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Search Results: 1 - 10 of 22320 matches for " Sang Heum Kim "
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Successful Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for Recurrent Uterine Fibroid Previously Treated with Uterine Artery Embolization
Sang-Wook Yoon,Kyoung Ah Kim,Sang Heum Kim,Jong Tae Lee
Obstetrics and Gynecology International , 2010, DOI: 10.1155/2010/351273
Abstract: A 45-year-old premenopausal woman was referred to our clinic due to recurring symptoms of uterine fibroids, nine years after a uterine artery embolization (UAE). At the time of screening, the patient presented with bilateral impairment and narrowing of the uterine arteries, which increased the risk of arterial perforation during repeated UAE procedures. The patient was subsequently referred for magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) treatment. Following the treatment, the patient experienced a significant improvement in symptoms (symptom severity score was reduced from 47 to 12 by 1 year post-treatment). MR images at 3 months showed a 49% decrease in fibroid volume. There were no adverse events during the treatment or the follow-up period. This case suggests that MRgFUS can be an effective treatment option for patients with recurrent fibroids following previous UAE treatment. 1. Introduction Uterine leiomyoma (fibroid) is the most common reproductive tract tumor in women of reproductive age. Fibroids have been clinically identified in at least 25% of women [1], and pathological analysis suggests that the prevalence of fibroids may be as high as 77% [2]. Symptomatic fibroids can significantly affect quality of life (QOL) and can result in heavy and prolonged menstrual flow, urinary frequency, pelvic pain, abdominal pressure, infertility, and dyspareunia [3–5]. Surgical treatments for uterine fibroids include hysterectomy and myomectomy [6]. Minimally invasive or noninvasive treatments include uterine artery embolization (UAE), magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS), and hormonal therapy [6–9]. Each of these treatment options, which require minimal or no hospitalization, enables women to preserve their uteri [10] and usually minimize complications, recovery time, and treatment costs [11, 12]. UAE is a minimally invasive, image-guided therapy, in which the blood supply to the uterine fibroid is blocked by catheterization, and the ischemic necrosis of the fibroids is induced by the insertion of embolic particles [13]. The embolic particles are usually composed of polyvinyl alcohol, tris-acryl, or gelatin sponge material. MRgFUS is a noninvasive treatment in which ultrasound energy, focused on the fibroid in multiple focal spots, raises the temperature of tissue within the focal zone and causes coagulative necrosis. MRI guides and monitors the procedure, thereby providing closed loop anatomical and thermal feedback [9]. Several measures are used to assess the efficacy of these minimally invasive
Contrast-Enhanced Dynamic MR Imaging of Uterine Fibroids as a Potential Predictor of Patient Eligibility for MR Guided Focused Ultrasound (MRgFUS) Treatment for Symptomatic Uterine Fibroids
Sang-Wook Yoon,Chan Lee,Kyoung Ah Kim,Sang Heum Kim
Obstetrics and Gynecology International , 2010, DOI: 10.1155/2010/834275
Abstract: Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a non-invasive treatment approach for symptomatic uterine fibroids. One imaging characteristic considered in selecting patients who may benefit from MRgFUS of their uterine fibroids is the signal intensity of the fibroid compared with surrounding myometrium on T2-weighted MR images. Previous reports suggest that hyper-intense fibroids are less amenable to MRgFUS compared with iso- or hypo-intense fibroids. In this case study, we utilized contrast-enhanced dynamic MR imaging to further characterize the vascularity of a hyper-intense fibroid. Based on the results of dynamic T1-weighted contrast-enhanced images, we assumed that the hyper-intense appearance resulted from high fluid content rather than high vascularity and predicted that the fibroid would respond to MRgFUS. The patient underwent the MRgFUS without complication and reported significant decrease in fibroid symptoms at 3 and 12 months post-treatment. This case suggests that pre-treatment dynamic contrast-enhanced imaging used in conjunction with T2-weighted imaging may improve the criteria for selecting uterine fibroids amenable to treatment with MRgFUS, potentially leading to improved patient outcomes. 