• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.310-313
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• 2016

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.354-356
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• 2010

Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of $2{\times}2\;mm$ with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, $9{\times}13\;mm$ sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.88-90
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• 2010

Retroperitoneal hematoma (RH) due to radiologic intervention for an intracranial lesion is relatively rare, difficult to diagnose, and can be lifethreatening. We report a case of RH that developed in a patient on anticoagulant therapy following endovascular coiling of a ruptured anterior communicating artery (AcoA) aneurysm. An 82-year-old man presented with a 12-day history of headache. Computed tomography (CT) on admission demonstrated slight subarachnoid hemorrhage, and left carotid angiography revealed an AcoA aneurysm. The next day, the aneurysm was occluded with coils via the femoral approach under general anesthesia. The patient received a bolus of 5,000 units of heparin immediately following the procedure, and an infusion rate of 10,000 units/day was initiated. The patient gradually became hypotensive 25 hours after coiling. Abdominal CT showed a huge, high-density soft-tissue mass filling the right side of the retroperitoneum space. The patient eventually died of multiple organ failure five days after coiling. RH after interventional radiology for neurological disease is relatively rare and can be difficult to diagnose if consciousness is disturbed. This case demonstrates the importance of performing routine physical examinations, sequentially measuring the hematocrit and closely monitoring systemic blood pressures following interventional radiologic procedures in patients with abnormal mental status.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.2
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• pp.61-76
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• 2004

This research tries to find out the methods to enhance the rehabilitation ability of Cerebro Vascular Accident(CVA) patients and their family members. For this purpose, the authors identify the factors that may affect the medical rehabilitation process as well as the rehabilitation itself. Furthermore, the current status of the rehabilitation ability and the desires of CVA patients and their family members are surveyed in this research. The results of this research are as follows: Firstly, the surveyed CVA patients, most of whom are over fifties in the age, have cerebral infection and hemorrhage in a numerical order. The survey showed that the larger cities they live in, the more CVA occur to them. Secondly, the survey for the treatment cost demonstrated that the lower are their living level and their education level, the more pressure is put on the CVA patients and their family. The statistical data proved this conclusion is reasonable. Thirdly, as for the safisfaction for the rehabilitation treatment, the statistical survey showed that it is directly proportional to their financial income. Moreover, those who have lower income generally want the rehabilitation services from a public health center. On the other hand, those who have higher income want the home therapy services.

• The Journal of Internal Korean Medicine
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• v.21 no.4
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• pp.583-590
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• 2000

Objective : The major risk factors of stroke are hyperlipemia, ateriosclerosis, hypertension, diabetis mellitus, smoking, drinking, age, personal history, family history etc. Hypertension, smoking and hyperlipemia are very important factor to promote stroke. We intended to observe the serum lipid density of 51 patients come to Joongpoong & Chronic Disease Center of Conmaul Oriental hospital, comparing with already reported study. Methods : We studied 51 stroke-patients( 38 cerebral infarction, 13 intracerebral hemorrhage) of Conmaul Oriental hospital, Department of oriental internal medicine, Joongpoong & Chronic Disease Center from January 1. 1999 to August 31. 2000, which examined by neurologic test, brain-CT, brain-MRI. . We used DOSHISA TBA-30FR(Japan) as instrument for measuring total cholesterol and triglyceride of serum. Results and conclusions : The results are as follows 1. The rate of hyperlipemia and presumed-hyperlipemia is higher in female patient-group than male patient-group. 2. The rate of hyperlipemia and presumed-hyperlipemia is higher in drinking group than non-drinking group. 3. The rate of hyperlipemia and presumed-hyperlipemia is higher in hypertension group than normotention group.

