• Clinical Pain
• /
• v.20 no.1
• /
• pp.25-29
• /
• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.16 no.2
• /
• pp.86-92
• /
• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.5 no.2
• /
• pp.94-98
• /
• 2012

Calcific tendinitis is characterized by inflammation around calcium hydroxyapatite crystal deposits. Minimally invasive extracorporeal shock wave therapy (ESWT) has been postulated to be an effective treatment option for treating calcific tendinitis. In clinical practice, shock waves usually are aimed at the painful area after palpation and not focused. It has been known that exact fluoroscopic focusing of ESWT at the calcific deposit for treatment of calcifying tendinopathy is highly effective. Ultrasound is a simple, inexpensive and radiation-free diagnostic tool that has been used to demonstrate tendinopathy including calcific tendinitis. However, focusing of shock wave under ultrasound is less well established. We present a patient in whom large calcific tendinitis of gluteus medius was completely resolved by exact focusing of ESWT by ultrasound with literature review.

• Journal of Chest Surgery
• /
• v.16 no.3
• /
• pp.301-309
• /
• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Pediatric Infection and Vaccine
• /
• v.4 no.1
• /
• pp.160-166
• /
• 1997

Toxic shock syndrome(TSS) is a multisystemic disease presenting with high fever, sunburn like rash that subsequently desquamates, and hypotension mainly caused by toxin producing strains of Staphylococcus aureus. It was first reported in 1978 by Todd et al, thereafter many patients have been reported. In children, TSS is rare and must be differentiated from other erythematous febrile diseases such as Kawasaki disease, scarlet fever, drug eruption etc. We experienced a case of TSS associated with staphylococcal cellulitis in 26-month old boy, who was presenting similar symptoms to Kawasaki disease at initial stage of illness. As time passed, the patient represented more typical symptoms of TSS and Staphylococcus aureus was isolated from cellulitis of the right elbow area. Therefore, we report this case with a brief review of related literatures.

• PNF and Movement
• /
• v.18 no.1
• /
• pp.117-126
• /
• 2020

Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.

• Journal of Trauma and Injury
• /
• v.32 no.1
• /
• pp.17-25
• /
• 2019

Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

• Parasites, Hosts and Diseases
• /
• v.59 no.4
• /
• pp.409-413
• /
• 2021

In this study, we have collected and screened a total of 268 stool samples from diarrheal patients admitted to an Infectious disease hospital in Kolkata for the presence of Cryptosporidium spp. The initial diagnosis was carried out by microscopy followed by genus specific polymerase chain reaction assays based on 70 kDa heat shock proteins (HSP70). DNA sequencing of the amplified locus has been employed for determination of genetic diversity of the local isolates. Out of 268 collected samples, 12 (4.48%) were positive for Cryptosporidium spp. Sequences analysis of 70 kDa heat shock proteins locus in 12 Cryptosporidium local isolates revealed that 2.24% and 1.86% of samples were showing 99% to 100% identity with C. parvum and C. hominis. Along with the other 2 major species one recently described globally distributed pathogenic species Cryptosporidium viatorum has been identified. The HSP70 locus sequence of the isolate showed 100% similarity with a previously described isolate of C. viatorum (Accession No. JX978274.1, JX978273.1, and JN846706.1) present in GenBank.

• Biomedical Science Letters
• /
• v.19 no.3
• /
• pp.280-283
• /
• 2013

Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.2
• /
• pp.145-147
• /
• 2013

We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.