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Unexpected postoperative atlantoaxial rotatory subluxation after excision of melanocytic nevi of the head and neck in older children: two case reports and literature review

  • Jiwon Kang;Byung Jun Kim
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.85-89
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    • 2024
  • Postoperative atlantoaxial rotatory subluxation (AARS) is a rare complication that develops almost exclusively in children following oropharyngeal and otologic surgeries, proposing that oropharyngeal inflammatory responses and excessive head rotation are responsible factors. However, there have been no reports of AARS after excision of a nevus on the head and neck. Here, we present two cases of AARS following limited head rotation during simple nevus excision. Patient 1, a 9-year-old girl, complained of neck pain and limited range of motion after excision of the nevus on the neck. After 2 months, computed tomography and magnetic resonance imaging finally revealed AARS with a ruptured transverse atlantal ligament. A month of halo traction was required for the treatment. Patient 2, an 11-year-old girl, presented with immediate pain and limited neck extension after tissue expander insertion under the upper chest and excision of the nevus on her left cheek. The diagnosis was promptly made using cervical spine radiography. A cervical collar was applied for 1 month. Both patients recovered without any complications after treatment. This report highlights the importance of suspicion for AARS after surgery regardless of surgical duration or amount of head rotation.

Unexpected Aggravation of COVID-19 After Recovery in Three Adolescents With Chronic Neurologic Conditions: A Case Series

  • Dayun Kang;Seung Ha Song;Bin Ahn;Bongjin Lee;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.147-154
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    • 2022
  • The clinical severity of coronavirus disease 2019 (COVID-19) in children is usually mild. Most of the affected patients completely recovered from COVID-19 before being released from approximately 7-day quarantine. However, children with comorbidities are at risk of more severe disease and adverse outcomes. We report three cases of COVID-19-affected adolescents with underlying chronic respiratory difficulty due to neurologic diseases who showed sudden clinical aggravations at the time of discharge, even after full clinical improvement. Patient 1 is a 17-year-old boy with Ullrich congenital muscular dystrophy who had cardiopulmonary arrest 9 days after the initial COVID-19 symptoms. Patient 2 is a 17-year-old girl with intracerebral hemorrhage with infarction in bed-ridden status who had cardiopulmonary arrest 11 days after the initial symptoms. Patient 3 is a 12-year-old boy with intraventricular hemorrhage with hydrocephalus in bed-ridden status who showed multiorgan failure 10 days after the initial symptoms. Remdesivir, dexamethasone, and empirical antibiotics were administered with mechanical ventilation and intensive unit care. Among the three patients, two (patients 1 and 3) were alive, and one (patient 2) expired. Clinicians caring for adolescents with chronic neurologic and/or pulmonary disease should keep in mind that these patients could have sudden deterioration after recovery from the acute phase of COVID-19 around or after the time of discharge.

Clinical Study for the One Case that Diagnosed Polycystic Ovarian Disease (다낭성 난소증후군 치험 1례)

  • Oh, Tak-Geun;Kim, Song-Baeg;Lee, Su-Jeong;Ryu, Sung-Won;Kim, Ji-Ryang;Kang, Jung-Ah
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.2
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    • pp.284-291
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    • 2008
  • Purpose: The purpose of this study is to report the effect of oriental treatments for PCOD(Polycystic Ovarian Disease) patient with amenorrhoea. Methods: A 24 years old women, who diagnosed PCOD(Polycystic Ovarian Disease), was enrolled in this study. She received oriental treatments such as herbal medicine, acupuncture for 5 months. And we proceeded to checkup female hormone regularly, such as Estrogen, Progesteron, LH, FSH, Prolactin, testosterone. We observed the menstruation period and figure out LH/FSH ratio. Results: 1. We treated PCOD patient with oriental herbal medicine(Changbudodamtang) and acupuncture. 2. PCOD patient restart menstruation regularly. 3. PCOD patient's LH/FSH ratio decreased. 4. PCOD patient's testosterone was within normal limit. Conclusion: 1. We treated PCOD patient with oriental herbal medicine(Changbudodamtang) and acupuncture, and then PCOD patient restart menstruation regularly. 2. We treated PCOD patient with oriental herbal medicine(Changbudodamtang) and acupuncture, and then we observed that LH/FSH ratio decreased.

