BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Adult ; Choroid Diseases/*surgery ; Choroidal Neovascularization/etiology/*surgery ; Diagnostic Techniques, Ophthalmological ; Female ; Human ; Interferometry ; Laser Coagulation/*adverse effects ; Light ; Male ; Retinal Diseases/*surgery ; Tomography ; Treatment Outcome ; Visual Acuity

No abstract available.
Scoliosis* ; Syringomyelia*

Diencephalic syndrome of infancy which is characterized by progressive and profound emaciation often with normal or accelerated skeletal growth, hyperkinesias, hypotension, and hypoglycemia. The profound emaciation so characteristic this syndrome has yet to be explained. The diencephalic syndrome is caused by low grade astrocytoma, ependymoma in the third ventricle including the hypothalamus. Authers report a case of diencephalic syndrome which was confirmed in this patient with ependymoma in the region of anterior hypothalamus by transcallosal approach.
Astrocytoma ; Emaciation ; Ependymoma ; Humans ; Hyperkinesis ; Hypoglycemia ; Hypotension ; Hypothalamus ; Hypothalamus, Anterior ; Third Ventricle

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

A majority of patients who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but gradual return of sensation that is functional and tolerable, if not the same as before the injuries. However, long-term effects of such injuries are aggravating for many patients, and a few patients experience significant suffering. In some of these patients, posttraumatic symptoms become pathological and are painful. The predominant painful components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning and aching causalgiaform pain, and (4) phantom pain. This is a case report of conservative management of traumatic neuralgia and neuritis as part of posttraumatic pain syndromes in geriatric patients who have undergone the teeth extraction and alveoloplasty.
Alveoloplasty* ; Anesthesia ; Burns ; Humans ; Jaw ; Neuralgia* ; Neuritis ; Phantom Limb ; Sensation ; Tooth Extraction ; Tooth*

OBJECTIVE: Surgical site infection (SSI) is a problem constantly uppermost in the minds of all surgeons, although the actual rate of occurrence is only 1-5% in general surgery. In neurosurgical fields, there have been a few papers published about efficacy of post-operative antimicrobial prophylaxis (PAMP) to prevent SSI, compared to well known effectiveness of pre-operative antibiotics. Thus, infection rates of short-term PAMP groups and those of long-term PAMP groups were investigated to evaluate the effectiveness of PAMP and the efficacy of short-term PAMP compared to long-term PAMP for prevention of SSI. METHODS: Between April 2010 and April 2012, we retrospectively analyzed the data of 35 patients in the aneurysmal neck clipping groups (short-term PAMP group: PAMP for 3 days and fewer, long-term PAMP group: PAMP for 10 days and more) and 79 patients in the microdiscectomy groups (short-term PAMP group: 3 days and fewer, long-term PAMP group: PAMP for 6 days and more). RESULTS: In aneurysmal neck clipping groups, SSI occurred 23.1% of short-term PAMP group and 9.1% of long-term PAMP group (p=0.3370). And in microdiscectomy groups, SSI occurred 6.7% of short-term PAMP group and 4.1% of long-term PAMP group (p=0.9840). CONCLUSION: There is no significant difference between the short-term PAMP group and the long-term PAMP group in terms of SSI, regardless of operation type. We therefore suggest that short-term PAMP usage could be an appropriate therapy for preventing SSI in clean neurosurgical operations.
Aneurysm ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Humans ; Neck ; Neurosurgical Procedures ; Retrospective Studies ; Surgical Wound Infection

OBJECTIVES: The aim of this study was to evaluate the therapeutic effect of Korean-type cognitive behavioral group therapy (CBGT) in the treatment of social anxiety disorder (SAD). METHODS: Twenty-nine patients with SAD completed the Korean-type CBGT for SAD. The Korean-type CBGT for SAD is characterized by Korean-culture specific methods such as paradoxical intention, video feedback, and Korean cultural receptivity process on the classical CBGT course. The main outcome measure was a self-report version of the Liebowitz Social Anxiety Scale (LSAS-SR). RESULTS: After the treatment, the total score on the LSAS-SR had significantly improved (15.80+/-29.14, p=0.006, cohen's d=0.69), with both fear and avoidance subscales decreased (7.60+/-13.94, p=0.006 vs. 8.30+/-16.31, p=0.009, respectively). We also found significant correlation between the effect of the Korean-type CBGT (r=0.414, p=0.026) and the educational level of subjects. Accompanying pharmacotherapy for SAD did not elicit any differences in the treatment response. CONCLUSION: Our study showed that the Korean-type CBGT was effective in the treatment of SAD patients in reducing both fear and avoidance symptoms.
Anxiety ; Anxiety Disorders ; Humans ; Intention ; Outcome Assessment (Health Care) ; Psychotherapy, Group