• Title/Summary/Keyword: progressive patient

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Strategy for the Patient with Tuberculum Sellae Meningioma Combining Bilateral Internal Artery Aneurysm

  • Cha, Ki-Yong;Park, Sang-Keun;Hwang, Yong-Soon;Kim, Tae-Hong
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.151-154
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    • 2005
  • A 43-year-old woman was admitted with the chief complaint of progressive visual disturbance and her brain radiological studies disclosed well demarcated tumor at tuberculum sellae area and bilateral mirror image paraclinoid internal carotid artery saccular aneurysms. A larger left side aneurysm was pointing medialy and almost encased by the tumor. Although a brain tumor and intracranial aneurysm can be simultaneously treated by surgery, the high risk of intra-operative aneurysm rupture should be considered. Therefore, the author secondly performed tumor resection after the endovascular embolization of the aneurysm which was embedding the tumor using a Guglielmi detachable coil. After successful treatment of the patient with tuberculum sellae meningioma associated with bilateral mirror image paraclinoid aneurysms using endovascular and surgical techniques, the authors present the case with a review of the related literatures.

Esophageal Leiomyomatosis in a patient with Alport Syndrome (Alport syndrome과 동반된 식도 평활근종증)

  • 최인석;박주철;이주희
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.112-115
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    • 2000
  • A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7$\times$5$\times$5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.

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Severe trismus due to bilateral coronoid process hyperplasia in growth hormone therapy patient: a case report

  • Lee, Sung-Tak;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.249-254
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    • 2012
  • Bilateral coronoid process hyperplasia is a rare condition characterized by an enlarged mandibular coronoid process. The painless progressive reduction of a mouth opening is caused by coronoid process impingement on the posterior aspect of the zygomatic bone. Hyperplasia of the bilateral coronoid process leads to the restriction of a mandibular opening consequent to the impingement of the enlarged coronoid process on the temporal surface of the zygomatic bone or with the medial surface of the zygomatic arch. The process has been diagnosed as developmental hyperplasia. Otherwise, the development of the coronoid process may be associated with growth hormone. This paper describes a case of trismus caused by coronoid hyperplasia in an idiopathic short-stature patient who received growth hormone therapy by somatropin injections.

Oral Vancomycin Therapy in a Child with Primary Sclerosing Cholangitis and Severe Ulcerative Colitis

  • Buness, Cynthia;Lindor, Keith D.;Miloh, Tamir
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.210-213
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    • 2016
  • Primary sclerosing cholangitis (PSC), a rare progressive liver disease characterized by cholestasis and bile duct fibrosis, has no accepted, effective therapy known to delay or arrest its progression. We report a 15 year old female patient diagnosed with PSC and moderate chronic active ulcerative colitis (UC) who achieved normalization of her liver enzymes and bile ducts, and resolution of her UC symptoms with colonic mucosal healing, after treatment with a single drug therapy of the antibiotic oral vancomycin. We postulate that the oral vancomycin may be acting both as an antibiotic by altering the intestinal microbiome and as an immunomodulator. Oral vancomycin may be a promising treatment for PSC that needs to be further studied in randomized trials.

A Case of Infantile Nephrotic Syndrome with Focal Segmental Glomerulosclerosis (국소성 분절성 사구체 경화증에 의한 영아형 신증후군 1례)

  • Kim Se Eun;Han Young Sim;Song Min Seop;Chung Woo Yeong
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.100-103
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    • 1999
  • Focal Segmental Glomerulosclerosis(FSGS) is one of the underlying pathology of congenital and infantile nephrotic syndrome. There is no ultimate curative treatment except renal transplantation. We have experienced a case of infantile nephrotic syndrome In a 10 month old boy who presented with proteinuria and hematuria. His elder brother also suffered from nephrotic syndrome and died at the age of 18 months due to sepsis. We have diagnosed this patient with clinical manifestations, laboratory data and pathologic findings which was done by open renal biopsy. The patient expired 54 days after admission because or progressive uremia and sepsis.

