • 1989
  • CT findings of proven 25 malignant tumors of the maxillary sinus were retrospectively analyzed to be of help in the diagnosis and treatment. The results were follows: 1. Average age was 54 years old, and eighteen were males and seven were females with a ratio of 2.6:1 2. The most common histopathologic feature was squamous cell carcinoma (19 cases) and others were two cases of adenoid cystic carcinoma, one case of malignant fibrous histiocytoma, mucoepidermoid tumor, histiocytic lymphoma, unidentified malignant tumor. 3. CT findings were sinus opacificaqtion (4%), soft tissue mass (92%), low densities within soft tissue mass (44.%), air densities within soft tissue mass (24%), osteosclerosis (4%), bone destruction (92%), bone displacement (32%), fat plane obliteration (76%). 4. CT in the malignant maxillary sinus tumors approved the value in evaluation of tumor extension to nasal cavity, ethmoid sinus, orbit, infratemporal fossa, pterygopalatine fossa, pterygoid fossa, pterygoid muscle, cheek skin and intracranial cavity. 5. Twenty four cases (96%) were stage Ⅲ, stage Ⅳ according to AJCC TNM classification. 6. Bone findings were destruction, displacement, sclerosis and most frequent site of bone destruction was the medial wall of the antrum(92%). 7. Tumor growth pattern showed destructive pattern in 18 cases(72%), and squamous cell carcinoma showed destructive pattern. (P<0.05)

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Orbital roof and supraorbital ridge fracture: a report of three cases (상안와벽 및 상안와연 골절의 치험례)

  • Lee, Jae-Yeol;Lee, Sung-Tak;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Chung, In-Kyo;Hwang, Dae-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.524-529
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    • 2011
  • Orbital roof and supraorbital ridge fractures are frequently associated with high energy concomitant craniofacial trauma. When a displacement of the orbital roof and supraorbital rim occurs, exploration, stabilization and reconstruction are warranted to limit the ocular complications. The management of fractures involving the frontal sinus must consider the possible need for obliteration or cranialization of the sinus. Many incisions have been described and used to approach these fractures, such as a coronal incision, eyebrow incision, and an incision through the laceration. We report 3 cases of orbital roof and supraorbital ridge fracture patients with a review of the relevant literature.

Computed tomographic features of fibrous dysplasia of maxillofacial region

  • Sontakke, Subodh Arun;Karjodkar, Freny R.;Umarji, Hemant R.
    • Imaging Science in Dentistry
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    • v.41 no.1
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    • pp.23-28
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    • 2011
  • Purpose : This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. Materials and Methods : All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. Results : All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. Conclusion : The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

A Case of Idiopathic Mediastinal Fibrosis Presenting with Vocal Cord Palsy (성대마비를 동반한 특발성 종격동 섬유화증 1예)

  • Yoo, Sung-Jae;Suh, Yo-Ahn;Kim, Sang-Il;Kim, Dae-Han;Kwak, Jin-Young;Lee, Jae-Cheol;Park, Jong-Ho;Chung, Jin-Haeng
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.373-378
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    • 2001
  • An idiopathic mediastinal fibrosis is a rare disease with an unknown etiology. It is a benign condition in which a fibrosis of the soft tissue and chronic inflammation occurs within the mediastinum. This leads to a constriction and obliteration of the adjacent mediastinal structures, particularly the great veins. This can result in a variety of clinical conditions depending on the anatomic location of the disease. Here, we report a case of an idiopathic mediastinal fibrosis with vocal cord palsy, which was confirmed by a biopsy with a thoracotomy. Postoperative medical treatment using prednisolone and tranilast was performed.

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Chest Wall Reconstruction for Chronic Intrathoracic Wounds Using Various Flaps

  • Hong, Joon Pio;Cho, Pil-Dong;Kim, Sug Won;Chung, Yoon-Kyu;Kim, Eun-Gi
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.68-74
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    • 2000
  • The treatment of chronic chest wounds should be focused on eradicating the infection and obliterating the dead space thus providing improved pulmonary function. Chronic chest wounds, although the incidence has decreased over the years, is still associated with high morbidity and prolong hospitalization. In cases where the disease is advanced and conventional measures fail, aggressive approaches achieve adequate resolution or significant improvement. This paper reports four cases of chronic chest wound including bronchopleural fistula and osteomyelitis managed by debridement followed by muscle coverage using latissimus dorsi, rectus abdominis, and omental flap. The intrathoracic reconstruction entails thorough debridement of empyema cavities, bronchpleural fistulas and infection focus. The infection must be completely eradicated prior to or at the time of flap transposition. The flaps used for obliteration of dead spaces provided adequate bulk, abundant blood supply, and minimal donor morbidity. The results were satisfactory with improved respiratory function without complications.

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