• Title/Summary/Keyword: physical examination of abdomen

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A Case of Early Diagnosed Hunter Syndrome Detected by Large Head on Routine Examination (큰 두위를 주소로 내원하여 헌터 증후군으로 일찍 진단된 증례 1례)

  • Lee, Seung Ho;Park, Woo Sung;Lee, Young Seok;Yu, Jeesuk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.156-162
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    • 2014
  • A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.

Epidemiologic Study of Female's Part-Cold Hypersensitivity Syndrome (여성(女性) 냉증(冷症)의 설문(設問)을 통(通)한 실태분석(實態分析))

  • Jang, Jun-Bock;Lee, Kyung-Sub;Song, Byung-Kee
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.21-35
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    • 1995
  • The female's part-cold hypersensitivity syndrome is a disease which the oriental people better than the western people suffer from and if it would be sick for a long time, it could bring into the other diseases. In the Oriental Medicine, the coldness is regarded as one of the most important causes which induce female's diseases. Nowadays the number of the female patients are ascending that serously appeal the coldness-sense and pain-sense at the particular part of the body, for example, hand, foot, abdomen, waist, external genital portion and so on. These are caused by female's own characteristics of the menstration and delivery, and the influence of the circumstances. The Oriental Medicine have better effects by the diagnosis and treatment according per symptom in the contrast with the Western Medicine having difficulties in the point of accurate diagnosis and treatment. This epidemiologic study was undertaken by using specifically designed questionair and physical examination to evaluate the incidence and degree of female's part-cold hypersensitivity syndrome in 362 parous women, Who were randomly selected among the patients visiting the Department of Gynecology, Kyung Hee Medical Center from Feb. to Jul. 1995. The results were as follows: 1. The overall incident of female's part-cold hypersensitivity syndrome was 92.8%. 2. Subdivision of 336 patients was made according to severity Grade I - 31.9%, severity Grade II - 46.9%, severity Grade III - 21.4%. 3. As for the appealed portion of female's part-cold hypersensitivity syndrome, foot and hand, lower abdomen, knee, waist, hip, shoulder, leg, and ankle were in desending order. 4. As for the causes of female's part-cold hypersensitivity syndrome, it was deeply associated with the management of the abortion, delivery and puerperium. 5. The incidence of female's part-cold hypersensitivity syndrome did not show incerased tenency according to the quantity and quality of female's menstration, leukorrhea, and the increase of parity. 6. 165 patients among 336 patients wanted the treatments of the Oriental Medicine.

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Mammary Squamous Cell Carcinoma in a Collard Peccary (Tayassy Tajacu) (페커리 (Collard peccary)에서 발생한 유선 편평 세포 선암종)

  • Lee, So-Young;Yoo, Jong-Hyun;Park, Chul;Sur, Jung-Hyang;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.386-390
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    • 2009
  • A 10-year-old female collared peccary (Tayassu tajacu) was referred due to a large palpable mass in caudal abdomen. Physical examination revealed a firm and freely moveable mass (15 ${\times}$ 9 cm) in the right side of caudal abdomen. Thoracic radiographic findings revealed a few well circumscribed nodules. This case was diagnosed as mammary gland squamous cell carcinoma with pulmonary metastasis based on histopathological and immunohistochemical findings. This type of mammary gland tumors is uncommon in wild animals. The patient survived for one month after the diagnosis. This is the first case report of mammary squamous cell carcinoma in a collard peccary and the second case report of metastatic carcinoma to lung in a collared peccary.

Unusual Tc-99m MDP Uptake in the Keloid Developed after Subtotal Gastrectomy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.436-437
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    • 2000
  • A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scat along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated all unusual linear increased uptake along the midline of the upper abdomen that corresponded to the,skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.$^{1)}$ Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.$^{2)}$ It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.$^{2)}$ Siddiqui et al$^{3)}$ suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.

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A Case of Platyspondylic Lethal Skeletal Dysplasia Torrance Type

  • Lee, Sung Chan;Choi, Min Seon
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.44-48
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    • 2018
  • Platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T), is one of the pheno-types of type II collagenopathy and is characteristic of severe bone growth disorder. This phenotype may limit the growth and expansion of the lungs, which is known to cause death from respiratory failure during or shortly after birth, but in few less severe cases, patients have been reported to have survived to adulthood. We have experienced a case of PLSD-T in a preterm infant who was delivered via cesarean section at the gestational age of 29 weeks 3 days, with a birth weight of 1.15 kg. Physical examination of the infant revealed characteristic findings of short arms and legs, small thorax, distended abdomen, and cleft palate. On the basis of the subsequent genetic testing, the patient had a heterozygous mutation in the encoded c-propeptide region of collagen, type II, alpha 1 (COL2A1), c.4335G>A ($p.Trp1445^{\ast}$) in exon 52. This is the first case of PLSD-T diagnosed in Korea, and we hereby report the case.

