• Oral Biology Research
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• v.42 no.4
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• pp.241-247
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• 2018

Toothache is one of the most common discomforts experienced by patients in dental clinic. If clinical and radiographic examinations do not reveal any pathologic findings, we can suspect nonodontogenic toothache. Nonodontogenic toothache can be caused by a variety of causes such as muscle disorders, sinus and nasal mucosal problems, neuropathic pain, neurovascular pain, psychogenic problems, and cardiogenic disease. A thorough history and clinical examination should be performed to confirm the cause of the pain, and more accurate diagnosis can be established through local anesthetic injection. If the nonodontogenic toothache is misdiagnosed, unnecessary dental treatment such as root canal treatment, periodontal treatment, and extraction can be performed, and the patient's pain is not alleviated through such treatment. Therefore, the cause of toothache must be diagnosed correctly before dental treatment is performed, and clinicians should be fully aware of the diseases that may cause these symptoms.

• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.63-67
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• 2004

Tracheomalacia can be a life threatening upper air way obstructive disease in an infant and vascular rings can be also a major rare cause of tracheoesophageal obstruction. These two rare entities can be combined in one patient because the vascular ring can cause secondary tracheomalacia during development of fetus. The diagnosis of this combination and adequate surgical correction is occasionally difficult. This is a report of an infant who had not diagnosed tracheomalacia associated with vascular ring until 5 months of age because of the prolonged tracheal intubation. The rigid bronchoscopic examination performed under impression of tracheomalacia revealed a concentric tracheal collapse, an unusual bronchoscopic findings of tracheomalacia, which raised a suspicion of the tracheal compression by vascular rings. The 3-D reconstructive DT aortography clearly demonstrated the double aortic arch. The patient was treated surgically by simple division of the left aortic arch and aortopexy with good result. The vascular ring such as double aortic arch should be considered during the diagnosis of tracheomalacia in infants. If the tracheomalacia is associated with vascular ring, simultaneous surgical correction should be performed.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.115-121
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• 1990

We have experienced twenty-eight patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Seoul National University Hospital during the period from Jan. 1957 to Jun. 1989. The ratio between male and female patients was 17:11, and their age ranged from 2 years to 61 years old. [average: 30.4 years old] The cause of esophageal perforation were instrumental trauma in 9 cases, caustic perforation in 6 cases, spontaneous perforation in 6 cases, surgical trauma in 2 cases, and others in 5 cases. The most frequent location of perforation was in the lower third portion of the esophagus [13 case, 46 %]. Patients complained of chest pain [86 %], dyspnea [57 %], fever [57 %], subcutaneous emphysema [43 %], and others. The frequent complications of esophageal perforation were empyema [13 cases, 46 %] and mediastinitis [11 cases, 39 %]. The first treatment was supportive care in 3 cases, primary closure and reinforced procedures in 13 cases with 3 deaths, open drainage in 5 cases with 2 deaths, diversion in 4 cases with 2 deaths and closed thoracostomy drainage in 3 cases. After the first treatment, 6 patients received multi-staged operations for several months. Overall mortality was 25 %, and the most frequent cause of death was sepsis[57 %]. We thought that factors affecting the outcome of esophageal perforation are;[1] early diagnosis and adequacy in the first treatment, [2] intensive perioperative management including multi-stage surgical approach, [3] patient`s condition at the diagnosis

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.159-162
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• 2015

Neurological deficits after brain surgery are not uncommon, and correct and prompt differential diagnosis is essential to initiate appropriate treatment. We describe a patient suffering from loss of consciousness due to hyperammonemia, following valproic acid treatment after surgery for an unruptured cerebral aneurysm. A 57-year-old female patient underwent successful aneurysmal neck clipping to correct an unruptured aneurysm. Her postoperative course was good, and she received anti-epileptic therapy (valproic acid) and a soft diet. Within a few days the patient experienced mental deterioration. Her serum valproic acid reached toxic levels (149.40 mg/L), and serum ammonia was fifteen times the upper normal limit (553 mmol/L; normal range, 9-33 mmol/L). After discontinuation of valproic acid and with conservative treatment, the patient recovered without any complications. Valproate-induced hyperammonemic encephalopathy is an unusual but serious neurosurgical complication, and should not be disregarded as a possible cause of neurological deficits after neurovascular surgery. Early diagnosis is crucial, as discontinuation of valproic acid therapy can prevent serious complications, including death.

• Journal of Genetic Medicine
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• v.10 no.2
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• pp.88-93
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• 2013

Alexander disease (ALXD) is a rare demyelinating disease of the white matter of the brain that is caused by a mutation in the glial fibrillary acidic protein (GFAP) gene. The overexpression of GFAP in astrocytes induces a failure in the developmental growth of the myelin sheath. The neurodegenerative destruction of the myelin sheath of the white matter is accompanied by an accumulation of abnormal deposits of Rosenthal fibers in astrocytes, which is the hallmark of ALXD. The disease can be divided into four groups based on the onset age of the patients: neonatal, infantile, juvenile, or adult. Early-onset disease is more severe, progresses rapidly, and results in a shorter life span than late-onset cases. Magnetic resonance imaging and genetic tests are mostly used for diagnostic purposes. Pathological tests of brain tissue for Rosenthal fibers are definitive diagnostic methods. Therapeutic strategies are being investigated. Ceftriaxone, which is an enhancer of glial glutamate transporter (GLT-1) expression, is currently in clinical trials for the treatment of patients with ALXD. To date, there are no clinically available treatments. The cause, pathology, pathophysiology, inheritance, clinical features, diagnosis, and treatment of ALXD will be reviewed comprehensively.

