• Title/Summary/Keyword: Delayed Diagnosis

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Osteopetrosis Tards (만발형골화석증)

  • Kim Young-Hee;Yi Jae-Seo;Yoon Suk-Ja;Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.507-521
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    • 1999
  • Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31.41.36.46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.

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Successful Management of Delayed Esophageal Rupture with T-Tube Drainage Using Video-Assisted Thoracoscopic Surgery

  • Do, Young Woo;Lee, Chang Young;Lee, Sungsoo;Kim, Ha Eun;Kim, Bong Jun;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.478-480
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    • 2016
  • Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications.

Survival Analysis for Prognostic Factors of Occupational Low Back Pain (직업성 요통 근로자의 장애기간에 영향을 미치는 요인 연구)

  • Kim, Ji-Yun
    • Research in Community and Public Health Nursing
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    • v.17 no.1
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    • pp.17-25
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    • 2006
  • Purpose: The goals of this research are to find out factors influencing the duration of work-related disability and to present implications for policies to prevent delayed recovery. Method: The subjects of this study were 238 workers who had been proved to be industrial disaster victims for occupational low back pain between January 1 2000 and December 31 2003. Kaplan-Meier method was used to estimate the proportion of duration of disability associated with low back pain, and Cox proportional hazards analysis was used to identify factors predicting it. The model distinguished main symptom variables affecting acute(${\leq}90\;days$) and chronic phase of disability (>90 days). Result: Fifty percent of the workers had not recovered in 408 days. The results of Cox regression show that delayed duration of disability was predicted by diagnosis, pain radiation (in chronic phase), sex, the size and labor union of the workplace, scheduled rest, compensation from the company, and operation. Conclusion: Duration of disability associated with compensated low back pain is influenced not only by factors related to the company and compensation system but also by individual factors. Thus, future efforts to reduce duration of disability may need to take into account all these factors.

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Delayed Clinical Symptoms of Gallbladder Rupture by Gallbladder Mucocele in a Dog (담낭 점액낭종에 의한 담낭 파열의 만성 경과 증례)

  • Noh, Daji;Kwon, Youngsam;Choi, Hojung;Lee, Youngwon;Lee, Kija
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.58-61
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    • 2016
  • An 11-year-old, intact male Cocker Spaniel dog was presented with history of abdominal distension, dyspnea for 10 days and lethargy for 1 day. Abdominal radiographs showed decreased serosal detail with abdominal distension. Abdominal ultrasounds revealed gallbladder mucocele with generalized peritonitis showing stellate-like sludge in the gallbladder with echogenic fat degeneration of cranial abdomen and abdominal free fluid containing echogenic materials. Loss of gallbladder wall integrity was shown clearly on computed tomography but ambiguously on ultrasound. Ultrasound-guided abdominocentesis was performed and showed amount of yellowish-bloody peritoneal fluid with vegetable matter and mucoid substance. On peritoneal fluid analysis, bilirubin level was elevated over three times than those of the serum. On exploratory laparotomy, gallbladder rupture and generalized bile peritonitis with intestinal adhesions were confirmed and cholecystectomy with peritoneal lavage was performed. One day after operation, patient died. This report describes delayed clinical symptoms of gallbladder rupture by gallbladder mucocele. In addition, this is the first case report using computed tomography made a diagnosis gallbladder rupture in a dog. Computed tomography might be helpful to diagnose gallbladder rupture.

AMELOBLASTIC ODONTOMA OCCURRED IN THE MANDIBLE (하악골에 발생된 법랑모치아종)

  • Ha Ssang-Yong;Song Nam-Kyu;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.26 no.2
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    • pp.181-189
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    • 1996
  • Ameloblastic odontoma is a mixed odontogenic tumor, which is characterized as being extremely rare, displaying aggressive clinical behavior, resembling a mixed radiopaque and radiolucent radiographic appearance and containing both ameloblastoma and a composite odontoma. Seven-year-old boy complaining of delayed eruption of the left lower permanent 1st molar came to the department of Oral & Maxillofacial Radiology at Chonbuk National University Hospital. The list of our radiographic differential diagnosis included the dental follicle, compound odontoma, complex odontoma and cystic odontoma. The microscopic analysis showed the lesion with the characteristics of an ameloblastic odontoma. The obtained results were as follows; 1. The area was asymptomatic, but the delayed eruption of the left lower permanent 1st molar was observed. Radiographically, well-defined widened pericoronal radiolucency containing several tooth-like radiopacities involving the impacted left lower permanent 1st molar and well-defined round radiolucency containing irregular radiopaque mass were observed. 3. Histopathologically, several tooth-like structures, odontoma components with the area of typical enamel, dentin and pulp, and ameloblastic components with typical follicular ameloblastoma were observed.

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Tracheoesophageal Fistula Due to Endotracheal Intubation: a case Report of Requiring Tracheal Reconstruction (기관상관후 발생한 기관식도루의 교정 1 례)

  • 신원선;곽영태
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.636-640
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    • 1997
  • The common cause of tracheoesophageal fistula(T-I fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-I fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed ope ative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.

