OBJECTIVE: This study is undertaken to review the characteristics, risk factors and the surgical outcomes in long term follow-up of brain abscesses. METHODS: We had reviewed medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from January 1992 to June 2003. RESULTS: Observed 11 cases were comprised of 8 men and 3 women with 42 years old average age ranging from 17 to 66. Lesions were located at frontal lobe in 5 cases, parietal in 4 cases, temporal in 1 case, and occipital in 1 case. The mean follow-up period was 23.8 months and ranged from 5 to 33 months. The microbial sources of infection had been found in 5 cases (45%). The organisms were identified by using the microbial culture obtained from the excisional biopsy. We had applied all cases with surgical excision. Empirical antibiotic treatment started soon after diagnosis in all cases. The mortality and morbidity of surgical excision were low. Nine patients were neurologically improved. One patient had died after the operation due to acute respiratory distress syndrome (ARDS). CONCLUSION: The single and large abscess located in an accessible lesion is a good candidate for surgical excision because of it's low morbidity, mortality, and favorable outcome after surgical excision. Further study is required to compare the surgical excision with other treatment modalities of brain abscess.
Abscess ; Adult ; Anti-Bacterial Agents ; Biopsy ; Brain Abscess* ; Brain* ; Diagnosis ; Female ; Follow-Up Studies ; Frontal Lobe ; Humans ; Male ; Medical Records ; Mortality ; Rabeprazole ; Respiratory Distress Syndrome, Adult ; Risk Factors

The significance of intraoperative electrophysiologic monitoring during microvascular decompression was evaluated prospectively in 261 patients with the hemifacial spasm from 1985 to 1995. The patients were divided into a monitored group and a non-monitored group. Identification of the offending vessels was facilitated by the monitoring during the surgical procedure and the complication rate of the monitored group was significantly lower than that of the non-monitored group (p< 0.05). In addition, the abnormal muscle response continued to improve during the follow-up period, thus the electrophysiological status of the hemifacial spasm after the microvascular decompression improved significantly with time (p< 0.05). In conclusion, intraoperative monitoring is useful for identifying the exact offender among multiple vessels, and lowering the complication rate of the microvascular decompression for the hemifacial spasm.
Adult ; *Decompression, Surgical ; *Facial Muscles ; Female ; Follow-Up Studies ; Human ; Male ; Middle Age ; *Monitoring, Intraoperative ; Spasm/physiopathology/*surgery

Ganglions commonly occur on the hand, wrist, knee, ankle and foot, with occasional development around the hip joint. Ganglion in the acetabular fossa is rare. We present a case of a ganglion in the acetabular fossa of the hip with treatment.
Animals ; Ankle ; Foot ; Ganglion Cysts ; Hand ; Hip ; Hip Joint ; Knee ; Wrist

Axillary ultrasonography (US) is the most commonly used imaging modality for nodal evaluation in patients with breast cancer. No Axillary Surgical Treatment in Clinically Lymph Node-Negative Patients after Ultrasonography (NAUTILUS) is a prospective, multicenter, randomized controlled trial investigating whether sentinel lymph node biopsy (SLNB) can be safely omitted in patients with clinically and sonographically node-negative T1–2 breast cancer treated with breast-conserving therapy. In this trial, a standardized imaging protocol and criteria were established for the evaluation of axillary lymph nodes. Women lacking palpable lymph nodes underwent axillary US to dismiss suspicious nodal involvement.Patients with a round hypoechoic node with effaced hilum or indistinct margins were excluded. Patients with T1 tumors and a single node with a cortical thickness ≥ 3 mm underwent US-guided biopsy. Finally, patients with negative axillary US findings were included. The NAUTILUS axillary US nodal assessment criteria facilitate the proper selection of candidates who can omit SLNB.

Background: Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. Methods: This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. Results: Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month–17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had LennoxGastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9–38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1–8 days after symptom onset. Pneumonia progressed in these children for 2–6 days and was improved within 5–32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases.Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9–39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. Conclusion To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population.