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Lee C, Yoon SY, Hwang JH, Park SH, Kwon M, Yoon C, Lee K, Hahm MH, Park KS. External border zone may be correlated with radiation necrosis after radiosurgery in metastatic brain tumor. World Neurosurg 2024:S1878-8750(24)00532-1. [PMID: 38561029 DOI: 10.1016/j.wneu.2024.03.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Radiation necrosis (RN) after stereotactic radiosurgery (SRS) in brain metastases has been extensively evaluated, and RN is correlated with various risk factors. However, no study comprehensively analyzed the correlation between RN and the border zones of the brain that are vulnerable to ischemia. We hypothesized that patients with tumors in the border zone are at high risk of RN. Hence, the current study aimed to assess the correlation between border zone lesions and RN, with consideration of other predetermined factors. METHODS This retrospective study included 117 patients with 290 lesions who underwent Gamma Knife® stereotactic radiosurgery (SRS). Radiological and clinical analyses were performed to identify factors possibly correlated with RN. Notably, the lesion location was classified into two groups (border zone and non-border zone) based on the blood supply. RESULTS In total, 22 (18.8%) patients with 22 (7.5%) lesions developed RN. Univariate analysis revealed a significant correlation between RN and external border zone lesions, second course of SRS administered at the same site of the previous SRS, prescribed dose, and tumor volume. Multivariate analysis showed that border zone lesions, second course of SRS at the same site of the previous SRS, and tumor volume were significantly correlated with RN. CONCLUSIONS Patients with tumors in the border zone are at high risk of RN. The potential risks of RN can be attributed hypothetically to hypoperfusion. Hence, the association between RN and border zone lesions seems reasonable.
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Affiliation(s)
- Chaejin Lee
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang-Youl Yoon
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Minjae Kwon
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Chaemin Yoon
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyungyoung Lee
- School of Medicine, Kyungpook National University, Daegu, Korea
| | | | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.
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2
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Lee C, Kim MS, Hwang JH, Park SH, Park KS, Yoon SY. Venous ectasia preceding intra-tumoral hemorrhage in a case of gliosarcoma with transverse sinus involvement. J Surg Case Rep 2023; 2023:rjad429. [PMID: 37525746 PMCID: PMC10387368 DOI: 10.1093/jscr/rjad429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/08/2023] [Indexed: 08/02/2023] Open
Abstract
Although intratumoral hemorrhage is common in patients with malignant brain tumors, reports on its clinical course are scarce. This report presents a rare case of a patient with intratumoral hemorrhage with gliosarcoma invading the venus sinus. This invasion and a small draining vein were observed at diagnosis. Magnetic resonance imaging performed 1 week later showed new-onset venous ectasia, which caused intratumoral hemorrhage. This case provides insight into the mechanisms underlying intratumoral hemorrhage and highlights the emergence of new intratumoral vasculature as a potential warning sign for hemorrhage.
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Affiliation(s)
- Chaejin Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mee-Seon Kim
- Department of Pathology, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Korea
| | - Sang-Youl Yoon
- Correspondence address. Department of Neurosurgery, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu 41404, Korea. Tel: +82-10-9545-4515, Fax: +82-53-200-7239, E-mail:
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3
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Seo H, Lee HW, Yoon SY, Chang SH, Park SH, Hwang JH, Park TI, Park KS. Effect of Cadherin-11 Expression on the Prognosis of a Newly Diagnosed Primary Glioblastoma. Brain Tumor Res Treat 2021; 9:63-69. [PMID: 34725986 PMCID: PMC8561220 DOI: 10.14791/btrt.2021.9.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022] Open
Abstract
Background Cadherin-11, a cell-to-cell adhesion molecule, is associated with higher tumor grade and decreased patient survival. The purpose of this study was to investigate the clinical significance of cadherin-11 expression in the progression and prognosis of a newly diagnosed primary glioblastoma (GBL). Methods Between 2007 and 2016, 52 out of 178 patients diagnosed with a GBL and satisfied the following criteria: 1) a new primary GBL, 2) gross-total resection, 3) immunohistochemically-available tissue, and 4) standardized adjuvant treatment. Results In terms of staining intensity, the low-intensity cadherin-11 group showed longer progression-free survival (PFS) than the high-intensity cadherin-11 group (median PFS, 12.0 months [95% CI, 11.1–12.9] vs. median PFS, 6.0 months [95% CI, 3.7–8.3]; p<0.001). The low-intensity cadherin-11 group revealed longer overall survival (OS) than the high-intensity cadherin-11 group (median OS, 20.0 months [95% CI, 11.8–16.6] vs. median OS, 15.0 months [95% CI, 11.8–18.2]; p=0.003). The staining intensity of cadherin-11 was a statistically significant factor in PFS and OS in terms of univariate and multivariate analyses (univariate analysis: p<0.001 and p=0.005; multivariate analysis: p<0.001 and p=0.005). Conclusion Our clinical study demonstrates high cadherin-11 expression may be associated with poor PFS and OS for a newly diagnosed primary GBL.
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Affiliation(s)
- Hyunwoo Seo
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hye Won Lee
- Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Sang-Youl Yoon
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Hyun Chang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae In Park
- Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.
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4
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Lee C, Seo H, Yoon SY, Chang SH, Park SH, Hwang JH, Kang K, Kim CH, Hahm MH, Park E, Ahn JY, Park KS. Clinical significance of vitamin D in idiopathic normal pressure hydrocephalus. Acta Neurochir (Wien) 2021; 163:1969-1977. [PMID: 33881606 DOI: 10.1007/s00701-021-04849-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although recent studies show vitamin D deficiency is associated with cognitive decline, urinary incontinence, and gait instability, there has been no study on the effect of vitamin D on idiopathic normal pressure hydrocephalus (iNPH) characterized by the classic symptom triad of cognitive decline, urinary incontinence, and gait instability. We investigated the clinical significance of vitamin D in patients with iNPH. METHODS Between 2017 and 2020, 44 patients who underwent ventriculoperitoneal shunt surgery were divided into low (< 15 ng/mL) and high (≥ 15 ng/mL) vitamin D groups according to the concentration of 25(OH)D, an effective indicator of vitamin D status. They were respectively evaluated according to clinical and radiological findings. RESULTS The low vitamin D group (n = 24) showed lower preoperative cognition compared to the high vitamin D group (n = 20) in terms of Korean-Mini Mental Status Examination (K-MMSE) and iNPH grading scale (iNPHGS) (K-MMSE: 20.5 ± 5.4 versus 24.0 ± 4.5, p = 0.041; iNPHGS cognitive score: 2 ± 0.9 versus 1 ± 0.6, p = 0.025). And the low vitamin D group showed pre- and postoperatively more severe urinary incontinence (preoperative iNPHGS urinary score: 1 ± 1.0 versus 0 ± 0.9, p = 0.012; postoperative iNPHGS urinary score:1 ± 1.0 versus 0 ± 0.9, p = 0.014). The score of narrow high-convexity sulci for the low vitamin D group was lower (low vitamin D group: 1 ± 0.7 versus high vitamin D group: 2 ± 0.4, p = 0.031). CONCLUSION Lower concentration of vitamin D in iNPH may be related to lower preoperative cognition, pre- and postoperative urinary incontinence, and brain morphological change.
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Affiliation(s)
- Chaejin Lee
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyunwoo Seo
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sang-Youl Yoon
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sung Hyun Chang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Chi-Hun Kim
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myong Hun Hahm
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Eunhee Park
- Department of Physical and Rehabilitation Medicine, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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5
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Kim DJ, Lee S, Kim MS, Hwang JH, Hahm MH. Spindle cell oncocytoma of the sella turcica with anaplastic features and rapid progression in short-term follow-up: a case report with proposal of distinctive radiologic features. J Pathol Transl Med 2021; 55:225-229. [PMID: 33677954 PMCID: PMC8141972 DOI: 10.4132/jptm.2021.01.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 11/17/2022] Open
Abstract
We present a rare case of spindle cell oncocytoma (SCO) of the sella turcica with malignant histologic features and rapid progression. A 42-year-old woman experienced bilateral blurred vision and was preoperatively misdiagnosed as having a pituitary macroadenoma on magnetic resonance imaging. After surgery, SCO was diagnosed by the histopathologic features of interlacing fascicles of spindle tumor cells with finely granular, eosinophilic cytoplasm. Focal anaplastic changes and necrosis were present. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, S-100, galectin-3, and thyroid transcription factor 1. Four months later, the tumor had progressed, and second surgery with adjuvant radiotherapy was performed; the patients remains under observation. In this report, we proposed distinctive radiologic features for differential diagnosis between SCO and other pituitary tumors.
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Affiliation(s)
- Dong Ja Kim
- Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - SangHan Lee
- Department of Forensic Medicine, Defense Institute of Forensic Science, Seoul, Korea
| | - Mee-Seon Kim
- Department of Pathology, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Departments of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myong Hun Hahm
- Departments of Radiology, School of Medicine, Kyungpook National University, Daegu, Korea
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6
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Park S, Park SH, Hwang JH, Kim JH, Lee KH, Park SH, Shin JH, Pak SY, Kang JM. Low-dose CT angiography of the lower extremities: a comparison study of image quality and radiation dose. Clin Radiol 2020; 76:156.e19-156.e26. [PMID: 33256975 DOI: 10.1016/j.crad.2020.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/28/2020] [Indexed: 01/22/2023]
Abstract
AIM To investigate the image quality and radiation dose of ultralow-dose (ULD) and low-dose (LD) lower-extremity computed tomography (CT) angiography (LE-CTA) using the advanced modelled iterative reconstruction (ADMIRE) algorithm to detect peripheral arterial disease (PAD) in comparison with standard-dose (SD) CT. MATERIALS AND METHODS One hundred and seven consecutive patients were examined using LE-CTA at 70 kVp and a dual-source scanner to achieve three image sets using 30% (ULD), 70% (LD), and 100% (SD) tube loads. Qualitative analysis was conducted by examining the three image sets for overall quality. The image quality of arterial segments was analysed by two independent readers. In addition, the CT dose index (CTDIvol) was measured in the three image sets. RESULTS The mean overall quality scores were 3.4±0.6 for ULD CT, 3.9±0.3 for LD CT, and 3.9±0.2 for SD CT. Both readers scored the arterial segments as 2-4 (adequate-excellent) in the three image sets. In addition, 89.4% (93/104) and 54.8% (57/104) segments of PAD with calcified plaques were scored 4 between SD and LD CT and between SD and ULD CT, respectively, and 45.2% (47/104) segments had a lower score by one point in ULD CT compared with SD CT. The mean CTDIvol was 4.1±1.1 mGy for SD CT, 2.9±0.8 mGy for LD CT, and 1.2±0.3 mGy for ULD CT. CONCLUSIONS LD/ULD CT at 70 kVp using ADMIRE reconstruction enables a reduction in the radiation dose while enabling adequate evaluation or follow-up of PAD based on LE-CTA.
