• 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.45 no.1
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• pp.53-56
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• 2009

The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.381-384
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• 2010

Progressive ptosis and headache developed in a 50-year-old woman with non-small cell lung cancer. Although brain magnetic resonance imaging showed improved cerebellar metastasis after prior radiotherapy without any other abnormality, the follow-up examination taken 6 months later revealed metastasis to the cavernous sinus. The diagnosis of metastasis to the cavernous sinus is often difficult because it is a very rare manifestation of lung cancer, and symptoms can occur prior to developing a radiologically detectable lesion. Therefore, when a strong clinical suspicion of cavernous sinus metastasis exists, thorough neurologic examination and serial brain imaging should be followed up to avoid overlooking the lesion.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.145-149
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• 2004

A 12-year-old boy with severe periumbilical pain visited the emergency room. Physical examination, abdominal ultrasonography, colonoscopy and CT, identified a lesion of sigmoid colon. Endoscopic biopsy showed a signet ring cell carcinoma of the sigmoid colon. On explorative laparotomy, cancer invasions of the adjacent structures and metastases on peritoneal wall were noticed. We performed palliative loop-ileostomy. He underwent chemotherapy and radiotherapy for 3 months. The second case was a 16-year-old boy with abdominal pain and hematochezia, transferred to our hospital with the diagnosis of acute appendicitis with periappendiceal abscess. Although he underwent appendectomy, the abdominal pain persisted. Digital rectal examination revealed a lumen-obstructing fungating mass in the rectum. Endoscopic biopsy revealed a adenocarcinoma. Cancer invasion of the adjacent structures and metastases involving the mesentery of the small intestine were found at laparotomy. A palliative procedure, a Hartmann's operation and end-colostomy at the sigmoid colon were performed. The patient died 8 month later due to pneumonia and sepsis. Chemotherapy was not applied.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.276-279
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• 2015

This report details a case of post-traumatic pseudocyst in the spleen that was successfully treated with sclerotherapy using ethanol. A sixteen-year-old boy visited our hospital for a follow-up examination of a splenic cyst. He had experienced blunt trauma to the abdomen three years prior to presentation. An abdominal computed tomography scan revealed a large cyst of the lower pole of the spleen. The cyst was $6.8{\times}9.5{\times}7.0cm$ and conservative management was tried. A follow-up ultrasonographic examination three years later revealed that the size of the cyst was unchanged and another treatment was needed to prevent complications. One session of sclerosis with ethanol (90 mL of 99% ethanol) percutaneously was applied to the cyst. A follow-up after four months revealed that the cyst had completely resolved.

• Korean Journal of Veterinary Research
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• v.46 no.1
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• pp.83-86
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• 2006

About 8 year-old castrated male Yorkshire terrier was presented for evaluation of dysuria, stranguria, hemtauria, and pollakiuria. On history taking, dysuria first was observed three months ago and these signs were waxed and waned. Physical examination revealed mild left perineal swelling. On routine laboratory examination, no significant findings were identified. Positive contrast urogram identified peritoneal herniation of urinary bladder. Urinalysis showed proteinuria and hematuria. Urine sediment revealed epithelial cells, white blood cells and rod-shaped bacteria. Pseudomonas aeroginosa was isolated from urine obtained through cystocentesis, and had resistance against fourteen antibiotics. Cystitis caused by P. aeruginosa concurrent with cystolithiasis and perineal hernia was diagnosed. Cystotomy, herniorrhaphy and EDTA-Tris solution lavage of bladder were performed. The patient was recovered to normal condition 2 days after treatment. Two weeks later, bacterial culture of urine was negative and any abnormality in ultrasonogram and urinalysis was not observed except calcium oxalate dihydrate crystals.

