• Title/Summary/Keyword: Midline

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Tuberculous Empyema Thoracis which was misled to Anterior Mediastinal Tumor (종격동 종양으로 오인된 결핵성 농포)

  • 최영호
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.624-629
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    • 1987
  • Tuberculosis is one of the most common chronic disease. While the disease process may involve anywhere of the body, tuberculosis of anterior mediastinum which forming tumor like mass was not recognized commonly. We experienced a surgical case of tuberculous empyema thoracis at anterior mediastinum in 16 year old boy. Preoperatively, he was diagnosed to anterior mediastinal tumor such as teratoma or dermoid cyst by routine study. Operation was performed by midline sternotomy extending over right 4th intercostal space. The mass was elongated football shaped [20x16x15] and markedly adhered to right side of pericardium, upper 8< lower lobe of the right lung. Opening the mass, enormous pus-like material was evacuated and excised segmentally with decortication. Postoperative pathologic diagnosis was tuberculous empyema thoracis and granuloma.

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Trilateral Retinoblastoma - Case Report - (일측성 망막아세포종과 동반된 이소성 정중선 원시신경외배엽종 - 증례보고 -)

  • Kim, Hyung Seok;Cho, Kyung Gi;Cho, Ki Hong;Yoon, Soo Han;Ahn, Young Min;Ahn, Young Hwan;Shim, Chul
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.647-651
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    • 2001
  • Trilateral retinoblastoma is a syndrome involving midline intracranial malignancies in children with the heritable form of retinoblastoma. It is rare and usually lethal in spite of aggressive treatments. We report a case of trilateral retinoblastoma with review of the literature to gain further insight into this uncommon disease.

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Acute Cerebral Infarction after Head Injury

  • Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.393-395
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    • 2005
  • Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

Totally Ossified Metaplastic Spinal Meningioma

  • Ju, Chang Il;Hida, Kazutoshi;Yamauchi, Tomohiro;Houkin, Kiyohiro
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.257-260
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    • 2013
  • A 61-year-old woman with a very rare case of totally ossified large thoracic spinal metaplastic meningioma, showing progressing myelopathy is presented. Computed tomographic images showed a large totally ossfied intradural round mass occupying the spinal canal on T9-10 level. Magnetic resonance imaging revealed a large T9-10 intradural extramedullary mass that was hypointense to spinal cord on T1- and T2-weighted sequences, partial enhancement was apparent after Gadolinium administration. The spinal cord was severely compressed and displaced toward the right at the level of T9-10. Surgical removal of the tumor was successfully accomplished via the posterior midline approach and the histological diagnosis verified an ossified metaplastic meningioma. The clinical neurological symptoms of patient were improved postoperatively. In this article we discuss the surgical and pathological aspects of rare case of spinal totally ossified metaplastic meningioma.

Surgical Treatment of the Morgagni Hernia: report of one case (Morgagni 탈장증 수술 1예)

  • 김송명
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.429-433
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    • 1979
  • Morgagni hernia is a rare condition of the congenital diaphragmatic hernia which Is located at the anteromedial portion of the diaphragm, and is located immediately posterior to the sternum. Its cause is considered by embryologic defect and the abdominal organs are passed through a defect. The incidence is predirected women over 50 years old. Its synonym is hernia of subcostosternal, retrosternal, parasternal, rectocostoxiphoid, anterior diaphragmatic or Larrey`s. This report presents a symptomatic Morgagni hernia of ten months old male child on whom the diagnosis was established and was operated at the Busan Gospel Hospital. This patient was admitted with the chief complaints of mild cyanosis, frequent upper respiratory infections and protrusion of the right lower anterior chest. Herniorrhaphy was performed through the upper abdominal midline incision, hernial contents of the omentum and the colon, and sac as noticed from the Larrey`s space measuring 4 x 2 cm. in diameter and oval in shape. Interrupted sutures without difficulty repaired the defect. The cyanosis was disappeared and the patient had uneventful course of post-operative period. The patient was discharged at 7th. postoperative day. This case presentation with a brief review of literatures is given.