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Affiliation(s)
- S Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea
| | - S H Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea
| | - J H Hwang
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea.
| | - J H Kim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea
| | - K H Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea
| | - S H Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Y Pak
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J M Kang
- Department of Surgery, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, Republic of Korea
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7
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Park KS, Kim JB, Keung M, Seo YJ, Seo SY, Mun SA, Lee YS, Cho DC, Hwang JH, Han I, Kim CH, Kim KT. Chronic Hyperglycemia before Spinal Cord Injury Increases Inflammatory Reaction and Astrogliosis after Injury: Human and Rat Studies. J Neurotrauma 2020; 37:1165-1181. [DOI: 10.1089/neu.2019.6724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jin Bum Kim
- UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Martin Keung
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ye Jin Seo
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sung Young Seo
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seul Ah Mun
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Young-Seok Lee
- Department of Neurosurgery, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Dae-Chul Cho
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Inbo Han
- Department of Neurosurgery, CHA University, School of Medicine, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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8
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Lee C, Park SH, Yoon SY, Park KS, Hwang JH, Hwang SK. Gamma Knife Radiosurgery Using Co-Registration with PET-CT and MRI for Recurrent Nasopharyngeal Carcinoma with Previous Radiotherapy : A Single Center 14-Year Experience. J Korean Neurosurg Soc 2019; 63:397-405. [PMID: 31775216 PMCID: PMC7218195 DOI: 10.3340/jkns.2019.0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023] Open
Abstract
Objective We retrospectively evaluated the efficacy of Gamma Knife radiosurgery (GKS) for recurrent nasopharyngeal carcinoma (NPC) in patients who previously underwent radiotherapy, and analyzed the treatment outcomes over 14 years.
Methods Ten patients with recurrent NPC who had previously received radiotherapy underwent stereotactic radiosurgery using a Gamma Knife® (Elekta Inc, Atlanta, GA, USA) between 2005 and 2018. The median target volume was 8.2 cm3 (range, 1.7–17.8), and the median radiation dose to the target was 18 Gy (range, 12–30). The median follow-up period was 18 months (range, 6–76 months). Overall and local failure-free survival rates were determined using the Kaplan-Meier method.
Results The NPCs recurred at the primary cancer site in seven patients (70%), as distant brain metastasis in two (20%), and as an extension into brain in one (10%). The recurrent tumors in seven of the 10 patients (70%) were found on the routine follow-up imaging studies. Two patients presented with headache and one with facial pain. Local failure after GKS occurred in five patients (50%) : two of whom died eight and 6 months after GKS, respectively. No adverse radiation effects were noted after GKS. The 1- and 3-year overall survival rates after GKS were 90% and 77%, respectively. The local failure-free survival rates at 6 months, 1 year, and 3 years after GKS were 80%, 48%, and 32%, respectively. The median interval from GKS to local failure was 8 months (range, 6–12). Univariate analysis revealed that using co-registration with positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) was associated with a lower local failure rate of recurrent NPC (p=0.027).
Conclusion GKS is an acceptable salvage treatment option for patients with recurrent NPC who previously received radiation therapy. PET-CT and MRI co-registration for dose planning can help achieve local control of recurrent NPC.
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Affiliation(s)
- Chaejin Lee
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sang-Youl Yoon
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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9
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Baek HG, Park SH, Park KS, Kang DH, Hwang JH, Hwang SK. Stereotactic Radiosurgery for Dural Arteriovenous Fistulas Involving the Transverse-Sigmoid Sinus : A Single Center Experience and Review of the Literatures. J Korean Neurosurg Soc 2019; 62:458-466. [PMID: 31064039 PMCID: PMC6616977 DOI: 10.3340/jkns.2018.0211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/31/2018] [Indexed: 11/27/2022] Open
Abstract
Objective We retrospectively assessed the efficacy of stereotactic radiosurgery (SRS) for dural arteriovenous fistulas (DAVFs) involving the transverse-sigmoid sinus and analyzed the angiographic and clinical results with our 8-year experience.
Methods Nine patients with intracranial DAVFs involving the transverse-sigmoid sinus underwent SRS using a Gamma Knife® (Elekta Inc., Atlanta, GA, USA) between 2009 and 2016. Five patients underwent SRS for residual DAVFs after embolization and four patients were treated with SRS alone. The median target volume was 1.9 cm3 (range, 0.8–14.2) and the median radiation dose of the target was 17 Gy (range, 16–20). The median follow-up period was 37 months (range, 7–81).
Results Pulsating tinnitus (33%) was the most common symptom. DAVFs were completely obliterated in four patients (44%) and subtotally obliterated in five (56%). Six patients (67%) showed complete recovery of symptoms or signs, and three (33%) showed incomplete recovery. One patient experienced a recurrent seizure. Adverse radiation effects after SRS occurred in one patient (11%). The total obliteration rates after SRS were 16.7%, 37.5%, and 68.7% at 1, 2, and 3 years, respectively. The median interval from SRS to total obliteration of the fistula was 31 months (range, 12–38). The rates at which the symptoms started to improve were 40% at 1 month and 80% at 2 months after SRS. Symptoms started to improve at a median of 5 weeks after SRS (range, 3–21).
Conclusion SRS with or without embolization is a safe and effective treatment to relieve symptoms and obliterate DAVFs on the transverse-sigmoid sinus.
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Affiliation(s)
- Hong-Gyu Baek
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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10
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Lee JG, Park SH, Park KS, Kang DH, Hwang JH, Hwang SK. Do Serum Vascular Endothelial Growth Factor and Endostatin Reflect Radiological Radiation-Induced Changes After Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations? World Neurosurg 2019; 126:e612-e618. [PMID: 30831282 DOI: 10.1016/j.wneu.2019.02.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/10/2019] [Accepted: 02/10/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to analyze serum levels of vascular endothelial growth factor (VEGF) and endostatin in patients with cerebral treated by stereotactic radiosurgery (SRS), and to assess their association with radiological radiation-induced changes (RICs). METHODS To measure serum biomarkers, peripheral venous blood was collected before SRS and 1 week, 1 month, 3 months, and 6 months after SRS. To evaluate RICs, clinical and neuroimaging follow-up were performed concurrently every 6 months after SRS. RESULTS Twenty-seven patients were enrolled (11 in the group with RIC, 16 in the group without RIC). Serum VEGF and endostatin levels were positively correlated (P = 0.036, r = 0.405). In the group with RIC, the median serum VEGF 6 months after SRS (58.98 pg/mL) was significantly higher than that of the group without RIC (15.17 pg/mL) (P = 0.001). Multivariate analysis revealed that higher VEGF 6 months after SRS (P = 0.001, hazard ratio, 1.032; 95% confidence interval, 1.012-1.052) and lower endostatin 1 month after SRS (P = 0.007, hazard ratio, 0.964; 95% confidence interval, 0.935-0.993) were significantly associated with RICs. CONCLUSIONS Our results show that serum levels of VEGF 6 months after SRS were higher in the group with RIC. Serum levels of VEGF 6 months and endostatin 1 month after SRS were associated with the radiological RICs. Thus, serial measurements of serum VEGF and endostatin after SRS might help predict RICs in patients with arteriovenous malformation treated by SRS.
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Affiliation(s)
- Jae-Gwang Lee
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea; Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Sung MJ, Kim KT, Hwang JH, Sung JK, Cho DC. Safe Margin beyond Dens Tips to Ventral Dura in Anterior Odontoid Screw Fixation : Analysis of Three-Dimensional Computed Tomography Scan of Odontoid Process. J Korean Neurosurg Soc 2018; 61:503-508. [PMID: 29991109 PMCID: PMC6046568 DOI: 10.3340/jkns.2018.0034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/09/2018] [Indexed: 11/27/2022] Open
Abstract
Objective Anterior odontoid screw fixation is a safe and effective method for the treatment of odontoid fractures. The surgical technique is recommended for perforation of the apical cortex of the dens by the lag screw. However, overpenetration of the apical cortex may lead to potentially serious complications such as damages of adjacent vascular and neural structures. The purpose of this study was to assess the role of three-dimensional computed tomography (CT) scan to evaluate the safe margin beyond dens tip to ventral dura for anterior odontoid screw fixation. Methods We retrospectively analyzed the three-dimensional CT scans of the cervical spines in 55 consecutive patients at our trauma center. The patients included 38 males and 17 females aged between 22 and 73 years (mean age±standard deviation, 45.8±14.2 years). Using sagittal images of 3-dimensional CT scan, the safe margins beyond dens tip to ventral dura as well as the appropriate screw length were measured. Results The mean width of the apical dens tip was 9.6±1.1 mm. The mean lengths from the screw entry point to the apical dens tip and posterior end of dens tip were 39.2±2.6 mm and 36.6±2.4 mm. The safe margin beyond apical dens tip to ventral dura was 7.7±1.7 mm. However, the safe margin beyond the posterior end of dens tip to ventral dura was decreased to 2.1±3.2 mm, which was statistically significant (p<0.01). There were no significant differences of safe margins beyond dens tip to ventral dura with patient gender and age. Conclusion Extension by several millimeters beyond the dens tip is safe, if the trajectory of anterior odontoid screw is targeted at the apical dens tip. However, if the trajectory of the screw is targeted to the posterior end of dens tip, extension beyond dens tip may lead to damage immediately adjacent to the vental dura mater.
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Affiliation(s)
- Min-Jae Sung
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joo-Kyung Sung
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dae-Chul Cho
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.,Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Zaharia OP, Pesta D, Bobrov P, Kupriyanova Y, Bódis K, Markgraf D, Hwang JH, Burkart V, Müssig K, Roden M, Szendroedi J. Assoziation von muskuloskelettaler Einschränkung mit Betazell-Dysfunktion bei Patienten mit Typ-2-Diabetes und Arthrose. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- OP Zaharia
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - D Pesta
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - P Bobrov
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - Y Kupriyanova
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - K Bódis
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - D Markgraf
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - JH Hwang
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - V Burkart
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
| | - K Müssig
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - M Roden
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - J Szendroedi
- Deutsches Diabetes-Zentrum (DDZ), Düsseldorf, Germany
- Deutsches Zentrum für Diabetes Forschung (DZD e.V.), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
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Bódis K, Lundbom J, Jelenik T, Markgraf D, Strom A, Zaharia OP, Karusheva Y, Burkart V, Müssig K, Kupriyanova Y, Ouni M, Hwang JH, Ziegler D, Schürmann A, Roden M, Szendroedi J. Reduzierte Stearoyl-CoA-Desaturase-1 und hormonsensitive Lipase-Genexpression im oberflächlichen subkutanen Fettgewebe bei männlichen, aber nicht weiblichen Patienten mit Typ-2-Diabetes. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Bódis
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - J Lundbom
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - T Jelenik
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - D Markgraf
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - A Strom
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - OP Zaharia
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - Y Karusheva
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - V Burkart
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - K Müssig
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Y Kupriyanova
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - M Ouni
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Deutsches Institut für Ernährungsforschung (DIfE), Potsdam-Rehbrücke, Germany
| | - JH Hwang
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - D Ziegler
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - A Schürmann
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Deutsches Institut für Ernährungsforschung (DIfE), Potsdam-Rehbrücke, Germany
| | - M Roden
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - J Szendroedi
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum an der Heinrich-Heine-Universität, Leibniz-Zentrum für Diabetes-Forschung, Düsseldorf, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany
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Ahn JK, Hwang J, Hwang JH, Yoon WT, Chung PW, Ryu S. The association between serum uric acid and asymptomatic intracranial arterial stenosis in middle-aged Koreans. Nutr Metab Cardiovasc Dis 2018; 28:14-22. [PMID: 29191476 DOI: 10.1016/j.numecd.2017.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/07/2017] [Accepted: 10/17/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, especially in Asians. Hyperuricemia has been associated with an increased risk of comorbidities such as metabolic syndrome or cardiovascular diseases. However, there are few studies focusing on the association between serum uric acid (SUA) levels and asymptomatic ICAS. The aim of this study was to explore the association between SUA and the prevalence of ICAS in middle-aged Korean health screening examinees. METHODS AND RESULTS A cross-sectional study was performed on 9417 males and 7755 females who underwent a comprehensive health examination including transcranial Doppler (TCD) ultrasonography. The association of SUA and ICAS was analyzed using multivariate logistic regression. The prevalence of ICAS among the total examinee population was 3.55%. In females, the multivariate-adjusted odds ratio for ICAS was 1.52 (confidence interval 1.13-2.04) in the 3rd quartile of SUA and 1.45 (1.05-2.00) in the highest quartile, compared to the reference (P for trend 0.008). This trend was evident in all clinically relevant subgroups evaluated, including women with low inflammation status. SUA was not significantly associated with the prevalence of ICAS among males. In a sensitivity analysis, the multivariate-adjusted odds ratio of middle cerebral artery stenosis in females was 1.60 (1.09-2.37) in the highest quartile compared to the reference (P for trend 0.023). CONCLUSIONS Higher SUA level was associated with increased risk of ICAS among middle-aged females but not males. A further cohort study is warranted to elucidate the effect of SUA on asymptomatic ICAS.
