• Title/Summary/Keyword: 증상호소

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Discrepancy of Ultrasound-MR arthrography-Arthroscopy for the Diagnosis of Rotator Cuff Tear - Case report - (회전근 개 파열의 진단에서 초음파-자기공명 조영술-관절경의 불일치 - 증례 보고 -)

  • Oh, Chung Hee;Oh, Joo Han;Jo, Ki Hyun;Kim, Sae Hoon;Bin, Seung Woo;Gong, Hyun Sik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.23-26
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    • 2008
  • Ultrasonography (USG) is widely accepted diagnostic method for the rotator cuff tear. The availability, low cost, easy to access is main factors that favor USG as a primary diagnostic modality for various cuff disorders. We experienced a case of discrepancy between USG, MR arthrography (MRA) and arthroscopic examination. Seventy four year old female patient complained of right shoulder pain. USG depicted rotator cuff tear with the size of 1cm, and MRA demonstrated about 3cm sized tear. Complex massive tear with delamination of degenerated rotator cuff was identified in the arthroscopic examination. When we encounter a patient who has loss of rotator cuff power or severe symptom than findings of USG, MRA or repeat USG is warranted. We report a case of discrepancy between examination modalities with brief review of the literature.

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Treatment of the Headache (두통의 치료)

  • Chung, Kyung-Cheon
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.263-273
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    • 1999
  • Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

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Usefulness of Ultrasonography in Diagnosis of Baker's Cyst (베이커 낭종에 대한 초음파 검사의 진단적 유용성)

  • Kim, Jung-Man;Ra, Ki-Hang;Nam, Ho-Jin;Park, Bum-Yong;Choi, Seung-Kyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.1-7
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    • 2010
  • Purpose: The goal of this study is to assess the usefulness of ultrasonography in diagnosis of Baker's cyst. Materials and Methods: 42 cases of popliteal mass in 41 patients were reviewed between August 2006 and April 2009. All patients were evaluated with both MR imaging and ultrasonography. We investigated the comparison of a morphology, location, septation, and communication of mass between MR imaging and ultrasonography. Results: On ultrasonography, 40 Baker's cysts and 2 lipomas were detected, and all cysts were located at the medial side. 11 simple septated masses and 3 multiple cysts were detected, and 26 simple communicated cysts were suspected. On MR imaging, 40 Baker's cysts and 2 lipomas were detected, and all cysts were located at the medial side. 13 simple septated masses and 3 multiple cysts were detected, and 15 simple communicated cysts were suspected. Conclusion: Ultrasonography didn't give the definite information of Baker's cyst about communication with joint, but ultrasonography was a cost-effective useful tool for evaluation of a morphology, location and differential diagnosis of the Baker's cyst.

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Surgical Experience of Pericardial Mesothelioma: 2 Cases (심막에 발생한 중피종의 수술적 치험 2예)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Hong, Sook-Hee;Roh, Mee-Sook
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.437-440
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    • 2010
  • Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

The Role of Meniscal Arrow in the Treatment of the Meniscal Tear (반월상 연골 파열의 치료에서 meniscal arrow의 역할)

  • Bae, Dae Kyung;Yim, Chang Moo;Jeong, Ki Woong
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.24-29
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    • 1999
  • Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

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Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report (뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고)

  • Lee, Kkotnim;Kim, Miae;Hwang, Inkyung;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.327-333
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    • 2016
  • Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

Sleep Disorders and Restless Legs Syndrome in Alcohol Dependence Patients (알코올 의존 환자의 수면 장애와 하지불안증후군)

  • Lee, Moon-In;Jung, Hong-Joo;Kim, Han-Sok;Hwang, In-Bok;Sin, Jae-Jung;Kang, Sang-Bum;Yun, Woo-Sang;Kim, Sang-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.16-20
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    • 2010
  • Objectives: We review the sleep problems of the alcohol dependence patients. Especially we are interested in the prevalence, the severity of symptoms, anxiety, depression, and sleep quality of restless legs syndrome (RLS) in the alcohol dependence patients. Methods: We recruit 86 alcohol dependence patients who were admitted from October 6th, 2008 to October 17th, 2008. We interviewed each patient and evaluated sleep questionnaires such as the Sleep Disorder Questionnaire (SDQ), the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. The presence of RLS and its severity were assessed using the IRLSSG diagnostic criteria and the IRLSSG severity scale, respectively. Depression and anxiety were evaluated by the Beck Depression Inventory (BDI) and the Beck anxiety inventory (BAI). Results: Of all 86 patients, 59 patients have insomnia, 33 patients have RLS, 30 patients have Periodic limb movement disorder (PLMD), 29 patients have nightmare. RLS patients have more high score in the BAI ($21.70{\pm}10.36$ vs $14.67{\pm}11.98$), and their sleep quality was poor in the PSQI ($11.09{\pm}4.08$ vs $7.92{\pm}3.91$) than non-RLS patients. Conclusion: This study shows that alcohol dependence patients show many sleep problems such as insomnia and RLS. So we should notice that the sleep problems of alcohol dependence patients are important in clinical approach and treatment.