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.358-363
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• 2019

An 11-year-old, female Miniature Schnauzer dog was presented with recurrent skin ulcer of the second metatarsal region in the right hindlimb following metatarsal resection. Physical examination revealed an ulcerated and bleeding lesion of the second metatarsal region in the right hindlimb. Impression smears of the ulcerative lesion confirmed numerous degenerated neutrophils and mixed bacterial infection. Initially, the dog was treated with antibiotics and povidone-iodine flushing for the control of deep pyoderma. Because the skin lesion had been deteriorated over time despite of topical and systemic treatments, skin biopsy was performed. Histopathologic examination indicated squamous cell carcinoma based on the features of multiple nests of squamous neoplastic cells and mitotic figures. Although amputation of the right hindlimb was performed, the dog was expired five months later because of tumor metastasis to the lung and the popliteal lymph node. This is the first case report describes malignant digital squamous cell carcinoma in Korea.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.147-151
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• 2021

A 5-year-old castrated male Maine Coon cat presented with chronic otitis on the right ear. The clinical signs, scratching and head shaking, were recurrent despite symptomatic treatment, including antibiotics and antifungal agents. Video otoscopic examination and computed tomography (CT) examination revealed a polyp in the right ear canal. The polyp was removed via per-endoscopic trans-tympanic traction (PTT) with a grasping forceps. After treatment, Horner's syndrome occurred in the right eye but spontaneously resolved a week later. The mass was diagnosed as inflammatory polyp with a fibrovascular stroma containing plasma cells, lymphocytes, and neutrophils. All clinical signs were improved, and no recurrence was observed after 3 weeks of follow-up. This case report demonstrates that CT scan is effective in identifying the margin of polyp and PTT technique is non-invasive method for treating inflammatory polyp in cats without severe complications.

• Journal of Veterinary Clinics
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• v.39 no.2
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• pp.70-74
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• 2022

A 14-year-old intact male captive leopard (Panthera pardus) first presented with a focal alopecic lesion on the dorsal aspect of the distal one-third of its tail. Although itraconazole was administered, the lesion progressed deeper and became ulcerated due to self-trauma. Due to the wild nature of the leopard, daily dressing of the wound and replacing the bandages without anesthesia became too dangerous, and amputation became necessary. A postoperative tissue sample was submitted for histopathological examination, and tramadol, amoxicillin/clavulanate, and gabapentin were administered. In the days following the amputation, the leopard's appetite significantly decreased, and the patient passed away 18 days later. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma (SCC). In hindsight, had more cells been collected by a fine-needle aspirate (FNA) biopsy or had additional FNA biopsies been performed, SCC might have been diagnosed based on its cytological features rather than delayed histopathological findings. The current study highlights the critical reasons why clinicians may often misdiagnose SCC and the importance of being more aware of potential tumors in ulcerative lesions, which are often incorrectly treated as infectious skin diseases. This is also the first report of cutaneous SCC in a leopard.

• Journal of Korean Neurosurgical Society
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• v.66 no.2
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• pp.199-204
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• 2023

It is critical to identify the ruptured cerebral arteriovenous malformations (AVMs) for secondary prevention. However, there are rare cases unidentified on the radiological evaluation. We report on a patient with the delayed appearance of radiologically occult AVM as a probable cause of the previous intracerebral hemorrhage (ICH). An 18-year-old male patient presented with a right temporal ICH. The preoperative radiological examination did not reveal any causative lesions. Because of the intraoperative findings suggesting an AVM, however, only hematoma was evacuated. Disappointedly, there were no abnormal findings on postoperative and follow-up radiographic examinations. Eleven years later, the patient presented with an epileptic seizure, and an AVM was identified in the right temporal lobe where ICH had occurred before. The patient underwent partial glue embolization followed by total surgical resection of the AVM and anterior temporal lobe. Based on the literature review published in the era of magnetic resonance imaging, common clinical presentation of radiologically occult AVMs included headache and seizure. Most of them were confirmed by pathologic examination after surgery. In cases of the ICH of unknown etiology in young patients, long-term follow-up should be considered.