• Title/Summary/Keyword: Dysphagia therapy

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A Case of Occult Papillary Carcinoma of Thyroid, Invaded Trachea and Esophagus (기관지 내시경에 의해 진단된 기관과 식도를 침범한 갑상선 잠재성 유두암 1예)

  • Cho, Deok-Su;Ahn, Byung-Yi;Lee, Deok-Su;Han, Dong-Ho;Kim, Sang-Young;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1125-1131
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    • 1997
  • Occult papillary adenocarcinoma of the thyroid is known to be indolent, slow metastatic, and has a good prognosis. Occult thyroid carcinoma presenting as a blood-borne metastasis without obvious cervical lymph node involvement is extremely rare. A 65-year-old male patient was visited for hoarseness, dysphagia, and shortness of breath. Bronchoscopy with biopsy revealed a papillary carcinoma of thyroid by immunohistochemical staining. Head & neck CT revealed that involving both the upper esophagus and the posterior tracheal wall, extending into the mediastinum along the upper thoracic spine at $T_1-T_2$. We have experienced a rare case of occult papillary carcinoma which invaded the trachea, esophagus and fascia of thoracic spine. Treatment was initiated with radioactive iodine and external bean therapy.

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Synchronous Primary Cancer in Hypopharyngeal Cancer (하인두암에 병발한 동시성 암종)

  • Hur Kyung-Hoe;Lee Sung-Hoon;Jung Kwang-Yoon;Choi Jong-Ouck
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.173-177
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    • 1995
  • Multiple primary malignant neoplasms occur relatively frequently today and are important especially in the head and neck area for they usually carry a bad prognosis. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. The first case was a T1 hypopharyngeal cancer with a mid-esophageal second primary who complained of a huge neck node. The second case was a T3 hypopharyngeal cancer who was initially seen by the chest surgeons for a large lower esophageal tumor. The third case was a patient previously operated for stomach adenocarcinoma three years ago, who had newly developed symptoms like dysphagia and hoarseness, and was diagnosed as hypopharyngeal T3 with oropharyngeal second primary cancer. Three cases were all heavy smokers and had histories of heavy alcohol consumption. They were all treated at the same sitting by en-block resection of the involved organs and postoperative radiation therapy. The authors have recently experienced 3 cases of synchronous second primary cancers in association with hypopharyngeal cancer and a report is made.

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A Case of The Stroke Patient with Systemic lupus erythematosus(SLE) (뇌경색이 병발(倂發)한 전신성 홍반성 루푸스 환자 1례(例) 보고)

  • Lim, Seung-Man;Oh, Sang-Deok;Shin, Hyeon-Su;Kim, Yeong-Tae;Ra, Su-Yeon;Paik, Eun-Tan
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.729-733
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    • 2001
  • We report a case of the cerebellar infarction and pons, medulla and mid brain infarction seen in a 30-year-old female with systemic lupus erythematosus(SLE). SLE has been diagnosed at 1992, and treated with western medicine for 10 years. The patient with right hand tremor and dysarthria, as the symptoms of a cerebellar infarction, visited our hospital. During treatment, the patient constantly complained left knee pain, it turned out the bone infarction and ligament injury in the MRI scan at May, 18, 2001, that was the side effect of the long period steroid therapy. At June 1, 2001, the patient revealed quadriparesis, dysphagia and dizziness. So we took the brain MRI scan, it showed pons, medulla and mid brain infarction. As the consequence of the oriental treatments, the symptoms of SLE had the improvement and the values of BUN, Creatinine were improved. But the symptoms of the stroke were not much changed.

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A Case of Selective Laryngeal Adductor Denervation-Reinnervation Surgery for Adductor Spasmodic Dysphonia (선택적 갑상피열분지 및 측윤상피열분지의 절단과 경신경고리 신경재지배 방법을 이용한 연축성발성장애의 수술적 치료 1례)

  • Park, Young-Hak;Bae, Seong-Cheon;Lee, Seok-Eun;Cho, Seune-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.146-148
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    • 2006
  • Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

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A Case of Laryngeal Candidiasis Presented as Laryngeal Leukoplakia (후두백반증으로 발현된 후두 칸디다증 1예)

  • Choi, Ki Yong;Kim, Young Hwan;Myong, Na-Hye;Lee, Sang Joon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.48-51
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    • 2017
  • Candida exists in the oral cavity as normal flora, which is cultured in 7% of the population. And the development of candidiasis is usually related to the systemic or local immunosuppressed status such as diabetes, long-term antibiotics, steroid, radiation therapy or chemotherapy. However, isolated laryngeal candidiasis in immunocompetent patients is a rare entity with fewer than 40 cases reported in the world. Symptoms of laryngeal candidiasis are variable such as hoarseness, dysphagia, or odynophagia according to its extent, but it has clinical importance because of its resemblance with laryngeal premalignant or malignant lesions. Diagnosis is made by biopsy under direct laryngoscopy with special staining to identify the hyphae. In this article, we report a case of laryngeal candidiasis presented as leukoplakia localized on vocal fold with literature reviews.