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A Case of Thyroglossal Duct Cyst Presenting as Thyroid Cyst (갑상선 낭종으로 오인된 갑상설관 낭종 1예)

  • Park, Yoon-Ah;Choi, Hong-Shik;Lee, Ja-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.234-236
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    • 2011
  • Thyroglossal duct cyst is the most common congenital neck mass. It develops from remnants of precursors of thyroid gland left behind during embryologic descent form the foramen cecum at the tongue base into the anterior neck during fetal development. An anterior midline neck mass presenting before the age of twenty and displaying vertical movement with tongue protrusion and swallowing is characteristic of this lesion. In this paper, we report on a case of TGDC without remnant duct that is presenting as thyroid cyst.

A Case of Brain Stem Anaplastic Oligodendroglioma with Exophytic Growth (뇌교에 발생한 악성 핍지신경교종 1례)

  • Kim, Dong-Hwan;Chung, Chang-Oh;Kim, Hyung-Ihl;Lee, Min-Cheol
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.684-687
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    • 2000
  • Primary anaplastic oligodendroglioma in brain stem is extremely rare. The authors present a case of a anaplastic oligodendroglioma arising from pons. A 29 year-old male patient was admitted because of cranial nerve palsy and visual disturbance. Neurological examination revealed bilateral sixth and left seventh cranial nerve plasies. Near-total resection of tumor mass was performed through midline suboccipital appraoch. Tumor was not related with choroid plexus and major vessels but it was firmly attached to the fourth ventricle floor. Tumor was considered to be arised from the tegmental portion of pons, growing dorsally into the 4th ventricle. Hitopathological exmination revealed primary anaplastic oligodendroglioma. Postoperative course was uneventful. The authors believe that this type of tumor with dorsally growing pattern can be successfully resected without major neurological deficit.

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Paradoxical Transtentorial Herniation Caused by Lumbar Puncture after Decompressive Craniectomy

  • Jung, Heyun-Jin;Kim, Dong-Min;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.102-104
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    • 2012
  • Although decompressive craniectomy is an effective treatment for various situations of increased intracranial pressure, it may be accompanied by several complications. Paradoxical herniation is known as a rare complication of lumbar puncture in patients with decompressive craniectomy. A 38-year-old man underwent decompressive craniectomy for severe brain swelling. He remained neurologically stable for five weeks, but then showed mental deterioration right after a lumbar puncture which was performed to rule out meningitis. A brain computed tomographic scan revealed a marked midline shift. The patient responded to the Trendelenburg position and intravenous fluids, and he achieved full neurologic recovery after successive cranioplasty. The authors discuss the possible mechanism of this rare case with a review of the literature.

A Case of Labial Adhesion (음순 유착(Labial Adhesion) 1례)

  • Roh, Ha Young;Oh, Chan Kyun;Son, Kyung Ran;Kook, Jin Hwa;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1271-1273
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    • 2003
  • Labial adhesions are postnatal fusion of the labia minora in the midline of varying degrees. They are postulated to be the result of low estrogen levels in the prepubertal child and possibly of a chronic inflammatory process. Topical treatment with conjugated estrogens has been the mainstay of therapy. We experienced one case of labial adhesion in an infant who was treated with estrogen cream for three weeks without any complication. Here we present this case with a brief review of the literature.

Paradoxical Herniation after Decompressive Craniectomy for Acute Subdural Hematoma

  • Cho, Hyun;Kim, Choong-Hyun;Kim, Jae-Hoon;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.51-53
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    • 2006
  • Decompressive craniectomy is usually performed to relieve raised intracranial pressure[ICP] caused by various intracranial lesions. A 67-year-old man presented with acute subdural hematoma and traumatic intracerebral hematoma. The patient underwent a decompressive craniectomy. Four weeks later, the patient presented with acute neurological deterioration. Brain computed tomographic[CT] scans revealed the marked concavity of the brain at the site of the craniectomy and associated with midline shift which was reversed by cranioplasty. We report an unusual case of cerebral herniation from intracranial hypotension after decompressive craniectomy for a traumatic subdural hematoma. The cranioplasty may be helpful to prevent paradoxial cerebral herniation.