Cerebral cysticercosis is unfortunately a frequent disease in Korea. Cysticercosis in the ventricular system is most frequently found in the fourth ventricle. However it is found rarely in the lateral and third ventricle. Recently, we have encountered accidently a lateral ventricular cysticercosis during a V-P Shunt operation on a 32 year old hydrocephalus patient. The diagnosis was confirmed by the presence of an encysted larvae on aspiration.
Adult ; Cysticercosis* ; Diagnosis ; Fourth Ventricle ; Humans ; Hydrocephalus ; Korea ; Larva ; Lateral Ventricles* ; Third Ventricle

Post-stroke epilepsy presenting as paroxysmal pain is rare. In most cases, the characteristic pain nature responsible for this kind of post-stroke epilepsy is associated with lesion of somatosensory areas. In this case, however, the precental motor cortex was responsible lesion site. A 60-year-old male with right frontal cortical and subcortical infarction complained paroxysmal shock like painful sensation on left lower extremity. This sensory symptom began after 2 weeks of stroke, and all analgesics failed to relieve the pain. EEG revealed sharp and slow wave at right frontotemporal region. Antiepileptic drug medication dramatically reduced the pain. In addition, epileptiform discharge disappeared after antiepileptic medication. In this paper, we report a post-stroke epilepsy presenting as focal paroxysmal pain associated with involvement of precental motor cortices.
Analgesics ; Cerebral Infarction ; Electroencephalography ; Epilepsy* ; Humans ; Lower Extremity ; Male ; Middle Aged ; Motor Cortex ; Sensation ; Shock ; Stroke

BACKGROUND: The optimal dose infusion of 0.125% bupivacaine via a femoral catheter after total knee replacement (TKR) has not been defined. This study examined various dose infusions of bupivacaine to determine the analgesic quality in patients receiving a continuous femoral nerve block (CFNB). METHODS: Patients were randomized to receive a single-injection femoral nerve block (SFNB) or CFNB performed with 20 ml of 0.125% bupivacaine, followed by a continuous infusion of 0.125% bupivacaine in four groups (n = 20 per group): 1) 0 ml/h (SFNB), 2) 2 ml/h, 3) 4 ml/h, and 4) 6 ml/h. The pain intensity at rest and on knee movement was assessed using a visual analog scale (VAS) for the first 2 postoperative days. The cumulative bolus use of IV patientcontrolled analgesia (PCA) with a morphine-ketorolac combination was evaluated. RESULTS: A lower cumulative bolus of IV PCA was noted in all CFNB groups compared to SFNB on postoperative days (PODs) 1 and 2, respectively (P < 0.05). Lower VAS scores at rest were observed in the 4 ml/h and 6 ml/h groups than in the SFNB group on PODs 1 and 2, respectively, but only on POD 2 in the 2 ml/h group (P < 0.05). Lower VAS scores on movement were noted in the 4 ml/h than the SFNB group on PODs 1 and 2, but only on POD 1 in 6 ml/h (P < 0.05). CONCLUSIONS: The minimum effective infusion rate of 0.125% bupivacaine for CFNB after TKR appears to be 4 ml/h according to the VAS pain scores.
Analgesia ; Analgesia, Patient-Controlled ; Arthroplasty, Replacement, Knee ; Bupivacaine ; Catheters ; Femoral Nerve ; Humans ; Knee ; Passive Cutaneous Anaphylaxis

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.
Acute Kidney Injury* ; Adolescent ; Azotemia ; Biopsy ; Bone Marrow ; Calcitonin ; Calcium ; Child ; Diuretics ; Hematologic Neoplasms ; Humans ; Hypercalcemia* ; Hyperparathyroidism ; Induction Chemotherapy ; Leukemia ; Male ; Nephrocalcinosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Renal Dialysis ; Renal Insufficiency