Biomedical subjects

R Huh

Publications and source records attributed to R Huh.

5 recordsLinked to original sources

PubMed2001

Therapeutic embolization of the dural arteriovenous malformation involving the jugular bulb.

Pulsatile tinnitus is a rarely occurring symptom of vascular origin. Most frequently, the symptoms are due to an arteriovenous malformation, to a tumor of the jugular glomus or to a local arterial stenosis. A 39-yr-old Korean male suffering from pulsatile tinnitus of the left ear was diagnosed to have dural arteriovenous malformation of the jugular bulb. Magnetic resonance imaging and angiography revealed a high-velocity vascular lesion encroaching the internal jugular vein and sigmoid sinuses. Digital subtraction angiography demonstrated a dural arteriovenous malformation involving the jugular bulb. The arterial supply was from the neuromeningeal branch of the left ascending pharyngeal artery and inferior tympanic artery. Stenosis of the left jugular vein caused retrograde venous drainage through the contralateral transverse sinus. Superselective embolization of these feeding arteries was successfully performed using 25% mixture of N-butylcyanoacrylate and lipiodol. In postembolization period, his complaints of pulsatile tinnitus and buzzing noise behind his left ear disappeared.

Adult↗

PubMed1999

Endoscopic approach to arachnoid cyst.

A prospective study of 36 consecutive patients with congenital arachnoid cysts treated endoscopically is reported. There were 15 female and 21 male patients. The mean age at the time of diagnosis was 12.3 years (10 days to 38 years). Arachnoid cysts were located in the suprasellar region in 16 patients, the sylvian fissure in 11, the quadrigeminal cistern in 4 and the posterior fossa in 5. Endoscopic fenestration was combined with cysto-peritoneal shunting for 6 temporal cysts and with ventriculo-peritoneal shunting in 1 suprasellar cyst. Mean postoperative follow-up was 4.2 years (range 1-8 years). Follow-up imaging studies showed that 28 arachnoid cysts (77.8%) were obliterated after endoscopic procedures. Long-term clinical results were good in all patients, although the cysts of 8 patients were not reduced in size. There was no mortality or morbidity. We conclude that endoscopic procedures may be a promising alternative to microsurgical operations or shunting for the treatment of arachnoid cysts.

Adult↗

PubMed1999

Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus.

This investigation was undertaken to characterize CSF flow at the level of the aqueduct of Sylvius with a phase-contrast cine MR pulse sequence in 28 healthy volunteers. Sixteen patients with obstructive hydrocephalus and 11 patients with normal pressure hydrocephalus (NPH) were investigated with the same sequence before and after CSF diversion. The peak CSF flow velocity and stroke volume in the aqueduct increased significantly in the NPH group and decreased significantly in the obstructive hydrocephalus group. After lumboperitoneal shunting in the NPH group, the retrograde flow of CSF was anterogradely converted and the peak flow velocities decreased somewhat. The clinical diagnosis of NPH was well correlated with the results of cine MRI. After endoscopic III ventriculostomy in the obstructive hydrocephalus group we noted increased CSF flow velocity with markedly increased stroke volume at the prepontine cistern. Phase-contrast cine MR is useful in evaluating CSF dynamics in patients with hyperdynamic aqueductal CSF or aqueductal obstruction.

Adult↗

PubMed1999

The effects of stereotactic radiosurgery on secondary facial pain.

Twenty-seven patients with tumor-related secondary facial pain were treated by stereotactic radiosurgical procedures between November 1991 and October 1998. They had 14 meningiomas, 11 schwannomas (one trigeminal, 10 vestibular), one nasopharyngeal cancer and one chordoma. The mean maximum dose administered was 26.4 Gy (range 16 to 35 Gy) and the margin of the tumor was encompassed within the 45 to 90% isodose. The patients were analyzed based on their pain relief with a mean follow-up duration of 32.1 months. In 24 patients (85.7%), there was initial pain improvement after radiosurgery, but half had recurrent pain. A pain response was obtained in 12 cases (pain response rate = 42.9%), five were pain free and seven had pain reduction. On the follow-up MRI, a decrease in tumor volume of more than 20% of the preoperative volume occurred in 14 of 25 cases. The mean time interval to initial pain improvement (10.3 months) and pain response (5.7 months) were shorter than for a decrease in tumor volume (18.6 months). Tumor-related secondary facial pain was less responsive to stereotactic radiosurgery than idiopathic trigeminal neuralgia. It would seem that the mechanism of pain relief in radiosurgery is not only trigeminal root decompression secondary to tumor volume reduction, but also other mechanisms involving inactivation of abnormal electrical transmission may be involved.

Adult↗

PubMed1999

Gamma Knife radiosurgery for functioning pituitary adenomas.

Stereotactic radiosurgery has been an important treatment modality in the treatment of pituitary adenomas. However, it has the disadvantage of a delayed effect on hormonal normalization compared with microsurgical resection of functioning pituitary adenomas. To define the efficacy of radiosurgery in the treatment of functioning pituitary adenomas, 37 cases with a mean follow-up duration of 26.9 months were analyzed. There were 18 prolactinomas, 11 cases with acromegaly, and 8 cases with Cushing s disease. The mean maximum dose was 54.8 Gy. The tumor margin was encompassed within the 50 to 90% isodose. The level of serum prolactin, growth hormone, and 24-hour urine free cortisol were evaluated for hormonal follow-up according to the relevant endocrinopathy. There was 35.1% hormonal normalization and an 81.8% decline in hormone levels to below 50% of the preoperative value (hormonal response). Hormonal normalization was obtained in 13 patients (mean latency = 22 months). A hormonal response was seen in 30 patients (mean latency = 7.6 months). The maximum dose and tumor volume included in the prescription isodose were significantly correlated with the latency period from radiosurgery to hormonal normalization. These results suggest that early hormonal normalization can best be achieved by a high maximum dose (at least 55 Gy) and broad coverage of the target tumor volume within the prescription dose thereby increasing the integral dose.

Acromegaly↗