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Analysis of Clinical Questionnaire on the Five Retardation, Five Stiffness and Five Limpness (오지(五遲) 오연(五軟) 오경(五硬) 유아(幼兒)의 임상면접지 분석)

  • Park, Jae-Hyung;Yun, Young-Ju;Park, Jae-Hyun;Paeck, Eun-Kyung
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.2
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    • pp.1-12
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    • 2010
  • Objectives Taking detailed patient history helps earlier diagnosis and treatment of developmental disability. In this study we analyzed the clinical questionnaire to find out the clinical characteristics of those with five-retardation, five-limpness, or five-stiffness. Methods The data was collected from 484 children under the age of six who have visited H oriental medicine clinic for developmental delay. The clinical questionnaire was filled out by their parents and the data was analyzed statistically. Results 436 children showed symptoms of five-retardation, 90 children suffered from five-stiffness, 54 children showed five-limpness and 7 children suffered from five-stiffness and five-limpness complex. Generally, boys had higher chance to show disease symptoms than the girls (2.32:1) and 40 children (8.26%) reported family history of developmental disability. Cerebral palsy ranks the most common familial disease, followed by developmental delay, mental retardation, autistic disorder and language disorder. Among the children we have studied, 285 children (63.19%) showed delayed unassisted walk while 192 children (42.57%) had language disorder. Also, 138 children (28.51%) had both walk and language disorders. The children in this study also showed delayed toilet training and half of them had little stranger anxiety when they were infants. It was also found that 120 children (24.79%) experienced epilepsy. This study reaffirmed that low birth weight, premature birth, and suffocation are major risks causing neurological damage. Conclusions They had history which including family history, problems at birth, epilepsy, face recognition, muscle tone disorder, delayed walking without assistance, language ability, and toilet training.

Postoperative Non-Pathological Fever Following Posterior Cervical Fusion Surgery : Is Laminoplasty a Better Preventive Method than Laminectomy?

  • Lee, Subum;Jung, Sang Ku;Kim, Hong Bum;Roh, Sung Woo;Jeon, Sang Ryong;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.487-494
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    • 2020
  • Objective : To analyze the incidence and characteristics of delayed postoperative fever in posterior cervical fusion using cervical pedicle screws (CPS). Methods : This study analyzed 119 patients who underwent posterior cervical fusion surgery using CPS. Delayed fever was defined as no fever for the first 3 postoperative days, followed by an ear temperature ≥38℃ on postoperative day 4 and subsequent days. Patient age, sex, diagnosis, laminectomy, surgical level, revision status, body mass index, underlying medical disease, surgical duration, and transfusion status were retrospectively reviewed. Results : Of 119 patients, seven were excluded due to surgical site infection, spondylitis, pneumonia, or surgical level that included the thoracic spine. Of the 112 included patients, 28 (25%) were febrile and 84 (75%) were afebrile. Multivariate logistic regression analysis showed that laminectomy was a statistically significant risk factor for postoperative non-pathological fever (odds ratio, 10.251; p=0.000). In contrast, trauma or tumor surgery and underlying medical disease were not significant risk factors for fever. Conclusion : Patients who develop delayed fever 4 days after posterior cervical fusion surgery using CPS are more likely to have non-pathologic fever than surgical site infection. Laminectomy is a significant risk factor for non-pathologic fever.

[ $^{99m}Tc-RBC$ ] Hepatic Scintiscan in focal Hepatic Lesions ($^{99m}Tc-RBC$ 간신티스캔을 이용한 간내 공간점유병소의 감별진단)

  • Lee, Do-Yun;Yoo, Hyung-Sik;Lee, Jong-Tae;Kim, Ki-Whang;Park, Chang-Yun;Park, Chan-H.
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.191-197
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    • 1987
  • 39 patients with focal hepatic lesions were evaluated by $^{99m}Tc-RBC$ liver scan. The diagnosis of focal hepatic lesions were made by percutaneous needle biopsy, angiography, surgery, or clinical courses. Thses diagnoses included 24 cases of hemangioma, 7 hepatomas, 6 metastatic disease, 1 abscess, and 1 cyst. 19 hemangiomas showed focal hot activity on delayed static planar images. 3 small deep seated hemangiomas were diagnosed by SPECT that would have been missed by planar images alone. 2 large hemangiomas had no radioisotope uptake within the lesions on delayed images and at surgery cavernous hemangioma with thrombosis, calcification, and fibrosis were found. For hepatic hemangiomas in our series, the sensitivity was 91.7% and the specificity was 100%. The remaining 15 patients including hepatomas, metastatic lesions, cyst and abscess showed cold defect on delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ liver scan should be the choice of primary diagnostic procecure for clinically suspected hepatic hemangioma since it's inexpensive, non-invasive, and readly available.

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Delayed Orbital Hemorrhage around Alloplastic Implants after Blowout Fracture Reduction

  • Ryu, Yong Ah;Park, Jae Beom;Kyung, Hyun Woo;Song, Seung Han;Kang, Nak Heon
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.35-38
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    • 2015
  • Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.