PubMed Health⌕ Search

Biomedical subjects

Yong Pil Cho

Publications and source records attributed to Yong Pil Cho.

At least 19 recordsLinked to original sources
PubMed2006

Lemierre's syndrome in a patient with antiphospholipid syndrome.

Internal jugular vein thrombosis is usually associated with intravenous drug abuse, long-term venous catheterization, local infection, or spontaneous occlusion. The antiphospholipid syndrome is now recognized as one of the commonest causes of acquired arterial or venous thrombosis. Lemierre's syndrome is an uncommon but potentially lethal complication of internal jugular vein thrombosis after an oropharyngeal infection. A 34-year-old man presented with fever and progressive, painful right neck swelling 6 days after an episode of pharyngitis. Clinical studies including radiological and laboratory tests confirmed the diagnosis of Lemierre's syndrome associated with antiphospholipid syndrome. Although Lemierre's syndrome is a well-known cause of internal jugular vein thrombosis, association with antiphospholipid syndrome is very rare.

Adult↗
PubMed2005

Mesenteric involvement of acute-stage Buerger's disease as the initial clinical manifestation: report of a case.

Buerger's disease is almost always a disease of the blood vessels in the extremities. Conversely, mesenteric involvement of Buerger's disease is rare, and no true series have been reported. We report the case of a 37-year-old man with clinical symptoms of upper extremity Buerger's disease, who underwent surgery for extensive small bowel infarction. Histopathologic findings revealed that the mesenteric arteries were swollen and infiltrated with neutrophils, but not associated with fibrinoid necrosis. The lumen was occluded by a highly cellular thrombus with the appearance of a microabscess. These findings were compatible with acute-stage mesenteric Buerger's disease and postoperative studies revealed multiple occluded segments in the small and medium-sized arteries of both legs and the left arm, suggestive of Buerger's disease in the extremities.

Acute Disease↗
PubMed2005

Compartment syndrome after compression sclerotherapy.

Acute limb compartment syndrome is a condition in which raised pressure within a closed fascial space reduces capillary perfusion below a level necessary for tissue viability. Although it is a rare but potentially disastrous complication of orthopedic injury to the extremities, it may occur spontaneously without a history of trauma, and any insult that tends to increase resistance to flow in the capillary bed in any anatomical situation may result in a compartment syndrome. We report an extremely rare case of compartment syndrome following compression sclerotherapy.

Adult↗
PubMed2005

Aneurysm of the popliteal artery in neurofibromatosis.

The neurofibromatoses are a heterogeneous set of genetic disorders having clinical manifestations that involve the skin, the nervous system, or both. In addition, the disease can be confounded by a broad spectrum of complications, such as various kinds of osseous lesion, vascular lesions, aqueduct stenosis, optic glioma, and learning disabilities. Neurofibromatosis results in vascular involvement in approximately 10% of cases. Stenotic lesions predominate, but aneurysms have been documented as well. Rarely noted, however, have been peripheral aneurysms. In this report, we discuss the case of a 66-year-old woman with type 1 neurofibromatosis and a popliteal artery aneurysm who was operated upon because of threatened limb ischemia. Histological findings confirmed neurofibromatous invasion of the vessel wall.

Aged↗
PubMed2004

Superior mesenteric artery syndrome after successful coil embolization of a ruptured pancreaticoduodenal artery aneurysm: report of a case.

Superior mesenteric artery (SMA) syndrome is a rare condition in which the third part of the duodenum is trapped between the abdominal aorta and the SMA. Any disease process decreasing the angle between the aorta and the SMA can result in external compression of the duodenum and subsequent intestinal obstruction. Aneurysms of the pancreaticoduodenal artery (PDA) and its branches are also rare and account for only 2% of all splanchnic artery aneurysms. We report a case of SMA syndrome that developed after successful coil embolization of a ruptured PDA aneurysm.

Aged↗
PubMed2004

Staged surgery for chronic primary aortoduodenal fistula in a septic patient.

