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박광보,주성욱,도영수,신성욱,조성기,주인욱 대한영상의학회 2005 Korean Journal of Radiology Vol.6 No.3
Objective: We wanted to valuate the mid-term therapeutic results of percutaneous transhepatic balloon angioplasty for portal vein stenosis after liver transplantation. Materials and Methods: From May 1996 to Feb 2005, 420 patients underwent liver transplantation. Percutaneous transhepatic angioplasty of the portal vein was attempted in six patients. The patients presented with the clinical signs and symptoms of portal venous hypertension or they were identified by surveillance doppler ultrasonography. The preangioplasty and postangioplasty pressure gradients were recorded. The therapeutic results were monitored by the follow up of the clinical symptoms, the laboratory values, CT and ultrasonography. Results: The overall technical success rate was 100%. The clinical success rate was 83% (5/6). A total of eight sessions of balloon angioplasty were performed in six patients. The mean pressure gradient decreased from 14.5 mmHg to 2.8 mmHg before and after treatment, respectively. The follow up periods ranged from three months to 64 months (mean period; 32 months). Portal venous patency was maintained in all six patients until the final follow up. Combined hepatic venous stenosis was seen in one patient who was treated with stent placement. One patient showed puncture tract bleeding, and this patient was treated with coil embolization of the right portal puncture tract via the left transhepatic portal venous approach. Conclusion: Percutaneous transhepatic balloon angioplasty is an effective treatment for the portal vein stenosis that occurs after liver transplantation, and our results showed good mid-term patency with using this technique.
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소장 질환의 진단에서 경구 메틸셀룰로스를 사용한 바륨소장추적 검사의 유용성
박광보,하현권,김지훈,이승훈,정애경,이양섭,유홍상,김표년,이문규 대한영상의학회 1998 대한영상의학회지 Vol.38 No.1
Purpose: To evaluate the usefulness of modified Small Bowel Follow Through(SBFT) with oral administration ofmethylcellulose in patients with small bowel pathology. Materials and Methods: Between September 1995 and Fbmary1996, a total of 228 patients underwent modified SBFT ; in 71 of these, small bowel pathology was confirmed bysurgery(n=18), biopsy(n=29), or clinical diagnosis(n=24). After the administration of 150ml 70% w/v bariumsuspension the patient assumed the decubitus position for 5minutes and 600ml of 0.5% methylcellulose wasadministered. We measured transit time, time and frequency of flocculation, and the luminal diameter of thejejunum and ileum. Using four scales ("Excellent", "Good", "Fair", and "Poor"), three radiologists graded thequality of images. Results: Mean transit time was 142 minutes, and the maximum diameter of the jejunum and ileumwas 2.9cm and 2.1 cm respectively ; in 45 patients (63%) the examination was concluded within 2 hours. The qualityof images was excellent in 29 cases(41%), good in 30(42%), fair in 8(11%), and poor in 3(4%). Imagies relating toinflammatory and vascular diseases were graded as "good" or "excellent" in 92% and 89% of cases, respectively, andthe image quality of lesions of the jejunum and ileum were graded, respectively, as "good" or "excellent" in 96%and 63% of cases. Usig this modified technique, sensitivity and specificity were 90% and 99%, respectively.Conclusion: Modified SBFT with the oral administration of methylcellulose is a simple but highly sensitive methodof evaluating small bowel deseases. It is especially valuable in cases of inflammatory and vascular disease of thesmall intestine and lesions in the jejunum.lammatory and vascular disease of thesmall intestine and lesions in the jejunum.
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현동호,박광보,조성기,박홍석,신성욱,주성욱,도영수,주인욱,최동욱 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.5
Objective: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Materials and Methods: Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. Results: All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Conclusion: Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.
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뇌졸중 환자에서 항응고치료 중 발생한 자발성 허리근 혈종의 치료 - 증례 보고 -
이강우,김민수,박광보,강태욱,조남순,정진욱,김영범 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.5
Spontaneous psoas hematoma in patients receiving anticoagulation therapy is a rare condition, but sometimes very serious even fatal, if not properly treated on time. One of our patients developed large spontaneous psoas hematoma while intensive rehabilitation therapy due to recent stroke with global aphasia and right hemiplegia. He had undergone anticoagulation therapy with warfarin and prothrombin time was within therapeutic range. Patient revealed sudden cold sweating with change of vital sign. Because of global aphasia, he could not explain subjective symptoms, but revealed rebound tenderness in right lower quadrant on physical examination. Emergency abdominal & pelvic CT scan showed large hematoma on right iliopsoas area with retroperitoneal extension. Because of unstable hemodynamics and high risks for surgery, transcatheter arterial emboilzation was recommended. Bleeding was controlled successfully after transcatheter arterial embolization, and vital sign was stabilized without other neurologic change.