• Parasites, Hosts and Diseases
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• v.53 no.6
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• pp.749-753
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• 2015

Toxoplasma gondii atypical type II genotype was diagnosed in a pet peach-faced lovebird (Agapornis roseicollis) based on histopathology, immunohistochemistry, and multilocus DNA typing. The bird presented with severe neurological signs, and hematology was suggestive of chronic granulomatous disease. Gross post-mortem examination revealed cerebral hemorrhage, splenomegaly, hepatitis, and thickening of the right ventricular free wall. Histologic sections of the most significant lesions in the brain revealed intralesional protozoan organisms associated with malacia, spongiform changes, and a mild histiocytic response, indicative of diffuse, non-suppurative encephalitis. Immunohistochemistry confirmed the causative organisms to be T. gondii. DNA isolated from the brain was used to confirm the presence of T. gondii DNA. Multilocus genotyping based on SAG1, altSAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico markers demonstrated the presence of ToxoDB PCR-RFLP genotype #3 and B1 gene as atypical T. gondii type II. The atypical type II strain has been previously documented in Australian wildlife, indicating an environmental transmission route.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1346-1353
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• 1992

From Febrary 1984 to July 1992, 138 cases of multiple valve replacements were performed at the Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. There were 81 females and 57 males, and their ages ranged from 19 to 60 years [mean age, 40.1$\pm$10.9 years]. Thirteen of these patients had undergone previous cardiovascular procedures, with an average of 76.3 months between procedures[range, 3 to 180 months]. Mitral and aortic valve replacement were done in 135 patients, 2 underwent triple valve replacement and 1 underwent mitral and tricuspid valve replacement. Associated procedures were necessary in 20 patients[14.5%]. The operative mortality was 5.8% and the most common cause was low cardiac output. Late follow-up of 83% has been accomplished in 130 early survivors, with a late mortality of 5.9%. The late mortality was due to valve thrombosis in 2 patients, cerebral infarction in 1, heart failure in 1, arrhythmia in 1, and bleeding in l. Of those patients who survived, New York Heart Association functional class improved significantly[from 70% class III and IV before to 88% class I and II after]. Actuarial survival rate including all deaths was 88.8% at 8 years. The follow-up studies revealed that thromboembolism, reoperation and bleeding rate were 1.2%/patient-year, 0.85% /patient-year and 0.57%/patient-year at 8 years postoperatively. We concluded that valve thrombosis, embolism, and anticoagulant-related hemorrhage were the main risk factors of longterm survival of patients.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.545-549
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• 2002

A pulmonary arteriovenous fistula is an uncommon malformation. In pregnancy altered hemodynamics and hormones cause changes in a PAVM(pulmonary arteriovenous malformation) that predispose them to deterioration. Therefore, a PAVM can cause serious and life-threatening complications in pregnancy. Death often results from a cerebral abscess and a rupture of the malformation with a massive hemorrhage. Recently, we experienced a case of a multiple PAVM in pregnant 38 year old woman, which could not be observed in the old chest PA, 1 year ago. The PAVM was confirmed by CT and was angiography and treated by percutaneous embolization. The patient is suspected to have HHT (Hereditary hemorrhagic telangiectasia).

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4997-4999
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• 2015

Advanced oral squamous cell carcinoma (SCC) is a possible risk factor for myiasis, a parasitic infestation of vital tissue of humans or other mammals by dipterous larvae (maggots). Oral myiasis is a rare entity, and is mostly associated with various medical and anatomical conditions, such as neglected mandibular fracture, lip incompetence, cerebral palsy, poor oral hygiene, suppurative lesions, and cancerous wounds. Larvae cause itching and irritation due to their crawling movements and can destroy vital tissues, inducing serious or even life-threating hemorrhage. The aim of the present article was to highlight the occurrence of oral myiasis in association with squamous cell carcinoma and also to highlight the treatment and preventive approaches for such cases. A literature search was performed using MEDLINE for articles published in English relating to the occurrence of oral myiasis in oral SCC. Our search revealed 6 reports on myiasis associated with oral SCC. The surgical debridement of infected tissue with the removal of maggots is the treatment of choice in most cases of oral myiasis.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1657-1663
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• 2000

The authors report a case of a 72-year-old woman who presented with intraventricular and subarachnoid hemorrhage of Hunt and Hess grade IV after the rupture of a giant aneurysm arising from the right internal carotid artery. The aneurysm was clipped successfully with the aid of cardiopulmonary bypass(closed chest method), deep hypothermic circulatory arrest, and cerebral protection with barbiturate resulting in moderate disability. We discuss the usefulness and problems related to technique of circulatory arrest and cardiopulmonary bypass using closed chest method, and suggest the possible benefits of open chest method in elderly people and the importance of preoperative plan to coordinate anesthesia and operation.