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Characteristics and Treatment Outcome of Intracranial Aneurysms in Children and Adolescents

  • Nam, Sun Mo;Jang, Donghwan;Wang, Kyu-Chang;Kim, Seung-Ki;Phi, Ji Hoon;Lee, Ji Yeoun;Cho, Won-Sang;Kim, Jeong Eun;Kang, Hyun-Seung
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.551-560
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    • 2019
  • Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.

Trapping and A4-A4 end-to-side anastomosis for the treatment of a ruptured A3 fusiform aneurysm: Potential risk of in-situ bypass

  • Young Rak Kim;Sung Ho Lee;Jin Woo Bae;Young Hoon Choi;Eun Jin Ha;Kang Min Kim;Won-Sang Cho;Hyun-Seung Kang;Jeong Eun Kim
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권1호
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    • pp.62-68
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    • 2023
  • The treatment of complicated anterior cerebral artery aneurysms remains challenging. Here, the authors describe a case of ruptured complicated A3 aneurysm, which was treated with trapping and in-situ bypass. A 47-year-old man presented to the emergency department with severe headache and vomiting. Computed tomography illustrated acute intracerebral hemorrhage in the right frontal lobe. Digital subtraction angiography (DSA) confirmed a ruptured fusiform A3 aneurysm with lobulation and a daughter sac. Trapping of the ruptured fusiform A3 aneurysm and distal end-to-side A4 anastomosis was performed. DSA on postoperative day 7 showed mild vasospasm to the afferent artery. However, 2 months later, DSA demonstrated that the antegrade flow through the anastomosis site had recovered. Thus, surgeons should be aware of the possibility of postsurgical vasospasm of anastomosed arteries, especially in cases of ruptured aneurysms.

Use of Embolic Protection Devices during Hybrid Thoracic Endovascular Aortic Repair for a Shaggy Aorta: A Case Report

  • Kim, Eun Chae;Lee, Jae Hang;Chang, Hyoung Woo;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.513-516
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    • 2021
  • An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV6 Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

Two Cases of Unresectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgical Resection

  • Huh, Gunn;Chun, Jung Won;You, Min Su;Paik, Woo Hyun;Lee, Sang Hyub;Kim, Yong-Tae;Ryu, Ji Kon
    • Journal of Digestive Cancer Research
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    • 제7권2호
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    • pp.61-64
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    • 2019
  • We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.

Genome-Wide Association Study of Bone Mineral Density in Korean Men

  • Bae, Ye Seul;Im, Sun-Wha;Kang, Mi So;Kim, Jin Hee;Lee, Soon Hang;Cho, Be Long;Park, Jin Ho;Nam, You-Seon;Son, Ho-Young;Yang, San Deok;Sung, Joohon;Oh, Kwang Ho;Yun, Jae Moon;Kim, Jong Il
    • Genomics & Informatics
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    • 제14권2호
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    • pp.62-68
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    • 2016
  • Osteoporosis is a medical condition of global concern, with increasing incidence in both sexes. Bone mineral density (BMD), a highly heritable trait, has been proven a useful diagnostic factor in predicting fracture. Because medical information is lacking about male osteoporotic genetics, we conducted a genome-wide association study of BMD in Korean men. With 1,176 participants, we analyzed 4,414,664 single nucleotide polymorphisms (SNPs) after genomic imputation, and identified five SNPs and three loci correlated with bone density and strength. Multivariate linear regression models were applied to adjust for age and body mass index interference. Rs17124500 ($p=6.42{\times}10^{-7}$), rs34594869 ($p=6.53{\times}10^{-7}$) and rs17124504 ($p=6.53{\times}10^{-7}$) in 14q31.3 and rs140155614 ($p=8.64{\times}10^{-7}$) in 15q25.1 were significantly associated with lumbar spine BMD (LS-BMD), while rs111822233 ($p=6.35{\times}10^{-7}$) was linked with the femur total BMD (FT-BMD). Additionally, we analyzed the relationship between BMD and five genes previously identified in Korean men. Rs61382873 (p = 0.0009) in LRP5, rs9567003 (p = 0.0033) in TNFSF11 and rs9935828 (p = 0.0248) in FOXL1 were observed for LS-BMD. Furthermore, rs33997547 (p = 0.0057) in ZBTB and rs1664496 (p = 0.0012) in MEF2C were found to influence FT-BMD and rs61769193 (p = 0.0114) in ZBTB to influence femur neck BMD. We identified five SNPs and three genomic regions, associated with BMD. The significance of our results lies in the discovery of new loci, while also affirming a previously significant locus, as potential osteoporotic factors in the Korean male population.

Two cases of unilateral renal agenesis in a dog and a cat

  • Oh, Sun-Kyoung;Lee, Jung-Min;Kim, Hak-Sang;Kim, Gyeong-Min;Lee, Sung-Ok;Canang, Jin-Hwa;Jang, Joo-Hyun;Bang, Dong-Ha;Jeong, Seong-Mok;Yoon, Hwa-Young;Choi, Min-Cheol;Yoon, Jung-Hee
    • 한국임상수의학회:학술대회논문집
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    • 한국임상수의학회 2006년도 춘계학술대회
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    • pp.181-181
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    • 2006
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