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Comparative study on factors affecting patient cooperation for dental treatments between orthodontic patients and non-orthodontic patients (치과교정여부에 따른 치과협조도에 영향을 미치는 요인 연구)

  • Lee, Kyeong-Hee;Park, Han-Bit;Yong, Hee-Yeon;Lee, Ji-Hee;Choi, Da-In;Hyeon, Hye-Min;Jung, Eun-Seo
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.4
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    • pp.565-575
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    • 2017
  • Objectives: This study aims to investigate patient cooperation for dental treatments by dividing patients into two groups with different treatment categories, i.e. orthodontic patients versus non-orthodontic patients. Methods: On December 2016, the study conducted survey targeting 311 orthodontic or non-orthodontic patients who are 20 years old or older living in Seoul and Gyeonggi-do, South Korea. The study subject were informed with the adequate information of the study and signed consent forms. Except for the questionnaire copies from 23 respondents whose answers were insincere those from 288 respondents, equivalent to 92.6% of the data collected, were used in the present analysis. Results: This review intended to clarify any factors affecting patient cooperation for dental treatments shows that the perception of oral condition, the reliability of dentistry, and the patient preventive cooperation had an effect on patient cooperation for dental treatments. Conclusions: The results summarized above suggest orthodontic patients who are familiar with dental treatments by virtue of their regular visits to dental clinics have higher cooperation for dental treatments compared to non-orthodontic patients, and the higher reliability of dentistry leads to higher patient cooperation for dental treatments.

A Case Study of Taeeumin Patient Who Experienced Refusing Food Intake after Stroke (뇌경색 발병 후 오식증(惡食症)을 보인 태음인(太陰人) 환자 1례)

  • Kim, Min-Ji;Bae, Hyo-Sang;Park, Seong-Sik
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.1
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    • pp.71-79
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    • 2013
  • Objectives The purpose of this case thesis paper is to report the improvement of symptoms for a 58-year-old male patient who experienced refusing food intake 1 month after onset of stroke by treating the patient with Chungpyesagan-tang. Methods We have determined the patient to have the Taeeumin type physique with Dry Heat Syndrome and provided Chungpyesagan-tang to alleviate the patient's symptoms. The level of improvement was measured based on changes of food intake amount. Results The patient was hospitalized to receive treatment for roughly 2 weeks. The symptom of refusing food intake as well as other symptoms that simultaneously appeared including insomnia, headache, dizziness, and general weakness have improved. Conclusions In this case, the symptom of refusing food intake appeared one month after experiencing stroke, and the patient refused not only meals, but the intake of all other forms of food including water and medicine. The cause of such symptoms were deemed to be emotional rather than the types of food which generally provide the causes for Oh Shik Jeung. As the patient was deemed to have the Taeeumin type physique with Dry Heat Syndrome. Chungpyesagan-tang was provided for treatment. Acupuncture and oriental cupping therapy were also provided concurrently, and the main symptom and other accompanying conditions have largely improved after 2 weeks of hospitalized treatment.

General Anesthesia for Dental Treatment of a Pediatric Patient with Marfan Syndrome (마판 증후군 소아 환자의 전신마취 하 치과치료)

  • Kim, Kyung Jin;Bak, Soyeon;Hyun, Hong-Keun;Shin, Teo-Jeon;Kim, Jung-Wook
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.209-214
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    • 2013
  • Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

A Case of Panic Disorder Patient Improved by Gyeji-tang(Guizhi-tang) Based on Shanghanlun Provision (상한론(傷寒論) 변병진단체계(辨病診斷體系)에 근거한 계지탕(桂枝湯)의 투여로 호전을 보인 공황장애 환자 1례)

