• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.337-339
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• 2001

The development of completely new intracranial aneurysms after previous successfully treated aneurysm is uncommon. A 50-year-old female presented with a case of multiple de novo aneurysm which were an aneurysm of right ophthalmic segment of internal carotid artery and an aneurysm of right A1 artery, 6 years after the clipping of an aneurysm of right posterior communicating artery. She had no history of hypertension, cigarette smoking and use of oral contraceptives, and had no evidence of genetic disorder. The laboratory findings were normal. All de novo aneurysms were clipped by basal anterior interhemispheric approach in one stage due to the direction of the aneurysm of the ophthalmic segment of the internal carotid artery.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.144-147
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• 2018

Although dysgeusia can occur as a consequence of stroke attacks, many physicians and patients tend to overlook it. A 50-year old woman complained of a 2-week history of abnormal sense of taste on the anterior two-thirds of right tongue. Blink reflex test demonstrated prolonged ipsilateral and contralateral R2 responses with the right supraorbital nerve stimulations, which suggest the lesion on the descending pathway. Brainstem magnetic resonance imaging (MRI) demonstrated abnormal findings in the right lower dorsal pons, anterior to 4th ventricle, lateral to inferior colliculus, and at the level of the pontomedullary junction, which was compatible with solitary tract nucleus and spinal trigeminal nucleus. Brainstem infarction should be considered in patients who have abnormal sense of taste. Additionally, blink reflex test may be helpful for the detection of central origin dysgeusia.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.161-169
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• 2022

A 50-year-old Korean male tour guide without any medical or family history complained of left knee pain. After receiving umbilical cord blood injection treatment, the pain gradually worsened. After being diagnosed with septic arthritis in the left knee, arthroscopic lavage, debridement, antibiotic treatment, and routine rehabilitation therapy were performed, but the symptoms persisted. In the hospital, acupuncture, pharmacopuncture, acupotomy, Chuna manual therapy, and cupping therapy were performed in addition to the usual treatment for 59 days. To evaluate the patient's improvement, the numeric rating scale, EuroQol 5-dimension, pain disability index, and Lysholm knee scoring system were used. After treatment, the symptoms improved in all assessment tools, swelling, and range of motion of the joint. Through this study, it was found that complex Korean medical therapies may be effective for postoperative ankylosis in septic arthritis of the knee, and further studies are needed to clarify the therapeutic effect.

• Korean Journal of Head & Neck Oncology
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• v.38 no.1
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• pp.49-52
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• 2022

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a low-grade B-cell lymphoma that typically follows an indolent clinical course. It occurs in a variety of mucosal linings extranodal tissue, most commonly in the stomach. Other commonly involved sites include other parts of the gastrointestinal tract, thyroid, salivary gland, lung, lacrimal gland, synovium, dura mater, breast, skin, and eyes. It occurs very rarely in the buccal mucosa. A 50-year-old man came to the clinic while presenting a 5-month history of right-sided buccal mass. The incisional biopsy did not confirm the diagnosis of the lesion. He underwent complete excision of buccal mass for the diagnosis and treatment. The final pathology confirmed MALT lymphoma immunohistochemically. After surgery, he received radiotherapy with 30.6 Gy. There is no recurrence for 8 months after treatment. Herein we report a rare case of buccal MALT lymphoma with a review of the literature.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.233-237
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• 2022

Postpolio syndrome (PPS) is widely known to manifest as muscle weakness in patients affected by poliomyelitis in early childhood. This is caused by the long-term overwork of motor nerves regenerated from surviving nerve cells. We report a characteristic delay in recovery from muscle relaxation after administering rocuronium to a patient with PPS under general anesthesia with desflurane. A 59-year-old woman was scheduled to undergo surgical debridement for jaw osteonecrosis. She had a history of poliomyelitis at the age of 2 years, and was diagnosed with PPS at the age of 51 years. General anesthesia was induced with 80 mg propofol, 50 ㎍ fentanyl, and 30 mg (0.69 mg/kg) rocuronium, and maintained with desflurane and remifentanil. The durations of train-of-four (TOF) count 0 and 1 were 96 and 37 min, respectively. Five minutes after discontinuing desflurane, the TOF count was 4. Three minutes after administering 200 mg sugammadex, the TOF ratio was 0.83, and the tracheal tube was subsequently removed. In summary, the effect of a single dose of rocuronium on twitch in TOF monitoring was significantly prolonged in a patient with PPS, which may have been exacerbated by desflurane.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.463-467
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• 2023

Madelung's disease (MD) is a rare disease characterized by diffuse, nonencapsulated, multiple fat masses in different areas of the body. In this case report, we present a case of MD in Asia and its management. A 66-year-old man with a history of hypertension presented with massive growth of soft tissue around the neck, breasts, upper back, and lower abdomen. Preoperative magnetic resonance imaging revealed remarkably hypertrophic fat tissue around the neck and anterior chest was wall, which consistent with the diagnosis of MD. Multiple linear incisions were made on the neck and 763, 186, 635 g of posterior, right, and left fat tissues were excised, respectively. A single wide, transverse incision was done to excise 1,072 g of fat from the upper back. Masses of both breasts were excised, preserving the inferior pedicle, weighing 1,086 (right) and 1,164 g (left). The recovery was optimal and the patient was discharged without complications. In this case, we excised the adipose masses as much as possible and improved contour and symmetry. However, the fat infiltrations in the patient were diffusely distributed, making total fat excision difficult. This rare case report may help in managing patients with MD.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3549-3554
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• 2013

Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran. Materials and Methods: This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year. Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant. Conclusions: We found that incomplete IM increased the risk of subsequent dysplasia in this study.

• Journal of Preventive Medicine and Public Health
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• v.53 no.1
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• pp.56-63
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• 2020

Objectives: The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly. Methods: A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders. Results: In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants. Conclusions: Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.315-318
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• 2011

Purpose: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. Methods: A 49-year-old male patient was refered to our institution with a $0.73{\times}0.44{\times}1.37cm$ sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. Results: Histologic examination of the specimen ($3.4{\times}0.7cm$) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. Conclusion: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.451-456
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• 2016

Background Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. Methods The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05). Results Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level. Conclusions Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.