• Title/Summary/Keyword: Clinical patterns

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A Case Report of Nerve Entrapment Syndrome with Lymphedema (림프부종에 의한 신경포착증후군: 증례 보고)

  • Kim, Hong-Ryul;Ahn, Duck-Sun
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.95-98
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    • 2010
  • Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

A Comparative Study on Recovery of Motor Function in Stroke Patients with Corona Radiata Infarcts and Intracerebral Hemorrhage

  • Kim, Chung-Sun;Park, Sang-Young;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • v.22 no.6
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    • pp.53-58
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    • 2010
  • Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

$^{99m}Tc-MDP$ Uptake Pattern of Normal Pubic Bone (정상 골스캔에서 치골 핵종 섭취 패턴)

  • Chung, Myung-Hee;Lee, Hong-Jae;Kim, Sung-Hoon;Chung, Soo-Kyo;Yim, Jung-Ik;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.333-337
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    • 1992
  • In order to establish the clinical significance of pubic bone uptake of radionuclide on $^{99m}Tc-MDP$ bone scintigraphs, we analyzed uptake patterns of normal adult pubic bone in 300 randomly sampled subjects. Bone scintigraphy was performed in each patient for the reasons other than pubic or pelvic problems. One-hundred-fifty-four were men and 146 women. The age ranged from 8 to 78 years. The pubic uptake was graded arbitrarily into 4 grades by comparing the pubic uptake density with that of L5 vertebra. Thus, grade I was defined as the L5 density greater than the pubic density, grade II as the L5 density equals to the pubic density, grade III as the L5 density less than the pubic cdensity, and grade IV as the L5 density much less than the pubic density. Statistical analysis revealed negative trend in the pubic uptake from grade IV to grade I with age. There was no sexual difference in the pubic uptake. The women in the 3rd and 4th decades disclosed higher pubic uptake (grades III, IV) probably due to pregnancy and labor.

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Two cases of Antley-Bixler syndrome caused by mutations in different genes, FGFR2 and POR

  • Woo, Hyewon;Ko, Jung Min;Shin, Choong Ho;Yang, Sei Won
    • Journal of Genetic Medicine
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    • v.13 no.1
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    • pp.31-35
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    • 2016
  • Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.

Antimicrobial Drug Resistance and R Plasmids of Serratia marcescens (Serratia marcescens의 항균제 내성 및 R plasmid)

  • Huh, Chan-Hee;Lee, Yoo-Chul;Seol, Sung-Yong;Cho, Dong-Taek;Chun, Do-Ki
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.1
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    • pp.17-31
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    • 1986
  • Forty clinical isolates of Serratia marcescens were tested for their susceptibility to 19 antimicrobial drugs and studied on the molecular characteristics of R plasmids. Cefotaxime (Ct) was the most effective drug and only 2 (5%) strains were resistant to this drug. Thirteen to 18% of strains were resistant to cefoperazone (Cz), amikacin (Ak). and trimethoprim (Tp), and 28 to 40% were resistant to piperacillin (Pi), nalidixic acid (Na), gentamicin (Gm), and cefoxitin (Cx). A majority of strains were resistant to carbenicillin (Cb), tobramycin (Tp), kanamycin (Km), and cefamandole (Cd), and all to cephalothin. One half of the isolates were resistant to 10 or more drugs. $MIC_{90}$ of Pi to Gm-resistant strains (Gm') were 8 times higher than that to Gm-susceptible strains (Gm'), but $MIC_{90}$ of Ak, Cx, Ct, and Cz were almost the same between both Gm' and Gm' strains. Nine (23.7%) strains among 38 of multiply drug-resistant S. marcescens transferred conjugally their partial patterns of resistance to E. coli or Klebsiella strains, and two S. marcescens strains producing bacteriocin transferred their resistance to Klebsiella only, but not to E. coli. The plasmid profiles of S. marcescens were studied by the methods of SDS lysis and agarose gel electrophoresis. Twenty-four (60%) strains carried one to four plasmids of 1.4. to 144 Mdal, and conjugative R plasmids of 49 to 127 Mdal were noted in transconjugants. MIC levels of drugs in transconjugants were variable by the R plasmids and recipient strains.