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Affiliation(s)
- J K Ahn
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - J Hwang
- Department of Internal Medicine, National Police Hospital, Seoul, South Korea
| | - J H Hwang
- Center for Health Promotion, Samsung Medical Center, Seoul, South Korea
| | - W T Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - P W Chung
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
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15
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Hwang JH. Greetings from the New Editor-in-Chief. Brain Tumor Res Treat 2017; 5:53. [PMID: 29188204 PMCID: PMC5700027 DOI: 10.14791/btrt.2017.5.2.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Jeon T, Park KS, Park SH, Hwang JH, Hwang SK. Expression of Aquaporin 1 and 4 in the Choroid Plexus and Brain Parenchyma of Kaolin-Induced Hydrocephalic Rats. Korean J Neurotrauma 2017; 13:68-75. [PMID: 29201837 PMCID: PMC5702761 DOI: 10.13004/kjnt.2017.13.2.68] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/09/2017] [Accepted: 07/14/2017] [Indexed: 11/15/2022] Open
Abstract
Objective Aquaporin (AQP) is a recently discovered protein that regulates water homeostasis. The present study examines changes in AQP 1 and 4 in kaolin induced experimental hydrocephalic rats to elucidate the pathophysiology of water homeostasis in the disease. Methods Hydrocephalus was induced by percutaneous intracisternal injection of kaolin. The brain parenchyma and choroid plexus were obtained at 3, 7, 14 and 30 days after injection. Protein expressions of AQP 1 and 4 were measured by western blot, immunohistochemistry (IHC) and immunofluorescence (IF) stains. Results In the choroid plexus of the kaolin-induced hydrocephalus group, AQP 1 expression identified by western blot exhibited sharp decrease in the early stage (55% by the 3rd day and 22% by the 7th day), but indicated a 2.2-fold increase in the later stage (30th day) in comparison with control groups. In the parenchyma, a quantitative measurement of AQP 4 expression revealed variable results on the 3rd and 7th days, but indicated expression 2.1 times higher than the control in the later stage (30th day). In addition, the IHC and IF findings supported the patterns of expression of AQP 1 in the choroid plexus and AQP 4 in the parenchyma. Conclusion Expression of AQP 1 decreased sharply in the choroid plexus of acute hydrocephalus rats and increased at later stages. Expression of AQP 4 in the brain parenchyma was variable in the early stage in the hydrocephalus group, but was higher than in the control in the later stage. These findings suggest a compensating role of AQPs in water physiology in hydrocephalus.
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Affiliation(s)
- Taehyung Jeon
- Department of Neurosurgery, Kyungpook National Univeristy Hospital, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National Univeristy Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National Univeristy Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National Univeristy Hospital, Daegu, Korea
| | - Sung Kyoo Hwang
- Department of Neurosurgery, Kyungpook National Univeristy Hospital, Daegu, Korea
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Song JE, Kwak YG, Um TH, Cho CR, Kim S, Park IS, Hwang JH, Kim N, Oh GB. Outbreak of Burkholderia cepacia pseudobacteraemia caused by intrinsically contaminated commercial 0.5% chlorhexidine solution in neonatal intensive care units. J Hosp Infect 2017; 98:295-299. [PMID: 28935523 DOI: 10.1016/j.jhin.2017.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/13/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Burkholderia cepacia is intrinsically resistant to certain antiseptics. The authors noted a sudden increase in the frequency of isolation of B. cepacia from blood cultures in a neonatal intensive care unit (NICU) of a university-affiliated hospital. AIM To identify the source and intervene in the ongoing infections. METHODS The cases were defined as patients with positive blood cultures for B. cepacia in an NICU between November 2014 and January 2015. Medical records were reviewed and NICU healthcare workers were interviewed. Samples of suspected antiseptics, blood culture bottles, cotton balls, gauze and a needle used in the NICU were analysed microbiologically. FINDINGS During the outbreak period, B. cepacia was identified in 25 blood cultures obtained from 21 patients. The clinical features of the patients were suggestive of pseudobacteraemia. Regarding environmental samples, B. cepacia was cultured from 0.5% chlorhexidine gluconate (CHG) solution products that had been used as a skin antiseptic during blood drawing in the NICU. The clinical B. cepacia isolate and two strains obtained from 0.5% CHG exhibited identical pulsed-field gel electrophoresis patterns. After the CHG products were withdrawn, the outbreak was resolved. CONCLUSIONS The pseudobacteraemia cases were caused by contaminated 0.5% CHG produced by a single manufacturer. Stricter government regulation is needed to prevent contamination of disinfectants during manufacturing. In addition, microbial contamination of antiseptics and disinfectants should be suspected when a B. cepacia outbreak occurs in hospitalized patients.
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Affiliation(s)
- J E Song
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Y G Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
| | - T H Um
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - C R Cho
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - S Kim
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - I S Park
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - J H Hwang
- Department of Paediatrics, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - N Kim
- Department of Paediatrics, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - G-B Oh
- Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
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Yoon SY, Choi YJ, Park SH, Hwang JH, Hwang SK. Traumatic Brain Injury in Children under Age 24 Months: Analysis of Demographic Data, Risk Factors, and Outcomes of Post-traumatic Seizure. J Korean Neurosurg Soc 2017; 60:584-590. [PMID: 28881122 PMCID: PMC5594624 DOI: 10.3340/jkns.2016.0707.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/15/2016] [Accepted: 03/14/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. METHODS We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. RESULTS The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows: 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. CONCLUSION The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.
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Affiliation(s)
- Sang-Youl Yoon
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Yeon-Ju Choi
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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19
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Park SH, Park KS, Kang DH, Hwang JH, Hwang SK. Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: its clinical and angiographic perspectives. Acta Neurochir (Wien) 2017; 159:1093-1103. [PMID: 28401318 DOI: 10.1007/s00701-017-3177-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/30/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND To assess the efficacy of stereotactic radiosurgery (SRS) for intracranial dural arteriovenous fistulas (DAVFs), the authors retrospectively reviewed our 7-year experience. We evaluated the obliteration rate, improvement in clinical symptoms, and complications. METHODS Thirty patients with DAVF underwent SRS using a Gamma Knife between 2009 and 2015. Twenty-three patients were treated with SRS alone, and seven patients underwent SRS for residual or recurrent DAVFs after embolization or surgery. Chemosis, diplopia, and pulsating tinnitus were the most common symptoms. Median target volume was 2.9 cm3 (range, 0.8-13.6 cm3), and median radiation dose to the target was 17 Gy (range, 12-20 Gy). Median follow-up period was 33 months (range, 6-82 months). RESULTS At the last neuroimaging follow-up, DAVFs were totally obliterated in 23 patients (77%) and subtotally in 7 (23%). At the last clinical follow-up, 21 patients (70%) showed complete recovery, and 9 (30%) showed incomplete recovery in symptoms or signs. None experienced worsening symptoms or signs. Asymptomatic perilesional edema after SRS occurred in one patient (3%). Total obliteration rates after SRS were 43% at 1 year, 79% at 2 years, and 95% at 5 years. Improvement rates of neurological function after SRS were 12% at 1 month, 52% at 2 months, 72% at 3 months, and 96% at 6 months. A multivariate analysis revealed that Borden type 1 (p = 0.019, hazard ratio, 3.254, 95% confidence interval, 1.216-8.707) was significantly associated with symptom improvement. CONCLUSIONS SRS for intracranial DAVFs provided a high obliteration rate and a relatively low risk of radiation-induced complications. In selected benign cases without cortical venous drainage, SRS is a safe and effective treatment for symptom relief and fistula obliteration, even though the time course of improvement is longer than those of embolization and surgery.
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Affiliation(s)
- Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea.
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea
- Department of Radiology, Kyungpook National University Hospital, Daegu, South Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea
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20
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Yu GE, Kwon S, Hwang JH, An SM, Park DH, Kang DG, Kim TW, Kim IS, Park HC, Ha J, Kim CW. Effects of cell death-inducing DFF45-like effector B on meat quality traits in Berkshire pigs. Genet Mol Res 2017; 16:gmr-16-02-gmr.16029408. [PMID: 28549200 DOI: 10.4238/gmr16029408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cell death-inducing DFF45-like effector (CIDE) B is a member of the CIDE family of apoptosis-inducing factors. In the present study, we detected a single nucleotide polymorphism (SNP), c.414G>A, which corresponds to the synonymous SNP 414Arg, in CIDE-B in the Berkshire pigs. We also analyzed the relationships between the CIDE-B SNP and various meat quality traits. The SNP was significantly associated with post-mortem pH24h, water-holding capacity (WHC), fat content, protein content, drip loss, post-mortem temperature at 12 h (T12) and 24 h (T24) in a co-dominant model (P < 0.05). A significant association was detected between the SNP and post-mortem pH24h, fat content, protein content, drip loss, shear force, and T24 in gilts; and color parameter b*, WHC, and T24 in barrows (P < 0.05). The SNP was significantly correlated with the fat content, and CIDE-B mRNA expression was significantly upregulated during the early stage of adipogenesis, suggesting that CIDE-B may contribute towards initiation of adipogenesis (P < 0.05). Furthermore, CIDE-B mRNA was strongly expressed in the liver, kidney, large intestine, and small intestine, and weakly expressed in the stomach, lung, spleen, and white adipose tissue. These results indicate that the CIDE-B SNP is closely associated with meat quality traits and may be a useful DNA marker for improving pork quality.
