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RISS 인기검색어
- 검색키워드
- 저자 : 우호걸(Ho Geol Woo) (검색결과 3 건)
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김재민(Jae Min Kim),우호걸(Ho Geol Woo),이도경(Do kyung Lee),곽형우(Hyung Woo Kwak),안태범(Tae Beom Ahn) 대한안과학회 2016 대한안과학회지 Vol.57 No.4
목적: 아스페르길루스 안내염이 선행한 중추신경계림프종 1예를 보고하고자 한다. 증례요약: 66세 여자가 3일 전부터 발생한 의식저하로 신경과에 입원하였다. 환자는 입원 7개월 전 양안의 시력저하로 양안 망막혈관염을 진단 받고 스테로이드를 복용하였다. 증상이 호전되지 않아서 입원 3개월 전 유리체액배양을 시행하였는데 아스페르길루스가 동정되었고, 아스페르길루스 안내염 진단하에 유리체 내 보리코나졸 주입술, 보리코나졸 정맥주사 및 경구요법을 시행하였다. 처음 시행한 뇌척수액검사와 뇌자기공명영상은 정상이었다. 그러나 입원 2개월 전 뇌자기공명영상에서 다발성 조영증강병변이 발견되었고, 입원 시에 더 악화되었다. 조직검사는 환자 상태가 나빠서 시행할 수 없었다. 중추신경계 림프종 가능성이 가장 높다고 판단하였다. 스테로이드 투여 및 방사선 치료를 시행하였고 치료 후 종양의 크기는 감소하였으며, 신경학적으로도 호전되었다. 결론: 아스페르길루스 안내염은 면역저하상태에서 기회감염으로 발생하며 안구가 중추신경계에 인접하여 있으므로 중추신경계 질환을 고려해야 한다. 안내염으로 설명되지 않는 신경학적 증상에 대한 인지 및 신경학적 검진이 중요하며 적시에 영상진단을 시행하는 것이 필요하다. Purpose: To report a rare case of Aspergillus endophthalmitis as a preceding symptom of central nervous system (CNS) lymphoma. Case summary: A 66-year-old female was admitted to our clinic with mental change for 3 days. Seven months earlier, she had been diagnosed with retinal vasculitis in an ophthalmology clinic because of blurred vision in both eyes and was administered steroid therapy. Three months earlier, because of progressive symptoms, vitreous fluid culture had been performed and showed Aspergillus endophthalmitis. She was treated with intravitreous voriconazole injection and oral voriconazole. Initial brain magnetic resonance imaging (MRI) and cerebrospinal fluid study was normal. Two months later, a second MRI showed multiple enhancing lesions, which were aggravated on the third MRI at admission to our clinic. Although brain biopsy was not performed due to the poor condition of the patient, CNS lymphoma was suspected based on the neuroimaging. After steroid pulse therapy and whole brain radiation, follow-up neurologic examination showed improved mental state, and follow-up MRI showed remarkable shrinkage of multiple lesions. Conclusions: As Aspergillus endophthalmitis is an opportunistic infection in those with an immune-compromised state and the orbit is near the central nervous system, the clinician should be alert to concomitant disorders in CNS. For a prompt and accurate diagnosis of CNS disorder, early evaluation of neurologic symptoms beyond symptoms of endophthalmitis and neuroimaging is essential.
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송수진,나부석,송종민,우호걸,이도경,안태범,Song, Soo Jin,Na, Boo Suk,Song, Jong Min,Woo, Ho Geol,Lee, Dokyung,Ahn, Tae-Beom 대한임상신경생리학회 2015 Annals of Clinical Neurophysiology Vol.17 No.2
A 59-year old man was admitted for drowsiness and stiff neck. CSF examination showed lymphocytic pleocytosis and PCR for herpes simplex virus (HSV)-1 was positive in CSF. Brain MRI revealed enhanced lesions in left temporal lobe. His symptom improved with acyclovir. Follow-up studies showed red blood cells in CSF and a hematoma in the left temporal lobe. There was no additional symptom related to the hematoma. He was discharged after conservative care. Although rare, hematoma can develop in HSV-1 meningoencephalitis.
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나부석,송수진,송종민,우호걸,권영남,이도경,안태범,Boo Suk Na,Soo Jin Song,Jong Min Song,Ho Geol Woo,Young Nam Kwon,Dokyung Lee,Tae-Beom Ahn 대한소화기암연구학회 2015 Journal of digestive cancer reports Vol.3 No.2
Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.
KCI
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