• Title/Summary/Keyword: recurrence symptoms

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Short-term Low-dose Oral Corticosteroid Therapy of Impingement Syndrome of the Shoulder: A Comparison of the Clinical Outcomes to Intra-articular Corticosteroid Injection

  • Kim, Young Bok;Kim, Young Chang;Kim, Ji Wan;Lee, Sang Jin;Lee, Sang Won;Choi, Hong Joon;Lee, Dong Hyun;Kim, Joo Young
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.50-56
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    • 2014
  • Background: To assess the clinical outcomes of short-term oral corticosteroid therapy for impingement syndrome of the shoulder and determine whether it can be substituted as an alternative to the intra-articular injection. Methods: The clinical outcomes of the 173 patients, the oral steroid group (n=88) and the injection group (n=85), were measured at 3 weeks, 2, 4, and 6 months postoperatively. The clinical outcomes were assessed by measuring the the University of California at Los Angeles (UCLA) score, visual analog scale (VAS) and range of motion (ROM) at every follow-up. Any complications and recurrence rate were noted. A relationship between the treatment outcomes and factors such as demographic factors, clinical symptoms and radiographic findings were determined. Results: No difference was observed in VAS and UCLA scores between the two groups, but forward flexion and internal rotation of ROM were significantly improved in the injection group at the 2nd and 4th postoperative month (p < 0.05). At 6th postoperative month, recurrence rate of symptoms was 26% in the oral steroid group and 22% in the injection group. No major adverse effects were observed. When the clinical outcomes of the oral steroid group were compared to either demographic, clinical symptoms, or radiographic findings, UCLA score was found to be significantly low (p < 0.05) in patients with joint stiffness and UCLA score, whereas VAS score was significantly improved in patients with night pain (p < 0.05). Conclusions: Short-term low-dose oral corticosteroid therapy of impingement syndrome showed comparable clinical outcomes to intra-articular injection without any remarkable adverse effects. Low-dose oral steroids can be regarded as a partial alternative to intra-articular injection for the initial therapy of impingement syndrome of the shoulder.

A Comparative Study between First Attack and Reattack Groups in C.V.A (중풍환자의 초발군과 재발군에 관한 임상적 고찰)

  • 박숙자;권정남;김영균
    • The Journal of Korean Medicine
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    • v.23 no.3
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    • pp.119-133
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    • 2002
  • Objectives : This study was designed to investigate significant differences between the first attack and reattack groups to form fundamental data for decreasing recurrence and secondary prevention of stroke. Methods : I studied 204 patients admitted within 7 days of onset, after the diagnosis of stroke, in the Oriental Medical Hospital of Dongeui University from February to July in 2001.compared the reattack group with the first attack group for risk factors, clinical symptoms and progress, average mark and degree of improvement in Activity Index. Results : 1. Meaningful risk factors associated with the reattack group were male sex, a past history of hypertension and transient ischemic attack, and a family history of stroke. 2. The reattack group had conscious or cognitive disorder in early stage of onset, dysphagia, constipation, urinary incontinence, visual field defect in acute stage, high blood pressure and tachycardia in abnormalvital sign in acute stage, neuropsychosis, shoulder pain and rigidity, and pneumonia in complications more than the first attack group. 3. In Activity Index, the average mark of reattack group was lower than that of the first stroke group and improvement of the reattack group was delayed compared with the first attack group. Conclusions : The reattack group had more severe symptoms and clinical progress than the first attack group.

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Two Cases of Castlema's Disease in Childern (소아에 발생한 Castleman's Disease 2례)

  • Kim, Eun Ah;Lee, Chong Guk;Kim, Han Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.203-206
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    • 2003
  • Castleman's disease is an atypical lymphoproliferative disorder of unknown origin. It has three histologic variants(hyaline vascular, plasma-cell, and mixed) and two clinical types(localized and multicentric). Some sufferers have constitutional symptoms and laboratory abnormalities such as anemia, hypoalbuminemia, hypergammaglobulinemia, and elevated erythrocyte sedimentation rate. The localized form is cured by complete surgical excision whereas the multicentric form is managed by prednisone and other immunosuppressor drugs. The prognosis of the multicentric form is worse than the localized form since malignancies and severe infections may lead to a rapidly fatal outcome. Castleman's disease has been rarely reported at pediatric age in Korea. We experienced two cases of Castleman's disease detected at 3 and 5 years of age. They were presented with painless enlargement of submandibulars and axillary lymph nodes but had no associated symptoms. The lesions were excised and diagnosed as Castleman's disease, and no recurrence was noted during follow-up periods.

