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Dong-Ik Kim

Publications and source records attributed to Dong-Ik Kim.

31 records · Page 2Linked to original sources
PubMed2004

The new role of magnetic resonance imaging in the contemporary diagnosis of venous malformation: can it replace angiography?

BACKGROUND: Magnetic resonance imaging (MRI) is well accepted for the contemporary diagnosis of venous malformation (VM), providing hemodynamic and anatomic information on the lesion, including its relationship with surrounding tissues and organs. STUDY DESIGN: A total of 196 clinically suspected VM patients were reviewed retrospectively to assess the accuracy and reliability of MRI for the diagnosis of VM. Initial workup included MRI, duplex ultrasonography, and whole-body blood pool scintigraphy, along with additional transarterial lung perfusion scintigraphy and lymphoscintigraphic assessment when indicated. Phlebography or arteriography, or both, were generally reserved as a road map for the treatment. A total of 294 MRI findings for 196 patients were also compared with the matching duplex ultrasonography findings available for 178 patients and matching whole-body blood pool scintigraphy findings for 136 patients. The phlebographic findings available for 87 patients were also compared. RESULTS: Among the 196 patients with clinically suspected VM, 174 were confirmed as having VM by MRI with true-positive findings and 2 as false-positive findings by MRI (sensitivity, 98.9%; positive predictive value, 98.9%). MRI ruled out VM for 18 patients with true-negative findings, though 2 were false-negative (specificity, 90%; negative predictive value, 90.0%). Two positive and two false-negative findings of VM, made by MRI, were subsequently confirmed by angiography. Among the 87 patients for whom phlebographic findings were available, 73 were confirmed as true-positive diagnoses of VM, 1 as false-positive, 11 as true-negative, and 2 as false-negative (sensitivity, 97.3%; specificity, 91.7%; positive predictive value, 98.7%; negative predictive value, 84.6%). CONCLUSIONS: MRI is likely to modify the traditional role of angiography for the management of VM and become a new standard, at least for diagnosis. MRI also is an excellent parameter in the assessment of treatment results.

Adolescent↗
PubMed2004

TWEAK can induce pro-inflammatory cytokines and matrix metalloproteinase-9 in macrophages.

The expression of TWEAK (TNFSF12) and TweakR/Fn14 was detected in regions rich in macrophage/foam cells in atherosclerotic plaques. The role of TWEAK in monocytes in relation to atherogenesis was investigated by analyzing the cellular events induced by TWEAK in a human macrophage-like cell line, THP-1. TWEAK induced various molecular mediators of atherogenesis, such as IL-6, MCP-1, IL-8 and MMP-9, and the induction was augmented by interferon-gamma. TWEAK-induced activation of MMP-9 was mediated by activation of NF-kappaB. These results suggest that TWEAK is involved in atherosclerosis by inducing pro-inflammatory cytokines and extracellular matrix degrading enzymes, which reduce plaque stability.

Aged↗
PubMed2003

Surgical experience of carotid pseudoaneurysm.

An extracranial carotid artery pseudoaneurysm is a rare condition that is caused by various types of arteritis, trauma and infectious causes. Generally, a pseudoaneurysm may be difficult to treat surgically when dissecting the paraaneurysmal fibrotic dense inflammatory tissues. The surgical management of a peudoaneurysm of the carotid artery involves a risk of nerve and arterial injury. This paper reports the repair of a carotid artery pseudoaneurysm after the proximal and distal control of the internal carotid artery using a Pruitt-Inahara shunt (P-I shunt) and the distal control of the external carotid artery using a small sized occlusion balloon catheter.

Adult↗
PubMed2003

Clinical and functional assessment after anticoagulant therapy of acute deep vein thrombosis involving the lower limb.

We assessed the clinical status after anticoagulant therapy in acute deep vein thrombosis (DVT) involving the lower limbs. Between 1994 and 2001, 139 patients suffering from acute DVT were treated with heparin therapy followed by oral anticoagulant therapy. The coagulation factor assay was done prior to any anticoagulation therapy. The duplex scan was checked serially. The mean follow-up periods was 32 +/- 19 months. There were 32 (23.0%)cases of protein C deficiency, 12 (8.6%) cases of protein S deficiency, 13 (9.4%) cases of AT-III deficiency and 11 (7.9%) cases of abnormal plasminogen level. Fourteen cases had coagulation factor abnormalities within the family. The initial lung scan showed 29 (20.9%) cases with high, 13 (9.4%) cases with intermediate and 70 (50.4%) cases with a low probability of pulmonary embolism (PE) developing. During the follow-up periods, there were 3 cases of non-fatal PE documented with chest CT scan. The patients were divided according to the extent of the thrombus; Group I (38 cases) was limited to the infrainguinal deep vein, Group II (70 cases) extended to the iliac vein and Group III (9 cases) extended to the vena cava. Partial lysis occurred in 20/35/3 (52.6/50.0/33.3%) cases and no change in 10/24/6 (26.3/ 34.3/ 66.7%) cases in Groups I/ II/ III, respectively. Deep vein valvular reflux occurred in 15/25/5 (39.5/35.7/55.6%) cases in Groups I/ II/ III, respectively. With anticoagulation therapy, most of the thrombi remained in unresolved states and there was a high rate of deep vein valvular reflux. However, there was no serious complications which affected the patients' quality of life.