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Affiliation(s)
- G E Yu
- Swine Science and Technology Center, , , South Korea
| | - S Kwon
- Swine Science and Technology Center, , , South Korea
| | - J H Hwang
- Swine Science and Technology Center, , , South Korea
| | - S M An
- Swine Science and Technology Center, , , South Korea
| | - D H Park
- Swine Science and Technology Center, , , South Korea
| | - D G Kang
- Swine Science and Technology Center, , , South Korea
| | - T W Kim
- Swine Science and Technology Center, , , South Korea
| | - I-S Kim
- Department of Animal Resources Technology, Gyeongnam National University of Science and Technology, Gyeongnam, South Korea
| | - H C Park
- Dasan Pig Breeding Co., Namwon-si, South Korea
| | - J Ha
- Swine Science and Technology Center, , , South Korea
| | - C W Kim
- Swine Science and Technology Center, , , South Korea
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21
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Weber KS, Straßburger K, Fritsch M, Bierwagen A, Pacini G, Hwang JH, Szendroedi J, Müssig K, Roden M. Effekte der Inkretin- und Glukagon-Sekretion auf den hepatischen Energiestoffwechsel bei Adipositas und Typ-2-Diabetes. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- KS Weber
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - K Straßburger
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - M Fritsch
- Universitätsklinikum für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Austria
| | - A Bierwagen
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - G Pacini
- Institute of Neuroscience, National Research Council (CNR), Padua, Italy
| | - JH Hwang
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - J Szendroedi
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - K Müssig
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - M Roden
- Institut für Klinische Diabetologie, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetesforschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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Park SH, Park KS, Kang DH, Hwang JH, Hwang SK. Stereotactic Radiosurgery for Dural Carotid Cavernous Sinus Fistulas. World Neurosurg 2017; 106:836-843. [PMID: 28465265 DOI: 10.1016/j.wneu.2017.04.143] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/20/2017] [Accepted: 04/21/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We reviewed our 7-year experience to assess the efficacy of stereotactic radiosurgery (SRS) for dural carotid cavernous fistulas (DCCFs). We analyzed the clinical outcome, complications, and angiographic results. METHODS We performed a retrospective analysis of 18 consecutive patients with DCCFs treated by SRS alone using Gamma Knife between 2009 and 2015. Median target volume was 2.6 cm3 (range, 0.6-11.6 cm3), and median radiation dose to the target was 17 Gy (range, 14-19 Gy). Median follow-up period was 30 months (range, 6-65 months). RESULTS Fifteen patients (83%) achieved total obliteration of the DCCF, and a subtotal obliteration of the DCCF was achieved in 3 patients (17%). Total obliteration rates after SRS were 53% at 1 year and 90% at 2 years. Twelve patients (67%) showed complete recovery from symptoms or signs, and 6 patients (33%) showed incomplete recovery. Improvement rates of neurologic function after SRS were 56% at 1 month, 72% at 3 months, and 94% at 6 months. None of the patients experienced radiation-related complications. A univariate analysis revealed that absence of hypertension (P = 0.025), seizure (P = 0.025), and cortical venous drainage (P = 0.013) were significantly associated with symptoms improvement. CONCLUSIONS SRS for DCCFs offered a high obliteration rate with low risk of radiation-induced complications. In patients with benign DCCFs that are not amenable to embolization or microsurgery, SRS is a safe and effective treatment for complete obliteration of the arteriovenous shunt and for improving quality of life.
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Affiliation(s)
- Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea.
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea; Department of Radiation, Kyungpook National University Hospital, Daegu, South Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea
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Lee KT, Bang SI, Pyon JK, Hwang JH, Mun GH. Method of breast reconstruction and the development of lymphoedema. Br J Surg 2016; 104:230-237. [DOI: 10.1002/bjs.10397] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/07/2016] [Accepted: 09/06/2016] [Indexed: 11/11/2022]
Abstract
Abstract
Background
Several studies have demonstrated an association between immediate autologous or implant-based breast reconstruction and a reduced incidence of lymphoedema. However, few of these have ocused specifically on whether the reconstruction method affects the development of lymphoedema. The study evaluated the potential impact of breast reconstruction modality on the incidence of lymphoedema.
Methods
Outcomes of women with breast cancer who underwent mastectomy and immediate reconstruction using an autologous flap or a tissue expander/implant between 2008 and 2013 were reviewed. Arm or hand swelling with pertinent clinical signs of lymphoedema and excess volume compared with those of the contralateral side was diagnosed as lymphoedema. The cumulative incidence of lymphoedema was estimated by the Kaplan–Meier method. Clinicopathological factors associated with the development of lymphoedema were investigated by Cox regression analysis.
Results
A total of 429 reconstructions (214 autologous and 215 tissue expander/implant) were analysed; the mean follow-up of patients was 45·3 months. The two groups had similar characteristics, except that women in the autologous group were older, had a higher BMI, and more often had preoperative radiotherapy than women in the tissue expander/implant group. Overall, the 2-year cumulative incidence of lymphoedema was 6·8 per cent (autologous 4·2 per cent, tissue expander/implant 9·3 per cent). Multivariable analysis demonstrated that autologous reconstruction was associated with a significantly reduced risk of lymphoedema compared with that for tissue expander/implant reconstruction. Axillary dissection, a greater number of dissected lymph nodes and postoperative chemotherapy were also independent risk factors for lymphoedema.
Conclusion
The method of breast reconstruction may affect subsequent development of lymphoedema.
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Affiliation(s)
- K-T Lee
- Department of Plastic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S I Bang
- Department of Plastic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J-K Pyon
- Department of Plastic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J H Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - G-H Mun
- Department of Plastic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
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24
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Jo JL, Hwang JH, Kwon SG, Park DH, Kim TW, Kang DG, Yu GE, Kim IS, Ha JG, Kim CW. Association between a non-synonymous HSD17B4 single nucleotide polymorphism and meat-quality traits in Berkshire pigs. Genet Mol Res 2016; 15:gmr-15-gmr15048970. [PMID: 27819726 DOI: 10.4238/gmr15048970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Single nucleotide polymorphisms (SNPs) are useful genetic markers that allow correlation of genetic sequences with phenotypic traits. It is shown here that HSD17B4, a bifunctional enzyme mediating dehydrogenation and anhydration during β-oxidation of long-chain fatty acids, contains a non-synonymous SNP (nsSNP) of chr2:128,825,976A>G, c.2137A>G, I690V, within the sterol carrier protein-2 domain of the HSD17B4 gene, by RNA-Seq of liver RNA. The HSD17B4 mRNA was highly expressed in the kidney and liver among various other tissues in four pig breeds, namely, Berkshire, Duroc, Landrace, and Yorkshire. The nsSNP was significantly associated with carcass weight, backfat thickness, and drip loss (P < 0.05). Furthermore, HSD17B4 may play a crucial role during the early stages of myogenesis when expression of its mRNA was significantly high. In conclusion, HSD17B4 may serve as a possible regulator of muscle development, and its identification should help to select for improved economic traits of Berkshire pigs such as carcass weight, backfat thickness, and drip loss.
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Affiliation(s)
- J L Jo
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - J H Hwang
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - S G Kwon
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - D H Park
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - T W Kim
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - D G Kang
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - G E Yu
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - I S Kim
- Department of Animal Resource Technology, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - J G Ha
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
| | - C W Kim
- Swine Science and Technology Center, Gyeongnam National University of Science & Technology, Jinju, South Korea
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Park KS, Lee CH, Park SH, Hwang SK, Hwang JH. Chronic Subdural Hematoma Preceded by High-Impact Trauma: Does the Intensity of Trauma Influence the Pathogenesis of Traumatic Chronic Subdural Hematoma? Turk Neurosurg 2016; 27:53-59. [PMID: 27593764 DOI: 10.5137/1019-5149.jtn.14452-15.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM The purpose of this study was to investigate whether the intensity of trauma influences the pathogenesis of traumatic chronic subdural hematoma (CSDH). MATERIAL AND METHODS Thirty-one patients treated surgically for traumatic CSDH were divided into high-impact and lowimpact groups according to the intensity of trauma. They were respectively evaluated with respect to clinical and radiological findings at presentation, and the subdural concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), basic fibroblast growth factor, and beta-trace protein (ΒTP) [a highly specific protein in the cerebrospinal fluid (CSF)] related to the pathogenesis of CSDH. If ΒTP (subdural fluid/serum) was > 2, an admixture of CSF to the subdural fluid was indicated. RESULTS The ΒTP (subdural fluid/serum) was > 2 in all patients with a traumatic CSDH. The mean concentration of subdural ΒTP in the high-impact group was higher than in the low-impact group (6.1 mg/L versus 3.9 mg/L), and the difference was statistically significant (p=0.02). In addition, mean concentrations of IL-6, IL-8 and VEGF were higher in the high-impact group, as compared to the low-impact group, though the differences did not reach statistical significance. CONCLUSION Trauma may be related to CSF leakage into the subdural space in CSDH, and the intensity of trauma may influence the amount of CSF leakage. Although there is no direct correlation between the amount of CSF leakage and other subdural molecules, the intensity of trauma may be associated with larger concentrations of molecules in traumatic CSDH.
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Affiliation(s)
- Ki-Su Park
- Kyungpook National University School of Medicine, Department of Neurosurgery, Daegu, Republic of Korea
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Abstract
A lymphatic malformation (LM) is the most common form of congenital vascular malformation (CVM). The new Hamburg classification of CVM distinguishes the truncular (T) form from the extratruncular (ET) form of LMs. Both are consequences of a developmental arrest at the different stages of lymphangiogenesis as a result of defective genes. The purpose of this review was to evaluate the current management results of both forms of LMs. A retrospective review of the clinical data of 315 patients with a diagnosis of LMs treated between September 1994 and December 2001 was performed. Lymphoscintigraphy was the most frequent diagnostic test. The patients with the ET form were treated with sclerotherapy with OK-432 and/or ethanol. Combinations of CDP (complex decongestive physiotherapy) and/or compressotherapy were used to treat all the T-form patients. In addition, surgery, either reconstructive or ablative, was offered to patients with the T form who failed to respond to the proper CDP. A multidisciplinary team performed the management of LM, and the results were evaluated every 6 months. Among 797 patients with CVM, 315 were confirmed to have LMs, either as the T form (226) or the ET form (89). Another 66 LMs were diagnosed with hemolymphatic malformations (HLM). Most of the ET forms (89/315) were the cystic type (70/89), while the T forms included aplasia and/or an obstruction (204/226). The ET form was most frequent in the head, neck, and thorax (69/89). The T form was located most frequently to the extremities (202/226), mostly to the lower limb (180/202). Two hundred and twenty-six T forms belonged to the various clinical stages: stages I-32, II-104, III-48, IV-18, and an unclear stage-24. The ET form was treated with sclerotherapy using OK-432 (108/120) and absolute ethanol (12/120). Among the 11 patients with the multiple ET form, 7 patients underwent perioperative sclerotherapy with OK-432 and a subsequent surgical excision. The clinical response of the T form at the extremity to CDP was excellent to good in a majority of clinical stages I to II (121/136) but decreased to a good to fair degree in stages III to IV (31/66). The additional surgical therapy, either reconstructive (10/19) or ablative (9/19), provided limited success in improving CDP efficacy, owing mainly to poor compliance. The long-term outcome of the initial success through self-motivated home-maintenance care during the follow-up period of up to 48 months was totally dependent on patient compliance. OK-432 sclerotherapy to 51 ET forms has shown excellent results on 88.9% of the cystic type (40/45) and 50% (3/6) of the cavernous type (minimum follow-up for 24 months). Seventeen ET forms in 7 patients were treated with a preoperative OK-432 sclerotherapy and a subsequent surgical excision, which provided good to excellent results in 14 for a minimum of 24 months. Primary lymphedema, which is the T form of LMs, can be managed safely by a combination of CDP with compressotherapy. Patients with good compliance can benefit from additional surgical therapy, either reconstructive or ablative. The ET form, particularly the cystic type, can be treated with various scleroagents that are preferably less toxic as the primary therapy. A surgical excision with or without perioperative sclerotherapy provides good results for patients with the localized cavernous type of the ET form. A multidisciplinary team approach is essential for the proper care of LM.
