• Title/Summary/Keyword: severe pain

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Isolated Glycerol Kinase Deficiency (글리세롤 키나제 단독결핍증)

  • Lee, Jong Yoon;Kim, Hui Kwon;Bae, Eun Ju;Oh, Phil Soo;Park, Won Il;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.54-57
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    • 2012
  • A 3-year-old boy was transferred to emergency room (ER) with lethargy and abdominal pain. Physical examination revealed drowsy mental status but neurologically intact. Basic evaluation in ER shows hypoglycemia (43 mg/dL), hyperglycerolemia, ketonemia and ketonuria. Initial urine organic acid was performed and the result showed severe hyperglyceroluria. Under suspicion of isolated GKD, GKD gene was obtained from his DNA from white blood cell in peripheral blood and sequencing was performed. Isolated glycerol kinase deficiency (GKD) is an X-linked inborn error of metabolism that is either symptomatic or asymptomatic. GKD is due to deletions of, or mutations within, the GK gene, and there is no genotype-phenotype correlation. Gene study that we performed showed normal at a well-known mutation site, but found 4-base insertion at 79 base pair away from the beginning of exon 11.

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Infectious Pseudoaneurysm Caused by Group A Streptococcus in a Child without Underlying Disease (기저 질환이 없는 소아에서 A군 사슬알균 균혈증에 동반된 감염성 가성동맥류 1예)

  • Kim, Kyoung Ha;Lee, Hyunju;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.183-187
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    • 2017
  • Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

Treatment for Hydrofluoric Acid Chemical Burn Using Acticoat® (Acticoat®를 이용한 불산에 의한 화학 화상의 치료)

  • Choi, Hwan Jun;Wee, Syeo Young;Choi, Chang Yong
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.407-412
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    • 2008
  • Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

Usefulness of Gold Thread Implantation for Crow's Feet

  • Shin, Kee-Cheol;Bae, Tae-Hui;Kim, Woo-Seob;Kim, Han-Koo
    • Archives of Plastic Surgery
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    • v.39 no.1
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    • pp.42-45
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    • 2012
  • Background : Conservative techniques designed to block or delay the aging process have been utilized in various ways for many years. However, their effects can be relatively minimal and short-term in most cases compared to surgery. The objective of this study was to evaluate the efficacy and safety of gold thread implantation for the treatment of periorbital wrinkles. Methods : A total of 78 consecutive patients who showed mild to severe periorbital wrinkles were deemed appropriate candidates, including 69 women and 9 men ranging from 31 to 59 years (mean, 47 years). Six gold threads about 4 cm in length were inserted subdermally in each patient at intervals of about 0.5 cm. Follow-up assessments were performed 1, 4, and 12 weeks after the procedure. The efficacy was rated by the physician using the Wrinkle Severity Rating Scale and patients who made global assessments of changes in periorbital wrinkles using the Visual Analog Scale. Adverse events were monitored throughout the course of the study. Results : The patients showed significant improvements after the procedure. There were minor complications such as foreign body sensation in the eye (2.63%) and eye pain (1.32%) that improved spontaneously without any specific treatments. Conclusions : Subdermal implantation of gold thread improves the appearance of periorbital wrinkles and does not appear to have serious side effects. Insertion of gold thread may be an effective and safe method for facial rejuvenation.

Clinical Study of Chronic Hepatitis and Liver Cirrhosis Treated with Sodalgeonbitang-gamibang (소달건비탕가미방 투약 후 호전된 만성간염을 동반한 간경변 환자 1례)

  • Baek Dong Gi;Hwang Sang Il;Rhim Eun Kyung;Lee Yun Jae;Kim Dong Woung;Shin Sun Ho;Kim Hong Jun;Moon Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.306-309
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    • 2004
  • Liver cirrhosis is caused by virus, alcohol, toxins, drugs and chronic hepatitis. Clinical symptoms of liver cirrhosis are severe fatigue, nausea, fever, dyspepsia, anorexia, RUQ pain, jaundice, ascites. We applied oriental medicines to patient who had chronic hepatitis and liver cirrhosis. Sodalgeonbitang-gamibang has been used to treat hepatitis and liver cirrhosis because of its beneficial effects. The patient symptoms began to improve after about one month of treatment. After medication we could find remarkable effect on clinical symptoms and blood test. So we hope that this clinical study is helpful in treat a patient with hepatic disease.

Study about Validity of Measuring Instrument for Symptoms Improvement on the Alcoholic Hepatitis Patients (알코올성 간질환자를 대상으로 한 증상개선 측정도구의 타당성 연구)

