• Title/Summary/Keyword: recurrence symptoms

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Identifying Predictive Factors for the Recurrence of Pediatric Intussusception

  • Lee, Dong Hyun;Kim, Se Jin;Lee, Hee Jung;Jang, Hyo-Jeong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.142-151
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    • 2019
  • Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

Surgical treatment and pathological anatomy of mid-thoracic esophageal diverticula-report of 6 cases- (식도중간부게실의 병리해부와 외과적 치례)

  • 이병우
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.391-398
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    • 1983
  • This is a report of 6 cases of esophageal diverticulum at the mid-thoracic esophagus treated surgically at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the 10 years. Five patients were female and one was male and the age distribution was between 31 and 61 years, Various subjective symptoms were noticed preoperatively. Diagnosis was confirmed by esophagography. The type of esophageal diverticulum were pulsion type in five cases and traction type in one case. After diverticulectomy, subjective symptoms disappeared and there were no operative complications and mortality. Recurrence of symptoms was not noticed during follow-up.

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Aneurysmal bone cyst arising from the surgically removed craniofacial fibrous dysplasia in the long-term follow-up: a case report

  • Seungchul Baek;Byung Jun Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.5
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    • pp.244-249
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    • 2023
  • Fibrous dysplasia (FD) is a rare skeletal disorder characterized by abnormal fibro-osseous connective tissue replacing normal bone. Despite its benign behavior, craniofacial FD can cause morphological disfigurement, headache, and even blindness as a result of the produced mass effect. Surgical resection is recommended when the patient shows apparent clinical symptoms or aggravating facial asymmetry. Postoperative complications have been reported, such as hematoma, surgical site infection, abscess formation, resorption of the bone graft used for reconstruction, and recurrence. An aneurysmal bone cyst (ABC) is a rare benign bony lesion that can occur secondary to preexisting bone tumor. Secondary ABCs in craniofacial FD are extremely rare in the literature, accounting for less than 30, all of which are either case reports or series. We report an extremely rare case of symptomatic secondary ABC arising from craniofacial FD that had been misdiagnosed with abscess formation or recurrence and was surgically removed. Notably, 17 years elapsed between the primary surgery and the complication of secondary ABC. The patient underwent total removal of secondary ABC. After surgery, symptoms were relieved, with no recurrence observed during a 6-month follow-up.

Risk Factors of Recurrence after Gross Total Excision in Pediatric Craniopharyngioma (전적출후 재발한 소아 두개인두종의 재발인자에 대한 분석)

  • Kim, Seung-Ki;Wang, Kyu-Chang;Chung, Young Seob;Sim, Ki-Bum;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.20-25
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    • 2001
  • Objectives : A substantial number of craniopharyngiomas recur despite gross total excision. The purpose of our study was to investigate pattern of recurrence and to verify prognostic factors for recurrence after gross total excision of craniopharyngiomas in children. Methods : A series of 36 patients with craniopharyngiomas were reviewed. All patients had undergone gross total excision and none of them received radiotherapy after initial surgery. Fifteen were girls and twenty-one were boys, with a mean age of 7.3 years(range, one to 15 years). The mean follow-up period was 52 months(range, one to 149 months). Recurrence was noted in 14 patients within 83 months(mean 31.4 months). Results : The overall three-year recurrence free survival rate was 65%, and the five-year recurrence-free survival rate was 55%. Regular neuroimaging follow-up at six to 12-month intervals detected tumor recurrence of a smaller size before symptoms developed(p<0.05). At the first surgical procedure, the optic nerve/chiasm(n=23) was the most common adhesion site. The most frequent sites of recurrence were the optic nerve/chiasm(n=6) and the pitiutary fossa(n=6). Tumor location was the single significant clinical predictor of recurrence. The five-year recurrence-free survival rate was 39% for those who had an intrasellar tumor component and 81% for those who did not (p<0.05). Conclusion : Craniopharyngiomas with intrasellar components should be followed cautiously and regular followup of patients should be emphasized, even when the tumors are totally resected.

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Cystic Adventitial Disease of the Popliteal Artery: Resection and Repair with Autologous Vein Patch

  • Maeng, Young-Hee;Chang, Jee-Won;Kim, Sun-Hyung
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.266-268
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    • 2011
  • Cystic adventitial disease is rare, but it is one of the well-recognized causes of non-atherosclerotic arterial stenosis or obstruction. Despite one of its most common symptoms being chronic intermittent claudication, it may be misdiagnosed as arterial embolism when presented with acute ischemic symptoms. Surgical resection is recommended because of recurrence or a low success rate with aspiration or endovascular stent. We performed resection and repair with autologous vein patch for cystic adventitial disease of the popliteal artery of a 57-year-old man presenting with pain, pallor, and paresthesia, without any postoperative complications or recurrence.

Various Approaches and Treatments for Pelvic Organ Prolapse in Women

  • Chung, Soo-Ho;Kim, Woong Bin
    • Journal of Menopausal Medicine
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    • v.24 no.3
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    • pp.155-162
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    • 2018
  • Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.

