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Congestive myelopathy due to spinal dural arteriovenous fistula mimicking CNS demyelinating disease
Nakhoon Kim,Hongil Kim,Hyunkee Kim,Jinseok Park 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.4
Spinal dural arteriovenous fistula (SDAVF) is known for its ambiguous and various clinical presentations. Among these presentations, congestive myelopathy is one of the most common, yet it is challenging to correctly diagnose SDAVF at initial presentation. Several diseases present as myelopathy, including demyelinating diseases. Herein, we present two cases of congestive myelopathy due to SDAVF presenting to the emergency room (ER) with progressive quadriparesis. Even though the patients had a proper magnetic resonance imaging (MRI) examination from the initial presentation, there was a delay in making a final diagnosis. Both patients’ clinical presentation and MRI mimicked central nervous system (CNS) demyelinating disease initially, and a more thorough examination revealed SDAVF. Such a delay in diagnosis can result in more neurological deterioration and may result in more sequelae. Hence, SDAVF should always be considered as a differential diagnosis when examining patients with myelopathy.
Lower Cranial Nerve Palsy due to Prevertebral Tuberculosis Infection
Nakhoon Kim,Hyunkee Kim,Il Mo Kang,Young Seo Kim 대한신경초음파학회 2021 대한신경초음파학회지 (JNN) Vol.13 No.2
Prevertebral tuberculosis is a rare infectious disease that often affects immunocompromised patients in developing countries. We present the case of a patient who complained of headache, dysarthria, and dysphagia. Neurological examination revealed multiple cranial nerve palsies, including the hypoglossal, glossopharyngeal, and vagus nerves. Brain magnetic resonance imaging demonstrated an infiltrative lesion in the prevertebral space, and the biopsy revealed chronic inflammation. On suspicion of immune-mediated inflammation, the patient was treated with intravenous dexamethasone and oral prednisolone, with minimal response. Eleven months after the initial diagnosis, the patient’s neurological symptoms were aggravated, and we detected newly developed pulmonary tuberculosis. After the treatment of pulmonary tuberculosis, his neurological symptoms improved, and the imaging study demonstrated improvements. Although we lacked positive laboratory or biopsy results for tuberculosis, we suspect that the lesions were distant tuberculosis infections. Tuberculosis should be considered in patients with unknown infiltrative mass-like lesions in the prevertebral spaces.
블록체인 기반의 범서비스적 저작권 보호 및 관리 시스템
최낙훈(Nakhoon Choi),김희열(Heeyoul Kim) 한국정보기술학회 2021 한국정보기술학회논문지 Vol.19 No.9
In this paper, we propose a system for protecting and tracking intellectual property using blockchain and collective intelligence. The proposed system is constructed though Hyperledger Fabric and constructed consorcium with node which Video-hosting-service. User of Video-hosting-service can register and track their intellectual property in the blockchain, and can propse a copyright transfer contract to the original author for the use of intellectual property. Users of the system can use Flag, an objection for self-purification for registered video media, and the media that is raised is managed through a collective intelligence-based voting process. In addition, through compensation policy, user participation is categorized and forward voting is induced. Tracking, contracting and midnight of intellectual property are applied to copyright holders of node services that do not belong to them, and it has a high effect on sharing intellectual property rights protection value.