1. Introduction Uterine fibroids are the most common tumors of the female reproductive tract. Fibroids have been identified clinically in at least 25% of women [1], and pathological analyses suggest that the prevalence of fibroids may be as high as 77% [2]. Although most fibroids are asymptomatic, approximately 25% are associated with symptoms that can have a significant impact on patient’s quality of life, including prolonged or excessive menstrual bleeding, pelvic pain or bulkiness, dyspareunia, increased urinary frequency, and infertility [3]. Several options, each with varying degrees of invasiveness, are available for treatment of symptomatic uterine fibroids. These include among others, hysterectomy, myomectomy (abdominal or laparoscopic), uterine artery embolization, MR-guided Focused Ultrasound (MRgFUS), and hormonal therapy [4], which also is sometimes provided as an adjuvant to other therapies. Each of the treatments has its own benefits and disadvantages. For example, the benefit of hysterectomy is that the removal of the uterus is 100% effective in alleviating fibroid-related symptoms [5]. However, the procedure is invasive, requires general or epidural anesthesia, and typically involves several weeks of postoperative recovery time during which patients may be limited from engaging in daily activities, including work.
Abdominal wall hemorrhage after intravenous thrombolysis for acute ischemic stroke
An Se-A,Kim Jinkwon,Kim Sang Heum,Kim Won Chan
BMC Neurology , 2013, DOI: 10.1186/1471-2377-13-6
Abstract: Background Thrombolysis is strongly recommended for patients with significant neurologic deficits secondary to acute ischemic stroke. Extracranial bleeding is a rare but major complication of thrombolysis. Case presentation A 78-year-old woman presented with acute ischemic stroke caused by occlusion of the basilar artery. Clinical recovery was observed after successful recanalization by intravenous thrombolysis and intraarterial thrombectomy. However, the patient complained of sudden abdominal pain following the intervention and a newly developed abdominal wall mass was found. CT scan and selective angiography confirmed active bleeding from the left epigastric artery into the abdominal muscle layer and the bleeding was successfully managed by selective embolization of the bleeding artery. Conclusions We report a rare case of abdominal wall hemorrhage after thrombolysis for acute ischemic stroke. The findings indicate that abdominal wall hemorrhage should be considered as a differential diagnosis in the presence of abdominal discomfort after thrombolysis for acute ischemic stroke.
Chemical ablation of the gallbladder using alcohol in cholecystitis after palliative biliary stenting
Tae Hoon Lee, Sang-Heum Park, Sang Pil Kim, Ji-Young Park, Chang Kyun Lee, Il-Kwun Chung, Hong Soo Kim, Sun-Joo Kim
World Journal of Gastroenterology , 2009,
Abstract: Chemical ablation of the gallbladder is effective in patients at high risk of complications after surgery. Percutaneous gallbladder drainage is an effective treatment for cholecystitis; however, when the drain tube cannot be removed because of recurrent symptoms, retaining it can cause problems. An 82-year-old woman presented with cholecystitis and cholangitis caused by biliary stent occlusion and suspected tumor invasion of the cystic duct. We present successful chemical ablation of the gallbladder using pure alcohol, through a percutaneous gallbladder drainage tube, in a patient who developed intractable cholecystitis with obstruction of the cystic duct after receiving a biliary stent. Our results suggest that chemical ablation therapy is an effective alternative to surgical therapy for intractable cholecystitis.
