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Kyung-Pil Park

Publications and source records attributed to Kyung-Pil Park.

7 recordsLinked to original sources
PubMed2007

Statistical parametric mapping and statistical probabilistic anatomical mapping analyses of basal/acetazolamide Tc-99m ECD brain SPECT for efficacy assessment of endovascular stent placement for middle cerebral artery stenosis.

INTRODUCTION: Statistical parametric mapping (SPM) and statistical probabilistic anatomical mapping (SPAM) were applied to basal/acetazolamide Tc-99m ECD brain perfusion SPECT images in patients with middle cerebral artery (MCA) stenosis to assess the efficacy of endovascular stenting of the MCA. METHODS: Enrolled in the study were 11 patients (8 men and 3 women, mean age 54.2 +/- 6.2 years) who had undergone endovascular stent placement for MCA stenosis. Using SPM and SPAM analyses, we compared the number of significant voxels and cerebral counts in basal and acetazolamide SPECT images before and after stenting, and assessed the perfusion changes and cerebral vascular reserve index (CVRI). RESULTS: The numbers of hypoperfusion voxels in SPECT images were decreased from 10,083 +/- 8,326 to 4,531 +/- 5,091 in basal images (P = 0.0317) and from 13,398 +/- 14,222 to 7,699 +/- 10,199 in acetazolamide images (P = 0.0142) after MCA stenting. On SPAM analysis, the increases in cerebral counts were significant in acetazolamide images (90.9 +/- 2.2 to 93.5 +/- 2.3, P = 0.0098) but not in basal images (91 +/- 2.7 to 92 +/- 2.6, P = 0.1602). The CVRI also showed a statistically significant increase from before stenting (median 0.32; 95% CI -2.19-2.37) to after stenting (median 1.59; 95% CI -0.85-4.16; P = 0.0068). CONCLUSION: This study revealed the usefulness of voxel-based analysis of basal/acetazolamide brain perfusion SPECT after MCA stent placement. This study showed that SPM and SPAM analyses of basal/acetazolamide Tc-99m brain SPECT could be used to evaluate the short-term hemodynamic efficacy of successful MCA stent placement.

Acetazolamide↗
PubMed2007

Diffusion-weighted imaging of intramural hematoma in vertebral artery dissection.

BACKGROUND AND PURPOSE: Dissections of the carotid and vertebral arteries can be detected by several imaging modalities, but there is yet no consensus on the most efficient and effective choice. METHODS: We performed diffusion-weighted imaging (DWI) in four patients with vertebral artery dissection documented with T2- and T1-weighted axial magnetic resonance imaging (MRI), and conventional angiography. Intervals from the onset of headache to evaluation ranged from one day to two weeks. RESULTS: All the patients showed high signal intensity within the affected vertebral artery on DWI. CONCLUSION: The movements of water molecules are more or less restricted within the clots according to the stage of thrombus formation in arterial dissection. Our study may provide another potential imaging method in the difficult task of proving arterial dissection.

Cerebral Angiography↗
PubMed2005

Phenotypic variability in Kennedy's disease: implication of the early diagnostic features.

OBJECTIVES: The clinical diagnosis of Kennedy's disease (KD) is not easy when the typical manifestations are lacking, especially in early stage of the disease. In our study, we tried to identify the relative frequency of common clinical features and early symptoms in KD. METHOD: Eighteen Korean patients with KD were included. Clinical findings were subdivided into two parts: the age at onset of each clinical symptoms and characteristic signs on investigations. With detailed clinical examinations, the serum creatine kinase (CK) level, electrophysiologic study and DNA analysis were performed and analyzed in detail. RESULTS: In KD, the most consistent clinical findings at evaluations included perioral fasciculation with variable bulbar paresis, limb weakness with wasting, hyporeflexia, hand tremor, and elevated CK level. Some distinguishing features, such as X-linked family history, gynecomastia, and sensory abnormalities were absent in a half of cases. Frequent initial clinical findings include tremor (50%) and symptoms other than weakness, such as cramps and fatigability (33.3%). CONCLUSION: We conclude that KD shows variable clinical and electrophysiological features. Our description on the onset and subsequent progression of each clinical finding might help to identify KD in early stage and avoid misdiagnosis.

Adult↗
PubMedDate not supplied

Techniques for intracranial stent navigation in patients with tortuous vessels.

BACKGROUND AND PURPOSE: In some patients with stenosis of an intracranial artery, navigating the balloon or stent-delivery system is difficult of tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries Our purpose was to describe techniques of intracranial stent placement that help in navigating the stent-delivery system in tortuous vessels. METHODS: Between May 1998 and June 2004, 73 symptomatic stenotic (>50%) intracranial arteries were successfully treated with stent-assisted angioplasty. In 11 cases, standard techniques of navigating the stent-delivery system into the intended lesion failed because of vascular tortuosity. In these difficult cases, several techniques were used to overcome the tortuosity. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries. RESULTS: In all difficult cases, stents were successfully placed in the intracranial artery by using several techniques: 1) waiting method in which we waited for 20-30 minutes after advancement of the microwire across the lesion, 2) the double-wire technique, and 3) the coaxial double-guiding catheter technique. The waiting method made smooth stent navigation possible in five cases, the double-wire technique was successful in four cases, and the coaxial double-guiding catheter technique was effective in two cases. No technique-related complications occurred. CONCLUSION: In difficult cases in which standard techniques of navigating the stent-delivery system into the intended lesion fail because of vascular tortuosity, our techniques were useful methods for intracranial stent navigation.

Adult↗