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Year of Publication
1.  Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm 
Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).
doi:10.3340/jkns.2014.56.6.496
PMCID: PMC4303726  PMID: 25628810
Blood blister-like aneurysm; Endovascular intervention; ICA dorsal wall aneurysm; Multiple paraclinoid aneurysms and Sundt clip graft
2.  Endovascular Rescue Method for Undesirably Stretched Coil 
Undesirable detachment or stretching of coils within the parent artery during aneurysm embolization can be related with thrombus formation, which can be caused occlusion of parent artery or embolic event(s). To escape from this situation, several rescue methods have been reported. A case with undesirably stretched coil in which another rescue method was used, is presented. When the stretched coil is still located in the coil delivery microcatheter, the stretched coil can be removed safely using a snare and a handmade monorail microcatheter. After a snare is lodged in the handmade monorail microcatheter, the snare is introduced over the coil delivery micorcatheter and located in the distal part of the stretched coil. After then, the handmade monorail microcatheter captures the stretched coil and the snare as one unit. This technique using a handmade monorail microcatheter and a snare can be a good rescue modality for the undesirably stretched coil, still remained within the coil delivery microcatheter.
doi:10.3340/jkns.2014.56.4.364
PMCID: PMC4219199  PMID: 25371791
Intracranial aneurysm; Embolization; Complication; Removal
3.  Ruptured Intracranial Dermoid Cyst Associated with Rupture of Cerebral Aneurysm 
Many tumors have been reported to coexist with cerebral aneurysm. However, intracranial dermoid cysts associated with cerebral aneurysm are very rare. We report a case in which rupture of a cerebral aneurysm resulted in a ruptured dermoid cyst. We present this interesting case and review current literature about the relationship between tumors and aneurysm formation.
doi:10.3340/jkns.2011.50.5.453
PMCID: PMC3259466  PMID: 22259693
Dermoid cyst; Aneurysm; Rupture
4.  Clinical and Angiographic Results after Treatment with Combined Clipping and Wrapping Technique for Intracranial Aneurysm 
Objective
There have been numerous follow-up studies of patients who had ruptured or unruptured intracranial aneurysms treated by wrapping technique using various materials have been reported. Our objective was to ascertain whether our particular wrapping technique using the temporalis muscle provides protection from rebleeding and any aneurysm configuration changes in follow-up studies.
Methods
Clinical presentation, the location and shape of the aneurysm, outcomes at discharge and last follow-up, and any aneurysm configuration changes on last angiographic study were analyzed retrospectively in 21 patients. Reinforcement was acquired by clipping the wrapped temporalis muscle. Wrapping and clipping after incomplete clipping was also done. Follow-up loss and non-angiographic follow-up patient groups were excluded in this study.
Results
The mean age was 53 years (range 29-67), and 15 patients were female. Among 21 patients, 10 patients had ruptured aneurysms (48%). Aneurysms in 21 patients were located in the anterior circulation. Aneurysm shapes were broad neck form (14 cases), fusiform (1 case), and bleb to adjacent vessel (6 cases). Five patients were treated by clipping the wrapped temporalis, and 16 patients by wrapping after partial clipping. The mean Glasgow coma scale (GCS) at admission was 14.2. The mean Glasgow outcome scale (GOS) at discharge was 4.8, and 18 patients were grade 5. The mean period between initial angiography and last angiography was 18.5 months (range 8-44). Aneurysm size was not increased in any of these patients and configuration also did not change. There was no evidence of rebleeding in any of these treated aneurysms.
Conclusion
Our study results show that wrapping technique, using the temporalis muscle and aneurysm clip(s), for intracranial aneurysm treatment provides protection from rebleeding or regrowth.
doi:10.3340/jkns.2008.44.4.190
PMCID: PMC2588311  PMID: 19096675
Aneurysm; Wrapping technique; Temporal muscle
5.  Endovascular Treatment of "Kissing Aneurysms" at the Anterior Communicating Artery 
Kissing aneurysms are the rare type of multiple aneurysms. They are adjacent aneurysms of different origin arteries in the same region, which require great care in diagnosis and treatment. We report a case of kissing aneurysms at the anterior communicating artery (AcomA) which were treated by endovascular coil embolization.
doi:10.3340/jkns.2008.44.3.163
PMCID: PMC2588296  PMID: 19096669
Kissing aneurysms; Subarachnoid hemorrhage; Coil embolization
6.  Endoscopic Coagulation of Choroid Plexus in Hydranencephaly 
Hydranencephaly is a rare congenital disease defined as an absence of cerebral hemispheres with an intact thalamus, brain stem, and cerebellum. Generally, patients with hydranencephaly require cerebro-spinal fluid diversion due to progressive hydrocephalus. An excellent view of the choroid plexus and advancement of the neurosurgical endoscope were possible, leading to easy coagulation of the choroid plexus to balance cerebro-spinal fluid production without the use of a shunt device. We present this rare case and good treatment outcome from endoscopic coagulation of the choroid plexus.
doi:10.3340/jkns.2014.55.6.375
PMCID: PMC4166337  PMID: 25237437
Hydranencephaly; Choroid plexus; Coagulation; Endoscope; Hydrocephalus
7.  Olfactory Identification Test Using Familiar Distracters for Koreans 
Objectives
Odors used in an odor identification test should be familiar to the subject, but there are some unfamiliar distracters in Korean version of Sniffin' stick (KVSS) II identification test. In this study, we used the results of the original version of KVSS II identification to modify the KVSS II identification test.