A Case Study of Contralateral Occurrence after Unilateral Repair of Hydrocele in Children (소아의 일측 음낭수종 교정술 후 반대측 발생의 치험 1례)

  • Kim, Eun Jin;Min, Sang Yeon;Kim, Jang Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.1
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    • pp.44-49
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    • 2015
  • Objectives Hydrocele is a common disease found in pediatrics and is usually treated by hydrocelectomy, and even after the unilateral repair of hydrocele, it has been reported that the contralateral hydrocele still occurs in 5.4-12.5%. Therefore, the purpose of this study is to conduct a case study of contralateral hydrocele treated by Oryeong-san and Bangkeehwangkee-tang (五苓散 合 防己黃芪湯). Methods A patient diagnosed with San Syndrome (Su-San) (水疝) was administered Oryeong-san and Bangkeehwangkee-tang (五苓散 合 防己黃芪湯). Results The sizes of hydrocele and symptoms were reduced. Conclusions In the case of contralateral occurrence after unilateral repair of hydrocele in children, it is better to select a safer treatment than operation considering other possible complications. In this report, we have proven that Oryeong-san and Bangkeehwangkee-tang (五苓散 合 防己黃芪湯) can be very effective in reducing the size of hydrocele, improving symptoms and preventing recurrence.

A Clinical Study of Cavernoplasty (공동 성형술에 대한 임상적 검토)

  • 우종수
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.147-152
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    • 1978
  • Six patients with pulmonary tuberculosis with cavity had cavernoplasty at Seoul National University Hospital during the last 4 years and 9 months, from October 1973 to April 1978, were studied in order to assess the clinical values of cavernoplasty. 2] All the cases were male, and the mean age was 31.5 years. 2] All the patients had combined therapy with more than two antituberculosis drugs preoperatively, its minimum duration being 8 months and maximum duration 5 years. 2] Nonspecific symptoms were predominant just prior to admission, weight loss being in 50% and loss of appetite in 50% of cases, respectively. The preoperative cavity size on plain film was minimum 2.5cm by 3.5cm and maximum 6.0cm by 4.0cm with the mean of 4. 4cm by 3.4cm. The cavity size was reduced postoperatively to 1/3-1/4 of preoperative size with the mean of 1.15cm by 1.59cm. 2] Sputum smear for acid fast bacilli was converted to negative postoperatively in two cases. 2] Complications occurred in two cases. One was postoperative pleural effusion and the other was recurrence of symptoms 2 years after surgery. 2] Of the 3 cases able to follow, 2 stopped antituberculous medication after one year. The third case was still on medication because of bronchiectasis due to tuberculous infection.

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Aneurysmal Bone Cyst of the Orbit : A Case Report with Literature Review

  • Yu, Jae-Won;Kim, Ki-Uk;Kim, Su-Jin;Choi, Sun-Seob
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.113-116
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    • 2012
  • Aneurysmal bone cyst (ABC) is benign vascular lesion destructing the cortical bone by the expansion of the vascular channel in the diploic space that usually involve long bone and spine. Orbital ABC is rare and the clinical symptoms deteriorate rapidly after initial slow-progression period for a few months. A 12-year-old female patient visited ophthalmologist due to proptosis and upward gaze limitation of the right eye, and orbital mass was noted in the upper part of right eye on orbital MRI. Five months later, exophthalmos was worsened rapidly with other features of ophthalmoplegia. Orbital mass was enlarged on MRI with intracranial extension. Surgery was done through frontal craniotomy and intracranial portion of the tumor was removed. Destructed orbital roof and mass in the orbit was also removed, and surrounding bone which was suspected to have lesion was resected as much as possible. Histopathological diagnosis was aneurysmal bone cyst. Postoperative course was satisfactory and the patient's eye symptoms improved. Authors report a rare case of orbital ABC with review of the literature. Exact diagnosis by imaging studies is important and it is recommended to perform surgical resection before rapid-progressing period and to resect the mass completely to prevent recurrence.

Two Case Reports and an Updated Review of Spinal Intraosseous Schwannoma

  • Zhang, Fan;Lu, Feizhou;Jiang, Jianyuan;Wang, Hongli
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.478-483
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    • 2015
  • We report two rare cases of spinal intraosseous schwannoma (SIS) with sustained myelopathy symptoms and provide an updated review regarding SIS in the literature. A 71-year-old man experienced right lumbocrural pain and gait disturbance accompanied with paresthesia and right leg weakness. Imaging examinations revealed a mass with lesions in L4 vertebral body causing bone destruction and spinal cord compression. Complete resection of the well-demarcated tumor and posterior fusion were performed. A 54-year-old female reported bilateral gait disturbance, paresthesia, and numbness without weakness, and imaging revealed a posterior mass from T9 causing spinal cord compression and bone erosion. The tumor was completely separated from the spinal nerve root. The tumors from both patients were confirmed as schwannomas. Tumor recurrence was not observed at the 2-4 year follow-up. Although rare, SIS should be considered during differential diagnosis and can affect treatment planning. SIS symptoms vary depending on tumor location, and fusion is frequently necessary for spinal reconstruction after complete tumor resection.