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Affiliation(s)
- B B Lee
- Department of Surgery, Sungkyunkwan University School of Medicine and Samsung Medical Center, Seoul, Korea.
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Park KS, Lee HW, Park SH, Park TI, Hwang JH. The clinical significance of fascin expression in a newly diagnosed primary glioblastoma. J Neurooncol 2016; 129:495-503. [PMID: 27406586 DOI: 10.1007/s11060-016-2200-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/04/2016] [Indexed: 10/25/2022]
Abstract
The actin-binding protein fascin has been associated with clinically aggressive tumors and poor prognosis. The purpose of this study was to investigate possibility of fascin expression as a prognostic factor in a newly diagnosed primary glioblastoma (GBM). Between July 2007 and December 2013, 37 out of 126 patients diagnosed with GBM satisfied the following inclusion criteria: (1) the presence of immunohistochemically-available tissue, (2) a new primary GBM, (3) gross-total resection, and (4) standardized adjuvant treatment, known as the Stupp regimen. The median follow-up period was 18 months (range 5-95). According to the staining intensity of fascin, progression-free survival (PFS) in the low-intensity fascin group (median PFS 9.0 months; 95 % CI 6.0-12.0) was longer than PFS in the high-intensity fascin group (median PFS 7.0 months; 95 % CI 5.6-10.4; p = 0.024). Overall survival (OS) in the low-intensity fascin group (median OS 20.0 months; 95 % CI 17.7-22.4) was longer than OS in the high-intensity fascin group (median OS 13.0 months; 95 % CI 8.2-17.8; p = 0.031). And, the staining intensity of fascin was a statistically significant factor in PFS and OS according to univariate and multivariate analyses (univariate analysis p = 0.043 and p = 0.043; multivariate analysis p = 0.041 and p = 0.044). Our clinical study showed that fascin expression intensity may be correlated with clinical outcomes of a newly diagnosed primary GBM, especially with regard to PFS and OS.
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Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hye Won Lee
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, 50, Samduk 2-Ga, Jung-Gu, Daegu, 700-721, Republic of Korea
| | - Tae In Park
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, 50, Samduk 2-Ga, Jung-Gu, Daegu, 700-721, Republic of Korea.
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Yoon SY, Park SH, Hwang JH, Hwang SK. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures. Korean J Neurotrauma 2016; 12:34-7. [PMID: 27182500 PMCID: PMC4866564 DOI: 10.13004/kjnt.2016.12.1.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 12/02/2015] [Accepted: 12/16/2015] [Indexed: 11/15/2022] Open
Abstract
We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered.
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Affiliation(s)
- Sang-Youl Yoon
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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Abstract
UNLABELLED The aims of this study were to report functional outcomes of salvage procedures for patients with cerebral palsy (CP) who have chronic dislocation of the hip using validated scoring systems, and to compare the results of three surgical techniques. We reviewed 37 patients retrospectively. The mean age at the time of surgery was 12.2 years (8 to 22) and the mean follow-up was 56 months (24 to 114). Patients were divided into three groups: 14 who underwent proximal femoral resection arthroplasty (PFRA group 1), ten who underwent subtrochanteric valgus osteotomy (SVO group 2), and 13 who underwent subtrochanteric valgus osteotomy with resection of the femoral head (SVO with FHR group 3). All patients were evaluated using the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) and the Pediatric Quality of Life Inventory (PedsQL). Significant improvements occurred in most CPCHILD and PedsQL subsection scores following surgery in all patients, without significant differences between the groups. There were 12 post-operative complications. Less severe complications were seen in group 1 than in groups 2 and 3. Salvage surgery appears to provide pain relief in patients with CP who have painful chronic dislocation of the hip. The three salvage procedures produced similar results, however, we recommend the use of PFRA as the complications are less severe. TAKE HOME MESSAGE Salvage surgery can be of benefit to patients with CP with chronic painful hip dislocation, but should be limited to selected patients considering complications.
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Affiliation(s)
- J H Hwang
- Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - L Varte
- Synod Hospital, Durtlang, Aizawl 796 025 Mizoram, India
| | - H W Kim
- Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - D H Lee
- Severance Children's Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - H Park
- Gangnam Severance Hospital Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea
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Lee BS, Lee SH, Jang DK, Chung KH, Hwang JH, Jang SE, Cha BH, Ryu JK, Kim YT. Belching during gastroscopy and its association with gastroesophageal reflux disease. Dis Esophagus 2016; 29:342-9. [PMID: 25708811 DOI: 10.1111/dote.12326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Belching may result from transient lower esophageal sphincter relaxation; therefore, it has been proposed that belching may be a manifestation of gastroesophageal reflux disease (GERD). This study was conducted to investigate the frequency of belching during esophagogastroduodenoscopy (EGD) and its association with GERD. A retrospective review was performed on prospectively collected clinical and endoscopic data from 404 subjects who underwent EGD without sedation from December 2012 to May 2013 in a training hospital in Korea. All detectable belching events during endoscopy were counted. Frequency and severity of belching events were compared between the group with and without GERD using an ordinal logistic regression model. There were 145 GERD patients (26 erosive reflux disease and 119 nonerosive reflux disease [NERD]). In the multivariable analysis, GERD was significantly associated with a higher frequency of belching events (odds ratio = 6.59, P < 0.001). Central obesity, female, and younger age were also risk factors for frequent belching during EGD. Subgroup analyses were performed in subjects without erosive reflux disease (n = 378) and NERD (n = 293). NERD was also a predictive factor for frequent belching during EGD (odds ratio = 6.61, P < 0.001), and the frequency of belching was significantly correlated with GERD severity according to the Los Angeles classification (P < 0.05). Frequent belching during EGD was associated with GERD, including NERD. Future research should focus on its adjuvant role in the diagnosis of GERD/NERD and the necessity for applying differentiated endoscopy strategies for GERD patients, leading to less discomfort during EGD in patients at risk for intolerability.
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Affiliation(s)
- B S Lee
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.,Digestive Disease Center, Department of Internal Medicine, Cheju Halla General Hospital, Jeju, South Korea
| | - S H Lee
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - D K Jang
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - K H Chung
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - J H Hwang
- Department of Internal Medicine, Busan Medical Center, Busan, South Korea
| | - S E Jang
- Department of Internal Medicine, Cheongju St. Mary's Hospital, Cheongju, South Korea
| | - B H Cha
- Digestive Disease Center, Department of Internal Medicine, Cheju Halla General Hospital, Jeju, South Korea
| | - J K Ryu
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Y-T Kim
- Departments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
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Lee S, Lee JY, Hwang JH, Shin JH, Kim TH, Kim SK. Clinical importance of inflammatory facet joints of the spine in ankylosing spondylitis: a magnetic resonance imaging study. Scand J Rheumatol 2016; 45:491-498. [PMID: 27098409 DOI: 10.3109/03009742.2016.1150506] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aims of this study were to assess the reliability of a novel magnetic resonance imaging (MRI) scoring system for inflammatory lesions of facet joints and to clarify the clinical significance of facet joint inflammation in ankylosing spondylitis (AS). METHOD A total of 53 AS patients (45 males, 84.9%) were assessed for active inflammatory lesions involving the facet joints, as indicated by bone marrow oedema, at 23 discovertebral units (DVUs) between C2 and S1 using a novel scale, the AS Activity of the Facet joint (ASAFacet). The reliability of the ASAFacet was evaluated using intraclass correlation coefficients (ICCs) and Bland-Altman plots. RESULTS ICC values for the ASAFacet scores were 0.857 [95% confidence interval (CI) 0.741-0.919] for inter-observer and 0.941 (95% CI 0.873-0.969) for intra-observer reliability. Inflammatory activity scores in facet joints were evenly distributed at all spine levels (p = 0.294 for ASAFacet), whereas vertebral body inflammation was more prominent in the thoracic spine than in the cervical and lumbar spine [p < 0.001 for the AS spine MRI activity (ASspiMRI-a) score, p = 0.002 for the Berlin method, and p < 0.001 for the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI index]. ASAFacet scores were closely associated with erythrocyte sediment rate (ESR) and C-reactive protein (CRP) levels (p < 0.05, respectively). Patients with peripheral arthritis had fewer lesions involving the vertebral bodies or facet joints than patients without peripheral arthritis (p < 0.001 for the four different MRI activity indexes). CONCLUSIONS This study suggests that recognition of facet joint inflammation has the potential to contribute to our understanding of clinical outcomes in AS.
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Affiliation(s)
- S Lee
- a Department of Radiology , Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea
| | - J Y Lee
- a Department of Radiology , Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea
| | - J H Hwang
- b Department of Preventive Medicine , Catholic University of Daegu School of Medicine , Daegu , South Korea
| | - J H Shin
- c Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea
| | - T-H Kim
- c Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea
| | - S-K Kim
- d Division of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research Centre , Catholic University of Daegu School of Medicine , Daegu , South Korea
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Lee KM, Park SH, Park KS, Hwang JH, Hwang SK. Analysis of Circulating Endostatin and Vascular Endothelial Growth Factor in Patients with Pituitary Adenoma Treated by Stereotactic Radiosurgery: A Preliminary Study. Brain Tumor Res Treat 2015; 3:89-94. [PMID: 26605263 PMCID: PMC4656901 DOI: 10.14791/btrt.2015.3.2.89] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/02/2015] [Accepted: 07/16/2015] [Indexed: 12/30/2022] Open
Abstract
Background The purpose of this study was to investigate plasma levels of endostatin and vascular endothelial growth factor (VEGF) in normal subjects and in patients with pituitary adenoma and to evaluate change in these levels following stereotactic radiosurgery (SRS) for pituitary adenoma. Methods Peripheral venous blood was collected from five patients with pituitary adenoma before SRS using Gamma Knife and at the 1 week and 1 month follow-up visits. Plasma endostatin and VEGF levels were measured using commercially available enzyme-linked immunosorbent assay kits. Peripheral blood samples were obtained from 10 healthy volunteers as controls. Results Mean baseline plasma endostatin level (105.3 ng/mL, range, 97.0-120.2 ng/mL) in patients with pituitary adenoma was higher than that of the healthy controls (86.6 ng/mL, range, 71.3-98.2 ng/mL) (p=0.001). Mean plasma VEGF level was 89.5 pg/mL (range, 24.1-171.8 pg/mL) in patients with pituitary adenoma at baseline and 29.3 pg/mL (range, 9.2-64.3 pg/mL) in the control group (p=0.050). Plasma endostatin level changed to 106.6 ng/mL 1 week after SRS and decreased to 95.9 ng/mL after 1 month. Plasma VEGF level following SRS decreased to 74.1 pg/mL after 1 week and 79.0 pg/mL after 1 month. There was a trend toward decreased plasma endostatin and VEGF concentrations 1 month after SRS compared to baseline levels (p=0.195, p=0.812, respectively). Conclusion Plasma endostatin and VEGF levels in patients with pituitary adenoma were significantly elevated over controls at baseline, which decreased from baseline to 1 month after SRS for pituitary adenomas.