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Endoscopic Aqueductoplasty and Stenting for Isolated Fourth Ventricle

  • Cho, Won-Ho;Lee, Sang-Weon;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.292-295
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    • 2006
  • Isolated fourth ventricle[IFV] is a rare entity producing symptoms of a progressive posterior fossa mass lesion. It is mainly reported in a patient who undergo shunt placement as its late complication. However, its surgical management has been difficult and its optional treatment remains controversial. We had an occasion to admit 19-year-old female to our hospital due to hydrocephalus : she had a history of meningitis when she was 2 years old. Ten years later she was diagnosed as hydrocephalus and managed by lateral ventriculo-peritoneal shunting procedure. Seven years after the procedure, the patient presented with headache, nausea, truncal ataxia and nystagmus. Computed tomography and magnetic resonance image scan demonstrated markedly enlarged fourth ventricle : and thus, neuroendoscopic aqueductoplasty and aqueductal stent insertion was performed. The authors present a case of an IFV after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated successfully with a neuroendoscopic surgery. The technique of this procedure is described below.

Malignant Transformation of Craniopharyngioma without Radiation Therapy: Case Report and Review of the Literature

  • Jeong, Tae Seok;Yee, Gi Taek;Kim, Na Rae
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.108-113
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    • 2017
  • Craniopharyngiomas exhibiting histologic malignancy are extremely rare. Herein, we report the case of a 26-year-old male patient who underwent suprasellar mass excision via an interhemispheric transcallosal approach. Histopathological examination indicated that the craniopharyngioma was of the adamantinomatous subtype. The patient received postoperative medical treatment for endocrine dysfunction and diabetes mellitus without radiation treatment. Two years after the operation, he presented with progressive visual disturbance and altered mentality. Magnetic resonance imaging revealed a huge mass in the suprasellar cistern and third ventricle. He underwent a second operation via the same approach. The histopathological examination showed an adamantinomatous craniopharyngioma with sheets of solid proliferation in a spindled pattern, indicating malignant transformation. Malignant transformation of craniopharyngioma in the absence of radiation therapy has been reported in only five cases, including this one. We present a case of malignant transformation of craniopharyngioma with a brief review of relevant literature.

Reconstructive rhinoplasty with costal cartilage grafting: A case report of relapsing polychondritis

  • Lee, Yunhae;Choi, Hyungon
    • Archives of Craniofacial Surgery
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    • v.20 no.5
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    • pp.341-344
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    • 2019
  • Relapsing polychondritis (RP) is a rare autoimmune disorder of unknown etiology characterized by recurrent episodes of inflammation and the destruction of cartilaginous tissues, primarily involving the ear, nose, and the respiratory tract. Nasal chondritis is present in 24% of patients at the time of diagnosis and develops subsequently in 53% throughout the diseases progress. Progressive destruction of nasal cartilage leads to the characteristic flattening of the nasal bridge, resulting in the saddle nose deformity. In patients with RP, surgical management for saddle nose is carefully decided due to the disease relapsing characteristics. We present a RP patient with a saddle nose deformity who underwent reconstruction rhinoplasty with autologous costal cartilage grafting. At 6-month follow-up, the patient retained good esthetic results and showed neither complication nor relapse of RP.

Intractable Coronary Spasm Requiring Percutaneous Coronary Intervention after Coronary Artery Bypass Grafting in a Patient with Moyamoya Disease

  • Kim, Hyeon A;Kim, Young Su;Kim, Wook Sung
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.150-153
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    • 2021
  • Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.

Cutaneous epitheliotropic T-cell lymphoma with Sézary syndrome in a dog

  • Lee, Song in;Lee, Han Joon;Seo, Kyoungwon;Song, Kunho
    • Korean Journal of Veterinary Service
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    • v.44 no.4
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    • pp.309-313
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    • 2021
  • A 12-year-old, spayed female, Toy-poodle dog presented in progressive, pruritic carpal mass and mandibular papule. The skin lesions and enlarged superficial lymph nodes were surgically removed. According to histopathology and immunohistochemistry, the patient diagnosed as cutaneous epitheliotropic T-cell lymphoma with lymph node metastasis. Chemotherapy with L-asparaginase, lomustine and prednisolone was initiated. The patient deteriorated despite treatment and was admitted to the hospital. Blood tests revealed significant leukocytosis. Circulating large lymphocytes with convoluted and cerebriform nuclei seen in peripheral blood led to presumption of Sézary cells. Thus, considering skin, lymph nodes and blood involvement, Sézary syndrome was diagnosed.