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- 저자 : Jeon Chiman (검색결과 2 건)
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Jeon, Chiman,Hong, Sang Duk,Seol, Ho Jun,Lee, Jung-Il,Nam, Do-Hyun,Hwang, Yoon Jung,Kong, Doo-Sik Elsevier 2017 Journal of clinical neuroscience Vol.45 No.-
<P><B>Abstract</B></P> <P>Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery. We performed surgical repairs with a multilayered nonvascularized construct (38 patients) and a vascularized pedicled nasoseptal flap construct combined with a fascia graft (57 patients). Overall, 14 of 95 patients (14.7%) who underwent endoscopic transnasal surgery for skull base tumors developed postoperative CSF leaks. The major causes of repair failure included graft disruption by a lack of counter-pressure in the multilayered non-vascularized technique, and inadequate drilling of the sphenoid bone, displacement of the flap due to pressure from CSF or gravity, or disruption of flap integrity in the vascularized pedicled flap technique. Logistic regression analysis revealed that there was no significant association between repair failure and age, sex, type of reconstructive method used, and primary tumor type (<I>p</I> >0.05). Reconstruction after endoscopic endonasal surgery remained challenging, especially for non-pituitary skull base tumors requiring intra-arachnoidal dissection. Recent advances in reconstructive techniques require the accumulation of experiences with sufficient dexterity to achieve an acceptable morbidity rate.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We assessed the repair outcome for CSF leak after transnasal endoscopic surgery for non-pituitary skull base tumors. </LI> <LI> Postoperative CSF leaks occurred in 14 of 100 patients (14.0%) after endoscopic transnasal surgery for skull base tumors. </LI> <LI> Repair failure after endoscopic transnasal surgery for skull base tumors remained challenging. </LI> </UL> </P>
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고혈관성 종양으로 오인된 Trichophyton verrucosum에 의한 두피 백선종창 1례
Kim Kyung-Ran,Park Hwanhee,Kim Doo Ri,Yoon Yoonsun,Jeon Chiman,Lee Sanghoon,Lim So Young,Kim Ji Hye,Kim Yae-Jean 대한소아감염학회 2022 Pediatric Infection and Vaccine Vol.29 No.2
A dermatophyte is a zoonotic infection that causes infection on the skin, hair, and nails and is transmitted through contact. The species of Microsporum, Trichophyton, and Epidermophyton are the major dermatophytes that infect humans. Tinea capitis is a dermatophyte infection in the scalp, and it may progress to kerion celsi, including severe redness, swelling, and pus formation. Kerion celsi is sometimes misdiagnosed as a bacterial infection or a tumor. Trichophyton verrucosum is a zoophilic dermatophyte that mainly causes infection in cattle. It can be spread to dairy farmers or ranchers who have frequent contact with infected cattle. We report a pediatric case who received scalp tumor excision and a split-thickness skin graft for extensive and severe inflammatory scalp tumors that occurred after contact with cattle with ringworm. Finally, the patient was diagnosed with kerion celsi caused by T. verrucosum infection. This was based on the patient’s medical history, clinical manifestations, and histopathologic findings. 피부사상균은 접촉을 통해 피부, 모발, 손발톱 등에 감염을 일으키며, 심한 경우 백선종창으로 진행되기도 한다. 건강했던 4세 여자 환자가 심한 두피병변으로 내원하여 세균, 진균감염뿐만 아니라 고혈관성 종양도 의심되어 두피 종양 절제술과 피부이식까지 받았다. 저자들은 면밀한 병력청취와 신체 진찰 및 임상양상을 토대로 Trichophyton verrucosum을 의심하여, 최종적으로 조직병리검사 소견을 종합하여 T. verrucosum에 의한 백선종창으로 진단 및 치료한 증례 1 례를 보고하는 바이다.
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