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S J Ryu

Publications and source records attributed to S J Ryu.

At least 37 records · Page 2Linked to original sources
PubMed1993

Carotid ultrasonographic findings in intracranial internal carotid artery occlusion.

Five cases of unilateral intracranial internal carotid artery (ICA) occlusion received both carotid angiographic and ultrasonographic studies. The Doppler examination showed that the resistive index (RI) of the common carotid artery (CCA) and ICA was higher but the peak systolic velocity was lower on the diseased side as compared with the normal side. Absence of the diastolic phase was found in the CCA flow in 2 cases and in the ICA flow in 3 cases on the diseased side. The mean CCA flow volume on the diseased side (271 +/- 82 mL/min) was half or less than that on the normal side (680 +/- 86 mL/min) (P < 0.01). The flow volume of the diseased ICA (49 +/- 20 mL/min) was markedly lower than that of the normal side (344 +/- 49 mL/min) (P < 0.01) and was also less than that of the ipsilateral external carotid artery (ECA) (129 +/- 43 mL/min). The Doppler ophthalmic artery flow all showed a forward direction. The authors propose that the following extracranial carotid ultrasonographic findings may be helpful in the prediction of intracranial carotid artery occlusion: (1) diminished frequencies, increased RI, and a more than 50% reduction of flow volume in the CCA as compared with the opposite side; (2) diminished frequencies to loss of the diastolic phase, a more than 50% reduction of the flow volume, and reversed ICA/ECA flow volume in the ICA as compared with the opposite side; and (3) a forward Doppler ophthalmic artery flow.

Adult↗
PubMed1993

Forward Doppler ophthalmic artery flow in patients with extracranial carotid artery occlusion--a case report.

The authors report 2 cases of common carotid artery (CCA) occlusion and 4 cases of extracranial internal carotid artery (ICA) occlusion with forward Doppler ophthalmic artery flow. The compression test during Doppler study showed that the ophthalmic artery flow was reduced to zero when compressed contralateral to the CCA in 1 case of CCA occlusion and when compressed ipsilateral to the CCA in all 4 cases of ICA occlusion. The angiograms showed that in the 2 cases of CCA occlusion, 1 had the ophthalmic artery originating from the anterior communicating artery, and the other had subclavian steal syndrome with a reversed vertebral flow. In 3 of the 4 cases of ICA occlusion, the ophthalmic artery was found to originate from the ipsilateral middle meningeal artery. Their findings suggest that in cases of extracranial carotid artery occlusion, the forward ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA occlusion and from the branches of the ipsilateral external carotid artery in cases of ICA occlusion, and the vertebrobasilar system plays a less important role.

Adult↗
PubMed1992

Correlation between sonographic and angiographic findings of extracranial carotid artery disease.

Comparison between sonographic and angiographic findings of the extracranial carotid arteries were made in 68 patients. We used a Diasonic Duplex Ultrasonograph (DRF 400) which combined a real-time B-mode imaging system and a pulsed-wave Doppler spectral analyser. Continuous-wave Doppler was also used to determine ophthalmic artery flow direction. The findings were classified into four categories: (1) normal or less than 10% stenosis, (2) 10-49% stenosis, (3) 50-99% stenosis, (4) and total occlusion. The agreement between the two tests was 0.53 which meant fair agreement beyond chance by Kappa statistics. When angiograms were used as gold standard, the sensitivity of duplex sonography was above 80% in all categories of stenosis, and the overall accuracy and specificity were above 90% in those stenosis greater than 50% and occlusion. We conclude that duplex sonography, a reproducible noninvasive test, is a safe and cost-efficient screening method which can provide a good correlation with angiograms in detecting extracranial carotid artery disease.

Adult↗
PubMed1992

Primary medullary hemorrhage: report of a case.

A 40-year-old normotensive man suddenly developed dizziness, vomiting, hoarseness and swallowing disturbance. Neurologic examinations showed bilaterally decreased palatal elevation and gag reflex, upbeat nystagmus and gait ataxia. The diagnosis of medullary hemorrhage was first established by computed tomography (CT). Magnetic resonance imaging study further showed a hematoma in the paramedial medulla oblongata extending dorsorostrally to the pontomedullary junction. It gave the precise anatomic boundary of the intramedullary hematoma and was well correlated with the clinical findings. This patient's subsequent prognosis was good with gradual improvement of the clinical signs and symptoms. A follow-up CT scan showed resolution of the hematoma, and the prognosis was consistent with a good neurologic recovery.

