Intraparenchymal Neurocysticercosis Unmasked by Cessation of Oral Corticosteroids: Immune Evasion and Therapeutic Approaches

In a unique case of neurocysticercosis in Korea, a 73-year-old woman previously treated with steroids for rheumatoid arthritis exhibited neurological symptoms following steroid cessation. Magnetic resonance imaging findings confirmed vesicular stage neurocysticercosis, and subsequent antiparasitic treatment led to symptom resolution. The immunopathology of neurocysticercosis involves intricate interactions between the cyst’s immune evasion mechanisms and host inflammatory responses. The parasites’ strategy of inducing Th2- mediated anti-inflammatory responses for survival suggests potential therapeutic options for autoimmune disorders.

A Statistical Analysis of Superior Orbital Fissure Width in Korean Adults using Computed Tomography Scans

BACKGROUND: The superior orbital fissure is a small area that connects the middle cranial fossa and the orbit. Many studies have measured the size of the superior orbital fissure. However, there is no standard value for the size of the superior orbital fissure. Therefore, we conducted this study to provide the average size of the superior orbital fissure in Korean adults. METHODS: We measured the widths of the superior orbital fissures of 142 patients using computed tomography scans. Because the width of the superior orbital fissure varies at different locations, we measured the superior orbital fissure width at the level of the optic canal. RESULTS: In the males, the width of the superior orbital fissure on both sides was 3.79±0.93 mm, and these values were 3.79±0.96 mm for the left side and 3.783±0.92 mm for the right side. In the females, the widths of the superior orbital fissures were 3.62±1.35 mm on the left side, 3.69±1.18 mm on the right side, and 3.65±1.26 mm across both sides. CONCLUSION: There were no significant differences between the males and females or between the left and right sides. The present study suggests that we may accept the hypothesis that a congenitally narrow superior orbital fissure may be a risk factor for the superior orbital fissure syndrome. Surgeons should take precaution with patients who have narrow superior orbital fissures during the perioperative period.

Hand Injury Patterns Caused by Different Electric Saws in South Korea

PURPOSE: Electric saw is widely used and patients involved with the tool are increasing. We made efforts to analyze data of saw-related hand injuries. METHODS: Electric saw-related hand injuries that required operation were analyzed retrospectively by reviewing medical charts, clinical photographs and X-ray films from 2009 through 2013. Additionally, we interviewed patients regarding the type of electric saw involved (hand-held/table-mounted) and how the hand was injured. RESULTS: There were 16 male patients with 19 injured fingers and 22 injured tendons. Due to the damaging mechanism of the electric saw, injuries were severe and complex such as tendon, bone defects, fractures and amputations. 4 fingers had open fractures. Separately, 4 were amputated. Non-dominant hands were injured more by hand-held saw, while, dominant hands were damaged more by table-mounted saw. The thumb and index fingers were injured mostly by electric saw. Probability of dominant and non-dominant hand injury depends on the types of electric saw because of the working position when using this tool. CONCLUSION: Hand injuries can be classified according to the type of electronic saw used. Complete understanding of a specific trauma mechanism and the resulting injury patterns is important especially for hand surgeons. Surgeons should take into account the type of electric saw when examining patients. However, the most important step to prevent these types of injuries is to provide all workers with appropriate training and precautions before using the electric saw.

A Skin Ulceration Complicated by Alcaligenes Xylosoxidans Infection

A. xylosoxidans infection can result in potentially severe sequelae, especially in unhealthy populations. We present a rare case of infectious skin ulceration with scar contracture due to A. xylosoxidans in a healthy patient. A 53-year-old male patient without underlying disease and trauma history visited our department for an irritating skin ulcer with purulent discharge on the right lower leg. The chronic wound on the leg exists since he got contact burn 30 years ago. The wound did not respond to treatment, and the wound culture results indicated A. xylosoxidans. Given the incurable character of A. xylosoxidans, we performed a wide excision and split thickness skin graft with collagen-elastin matrix (Matriderm(R)). A. xylosoxidans is an opportunistic, aerobic, gram-negative, rod-shaped bacterium that is oxidase positive. According to reports, A. xylosoxidans is not sensitive to many antibiotics and can cause bacteremia. It is suggested that the blood supply is compromised near a scar lesion despite the fact that blood flow is rather increased during the initial scar formation phase. Therefore, we presumed that the infection was most likely caused by low blood circulation due to scar contracture. Thus, when a scar contracture is present, A. xylosoxidans infection can manifest in a healthy patient.