Aortoenteric fistula is one of the most challenging problems that confront the vascular surgeons. Controversy remains over the optimal treatment because of the continued publication of series with high mortality, amputation, and aortic disruption rates. A positive preoperative blood culture is the best predictor of mortality with increased amputation rates due to infection of the extra-anatomic bypass. Therefore, in selected cases with sepsis, a prudent management protocol is required. We report a 68-yr-old male presenting with a chronic primary aortoduodenal fistula extensively involving the duodenum and Gram-negative sepsis. We planned a staged operation. Initially, an emergency laparotomy and control of the aorta allowed stabilization of the patient, identification of the fistula, and direct in situ placement of the prosthetic graft followed by an en bloc resection of the aneurysm and the surrounding structures. After he recovered from sepsis and had been stabilized, a staged extra-anatomic bypass followed by transabdominal removal of the temporarily placed graft was done. This management plan will allow the highest success rate and may be a prudent management protocol for these difficult cases.

Aged↗
PubMed2004

Endovascular management of iliofemoral deep venous thrombosis due to iliac vein compression syndrome in patients with protein C and/or S deficiency.

The purpose of this study was to evaluate the early outcome of endovascular management in patients with iliofemoral deep venous thrombosis (DVT) due to iliac vein compression syndrome (IVCS) and protein C and/or S deficiency. Between September 2000 and January 2003, catheter-directed thrombolysis was performed in 11 patients with a diagnosis of acute iliofemoral DVT: 7 with protein C and/or S deficiency and 4 without protein C and/or S deficiency. After thrombolysis, the diagnosis of IVCS was confirmed in 6 patients: 4 with protein C and/or S deficiency and 2 without protein C and/or S deficiency. Further intervention consisted of angioplasty and stent placement was performed. Four patients with IVCS and protein C and/or S deficiency were included in this study. The immediate technical and clinical success rates were 100% in all 4 patients. There were no complications or clinically detectable pulmonary emboli. This initial experience suggests that endovascular management of iliofemoral DVT due to IVCS in patients with protein C and/or S deficiency is safe and effective.

Adult↗
PubMed2003

Mesenteric Buerger's disease.

A young male patient with a history of heavy smoking and low-extremity Buerger's disease was operated on because of small bowel infarction. The postoperative histopathological diagnosis was mesenteric involvement of Buerger's disease. Mesenteric Buerger's disease is extremely rare, the early diagnosis is difficult, and the prognosis is poor. Considering the difficulty in diagnosis and the poor prognosis, patients with Buerger's disease presenting with gastrointestinal manifestations should be carefully evaluated, and early surgical intervention is recommended.

Humans↗
PubMed2003

Role of diagnostic laparoscopy in managing acute mesenteric venous thrombosis.

We describe two cases with acute mesenteric venous thrombosis in which diagnostic laparoscopy helped to diagnose the possible bowel infarction. These patients presented with abdominal pain out of proportion to physical findings, and computed tomography demonstrated thrombus in the superior mesenteric vein. Anticoagulation with heparin followed by diagnostic laparoscopy was done immediately after the diagnosis was established. According to the laparoscopic findings, one was managed with full anticoagulation without laparotomy and the other was managed with full anticoagulation and surgical resection. Considering that delay in diagnosis and surgical exploration is still frequent and is a significant contributory factor to the reported high mortality rate, diagnostic laparoscopy in an early position in the management algorithm for acute mesenteric venous thrombosis can furnish a rapid precise diagnosis of bowel infarction. It can also reduce the unnecessary laparotomies in these difficult cases.

Acute Disease↗
PubMed2003

Metabolic changes after revascularization in a patient with innominate artery occlusion by localized in vivo proton magnetic resonance spectroscopy.

Localized in vivo proton magnetic resonance spectroscopy ((1)H-MRS) has been used to measure the metabolic status of the human brain in a non-invasive manner; thus, it is often called "a non-invasive biochemical assay". MRS is more sensitive than magnetic resonance imaging (MRI) in detecting ischemic damage by measuring the metabolic changes that occur prior to the anatomic changes. We report a patient who presented with innominate artery occlusion and symptoms of posterior circulation insufficiency and showed favorable metabolic changes by (1)H-MRS after revascularization. He showed no visible lesion in brain MRI, but in (1)H-MRS, decreased N-acetylaspartate (NAA) signal was noted in a resting state. After revascularization, both symptomatic improvement and recovery of NAA signal were observed. (1)H-MRS may provide valuable clinical information in diagnosis and management of cerebral hypoperfusion at a much earlier stage prior to the anatomic changes.

