• Title/Summary/Keyword: Old patient

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Glioblastoma Mimicking Herpes Simplex Encephalitis

  • Nam, Tai-Seung;Choi, Kang-Ho;Kim, Myeong-Kyu;Cho, Ki-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.119-122
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    • 2011
  • We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

Spontaneous Spinal Subarachnoid Hemorrhage with Spontaneous Resolution

  • Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.253-255
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    • 2009
  • Spontaneous spinal subarachnoid hematoma (SSH) is a rare entity to cause spinal cord or nerve root compression and is usually managed as surgical emergencies. We report a case of spontaneous SSH manifesting as severe lumbago, which demonstrated nearly complete clinical resolution with conservative treatment A 58-year-old female patient developed a large SSH, which was not related to blood dyscrasia, anticoagulation, lumbar puncture. or trauma. Patient had severe lumbago but no neurologic deficits. Because of absence of neurologic deficits, she was treated conservatively. Follow-up magnetic resonance (MR) image showed complete resolution. Conservative treatment of SSH may be considered if the patient with spontaneous SSH has no neurologic deficits.

Atypical Guillain-Barr$\acute{e}$ Syndrome Misdiagnosed as Lumbar Spinal Stenosis

  • Jung, Dae Young;Cho, Keun-Tae;Lee, Seung Chul
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.245-248
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    • 2013
  • Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

Multiple Spinal Revision Surgery in a Patient with Parkinson's Disease

  • Malla, Hridayesh Pratap;Kim, Min Ki;Kim, Tae Sung;Jo, Dae Jean
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.655-658
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    • 2016
  • Parkinson's disease (PD) patients frequently have several spinal deformities leading to postural instabilities including camptocormia, myopathy-induced postural deformity, Pisa syndrome, and progressive degeneration, all of which adversely affect daily life activities. To improve these postural deformities and relieve the related neurologic symptoms, patients often undergo spinal instrumentation surgery. Due to progressive degenerative changes related to PD itself and other complicating factors, patients and surgeons are faced with instrument failure-related complications, which can ultimately result in multiple revision surgeries yielding various postoperative complications and morbidities. Here, we report a representative case of a 70-year-old PD patient with flat back syndrome who had undergone several revision surgeries, including anterior and posterior decompression and fusion for a lumbosacral spinal deformity. The patient ultimately benefitted from a relatively short segment fixation and corrective fusion surgery.

A Case Report on Hwabyung Patient with Blepharoptosis (안검하수(眼瞼下垂)를 동반한 화병(火病) 환자 치험 1례)

  • Hwang, Jeong-Hyun;Kim, Jee-Hoon;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.4
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    • pp.161-172
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    • 2009
  • Objectives : This study was designed to research the effect of oriental treatments for Hwabyung with Blepharoptosis. Methods : A 51 year-old female patient has been suffered by Hwabyung for 5 months and by Blepharoptosis for 2 weeks. We treated the patient with Herbal medication, oriental psychotherapy and acupuncture. Results : As a result of oriental treatments, Blepharoptosis was disappeared, and the symptoms of Hwabyung was improved gradually. Conclusions : These result suggest that oriental treatments have an effect on Hwabyung with Blepharoptosis.

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Behavioral and Psychological Symptoms of Dementia Treated with Korean Medicine: A Case Report

  • Song, Sue-jin;Sung, Yung-wei;Koo, Byung-soo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.4
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    • pp.391-399
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    • 2017
  • Objectives: To determine the effects of Korean medicine on behavioral and psychological symptoms of dementia (BPSD) of an Alzheimer's disease (AD) patient. Methods: A 85-year old female patient diagnosed with AD was treated with herbal medicine formula Chungsimyeonja-tang (淸心蓮子湯), Woohwangchungsim-won (牛黃淸心元), and acupuncture. Korean version of Mini-mental State Examination (MMSE-K) scores were used at baseline and post treatment as outcome measures to evaluate clinical symptoms of the patient. Results: Improvements in MMSE-K post treatment scores were observed compare to those at baseline. BPSD were also alleviated. Such changes were visually noticeable. Conclusions: Herbal medicine and acupuncture treatment were effective in alleviating symptoms of AD. Further studies with a larger sample size and randomized clinical trials are needed to obtain more reliable and valid treatment outcomes.

Traumatic Cardiac Perforation (외상성 심장파열의 외과적 고찰)

  • 성시찬
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.365-370
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    • 1979
  • The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.

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Localized Pleural Mesothelioma Inducing Hypoglycemia - 1 case report - (저혈당증을 동반한 늑막 중피세포종 -1례 보고-)

  • 홍유선
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.558-562
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    • 1988
  • Localized mesothelioma is a primary pleural tumor that induces hypoglycemia rarely. We experienced a case of the localized mesothelioma that induced hypoglycemia. The patient was 70 year-old man who was admitted to Severance Hospital because of general weakness and mental confusion in morning before breakfast. He was found to have low level of fasting blood sugar and C-peptide, but had normal serum insulin level. After excision of the tumor, the patient was free from symptoms of hypoglycemia, and fasting blood sugar level was returned to normal range. The most likely speculation of causing hypoglycemia by the mesothelioma was thought to be that the tumor did not secrete insulin itself but the undetectable insulin-like substance and/or antigluconeogenic substances. During the follow up, 5 months after surgical removal of tumor, the patient was in a good condition without symptoms of hypoglycemia.

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Thoracoscopic Enucleation of Esophageal Leiomyoma (흉강경을 이용한 식도 평활근종의 절제)

  • 이성호
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.518-520
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    • 1995
  • Leiomyoma is the most common benign tumor of the esophagus,and surgical enucleation is the treatment of choice. Recently we successfully performed thoracoscopic enucleation of large esophageal leiomyoma without complication in one patient. The 46 years old male patient complained epigastric discomfort and showed a submucosal mass in lower esophagus under the endoscopic ultrasonography . During operation minimal perforation occurred, it was closed with clipping without conversion to an open procedure.The tumor size was 8cm x 3cm x 1.5cm respectively. There were less post-operative pain,minimal wound size, and early recovery time.Patient was satisfactory these outcome. These result suggest that esophageal enucleation was performed more large size benign tumor and esophageal perforation during operation was treated thoracoscopically.

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Referred Shoulder Pain due to Liver Abscess -A case report- (간농양의 연관통으로 밝혀진 우측 견부통 환자의 치료증례)

  • Park, Sang Hyun;Lee, Pyung Bok;Seo, Myung Sin;Lim, Yun Hee;Oh, Yong Seok
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.267-270
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    • 2005
  • Referred pain is not localized to the site of its cause, but referred to an area that may be an adjacent distant from such a site. With respect to this, there is the possibility of misdiagnosis in the treatment of referred pain patient. We experienced a case of a 31-years-old male patient complaining of right shoulder pain, which subsided after a bursa injection. The patient revisited our clinic after 3 weeks complaining not only of right shoulder pain, but also of right upper quadrant pain and fever. He was diagnosed as having a liver abscess by an imaging study.