• Title/Summary/Keyword: Ruptured

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Incidence of Chronic Shunt-dependent Hydrocephalus after Surgical or Endovascular Treatment of Ruptured Intracranial Aneurysm (동맥류 결찰술 시행군과 GDC색전술 시행군에서 지주막하 출혈 후 만성 션트-의존성 수두증의 발생빈도)

  • Kwon, Young-Yi;Cho, Maeng Ki;Park, Bong-Jin;Sung, Jung-Nam;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.68-72
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    • 2001
  • Objective : The goal of this study was to document the influence of the treatment modality(surgery versus endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 296 patients treated after aneurysmal subarachnoid hemorrhage(SAH). Methods : The following parameters were retrospectively analyzed for association with chronic shunt-dependent hydrocephalus : 1) Age and Sex, 2) Hunt and Hess grade, 3) Fisher computed tomographic grade, 4) aneurysm location, and 5) treatment modality(surgery versus endovascular treatment). Results : Thirty-six of 251 patients(14.3%) who survived the SAH and its neurological and/or medical sequelae underwent definitive shunting for treatment of chronic hydrocephalus. The rate of shunt dependency was positively correlated with a higher age, a higher Hunt and Hess grade, a higher Fisher computed tomographic grade, and aneurysms arising at the anterior communicating artery(p<0.05). Conclusion : The results of the present study indicate that the treatment modality used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus(surgery, 16.2% [25 of 154] ; endovascular treatment, 11.3% [11 of 97] ; p=0.45).

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Cerebral Aneurysms Arising from Unbranched Site of Intracranial Arteries (혈관가지가 없는 두개강내 혈관에서 발생한 뇌 동맥류)

  • Kim, Young Jin;Kim, Jae Min;Yi, Hyeong Joong;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.521-527
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    • 2000
  • Objective : In general, most of saccular aneurysms arise at arterial divisions, but those arising at unbranched site are rare. These aneurysms might impose neurosurgeons a formidable surgical challenge, due to uncommon features and a difficult surgical technique. Methods : Between the period of Jan. 1996 and Dec. 1998, a total of 110 cases of aneurysms were operated. Among them, five cases of unbranched site aneurysms were retrospectively analyzed through medical records, angiographic and operative findings. Results : The incidence of aneurysms unrelated to arterial branches was 4.5%. All cases presented with subarachnoid hemorrhage(SAH) ; three(60%) were at internal carotid artery(ICA) and two(40%) at middle cerebral artery (MCA). Two had a history of hypertension and three showed atherosclerotic changes in the arterial wall. One ICA and one MCA aneurysms proved to be a blood blister-like aneurysm(BBA) in their shape. Strikingly, a rapid neurological deterioration was shown in two ruptured ICA variants, which resulted in death and another two aneurysms left with morbidity. Conclusion : The preoperative neurological status in most cases was relatively poor compared to that of aneurysms arising at a branched site. Regarding its pathogenesis, atherosclerosis as well as hemodynamic factors may play an important role in formation of these variant aneurysms among various etiological factors. The overall prognosis of unbranched site aneurysms was worse than that of branched site aneurysms. In cases of BBAs, special attention was requisite to handle them during clipping and/or wrapping due to an easy fragile, thin aneurysmal wall.

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Usefulness of Computed Tomographic Angiography in the Detection and Evaluation of Aneurysms of the Circle of Willis (Willis환 내 뇌동맥류 진단시 전산화단층촬영 뇌혈관 조영술의 유용성)

  • Lee, Hyuk Gi;Cho, Jae Hoon;Lee, Sung Lak;Kang, Dong Gee;Kim, Sang Chul
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.345-352
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    • 2000
  • Objective : The purpose of this study was to compare computed tomographic angiography(CTA) with conventional cerebral angiography(CCA) and to assess usefulness of CTA in detection and anatomic definition of intracranial aneurysms of the circle of Willis in subarachnoid hemorrhage. Patients and Methods : Fifty consecutive patients with known or suspected intracranial saccular aneurysms underwent CTA with preoperative CCA from 1997 to 1999. Using surface shaded display post-processing technique, CTA was interpreted for the presence, location of aneurysms and anatomic features. The image obtained with CTA was then compared with CCA image. Results : In 47 patients, CCA revealed 57 cerebral aneurysms and CTA revealed 54 aneurysms. Two of the 57 cerebral aneurysms were located outside of the imaging volume of CTA and one case was misdiagnosed. The sensitivity of CTA was 94.7% and the specificity was 100%. The results obtained with CTA were, compared with the results obtained with CCA, equal in determining dome shape, direction and lobularity. However, CTA provided a 3-dimensional representation of aneurysmal lesion very useful for surgical planning. Moreover, CTA was useful for rapid and relatively noninvasive detection of aneurysms in the circle of Willis. Conclusion : CTA can be a diagnostic tool for the patients with acute subarachnoid hemorrhage due to a ruptured aneurysm of the circle of Willis and provides adequate anatomic detail for surgical planning, especially to complex cerebral aneurysms. However, we think CCA is necessary because of CTA limitations including its difficulty in detecting unusually located aneurysms(including those in cavernous sinus or distal artery) and combined vascular lesion (including arteriovenous malformation) and acquiring dynamic flow information.

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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.

[Secondary publication] Sudden Aortic Rupture in Ehlers-Danlos Syndrome Type IV (엘러스-단로스 제4형 증후군 환자에서 발생한 대동맥 파열)

  • Baek, Taehwa;Kim, Minjung;Ki, Chang-Seok;Park, Seong Hwan;Lee, Heon;Kim, Kyung Ryoul;Choi, Byung-Ha
    • The Korean Journal of Legal Medicine
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    • v.40 no.2
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    • pp.61-64
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    • 2016
  • Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.