Arterial Occlusive Diseases↗
PubMed2003

Leakage of jejunal end of roux limb after total gastrectomy: management with a placement of a covered metallic stent: case report.

Postoperative leakage is a serious complication in patients after gastric surgery. It can lead to a rapid deterioration in the patient's condition and quality of life. Treatment is guided by the type of anastomosis and the patient's clinical status. The role of interventional radiology in gastrointestinal tract is evolving. Metallic stent placement has shown encouraging results for the palliation of gastrointestinal tract obstruction and fistula in malignant patients. We encountered a case of the leakage of jejunal end of Roux limb after total gastrectomy. This patient required a drainage procedure with long-term parenteral nutrition. We performed peroral placement of a covered metallic stent to avoid surgery and long-term parenteral nutrition, and he resumed adequate oral intake immediately after stent placement. This minimally invasive procedure is very promising for the treatment of a gastrointestinal fistula to avoid surgery and long-term parenteral nutritional support in selected cases.

Aged↗
PubMed2003

Retroperitoneal abscess complicated by acupuncture: case report.

With acupuncture treatment becoming an increasingly popular analgesic, there have been increasing reports on its associated complications. Although pneumothorax is the most frequently reported injury caused by acupuncture needles, infectious complications may not be uncommon. Most infectious complications show less serious clinical manifestations than pneumothorax, but retroperitoneal or intraabdominal abscess caused by acupuncture may be much more serious conditions. We experienced a 56-yr-old male diabetic patient presenting with serious retroperitoneal abscess after acupuncture treatments. Emergency operative drainage with adequate antibiotic therapy was performed. Bacterial culture of blood and closed pus specimens recovered Klebsiella pneumoniae. In addition to application of better knowledge on anatomy, appropriate antiseptic practice by practitioners will reduce many serious complications associated with acupuncture.

Abdominal Abscess↗
PubMed2003

Role of endoscopy in the diagnosis of aneurysm-duodenal fistula.

BACKGROUND: Aneurysms complicated by enteric fistulae are uniformly fatal clinical conditions and therefore should be placed high on the list of possible diagnoses in any patient with aneurysmal disease and gastrointestinal bleeding. A number of different diagnostic techniques have been proposed, but most of them are usually of little help or even misleading. METHODOLOGY: Between May 2000 and April 2002, endoscopy was performed in 290 consecutive patients with upper gastrointestinal bleeding. We retrospectively evaluated that endoscopy may provide an important diagnostic clue in aneurysm-enteric fistulae. RESULTS: Three patients with gastrointestinal bleeding presented with aneurysmal disease complicated by duodenal fistula formation. Two patients presented with aortoduodenal fistula, and the last one hepatic artery aneurysm with duodenal fistula formation. In all of our cases, endoscopic findings were suggestive and helpful for the preoperative diagnosis. CONCLUSIONS: Considering that prompt aggressive surgical intervention is mandatory for survival and more than 90% of aneurysmal disease with duodenal fistula formation should be within range of the endoscopists, aggressive and thorough endoscopy with a high index of clinical suspicion seems to be the most important diagnostic test in these difficult cases.

Adult↗
PubMed2002

Sonographic appearance of a free-floating atheromatous plaque in a patient with acute stroke.

We report the case of a neurologically unstable acute stroke patient in whom carotid sonography identified the need for emergency carotid surgery because of an increased risk of distal embolization from a free-floating atheromatous plaque. Longitudinal and transverse sonograms revealed a 6-mm free-floating thrombus loosely attached to the wall of the left common carotid artery. During emergency surgery, a free-floating atheromatous plaque was seen at this location, along with extensive atheromatous lesions. The diseased segment of the common carotid artery was resected and repaired with an interposition graft, and the patient recovered uneventfully, with no recurrence of stroke.

Acute Disease↗
PubMed2002

Can carotid endarterectomy improve metabolic status in patients with asymptomatic internal carotid artery flow lesion? Studies with localized in vivo proton magnetic resonance spectroscopy.

