Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.
Ankle Joint ; Ankle ; Recurrence ; Synovial Membrane ; Synovitis, Pigmented Villonodular

Neurocysticercosis (NCC) by Taenia solium is the most common parasitic infection of the central nervous system involving the cerebrum. However, spinal involvement of NCC is rare. Spinal NCC can cause radiculopathy, myelopathy, cauda equina syndrome, and even paraparesis, depending on its location and size. Spinal NCC may require surgical treatment as a first-line treatment because medical therapy can further aggravate the inflammation due to dead cysts, resulting in clinical deterioration. The current standard therapy for spinal NCC is surgical decompression followed by medical therapy. We experienced a case of widespread thoracolumbar intradural extramedullary cysticercosis involving the spinal canal with cerebral cysticercosis. We report this rare case with literature review.
Central Nervous System ; Cerebrum ; Cysticercosis* ; Decompression, Surgical ; Humans ; Inflammation ; Neurocysticercosis ; Paraparesis ; Polyradiculopathy ; Radiculopathy ; Spinal Canal* ; Spinal Cord Diseases ; Spine ; Taenia solium

STUDY DESIGN: Case report. OBJECTIVES: We report a case of widespread lumbosacral subdural abscess in a patient who underwent bee venom therapy. SUMMARY OF LITERATURE REVIEW: Subdural abscess is rare, but has a poor prognosis. Therefore, prompt recognition and appropriate treatment are paramount. MATERIALS AND METHODS: A 54-year-old woman was hospitalized due to severe back pain. Two days previously, she had undergone bee venom therapy. The patient then visited the emergency room because of severe back pain. However, a paraspinal infection was not detected on enhanced magnetic resonance imaging (MRI). Six days after admission, the patient showed signs of meningeal irritation and an emergency cerebrospinal fluid analysis showed typical findings of bacterial meningitis. Although adequate antibiotic treatment was administered, 20 days after admission, the patient's symptoms became aggravated. Pachymeningeal enhancement, myelomeningitis, and subdural abscess compressing the cauda equina were found on enhanced MRI. Thus, laminectomy between L3–L4 and L5–S1 was performed, as well as subdural abscess drainage. Antibiotic agents were applied for 6 weeks after the operation, and resolution of the subdural abscess was identified on follow-up MRI. RESULTS: In this patient, lumbosacral subdural abscess occurred due to bee venom therapy. It was cured by adequate surgical and antibiotic treatment. CONCLUSIONS: Bee venom therapy can cause subdural abscess of the spinal cord. Even if it is a rare case, this possibility is worth consideration in the Korean medical context.
Abscess ; Back Pain ; Bee Venoms ; Bees ; Cauda Equina ; Cerebrospinal Fluid ; Drainage ; Emergencies ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Meningitis, Bacterial ; Middle Aged ; Prognosis ; Spinal Cord ; Spine

STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
Analgesia ; Analgesia, Patient-Controlled ; Decompression ; Humans ; Injections, Epidural ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Spinal Stenosis ; Vomiting

OBJECTIVES: We report a case of widespread lumbosacral subdural abscess in a patient who underwent bee venom therapy.SUMMARY OF LITERATURE REVIEW: Subdural abscess is rare, but has a poor prognosis. Therefore, prompt recognition and appropriate treatment are paramount. MATERIALS AND METHODS: A 54-year-old woman was hospitalized due to severe back pain. Two days previously, she had undergone bee venom therapy. The patient then visited the emergency room because of severe back pain. However, a paraspinal infection was not detected on enhanced magnetic resonance imaging (MRI). Six days after admission, the patient showed signs of meningeal irritation and an emergency cerebrospinal fluid analysis showed typical findings of bacterial meningitis. Although adequate antibiotic treatment was administered, 20 days after admission, the patient's symptoms became aggravated. Pachymeningeal enhancement, myelomeningitis, and subdural abscess compressing the cauda equina were found on enhanced MRI. Thus, laminectomy between L3–L4 and L5–S1 was performed, as well as subdural abscess drainage. Antibiotic agents were applied for 6 weeks after the operation, and resolution of the subdural abscess was identified on follow-up MRI. RESULTS: In this patient, lumbosacral subdural abscess occurred due to bee venom therapy. It was cured by adequate surgical and antibiotic treatment. CONCLUSIONS Bee venom therapy can cause subdural abscess of the spinal cord. Even if it is a rare case, this possibility is worth consideration in the Korean medical context.

OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression.SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.

No abstract available.
Alagille Syndrome* ; Cholestasis ; Xanthomatosis*

No abstract available.
Hemangioma ; Kasabach-Merritt Syndrome ; Skin Neoplasms

No abstract available.
Hemangioma ; Kasabach-Merritt Syndrome ; Skin Neoplasms

BACKGROUND: Malassezia species play an important role in the pathogenesis of seborrheic dermatitis. In particular, M. restricta and M. globosa are considered to be the predominant organisms in seborrheic dermatitis of Western countries. However, species distribution of Malassezia in seborrheic dermatitis has not been clearly determined yet in Asia. OBJECTIVE: To identify the distribution of Malassezia species on the scalp of seborrheic dermatitis patients in Korea using 26S rDNA PCR-RFLP analysis. METHODS: A total of 40 seborrheic dermatitis patients and 100 normal healthy volunteers were included in this study. For the identification of Malassezia species, the scalp scales of the subjects were analyzed by 26S rDNA PCR-RFLP analysis. RESULTS: The most commonly identified Malassezia species were M. restricta in the seborrheic dermatitis patients, and M. globosa in the normal controls. In the seborrheic dermatitis group, M. restricta was identified in 47.5%, M. globosa in 27.5%, M. furfur in 7.5%, and M. sympodialis in 2.5% of patients. In the healthy control group, M. globosa was identified in 32.0%, M. restricta in 25.0%, M. furfur in 8.0%, M. obtusa in 6.0%, M. slooffiae in 6.0%, and M. sympodialis in 4.0% of subjects. CONCLUSION: M. restricta is considered to be the most important Malassezia species in Korean seborrheic dermatitis patients.
Dermatitis, Seborrheic ; DNA, Ribosomal ; Humans ; Korea ; Malassezia ; Scalp ; Weights and Measures