Superior Vena Cava Syndrome -2 Bypass Graft Cases- (상공정맥 증후군 -Dacron & Nylon 환치수술 2예-)

  • 김정석
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.65-72
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    • 1969
  • Superior Vena Cava Syndrome: Dacron and Nylon graft between the left innominate vein and the right atrial appendage. Two cases with typical superior vena cave syndrome treated by by-pass graft between the left innominate vein and the right atrial apepndage were presented. One of them was a 58 year old farmer who suffered from marked swelling of the neck and upper half of body, the other was a 50 years old government employee who had acutely progressive symptoms of superior vena cave obstruction. Both of cases revealed that [1] cubitel venous pressure was markedly increased. [2] tumors were noted in the posterior mediastinum by laminography. [3] preoperative cavogram showed the occlusion of superior vena cava and marked collaterals. Dacron and Nylon graft were inserted between the left innominate vein and the right atrial appendage. Postoperatively, the symptoms were relieved markedly, showing edema free face and decreased cubital venous pressure. Postoperative cavogram showed patent graft. Histologically the first case was diagnosed as squamous cell carcinoma and the second as undifferentiated carcinoma, originated probably from bronchus. Total doses of 3150 r X-ray irradiation and 5000 mg of 5-FU were administered in each cases. The first case expired 11 months postoperatively without recurrence of superior vena cave obstruction symptom and the second case is living now without obstruction signs, 4 months after by-pass operation.

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Clinical and Histopathological Analysis of 66 Cases with Cardiac Myxoma

  • Zheng, Jian-Jie;Geng, Xi-Gang;Wang, Hai-Chen;Yan, Yang;Wang, Hong-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1743-1746
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    • 2013
  • Background and Purpose: Cardiac myxoma is a major primary heart tumor which often causes unexpected symptoms or sudden death. This present study was designed to investigate its clinical pathological features and biological behavior. Methods: A retrospective analysis of the clinical pathologic and immunohistochemical features of 66 cases with cardiac myxoma was conducted. Results: In 66 patients with cardiac myxoma, 61 cases had involvement of the left atrium, one case in both the right ventricular and left atria. The female: male ratio was 2.7:1. Patients had symptoms of blood flow obstruction and systemic alterations with performance of arterial embolization. Tumors were spherical, lobulated or irregular in shape, and soft and brittle. Immunohistochemical markers of vimentin and CD34 in tumor cells were positive. Conclusion: Cardiac myxoma always exists in the left atrium and is more common in women, with diverse clinical manifestations and pathomorphism. Although proliferative activity and the recurrence rate are low, in addition to thorough surgical resection, strengthened review is important for young patients.

Effectiveness of a Web-based Learning Program for Medication and Symptom Management Education of the Schizophrenia Patient (정신분열병환자를 위한 웹기반 약물 및 증상 자가 관리 교육 프로그램 효과*)

  • Shon, Kyung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.15 no.2
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    • pp.285-292
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    • 2009
  • Purpose: This study was to examine the effect of a web-based education program for schizophrenic patients in order to identify symptoms, facilitate medication and prevent recurrence. Method: The design of this study was a quasi experimental research with nonequivalent control group, pretest-posttest design. The subjects of this study were inpatients in the psychiatric day hospitals in Busan; 14 schizophrenic patients for the web-based education group (Exp.I); 14 schizophrenic patients for the web-based education with face -to- face education (Exp.II); and 16 schizophrenic patients for the face -to- face education as control group (Con. G). The data were collected from November 5th 2007 to January 28th 2008 and were analyzed with $\chi^2$-test, ANOVA, ANCOVA and Bonferroni test in SPSS Win 11.0. Results: After receiving education, each with different methods, the Exp.I group attained the highest learning achievement in the knowledge of medication and symptom management. In addition, the Exp.I group and Exp.II group attained the lower scores in the relapse warning symptoms than the control group. There were significant differences among the three groups. Conclusions: A web-based learning program for medication and symptom management education is an effective rehabilitation program that reduces the relapse rate of schizophrenic patients.