Methods
Eighty-three participants took an original version of KVSS II identification test and a visual analogue scale of subjective odor function. KVSS II identification which has 16 items was performed to choose one out of four odors items. And visual analogue scale was checked from 0 to 10 points of their subjective olfactory function. Two weeks later they took the modified version of KVSS II identification test. Hyposmic or anosmic patients were excluded.
Results
The mean score of the original version of KVSS II identification and modified version of KVSS II identification were 11.3 and 12.5, respectively (P<0.05). The KVSS II identification test and subjective olfactory function were positively correlated (r=0.247, P<0.05), as were the modified KVSS II identification test and subjective olfactory function (r=0.329, P<0.05).
Conclusion
After modification of distracters, KVSS II identification test appears to be suited for assessment of olfactory function.
doi:10.3342/ceo.2014.7.1.19
PMCID: PMC3932344  PMID: 24587876
Korean version of Sniffin' stick test; Odor identification test; Olfactory test; Distracter
8.  Standards for Endovascular Neurosurgical Training and Certification of the Society of Korean Endovascular Neurosurgeons 2013 
The need for standard endovascular neurosurgical (ENS) training programs and certification in Korea cannot be overlooked due to the increasing number of ENS specialists and the expanding ENS field. The Society of Korean Endovascular Neurosurgeons (SKEN) Certification Committee has prepared training programs and certification since 2010, and the first certificates were issued in 2013. A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members researched programs and systems in other countries to develop a program that best suited Korea. After 2 years, a rough draft of the ENS training and certification regulations were prepared, and the standard training program title was decided. The SKEN Certification Committee made an official announcement about the certification program in March 2013. The final certification regulations comprised three major parts: certified endovascular neurosurgeons (EN), certified ENS institutions, and certified ENS training institutions. Applications have been evaluated and the results were announced in June 2013 as follows: 126 members received EN certification and 55 hospitals became ENS-certified institutions. The SKEN has established standard ENS training programs together with a certification system, and it is expected that they will advance the field of ENS to enhance public health and safety in Korea.
doi:10.3340/jkns.2014.55.3.117
PMCID: PMC4024809  PMID: 24851145
Endovascular Neurosurgery; Certification Committee; Society of Korean Endovascular Neurosurgeons
9.  Effect of Dietary Calcium on Spinal Bone Fusion in an Ovariectomized Rat Model 
Objective
To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats.
Methods
Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography.
Results
The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group (71.80±8.06 mm3) than in controls (35.34±8.24 mm3) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks (610.08±10.41 vs. 551.61±12.34 ng/mL) and 8 weeks (552.05±19.67 vs. 502.98±22.76 ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks (77.07±12.57 vs. 101.75±7.20 ng/mL) and 8 weeks (69.58±2.45 vs. 77.15±4.10 ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01).
Conclusion
Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.
doi:10.3340/jkns.2012.52.4.281
PMCID: PMC3488633  PMID: 23133713
Osteoporosis; Ovariectomized rat; Calcium; Spinal bone fusion
10.  The Expression of NMDA Receptor 1 Correlates with Clinicopathological Parameters in Cutaneous Squamous Cell Carcinoma 
Annals of Dermatology  2009;21(4):382-388.
Background
Ionotropic glutamate receptors of the N-methyl-D-aspartate receptor (NMDAR) type are expressed on keratinocytes and play a role in the proliferation, differentiation, and cornification of keratinocytes. However, the expression profile of NMDAR and its role in cutaneous malignancy is unclear.
Objective
We analyzed the expression of NMDAR-1 in cutaneous squamous cell carcinoma (SCC) and investigated the relationship between NMDAR-1 expression and clinicopathological parameters.
Methods
Thirty-two patients with biopsy-proven cutaneous SCC were enrolled in this study. Each patient was analyzed for tumor diameter, location, local recurrence, and metastasis by conducting a chart review. The SCC specimens were histologically divided into differentiated and undifferentiated groups based on Broders' system. NMDAR-1 expression was examined by performing immunohistochemistry, and the relative staining intensity in the SCCs was graded into 5 levels. According to the staining intensity of NMDAR-1, the specimens were categorized into two groups: the higher group and the lower group.
Results
Fifteen (88%) of 17 tumors in the higher group were differentiated SCC, whereas 14 (93%) of 15 tumors in the lower group were undifferentiated SCC. In addition, NMDAR-1 expression was inversely correlated with metastasis (p=0.049). Local recurrence was associated with a lower staining intensity, but the results were not statistically significant.
Conclusion
Our results demonstrate that NMDAR-1 expression in cutaneous SCC is significantly correlated with its differentiation and metastasis. Therefore, it may be a prognostic indicator for cutaneous SCC.
doi:10.5021/ad.2009.21.4.382
PMCID: PMC2861274  PMID: 20523828
Cutaneous squamous cell carcinoma; Differentiation; Metastasis; N-methyl-D-aspartate receptor

Results 1-10 (10)