  • Kim, Jung-Eun;Park, Sang-Eun;Lee, Seung-Yeon;Son, Ho-Young;Hong, Sang-Hoon;Kang, Chang-Wan;Kim, Bo-Kyung;Chi, Gyoo-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.2
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    • pp.345-351
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    • 2010
  • Alcoholic hepatitis is an acute and severe liver disease associated with high mortality rate. This study was conducted to develop the instrument of criterion for symptoms improvement after temperance. We made the symptoms improvement questionnaire for alcoholic hepatitis patients through reviewing traditional oriental medical literatures and got advices from the advisor committee with delphi technique. The advisor committee on this study was organized by 10 professors of internal medicine of oriental medical colleges nationwide. The questionnaire was composed of questions about 10 symptoms - fatigue, pain, anorexia, abdominal bloat, heaviness of the body, itch, nausea, sleep, dryness in the mouth and stools. We named it Alcoholic Hepatitis Symptoms Improvement Questionnaire(AHSIQ). We surveyed 65 male alcoholic hepatitis patients and checked liver function profile and AHSIQ before and after temperance four times for six weeks. As a result of factor analysis the scales of AHSIQ had content validity and construct validity. And internal consistency reliability was good(Cronbach's alpha=0.768-0.871). The total scale scores were statistically significant in gamma-GTP related validity. We suggest that AHSIQ would be effective for measuring symptoms improvement degree in alcoholic hepatitis patients through further investigations with larger clinical trials.

A maxillary canine with two separated root canals: a case report (두 개의 근관을 가진 상악 견치: 증례보고)

  • Shin, Dong-Ryul;Kim, Jin-Man;Kim, Duck-Su;Kim, Sun-Young;Abbott, Paul V.;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.431-435
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    • 2011
  • Maxillary canines have less anatomical diversities than other teeth. They usually have a single root and root canal. This report describes an endodontic treatment of a maxillary canine with two separated root canals which have not been reported through the demonstration of radiography and computerized tomography (CT). Even though appropriated endodontic treatment has been performed, the severe pain could happen due to lack of consideration of anatomical variations of the teeth. Therefore, the clinicians should be well aware of the possibility of anatomical variations in the root canal system during endodontic treatment even if the number of root canals is obvious such as in this case.

Effects of Aqueous Extract of Achyranthes Japonica on Functional Recovery in Sciatic Nerve after Crushed Sciatic Nerve Injury in Rats (우슬 추출물이 흰쥐 좌골신경 손상 후 좌골신경의 기능회복에 미치는 영향)

  • Lee, Ma-Seong;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.143-158
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    • 2011
  • Objectives : Peripheral nerve injuries are commonly encountered clinical problem and often result in severe functional deficits. The aim of this study is to evaluate the effects of aqueous extract of Achyranthes japonica(AJ) on functional recovery in sciatic nerve after crushed sciatic nerve injury. Methods : In the present study, the animals in the AJ-treated groups received the aqueous extract of AJ at the respective doses orally for 13 consecutive days. In order to assess the effects of the aqueous extract of AJ on function recovery in crushed sciatic nerve injury, sciatic functional index(SFI) was performed. c-Fos expression in the paraventricular nucleus(PVN) and ventrolateral periaqueductal gray(vIPAG), and neurofilament, and the expressions of brain-derived neurotrophic factor(BDNF), nerve growth factor(NGF) following crushed sciatic nerve injury in rats were investigated. For this, immunohistochemistry and western blot were performed. Results : In the present study, crushed sciatic nerve injury showed characteristic gait changes showing decrease of SFI value and treatment with the aqueous extract of AJ significantly enhanced the SFI value. Neurofilament expression in the sciatic nerve was decreased by crushed sciatic nerve injury and treatment with the AJ increased neurofilament expression. The expressions of BDNF and NGF in the sciatic nerve were increased following crushed sciatic nerve injury and treatment with the AJ significantly controlled the sciatic nerve injury-induced increment of BDNF and NGF expressions. c-Fos expressions in the PVN and vIPAG were increased following crushed sciatic nerve injury and treatment with the AJ significantly suppressed the sciatic nerve injury-induced increment of c-Fos expressions. Conclusions : These results suggest that AJ treatment after crushed sciatic nerve injury is effective in the functional recovery by enhancing axonal regeneration and suppressing of pain.

A Case of Poncet's Disease in a Patient with Pulmonary Tuberculosis Accompanying Erythema Nodosum (결절홍반을 동반한 폐결핵환자에 나타난 Poncet병 1예)

  • Han, Na;Lee, Su-Kyeong;Kim, Tae-Jin;Song, Yun-Seok;Jung, Sun-Ho;Yang, Kyung-Ho;Choi, Sung-Jin;Shin, Won-Hyuk
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.221-224
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    • 2011
  • Poncet's disease is an aseptic polyarthritis developing in the presence of active Tuberculosis occurring elsewhere, and is not due to direct involvement of joints but to an immunological reaction to tuberculoprotein. We experienced a case of Poncet's disease accompanying erythema nodosum in a 55-year-old female patient with pulmonary tuberculosis. She had multiple tender erythematous nodules on both lower limbs for 3 months and a cough and sputum from one month ago. She felt severe pain in both knees and ankles with swelling one week before admission. Her chest X-ray, computed tomography (CT) scan and positive sputum AFB stain results revealed that she had active pulmonary tuberculosis accompanying erythema nodosum and aseptic polyarthritis. Her arthritis and erythema nodosum were dramatically improved within four weeks after anti-tuberculosis therapy. We report a case of Poncet's disease in pulmonary tuberculosis accompanying erythema nodosum.

Prognosis following dental implant treatment under general anesthesia in patients with special needs

  • Kim, Il-hyung;Kuk, Tae Seong;Park, Sang Yoon;Choi, Yong-suk;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.205-213
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    • 2017
  • Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.