Acute Disease↗
PubMed2003

Combined extracranial and intracranial atherosclerosis in Korean patients.

OBJECTIVES: To evaluate the frequency of intracranial atherosclerosis among patients with steno-occlusive extracranial carotid artery disease and to determine if there are factors related to the combined intracranial atherosclerosis. DESIGN: Cross-sectional study. SETTING: A tertiary referral hospital. Patients We studied 142 consecutive patients who had atherosclerotic steno-occlusive lesions (defined as > or =30% narrowing of the luminal diameter or occlusion) of an extracranial carotid artery confirmed by conventional angiography. We excluded patients who had potential cardiogenic sources of embolism. Potential vascular risk factors for each patient were obtained from medical records. Main Outcome Measure We determined the location and severity of atherosclerotic lesions by conventional angiography. We compared the vascular risk factors between patients with steno-occlusive extracranial carotid artery disease alone and patients with combined intracranial atherosclerosis and extracranial carotid artery disease. RESULTS: Intracranial steno-occlusive lesions (> or =30% stenosis or occlusion) were found in 80 patients (56.3%). Of 121 patients with significant (> or =50% stenosis or occlusion) extracranial carotid artery disease, 58 (47.9%) also had significant lesions of intracranial arteries. Univariate and multivariate analyses showed that diabetes mellitus was the only significant factor associated with combined intracranial atherosclerosis in patients with extracranial carotid artery disease. CONCLUSIONS: Intracranial atherosclerosis is common in Korean patients with steno-occlusive extracranial carotid artery disease. Diabetes mellitus is associated with intracranial atherosclerosis in patients who had steno-occlusive extracranial carotid artery disease.

Aged↗
PubMed2003

Vascular clips as a landmark for sites of anastomosis.

Vascular clips can be used in bypasses at risk of future occlusion, to assist with catheter placement for radiological intervention. We explain how vascular clips can be placed as a landmark for the sites of anastomosis. After completion of the vascular anastomosis, two or three bullets of medium-sized vascular clips are clipped to the tips of the vascular suture. The sites of the vascular anastomosis are checked by plain X-rays. Finding the inlet of the anastomosis in an occluded graft can be difficult, and the marker proved helpful for introducing the guide-wire through the inlet of the site of anastomosis. The vascular clips around the popliteal anastomosis enabled us to clearly differentiate above-knee from below-knee femoropopliteal bypasses using plain X-ray postoperatively. This is a simple yet effective method of identifying the site of vascular anastomosis. Thus, we recommend using vascular clips as a landmark to aid in postoperative intervention by allowing clear identification of the level of anastomosis.

Anastomosis, Surgical↗
PubMed2003

Identification of differentially expressed mRNAs of the autologous vein graft after an arterial bypass in mongrel dogs.

PURPOSE: Intimal hyperplasia (IH) is characterized by vascular smooth muscle cell (VSMC) proliferation in the intima and subsequent accumulation of extracellular matrix. A variety of factors that might be considered as possible VSMC mitogens induce the specific gene expression of VSMC. This study was designed to identify differentially expressed mRNA by method using an mRNA differential display. METHODS: A bilateral femoropopliteal reverse saphenous vein bypass was performed on both hind limbs of mongrel dogs. At 4 and 8 weeks after the implantation, the vein bypass grafts were harvested. The total RNAs were extracted from each specimen and transcribed into the cDNAs. Amplified cDNAs using 16 sets of primers were separated on DNA sequencing gel. Differentially displayed bands were excised from the gel, cloned, and then sequenced. The sequences were compared with the National Center of Biotechnology Information nonredundant sequence database using the Basic Local Alignment Search Tool (BLAST) program. RESULTS: Forty-three bands were cloned and sequenced. A computer search revealed that 11 of them had similarities to known genes while 32 cDNAs had no similarities to any registered DNA sequence. CONCLUSIONS: We found several genes to be related to IH. Some of them had already had their function and sequence identified whereas some of them have yet to be identified. Further studies are necessary to determine the precise relationship between these genes and IH.

Anastomosis, Surgical↗
PubMed2002

Pseudoaneurysm of the abdominal aorta caused by acupuncture therapy.

Acupuncture is a major treatment modality used in Oriental medicine to control chronic pain. However, several complications have been reported, including spinal cord injury, pneumothorax, and subcutaneous pseudoaneurysm, according to the puncture sites. We report the case of a pseudoaneurysm of the abdominal aorta caused by acupuncture.

Acupuncture Therapy↗
PubMed2002

A novel chemokine, Leukotactin-1, induces chemotaxis, pro-atherogenic cytokines, and tissue factor expression in atherosclerosis.