Adult↗
PubMed1992

Comparison between carotid duplex sonography and angiography in the diagnosis of extracranial internal carotid artery occlusion.

To determine the diagnostic accuracy of extracranial internal carotid artery (ICA) occlusion by carotid duplex sonography and ophthalmic flow direction, we compared both carotid sonograms and angiograms in 82 cases of ischemic cerebrovascular disease. A total of 157 carotid arteries were available for comparison. The overall diagnostic accuracy of ICA occlusion by duplex scanning was 96% (sensitivity, 83%; specificity, 98%; positive predictive value, 91%), by ophthalmic flow examination, 95% (sensitivity, 79%; specificity, 98%; positive predictive value 86%), and by combined study, 98% (sensitivity, 96%; specificity, 98%; positive predictive value 92%). We recommend that the ophthalmic flow examination should be used in combination with other sonographic methods in detecting extracranial carotid artery disease. The combined study gives higher diagnostic accuracy than the single method. When an occlusion or a tight stenosis is uncertain on carotid sonograms, color Doppler or angiography is indicated for further confirmation.

Adult↗
PubMed1991

CT, somatosensory and brainstem auditory evoked potentials in the early prediction of functional outcome in putaminal hemorrhage.

The CT and median somatosensory and brainstem auditory evoked potentials (SEP and BAEP) were studied in 80 patients with spontaneous putaminal hemorrhage for their values in the early prediction of functional outcome. The CT scan was performed within 2 days and EPs within a week after the onset of symptoms. The activities of daily living was assessed at 6 months. Patients with good functional recovery had the following findings: 1) the hemorrhage had not involved the thalamus or the posterior limb of the internal capsule; 2) the SEPs were normal or had prolonged central conduction time; and 3) the BAEP was normal. When the cortical SEPs were absent, the majority of patients were moderately or severely disabled. Attenuation or absence of BAEP wave V always forecast a grave prognosis. It is concluded that the combined use of CT, SEP and BAEP is an objective and reliable method for the early prediction of functional outcome in patients with putaminal hemorrhage.

Activities of Daily Living↗
PubMed1991

The prognostic value of blood glucose in patients with acute stroke.

We prospectively studied levels of blood glucose and glycohemoglobin, and their correlations with types, severity, and prognosis of stroke in 37 patients with brain infarction (BI) and 35 patients with brain hemorrhage (BH). We found that in the BH group, patients with an elevated glucose level due to stress, diabetes, or both, had a lower consciousness level on admission, larger hematoma size, higher incidence of rupture into the ventricles, and a worse 1-month outcome than patients with a normal glucose level (p less than 0.05). In patients with BI, however, no significant difference was found as related to levels of glucose, though a difference in 6-month mortality between stress hyperglycemic and normoglycemic patients (p less than 0.05) was found. We conclude that an elevated glucose level is associated with a worse clinical condition, larger hematoma size, higher incidence of rupture into the ventricles, and worse outcome in patients with BH. However, it seems to be the severity of the stroke, not the hyperglycemia, that causes the poor outcome. Hyperglycemia may be an epiphenomenon of stroke severity.

Aged↗
PubMed1991

[Primary mesencephalic hemorrhage: report of four cases].

Spontaneous intracerebral hemorrhage rarely occurs in the mesencephalon (midbrain), though thalamic or pontine hemorrhage may extend into that location. The neurologic manifestations and outcome in patients with primary mesencephalic hemorrhage (PMH) are different from those with thalamic or pontine hemorrhage. We report 4 patients (2 men and 2 women) with nontraumatic and non-neoplastic hemorrhages confined to the mesencephalon. One young patient, a 37-year-old woman, had no detectable risk factors for stroke, and her cerebral angiogram was normal. The other 3 elderly patients (73-85 years of age) all had a history of hypertension. The neurologic manifestations of patients with PMH are characterized by disturbance of ocular movements and cerebellar signs. Two patients with tegmental hematoma showed Claude's syndrome, i.e., ipsilateral oculomotor palsy and contralateral cerebellar signs. One patient with a small central midbrain hematoma showed bilateral oculomotor palsy. Another patient with a relatively large central midbrain hematoma presented with bilateral ptosis, bilateral internuclear ophthalmoplegia, upward gaze palsy, and bilateral cerebellar signs. The prognosis after conservative treatment for our patients with PMH was good.

Adult↗
PubMed1990

Intracranial hemorrhage in patients with polycystic kidney disease.

