• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.37-40
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• 2008

Brucellosis, a zoonosis with worldwide distribution, is a systemic infection caused by facultative intracellular bacteria of the genus Brucella, which can involve multiple organs and tissues. We report an uncommon case of spondylodiscitis with epidural abscess due to Brucella in a male stockbreeder. Diagnosis was based on clinical history, and supported by Brucella serology and magnetic resonance imaging. Clinical and radiological improvement were observed with a combined antimicrobial therapy of doxycycline, rifampicin, and gentamycin.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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• pp.1140-1143
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• 2001

The mortality of patients with brain abscess has decreased significaltly. This has been attributed to improved diagnostic imaging, the evolution of neurosurgical techniques and understanding of intracranial pressure pathophysiology, greater critical care understanding, and newer antibiotics. However, the mortality associated with intraventricular rupture of brain abscess remained consistently high at or above 80% once identified. A case of intraventicular rupture of thalamic abscess with good quality of survival is presented based on aggressive 4-component therapeutic plan used. The four components are 1) extraventricular drainage for 6 weeks, 2) lavage of the ventricular system using closed irrigation system, 3) intravenous antibiotics, 4) intraventricular gentamicin and vancomycin, twice and once daily, respectively.

• Investigative Magnetic Resonance Imaging
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• 제7권1호
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• pp.31-38
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• 2003

목적 : 실험적으로 토끼 대퇴부에 유발한 농양에서 연속적 추적검사를 통하여 MRS 스펙트럼의 특징과 항생제 치료에 따른 대사산물의 변화를 분석하고자 하였다. 대상 및 방법 : 토끼 10마리의 대퇴부에 흰쥐의 대변으로부터 추출한 용액을 주사하여서 농양을 유발시켰고, 대조군 5마리와 항생제 치료군 5마리로 나누어 4주 동안 1주 간격으로 MRI와 MRS로 추적 검사를 하였다 MRI에서는 농양의 모양과 크기를 분석하였으며, 기존 문헌을 참조하여 MRS에서 보이는 대사산물의 스펙트럼을 분류하였다. N-acetyl alanine을 외적기준으로, lipid를 내적기준으로 하여 각 대사산물을 정량 분석하였고, 정량화된 값들이 농양의 시기에 따라 대조군과 치료군 사이에 차이가 있는지를 분석하였다. 결과 : MRI에서 농양 10 예 모두는 낭성 종괴로 보였으며, 크기는 22-77 mm였다. MRS에서는 감염을 시사하는 acetate, succinate와 여러 종류의 아미노산 peak가 대조군, 치료군 모두에서 여러 가지 조합으로 검출되었다. 그 중 1.92 ppm의 acetate(70%)가 가장 흔하게 보였다. Lipid peak에 대한 acetate peak 비율과 외적기준의 peak에 대한 acetate peak 비율은 대조군에서는 시기에 따라 큰 변화가 없는 반면에 치료군에서는 감소하는 경향이 있었다. 결론 : MRS는 농양에서 감염을 시사하는 대사산물을 검출함으로써 진단에 도움을 줄 수 있을 뿐 아니라 acetate peak는 농양의 진행 및 항생제 치료에 의해 영향을 받아서 농양의 활동도 지표로서 유용한 가치가 있을 것으로 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제17권1호
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• pp.47-49
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• 2013

내인성안구염은 외부 혹은 내부의 원인으로 인한 안구 내의 염증반응으로 생기는 드문 질환이다. 자기공명영상은 안구염의 진단과 뇌농양의 진단에 모두 유용한 것으로 알려져 있다. 저자들은 내인성안구염과 함께 뇌농양이 동시에 병발된 예가 있어 자기공명영상 소견과 함께 보고하고자 한다.

• The Korean Journal of Pain
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• 제19권2호
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• pp.266-270
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• 2006

A case of an epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, which occurred in a cancer pain patient with an epidural port connected to the epidural catheter, is described. Although cases of a catheter related epidural abscess have been intermittently reported, those following epidural port implantation are very rare, with no case having been reported in Korea. Herein, the case of a 31-year-old man, who developed an epidural abscess 54 days after subcutaneous implantation of an epidural port connected to an epidural catheter, is reported. Methicillin-sensitive staphylococcus aureus was detected in a culture of the purulent discharge. Magnetic resonance imaging was essential, not only for the diagnosis of the epidural abscess, but also for determining the extent of spread. The patient refused further evaluation and treatment, and expired 22 days later.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.146-149
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• 2005

Most primary spinal abscesses, irrespective of pathogens and anatomical locations, have better prognosis than that of secondary abscesses with spondylitis. We report a 68-year-old man, previously undertaken pulmonary resection due to tuberculosis, presented with paraparesis. Imaging studies showed primary intraspinal abscesses at T-1 and T-3 vertebral levels, semi-invasive pulmonary Aspergillosis and inflammation of the posterior mediastinum. Operative procedure and histopathological examination revealed interdural Aspergillus abscess. Despite chemotherapy, he deteriorated progressively, and spondylitis developed at corresponding vertebrae. He eventually died 6 weeks postoperatively due to pulmonary complication. The authors intended to inform that such an extradural inflammatory lesion of Aspergillus abscess should be treated carefully.

• 대한족부족관절학회지
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• 제28권1호
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• pp.36-39
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• 2024

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.275-279
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• 2018

뇌농양은 심각한 신경학적 후유증을 일으킬 수 있는 중추신경계 감염이다. 신경집중치료 발달에도 불구하고, 여전히 뇌농양은 특정 위험 환자에게 높은 사망률을 보이고 있다. 특히 세균성 뇌농양은 즉각 진단 및 적절한 항생제 치료가 필요한 응급 상황이다. 또한 드물게 뇌농양이 재발되는 경우도 있다. 본 연구에서는 두통으로 내원한 59세 남자환자를 대상으로 증례보고를 통해 동일 분야 연구에 활용하고자 자료분석을 하였다. 59세 남자가 두통을 주소로 내원하였고, 연속적으로 시행한 뇌자기공명영상과 뇌척수액 검사에서 우측 전두엽에 뇌농양을 확인하였고, 항생제 치료 및 수술적 치료 후 완치하였다. 퇴원 후 5개월 뒤 두통 및 경기 증상 있어 다시 촬영한 뇌자기공명영상에서 뇌농양의 재발이 확인되었다. 뇌농양 재발은 특정 조건, 즉, 농양 부위에 이물질이 남아 있거나 만성 부비동염, 동정맥루, 좌우션트 등이 있을 때 생길 수 있다.

• Childhood Kidney Diseases
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• 제28권1호
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• pp.44-50
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• 2024

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

• Journal of Korean Neurosurgical Society
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• 제51권5호
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• pp.316-319
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• 2012

A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.