• 제목/요약/키워드: Atypical symptoms

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Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예 (Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft)

  • 장운하;유회성
    • Journal of Chest Surgery
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    • 제11권1호
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    • pp.81-84
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    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

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소아 청소년에서의 신경이완제 악성증후군에 대한 종설 (Neuroleptic Malignant Syndrome in Children and Adolescents : A Review)

  • 곽영숙;류재성
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권1호
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    • pp.13-20
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    • 2013
  • Neuroleptic malignant syndrome (NMS) is a severe iatrogenic complication of treatment with antipsychotic medication. The aim of this review is to provide the clinical characteristics and treatments of children and adolescents with NMS. Searches were conducted in Medline, Korean studies Information Service System (KISS), and Research Information Service System (RISS). Sixteen case reports and two review articles were selected in Medline, and two Korean cases reported in department of emergency medicine and pediatrics were selected from RISS. Heterogeneous and atypical presentations of NMS were observed in children and adolescents. Some noticeable differences were observed between adult patients and child patients with NMS. In addition, symptom presentations related to atypical antipsychotic agents differed from those of typical ones. In treatment, bromocriptine and benzodiazepine were recommended for management of symptoms. In particular, electroconvulsive therapy (ECT) was a useful treatment option. For prevention and early detection of NMS in children and adolescents, evaluation of risk factors and understanding of diagnostic features of NMS are very important.

Secondary Trigeminal Neuralgia Caused by Pharyngeal Squamous Cell Carcinoma - A Case Report -

  • Kim, Min Seok;Ryu, Yong Jae;Park, Soo Young;Kim, Hye Young;An, Sangbum;Kim, Sung Woo
    • The Korean Journal of Pain
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    • 제26권2호
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    • pp.177-180
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    • 2013
  • Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

흉막삼출액을 동반한 비정형 폐렴환자 치험 1례 (A case of Atypical pneumonia with Pleural effusion)

  • 김승욱;문성호;허영란;한이수;최준혁;임성우;손정숙
    • 대한한방내과학회지
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    • 제22권3호
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    • pp.489-494
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    • 2001
  • Pneumonia is the disease caused by inflammation of lung parenchyma. Major symptoms of pneumonia are fever, cough, etc and consolidation is seen in chest x-ray. When pleurisy gets in complication of pneumonia, pleural effusion occurs. Also chest pain occurs by pleurisy. Gyulhyung is the disease of which major symptom is chest pain. Sugyulhyung from in Gyulhyung, the water sound is audible from the flank side the fact that as Sugyulhyung. Symptom of Gyulhyung is similar to that of pneumonia. We diagnosed this case as Gyulhyung and administrated Banhabogryeongtang to patient. As result, there is remarkable Improvement in symptom and chest x-ray.

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만성적 경과관찰을 보이는 Guillain-Barré Syndrome 환자 1례 (A Clinical Case Study of Guillain-Barré Syndrome with Chronic Progression)

  • 노지애;장재원;이기언;홍정수;김동진
    • 대한한방내과학회지
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    • 제39권1호
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    • pp.76-83
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    • 2018
  • Objectives: This case study reports on one patient presenting atypical and chronic disorders after being diagnosed with $Guillain-Barr{\acute{e}}$ Syndrome (GBS). Methods: One patient was treated by Yeongseonjetong-eum-gami, Taklisodok-eum-gami, electroacupuncture, and physical therapy. Any improvement in symptoms was assessed by measuring changes in the motor grade of upper limb weakness, the numerical rating scale (NRS) of lower limb numbness, and GBS scores. Results: After 24 days of treatment, the patient's symptoms of GBS showed little improvement. Conclusions: Traditional Korean medical treatment appeared to be effective in reducing GBS symptoms, but more research is required to confirm these results. When treating GBS patients, the clinician should put effort into distinguishing GBS from other nervous disorders, such as acute onset Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).

Intracisternal Cranial Root Accessory Nerve Schwannoma Associated with Recurrent Laryngeal Neuropathy

  • Jin, Sung-Won;Park, Kyung-Jae;Park, Dong-Hyuk;Kang, Shin-Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.152-156
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    • 2014
  • Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.

근골격계 부담작업 기준을 이용한 병원 작업에 대한 평가 (A Study of Hospital Job Evaluation based on Criterion for High-Risk Musculoskeletal Disorders)

  • 박동현;최순영
    • 대한안전경영과학회지
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    • 제13권4호
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    • pp.91-100
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    • 2011
  • Main motivation for this study was to identify the relationship between high-risk hospital jobs and their symptoms associated. This study has three objectives; 1) Evaluate major jobs of hospital workers based on Criterion(Notification number 2003-24 from Ministry of Labor in Korea) for high-risk musculoskeletal disorders(MSDs), 2) Relate each jobs in criterion and the hospital jobs considered in this study, 3) Relate each jobs in criterion and MSDs symptoms of hospital workers. A total 141 hospital jobs was evaluated. Specifically, a total 688 hospital workers participated in the questionnaire survey in this study. There were two most jobs belonged to the numbers 2 and 4 from criterion. Most hospital workers participated in this study thought that the numbers 1 and 2 from criterion were associated with their jobs. In terms of MSDs symptoms, the numbers 1 and 2 from criterion were associated with their jobs as well. Further study for hospital jobs should be focused on breaking down quantification levels of each numbers in the criterion due to its atypical and non-repetitive job characteristics of hospital jobs.

Achalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children

  • Pyun, Jung Eun;Choi, Da Min;Lee, Jung Hwa;Yoo, Kee Hwan;Shim, Jung Ok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권1호
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    • pp.55-59
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    • 2015
  • Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.

Small Molecule Drug Candidates for Managing the Clinical Symptoms of COVID-19: a Narrative Review

  • Yun, Chawon;Lee, Hyun Jae;Lee, Choong Jae
    • Biomolecules & Therapeutics
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    • 제29권6호
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    • pp.571-581
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    • 2021
  • Towards the end of 2019, an atypical acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China and subsequently named Coronavirus disease 2019 (COVID-19). The rapid dissemination of COVID-19 has provoked a global crisis in public health. COVID-19 has been reported to cause sepsis, severe infections in the respiratory tract, multiple organ failure, and pulmonary fibrosis, all of which might induce mortality. Although several vaccines for COVID-19 are currently being administered worldwide, the COVID-19 pandemic is not yet effectively under control. Therefore, novel therapeutic agents to eradicate the cause of the disease and/or manage the clinical symptoms of COVID-19 should be developed to effectively regulate the current pandemic. In this review, we discuss the possibility of managing the clinical symptoms of COVID-19 using natural products derived from medicinal plants used for controlling pulmonary inflammatory diseases in folk medicine. Diverse natural products have been reported to exert potential antiviral effects in vitro by affecting viral replication, entry into host cells, assembly in host cells, and release. However, the in vivo antiviral effects and clinical antiviral efficacies of these natural products against SARS-CoV-2 have not been successfully proven to date. Thus, these properties need to be elucidated through further investigations, including randomized clinical trials, in order to develop optimal and ideal therapeutic candidates for COVID-19.