• Journal of Korea Association of Health Promotion
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• v.3 no.1
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• pp.97-109
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• 2005

Chronic fatigue syndrome(CFS) is a complex, debilitating disorder characterized by at least 6 months of severe persistent of relapsing fatigue and a group of characteristic but nonspecific symptoms. Many researchers have proposed that CFS has a specific cause. However currently no evidence exists that proves either a specific cause of CFS. And there is no diagnostic test for CFS. The diagnosis of chronic fatigue syndrome is based on the patient's history, excluding other illnesses In the absence of consistent biological markers, the diagnosis of CFS arises from operational criteria that do not afford validity. The prognosis is poor and often disability and impairment of daily function and performance are prolonged. A limited understanding of the CFS has complicated the management of this disorder. Therefore, treatment of CFS may be variable and should be tailored to each patient. Therapy should include exercise, diet, good sleep hygiene, antidepressants, and other medications, depending on the patient's presentation. Regular follow-up is key to continue to exclude other medical problems and provide support for patients. Chronic fatigue syndrome is a challenging illness to manage and requires a team approach of caring providers. For the majority of patients this is a chronic illness with the goals of therapy being to improve functional status and to prevent disability. Further understanding of the etiology and pathogenesis of this illness should lead to better specific therapy.

• Proceedings of the Korea Contents Association Conference
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• 2016.05a
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• pp.391-392
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• 2016

In Japan, the children with problem behavior have been called the difficult children. However, the definitions of the difficult children in the medical, health, childcare and education are different. As a result, it is difficult to support for the needs of children. In addition, the difficult children have been influenced by the subjectivity of the teachers. IN-Child (Inclusive Needs Child) is defined by the result of this study. IN-Child means "Child in need of inclusive education by a team, including experts. It does not depend on intellectual and developmental delays due to physical, mental, home environment." We developed the IN-Child record that enables the educational diagnosis of IN-Child. IN-Child record was made to organize and analyze of the items by experts including 3 researchers and 2 teachers. As a result, it was classified into two domains of "cause" and "effect". The domain of "cause" is classified by two domains of "physical" and "mental". The domain of effect is classified by two domains of "daily living" and "learning".

• The Journal of Internal Korean Medicine
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• v.18 no.2
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• pp.112-130
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• 1997

This study has been carried out to investigate the cause, pathological mechanism and treatment of stroke in Oidaibiyo(外臺秘要), written by Wangdo(王燾). The results were follows : 1. Oidaibiyo(外臺秘要), which is written by Wangdo gives an account of the symptomatic degree of intensity and diachronic procedure in the chapter of stroke. 2. The cause of stroke is quoted mainly from External Wind(外來風邪), and the hyper-sexual intercourse, hyperalimentation, hyper -consciousness, excessive lavour and so forth as additional. And personal character and external effect, like the climate conditions are also much affected the outbreak of stroke. 3 With respect to the diagnosis of stroke, pulse means here quoted from its conception in Chungumyobang(千金要方) Jebungwonhuron(諸病源候論), and pulse plays an important role in diagnosis of stroke. 4. The treatment for stroke generally attaches much importance to medicine therapy. The concrete cure, BalhanGeopungbub(發汗祛風法) has been mainly available, and the usage of Cheongyulyak(淸熱樂) has been increased, contray to formal.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.2
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• pp.89-97
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• 2013

Purpose: We retrospectively investigated individuals who hadbeen identified by neonatal screening as potential galactosemia patients to determine the etiology of galactosemia. Methods: One hundred fifty-three patients referred to Korea Genetics Research Center due to high galactose level detected by neonatal screening test between February 2005 and May 2013 were examined. Galactose and galactose-1-phosphate levels were measured by using a fluoro metric microplate reader. Lactose free diet was initiated immediately after confirmed by urine Clinitest. If reducing sugar was negative, we employed abdominal sonogram and echocardiogram to check for possible porto-systemic shunt. Results: Fifteen patients were diagnosed with galactosemia. One patient had galactokinase (GALK) deficiency; four had UDP galactose-4-epimerase (GALE) deficiency; two had citrin deficiency; and four had porto-systemic shunt. Two had unknown causes of galactosemia. Conclusion: In addition to genetic defects of GALT, GALK and GALE, citrin deficiency or porto-systemic shunt could also cause galactosemia. It is crucial to carry out differential diagnosis to determine the cause of galactosemia.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.59-63
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• 1998

Background： Unilateral vocal cord paralysis(UVCP) by recurrent laryngeal nerve injury is one of the common laryngological diseases. Objectives : We attempted to study the clinical feature and the causes of UVCP and also tried to investigate what is to be the initial approach for determining the causes of unknown-origin UVCP Materials and methods The charts of 82 patients with the diagnosis of UVCP were reviewed. The records were analyzed for patient's gender and age, the status of paralysed vocal cord, the crucial tests for the diagnosis, and the etiologies. Results : forty-nine(59.8%) male and 33(40.2%) female patients were included in this study. The age group of sixth decade was most commonly involved. Most of the cases showed paramedian position of palsy, and the left side(59.8%) was more frequently attacked. The most common cause of UVCP in this series was the unknown origin, followed by the surgical trauma and neoplasms. The etiologies of the six(12.5%) unknown-cause cases were found with the further evaluation, with the most useful test being a CT scan. Conclusion： Chest X-ray, esophagography, and CT scan should be included in the mandatory initial investigation of patients with unknown-origin UVCP