PURPOSE: Carotid endarterectomy (CEA) has proven to be effective in the prevention of stroke in patients with significant internal carotid artery (ICA) stenosis. However, whether increased cerebral blood flow after CEA improves the cerebral metabolism in patients with asymptomatic ICA flow lesions is unknown. Localized in vivo proton magnetic resonance spectroscopy ((1)H-MRS) has been used to measure the metabolic status of the human brain in a totally noninvasive manner. The aim of this study was to investigate the cerebral metabolism after CEA in patients with asymptomatic ICA flow lesions and no visible infarction on magnetic resonance imaging (MRI). MATERIALS AND METHODS: We designed a prospective study to investigate the metabolic changes in the middle cerebral artery (MCA) territory with (1)H-MRS for 18 consecutive patients with asymptomatic severe stenosis of the ICA (>70% reduction in diameter) and for 16 healthy control subjects. The 18 patients with ICA flow lesion and no visible infarction on MRI who underwent CEA were evaluated before and 7 days after surgery (CEA group). The 16 control subjects had never had a cerebral event, and brain MRI and carotid duplex scan study results were normal in all (control group). RESULTS: Preoperative ICA volume flow was severely decreased to less than 150 mL/min in all 18 patients, in comparison with our laboratory normal value of matched age group of 250 to 300 mL/min. After CEA, ICA volume flow was increased to greater than 300 mL/min in all patients (P =.00). For patients in the CEA group, preoperative N-acetylaspartate/creatine and choline/creatine ratios in the MCA territory were slightly decreased compared with the healthy subjects in the control group but were within normal limits. However, the postoperative values of N-acetylaspartate/creatine and choline/creatine ratios in the ipsilateral MCA territory were significantly increased as compared with the preoperative values (P <.05). In the contralateral side, the postoperative increase of choline/creatine ratio and the decrease of myo-inositol/creatine ratio were statistically significant as compared with the preoperative values (P <.05). CONCLUSION: CEA seems to improve the cerebral metabolic status in patients with asymptomatic ICA flow lesions and no visible infarction on MRI.

Aged↗
PubMed2002

The anatomy of the circle of Willis as a predictive factor for intra-operative cerebral ischemia (shunt need) during carotid endarterectomy.

The collateral flow to the cerebral hemisphere after carotid cross clamping during carotid endarterectomy is mainly through the circle of Willis, and the circle is incomplete in the majority of cases. A correlation between the status of the circle of Willis and the necessity of shunting was evaluated in 67 carotid endarterectomies with pre-operative four-vessel cerebral angiogram. All carotid endarterectomies were performed with selective shunting, based on the change of consciousness and motor function after carotid test clamping under regional anesthesia. Of the 55 patients with either an anterior or a posterior communicating artery, only four (7.3%) required shunting. Twelve patients had neither anterior nor posterior communicating artery, and 10 (83.3%) showed signs of cerebral ischemia necessitating shunting. Mandatory shunt was significantly higher in patients with absence of collaterals (p = 0.00). The rate of intraoperative cerebral ischemia was significantly higher in patients with poor collateral circulation defined by the anatomy of the circle of Willis.

Adult↗
PubMedDate not supplied

Extended surgery for the hepatic artery aneurysm involving duodenum and pancreas--a case report.

Hepatic artery aneurysms have been the most frequently reported splanchnic artery aneurysms in the past decade. Due to the complex anatomy and sensitivity of the liver to ischemic injury, a number of therapeutic alternatives exist in repairing aneurysmal hepatic arteries. Excision or obliteration of all hepatic artery aneurysms appears to be the management of choice. However, in managing aneurysms involving the proper hepatic artery and its extrahepatic branches, restoration of normal hepatic blood flow is most crucial. A 49-year-old man was found to have a huge extrahepatic artery aneurysm involving the area from the origin of the common hepatic artery to the distal proper hepatic artery. It ruptured into the duodenal bulb and firmly adhered to the surrounding structures including pancreas and common bile duct. Extended surgery with restoration of normal hepatic flow was performed safely. In cases with huge extrahepatic artery aneurysms, an aggressive approach to restore the hepatic arterial continuity seems appropriate for the prevention of ischemic damage to the liver.

Anastomosis, Surgical↗