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Medial Ankle Impingement Syndrome due to Talar Osteochondroma and Gout Attack: A Case Report (거골 내측 결절에 발생한 골연골종과 통풍 발작에 의한 발목 내측 충돌 증후군: 증례 보고)

  • Min Gyu Kyung;Dongjun Jeon;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.31-35
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    • 2024
  • Osteochondromas are benign bone tumors typically found in the metaphyseal region of long bones. These tumors are often asymptomatic and detected incidentally. However, their occurrence in atypical sites such as the talus can pose significant diagnostic and treatment challenges. This report describes a rare case of osteochondroma of the medial tubercle of the talus, which is an unprecedented location based on a review of relevant literature. A 28-year-old male presented with worsening medial ankle pain and limping. Imaging revealed a lesion consistent with osteochondroma contributing to medial ankle impingement syndrome. Uniquely, this case also featured a coinciding gout attack in the ankle joint. Surgical removal of the lesion resulted in significant symptom relief and functional improvement. This case underscores the need to consider rare diagnoses, such as talar osteochondroma, when presented with persistent medial ankle pain and highlights the potential presence of concurrent conditions, such as gout.

Genetic Polymorphisms of the $\beta_2$-Adrenergic Receptor in the Severity of Bronchial Asthma (기관지 천식 환자에서 천식 증상의 정도에 따른 $\beta_2$ 교감신경 수용체의 유전자 다형성)

  • Shim, Jae-Jeong;Kim, Jei-Hyung;Lee, Seung-Yong;Kwan, Young-Hwan;Lee, So-Ra;Lee, Sang-Youb;Kang, Se-Yong;Kang, Yong-Koo;Cho, Jae-Youn;In, Kwang-Ho;Won, Nam-Hee;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.77-89
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    • 1998
  • Background: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of $\beta_2$-Adrenergic Receptor ($\beta_2$AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the $\beta_2$AR has recently been seguenced. The $\beta_2$AR genotype at the polymorphic loci of codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the $\beta_2$AR and its functions are being elucidated. Purpose : The gene encoding the $\beta_2$AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. Methods: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the $\beta_2$AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16,27,34, and 164. Results: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of $\beta_2$AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of $\beta_2$AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1 %,10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the $\beta_2$AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. Conclusion: The arginine 16 to glycine polymorphism of the $\beta_2$AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the $\beta_2$AR gene and nocturnal asthma.

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Clinical Impact of Bronchial Reactivity and Its Relationship with Changes of Pulmonary Function After Asthmatic Attack Induced by Methacholine (기관지 반응성의 임상적 의의 및 메타콜린으로 유도된 천식 발작시 폐기능 변화와의 관계)

  • Ryu, Yon-Ju;Choi, Young-Ju;Kwak, Jae-Jin;Lee, Ji-A;Nam, Seung-Hyun;Park, Chang-Han;Chaon, Saon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.24-36
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    • 2002
  • Background: Bronchial reactivity is known to be a component of airway hyperresponsiveness, a cardinal feature of asthma, with bronchial sensitivity, and is increments in response to induced doses of bronchoconstrictors as manifested by the steepest slope of the dose-response curve. However, there is some controversy regarding methods of measuring bronchial reactivity and clinical impact of such measurements. The purpose of this study was to evaluate the clinical significance and assess the clinical use by analyzing the relationship of the bronchial sensitivity, the clinical severity and the changes in pulmonary function with bronchial reactivity. Method: A total of 116 subjects underwent a methacholine bronchial provocation test. They were divided into 3 groups : mild intermittent, mild persistent, moderate and cough asthma. Severe patients were excluded. Methacholine PC20 was determined from the log dose-response curve and PC40 was determined by one more dose inhalation after PC20. The steepest slope of log dose-response curve, connecting PC20 with PC40, was used to calculate the bronchial reactivity. Body plethysmography and a single breath for the DLCO were done in 43 subjects before and after methacholine test. Results: The average bronchial reactivity was 38.0 in the mild intermittent group, 49.8 in the mild persistent group, 61.0 in the moderate group, and 41.1 in the cough asthma group. There was a weak negative correlation between PC20 and bronchial reactivity. A heightened bronchial reactivity tends to produce an increased clinical severity in patients with a similar bronchial sensitivity and basal spirometric pulmonary function. There were significant correlations between the bronchial reactivity and the initial pulmonary function before the methacholine test in the order of sGaw, Raw, $FEV_1$/FVC, MMFR. There were no correlations between the bronchial sensitivity and the % change in the pulmonary function parameters after the methacholine test. However, there were significant correlations between the bronchial reactivity and the PEF, $FEV_1$, DLCO. Conclusion: There was weak significant negative correlation between the bronchial reactivity and the bronchial sensitivity, and the bronchial reactivity closely reflected the severity of the asthma. Accordingly, measuring both the bronchial sensitivity and the bronchial reactivity can be of assistance in assessing of the ongoing disease severity and in monitoring the effect of therapy.

