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Visual Outcome after Surgical Removal of Craniopharyngiomas

  • Kim, Yeon-Seong;Jung, Shin;Cheon, Hyo-Cheol;Jung, Tae-Young;Kang, Sam-Suk;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.171-175
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    • 2006
  • Objective : In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. Methods : This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function [visual acuity and field] of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. Results : Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved [38.0%], and 7 patients were worse [33.3%]. However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation [44.4%]. The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection : Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. Conclusion : After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.

Gamma Knife Radiosurgery for Low Grade Glioma - Long-Term Follow-up Results - (양성 신경교종의 감마나이프 방사선수술 - 장기 추적 결과 -)

  • Chun, Sae Myoung;Lim, Young Jin;Leem, Won;Kim, Tae Sung;Kim, Gook Ki;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.273-280
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    • 2001
  • Objectives : The purpose of this study is to assess the long-term outcome and delayed complications of Gamma Knife radiosurgery for low grade glioma(LGG). Methods : Among 31 patients of LGG who had been treated by using Leksell Gamma Knife between March 1992 and December 1996, we could follow up more than 5 years(range 5-9 years) in 17 patients and evaluated their clinical feature, changes of tumor volume and post-radiosurgical complications. Results : During the mean follow-up period of 7.6 years, the tumor was decreased in 5 patients(29.4%), unchanged in 4(23.5%), increased in 4(23.5%) and recurred in 4(23.5%). The tumor control rate was 52.9%(9/17). We have experienced eighteen postradiosurgical complications in 10 patients(58.8%). Early complication was none and delayed complications included radiation necrosis with cyst in ten cases, bleeding in five, radiation-induced edema in one and malignant transformation in one. Two patients ultimately died as a result of tumor progression during the follow-up period. The mortality rate was 11.7%. Conclusion : Gamma Knife radiosurgery may be useful as an adjunctive therapy for small volume, deep-seated LGG. Although radiosurgery can effectively prevent growth of solid tumor, several delayed complications such as radiation necrosis, cyst formation, bleeding or malignant transformation can develop during the long-term followup period. Because of the possible slow growth rate of LGG and development of the delayed complications, the long-term efficacy of radiosurgery requires further analysis.

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Prospective Comparison of Redo Microvascular Decompression and Percutaneous Balloon Compression as Primary Surgery for Recurrent Trigeminal Neuralgia

  • Chen, Jing-nan;Yu, Wen-hua;Du, Hang-gen;Jiang, Li;Dong, Xiao-qiao;Cao, Jie
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.747-752
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    • 2018
  • Objective : To prospectively compare facial pain outcomes for patients having either a repeat microvascular decompression (MVD) or percutaneous balloon compression (PBC) as their surgery for trigeminal neuralgia (TN) recurrence. Methods : Prospective cohort study of 110 patients with TN recurrence who had either redo MVD (n=68) or PBC (n=42) from July 2010 until September 2016. The mean follow-up was 45.6 months. Results : After redo MVD, 65 patients (95.6%) experienced immediate relief of pain. After PBC, 34 patients (81%) were immediately relieved of their neuralgia. After 1 month, the clinical effect of redo MVD was better than PBC (p<0.01). Patients who had redo MVD more commonly were pain free off medications (93.4% at 1 year, 78.2% at 4 years) compared with the PBC patients (85.1% at 1 year, 59.3% at 4 years). However, mean length of stay was longer (p>0.05). Patients after PBC who occurred developed herpes simplex (35.7%), facial numbness (76.2%), and annoying dysesthesia (21.4%) more frequently compared with patients after redo MVD who occurred developed herpes simplex (14.7%), facial numbness (8.8%), and hypoesthesia (5.9%) (p<0.05). The symptoms recurred respectively in 15 patients (22.1%) and 19 patients (45.2%) after redo MVD and PBC within the entire 6-year follow-up period. Conclusion : For the patients with TN recurrence, redo MVD was a more effective procedure than PBC. The cure rate and immediate relief of pain were better, and the incidence of complications was lower.

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young;Lee, Jae Sin;Kim, Dong Ryul;Jang, Jae Young;Jung, Hwa Young;Park, Jong Ho;Jin, Sue Sin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.109-113
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    • 2018
  • A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Triple Pelvic Osteotomy and Autograft to the Gap of Ischium for the Treatment of Pelvic Canal Narrowing in a Cat

  • Park, Ji-Hun;Kim, Keun-Yung;Lee, Chae-Yeong;Lee, Si-Eun;Park, Hyojin;Hwang, Tae-Sung;Lee, Hee-Chun;Lee, Dongbin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.5
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    • pp.235-239
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    • 2021
  • Pelvic canal narrowing secondary to pelvic fractures can lead to episodes of recurrent constipation in cats. Triple pelvic osteotomy is considered as a surgical treatment method; however, there is potential for future recurrence of pelvic canal narrowing. This report describes a surgical method using a pelvic symphyseal autograft to keep the distraction of the ischial osteotomy gap to prevent the recurrence of pelvic canal narrowing. A triple pelvic osteotomy was planned to expand the narrow pelvic canal. The cranial ramus of the pubis was cut, and ischiatic and iliac osteotomies were performed. After expanding the ilium, the malunion pelvic symphysis was cut approximately 1 cm and then autografted to the gap of the ischiatic osteotomy line to keep the distraction. The patient showed clinical improvement postoperatively without recurrent pelvic canal narrowing related to triple pelvic osteotomy. However, constipation recurred on post-operative month-5. It was managed conservatively, and subtotal colectomy was performed eventually nine months post-operatively. There were no complications for five months of follow-up.