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The Phenomenological Study on the Individuation Process of the Middle Aged Women Experienced Severe Depression (우울증을 경험한 중년여성의 개성화과정에 관한 현상학 연구)

  • Park, Sook-Kyung;Shin, Dong-Yeol
    • Industry Promotion Research
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    • v.5 no.2
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    • pp.51-58
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    • 2020
  • Middle-aged women who have experienced the depression have been in pain for a long time. Depression in middle-aged women, which is rapidly increasing from their forties, has a problem that do not decrease in spite of various treatment methods. If the essential cause of depression in middle-aged women is due to the inability to detect the meaning of life because of the lack of the perception about the identity resulting from self-loss, a more qualitative research for a fundamental treatment method is required. The purpose of this study is to find out the essence and meaning of the experience of depression in middle-aged women and to help them to find their own selves through the process of individualization and to recover the whole health as well as to live as a self-transcendent being. Three Christian middle-aged women falling on critical and serious condition by BDI diagnosis were selected for the study. In-depth counseling and interviews were held from January to August 2018. In-depth counseling has provided detailed statements about the process of individualization of middle-aged women who have experienced depression, which applied 5 stages of Giorgi's Phenomenological Research Methodology. As a result, 261 semantic units and 11 sub-components were derived and structured by dividing them into two themes: depression experience and the process of individualization process, which are the subject group. This study has its significance in realizing essential meaning of pain by middle-aged women who experience depression and fundamentally preparing an opportunity to be cured through the process of individualization, as well as contributing for such middle-aged women to have abundant living by suggesting preventive measures to general middle-aged women who prepare for their old age.

Efficacy of a self - applied paint - on whitening gel combined with wrap (Wrap을 사용하는 자가 도포 미백젤의 치아 미백 효과)

  • Kim, Soo-Yeon;Ahn, Jae-Hyun;Kim, Ji-Young;Kim, Jin-Woo;Park, Se-Hee;Cho, Kyung-Mo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.175-185
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    • 2018
  • Purpose: The aim of this clinical study was to evaluate the efficacy and safety of a self - applied paint - on whitening gel combined with wrap to increase the effect of a whitening gel and minimize gingival irritation. Materials and Methods: Ninety adult volunteers were randomly treated to a control group and two experimental groups using whitening gel containing 2.8% and 3.0% hydrogen peroxide for 30 persons each. They had used the wrap and whitening gel on maxillary 4 anterior teeth for 30 minutes per day during 2 weeks. Whitening tooth color response was measured by VITA shade guide and ShadeEye $NCC^{(R)}$. And side effects were assessed from interview and intraoral examination. The efficacy and safety evaluations were statistically analyzed. Results: In the evaluation with VITA shade guide, there was significantly the whitening effect in experimental groups compared with the control group. In the evaluation with ShadeEye $NCC^{(R)}$, the 3.0% experimental group showed significantly the whitening effect compared to the control group and the 2.8% experimental group (P < 0.05). There were some complaints of minor side effects, but there did not find abnormal symptoms of the gingival stimulation in all groups. Conclusion: A self - applied paint - on whitening gel combined with wrap can be used as a useful self-whitening material because the whitening effect increases as the concentration of hydrogen peroxide from 2.8% to 3.0% and also no significant side effects are observed.

Two Cases of Gastric Metastasis from Small Cell Lung Cancer (소세포 폐암에서의 위 전이 2예)

  • Yoo, Kwang-Ha;Kim, Hyung-Joong;Ahn, Chul-Min;Lee, Se-Joon;Kim, Seung-Kyu;Lee, Won-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.273-280
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    • 1999
  • This is a report of gastric metastases secondary from a primary small cell carcinoma of the lung in two men. Blood-borne metastatic involvement of the stomach by cancer is a rare entity. According to the reports in the literature the prevalence of metastasis to the stomach occurs in 0.4% and the most common cell type of the primary lung carcinoma is large cell type(3.7%) followed by adenocarcinoma(2.4%), small cell carcinoma(1.7%) and squamous cell carcinoma(0.7%). The most common tumors that spread to the stomach through the blood stream are malignant melanoma, breast carcinoma and lung carcinoma. Most of the gastrointestinal tract metastases had no specific symptoms because of its submucosal involvement. The prognosis was poor and the mean survival period from the onset of symptoms was 49 days. The first patient was a 56-year-old man who had primary lung carcinoma with brain metastasis. Gastroscopic findings showed two elevated mass lesions in the anterior wall of the mid body with central ulcer and the posterior wall of the fundus with intact surface mucosa. Pathologic examination of stomach tissue revealed small cell type tumor cells infiltrate in the stomach wall segmentally without destruction of the glands. The second patient was a 67-year-old man who had no other evidence of the distant metastasis. Gastroscopic findings showed a huge, oval shaped, ulcerofungating mass with deep penetrating central ulcer coated with dirty exudate in the anterior wall from mid to upper body of the stomach, and thickened elevated rugal folds in the posterior wall of the fundus. Pathologic examination of stomach tissues revealed the small cell type tumor cells showing small smudged nucleus infiltrate into the mucosa of the stomach and the architecture of mucosa intact. We report the two cases of metastatic gastric cancer from the primary small cell lung carcinoma with the literature review.

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