We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was teated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunt's hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.
Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.
Journal of The Korean Society of Clinical Toxicology
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v.17
no.2
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pp.132-134
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2019
Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.
Thirty-day-old piglets were intranasally or subcutaneously inoculated with 2ml of Aujeszky's disease virus, NYJ-1 strain, at the titer of $10^{6.75}$$TCID_{50}/0.1ml$, that was isolated from the diseased piglets in Korea, and histopathological studies were performed to elucidate the pathognomonic characters of the isolate. Results obtained through the experiments were as follows: 1. Major clinical signs on the 2nd and 3rd days post inoculation (p.i.) were fever, anorexia and dyspnea. On the 6th and 7th days p.i., nervous signs, severe dyspnea and salivation were observed in the group of intranasal inoculation, and one out of 3 piglets in this group died on the 7th day p.i.. General signs were more severe in the group of intranasal inoculation than the group of subcntaneous injection. Between the 8th and l0th days p.i., the signs subsided and the piglets were completely recovered from the illness. 2. Hematologically, most of the inoculated pigs showed a mild lymphocytopenia on the 5th and 6th days p.i.. 3. By necropsy, swelling and hemorrhagic lesions were observed in tonsil, central nervous system and lung. No specific changes were grossly found in other parenchymatous organs. 4. In histopathological study, degeneration and necrosis of nervous cells, non-suppurative meningoencephalitis, diffuse or focal gliosis, perivascular cutting and degeneration of ganglion cells were observed in central nervous system, and swelling and hemorrhagic changes were shown in the tissues of liver, lung and lymph nodes. 5. By indirect immunofluorescence antibody assay using ADV-monoclonal antibody, specific ADV antigens were detected in the tissues of tonsil, brain and spleen of the succumbed piglet. However, in the experimentally slaughtered piglets, the specific reactions were noted only in the tonsils.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor, cognitive, and psychiatric symptoms, accompanied by marked cell death in the striatum and cortex. Stereotaxic injection of quinolinic acid (QA) into striatum results in a degeneration of GABAergic neurons and exhibits abnormal motor behaviors typical of the illness. The objective of this study was carried out to obtain basic information about whether parthenogenetic mouse embryonic stem (PmES) cells are suitable for cell replacement therapy of HD. To establish PmES cell lines, hybrid F1 (C57BL/6xCBA/N) mouse oocytes were treated with 7% ethanol for 5 min and cytochalasin-B for 4 hr to initiate spontaneous cleavage. Thus established PmES cells were induced to differentiate using bFGF (20ng/ml) followed by selection of neuronal precursor cells for 8 days in N2 medium. After selection, cells were expanded at the presence of bFGF (20 ng/ml) for another 6 days, then a final differentiation step in N2 medium for 7 days. To establish recipient animal models of HD, young adult mice (7 weeks age ICR mice) were lesioned unilaterally with a stereotaxic injection of QA (60 nM) into the striatum and the rotational behavior of the animals was tested using apomorphine (0.1mg/kg, IP) 7 days after the induction of lesion. Animals rotating more than 120 turns per hour were selected and the differentiated PmES cells (1$\times$10$^4$cells/ul) were implanted into striatum. Four weeks after the graft, immunohistochemical studies revealed the presence of cells reactive to anti-NeuN antibody. However, only a slight improvement of motor behavior was observed. By Nissl staining, cell mass resembling tumor was found at the graft site and near cortex which may explain the slight behavioral improvement. Detailed experiment on cell viability, differentiation and migration explanted in vivo is currently being studied.
Background: Nasal polyps are benign mass of nasal mucose, chronic sinusitis are swelling of nasal mucose, so nasal polyps and chronic sinusitis take a place at the same time. Nasal polyps are located lateral wall of nose, middle meatus, between middle nasal concha and inferior nasal concha. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis and nasal polyps before and after treatment using computed tomography (CT). To compared before and after treatment of otitis media using earscope. Materials and methods: Five patients (4 mail and 1 femail) treated in our hospital between August 1998 and July 1999 were studied. Ages ranged from 9 to 23 years (mean age:13 years). All patients had a underlying family history, and past history(allergy or sinusitis of parents or brothers). Illness period was from 1 to 36 months (mean period:10.5 month). To ascertain the efficacy of treatment, CT were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. We classified treatment period into the type of allergic disease. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms. Results: Treatment period was from 126 to 157 days (mean period:140.7 days). To 3 patients with chronic sinusitis and nasal polyp, treatment period was 140.7 days, to 2 patients with otitis media and chronic sinusitis and nasal polyp, treatment period was 141.5 days. So they had no significance. Not nasal polyp from middle meatus, but also polypoid mucosal change of maxillary sinus is polyps Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis and otitis media using earscope and CT. Herbal medicine therapy was effective in increasing immunity, inhibiting allergic reaction and inflammation of respiratory system. we practice ECP(eosinophil cataionic protein) and MAST examination, objectify herbal medicine therapy.