Identification of Pisolithus tinctorius from GNU Campus

  • Han, Ki-Soo;Lee, Jung-Han;Kwon, Young-Sang;Bae, Dong-Won;Kim, Hee-Kyu
    • Journal of agriculture & life science
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    • v.43 no.4
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    • pp.33-36
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    • 2009
  • Globose to clavate base-ball sized, pear shaped, fruiting bodies were found under the Himalayan cedar, Cedrus deodora at less fertile and poor sandy poor soil in the campus of Gyeongsang National University in Jinju, Korea. The fruiting body was at first, round to club-shaped, usually with a narrow, rooting base with yellowish rhizomorphs attached to it and lack a volva and a sterile base. The peridium of fruiting body was tough and crusty. The peridioles were white pea-like capsules in a blackish matrix. The color change to darker tints of brown at the top of the exterior peridium reflected the gradual ripening of the interior gleba and peridioles, which proceeded from the top downward to become a mass of spore dust, appearing as cinnamon brown at the apex of the vertical section. At around this stage, the peridium cracked open linearly, exposing the gleba with powdery spores mass released from overmatured peridioles. Spores were more or less round, warty or spiny, 10 to $12{\mu}m$; globose, cinnamon brown in powdery mass, with spines up to $2{\mu}m$ long. The thin peridium ruptured further in response to the disintegration of the peridioles, releasing the powdery spores, which proceeded until whole fruiting body disappeared leaving the dry spore dust coats in the vicinity. The absence of a capillitium is a distinctive characteristic that distinguishes the specimen from other puff-ball fungi and from most of earthballs. Based on the above characteristics, the specimen was identified as Poslithus tinctorius.

Effect of High Voltage Pulsed Electric Fields on Extraction of Purple Sweet Potato Pigment (자색 고구마 색소의 추출에 미치는 고전압 펄스 전기장의 영향)

  • Shin, Jung-Kue;Shin, Hae-Hun
    • Food Science and Preservation
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    • v.14 no.2
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    • pp.165-169
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    • 2007
  • High voltage pulsed electric fields (PEF) is a promising technology for the nonthermal extraction of effective components from biological materials. Plant cells were ruptured with PEF at ambient or refrigerated temperature for a short treatment time of second or microsecond. Treatments of coarsely ground purple sweet potato (PSP) with PEF(30 kV/cm, 500 Hz) resulted in maximum extraction yield of 65% as compared with 45-50% for control. An increase in electric field strength (from 10kV/cm to 35kV/cm) and frequency (from 100Hz to 500Hz) resulted in increased amount of extracted pigments, but treatment time is not affected on pigment extraction. Starch granules were not detected and large intracellular spaces were visible between the cells on light and scanning election microscopy of PEF treated PSP. This result suggests that PEF have potential to use on extraction of pigments from plant cells.

Malfunction Analysis when a EFV is Working (과류차단 밸브 작동 시 오작동에 대한 분석)

  • Jeon, Hyung Taek;Park, Sung Jin;Kim, Sung Tae
    • Journal of the Korean Institute of Gas
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    • v.22 no.6
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    • pp.28-33
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    • 2018
  • Currently, the government has been expanding the supply of semi-low-pressure in order to solve the problems of unsupplied area of city gas and to secure the economical efficiency of small supplied area. It is mainly supplied from the central storage tank to each household by buried piping. It is necessary to provide such a shutoff valve that can block the excess flow gas due to pipeline leak or rupture when piping is damaged by other construction. For this study, System CFD code named Flownex has been used and a component corresponding to the actual EFV was developed. We compared Flownex results with experimental data to verify the accuracy of Flownex and confirmed the error rate to be around 2%. In this study, pipeline network modeling was done by selecting the LPG supply pipeline in a village and installed the component of the EFV at each junction. We selected the longest pipeline from the main pipeline and set scenarios so that the excess flow occurs by that the pipeline is ruptured before entering the household. The excess flow occurs by the pipeline rupture and the EFV is closed. At this time, we analyzed backflow effects to the other pipeline by closing EFV.

Stener-Like Lesions in the Metacarpophalangeal Joint of the Fingers (다른 수지의 중수수지 관절에서의 Stener 유사 병변)

  • Lee, Sanglim;Jung, Eui Yub;Lee, Jihae;Jeon, Suk Ha
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.547-551
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    • 2018
  • Three Stener-like lesions of the metacarpophalangeal joint of the fingers and a rupture of the first dorsal interosseous muscle mimicking the lesion in the index finger were observed. Two cases in the little fingers had a true Stener's lesion. In one case in the index finger, the ruptured ligament was retracted and located under the intact sagittal band, which was also observed by preoperative magnetic resonance imaging (MRI). Rupture of the first dorsal interosseous muscle was misdiagnosed preoperatively as a Stener's lesion in the index finger by ultrasonography. MRI should be an essential differential diagnostic exam for collateral ligament ruptures of the metacarpophalangeal joint of the fingers.

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms

  • Choi, Jae Young;Choi, Chang Hwa;Ko, Jun Kyeung;Lee, Jae Il;Huh, Chae Wook;Lee, Tae Hong
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.208-218
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    • 2019
  • Background: The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms. Methods: From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed. Results: Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only 3 aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, 5 (6.9%) remnant neck, and 1 (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of 8 asymptomatic and 2 symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included 1 major and 3 minor recanalizations. Conclusion: Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.