Escherichia Coli Subdural Empyema Following Subdural Hygroma in Elderly Patient

Subdural empyema of the brain is an uncommon disorder that occurs more frequently in children than in adult. Authors report a very rare of subdural empyema following the subdural hygroma after mild head injury. The exact mechanism of infection is not known. However, we have to consider subdural infection as one of differential diagnosis in elderly patient with subdural hygroma when new abnormal density lesion is developed in the subdural space.

Treatment Outcome of Ruptured Cerebral Aneurysms in the Elderly / 대한뇌혈관외과학회지

OBJECTIVE: This study aimed to assess the results of surgical and endovascular treatments in aneurysmal subarachnoid hemorrhage (SAH) patients older than 70 years. METHODS: This study included 18 patients, more than 70 years of age, treated for ruptured cerebral aneurysms between April 2004 and March 2009. In most cases, patients underwent the early obliteration procedure for each aneurysm, and we compared the clinical results according to the obliteration method (clipping or coiling). We assessed neurological outcomes at 6 months post-procedure according to the modified Rankin Scale (mRS): favorable (mRS score > 2) or unfavorable (mRS score > 2). RESULTS: Of the 18 patients, 12 (66.6%) underwent obliteration of the aneurysm sac via microvascular clipping patients, and 6 (33.3%) underwent endovascular coiling. At 6 months post-procedure, the clinical outcomes were favorable in 6 patients (33.3%), 5 (41.7%) who received microvascular clipping and 1 (16.7%) who underwent endovascular coiling. Unfavorable outcome was not statistically associated with poor initial clinical state, poor Fisher grade, occurrence of stroke, or hydrocephalus, although we frequently noted these variables in the unfavorable outcomes. CONCLUSIONS: In this study, aneurysm obliteration method (microvascular clipping vs. endovascular coiling) did not seem to significantly affect clinical outcomes. A poor initial clinical state, poor Fisher grade, occurrence of stroke, and hydrocephalus seemed to be associated with poor clinical outcomes.

Cognitive-evoked Potential Response in Low Back Pain Patients

OBJECTIVE: Cognitive-evoked potentials (P300) reflects a variety of cognitive functions and cognitive-behavioral strategies have been applied to a number of different chronic pain problems, including low back pain (LBP), headache, fibromyalgia, osteoarthritis, etc. Several studies showed delayed onset latency and increased amplitude of P300 in chronic LBP patients. The purpose of this study was to evaluate the cognitive processing differences in patients with chronic and acute LBP, and to examine the effectiveness of P300 to detect the mind of compensation in pending case. METHOD: P300 were recorded in 32 patients with LBP. We divided patients into two groups according to the duration of disease onset and the state of legal proceedings. RESULTS: P300 latency and amplitude was significantly increased in chronic LBP as compared with acute LBP (p <0.05). The state of legal proceedings showed no significant difference in P300 latency and amplitude. CONCLUSION: The results we gained suggested that the neurocognitive networks related to decision making and memory processing seemed to work differently in chronic and acute pain. Mind of compensation did not seem to be related with P300 in LBP patients.

Clinical Features and Long-term Outcome of Lower Extremity Amputees: A Follow-up Questionnaire Study in Three Regional Centers

OBJECTIVE: To evaluate the clinical features of lower extremity amputees and the process of prosthetic fitting and its use at follow up and to know the effects of prosthetic rehabilitation on adaptation to prosthesis and its long-term use. METHOD: One hundred and twenty four patients who underwent amputation surgery in 3 major hospitals in Korea from 1990 to 1997 were enrolled. They were evaluated by reviewing of medical records for anthropometry, level of amputation, causes of amputation, other coincidental medical problems, general physical states and followed up by telephone and mail questionnaire with respect to general outcome, prosthetic fitting, satisfaction of prosthesis, state of prosthetic use, functional state of prosthetic ambulation. RESULTS: The most common cause of amputation was trauma. The mean time to fit the prosthesis was 4.1 months and only 38 patients was supervised by rehabilitation programs. The patients who were supervised by rehabilitation program were fitted and able to ambulate significantly earlier than those who were not. They wore and used prosthesis significantly more often than those who were not supervised. The patients with above knee amputation who were supervised were significantly independent with walking aids. CONCLUSION: Rehabilitation training program enables amtupees to be fitted and walk earlier with prosthesis. Also, this program lowered the dependency on walking aids in above knee amputees.