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Affiliation(s)
- Kyung-Min Lee
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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Hwang JH, Kim HW, Lee DH, Chung JH, Park H. One-stage rotational osteotomy for congenital radioulnar synostosis. J Hand Surg Eur Vol 2015; 40:855-61. [PMID: 25827142 DOI: 10.1177/1753193415580066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/10/2015] [Indexed: 02/03/2023]
Abstract
We report the results of a one-stage rotational osteotomy of the proximal third of the ulna and distal third of the radius with segmental bone resection for treating congenital radioulnar synostosis. We retrospectively reviewed 25 patients (28 forearms) treated by operation. Patients were divided into two groups according to the method of internal fixation at the osteotomy sites. In Group 1 the ulnar osteotomy was stabilized with an intramedullary pin and in Group 2 no fixation was used. The average forearm position improved from 47° pronation before surgery, to 27° supination after surgery. There were no statistically significant differences between the two groups in surgical outcomes. One-stage rotational osteotomy of the proximal third of the ulna and distal third of the radius with segmental bone resection is a simple and safe treatment for patients with congenital radioulnar synostosis. Internal fixation at the osteotomy site seems to be unnecessary. Level of evidence: Level 4.
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Affiliation(s)
- J H Hwang
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H W Kim
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - D H Lee
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - J H Chung
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H Park
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Park MK, Kim M, Park KS, Park SH, Hwang JH, Hwang SK. A Retrospective Analysis of Ventriculoperitoneal Shunt Revision Cases of a Single Institute. J Korean Neurosurg Soc 2015; 57:359-63. [PMID: 26113963 PMCID: PMC4479717 DOI: 10.3340/jkns.2015.57.5.359] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/16/2015] [Accepted: 02/27/2015] [Indexed: 11/27/2022] Open
Abstract
Objective Ventriculoperitoneal (VP) shunt complication is a major obstacle in the management of hydrocephalus. To study the differences of VP shunt complications between children and adults, we analyzed shunt revision surgery performed at our hospital during the past 10 years. Methods Patients who had undergone shunt revision surgery from January 2001 to December 2010 were evaluated retrospectively by chart review about age distribution, etiology of hydrocephalus, and causes of revision. Patients were grouped into below and above 20 years old. Results Among 528 cases of VP shunt surgery performed in our hospital over 10 years, 146 (27.7%) were revision surgery. Infection and obstruction were the most common causes of revision. Fifty-one patients were operated on within 1 month after original VP shunt surgery. Thirty-six of 46 infection cases were operated before 6 months after the initial VP shunt. Incidence of shunt catheter fracture was higher in younger patients compared to older. Two of 8 fractured catheters in the younger group were due to calcification and degradation of shunt catheters with fibrous adhesion to surrounding tissue. Conclusion The complications of VP shunts were different between children and adults. The incidence of shunt catheter fracture was higher in younger patients. Degradation of shunt catheter associated with surrounding tissue calcification could be one of the reasons of the difference in facture rates.
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Affiliation(s)
- Man-Kyu Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Myungsoo Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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Park KS, Park SH, Hwang SK, Kim C, Hwang JH. Correlation of the Beta-trace protein and inflammatory cytokines with magnetic resonance imaging in chronic subdural hematomas : a prospective study. J Korean Neurosurg Soc 2015; 57:235-41. [PMID: 25932289 PMCID: PMC4414766 DOI: 10.3340/jkns.2015.57.4.235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/06/2015] [Accepted: 02/13/2015] [Indexed: 11/27/2022] Open
Abstract
Objective Magnetic resonance imaging (MRI) of chronic subdural hematoma (CSDH) detects various patterns, which can be attributed to many factors. The purpose of this study was to measure the level of interleukin-6 (IL-6), interleukin-8 (IL-8), and highly specific protein [beta-trace protein (βTP)] for cerebrospinal fluid (CSF) in CSDHs, and correlate the levels of these markers with the MRI findings. Methods Thirty one patients, treated surgically for CSDH, were divided on the basis of MRI findings into hyperintense and non-hyperintense groups. The concentrations of IL-6, IL-8, and βTP in the subdural fluid and serum were measured. The βTP was considered to indicate an admixture of CSF to the subdural fluid if βTP in the subdural fluid (βTPSF)/βTP in the serum (βTPSER)>2. Results The mean concentrations of IL-6 and IL-8 of the hyperintense group (n=17) of T1-WI MRI were 3975.1±1040.8 pg/mL and 6873.2±6365.4 pg/mL, whereas them of the non-hyperintense group (n=14) were 2173.5±1042.1 pg/mL and 2851.2±6267.5 pg/mL (p<0.001 and p=0.004). The mean concentrations of βTPSF and the ratio of βTPSF/βTPSER of the hyperintense group (n=13) of T2-WI MRI were 7.3±2.9 mg/L and 12.6±5.4, whereas them of the non-hyperintense group (n=18) were 4.3±2.3 mg/L and 7.5±3.9 (p=0.011 and p=0.011). Conclusion The hyperintense group on T1-WI MRI of CSDHs exhibited higher concentrations of IL-6 and IL-8 than non-hyperintense group. And, the hyperintese group on T2-WI MRI exhibited higher concentrations of βTPSF and the ratio of βTPSF/βTPSER than non-hyperintense group. These findings appear to be associated with rebleeding and CSF admixture in the CSDHs.
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Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chaekyung Kim
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
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Park KS, Kim KH, Park SH, Hwang JH, Lee DH. Intracranial meningioma with leptomeningeal dissemination : retrospective study with review of the literature. J Korean Neurosurg Soc 2015; 57:258-65. [PMID: 25932292 PMCID: PMC4414769 DOI: 10.3340/jkns.2015.57.4.258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/01/2015] [Accepted: 02/09/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purposes of this article are to present 5 cases of intracranial meningioma with leptomeningeal dissemination (LD) and investigate the characteristics of this disease. METHODS We present a retrospective case series of 5 females at our institutions (age ranged 21-72 years, mean 54.6 years) diagnosed with LD of an intracranial meningioma after surgery between 1998 and 2013. A database search revealed 45 cases with LD of meningioma in the English literature. Characteristic features were analyzed and compared. RESULTS The incidence rate at our institutions of LD of meningioma was 0.9% (5/534). World Health Organization (WHO) grade was distributed as follows: I : 2, II : 2, and III : 1. Time to LD ranged from 2.5 months to 6.9 years; the patient with WHO grade III had the shortest interval to LD. The patient with an intraventricular meningioma (WHO grade II) had the second shortest interval to LD (1.7 years), and simultaneously revealed both LD and extraneuronal metastases. Four of 5 patients showed a disease progression, with the survival ranging from 1 month to 3.8 years after LD. Based on the literature, the initial tumor was an intraventricular meningioma in 9 patients, and their time to LD was shorter on average (mean 1.9 years). Histologically, 26 of 45 (58%) were initially diagnosed with a WHO grade II or III meningioma, and 6 of 19 patients (32%) with WHO grade I revealed malignant transformation. CONCLUSION This study shows that intraventricular location and histologically aggressive features seem to increase the chance of LD of meningioma.
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Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ki-Hong Kim
- Department of Neurosurgery, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong-Hyun Lee
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
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Kim DH, Kang DH, Park J, Hwang JH, Park SH, Son WS. Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause. J Cerebrovasc Endovasc Neurosurg 2015; 17:36-42. [PMID: 25874184 PMCID: PMC4394118 DOI: 10.7461/jcen.2015.17.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/22/2014] [Accepted: 02/23/2015] [Indexed: 11/23/2022] Open
Abstract
Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were included in the radiation field and delayed injury to these is suggested to be the mechanism of the ischemic event.
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Affiliation(s)
- Dong-Han Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea. ; Department of Radiology, Kyungpook National University Hospital, Daegu, Korea
| | - Jaechan Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Won-Soo Son
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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Park SH, Hwang JH, Hwang SK. Change in plasma vascular endothelial growth factor after gamma knife radiosurgery for meningioma: a preliminary study. J Korean Neurosurg Soc 2015; 57:77-81. [PMID: 25733986 PMCID: PMC4345197 DOI: 10.3340/jkns.2015.57.2.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 09/23/2014] [Accepted: 09/26/2014] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study was to investigate changes in the plasma level of vascular endothelial growth factor (VEGF) after Gamma Knife radiosurgery (GKRS) for the treatment of meningioma. Methods Fourteen patients with meningiomas had peripheral venous blood collected at the time of GKRS and at 1 week, 1 month, 3 month and 6 month visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay. For controls, peripheral blood samples were obtained from 20 healthy volunteers. Results The mean plasma VEGF level (29.6 pg/mL) in patients with meningiomas before GKRS was significantly lower than that of the control group (62.4 pg/mL, p=0.019). At 1 week after GKRS, the mean plasma VEGF levels decreased to 23.4 pg/mL, and dropped to 13.9 pg/mL at 1 month, 14.8 pg/mL at 3 months, then increased to 27.7 pg/mL at 6 months. Two patients (14.3%) with peritumoral edema (PTE) showed a level of VEGF 6 months after GKRS higher than their preradiosurgical level. There was no significant association found in an analysis of correlation between PTE and tumor size, marginal dose, age, and sex. Conclusion Our study is first in demonstrating changes of plasma VEGF after stereotactic radiosurgery (SRS) for meningioma. This study may provide a stimulus for more work related to whether measurement of plasma level has a correlation with tumor response after SRS for meningioma.
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Affiliation(s)
- Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Kyoo Hwang
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea
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Choi YJ, Park KS, Park SH, Hwang JH. Two Cases of Cavernous Malformation Presenting with Unusual and Large Intracerebral Hemorrhages. J Cerebrovasc Endovasc Neurosurg 2015; 17:32-5. [PMID: 25874183 PMCID: PMC4394117 DOI: 10.7461/jcen.2015.17.1.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 12/16/2014] [Accepted: 02/13/2015] [Indexed: 11/23/2022] Open
Abstract
Cavernous malformations (CMs), characterized by the presence of a hemosiderin rim and intralesional hemorrhage, are relatively common intracranial vascular malformations. Extralesional hemorrhages arising from CMs are seen in a minority of cases, but most of them show typical CM findings on magnetic resonance imaging. Here, the authors report two cases of pathologically confirmed CM presenting with unusual and large intracerebral hemorrhages, which were not surrounded by the typical hemosiderin rim. CMs presenting with large intracerebral hemorrhage should be considered in the differential diagnosis of massive intracerebral hemorrhages.
