• Title/Summary/Keyword: Onset of symptoms

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Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms

  • Chung, Jaehwan;Park, In Sung;Hwang, Soo-Hyun;Han, Jong-Woo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.269-271
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    • 2014
  • Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis.

A Neurobiological Concept of Schizophrenia - Approach to Vulnerability -

  • Sato, Mitsumoto
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.37-45
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    • 1996
  • Recent studies on long-term outcome of schizophrenia revealed that schizophrenic symptoms recover in more than 50%, while it remains severe in less than 20% after 20 years or more from the onset. Psychopharmacological studies indicate that 75% of remitted schizophrenics may recur within 2 years after discontinuation of maintenance pharmacotherapy. In addition, family studies revealed that schizophrenic decompensation may occur significantly more frequent in discharged patients with high expressed emotion family than in low expressed emotion family. These findings strongly support a clinical validity of stress-vulnerability concept of schizophrenia which open a new viewpoint to two central problems in schizophrenia treatment, i.e. psychotic relapses and chronification of the fist episode schizophrenia. Moreover, recent psychopathological studies argue that schizophrenic symptoms are manifestations of psychological reaction secondary to a primary cognitive impairment(neurobiological vulnerability), which is originated in neurobiological changes in the brain. Recent approaches to the vulnerability to schizophrenic symptoms or schizophrenic decompensation are reviewed.

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Successful Surgical Resection of Left Atrial Myxoma by Total Cardiopulmonary Bypass - Report of a Case- (좌심방점액종의 개심술절제치험예)

  • 김근호
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.164-172
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    • 1977
  • This is a report of a case in which a left atrial myxoma was successfully removed by total cardiopulmonary bypass with total hemodilution and moderate hypothermia. The patient was a 17 old girl with mitral valvular symptoms that occured suddenly three months prior to operation. After the onset of symptoms. it was progressively aggravated to serious general condition. The preoperative diagnosis of left atrial tumor was made from echocardiography. and the tumor was confirmed as myxoma by the histopathological examination of the tumor tissue removed during operation. The myxoma was unusually originated from posterior wall of the left atrium. which was located between drainage orifices of right and left pulmonary veins, The tumor developed in the left atrial cavity and one of the polypoid processes of the myxoma was prolapsed into the the left ventricle through the mitral orifice. Following operation. there was no evidence for peripheral vascular embolism, and all valvular symptoms disappeared. The postoperative course was uneventful.

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A Case of an Antral Web with a Gastric Ulcer due to Ibuprofen (Ibuprofen 사용 후 위궤양을 합병한 유문동 격막 1예)

  • Jung, Ji;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.66-69
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    • 2010
  • An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is >1 centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment.

Treatment-Resistant Schizophrenia: Terminology and Clinical Features (치료저항성 조현병: 정의와 임상양상)

  • Lee, Kounseok
    • Korean Journal of Schizophrenia Research
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    • v.23 no.2
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    • pp.45-50
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    • 2020
  • Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.

Correlation Between Accompanying Symptoms of Facial Nerve Palsy, Clinical Assessment Scales and Surface Electromyography

  • Gyu Hui, Kim;Jung Hyeon, Park;Tae Kyung, Kim;Eun Ju, Lee;Su Eun, Jung;Jong Cheol, Seo;Cheol Hong, Kim;Yoo Min, Choi;Hyun Min, Yoon
    • Journal of Acupuncture Research
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    • v.39 no.4
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    • pp.297-303
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    • 2022
  • Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara's unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.

The Sleep Characteristics of Chronic Schizophrenia Patients with Insomnia in Community-based Mental Health Services (지역사회 정신보건 서비스를 이용하는 불면증을 동반한 만성 조현병 환자의 수면의 특징)

  • Hwang, Dong-Ki;Nam, Min;Lee, Yu-Jin G.
    • Sleep Medicine and Psychophysiology
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    • v.24 no.2
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    • pp.97-105
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    • 2017
  • Objectives: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. Methods: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from community-based mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K >15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. Results: The mean ISI-K and PSQI-K scores were $18.1{\pm}2.6$ and $12.0{\pm}2.2$, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. Conclusion: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

Cemento-osseous dysplasia: clinical presentation and symptoms

  • Nam, Inhye;Ryu, Jihye;Shin, Sang-Hun;Kim, Yong-Deok;Lee, Jae-Yeol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.79-84
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    • 2022
  • Objectives: The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. Materials and Methods: In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author's institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher's exact test and the chi-square test. Results: COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. Conclusion: In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

Frequency of Post-Concussion Syndrome in Korean Patients with Minor Head Injury

  • Lee, Ji Young;Yoon, Young Hoon;Lewis, Roger J.;Tolles, Juliana
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.41-46
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    • 2017
  • Purpose: To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury. Methods: We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care. Results: Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury. Conclusion: The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.

Peripheral Neuropathy in the Orofacial Region after Third Molar Extraction as an Initial Manifestation of Anemia: Two Case Reports

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.44 no.1
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    • pp.40-44
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    • 2019
  • Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.