• Title/Summary/Keyword: dura

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Successful Treatment of a Case with Rhino-Orbital-Cerebral Mucormycosis by the Combination of Neurosurgical Intervention and the Sequential Use of Amphotericin Band Posaconazole

  • Yoon, Young-Kyung;Kim, Min-Ja;Chung, Yang-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.74-77
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    • 2010
  • Rhino-orbital-cerebral (ROC) mucormycosis is an uncommon, acute and aggressive fungal infection. It remains a challenging problem to clinicians despite aggressive debridement surgery and antifungal therapy. The authors describe a case of ROC mucormycosis with pericranial abscess occurring in a female patient with uncontrolled diabetes mellitus. The infection initially developed in the right-sided nasal sinus and later progressed through the paranasal sinuses with the invasion of the peri-orbital and frontotemporal region, due to the delayed diagnosis and treatment. Numerous non-septate hyphae of the zygomycetes were identified by a punch biopsy from the nasal cavity and by an open biopsy of the involved dura. The patient was treated successfully with extensive debridement of her necrotic skull and surrounding tissues, drainage of her pericranial abscess and antifungal therapy, including intravenous amphotericin B for 61 days and oral posaconazole for the following 26 days. She returned to a normal life and has had no recurrence since the end of her treatment 15 months ago.

Meningitis Occurred during Continuous Lumbar Epidural Block -A case report- (지속적 요부 경막외 차단 중 발생한 뇌막염 -증례 보고-)

  • Lee, Seong-Yeon;Chae, Jeong-Hye;Choi, Bong-Choon;Chun, Tae-Wan;Kim, Jeong-Ho;Kim, Chan
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.383-385
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    • 1995
  • Postpuncture headache is the most common complication of epidural block, others include abscission of the tip of catheter, epidural abscess and subarachnoid infection, etc. A 69-year-old female patient visited the Neuro-Pain Clinic of Seran General Hospital for treatment of lower back pain and both sciatica. She received continuous epidural block, psoas compartment block, lumbar facet joint block and lumbar facet thermocoagulation. During the epidural block procedure the dura was accidently punctured and auto-logous blood patch was performed. Three days later, she manifested fever, nausea, vomiting, mild neck stiffness and mental deterioration. Meningitis was suspected as the cause of these signs. The CSF study reported: protein 400 mg/dl, sugar 14 mg/dl, WBC $468/mm^3$. She was recovered from the meningitis after adequate antibiotic therapy.

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A RADIOGRAPHIC STUDY ON THE CONVENTIONAL ENDODONTIC TREATMENT (근관치료에 대한 방사선학적 연구)

  • Kang Byung Cheol;Kwon Hyuk Choon;You Dong Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.15 no.1
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    • pp.41-49
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    • 1985
  • The purpose of this study was to evaluate the initial and postoperative radiographic features of the endodontic treated teeth. The author examined the radiographs which comprise 114 teeth with 155 canals of 64 persons. The following factors were considered; Age, sex, tooth location, number of root canals, postoperative periods, initial diagnosis, and radiographic findings, postoperative radiographic findings. The apical levels of the root fillings were 76.8% to apex, 19.0% underfilling, 3.9% overfilling. The following results were obtained. 1. Of the 93 teeth which revealed initial periapical rarefaction, 66 teeth (71.0%) had showed complete bone healing, 19 teeth (20.4%) decreased rarefaction, 6 teeth (6.5%) no change, 2 teeth (2.2%) increased rarefaction after 20.0 months mean healing time. 2. 21 teeth which had no initial periapical rarefaction showed no occurrence of new periapical rarefaction. 3. Of the 66 teeth completely healed, 53 teeth (80.3%) had showed reappearance of lamina dura, 64 teeth (97.0%) reappearance of periodontal ligament space after 23.4 months mean healing time.

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A STUDY OF THE CEMENTIFYING FIBROMA (백악질화성섬유종에 관한 연구)

  • Choi Heang-Hee;Ko Jae-Kyeung
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.235-243
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    • 1998
  • Cementifying fibroma is an odontogenic tumor of periodontal ligament origin, consisting of a proliferation of fibrous tissue that forms cementum. Cemento-ossifying fibroma, cementifying fibroma and ossifying fibroma are difficult to distinguish on clinical and radiographic exmination, and on histopathology. However, when the calcified product is represented by ovoid or curvilinear deposits, the lesion is often referred to as cementifying fibroma. Cementifying fibromas of the jaws are well-circumscribed, generally slow-growing lesions. Although most lesions appear to be limited to the tooth-bearing areas, a few have extended into the angle-ramus area or encroached on the maxillary sinus. Radiographically, the cementifying fibroma could present as a radiolucent, radiopaque or mixed density lesion, depending on the degree of maturity. We have observed two cases of cementifying fibroma occurred in the left maxillary premolar-molar area of 38-year-old woman and 35-year old man. We obtained that two cases were shown the followed results; 1. Clinically, main clinical symptom was facial swelling and pain at palpation 2. Radiographically, well-circumscribed radiolucent lesion and radiolucent lesion with radiopaqu e foci were seen on the left maxillary premolar-molar areas. Loss of lamina dura and root resorption or divergency were also seen. 3. Histopathologically, many cementum-like calcifications were observed in the hypercellular connective tissue.