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Effect of Neck Position on Muscle Fatigue during Shaker Exercise

  • Park, Eun-Jung;Koo, Jung-Wan
    • Journal of the Ergonomics Society of Korea
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    • v.32 no.6
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    • pp.541-547
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    • 2013
  • Objective: The aim of this study is to find the influence on muscle fatigue by changing an angle of neck while Shaker exercise. Background: Shaker exercise is commonly applied to dysphagia patients for strengthen suprahyoid muscle(SHM) and relaxing upper esophageal sphincter. Method: Experiments were conducted by measuring muscle fatigue with surface electromyography(SEMG) in case of neck $15^{\circ}$ and $50^{\circ}$ flexion, in addition to original method. For the study 30 undergraduate students were participated as subjects. Muscle fatigue was measured with variations of median frequency(MF) and median frequency slope(MFS) by attaching SEMG to 3 muscles. At the same time, perceived exertion was measured by using Borg's rating of perceived exertion(RPE). Results: A MF was increased when low angle in SHM, both male and female. It means that muscle fatigue was significantly decreased(p<.05). RPE was significantly increased when low angle(p<.01). Perceived exertion explained 15.2% of the variation of MF in SHM. And regression equation was, MF in SHM = 59.918 + (4,910 * RPE). Conclusion: The outcome shows that it is possible to use the efficient method which makes muscle fatigue decrease by reducing the angle of neck flexion. Application: The results might contribute to develop the effective Shaker exercise method.

Surgical Treatment of Plummer - Vinson Syndrome with Carcinoma in Situ - One case report - (상피내암종으로 발전한 Plummer - Vinson 증후군의 수술적 치험 - 1례 -)

  • 최주원;장운하;박찬필;오태윤
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.495-499
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    • 2002
  • Plummer-Vinson syndrome(Paterson-Kelly syndrome) is characterized by dysphagia due to upper esophageal or hypopharyngeal web, iron deficiency anemia, and atropic oral and glossal mucosa. This syndrome is usually known as precancerous lesion that develops into postcricoid carcinoma. Universally, the clinical manifestations of this syndrome were markedly improved after oral iron replacement therapy or endoscopic balloon or electrocautery treatment. 63 year-old woman was received a short segment, free jejunal transfer to be released from esophageal stricture. After the operation, the stenotic lesion proved to be Plummer-vinson syndrome with carcinoma in situ by pathologic study.

Use of Gastrointestinal Drugs in Patients without Digestive Symptoms (소화기계 무증상환자에 대한 소화기계 약제 투약현황)

  • Ko, Hee Kyung;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.2
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    • pp.57-61
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    • 2000
  • Gastrointestinal (GI) medications have been administered to many patients without any gastrointestinal diseases. The objectives of this study were to evaluate use of GI drugs and assess related factors. Medical records of 600 outpatients were reviewed from January 1997 to December 1997 at A Hospital, Kyunggi-do, Korea. Fifty patients every month among all outpatients were randomly selected up to total 600 patients. Surgical patients, visitors for regular health examination and inpatients were excluded. GI symptoms included nausea, vomiting, diarrhea, dyspepsia, constipation, heartburn, dysphagia and abdominal pain. The prescribed gastrointestinal drugs were antacids. $H_2$-antagonist, sucralfate, cisapride, omeprazole, laxatives, digestive enzymes and antidiarrheal agents. Patients without GI symptoms were 348 out of 600 outpatients who were screened. Two hundred and eighty two of 348 patients $(81\%)$ were given GI drugs though they did not have any GI symptoms. There were no differences in regard to sex and age of patients. Most of medical departments prescribed gastrointestinal drugs for these patients. The most frequently prescribed drugs were in order of digestive enzyme, antacids and $H_2$-antagonists. In view of economic aspects, patients paid 12.28 percents of total cost per prescription for unnecessary medicines. The medical practice of prescribing GI drugs should be assessed to define appropriate subgroups to have benefits with prophylactic administration and to reduce adverse effects caused by drug interactions. Pharmacists would have a significant role to promote rational drug therapy.

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A Case of Cobra Antivenom Therapy in a Patient Bitten by Elapid Snake in South Korea (코브라과 뱀에 물린 환자에서 코브라 항독소를 사용하여 치료한 1례)

  • Kim, Ji Eun;Kwon, In Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.1
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    • pp.22-24
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    • 2022
  • Elapid snakes have neurotoxic venom which causes diverse neuroparalytic manifestations, including fatal respiratory failure. In South Korea, since elapid snakebites are very rare, the cobra antivenom, which is effective against neurotoxicity, was only introduced recently. Most physicians in South Korea have little experience in the treatment of patients who have been bitten by elapid snakes. A 19-year-old man was brought to the emergency department with sudden diplopia, 1 hour after a snakebite on the left 2nd finger. The patient presented with drowsiness and complained of mild dizziness and binocular diplopia. After 1 hour, he had sudden onset of dyspnea and dysphagia and appeared to be agitated. He was immediately intubated and received mechanical ventilation as he was unable to breathe on his own. A total of 2.5 mg of neostigmine diluted with normal saline was slowly infused, and 1 vial of cobra antivenom was infused for an hour, 5 times every 2 hours, for a total of 5 vials. He slowly recovered self-breathing; on the 3rd day of hospitalization, he showed tolerable breathing and was extubated. He was discharged without any neurological deficits or other complications.

Clinical Study on 1 Case of Reflux Esophagitis (역류성식도염 환자 1례에 관한 증례보고)

  • Baek Dong Gi;Hwang Sang Il;Rhim Eun Kyung;Lee Yun Jae;Cho Young Kee;Moon Mi Hyeon;Jeong Hyeon Ae;Bae Young Chun;Kim Hong Jun;Moon Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1933-1937
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    • 2004
  • Gastroesophageal reflux disease(GERD) refers to the varied clinical manifestations of reflux of stomach and duodenal contents into the esophagus and is preferable to the 'reflux esophagitis'. Clinical symptoms of reflux esophagitis are heartburn, dysphagia, blood loss, abdominal pain, nocturnal wheezing, coughing, hoarseness. We applied oriental medicines to patient who had reflux esophagitis. we treated them with herb-medication, acupuncture, moxa therapy and aroma therapy for about 2 months. During this period, we observed that symptoms had been improved.