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Affiliation(s)
- Yeon-Ju Choi
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
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Abstract
Pituitary carcinomas, which are rare, generally present with craniospinal and systemic metastases. Although several treatments exist, the prognoses of patients with pituitary carcinomas are extremely poor to date. In this report, the authors describe the case of a 23-year-old male who had undergone trans-sphenoidal surgery and radiotherapy for an invasive prolactinoma. Seven years later, he presented with a new 4th ventricle metastasis from the pituitary lesion, and it was diagnosed with a pituitary carcinoma. He underwent resection and Gamma-knife radiosurgery (GKRS). The tumor has been well controlled for over 3 years. To our knowledge, there have been no reports of the effects of GKRS in patients with pituitary carcinomas. GKRS might have considerable effects in the treatment of pituitary carcinomas.
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Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Han MH, Park KS, Park SH, Hwang JH. Supratentorial extraventricular anaplastic ependymoma presenting with repeated intratumoral hemorrhage. Brain Tumor Res Treat 2014; 2:81-6. [PMID: 25408930 PMCID: PMC4231620 DOI: 10.14791/btrt.2014.2.2.81] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/03/2014] [Accepted: 05/07/2014] [Indexed: 11/23/2022] Open
Abstract
Supratentorial extraventricular anaplastic ependymomas are extremely rare. We report the case of a 23-year-old male with a supratentorial extraventricular anaplastic ependymoma that presented with repeated intratumoral hemorrhage. The patient was diagnosed with an intracerebral hematoma in the left occipital lobe and underwent operation. The hematoma did not reveal tumor cells, but a new tumor grew in the same location 5 years later. Magnetic resonance imaging showed a tumor with intratumoral hemorrhage. The patient underwent the tumor resection. Intraoperative findings showed that the tumor had no continuity with the ventricle. Histopathological examinations confirmed an anaplastic ependymoma. The spinal evaluation was unremarkable, and radiotherapy was administered to the left occipital lobe. Four years later, the tumor recurred at the cervicomedullary junction and T8-T9 levels. This case demonstrates that anaplastic ependymomas should be included in the differential diagnoses of supratentorial extraventricular tumors presenting with repeated intratumoral hemorrhage.
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Affiliation(s)
- Min-Hee Han
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Lee YS, Lee HW, Park KS, Park SH, Hwang JH. Immunoglobulin g4-related hypertrophic pachymeningitis with skull involvement. Brain Tumor Res Treat 2014; 2:87-91. [PMID: 25408931 PMCID: PMC4231624 DOI: 10.14791/btrt.2014.2.2.87] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 07/31/2014] [Accepted: 08/07/2014] [Indexed: 12/11/2022] Open
Abstract
Immunoglobulin G4 (IgG4)-related hypertrophic pachymeningitis, defined as focally or diffusely thickened dura mater and lymphoplasmacytic infiltration with increased IgG4 bearing plasma cells, is a rare disease. Moreover, cases involving bone are even rarer. In this report, the authors describe a case of IgG4-related hypertrophic pachymeningitis involving the skull in a 65-year-old man presenting with generalized tonic seizures. There is a 2.4 cm diameter extra-axial mass at the vertex of the left frontal convexity and thickened dura mater with contrast enhancement on magnetic resonance (MR) imaging. In addition, the skull adjacent to the mass was focally enhanced. He underwent surgical resection of the enhanced mass and skull. Histopathological findings revealed chronic inflammation with fibrosis, and idiopathic hypertrophic intracranial pachymeningitis was considered. However, eight months after surgery, partial seizures developed and brain MR imaging revealed a recurrence adjacent to the previous mass. We decided to perform additional immunohistochemical staining of the previous specimen, instead of a re-excision. Immunohistochemical staining showed markedly increased IgG4 (+) plasma cells. Consequently, IgG4-related hypertrophic meningitis was confirmed. Since then, steroids and immunosuppressant medications were started. Follow-up MR imaging at 3 months after medication initiation demonstrated complete remission. In conclusion, IgG4-related hypertrophic pachymeningitis should be considered in the differential diagnosis of hypertrophic cranial pachymeningitis.
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Affiliation(s)
- Young-Sub Lee
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hye Won Lee
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seong-Hyun Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
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Hong SM, Hwang JH, Kim IH. Effect of Medium-chain Triglyceride (MCT) on Growth Performance, Nutrient Digestibility, Blood Characteristics in Weanling Pigs. Asian-Australas J Anim Sci 2014; 25:1003-8. [PMID: 25049656 PMCID: PMC4092986 DOI: 10.5713/ajas.2011.11402] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/06/2012] [Accepted: 01/31/2012] [Indexed: 11/27/2022]
Abstract
One hundred and twenty weanling pigs in experiment 1 (Exp. 1) (6.91±0.99 kg; 21 d of age) and Exp. 2 (10.20±1.09 kg; 28 d of age) were used in two 42-d and 35-d experiments to evaluate the effect of medium-chain-triglyceride (MCT) on growth performance, apparent total tract digestibility (ATTD) of nutrients and blood profile. In both of Exp. 1 and Exp. 2, the same dietary treatments were utilized as follows : i) negative control (NC), ii) positive control (PC), NC+antibiotics (40 mg/kg Tiamulin, 110 mg/kg Tylosin, and 10 mg/kg Enramycin, iii) MCT3, NC+0.32% (phase 1, 2 and 3) MCT, and iv) MCT5, NC+0.55% (phase 1), 0.32% (phase 2 and 3) MCT. In Exp. 1, the pigs fed MCT5 diets had higher (p<0.05) ADG compared to NC treatment during the first 2 wk. From d 15 to 28, the ATTD of energy was improved (p<0.05) by MCT3 compared to the PC treatment. No effect has been observed on the blood profiles [red blood cell (RBC), white blood cell (WBC), immunoglobulin-G (IgG), lymphocyte concentration] measured in this study. In Exp. 2, the ADG were increased (p<0.05) by the MCT5 treatment than the PC treatment from d 0 to 14. Pigs fed PC treatment diet had lower ADFI (p<0.05) and better FCR (p<0.05) than NC treatment, whereas no differences were shown between MCT treatments and NC or PC treatment from d 15 to 35 and overall phase. The ATTD of DM and nitrogen were improved (p<0.05) by the effect of MCT5 related to the NC and PC treatment at the end of 2nd and 5th wk. The pigs fed MCT3 had higher (p<0.05) energy digestibility than PC treatment. No effects were seen in the blood profiles we measured (WBC, RBC, lymphocyte and immunoglobulin-G). In conclusion, the addition of MCT in the weanling pigs diet can improve the ADG and digestibility during the earlier period (first 2 wks), but had little effect on the blood characteristics.
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Affiliation(s)
- S M Hong
- Woosung Feed Cormpany, Ltd. Daejeon, Korea
| | - J H Hwang
- Woosung Feed Cormpany, Ltd. Daejeon, Korea
| | - I H Kim
- Woosung Feed Cormpany, Ltd. Daejeon, Korea
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Lee SB, Choi CW, Jin YC, Wang T, Lee KH, Ku MB, Hwang JH, Kim KH, Vega RSA, Lee HG. Effect of Oral Administration of Intact Casein on Gastrointestinal Hormone Secretion and Pancreatic α-Amylase Activity in Korean Native Steer. Asian-Australas J Anim Sci 2014; 26:654-60. [PMID: 25049835 PMCID: PMC4093330 DOI: 10.5713/ajas.2012.12510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 02/14/2013] [Accepted: 11/15/2012] [Indexed: 11/27/2022]
Abstract
Three Korean native steers (779±24 kg) fitted with duodenal cannulas were used in a 3×3 Latin square design to investigate the influence of oral administration of soluble proteins, intact casein (IC) and acid hydrolyzed casein (AHC), on gastrointestinal hormone (GIH) secretion in the blood and pancreatic α-amylase activity in the duodenum. Oral treatment consisted of a basic diet (control), IC (C+100% protein), or AHC (C+80% amino acid, 20% peptide) for 21 d. Blood and duodenum samples were collected for measurement of serum GI hormones, and pancreatic α-amylase activity was determined at 900, 1030, 1330, 1630, and 1930 h after feeding on d 21 of treatment. The levels of serum cholecystokinin (CCK) and secretin in the IC treatment group were higher compared to the other treatment groups (p<0.05). In addition to the changes in CCK and secretin levels upon IC treatment, the pancreatic α-amylase activity in the duodenum was higher in the IC group compared to the control diet group (p<0.05). The response of serum ghrelin to IC and AHC treatment was in accordance with the response of serum secretin. The level of peptide fragments flowing in the duodenum was higher in the IC treatment group than the other treatment groups (p<0.05). In conclusion, this study demonstrated that an increase in duodenal CCK and secretin upon IC oral administration increased pancreatic α-amylase secretion. In addition, ghrelin may be associated with GI hormone secretion in Korean native steers.
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Affiliation(s)
- S B Lee
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - C W Choi
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - Y C Jin
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - T Wang
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - K H Lee
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - M B Ku
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - J H Hwang
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - K H Kim
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - R S A Vega
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
| | - H G Lee
- Department of Animal Science and Technology, College of Animal Bioscience and Technology, Konkuk University, Seoul 143-701, Korea
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Hong SM, Hwang JH, Kim IH. Evaluation of the effect of low dietary fermentable carbohydrate content on growth performance, nutrient digestibility, blood characteristics, and meat quality in finishing pigs. Asian-Australas J Anim Sci 2014; 25:1294-9. [PMID: 25049693 PMCID: PMC4092942 DOI: 10.5713/ajas.2011.11403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 06/01/2012] [Accepted: 02/29/2012] [Indexed: 11/27/2022]
Abstract
A total of 96 pigs (49.23±3.20 kg) were used in an 11 wk growth trial to evaluate the effect of fermentable carbohydrate (FC) content on growth performance, apparent total tract digestibility (ATTD) of nutrient, blood profile, and meat quality. The dietary treatments were: i) negative control (NC), basal diet, ii) positive control (PC), NC+antibiotics (positive control diet with 5 ppm flavomycin), iii) PCL, PC-13% lower FC, and iv) NCL, NC-13% lower FC. The growth performance (average daily gain, average daily feed intake, and gain/feed) didn’t differ among treatments through the whole experiment. These pigs fed the PCL diet had the greater (p<0.05) apparent total tract digestibility (ATTD) of dry matter than those from PC and NC treatment at the end of the experiment. No differences were observed in white blood cell (WBC), red blood cell (RBC), and lymphocyte concentration among different treatments. After the feeding period, meat samples were collected from the pigs at slaughter. The pigs in NCL and PCL treatments had greater (p<0.05) backfat thickness and lower lean percentage. The color value of loin was higher (p<0.05) in NCL treatment compared to PCL treatment. Also, the NCL treatment had higher (p<0.05) marbling value than PC treatment. The drip loss was depressed by PCL and NCL treatment comapared to NC treatments. The water holding capacity (WHC) was higher (p<0.05) in NC and PCL treatment. In conclusion, the low FC can improve digestibility and meat quality of finishing pigs.