Interplay of electron-electron and electron-phonon interactions in the low temperature phase of 1T-TaS2
Doohee Cho,Yong-Heum Cho,Sang-Wook Cheong,Ki-Seok Kim,Han Woong Yeom
Physics , 2015, DOI: 10.1103/PhysRevB.92.085132
Abstract: We investigate the interplay of the electron-electron and electron-phonon interactions in the electronic structure of an exotic insulating state in the layered dichalcogenide 1T-TaS2, where the charge-density-wave (CDW) order coexists with a Mott correlation gap. Scanning tunneling microscopy and spectroscopy measurements with high spatial and energy resolution determine unambiguously the CDW and the Mott gap as 0.20-0.24 eV and 0.32 eV, respectively, through the real space electron phases measured across the multiply formed energy gaps. An unusual local reduction of the Mott gap is observed on the defect site, which indicates the renormalization of the on-site Coulomb interaction by the electron-phonon coupling as predicted by the Hubbard-Holstein model. The Mott-gap renormalization provides new insight into the disorder-induced quasi-metallic phases of 1T-TaS2.
Honeycomb Charge Ordering in IrTe$_2$
Hyo Sung Kim,Soo-Ran Kim,Kyoo Kim,Byung Il Min,Yong-Heum Cho,Sang-Wook Cheong,Han Woong Yeom
Physics , 2015,
Abstract: We report on the observation of a unique honeycomb charge ordering of the cleaved IrTe$_2$ surface by high-resolution scanning tunneling microscopy (STM) and spectroscopy (STS). IrTe$_2$ was recently established to exhibit intriguing stripe charge orderings. Here, we show that the stripe charge order coexists with a metastable honeycomb phase formed locally. The atomic and electronic structures of the honeycomb phase are consistent with the stripe phase indicating unambiguously its charge order nature. A simple model of the honeycomb structure is suggested based on the overlap of three degenerate stripe orders, which is analogous to the 3$q$ state description of a skyrmion. We suggest that the honeycomb charge order can be a route to an exotic Dirac electron system.
Primary endoscopic approximation suture under cap-assisted endoscopy of an ERCP-induced duodenal perforation
Tae Hoon Lee, Byoung Wook Bang, Jee In Jeong, Hyung Gil Kim, Seok Jeong, Seon Mee Park, Don Haeng Lee, Sang-Heum Park, Sun-Joo Kim
World Journal of Gastroenterology , 2010,
Abstract: Duodenal perforation during endoscopic retrograde cholangiopancreatography (ERCP) is a rare complication, but it has a relatively high mortality risk. Early diagnosis and prompt management are key factors for the successful treatment of ERCP-related perforation. The management of perforation can initially be conservative in cases resulting from sphincterotomy or guide wire trauma. However, the current standard treatment for duodenal free wall perforation is surgical repair. Recently, several case reports of endoscopic closure techniques using endoclips, endoloops, or fully covered metal stents have been described. We describe four cases of iatrogenic duodenal bulb or lateral wall perforation caused by the scope tip that occurred during ERCP in tertiary referral centers. All the cases were simply managed by endoclips under transparent cap-assisted endoscopy. Based on the available evidence and our experience, endoscopic closure was a safe and feasible method even for duodenoscope-induced perforations. Our results suggest that endoscopists may be more willing to use this treatment.
Nanoscale manipulation of the Mott insulating state coupled to charge order in 1T-TaS2
Doohee Cho,Sangmo Cheon,Ki-Seok Kim,Sung-Hoon Lee,Yong-Heum Cho,Sang-Wook Cheong,Han Woong Yeom
Physics , 2015,
Abstract: Quantum states of strongly correlated electrons are of prime importance to understand exotic properties of condensed matter systems and the controllability over those states promises unique electronic devices such as a Mott memory. As a recent example, a ultrafast switching device was demonstrated using the transition between the correlated Mott insulating state and a hidden-order metallic state of a layered transition metal dichalcogenides 1T-TaS2. However, the origin of the hidden metallic state was not clear and only the macroscopic switching by laser pulse and carrier injection was reported. Here, we demonstrate the nanoscale manipulation of the Mott insulating state of 1T-TaS2. The electron pulse from a scanning tunneling microscope switches the insulating phase locally into a metallic phase which is textured with irregular domain walls in the charge density wave (CDW) order inherent to this Mott state. The metallic state is a novel correlated phase near the Mott criticality with a coherent feature at the Fermi energy, which is induced by the moderate reduction of electron correlation due to the decoherence in CDW. This work paves the avenue toward novel nanoscale electronic devices based on correlated electrons.
Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome
Jun Seok Lee, Sang Heum Kim, Dae Won Jun, Jee Hye Han, Eun Chul Jang, Ji Young Park, Byung Kwan Son, Seong Hwan Kim, Yoon Ju Jo, Young Sook Park, Yong Soo Kim
World Journal of Gastroenterology , 2009,
Abstract: AIM: To investigate the clinical implications of lipid deposition in the pancreas (fatty pancreas).METHODS: The subjects of this study were 293 patients who had undergone abdominal computed tomography (CT) and sonography. Fatty pancreas was diagnosed by sonographic findings and subdivided into mild, moderate, and severe fatty pancreas groups comparing to the retroperitoneal fat echogenicity.RESULTS: Fatty pancreas was associated with higher levels for visceral fat, waist circumference, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high density lipoprotein, free fatty acid, γ-GTP, insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR) than the control group (P < 0.05). HOMA-IR, visceral fat, triglyceride, and ALT also tended to increase with the degree of fat deposition in the pancreas on sonography. In a multivariate logistic regression analysis, HOMA-IR, visceral fat, and ALT level were independently related to fatty pancreas after adjustment for age, body mass index, and lipid profile. The incidence of metabolic syndrome in the fatty pancreas group was significantly higher than in the control group, and the numbers of metabolic syndrome parameters were significantly higher in the fatty pancreas group (P < 0.05).CONCLUSION: Sonographic fatty pancrease showed higher insulin resistance, visceral fat area, triglyceride, and ALT levels than normal pancreases. Fatty pancreas also showed a strong correlation with metabolic syndrome.
Study design and rationale of "Synergistic Effect of Combination Therapy with Cilostazol and ProbUcol on Plaque Stabilization and Lesion REgression (SECURE)" study: a double-blind randomised controlled multicenter clinical trial
Young-Guk Ko, Byeong-Keuk Kim, Byoung Lee, Woong Kang, Seung Choi, Sang Kim, Jong Lee, Myoungsook Lee, Yasuhiro Honda, Peter J Fitzerald, Won-Heum Shim, SECURE Investigators
Trials , 2011, DOI: 10.1186/1745-6215-12-10
Abstract: The Synergistic Effect of combination therapy with Cilostazol and probUcol on plaque stabilization and lesion REgression (SECURE) study is designed as a double-blind, randomised, controlled, multicenter clinical trial to investigate the effect of cilostazol and probucol combination therapy on plaque volume and composition in comparison with cilostazol monotherapy using intravascular ultrasound and Virtual Histology. The primary end point is the change in the plaque volume of index intermediate lesions between baseline and 9-month follow-up. Secondary endpoints include change in plaque composition, neointimal growth after implantation of stents at percutaneous coronary intervention target lesions, and serum levels of lipid components and biomarkers related to atherosclerosis and inflammation. A total of 118 patients will be included in the study.The SECURE study will deliver important information on the effects of combination therapy on lipid composition and biomarkers related to atherosclerosis, thereby providing insight into the mechanisms underlying the prevention of atherosclerosis progression by cilostazol and probucol.ClinicalTrials (NCT): NCT01031667The benefit of reducing low-density lipoprotein (LDL) cholesterol in the management of coronary artery disease (CAD) has been demonstrated in various large-scale randomized clinical trials [1]. These trials have shown that statin therapy, which is currently considered an essential element in CAD treatment regimens, does improve clinical outcomes, but is only able to prevent coronary events in less than 30% of patients. Therefore, a need remains for new and more effective cardiovascular drug therapies.Probucol, a mild cholesterol-lowering agent with antioxidant and anti-inflammatory properties, has been shown to reduce atherosclerosis and prevent restenosis after percutaneous coronary intervention (PCI) [2]. However, probucol also causes a remarkable reduction in high density lipoprotein (HDL) and prolongation of QT
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