To emphasize the important association of polycystic kidney disease and hypertensive cerebral hemorrhage, a registry of 900 consecutive cases of hemorrhagic stroke was reviewed. Eleven patients (1.2%) had intracranial hemorrhage (eight had hypertensive cerebral hemorrhage and the other three had aneurysmal subarachnoid hemorrhage) found to be associated with polycystic kidney disease. These 11 patients also accounted for 11% of the 98 cases of polycystic kidney disease during the 28-month study period. As verified by computed tomography, parenchymal hemorrhage occurred mainly in the putamen and the thalamus, the usual sites for hypertensive cerebral hemorrhage. One patient with cerebral hemorrhage was autopsied and one was studied angiographically, but in neither patient was an intracranial aneurysm identified. In the patients with polycystic kidney disease and intracranial hemorrhage, hypertension had been inadequately treated or even undetected; therefore, I emphasize early detection and more effective control of hypertension in patients with polycystic kidney disease for prophylaxis against hemorrhagic cerebrovascular events.

Adult↗
PubMed1990

Secondary prevention of ischemic stroke with low dose acetylsalicylic acid.

In order to evaluate the efficacy of low dose acetylsalicylic acid (ASA) for the secondary prevention of ischemic stroke, this cooperative multicenter clinical trial was conducted on a non-blind basis. Patients having a first transient ischemic attack (TIA), reversible ischemic neurological deficit (RIND) or completed ischemic stroke were eligible for this trial. A total of 590 patients including 47 cases of TIA, 23 cases of RIND and 520 cases of completed stroke entered this study. These patients were allocated by the time of admission to one of the following 5 trial regimens: (1) vasodilators having no known inhibitory effect on platelet function (control group), (2) dipyridamole (DP) 50 mg 3 times a day (DP group), (3) ASA 300 mg once a day (ASA 300 mg group), (4) ASA 300 mg once in combination with DP 50 mg 3 times a day (ASADP group), and (5) ASA 100 mg once a day (ASA1 group). No difference in effect between the control and DP groups was observed, nor between the ASA 300 mg and ASADP groups. Therefore, we combined the control and DP groups to make a non-ASA group, and joined the ASA 300 mg and ASADP groups to make an ASA3 group. The differences in the cumulative event-free rate appeared to be significant between the non-ASA group and the ASA3 group and also between the non-ASA group and the ASA1 group. But the frequency distribution of age, territory of stroke, diabetes mellitus, cardiac disease, hematological disease and hyperuricemia were significantly different among these 3 study groups. We thus included these covariates in the Cox's proportional hazard model to control their possible confounding effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Guillain-Barré syndrome associated with acute delta hepatitis virus superinfection.

We describe a patient with the clinical characteristics of Guillain-Barré syndrome, including progressive ascending paresis; cerebrospinal fluid albumino-cytological dissociation; polyphasic small evoked potential, with prolonged latency and slow motor nerve conduction velocity; and active denervation pattern on electromyography, in association with acute delta hepatitis virus superinfection. The patient recovered from Guillain-Barré syndrome but developed chronic active delta hepatitis.

Acute Disease↗
PubMed1988

Moyamoya disease in Taiwan.

Moyamoya disease occurring in Chinese has been inadequately described. Here we report 13 cases of this disease identified by review of 3,200 cerebral angiograms performed between August 1979 and March 1986. Nine were males and four were females; there were 12 adults (aged 34-51 years) and one child (aged 11 years). All had hemorrhagic strokes with one exception, a patient with an occipital infarction. Intraventricular hemorrhage was noted by computed tomography in 10; five of these emanated from the caudate nucleus. A localized hematoma without intraventricular hemorrhage was found in two. All 13 angiograms had smokelike basal anastomoses with various degrees of stenosis or occlusion of the anterior portion of the circle of Willis; the involvement was bilateral in 12 and unilateral in one. Aneurysms were found in two patients, one in the anterior communicating artery and the other in the left anterior choroidal artery. Eleven patients recovered from the initial stroke, but two died with recurrent hemorrhage. This series differs from the series reported in Japan by the predominance of adult males. The high incidence of intraventricular hemorrhage and intracerebral hematoma is not in keeping with the previous Chinese series, in which subarachnoid hemorrhage was suspected to be the major clinical manifestation.

Adult↗
PubMed1988

Intracranial phycomycosis: case reports.

Cerebral phycomycosis is a rare disease. We describe two patients with unusual features of focal intracranial phycomycosis: a diabetic patient with chronic epidural abscess and a healthy individual with an isolated intracerebral abscess. Biopsy established the diagnosis in both patients. Treatment was successful in the patient with intracerebral abscess.

Adult↗