• Journal of Korean Neurosurgical Society
• /
• v.48 no.1
• /
• pp.73-78
• /
• 2010

Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.27 no.2
• /
• pp.71-82
• /
• 2014

Objectives: The purpose of this systematic review was to overview and evaluate the efficacy of acupuncture treatment for women with polycystic ovary syndrome (PCOS). Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to Dec 2013, and by additional hand searches. Data were extracted regarding anovulation, hyperandrogenism, obesity indices. Meta-analyses were separatedly conducted for the symptoms of PCOS. The risk of bias was assessed. Results: Three studies which were included for analysis, but they showed severly heterogeneity therefore meta-analysis could not be performed. Outcomes for evaluating the efficacy of acupuncture treatment for PCOS were anovulation index (menstrual frequency), hyperandrogenism index (free testosterone) and obesity index (body-mass index). For menstrual frequency, acupuncture treatment consistently suggested an interventional benefit. Although other outcomes did not suggest any enough relevant evidence to interventional benefit for acupuncture treatment. Conclusions: Acupuncture treatment appeared to improve menstrual frequency in PCOS patients. Since a limited number of RCTs were available in the current literature and those studies were also clinically heterogeneous, further research is needed to gather evidence to support acupuncture therapy in PCOS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.40 no.3
• /
• pp.140-146
• /
• 2014

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.4
• /
• pp.439-444
• /
• 2002

We report a very rare case of mediastinal tuberculosis in a 57-year old woman who presented with a large mediastinal cyst on chest radiography. She had a 10-year history of exertional dyspnea, but felt comfortable at a rest. A subsequent chest CT suggested a mediastinal cyst with mediastinal lymphadenopathy and communicating pericardial sac. She underwent a thoracotomy and excision of the mass, which was histologically revealed to be of tuberculous origin. Although rare, the apparent increase in the incidence of tuberculosis may result mediastinal cysts being diagnosed mediastinal tuberculosis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.

• Clinical and Experimental Pediatrics
• /
• v.54 no.5
• /
• pp.219-223
• /
• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.251-256
• /
• 2011

Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.10 no.1
• /
• pp.20-26
• /
• 2010

This type of neuropathic pain(atypical odontalgia) is seen most often in middle-aged women or men after dentoalveolar operation. Atypical odontalgia probably is caused by deafferentation leading to intraneural changes in the medullary dorsal horn. Treatment of this problem is difficult, but some success has been reported in uncontrolled, open-labeled studies using high doses of tricyclic antidepressants. This is the management report of a patient case, that had a neuropathic atypical odontalgia recognized with the right maxillary lateral incisor. The patient was consulted to the Department of Pain Clinics, ENT & Neurology and diagnosed the adenoid cystic carcinoma on left cerebellum and right paranasal sinus with extension to the cavernous sinus. In spite of the osteoplastic craniotomy, neurosurgical mass removal and radiation therapy were done with chemotherapy, atypical odontalgia was continued. In addition to the consultation to Psychology, stress management and antidepressant medication were done and improved slowly.

• Clinical and Experimental Pediatrics
• /
• v.53 no.4
• /
• pp.603-606
• /
• 2010

Paraneoplastic limbic encephalitis, a remote effect of cancer without nervous system metastasis, is rare, especially in childhood. Here, we report a case of paraneoplastic limbic encephalitis associated with an ovarian mature teratoma in an adolescent girl. The 15-year-old girl developed neuropsychiatric symptoms, memory loss, seizures, and unconsciousness. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were normal, while single photon emission computed tomography imaging showed hypoperfusion in both temporal lobes. Ultrasound and MRI of the abdomen revealed a left ovarian cystic mass. The patient experienced a significant recovery of cognitive function after surgical resection of the tumor, which was pathologically identified as a mature ovarian teratoma, and treatment with intravenous immunoglobulin.

• Journal of Veterinary Clinics
• /
• v.18 no.4
• /
• pp.438-441
• /
• 2001

Two female Yorkshire terrier was referred to Veterinary Medical Teaching Hospital, Seoul National University. In case 1, clinical signs were vomiting, anorexia and weight loss. Cystic intraabdominal mass was identified in radiographic and ultrasonographic examination. In case 2, clinical sign was abdominal distension. In radiographic and ultrasonographic examination, cellular ascites and bilateral intraabdominal masses next to kidneys were observed. Many clusters of glandular epithelial cells with anisocytosis, anisokaryosis, high N:C ratio coarse chromatin and prominent nucleoli were shown in cytologic examination of sanguineous ascites. In all two cases exploratory laparotomy was performed and enlarged ovaries were observed (Rt: 6$\times$5$\times$5 cm and Lt: 3$\times$2$\times$1 cm in case 1 and 3$\times$2$\times$1 cm bilaterally in case 2). After ovariohysterectomy histopathologic examinations were performed. Histopathologically the masses were diagnosed as ovarian adenocarcinoma and ovarian cystadenocarcinoma in case 1 and case 2, respectively. In both dogs no further chemotherapy was carried out. These two dogs had no gross evidence of tumor recurrence at the time of 3 months after tumor resection, but long-term follow-up might be needed.

• Childhood Kidney Diseases
• /
• v.12 no.2
• /
• pp.262-266
• /
• 2008

Crossed renal ectopia is a congenital malformation in which both kidneys lie on the same side of the spine, usually side by side longitudinally. More often on the right side. Fusion of the two renal units is eight times more common than nonfusion. Although crossed renal ectopia is uncommon, this unusual entity must be considered in an infant when cystic mass in the abdomen or pelvis paticularly if no kidney can be found on the opposite side. In many cases of crossed fused ectopia with multicystic dysplastic kidney(MCDK), the diagnosis can be strongly suspected from the sonogram, and no other studies may be necessary. However, both intravenous urography and isotope renography is useful to assess the function of the crossed kidney. Crossed renal ectopia and MCDKs are associated with a greater incidence of ureteropelvic junction obstruction and reflux. So, screening voiding cystourethrography should be performed. Very few studies of MCDK in the setting of crossed fused ectopia have been reported. We have experienced a 3-year-old boy with crossed fused renal ectopia with multicystic dysplasia.