A Case of Hunter Syndrome Presented with Chronic Purulent Rhinorrhea in 24-month-old Boy (24개월에 만성 화농성 비루를 주소로 내원하여 진단된 헌터 증후군 1례)

  • Kim, I An;Jin, Jang Yong;Park, Jae Ock;Hong, Yong Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.3
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    • pp.160-164
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    • 2015
  • Hunter syndrome(Mucopolysaccharidosis type II, MPS type II) is an X-linked disorder of glycosaminoglycans (GAGs) metabolism caused by an iduronate-2-sulfatase (IDS2) deficiency. A 24-month-old boy visited the department of pediatrics with the chief compliant of chronic purulent rhinorrhea beginning at age one. He had a history of repeated acute otitis media and chronic rhinitis. On physical examination he had a coarse face, enlarged tongue, distended abdomen, joint stiffness, and Mongolian spots at his first visit. The urine GAGs level was elevated at 66.10 mg/mmolCr (reference range, <11.1) and iduronate-2-sulfatase activity in leukocyte was decreased at 0.21 nmol/mg protein/hr (reference range, 18.7-57). Finally with an IDS gene mutational analysis, recombinant known mutation between intron 7 and distal of exon 3 in IDS2 was detected. Recombinant iduronate-2-sulfatase therapy was started without any infusion related reactions. The author highlights the importance of suspecting Hunter syndrome when pediatric patients visit with chronic purulent rhinorrhea which is a common cause of hospital visits for infants and children.

Successful Postoperative Management of Gastrointestinal Stromal Tumor in a Dog

  • Lee, Ki-Sung;Kim, Keon;Yang, Chul-Ho;Suh, Guk-Hyun;Lee, Chang-Min
    • Journal of Veterinary Clinics
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    • v.38 no.4
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    • pp.184-188
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    • 2021
  • A 10-year-old spayed female Maltese with a history of vomiting and lethargy was referred to the hospital. Physical examination revealed dehydration and severe pain following abdominal palpation. A large mass was observed in the cranial abdomen through radiography and ultrasonography. Laparotomy was performed to find the origin of the mass. The mass was about 8 cm originating from the cecum and subsequently removed. Histopathologic evaluation revealed that the cecal mass was suspected to be a mesenchymal-derived tumor. Through immunohistochemistry, the mass was diagnosed as a gastrointestinal stromal tumor (GIST) based on the c-kit expression. Given its recurrence, postoperative preventive therapy was initiated with masitinib mesylate, which is a tyrosine kinase inhibitor. The animal did not show any side effects during the medication period. After 6 months of therapy, it was well controlled without any recurrence. In this case, we introduced a novel postoperative management of GIST using masitinib mesylate.

Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.3
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    • pp.73-96
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea Most of the health screening programmes focused upon detection of risk factors and diagnosis of life - style related diseases (diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers (stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus) , infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites) , chronic obstructive respiratory diseases, chronic renal diseases (bacteriuria hematuria, proteinuria) , anemia, glaucoma, hearing loss, Alzheimer disease, stress, early psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests (CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests (HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray (chest PA, CT) , endoscopy (gastroscopy, colonoscopy) , sonography(abdomen, thyroid, pelvis, breast) ,cytology (cervix) , bone density, tumor markets (NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MRI, MRT/Angio, molecular testings) were widely used in hospital health screening programmes .In summary, a variety of tests were utilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few program used tests to excess disregarding health screening subjects.

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국내 주요 기관의 건강진단 검사 종목

  • Jo, Han-Ik;Kim, Sang-In
    • Journal of Korea Association of Health Promotion
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    • v.2 no.1
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    • pp.9-25
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items of major health screening program in Korea. Most, of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis), cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infections diseases(hepatitis, tuberculosis, sexually-transmitted diseases, parasites), chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress and earlypsychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests( CBC, urinalysis, liver function tests, lipid tests, glucose, HbA1c, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT) endoscopy(gastroscopy, colonoscopy), sonography (abdomen, thyroid, pelvis, breast), cytology(cervix), bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA125, PSA and eye tests. Advanced technologies, like CT, PET, MRI, MRI/Angio, molecular testing were widly used in hospital based health screening programmes. In summary, a variety of tests were untilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few programs used tests excessvely disregarding health screening subjects.

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Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients. (의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?)

  • Mun, You-Ho;Kim, Yun-Jeong;Shin, Soo-Jeong;Park, Dong-Chan;Park, Sin-Ryul;Ryu, Hyun-Wook;Seo, Kang-Suk;Park, Jung-Bae;Chung, Jae-Myung;Bae, Ji-Hye
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.