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Affiliation(s)
- S M Hong
- Woosung Feed Co., Ltd. Daejeon, Korea
| | - J H Hwang
- Woosung Feed Co., Ltd. Daejeon, Korea
| | - I H Kim
- Woosung Feed Co., Ltd. Daejeon, Korea
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Yoo JH, Hwang JH, Chang JD, Oh JB. Management of traumatic labral tear in acetabular fractures with posterior wall component. Orthop Traumatol Surg Res 2014; 100:187-92. [PMID: 24568794 DOI: 10.1016/j.otsr.2013.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 12/10/2013] [Accepted: 12/13/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Posterior labral tear is frequently encountered in acetabular fractures with posterior wall component (AFPWC). However, there has been very little information in the literature on the type and management of traumatic labral tears in AFPWC. HYPOTHESIS Traumatic labral tear is a constant intracapsular injury in AFPWC and can be repaired using adequate methods according to its type and size. MATERIALS AND METHODS A retrospective study of 14 patients (mean age 38 years [16-58]) who underwent open surgery for AFPWC was conducted using prospectively collected data. The types of posterior labral tear were investigated at intraoperative examination through the ruptured joint capsule or its extension, and were concomitantly managed. Surgical outcomes were clinically assessed using Merle d'Aubigné (PMA) score and Visual Analog Scale (VAS), and radiologically evaluated at final follow-up. RESULTS Posterior labral tears were present in all 14 patients. The types of labral tear were osseous avulsion and posterior root avulsion tear (n=9), longitudinal peripheral tear and posterior root avulsion tear (n=2), longitudinal peripheral tear (n=2), and osseous avulsion tear (n=1). All unstable labra in 12 patients (86%) were repaired. All avulsion tears of the posterior root were repaired using a suture anchor, longitudinal peripheral tears using suture fixation or/and suture anchors, and osseous avulsion tears using a spring plate. The mean PMA score and VAS were 16.4 (14-18) and 1.7 (0-3) at final follow-up, respectively. The radiologic grades at last follow-up were good or excellent in all patients. DISCUSSION All AFPWC in this study consistently revealed posterior labral tear. Posterior root avulsion tears accompanied with osseous avulsion was the most common type. Torn labra should be repaired as much as possible if unstable, considering the important functions of a normal labrum; fixation using a suture anchor may be useful for an avulsion tear of the posterior root. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- J H Yoo
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, 896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, Republic of Korea.
| | - J H Hwang
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1 Daerim 1-dong, Yeongdeungpo-gu, Seoul 150-950, Republic of Korea
| | - J D Chang
- Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40 Seokwoo-dong, Hwasung 445-907, Republic of Korea
| | - J B Oh
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, 896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, Republic of Korea
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Periolo N, Guillén L, Arruvito ML, Alegre NS, Niveloni SI, Hwang JH, Bai JC, Cherñavsky AC. IL-15 controls T cell functions through its influence on CD30 and OX40 antigens in Celiac Disease. Cytokine 2014; 67:44-51. [PMID: 24680481 DOI: 10.1016/j.cyto.2014.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 12/09/2013] [Accepted: 01/11/2014] [Indexed: 01/19/2023]
Abstract
AIM To evaluate the ability of interleukin (IL)-15 to control T cell functions through its influence on CD30 and OX40 expressing cells in Celiac Disease (CD). In peripheral blood (PB), by examining the expression of OX40 in conventional effectors cells and T cells with a phenotypic specialization of regulatory cells [CD4+CD25high forkhead box protein 3 (Foxp3)+], and the co stimulation of IFN-γ and IL-4 production within CD30 and OX40 positive subsets of T cells. At the duodenal mucosa, by assessing the expression of CD30 and OX40 in intraepithelial (IE) and lamina propria (LP) lymphocytes (IEL, LPL). PATIENTS AND METHODS PB and duodenal mucosal biopsies were obtained from 38 patients with classic CD (Cel) and 38 healthy controls (HC). Analysis of cell surface and/or intracellular antigens was performed in anti-CD3-treated PB mononuclear cells (PBMC) before and after treatment with recombinant IL-15 (rIL-15), and in IE and LP cellular suspensions prepared from duodenal biopsies pre-treated with/without rIL-15. RESULTS A subpopulation of CD3+OX40+ T blasts was induced in Cel and HC by a 3days treatment of PBMC with anti-CD3 and decreased its size thereafter, regardless of the presence of rIL-15. However, the addition of rIL-15 to T blasts distinctively induced the survival of T cells with a regulatory phenotype that expresses OX40 antigen in Cel (p<0.05). Celiac patients showed higher frequencies of IFN-γ-producing CD3+CD30+ blasts before and after treatment with rIL-15 (p<0.05, vs. HC). IL-15 increased the frequencies of CD3+CD30+ LPL (HC: p<0.05, Cel: p<0.05) but not of CD3+OX40+ LPL, and CD30 or OX40 positive IEL. CONCLUSIONS The distinctive control of OX40+ cells with a T regulatory phenotype mediated by the influence of IL-15 comes out as new function of this cytokine in the context of CD. The higher production of IFN-γ by a subpopulation of peripheral CD3+CD30+ cells contributes to the type I biased immune response.
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Affiliation(s)
- N Periolo
- Instituto de Inmunología, Genética y Metabolismo, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - L Guillén
- Instituto de Inmunología, Genética y Metabolismo, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - M L Arruvito
- Instituto de Inmunología, Genética y Metabolismo, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - N S Alegre
- Instituto de Inmunología, Genética y Metabolismo, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - S I Niveloni
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina
| | - J H Hwang
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina
| | - J C Bai
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina
| | - A C Cherñavsky
- Instituto de Inmunología, Genética y Metabolismo, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina.
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Kim KT, Kim MJ, Cho DC, Park SH, Hwang JH, Sung JK, Cho HJ, Jeon Y. The neuroprotective effect of treatment with curcumin in acute spinal cord injury: laboratory investigation. Neurol Med Chir (Tokyo) 2014; 54:387-94. [PMID: 24477066 PMCID: PMC4533440 DOI: 10.2176/nmc.oa.2013-0251] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The purpose of this study was investigating the effects of curcumin on the histological changes and functional recovery following spinal cord injury (SCI) in a rat model. Following either sham operation or SCI, 36 male Sprague–Dawley rats were distributed into three groups: sham group, curcumin-treated group, and vehicle-injected group. Locomotor function was assessed according to the Basso, Beattie, and Bresnahan (BBB) scale in rats who had received daily intraperitoneal injections of 200 mg/kg curcumin or an equivalent volume of vehicle for 7 days following SCI. The injured spinal cord was then examined histologically, including quantification of cavitation. BBB scores were significantly higher in rats receiving curcumin than receiving vehicle (P < 0.05). The cavity volume was significantly reduced in the curcumin group as compared to the control group (P = 0.039). Superoxide dismutase (SOD) activity was significantly elevated in the curcumin group as compared to the vehicle group but was not significantly different from the sham group (P < 0.05, P > 0.05, respectively) at one and two weeks after SCI. Malondialdehyde (MDA) levels were significantly elevated in the vehicle group as compared to the sham group (P < 0.05 at 1 and 2 weeks). MDA activity was significantly reduced in the curcumin group at 2 weeks after SCI when compared to the vehicle group (P = 0.004). The numbers of macrophage were significantly decreased in the curcumin group (P = 0.001). This study demonstrated that curcumin enhances early functional recovery after SCI by diminishing cavitation volume, anti-inflammatory reactions, and antioxidant activity.
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Cho DC, Jung HS, Kim KT, Jeon Y, Sung JK, Hwang JH. Therapeutic advantages of treatment of high-dose curcumin in the ovariectomized rat. J Korean Neurosurg Soc 2013; 54:461-6. [PMID: 24527187 PMCID: PMC3921272 DOI: 10.3340/jkns.2013.54.6.461] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/17/2013] [Accepted: 12/12/2013] [Indexed: 11/27/2022] Open
Abstract
Objective Although curcumin has a protective effect on bone remodeling, appropriate therapeutic concentrations of curcumin are not well known as therapeutic drugs for osteoporosis. The purpose of this study was to compare the bone sparing effect of treatment of low-dose and high-dose curcumin after ovariectomy in rats. Methods Forty female Sprague-Dawley rats underwent either a sham operation (the sham group) or bilateral ovariectomy (OVX). The ovariectomized animals were randomly distributed among three groups; untreated OVX group, low-dose (10 mg/kg) curcumin administered group, and high-dose (50 mg/kg) curcumin group. At 4 and 8 weeks after surgery, serum biochemical markers of bone turnover were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae were determined by micro-computed tomography (CT). In addition, mechanical strength was determined by a three-point bending test. Results High-dose curcumin group showed significantly lower osteocalcin, alkaline phosphatase, and the telopeptide fragment of type I collagen C-terminus concentration at 4 and 8 weeks compared with the untreated OVX group as well as low-dose curcumin group. In the analyses of micro-CT scans of 4th lumbar vertebrae, the high-dose curcumin treated group showed a significant increase in bone mineral densities (p=0.028) and cortical bone mineral densities (p=0.036) compared with the low-dose curcumin treated group. Only high-dose curcumin treated group had a significant increase of mechanical strength compared with the untreated OVX group (p=0.015). Conclusion The present study results demonstrat that a high-dose curcumin has therapeutic advantages over a low-dose curcumin of an antiresorptive effect on bone remodeling and improving bone mechanical strength.
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Affiliation(s)
- Dae-Chul Cho
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun-Sik Jung
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Younghoon Jeon
- Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Joo-Kyung Sung
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hyun Hwang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Gwak HS, Yee GT, Park CK, Kim JW, Hong YK, Kang SG, Kim JH, Seol HJ, Jung TY, Chang JH, Yoo H, Hwang JH, Kim SH, Park BJ, Hwang SC, Kim MS, Kim SH, Kim EY, Kim E, Kim HY, Ko YC, Yun HJ, Youn JH, Kim J, Lee B, Lee SH. Temozolomide salvage chemotherapy for recurrent anaplastic oligodendroglioma and oligo-astrocytoma. J Korean Neurosurg Soc 2013; 54:489-95. [PMID: 24527191 PMCID: PMC3921276 DOI: 10.3340/jkns.2013.54.6.489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 08/22/2013] [Accepted: 09/30/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA). METHODS A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 mg/m(2)/day) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed. RESULTS TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (≥grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01). CONCLUSION For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.
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Affiliation(s)
- Ho-Shin Gwak
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Gi Taek Yee
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Chul-Kee Park
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Jin Wook Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Yong-Kil Hong
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Seok-Gu Kang
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Jeong Hoon Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Ho Jun Seol
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Tae-Young Jung
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Jong Hee Chang
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Heon Yoo
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | | | - Se-Hyuk Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Bong Jin Park
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Sun-Chul Hwang
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Min Su Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Seon-Hwan Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Eun-Young Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Ealmaan Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Hae Yu Kim
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Young-Cho Ko
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Hwan Jung Yun
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Ji Hye Youn
- Registration Group, Korean Society for Neuro-Oncology, Korea
| | - Juyoung Kim
- Pharmaceutical Benefit Department, Health Insurance Review and Assessment Service, Korea
| | - Byeongil Lee
- Pharmaceutical Benefit Department, Health Insurance Review and Assessment Service, Korea
| | - Seung Hoon Lee
- Registration Group, Korean Society for Neuro-Oncology, Korea
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