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Molecular Typing of Acinetobacter Baumannii Strains by Randomly Amplified Polymorphic DNA (RAPD) Analysis (Randomly Amplified Polymorphic DNA (RAPD) 분석에 의한 Acinetobacter Baumannii 균주의 유전형 분류)

  • Oh, Jae-Young;Cho, Jae-Wee;Park, Jong-Chun;Lee, Je-Chul
    • The Journal of the Korean Society for Microbiology
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    • v.35 no.2
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    • pp.129-139
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    • 2000
  • Acinetobacter baumannii strains are emerging pathogens of the nosocomial infection with an increasing frequency in recent years. The therapeutic difficulty due to the wide spread of multiple resistant strains was major problem in A. baumannii infection. It seems likely that high frequency of A. baumannii infection will be increasing epidemiological importance in the future. However, the current limited understanding of the epidemiology of A. baumannii infections is caused by lack of a rapid and practical method for the molecular characterization of A. baumannii strains. This study was undertaken to determine molecular types and genetic similarity among A. baumannii strains isolated from four hospitals by RAPD analysis. Eighty-five strains, including 40 from Chunnam University Hospital, 27 from Dankook University Hospital, 15 from Yonsei University Hospital, and 3 from Seonam University Hospital, were classified into three molecular types. Molecular type II was the most common pattern and included 72 strains. All strains from Dankook University Hospital and 40 strains from Chunnam University Hospital belonged to molecular type I or II. A. baumannii strains form Yonsei University Hospital were very distant similarity values. The range of genetic similarity values among 85 strains of A. baumannii was 0.26 to 1.00. Although phenotypes including biotype and antimicrobial resistance pattern of A. baumannii strains were same or very similar to each other, their RAPD patterns were quite different. Typing with phenotypes was found to be less reliable than molecular typing by RAPD analysis. These results suggest that RAPD analysis provides rapid and simple typing method of A. baumannii strains for epidemiological studies. This work is the first epidemiological report of A. baumannii infections in Korea and it is hoped that results of this work may contribute to a better understanding of the clinical importance and epidemiology of A. baumannii strains.

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Experience of Penetrating Gunshot Wound on Head in Korea

  • Kim, Hong Rye;Go, Seung Je;Sul, Young Hoon;Ye, Jin Bong;Lee, Jin Young;Choi, Jung Hee;Choi, Seoung Myoung;Kim, Yook;Yoon, Su Young
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.82-86
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    • 2018
  • Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.

Effect of Sihogayonggolmoryeo-Tang on Hwa-byung: A Multicenter, Randomized, Double-Blinded, Placebo-Control Trial

  • Choi, Woo-Chang;Lee, Hun-Soo;Kim, Ju-Yeon;Kang, Wee-Chang;Park, Yang-Chun;Kim, Geun-Woo;Kim, Jong-Woo;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.135-147
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    • 2020
  • Objectives: Hwa-byung is a mental illness. It is also known as a Korean culture-related syndrome. In traditional Korean medicine, Sihogayonggolmoryeo-tang is used to treat Hwa-byung related neuropsychiatric symptoms. The purpose of this research was to examine the effect of Sihogayonggolmoryeo-tang on Hwa-byung. Methods: A multicenter, randomized, double-blinded, placebo-controlled study was performed for 160 patients with Hwa-byung. Patients were divided into a Sihogayonggolmoryeo-tang group and a placebo group. Treatment period was 8 weeks. Hamilton Rating Scale for Anxiety (HAM-A), Likert scale for major symptoms of Hwa-byung, Hwa-byung Scale (HBS), Korean Beck Depression Inventory (K-BDI), Korean State-Trait Anxiety Inventory (K-STAI), Korean State-Trait Anger Expression Inventory (K-STAXI), and Korean WHO Quality of Life Scale Abbreviated Version (WHOQOL-BREF) were used to evaluate the effect of Sihogayonggolmoryeo-tang on Hwa-byung. We also used an Instrument of Pattern Identification for Hwa-Byung to evaluate different responses for six patterns of patients. Results: Scores of all the measurements improved significantly for each group, showing no significant differences between the two groups. In the case of deficiency of both Qi and blood pattern, the Sihogayonggolmoryeo-tang group showed a significant decrease in the HAM-A score compared to the placebo group. Conclusions: The effect of Sihogayonggolmoryeo-tang on Hwa-byung did not exceed that of the placebo. Further studies involving more elaborate pattern identification are needed.