A practical approach to nasal reconstruction in Asian patients

  • Koh, In Suk;Sun, Hook
    • Archives of Craniofacial Surgery
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    • v.22 no.5
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    • pp.268-275
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    • 2021
  • Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features. Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence. Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity. Conclusion: Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

A Case Report of Chin Area Folliculitis Improved by Administration of Gyejigadaehwang-tang (계지가대황탕(桂枝加大黃湯) 투여 이후 호전된 턱 주위 모낭염 치험 1례)

  • Lee, Ju-Hyun;Jo, Eun-Heui;Kyung, Da-Hyun;Park, Ji-Won;Park, Min-Cheol
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.3
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    • pp.127-133
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    • 2021
  • Objectives : This study aims to report a case of chin area folliculitis improved by oral administration of Gyejigadaehwang-tang. Methods : The patient of this study visited our hospital with purulent lesions accompanied by erythema, papules and pustules around the chin area that have recurred over 10 years. Based on the patient's tendency of chills and constipation, Gyejigadaehwang-tang was prescribed. Results : About a month later, most of the skin symptoms improved (Total Folliculitis Symptom score 11→2), and only brown marks and mild erythema due to pigmentation after inflammation, were observed. Symptoms related to constipation also improved from 13 to 4 points. In the follow-up process after the treatment, It was confirmed that the symptoms of folliculitis did not recur. Conclusions : After taking Gyejigadaehwang-tang for a month, purulent lesions generally improved. Symptoms related to constipation also diminished, allowing regular bowel movements once a day.

A Case Report of Metastatic Leiomyosarcoma Patient Treated with Integrative Cancer Treatment (전이성 평활근육종 환자의 통합 암 치료에 대한 증례보고)

  • Song, Si-yeon;Chang, Hyeok-joon;Park, So-jung;Jun, Hyeong-joon;Lee, Yeon-weol;Cho, Chong-kwan;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.24 no.1
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    • pp.11-18
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    • 2019
  • Objective: The purpose of this study is to report the effectiveness and possibility of Integrative Cancer Treatment (ICT) on an advanced metastatic leiomyosarcoma patient. Methods: The patient was diagnosed with recurred and advanced metastatic Leiomyosarcoma, suffering from dyspnea, abdominal discomfort, lower limb edema. The patient refused conventional treatment, such as chemotherapy, radiotherapy but was treated with ICT including acupuncture, pharmacopuncture, moxibustion, hypertherapy and herbal medicine for symptom management. The clinical outcomes were measured by NRS (Numeral rating scale). Results: After treatment, dyspnea, abdominal discomfort and lower limb edema was relieved from NRS 6 to 3, 7 to 3 and 7 to 6 respectively. Also, loss of body weight, decrease in abdominal, thigh and calf circumference were improved. During and after treatment, we found neither hepatotoxicity nor nephrotoxicity on laboratory findings. Conclusion: This case study suggests that ICT may improve symptom relief and life quality of leiomyosarcoma patient.

Detection of Damaged Pine Tree by the Pine Wilt Disease Using UAV Image (무인항공기(UAV) 영상을 이용한 소나무재선충병 의심목 탐지)

  • Lee, Seulki;Park, Sung-jae;Baek, Gyeongmin;Kim, Hanbyeol;Lee, Chang-Wook
    • Korean Journal of Remote Sensing
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    • v.35 no.3
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    • pp.359-373
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    • 2019
  • Bursaphelenchus xylophilus(Pine wilt disease) is a serious threat to the pine forest in Korea. However, dead wood observation by Pine wilt disease is based on field survey. Therefore, it is difficult to observe large-scale forests due to physical and economic problems. In this paper, high resolution images were obtained using the unmanned aerial vehicle (UAV) in the area where the pine wilt disease recurred. The damaged tree due to pine wilt disease was detected using Artificial Neural Network (ANN), Support Vector Machine (SVM) supervision classification technique. Also, the accuracy of supervised classification results was calculated. After conducting supervised classification on accessible forests, the reliability of the accuracy was verified by comparing the results of field surveys.

Korean Medical Treatment of Sequela Following Chemotherapy for Recurrent Ovarian Cancer after Hysterectomy: a Case Report (재발성 난소암 환자의 화학적 항암요법 후유증 치험 1례)

  • Baek, Ji-Won;Nam, Woo-Jin;Kim, Su-Na;Kong, Won-Ho;Park, Yeo-Bin;Park, Yun-Leong;Gong, Bok-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.129-137
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    • 2019
  • Objectives: Most of the time after chemotherapy for ovarian cancer, the immune system is getting even worse with reduction of whole blood cell. The purpose of this study is to report the effect of korean medical treatment on Sequela including pancytopenia after chemotherapy for recurrent ovarian cancer after hysterectomy. Methods: The patient having treated with hospital management from June 8th in 2017 until July 5th in 2017, participated. Her chief complaints were fatigue, tinnitus, dizziness, decreased appetite due to glossodynia and constipation. We diagnosed her as pancytopenia based on her whole blood test result. We treated the patient with acupuncture, herbal medicine, cupping and moxibustion. The efficacy of treatment was evaluated with Numerical Rating Scale (NRS) and blood test. Results: During hospitalization period, the symptoms including fatigue, tinnitus, dizziness, decreased appetite, constipation and pancytopenia were reduced. After discharging, we identified that her blood levels are maintained and ovarian cancer no longer recurred. Conclusions: To recover from Sequela including pancytopenia following chemotherapy for recurrent ovarian cancer after hysterectomy, Korean medical treatment is considered to be effective.