A Study on the Anticonvulsant Effects of Centrally-Acting Drugs by Measuring Electroencephalography of Experimental Animals Intoxicated with Organophosphate Compounds (실험동물의 뇌파 측정에 의한 중추약물의 항경련효과 연구)

  • Cho, Young;Kim, Wang-Soo;Hur, Gyeung-Haeng
    • Journal of the Korea Institute of Military Science and Technology
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    • v.16 no.2
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    • pp.218-224
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    • 2013
  • Organophosphorus compounds are irreversible inhibitors of cholinesterase enzyme. Exposure causes a progression of toxic signs, including hypersecretion, tremor, convulsion, respiratory distress, epileptiform seizure, brain injuries and death. To protect brain injuries, administration of diazepam as a neuroprotectant is now considered essential for severely exposed nerve agent casualties. However, studies have shown diazepam to provide less than total protection against the neuropathological consequences of nerve agent exposure. In this context, extensive studies have been carried out to find out effective alternative drugs to protect brain from epileptiform seizures induced by organophosphate compounds intoxication. It has been reported that a combination of carbamate and anticholinergic or antiglutamatergic can be a very effective medical countermeasure in dealing with the threat of organophosphorous poisoning. In this study, experimental animals including rats and guinea pigs were implanted with microelectrodes on their brain sculls, and treated with various centrally acting drugs such as physostigmine and procyclidine prior to soman challenge, and then its electroencephalography(ECoG) was monitored to see anticonvulsant effects of the drugs. It was found that seizure activities in ECoG were not always in proportion to clinical signs induced by soman intoxication, and that combinative pretreatment with physostigmine plus procyclidine effectively stopped the seizures induced by organophosphorous poisoning.

MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE (기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료)

  • Cha, Yoon-Sun;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.38-42
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    • 2014
  • A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

Long-term Clinical Course of a Korean Girl with β-ureidopropionase Deficiency (β-ureidopropionase 결핍증의 장기간의 임상경과 1례)

  • Song, Woo Sun;Park, Youngjin;Lee, Jun Hwa
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.1
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    • pp.18-23
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    • 2017
  • ${\beta}$-ureidopropionase deficiency (${\beta}$-UPD; OMIM # 613161) is a rare autosomal recessive inborn error of pyrimidine metabolism caused by mutations in the UPB1 gene and approximately 30 cases have been reported in the world. The clinical features of patients with ${\beta}$-UPD have been reported to vary from asymptomatic to severe developmental delays. However, the long-term clinical courses of patients with ${\beta}$-UPD have not yet been reported. A Korean girl was diagnosed with ${\beta}$-UPD at the age of 8 years and 10 months by targeted next-generation sequencing which was subsequently confirmed by Sanger sequencing. She had many clinical features such as poor oral feeding, failure to thrive, global developmental delay, microcephaly, frequent infection, and intractable epilepsy. She died suddenly of an unknown cause at the age of 11 years and 5 months. Here we report the long-term (i.e. lifelong) clinical aspects of a Korean patient with ${\beta}$-UPD.