Physical Therapy of Conversion Disorder - Case Report - (전환장애의 물리치료 - 증례보고 -)

  • Oh, Duck-Won;Jung, Nak-Su
    • Physical Therapy Korea
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    • v.5 no.1
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    • pp.51-62
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    • 1998
  • Conversion disorder is defined as a specific and enduring sensorimotor dysfunction that contradicts known neurological or musculoskeletal pathology or physical findings. The patient with conversion symptoms unconsciously adopts these symptoms to convert their psychological stress to a physical phenomenon. Conversion disorder often involves the mimicry of organic symptoms similar to those experienced by a relative or an acquaintance. Because conversion symptoms are produced by psychological stress, specific treatment strategy and reinforcement program are needed for treatment. Treatment comprises avoiding unnecessary medical tests and removing symptoms by using graded exercises given by physical therapists. Clinical therapists must maintain a continuous and detailed follow-up to completely recover from conversion symptoms. The goal of treatment is to emphasize health rather than disease, to resolve physical symptoms, and to prevent recurrence. This study looks into the case reports of 4 patients diagnosed with conversion disorder.

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Significance of Follow-Up Ultrasonography 24 Hours Post-Reduction in Detecting Intussusception Recurrence

  • Kim, Sujin;Lim, HyeJi;Park, Sowon;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.21-29
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    • 2022
  • Purpose: The objective of this study was to identify the significance of 24-hour post-reduction ultrasonography (US) in pediatric patients with intussusception. Methods: A total of 229 patients with intussusception who were treated with saline reduction at Severance Children's Hospital between January 2014 and September 2020 were retrospectively reviewed. The 229 patients with successful saline reduction were divided into two groups: a recurrence at 24 hours group (R, n=41) and a non-recurrence group (NR, n=188). The full patient sample was divided into two groups: follow-up US (FU) or no follow-up US (NFU); the recurrence group was divided into follow-up (R-FU) and non-follow-up (R-NFU) subgroups, and stratified analyses were performed. Results: There were no significant differences in age, sex, laboratory findings, symptoms, and sonographic findings between the NR and R groups. In the R group, 24 patients underwent follow-up US, and 17 patients did not. Specific sonographic findings were statistically significant in the R-FU group compared to the R-NFU group (p=0.002). The R-FU group had fewer admissions (p=0.012) and longer mean hospitalization times (p<0.001) than the R-NFU group. The NFU group had a 12.2% recurrence rate, while the R-FU group recurrence rate was 25.8% (p=0.0099), suggesting that the omission of some recurrent events and follow-up US was a significant variable in the recurrence of intussusception. The median time to recurrence was 21 hours which supports the 24-hour follow-up protocol. Conclusion: Twenty-four-hour follow-up US was shown to be valuable for detecting early recurrence of intussusception.

A Case Study of a Soyangin Patient with Crohn's Disease who Reported Symptomatic Improvement after Being Treated with Dojeokgangki-tang (도적강기탕(導赤降氣湯)으로 호전된 크론병 환자 1례)

  • Lee, Mi-Suk;Hwang, Mim-Woo;Kim, Yun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.2
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    • pp.61-70
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    • 2012
  • 1. Objectives : The aim of this study was to report significant improvement of chronic diarrhea and hematochezia after treatment with Dojeokgangki-tang in a Soyangin Patient with Crohn's Disease. 2. Methods : The patient's subjective and objective symptoms were observed daily throughout the hospitalization period, and the Crohn's disease activity index(CDAI) was calculated to gauge the progress or lack of progress. 3. Results : The symptoms of diarrhea and hematochezia disappeared by the end of the hospitalization period without recurrence, and the CDAI score dropped from 92.5 to 47. 4. Conclusions : A patient with Crohn's disease, who was in the state of repetitive relapse and remission after long term clinical courses was treated with Dojeokgangki-tang in a short period and the the symptoms of diarrhea and hematochezia disappeared without recurrence. Then the patient could stop taking corticosteriods and taper off immune-suppressing drugs.

The Radiotherapy Result of the Nasopharyngeal Carcinoma (비인강암(鼻咽腔癌) 방사선치료성적(放射線治療成績))

  • Park, Charn Il;Koh, Kyoung Hwan;Kim, Chong Sun;Kim, Noe Kyeong
    • Radiation Oncology Journal
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    • v.1 no.1
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    • pp.85-94
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    • 1983
  • A total of 47 patients with a diagnosis of nasopharyngeal carcinoma was treated in Department of Therapeutic Radiology, Seoul National University Hospital during last 4 years. Of the 47 patients, 23(49%) had undifferentiated carcinoma, 20(43%) had squamous cell carcinoma, while 4(8%) had lymphoepithelioma. Most of the patients(71%) has Stage IV disease, cervical lymph node metastases were found in 36(77%) and distant metastasis was found in 1 at the time of diagnosis. Complete response rate after radiotherapy for 47 patients of nasopharyngeal carcinoma was 85.1%. The overall actuarial 3 year survival rates was 0.718 and the disease free actuarial 3 year survival rates was 0.468. Nodal involvement and symptom duration were statistically significiant influencing factors for actuarial survival rate. Treatment failures were found in 20 patients (42.6%), local recurrence only in 6(30%), local and neck recurrence in 3(15%), local recurrence with metastasis in 4(20%) and distant metastasis only in 7(35%). Local failures were more frequent in the patients with cranial nerve symptoms (P=0.032). Distant metastases were more frequent with T4 lesions (P=0.047), and with nodal involvement (P<0.01). Retreatment after the tumor recurrence was chemotherapy and/or radiotherapy, two pationts refreated for local recurrence were alive without evidence of disease for more than 19 and 44 months after retreatment.

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