Chemokines such as monocyte chemoattractant protein (MCP) -1 and interleukin (IL)-8 are known to be involved in various processes in atherosclerosis such as plaque formation, plaque rupture, and thrombus formation. We investigated whether a new chemokine, Leukotactin (LKN)-1, is involved in atherosclerosis. We tested the expression of LKN-1 by immunohistochemical methods in carotid atherosclerotic plaque specimen. Induction of pro-inflammatory cytokines, transmigration, and tissue factor (TF) expression were tested in THP-1 cells and human peripheral blood monocytes treated with recombinant human LKN-1. Immunohistochemical analyses revealed that expression of LKN-1 occurs in regions of plaques rich in foam cells. In a Boyden chamber assay, THP-1 cells treated with 0.01--10 nM of LKN-1 transmigrated through gelatin coated filters in a dose dependent manner. LKN-1 also induced the transient expression of TNF-alpha, IL-8, and MCP-1 within 15 min of the treatment of the THP-1 cells. When peripheral blood monocytes were treated with LKN-1, expression levels of TF and TF-mediated procoagulating activity were induced in a time- and dose-dependent manner. These results raise the possibility that LKN-1 is another chemokine that is involved in the atherogenesis. LKN-1 may chemoattract immune cells into the plaque, induce pro-inflammatory cytokines, and produce thrombi by inducing TF expression.

Aged↗
PubMedDate not supplied

Effect of different particles on cell proliferation in polymer scaffolds using a solvent-casting and particulate leaching technique.

Solvent-casting and particulate leaching are widely used in the manufacturing of porous polymer scaffolds. Salt is the most commonly used particulate because it is easily available and very easy to handle. Gelatin particles are another candidate for this method because they are known as a material that enhances cell attachment and proliferation. In this study, we compared the biocompatibility of the two scaffolds made from either salt (salt scaffold) or gelatin particles (gelatin scaffold). Sieved particles of salt and gelatin (particle size ranging 100-180 um) were dispersed in a poly-lactic-co-glycolic acid (PLGA)/chloroform solution and cast in a Teflon container. The solvent was allowed to evaporate and residual amounts were removed by vacuum drying. The particles were allowed to leach out by immersion in warm water (40 degrees C). Cultured chondrocytes (from knee cartilage) and smooth muscle cells (from bladder) were seeded on each scaffolds (5 x 10(6)/cm2) and cultured for 3 weeks, and their proliferation was compared using hematoxylin and eosin staining. These results demonstrated that the gelatin scaffold showed better attachment of cells at the initial stage, and both cell types showed much better proliferation of cells during 3 months. The better performance of a gelatin scaffold also contributed to the better connection of pores at the same porosity.

Absorbable Implants↗
PubMedDate not supplied

The mid-term efficacy and safety of a permanent nitinol IVC filter(TrapEase).

OBJECTIVE: 1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion. MATERIALS AND METHODS: A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE). Indications for filter placement were: 1) deep vein thrombosis with recurrent thromboembolism; 2) and/or free-floating thrombus with contraindication to anticoagulation; and 3) complications in achieving adequate anticoagulation. Follow-up evaluations (mean: 15.4 months, range: 2 to 28 months) were performed at 6- and 12-month intervals after the procedure and included clinical histories, chart reviews, plain film, Doppler ultrasounds, and contrasted abdominal CT scans. RESULTS: In follow-up evaluations, the data analysis revealed no cases of symptomatic PE. There were no cases of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study, there was one case of filter thrombosis; early symptomatic thrombosis that was successfully treated in the hospital. Of the 42 subjects, eight died. These deaths were not related to the filter device or the implantation procedure, but to the underlying disease. CONCLUSION: This study demonstrates that the TrapEase permanent IVC filter is a safe and an effective device with low complication rates and is best used in patients with thromboembolic disease with a high risk of PE.

Adult↗
PubMedDate not supplied

Subintimal angioplasty in the treatment of chronic lower limb ischemia.

OBJECTIVE: To present our experience with subintimal angioplasty (SA) for treatment of chronic lower limb ischemia (CLLI) and to assess its effectiveness and durability. MATERIALS AND METHODS: From April 2003 through June 2005, we treated 40 limbs in 36 patients with CLLI by SA. Balloons with or without secondary stent placement appropriate in size to the occluded arteries were used for SA of all lesions, except for iliac lesions where primary stent placement was done. The patients were followed for 1-23 months by clinical examination and color Doppler ultrasound and/or CT angiography. Technical results and outcomes were retrospectively evaluated. The presence of a steep learning curve for performance of SA was also evaluated. Primary and secondary patencies were determined using Kaplan-Meier analysis. RESULTS: Technical success was achieved in 32 (80%) of 40 limbs. There was no statistical difference between technical success rates of 75% (18/24) during the first year and 88% (14/16) thereafter. There were four complications (10%) in 40 procedures; two arterial perforations, one pseudoaneurysm at the puncture site, and one delayed hematoma at the SA site. Excluding initial technical failures, the primary patency rates at six and 12 months were 68% and 55%, respectively. Secondary patency rates at six and 12 months were 73% and 59%, respectively. CONCLUSION: Subintimal angioplasty can be accomplished with a high technical success rate. It should be attempted in patients with CLLI as an alternative to more extended surgery, or when surgical treatment is not recommended due to comorbidity or an unfavorable disease pattern.

Aged↗