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Brain-wave Analysis using fMRI, TRS and EEG for Human Emotion Recognition (fMRI와 TRS와 EEG를 이용한 뇌파분석을 통한 사람의 감정인식)

  • Kim, Ho-Duck;Sim, Kwee-Bo
    • Journal of the Korean Institute of Intelligent Systems
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    • v.17 no.6
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    • pp.832-837
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    • 2007
  • Many researchers are studying brain activity to using functional Magnetic Resonance Imaging (fMRI), Time Resolved Spectroscopy(TRS), Electroencephalography(EEG), and etc. They are used detection of seizures or epilepsy and deception detection in the main. In this paper, we focus on emotion recognition by recording brain waves. We specially use fMRI, TRS, and EEG for measuring brain activity Researchers are experimenting brain waves to get only a measuring apparatus or to use both fMRI and EEG. This paper is measured that we take images of fMRI and TRS about brain activity as human emotions and then we take data of EEG signals. Especially, we focus on EEG signals analysis. We analyze not only original features in brain waves but also transferred features to classify into five sections as frequency. And we eliminate low frequency from 0.2 to 4Hz for EEG artifacts elimination.

A Study for Anatomical Evidence of Anxiety Using Magnetic Resonance Imaging in Patients with Panic Disorder and Complex Partial Seizure (공황장애와 복합부분간질 환자의 뇌자기공명촬영소견을 통한 불안의 해부학적 증거에 대한 연구)

  • Choi, Byung-Hwi;Lee, Young-Ho;Chung, Young-Cho
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.107-114
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    • 1995
  • This study was to investigate the anatomical evidence of anxiety. MRI was used to study 11 patients with panic disorder and 15 patients with complex partial seizure, and 21 controls. The regions of interest in the MRI were measured with computer-assisted planimetry using the AutoCad and digitizer. The following results were obtained ; 1) The mean age was 49.7(12.4) years in patients with panic disorder and 30.1(7.5) years in patients with complex partial seizure. 2) There were na signi ficant differences between 3 groups in the values of cerebral area, temporal lobe, caudate nucleus, hippocampus, parahippocampus, amygdala, third ventricle and VBR. The right parahippocampal region which attracted most attention in neurobiological studies regarding anxiety, tended to be larger in both study groups compared to the control group, but with no statistical significance. 3) There was lett-right reversal of temporal lobes in both study groups. And these are mainly due to asymmetrical increase in area of the temporal lobe on right side. These results suggest that temporal lobe, especially right temporal, is the anatomical correspondence of anxiety and functional activation of temporo-limbic system may be accompanied by the structural change of temporal lobe.

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Factors Influencing the Changes of BAEPs in Vertebrobasilar Transient Ischemic Attacks (추골기저동맥 일과성 허혈발작에서 뇌간청각유발전위변화에 영향을 미치는 인자)

  • Park, Young Hyuk;Yoo, Bong Goo;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.101-106
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    • 2000
  • Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

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Acupuncture Treatment at HT8 Supresses Seizure and Inflammation in Hippocampi on an Epilepsy Mice Model (간질(癎疾) 동물(動物) 모델을 이용한 소부혈(少府穴)의 간질발작(癎疾發作) 및 해마(海馬)의 염증(炎症) 억제 효과(效果) 검증(檢證))

  • Doo, Ah-Reum;Kim, Seung-Nam;Yin, Chang-Shik;Kim, Yeon-Jung;Lee, Hye-Jung;Kim, Seung-Tae;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.29 no.3
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    • pp.396-405
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    • 2012
  • Objectives : To confirm whether acupuncture can suppress the degree of seizure and the activation of astrocytes in hippocampi using kainic acid(KA)-induced epilepsy mouse model. Methods : 8 weeks C57BL/6 mice(20~25 g) were given acupuncture once a day at acupoint HT8(Shaofu) bilaterally during 2 days before KA injection. After an intraperitoneal injection of 30 mg/kg KA, acupuncture treatment was subsequently administered once more(total 3 times), and the degree of seizure was observed for 120 min. The neuronal cell death, pERK expression, and astrocyte activation confirmed 1 hour and 24 hours after KA injection. Results : Acupuncture treatment at HT8 suppressed KA-induced epileptic seizure. One hour after KA injection, the pERK expression was increased, which was reduced by the acupuncture treatment. Twenty four hours after injection, the treatment decreased the KA-induced neuronal cell death, the interleukin-$1{\beta}$ expression and the astrocyte activation in the CA3 region of the mouse hippocampus. Conclusions : Acupuncture treatment at HT8 decreases the KA-induced epileptic seizure, the neural cell inflammation and death.