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Radiographic Diagnosis of 'Rubber Jaw Syndrome' Secondary to Chronic Renal Failure Due to Ethylene Glycol Intoxication in a Dog (개에서 Ethylene glycol 중독에 의한 만성신부전증의 속발성 'Rubber jaw syndrome'의 방사선학적 진단례)

  • Choi, Ho-Jung;Lee, Young-Won;Wang, Ji-Hwan;Jung, In-Jo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.260-263
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    • 2007
  • A 9-month-old, intact female mixed dog was referred to Veterinary Medical Teaching Hospital of Gyeongsang National University with symmetrically enlarged and protruded upper jaw. The patient was diagnosed as acute renal failure due to ethylene glycol poisoning and was treated for 1 month in a local animal hospital. In spite of treatment, the patient proceeded to chronic renal failure. Also, the patient's upper jaw begun to enlarge continuously. To evaluate this upper jaw, radiographic examination was performed. Skull radiographs revealed thickening of maxilla, decreased bone opacity, cortical thinning, loss of lamina dura and periodontal space in the maxilla. Diagnosis of rubber jaw syndrome is based on clinicial signs, radiographic findings and laboratory evidence of chronic renal failure due to ethylene glycol poisoning.

Dural Arteriovenous Malformation on the Anterior Cranial Fossa - Case Report - (전두개와 경막에 발생한 동정맥 기형 - 증례보고 -)

  • Park, Tae Il;Whang, Kum;Pyen, Jhin Soo;Hu, Chul;Hong, Soon Ki;Han, Yong Pyo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.244-249
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    • 2001
  • Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.

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Effects of Lumbar Stabilization Exercise on Motor Neuron Excitability and Pain in Patients with Lumbar Disc Herniation

  • Kang, Jeongil;Jeong, Daekeun;Choi, Hyunho
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1785-1790
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    • 2019
  • Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

Atypical proliferative nodule in congenital melanocytic nevus with dural invasion: a case report

  • Jung, Jae Hoon;Jang, Kee-Taek;Kim, Ara;Lim, So Young
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.139-143
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    • 2019
  • Here we report a case of a focal atypical proliferative nodule (PN) arising from a congenital melanocytic nevus (CMN). Diagnosis was challenging because it had both benign and malignant clinical features. Unusual histopathology, immunohistochemistry, and intraoperative findings of this atypical PN are discussed. A 5-year-old girl was admitted for a congenital $5{\times}5cm$ sized scalp mass. This hemangioma-like soft mass showed biphasic characteristics such as a slow, gradual, and benign increase in size but worrisome dural invasion with cranial bone defect. We removed the scalp mass with clear resection margins. Interoperatively, we found that the cranial bone defect had already filled. Histopathologic examination showed CMN with focal atypical PN. The nodule showed sharp demarcation and cellular pleomorphism. However, in immunohistochemical study, Ki-67 proliferation index and expression levels of protein S-100 and Melan-A were very low. These were unusual findings of atypical PNs. Despite her worrisome preoperative radiologic features, she showed an indolent clinical course compatible with previously reported biologic behavior. The patient underwent follow-up inspection with magnetic resonance imaging every 6 months for up to 3 years. The nodule appeared to be stationary at the last visit.

Type 1.5 Split Cord Malformation : A New Theory of Pathogenesis

  • Sun, Mengchun;Tao, Benzhang;Luo, Tianbao;Gao, Gan;Shang, Aijia
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.138-144
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    • 2022
  • To report two cases of type 1.5 split cord malformation (SCM), a subtype of SCM with combined characteristics of types I and II and to review the relevant literature and propose a new possible pathogenetic theory for type 1.5 SCM. A 52-year-old woman had hemicords within a single dural sac with a dorsal bony septum at the L5 level. A 9-year-old boy had hemicords within a single dural sac with a ventral bony septum and fibrous extension at the L3 level. Both patients underwent microsurgical treatments for removing the bony septum, detethering the spinal cord, and sectioning the filum terminale. The surgical procedure revealed an extradural partial bony septum and hemicords within an intact single dural sac in each patient. Both patients were discharged from the hospital without de novo nerve dysfunction. Published cases have validated that types I and II SCM can overlap. We recommend recent type 1.5 SCM as a normative terminology for this overlapping SCM and report two rare cases of this SCM. We propose an associated pathogenesis consisting of uneven distribution and regression to explain type 1.5 SCM. Furthermore, we postulate that the amount of condensing meninx primitiva might determine whether the left bony septum has fibrous extensions to the opposite dura in type 1.5 SCM.

A Case of Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma in Buccal Mucosa (협점막에서 발생한 MALT 림프종 1예)

  • Lee, Hyeon A;Myung, Jae Kyung;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.49-52
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    • 2022
  • Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a low-grade B-cell lymphoma that typically follows an indolent clinical course. It occurs in a variety of mucosal linings extranodal tissue, most commonly in the stomach. Other commonly involved sites include other parts of the gastrointestinal tract, thyroid, salivary gland, lung, lacrimal gland, synovium, dura mater, breast, skin, and eyes. It occurs very rarely in the buccal mucosa. A 50-year-old man came to the clinic while presenting a 5-month history of right-sided buccal mass. The incisional biopsy did not confirm the diagnosis of the lesion. He underwent complete excision of buccal mass for the diagnosis and treatment. The final pathology confirmed MALT lymphoma immunohistochemically. After surgery, he received radiotherapy with 30.6 Gy. There is no recurrence for 8 months after treatment. Herein we report a rare case of buccal MALT lymphoma with a review of the literature.