• Title/Summary/Keyword: Atypical symptom

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A Case of Retrophareangeal Tuberculosis Presenting as a Hypernasal Speech (과비음을 주소로 내원한 후인두의 결핵 1예)

  • Lee, Hyeong Joo;Kim, Dae Hwan;Kim, Jin Pyeong;Park, Jung Je
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.44-46
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    • 2018
  • Tuberculosis of the retropharynx is extremely rare. The diagnosis is frequently delayed because of its anatomical location and atypical symptom. It would be crucial to consider tuberculosis infection as a possible source of abscess and should be mindful about the tests to diagnose it. We experienced a 23-year-old man with retropharyngeal abscess caused by tuberculosis presenting hypernasality and hoarseness in the throat. In this article, we reviewed the etiology, diagnosis, and treatment of this case, with a review of literatures.

Clinical Diagnosis and Treatment of Herpes Zoster in an Immunocompromised Dental Patient: A Case Report

  • Kim, Hyun-Suk;Ahn, Kyo-Jin;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.7 no.2
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    • pp.99-105
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    • 2014
  • Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.

Temporomandibular Joint Disorder from Skull Base Osteomyelitis: A Case Report (측두하악관절 장애를 보인 두개저 골수염: 증례보고)

  • Ryu, Byoung-Gil;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.484-487
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    • 2012
  • Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.

A Case of Amisulpride Induced QT Prolongation (Amisulpride 중독과 QT 간격 연장 1례)

  • Lee Choung Ah;Park Hyeon Soo;Min Young Gi;Kim Gi Woon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.135-138
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    • 2005
  • Amisulpride is a newly developed atypical antipsychotic agent effective in treating the positive and negative symptom of schizophrenia. Over-dose of amisulpride can cause hypocalcemia and thus may lead to QT prolongation. We report a case of hypocalcemia and QT prolongation. The QT prolongation was normalized after calcium supplement.

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Cystic Abducens Schwannoma without Abducens Paresis : Possible Role of Cisternal Structures in Clinical Manifestation

  • Lee, Seul-Kee;Moon, Kyung-Sub;Lee, Kyung-Hwa;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.374-376
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    • 2013
  • The abducens nerve paresis generally can aid in the presumptive diagnosis of abducens schwannoma along with the typical radiological features of schwannomas. The authors present a case of a 76-year-old male patient with a abducens schwannoma without abducens nerve paresis. Peroperatively, abducens nerve located in the cerebellopontine cistern had normal in contour and diameter, despite the mass originated from this nerve. We hypothesize that anatomic location of abducens nerve may affect the vector of tumor growth to prevent destruction of its origin, the abducens nerve.

Antipsychotics for patients with pain

  • Shin, Sang Wook;Lee, Jin Seong;Abdi, Salahadin;Lee, Su Jung;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.3-11
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    • 2019
  • Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (${\alpha}$), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak $D_2$ receptor bindings with strong binding to the $5-HT_{2A}$ receptor, while typical antipsychotics block long-lasting, tight $D_2$ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.

Lipomatous Tumors in Hand (수부에 발생한 지방종성 종양)

  • Lee, Kwang-Hyun;Lee, Bong-Gun;Bong, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.131-139
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    • 2008
  • Purpose: Lipomatous tumor occurred in hand is very rare. There is a broad spectrum of lipomatous tumors including lipomas, variants of lipomas, lipomatosis, liposarcomas and so on. We report the clinical features of 11 cases of lipomatous tumor which occurred in hand. Materials and Methods: Between 1992 and 2008, 11 cases were histologically diagnosed as lipomatous tumor in hand. We reviewed all medical records and clinical photographs retrospectively and ascertained recurrence by telephone interview. Results: Eight cases were ordinary lipomas. Three cases were angiolipoma, fibrolipoma and atypical lipoma respectively. Four cases occurred in finger, two cases in thenar area, two cases in hypothenar area, one case in palm, two cases in wrist. All cases were situated on volar surface. All patients complained of palpable masses. One patient with subungal angiolipoma felt pain. There was no neurologic sign or vascular symptom preoperatively. In one case, postoperative complication (hypoesthesia in $5^{th}$ finger) was developed. There was no local recurrence. Conclusion: In our study, lipomatous tumors occurred in hand did not recur. Patients mainly complained of feeling of lump. Pain was uncommon symptom. Postoperative complication was rare if operation was performed carefully.

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Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.95-101
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    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

Treatment of Head and Neck Area Pain by Multidisciplinary Approach with Template

  • Lee, Gi-Cheol;Shin, Won-Han;Park, Suhyun;Heo, Hyun A
    • Journal of Korean Dental Science
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    • v.5 no.2
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    • pp.68-76
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    • 2012
  • Purpose: The headache is a symptom that various somatic or non-somatic disorders gives an effect to head and neck system. The neck and the shoulder pain is a common muscle pain that can not control and bothers the patient after chronic state. The headache and the neck and the shoulder muscle pain are treated with various conventional treatment methods. But, there are cases that symptoms did not resolve or increased in some clinical cases. And generally, the result of temporomandibular disorders (TMD) treatment is good. But, despite of a normal treatment was performed for TMD, there are cases that TMD symptoms did not resolved in clinical cases. In template clinic of Soonchunhyang University Bucheon Hospital, co-operative neurophysiologic treatment of Department of Neurosurgery and Dentistry are done for patients, who had head and neck pain or atypical symptoms that did not treated with various conventional treatment method such as surgery or medication etc. Materials and Methods: Four hundred fifty one patients who have treated in the template clinic, Soonchunhyang University Bucheon Hospital, from January of 2006 to December of 2008 were subjected in this study. Result: Overall average age was 31.9 years old. Ratio of numbers is 74.3% in female and 25.7% in male. The success rate of treatment in TMD symptom was 89.9%, in headache was 88.8%, in muscle pain was 81.6%. Statistically significance of differences visual analogue scale evaluation between before and after had been treated patients who have over average grade headache was calculated by paired t-test. P<0.05 was considered significant. Conclusion: We suggest the template appliance can be attempted for cases whose headache, the neck and the shoulder muscle pain and TMD are not resolved with various conventional treatment methods.

A Case of Jejunal Juvenile Polyp Presented as Intussusception (장중첩증 증상을 보인 공장에 발생한 연소성 용종 1례)

  • Kwon, Ki Beom;Shin, Mee Yong;Kwon, Kye Won;Park, Jae Ock
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.453-456
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    • 2005
  • Single or scattered sequential hamartomatous juvenile polyps are common in the large intestine, especially the rectosigmoid area, where they are usually nonfamilial. Juvenile polyps arising in the small inestine are very rare. Juvenile polyps are usually found in children aged between 1 and 10 years, the majority of cases are between 2 and 4 years of age. Bleeding is the most common symptom, but some children may suffer from autoamputation or prolapse through the anus, and rare cases are presented as intussusception. Approximately six cases of juvenile polyps in the small bowel have been reported. Jejunal intussusception arising from juvenile polyp is uncommon in comparison with the ileocolic form. It has an atypical subacute presentation. It must be better understood for its diagnosis can be made too late. Surgical exploration is the treatment of choice because of the recurrence of various clinical symptoms. We report a case of single juvenile polyp of jejunum found in a 10-year-old girl who presented with signs of intussusception.