• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.450-454
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• 2015

Although tuberculosis is highly prevalent worldwide, congenital tuberculosis is one of the least common manifestations of the disease. The diagnosis is usually difficult because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy and delivery. We present the case of a preterm neonate with congenital tuberculosis, born to a previously healthy mother who had developed severe disseminated tuberculosis during her pregnancy. Once the diagnosis was confirmed in the mother, the congenital infection was confirmed by isolation of Mycobacterium tuberculosis in gastric aspirates, and positive polymerase chain reaction in a cerebrospinal fluid examination. Treatment for tuberculosis with a four-drug regimen resulted in an adequate clinical response in both the mother and infant.

• 한국석유지질학회:학술대회논문집
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• 대한자원환경지질학회/한국석유지질학회/한국암석학회 2000년도 추계공동학술발표회 초록집
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• pp.74-74
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• 2000

• 한국임상수의학회지
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• 제34권6호
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• pp.441-444
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• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.

• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.186-190
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• 2015

Acute disseminated encephalomyelitis (ADEM) is a demyelinating and inflammatory condition of the central nervous system, occurring predominantly in white matter. ADEM involving the rhombencephalon without affecting the white matter is very rare. Here, we present an unusual case of ADEM involving only the rhombencephalon in a 4-year-old Asian girl. The patient complained of pain in the right lower extremities, general weakness, ataxia, and dysarthria. The initial brain CT showed subtle ill-defined low-density lesions in the pons and medulla. On brain MRI, T2 high signal intensity (T2-HSI) lesions with mild swelling were present in the pons, both middle cerebellar peduncles, and the anterior medulla. The initial diagnosis was viral encephalitis involving the rhombencephalon. Curiously, a cerebrospinal fluid (CSF) study revealed no cellularity, and negative viral marker findings. Three weeks later, follow up brain MRI showed that the extent of the T2-HSI lesions in the brain stem had decreased. After reinvestigation, it was found that she had a prior history of upper respiratory infection. In this case, we report the very rare case of a patient showing isolated involvement of the rhombencephalon in ADEM, mimicking viral rhombencephalitis on CT and MR imaging. ADEM can involve unusual sites such as the rhombencephalon in isolation, without involvement of the white matter or deep gray matter and, therefore, should be considered even when it appears in unusual anatomical areas. Thorough history taking is important for making a correct diagnosis.

• Clinical and Experimental Pediatrics
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• 제54권6호
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• pp.234-240
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• 2011

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

• Tuberculosis and Respiratory Diseases
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• 제60권1호
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• pp.97-101
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• 2006

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

• 대한한방부인과학회지
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• 제19권1호
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• pp.139-154
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• 2006

Objective : This experimental study was carried out to investigate anti-coagulation effects and mechanism of Hongdeung-tang on the dissentimenated intravascular coagulation Methods : Each 10 rats were classified as normal gorup, control group and treated group. The control group was given a 0.5mg/ml endotoxin intra-vein injection and was occurred Disseminated Intravascular Coagulation(DIC). The treated group were orally administrated 1ml Hongdeung-tang concentration once a day for 6 days and then it was treated the same as the control group. We took the blood from heart and were investigated number of Platelet and white blood cell(WBC), fibrinogen concentration, prothrombin time(PT), activated partial thromboplastin time(APTT), interleukin-6(IL-6), Tumor Necrosis $Factor-{\alpha}(TNF-{\alpha})$, Prostaglandin $E2(PGE_2)$ from them. Results : There were a statistically significant increase of platelet and fibrinogen concentration in the treated group compared to the treated group. The PT was a significantly reduced in treated group compared to the control group. There was no significant change in numbers of WBC and APTT between control and treated group. On the contrary, the number of PT, IL-6, $TNF-{\alpha}$, $PGE_2$ were significantly decreased in treated group compared to the control group. Conclusion : DIC which was occurred by endotoxin intravenous injection seems to related to the increase of IL-6, $TNF-{\alpha}$, $PGE_2$ and Hongdeung-tang has an effect that supress those factors. we can assume Hongdeung-tang has an anti-coagulation effect by those supressing effect.

• 대한신경과학회지
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• 제35권4호
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• pp.211-214
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• 2017

Acute disseminated encephalomyelitis (ADEM) and Guillain-$Barr{\acute{e}}$ syndrome (GBS) are both rare post-infectious neurological disorders. The co-existence of these conditions has often been reported despite of low incidence. We describe a 20-year-old male, who presented with acute flaccid paralysis and encephalopathy. The patient showed reversible MRI lesions suggesting ADEM. This case showed anti-GT1a IgG and anti-GM1 IgM antibodies positivity. We suggest that certain immunogenicity within central and peripheral nervous system may share a common autoimmune process during the disease course.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.32-36
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• 2009

본 증례는 AIDS가 아닌 면역저하 환자에서 M. intracellulare에 의하여 관절염 및 흉수가 발생한 파종성 질환의 예로 국내에서 두 번째로 보고되는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제61권2호
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• pp.171-177
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• 2006

MALT림프종은 질병의 진행이 느리고, 진단 당시 국소적인 병변이 대부분이며, 폐와 위장관을 동시에 침범하는 경우는 매우 드물다. 저자들은 흉부 단순촬영에서 고립성 폐결절이 발견된 73세 남자 환자에서 위, 폐, 골수를 침범한 파종성 MALT림프종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.