Kim, Bok-Youn;Kim, Seok-Beom;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
Journal of Yeungnam Medical Science
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v.8
no.2
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pp.185-201
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1991
A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.
Patterns are symbolic expressions of life style or sentiment of people as a product of culture. Furthermore, it is a type of language that the shape or implication does not change much over time. Patterns shown on the Korean medical containers are related to human life and health that they are not very diverse and splendid but closed used in real life. The medical containers include the alcohol container or tea-ware in broad sense, but under this study, it would be handled only for the Korean medical containers directly used to protect human health and treatment of diseases. They would be the Medicine Mortar and Pestle that is used to grind the herbal medical ingredients, pots that hold the liquid decoction, containers to keep the medical ingredients in general conceptual use for medical purposes. The patterns inscribed are classified in animal pattern, plant pattern or alphabet pattern. Turtle, crane, ginseng, and life patterns have the contemplation to pray for long life without disease or good fortune, while plum pattern, dragon pattern and the like are used in the medical containers used mainly in royal families with the social status and dignity shown. As such, patterns have not only ornament elements but also the symbolic implication to represent long life without illness for human. It provides the basic data of medical wisdom contained in the pattern and willingness of human to protect life from illness. On the basis of such research, it would require ensuing studies to make comparison and analysis with the medical containers with the patterns in the adjacent countries in the days to come.
Aseptic meningitis, the most common infection of the central nervous system, is an acute illness mostly caused by enteroviruses. Cerebrospinal fluid(CSF) has been used for the detection of enteroviral RNA but the detection has been mostly performed in a single CSF specimen obtained during the illness. A major objective was to evaluate the relation of sampling time to the recovery of enteroviral RNA in CSF. Thirty seven CSF specimens were obtained from 24 patients between May and August 1993, when an outbreak of asceptic meningitis by echovirus type 9 occurred. Enteroviral RNA in CSF was detected by polymerase chain reaction(PCR). Data about onset of symptom development were obtained by review of medical records. Enteroviral RNA was detected by PCR in 29 of 37 CSF specimens. PCR yielded positive results in 4 of 5 CSF specimens obtained on day 1 to 3, 10 of 11 on day 4 to 6, 8 of 10 on day 7 to 9, 6 of 8 on day 10 to 12, 1 of 3 on day 13 to 15 postonset. Of 11 patients from each of whom more than one CSF were obtained on different day postonset, PCR yielded positive resutls in 2 of 3 cases in whom enteroviral RNA detection was negative in the first CSF. These results indicate that two or more CSF specimens obtained within 12 days postonset are required for improving the accuracy of the diagnosis of enteroviral meningitis.
Journal of Korean Academic Society of Home Health Care Nursing
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v.7
no.1
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pp.83-93
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2000
This study was conducted to provide the data for the improvement of cerebral ischemia patient nursing services through the investigation of burden and hospital service satisfaction by family caregivers who were nursing the cerebral ischemia inpatients. The study subjects consisted of 125 family caregivers who were enrolled in four university hospitals with over 300 beds and one Chinese medicine hospital with over 100 beds. The Data were collected from all of the personal subjects using standardized questionnaires by interview from March 1 to March 30 in 2000. Data were analyzed by using t-test, ANOVA. Scheffe's multiple comparison, and Pearson's Correlation Coefficients. The results were as follows: 1. The mean score of burden felt by family caregivers who were nursing the stroke patient was 2.18. In relation to the characteristics of patients, higher scores were shown in male patients who were over 80 years old, and patients who had from 4 to 12 days care giving, over three month duration of admission, from one month to three month duration of illness. The burden felt by family caregivers revealed higher score of dependency in the Activities of Daily Living. 2. The mean score of hospital service satisfaction perceived by family caregivers was 3.35. The highest hospital service satisfaction score was shown in female caregivers, and caregivers whose patients graduated from element school, and treatment method was Chinese medicine, the duration of admission was under 1 month. As a result. the family caregivers' burden was seemed to be high when the patients who were old, male and as care giving time, duration of admission, duration of illness were getting longer. In conclution, hospital service satisfaction was good, but the satisfaction was tend to decrease that family caregivers who were male, higher education background and duration of patients' admission getting longer.
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