  • Roh, Young-Beum;Kim, Ji-Young
    • The Journal of Korean Medicine
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    • v.42 no.2
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    • pp.98-106
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    • 2021
  • Objectives: The objective of this case report is to find a therapeutic effect of Gyeji-tang in panic disorder patients, based on Shanghanlun provision. Methods: At patient's first visit, we had conducted a medical interview in order to diagnose the physical and mental symptoms of the patient. A questionnaire called BAI had been also used to measure the degree of anxiety in panic disorder. After all the diagnoses had been done, the patient was allowed to take 120cc of Gyeji-tang, three times a day for 25 weeks. 25 weeks later, we conducted a second medical interview to compare with the initial treatment and to evaluate whether his physical and mental symptoms had been decreased or not. Likewise, the patient was asked to fill out the BAI questionnaire to measure the decline of anxiety degree. Results: Based on Shanghanlun provision, the patient with panic disorder due to overwork was diagnosed as Tai-yang-bing. Considering that the patient was having dyspnea, 15th provision of Gyeji-tang was selected and administered for 25 weeks. After 25 weeks, we could have observed that the main physical symptoms such as palpitation, dyspnea, stifling, headache, and fatigue were moderately improved. Moreover, the BAI score, which was evaluated to measaure the degree of anxiety, was also decreased from 49 points to the level of normal condition, 16 points. Conclusions: A 44 year old male patient who suffered from panic disorder due to overwork was allowed to take 15th provision Gyeji-tang for 25 weeks, based on Shanghanlun Provision. In results, the main physical symtpoms including dyspnea, palpitation, stifling, headache, and fatigue, and mental symptom such as extreme anxiety were all effectively improved.

Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006 (2006년 인천의 한 유치원에서 발생한 홍역 유행 역학조사)

  • So, Jae-Sung;Go, Un-Yeong;Lee, Dong-Han;Park, Koang-Suk;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.153-158
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    • 2008
  • Objectives : This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. Methods : The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measles-specific IgM was preformed. Results : Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. Conclusions : High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

ORTHODONTIC TREATMENT FOR PATIENTS WITH CEREBRAL PALSY AND AUTISM: CASE REPORT (뇌병변 장애 환자와 자폐성 장애 환자의 교정치료: 증례 보고)

  • Moon, So yeon;Lee, Dae woo;Kim, Jae gon;Yang, Yeon mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.84-88
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    • 2019
  • Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.

A Study Clinical Analysis of Cervical Spine disease patient's (경추 질환환자의 임상증례 분석연구)

  • Kim, Kee-Bog
    • Journal of the Korean Society of Radiology
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    • v.1 no.3
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    • pp.35-40
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    • 2007
  • The purpose of this study was to investigate in S city of Chung-Nam using direction radiation Cervical spine among patient enforcing AP view, lateral view, total 113 subjects(40-year-old low)by target examine and got following as: 1) Distribution of age 14~40 years old 57 men (50.4%), woman 56subjects(49.6%)be, and age group 30~40year old 80subjects(70.8 %), 20~29year old 27subjects(23.9%). 2) It appeared most by 81subjects(71.7%) that can not know cause though traffic accident, misstep, cause ignorantness were investigated to revealed by the chronic 87subjects(77%) appeared by thing which statistical significance is with occurrence cause. 3) 20 Among whole 113subjects 20~29years old 27 subjects(23.9%), 30~40years old 80 subjects(70.8%) manifestationacute form of a disease, the chronic all high distributionsee. 4) This investigator left shoulder region pain among 39 subjects whole 113 subjects (left to direction that could know that is each main pain in 34.5 %), cervical vertebral portion upside 31 subjects(27.4%), both shoulder region pain 20 subjects(17.7%), and becomes left side scoliosis 62 subjects(54.9%)by the most frequencies appear. 5) Appeared antespondylolisthesis by all curve 48 subjects(42.5 %) in curve direction and at Systolic blood pressure from 160mmHg to all 19 subjects (before total 69 subjects (61.0 %) at 16.8 %), Diastolic blood pressures curve 31 subjects(27.4 %) by 100 mmHg appear.

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