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Experience of Meningovascular Syphilis in Human Immunodeficiency Virus Infected Patient

  • Lee, Jung-Pyo;Koo, Sun-Ho;Jin, So-Young;Kim, Tae-Hyong
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.413-416
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    • 2009
  • Since the start of the antibiotic era, syphilis has become rare. However, in recent times, it has tended to be prevalent concomitantly with human immunodeficiency virus (HIV) infection and coinfection in North America and Europe. Now, such cases are expected to increase in elsewhere including Korea. A 40-year-old male patient visited hospital complaining of a headache for about one month. Brain computed tomography and magnetic resonance imaging, showed leptomeninged enhancing mass with edema an right porisylvian region, which was suspected to be glioma. Patient underwent a blood test and was diagnosed with syphilis and acquired immune deficiency syndrome. Partial cortical and subcortical resection were performed after small craniotomy. The dura was thick, adhered to the brain cortex, and was accompanied by hyperemic change of the cortex. The pathologic diagnosis was meningovascular syphilis (MS) in HIV infection. After the operation, the patient was treated with aqueous penicillin G. Thereafter, he had no neurological deficit except intermittent headache. At first, this case was suspected to be glioma, but it was eventually diagnosed as MS in HIV coinfection. At this point the case was judged to be worth reporting.

Treatment of a Twelfth Rib Syndrome -A case report- (열두 번째 갈비뼈 증후군 환자의 치료경험 -증례보고-)

  • Choi, Jong Bum;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.96-98
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    • 2009
  • Twelfth rib syndrome is thought to be due to intercostal nerve irritation by a mobile twelfth rib, and presents with upper abdominal pain, or low thoracic pain. This syndrome appears to be a fairly common entity and diagnosis is based on clinical findings. Patients with twelfth rib syndrome can be misdiagnosed when it has been overlooked. We report a case of a 34-year-old male along with a presentation of twelfth rib syndrome. One patient was transferred from urologic clinic to pain clinic due to right flank pain and admitted. The patient had direct tenderness on twelfth rib area and direct tenderness was reproducible. Pain increased when the patient flexed laterally, rotated trunk. There were no specific abnormal findings in laboratory test, electrocardiogram, and radiologic examination. After intercostal nerve block and epidural block, pain decreased and the patient was discharged.

A New Method for Creating a Definite Philtrum by the Flipping of an Orbicularis Oris Muscle Flap in a Patient with an Indistinct Philtrum

  • Choi, Hyun Nam;Kim, Sin Rak;Han, Yea Sik
    • Archives of Plastic Surgery
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    • v.40 no.1
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    • pp.62-65
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    • 2013
  • The philtrum plays a key role in the appearance of the upper lip and nostril sill. Therefore, construction of the philtrum is crucial for attaining a natural appearance of the upper lip. We used a flipping myoplasty of the orbicularis oris muscle on a patient with a flat philtrum in order to effectively reconstruct the philtral dimple and column. A 35-year-old female presented to our department with the complaint of a flat upper lip. A superficial layer of the orbicularis oris muscle on the median aspect of the upper lip was vertically incised and elevated to a thickness of 2 mm. Both sides of the elevated muscle flap were then folded to the lateral sides so that the border could be sutured onto the outer portion of the orbicularis oris muscle. The patient was observed for one year postoperatively. Her philtrum deepened by 1.25 mm, with the central angle of her Cupid's bow improving from a preoperative measurement of $146^{\circ}$ to $128^{\circ}$ postoperatively. In a patient with an indistinct philtrum, a flipping orbicularis oris myoplasty was performed to attain a definite philtral column and a philtral dimple. Natural upper lip movement was maintained, and an aesthetically and functionally satisfactory reconstruction was achieved.

A case of the patient with Wei symptom suspected Guillain-Barre syndrome (Guillain-Barre syndrome으로 추정되는 계증 치험 1례(例))

  • Jeong, Byoung-Mu;Sin, Won-Yong;Choi, En-Young;Yoon, Cheol-Ho;Jeong, Ji-Cheon;Hyun, Min-Kyung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.450-456
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    • 2004
  • Guillain-Barre syndrome, or acute inflammatory polyneuritis, is a disorder in which the body's immune system attacks parts of the peripheral nervous system. The causes and mechanisms of this syndrome are unknown. Typically, Guillain-Barre syndrome can be diagnosed from the patient's symptoms and physical examination such as the rapid onset of weakness, paralysis and loss of reflexes. The analysis of CSF and electrical tests on nerve and muscle function can be performed to confirm the diagnosis. Most cases occur shortly after a viral infection. This is a clinical report about one patient suspected as having Guillain-Barre syndrome. The patient, a 62-year-old man had weakness in both legs after gastroduodenal disease. His weakness and general condition improved after Korean medical treatments, so this is reported as a potential treatment.

