Focal brainstem encephalitis due to Herpes simplex virus if a very rare infectious disease, occurs with a frequent of 1-2 million population per year. A 3 years old girl is described with infection due to Herpes simplex virus causing brainstem encephalitis. The diagnosis was established by enzyme immunosorbent assays of the cerebrospinal fluid and serum which demonstrated antibody responsed to Herpes simplex virus. The clinicopathological features, radiological findings, laboratories and brainstem biopsies are discussed in the context of the literature.
Biopsy ; Brain Stem* ; Cerebrospinal Fluid ; Child, Preschool ; Communicable Diseases ; Diagnosis ; Encephalitis* ; Female ; Herpes Simplex* ; Humans ; Simplexvirus*

BACKGROUND: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. METHODS: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. RESULTS: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. CONCLUSIONS: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.
Anticonvulsants ; Electric Stimulation Therapy ; Follow-Up Studies ; Glomerular Filtration Rate ; Health Resorts ; Humans ; Kidney ; Kidney Diseases ; Neuralgia, Postherpetic ; Pain, Intractable ; Renal Insufficiency, Chronic ; Spinal Cord ; Spinal Cord Stimulation

No abstract available.
Orientia tsutsugamushi* ; Rickettsia* ; Ulsan*

BACKGROUND: This study was purposed to study the therapeutic value of intraluminal oxygen insufflation on the oxygenation of gut mucosa in a feline model subjected to a hemorrhagic shock followed by reperfusion. METHODS: Eighteen cats were divided into three groups : For group 1, 6 cats were subjected to sham operation as a control group ; for group 2, 6 cats were subjected to a hemorrhagic shock for 2 hours prior to reperfusion as a hemorrhagic shock(HS) group ; for group 3, 6 cats were subjected to a simultaneous insufflation of intraluminal oxygen, continued during the shock and reperfusion periods as a oxygenated hemorrhagic shock(OHS) group. Mesenteric PvO2, mesenteric venous arterial(v-a) lactate difference, mesenteric P(v-a)CO2 and mesenteric pH(a-v) were measured for every 30 minutes during the shock and reperfusion. RESULTS: The lactate(v-a) was increased during the shock. For group OHS, the lactate(v-a) returned to the baseline value after reperfusion, but for group HS, it did not return. The values of pH(v-a) and P(v-a)CO2 were increased during the shock and returned to the baseline value for group OHS, but for group HS, the increase was greater than group OHS(p<0.05), but not returned to the baseline value after reperfusion. For both pH(v-a) and P(v-a)CO2, there were statistically significant differences(p<0.05) between group HS and group OHS during the shock and reperfusion. CONCLUSIONS: We conclude that the insufflation of intraluminal oxygen improves the oxygenation of gut mucosa in the feline model undergone a hemorrhagic shock followed by reperfusion.
Animals ; Cats* ; Insufflation* ; Lactic Acid ; Mucous Membrane* ; Oxygen* ; Reperfusion ; Shock ; Shock, Hemorrhagic

Small osteophytes are frequently encountered in the foot and ankle, and not to be confused with true osteochondromas, which are relatively uncommon in this region. Osteochondromas are the most common benign osseous neoplasm, occurs in the metaphysis of the long bone. It is rarely found in bones of the foot. Treatment of the osteochondroma is usually conservative, unless symptoms usually pain, are progressive rapid growth, and malignant transformation is suspected. We experienced a rare case of hallux rigidus with osteochondroma of the hallucal proximal phalanx which cause pain and corn of the plantar.
Animals ; Ankle ; Foot ; Hallux ; Hallux Rigidus ; Osteochondroma ; Osteophyte ; Zea mays

Kasabach-Merritt syndrome presents various problems for anesthetic management, which include thrombocytopenia, bleeding tendency, and problems arising from the hemangioma mass itself. A 1-month-old male was given sclerotherapies, platelet transfusions, steroid, interferon alpha, vincristine because of the bleeding from the right lower leg hemangioma, but platelet numbers were decreased and seizures occurred due to frontal lobe focal hemorrhage. After all, he was scheduled for his right lower leg amputation when he was 7 months old. Anesthesia was carefully induced with thiopental, rocuronium, fentanyl, and flexible bronchoscope. It was maintained with sevoflurane and air/oxygen with fentanyl injection. Although excessive bleeding was expected during anesthesia and surgery, the operation was performed without correction of platelet number. Two days later, postoperative course was improved almost normal.
Amputation ; Androstanols ; Anesthesia ; Bronchoscopes ; Fentanyl ; Frontal Lobe ; Hemangioma ; Hemorrhage ; Humans ; Infant, Newborn ; Interferon-alpha ; Kasabach-Merritt Syndrome ; Leg ; Male ; Methyl Ethers ; Platelet Count ; Platelet Transfusion ; Sclerotherapy ; Seizures ; Thiopental ; Thrombocytopenia ; Vincristine

Hereditary spastic ataxia is a familial neurological disorder which exhibit the features of a progressive combined pyramidal tract and cerebellar deficiency. The main features are progressive gait disturbance, incoordination, nystagmus, visual impairment, hyperreflexia, extensor plantar response, peripheral neuropathy, and pes cavus. A 27-year-old male patient with spastic ataxic gait was evaluated. He showed characteristic features of hereditary spastic ataxia. There were another twelve affected members in four generations of his family which may be inherited by autosomal dominant pattern. One of them is reported with review of the literature on familial spastic ataxia.
Adult ; Ataxia* ; Family Characteristics ; Foot Deformities ; Gait ; Humans ; Male ; Muscle Spasticity* ; Nervous System Diseases ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Reflex, Abnormal ; Reflex, Babinski ; Vision Disorders

The spontaneous hematomyelia is an uncommon event and its predisposing conditions are vascular malformation, syringomyelia, pregnancy and delivery, angioma, hemophilia, anticoagulant therapy, etc. We have recently experienced the patient with spontaneous onset and resolving hematomyelia in the cervical spinal cord. A 30-year-old male patient with non-traumatic spinal shock was evaluated. On MRI, a hematomyelia along cervical spi-nal cord was revealed. A suspicious AV malformation was noticed at C3-4 level. Fol-low-up MRIs showed spontaneous resolution of the hematoma.
Adult ; Hemangioma ; Hematoma ; Hemophilia A ; Humans ; Magnetic Resonance Imaging ; Male ; Pregnancy ; Shock ; Spinal Cord ; Spinal Cord Vascular Diseases* ; Syringomyelia ; Vascular Malformations

Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.
Adult* ; Femur ; Hemangioendothelioma* ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Korea ; Pelvic Bones ; Spine ; Vascular Neoplasms

Survival rates of preterm infants have improved in the past few decades, and central venous catheters play an important role in the intensive medical treatment of these neonates. Unfortunately, these indwelling catheters increase the risk of intracardiac thrombosis, and they provide a nidus for microorganisms during the course of septicemia. Herein, we report a case of persistent bacteremia due to methicillin-resistant Staphylococcus aureus in an extremely low birth weight (ELBW) infant, along with vegetation observed on an echocardiogram, the findings which are compatible with a diagnosis of endocarditis. The endocarditis was successfully treated with antibiotic therapy, and the patient recovered without major complications. We suggest a surveillance echocardiogram for ELBW infants within a few days of birth, with regular follow-up studies when clinical signs of sepsis are observed.
Bacteremia ; Catheterization, Central Venous ; Catheters, Indwelling ; Central Venous Catheters ; Diagnosis ; Endocarditis* ; Follow-Up Studies ; Humans ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Parturition ; Sepsis ; Survival Rate ; Thrombosis