Study of the Herbal Medicine for Stroke by Korean Standization of Pattern Identification for Stroke (한국형 중풍변증표준안-Ⅱ의 변증별 사용 처방에 대한 연구)

  • Kang, Ji-Sun;Kang, Byung-Gab;An, Joung-Jo;Jo, Hyun-Kyung;Yoo, Ho-Rhyong;Seol, In-Chan;Kim, Yoon-Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.2
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    • pp.469-480
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    • 2008
  • This study was performed to investigate using of herbal medicine based on pattern identification of symptoms, such as Qi deficiency pattern, Yin deficiency pattern, Phlegm -dampness pattern, Static blood pattern, Fire-heat pattern. These patterns settled by Korean Standard Differentiation of the Symptoms and Signs for Stroke in 2005. This study was done with 177 patients in Daejeon University Oriental Medical Hospital in the period of November 2006 to July 2007. Among the five types of pattern identification, Phlegm -dampness pattern showed significantly high frequency especially in 3 weeks after stroke. The sort of herbal medicine was 43 and Dodamhwalhyoel-tang(26.61%), Sunhwanki 1 hobang(14.52%), Banhabaekchulcheonma-tang(4.84%), Ansinchongnoi-tang(4.84%), Chongryuldodam-tang(4.03%) were most frequently used. Especially Dodamhwalhyoel-tang showed significantly high frequency in 2 weeks after stroke. Based on these results, it is suggested that more practical Korean Standard Differentiation of the Symptoms and Signs for Stroke would be established through continuous clinical studies by giving weight on relationship between herbal medicine and pattern identification.

Risk factors of a Complex Disease for the Diabetes Mellitus Group and the Hypertension Group in the Geoje Community (거제지역 당뇨병 및 고혈압 환자의 복합질병 위험요인)

  • Park, Phil-Sook;Jeong, Gi-Man;Kim, Jong-Hyun;Paik, Ji-Hyun;Park, Mi-Yeon
    • Journal of the Korean Society of Food Culture
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    • v.18 no.2
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    • pp.123-133
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    • 2003
  • The purpose of this study is to compare the correlation of clinical characteristics and patterns of disease. Subjects of the study were the adults(207) living in Geoje City, the diabetes mellitus and the hypertension patients(166) and the normal people(41). In the diabetes mellitus group and the hypertension group, blood pressure, blood glucose, total cholestero LDL-cholesterol and atherogenic index(AI) were significantly high. As the obesity index was getting higher, the blood pressure of the diabetes mellitus group was high, and the HDL-cholesterol of the hypertension group was low, but AI of it was significantly high. The AI was significantly high as serum lipid index were getting higher in both groups. The rate of the prevalence was very high in the diabetes mellitus group(74.3%) and the hypertension group(73.7%). The pattern in the diabetes mellitus group was in order of the hypertension, the hyperlipidemia, and the obesity but, in the hypertension group was the hyperlipidemia, and the obesity. The obesity index and serum lipid index of complex patient group were higher than single patient group.