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A Case of Psychogenic vomiting (七情吐) patient who showed loss of the weight due to Maladjustment in a Military life (군대생활 부적응으로 급격한 체중감소를 나타낸 칠정토(七情吐) 환자 치험 1례)

  • Yoo, Jong-Ho;Kim, Joo-Ho;Kim, Geuu-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.131-141
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    • 2006
  • Psychogenic vomiting (七情吐) is the disease of vomiting due to seven emotions that joy, anger, melancholy, anxiety, grief, fear and terror being the response of the mind to the environmental stimuli. We experienced a 21year-old man who had a psychogenic vomiting due to maladjustment in a military life, and whose condition was improved through oriental medical treatment. We treated the patient with Herbal medications and Giungoroen (至言高論)-wise saying and lofty opinion). Giungoroen is psychological therapy that promotes patient's recognition of disease and will to cure it through conversation. After being treated, the patient showed that symptoms (vomiting, nausea, abdominal discomfort, insomnia, a depressed mood, a feeling of uneasiness) was improved considerably. Tills result suggests that oriental medical treatment bas good effect on psychogenic vomiting due to adjustment disorder.

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Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

  • Park, Eun Jin;Song, Joon Young;Choi, Min Ju;Jeon, Ji Ho;Choi, Jah-Yeon;Yang, Tae Un;Hong, Kyung Wook;Noh, Ji Yun;Cheong, Hee Jin;Kim, Woo Joo
    • Parasites, Hosts and Diseases
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    • v.52 no.4
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    • pp.425-428
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    • 2014
  • A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

Splenic Hemochromatosis Incidentally Found on Tc-99m MDP Bone Scan in a Chronic Myelogenous Leukemia Patient who Received Bone Marrow Transplantation (골수 이식을 받은 만성 골수성 백혈병 환자의 Tc-99m MDP 골스캔에서 우연히 발견된 비장 Hemochromatosis)

  • Seo, Ji-Hyoung;Bae, Jin-Ho;Jeong, Sin-Young;Lee, Jae-Tae;Lee, Kyu-Bo;Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.1
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    • pp.109-110
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    • 2004
  • Purpose: Tc-99m MDP bone scan was performed to evaluate a generalized bone pain in a 24-year-old male chronic myelogenous leukemia patient who received bone marrow transplantation at 7 months ago. The patient had received large amounts of blood transfusion for managing symptoms related to anemia. Bone scan revealed substantial splenic tracer uptake. Magnetic resonance image and laboratory evidence of hemochromatosis suggests that the presence of large quantities of iron in the spleen of this patient may have been responsible for the splenic uptake of the bone scanning agent. The authors report a case of splenic hemochromatosis incidentally found on Tc-99m MDP bone scan.

Surgical Experience of Pulsed Dye Laser Using Laryngeal Mask Airway Under General Anesthesia in Glottal Papillomatosis Patient who Had Previously Failed to Undergo Surgery Under General Anesthesia Due to Impossible Laryngeal Exposure (전신 마취하 후두 노출이 되지 않았던 후두 유두종 환자에 대하여 시도한 후두 마스크 전신 마취하 Pulsed Dye Laser 수술 치험 1예)

  • Chung, Hyun-Pil;Park, Jun-Hee;Kim, Won-Sik;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.54-57
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    • 2008
  • Non-visualization of larynx is one of the reasons for failure of vocal fold surgery. Many otorhinolaryngologists may have a trouble in choice of alternative treatment if they experience this situation. The laryngeal mask airway could be alternative approach for this situation. We report a glottal papillomatous patient who was treated by pulsed dye laser via laryngeal mask airway after failure of vocal fold surgery via endotracheal intubation. The patient was a 73-year-old man. Laryngoscopy revealed a severe diffuse papillomatous lesion on right true vocal cord, anterior commissure, and partial left true vocal cord. The patient was refered for difficult laryngeal exposure during laryngomicrosurgey under general endotracheal anesthesia.

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A Case of Atypical Bone Growth after Femur Neck Fracture in the Paraplegic Patient with Trochanteric Sore (대전자부 압박궤양을 가지고 있는 하지마비 환자에서 대퇴골 골절부위에 발생한 비정상적 골증식의 치험례)

  • Yang, Jeong Yeol;Cheon, Ji Seon
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.92-95
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    • 2008
  • Purpose: Heterotopic ossification in pressure sore patients is reported to rarely develop, but once it occurs, it frequently causes joint stiffness and mobilization restriction. The aim of this article is to report our experience of atypical bone growing at femur neck fracture site with chronic, extensive pressure sore in patient with paraplegia secondary to spinal injury. Methods: A 28-year-old male patient presented with atypical bone growth at femur neck fracture site with pressure sore. He had undergone atypical growth bone removal and separation of united iliac bone and femur, and then pressure sore was covered by advanced rotation flap. Results: The patient mobilized hip joint and rode in a wheelchair. Complications such as dehiscence, infection, hematoma and flap necrosis did not occur. Conclusion: We experienced successful correction of atypical bone growth removal and recovery of pressure sore. We report our experience of atypical bone growth of fracture site and the related literature was reviewed.

Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

  • Jeong, Woo Shik;Choi, Jong Woo;Choi, Seung Ho
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.584-587
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    • 2014
  • In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.