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노영남,박홍석,박광보,도영수,김영욱,이경복,박의준,김해솔,윤우성,김동익 대한혈관외과학회 2011 Vascular Specialist International Vol.27 No.1
Purpose: This study evaluated the prevalence of cystic disease in the intra-abdominal organs in a normal population and a group of patients with vascular disease. Methods: We reviewed the medical records and computed tomography scans of the vascular disease group and the control group. Vascular disease group (n=586) were patients who suffered with abdominal aortic aneurysm (AAA), aorto-iliac occlusive disease (AOD) and peripheral arterial occlusive disease (PAOD) and who were treated in our institute. The control group (n=424) were patients who visited the health promotion center in our institute during the same period. Results: The prevalence of abdominal cysts in the control group and the vascular disease group was 41.7%and 65.2%, respectively. The vascular disease group showed a higher prevalence of abdominal cystic lesion for all the specific vascular diseases. However, when the two groups were stratified according to age, the vascular disease group displayed no significant difference in the prevalence of abdominal cyst compared to that of the control group. Conclusion: Abdominal cystic lesions are common in patients with vascular disease, including AAA, AOD,and PAOD. But this high prevalence of abdominal cystic lesions seems to be associated with the advanced age of vascular disease patients. Further molecular-based research is needed to clarify the pathogenetic relationship between vascular disease and abdominal cystic lesions.
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김수현,김미정,전준석,장혜련,박광보,허우성,도영수,김윤구,김대중,Ha Young Oh,이정은 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.3
Background: Previous randomized controlled trials of revascularization for atherosclerotic renal artery stenosis (ARAS) were not successful. We investigated the effects of percutaneous transluminal angioplasty with stent insertion (PTA/S) on kidney function and blood pressure (BP) control in patients with ARAS. Methods: From 2000 to 2017, 47 subjects who underwent PTA/S for ARAS were identified. A high-risk group was defined, composed of patients having one or more of the following clinical presentations: pulmonary edema, refractory hypertension, and rapid deterioration of kidney function. Subjects who met the criteria of ‘kidney function improvement’ or ‘hypertension improvement’ after PTA/S were classified as responders. Results: Twenty-one (44.7%) subjects were classified into the high-risk group. Two subjects (8.0%) in the low-risk group (n = 25) and 5 subjects (27.8%) in the high-risk group (n = 18) showed improvement in kidney function after PTA/S (P = 0.110). In patients with rapid decline of kidney function, estimated glomerular filtration rate improved from 28 (interquartile range [IQR], 10-45) mL/min/1.73 m2 to 41 (IQR, 16-67) mL/min/1.73 m2 at 4 months after PTA/S, although the difference was not significant (P = 0.084). Regarding BP control, 9 (36.0%) and 14 (77.8%) subjects showed improvement after PTA/S in the low- (n = 25) and high-risk (n = 18) groups, respectively (P = 0.007). In patients with refractory hypertension, the systolic BP dropped from 157 (IQR, 150-164) mmHg to 140 (IQR, 131- 148) mmHg at 4 months after PTA/S (P = 0.005). Twenty-five subjects were defined as responders and comprised a significant proportion of the high-risk group (P = 0.004). Conclusion: PTA/S might improve BP control and kidney function in patients with ARAS presenting with highrisk clinical features. The optimal application of PTA/S should be based on individual assessment of the clinical significance of renal artery stenosis.
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Interventional Management of Malignant Colorectal Obstruction: Use of Covered and Uncovered Stents
Jin Soo Choi,주성욱,박광보,신성욱,유소영,김지혜,도영수 대한영상의학회 2007 Korean Journal of Radiology Vol.8 No.1
Objective: We wanted to evaluate usefulness of uncovered stent in comparison with covered stent for the palliative treatment of malignant colorectal obstruction. Materials and Methods: Covered (n = 52, type 1 and type 2) and uncovered (n = 22, type 3) stents were placed in 74 patients with malignant colorectal obstruction. Stent insertion was performed for palliative treatment in 37 patients (covered stent: n = 23 and uncovered stent: n = 14). In the palliative group, the data on the success of the procedure, the stent patency and the complications between the two groups (covered versus uncovered stents) were compared. Results: The technical success rate was 89% (33/37). Symptomatic improvement was achieved in 86% (18/21) of the covered stent group and in 92% (11/12) of the uncovered stent group patients. The period of follow-up ranged from three to 319 days (mean period: 116 85 days). The mean period of stent patency was 157 33 days in the covered stent group and 165 25 days in the uncovered stent group. In the covered stent group, stent migration (n = 11), stent fracture (n = 2) and poor expansion of the stent (n = 2) were noted. In the uncovered stent group, tumor ingrowth into the stents (n = 3) was noted. Conclusion: Self-expanding metallic stents are effective for relieving malignant colorectal obstruction. The rate of complications is lower in the uncovered stent group than in the covered stent group. Objective: We wanted to evaluate usefulness of uncovered stent in comparison with covered stent for the palliative treatment of malignant colorectal obstruction. Materials and Methods: Covered (n = 52, type 1 and type 2) and uncovered (n = 22, type 3) stents were placed in 74 patients with malignant colorectal obstruction. Stent insertion was performed for palliative treatment in 37 patients (covered stent: n = 23 and uncovered stent: n = 14). In the palliative group, the data on the success of the procedure, the stent patency and the complications between the two groups (covered versus uncovered stents) were compared. Results: The technical success rate was 89% (33/37). Symptomatic improvement was achieved in 86% (18/21) of the covered stent group and in 92% (11/12) of the uncovered stent group patients. The period of follow-up ranged from three to 319 days (mean period: 116 85 days). The mean period of stent patency was 157 33 days in the covered stent group and 165 25 days in the uncovered stent group. In the covered stent group, stent migration (n = 11), stent fracture (n = 2) and poor expansion of the stent (n = 2) were noted. In the uncovered stent group, tumor ingrowth into the stents (n = 3) was noted. Conclusion: Self-expanding metallic stents are effective for relieving malignant colorectal obstruction. The rate of complications is lower in the uncovered stent group than in the covered stent group.
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