• Tuberculosis and Respiratory Diseases
• /
• 제84권3호
• /
• pp.245-246
• /
• 2021

• 한국전문물리치료학회지
• /
• 제6권1호
• /
• pp.47-61
• /
• 1999

The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.

• Journal of Korean Neurosurgical Society
• /
• 제56권5호
• /
• pp.436-440
• /
• 2014

Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis.

• Journal of Chest Surgery
• /
• 제31권2호
• /
• pp.182-185
• /
• 1998

최근 교통사고와 산업재해로 인한 기관지파열상이 증가하고 있는 추세이다. 일단 기관지 파열상이 발생한 경우는 매우 심각한 증상을 유발하여 생명의 위협을 초래하고, 많은 합병증을 야기하기 때문에 조기 진단과 조기 치료가 원칙이다. 본 저자들은 승용차 전복사고로 흉부둔상을 받아 좌주기관지가 완전 절단된 21세 여자 환자에서 수상후 14일이 경과된 후, 기관지내시경과 흉부 단층 촬영으로 확진하고 , 기관지 성형술과 단단문합술을 시행하였으며 술후 2일간의 호기말양압을 이용한 인공호흡기 적용, 기관지내시경을 이용한 분비액 흡인, 지속적인 물리치료와 체위 배액요법을 시행하여 좌폐기능이 완전 정상화되었음을 추적 검사하에 확인하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제48권6호
• /
• pp.342-347
• /
• 2022

Objectives: The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods: A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results: Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion: Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

• Archives of Plastic Surgery
• /
• 제50권2호
• /
• pp.188-193
• /
• 2023

Vascular injury following traumatic knee injury quoted in the literature ranges from 3.3 to 65%, depending on the magnitude and pattern of the injury. Timely recognition is crucial to ensure the revascularization is done within 6 to 8 hours from the time of injury to avoid significant morbidity, amputation, and medicolegal ramifications. We present a case of an ischemic limb following delayed diagnosis of popliteal artery injury after knee dislocation. Even though we have successfully repaired the popliteal artery, the evolving ischemia over the distal limb poses a reconstruction challenge. Multiple surgical debridement procedures were performed to control the local tissue infection. Free tissue transfer with chimeric latissimus dorsi flap was done to resurface the defect. However, the forefoot became gangrenous despite a free muscle flap transfer. His limb appeared destined for amputation in the vicinity of tissue and recipient vessels, but we chose to use a cross-leg free flap as an option for limb salvage.

• Clinical Pain
• /
• 제18권2호
• /
• pp.102-106
• /
• 2019

Tuberculosis in the foot progresses gradually; thus, diagnosis is usually delayed, and early treatment is rarely provided. If osteomyelitis occurs due to delayed diagnosis and treatment, surgical treatment should be considered. We report the case of a 46-year-old man with osteomyelitis of the calcaneus who was diagnosed with multidrug-resistant pulmonary tuberculosis and he was treated with anti-tuberculosis drugs. Bilateral adrenal masses, abscess of both testes and a small wound in the left plantar heel were observed. Both adrenal masses and abscess were regarded as paradoxical reaction of anti-tuberculosis treatment. After 1 month, he developed a pain in the left plantar heel that was compatible with calcaneal osteomyelitis in radiological features. He underwent right orchiectomy for right scrotal abscess aggravation and surgical treatment for left calcaneal osteomyelitis. Mycobacterium tuberculosis was confirmed by polymerase chain reaction. The patient was immobilized by cast for 8 weeks and the heel pain gradually improved.

• Journal of Trauma and Injury
• /
• 제37권3호
• /
• pp.243-246
• /
• 2024

Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.

• Tuberculosis and Respiratory Diseases
• /
• 제41권5호
• /
• pp.574-578
• /
• 1994

저자들은 폐쇄성 흉부외상 1년 후, 경미한 호흡 곤란으로 내원한 환자에서 단순 흉부X-선상 폐실질에는 이상이 없고 기관지 내시경 검사상 기관지 web형태로 발현한 외상성 기관지 파열을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제5권2호
• /
• pp.158-165
• /
• 2002

목 적: 급성 충수돌기염은 소아 환자에게 가장 흔한 외과적인 응급질환이며 최근의 그 발생 빈도가 감소된다는 보고에도 붙구하고 급성 충수돌기염의 천공으로 인한 합병증의 발생은 호전되고 있지 않고 있다. 소아 환아에서는 과거력과 진찰 소견이 매우 다양하고 비전형적인 경우가 흔해 급성 충수돌기염의 진단은 자주 지연될 수 있고 천공과 복막염, 복강 내 농양 등의 합병증이 발생하여 임상 경과를 어렵게 만들 수 있다. 저자들은 후향적으로 급성 충수돌기염으로 진단 받은 환아를 대상으로 진단 지연의 발생과 진단 지연을 초래한 요인, 진단 지연이 임상 경과에 미치는 영향을 알아보기 위하여 본 연구를 시행하였다. 방 법: 1996년 8월부터 2001년 12월까지 강릉 아산병원에서 급성 충수돌기염으로 진단되어 급성 충수돌기 제거술을 시행 받은 76명을 대상으로 하여 후향적으로 의무 기록을 조사하였으며, 통상 증상을 호소한지 48시간 이상 경과되어 진단이 이루어진 경우를 진단 지연이라고 하고, 48시간 이내 진단이 이루어진 군, 두 군으로 나누어 비교 조사를 하였다. 대상 환아에 대해서 나이, 성별, 진단까지의 시간, 초기 증상, 최초 환자를 검진한 의사의 진료분야, 입원경로, 최초 진단명, 방사선 검사의 효용성, 합병증 유무, 입원 기간 등을 조사하였다. 결 과: 본 연구에서는 설사 증상과 복부 X선 검사 상 분변 박힘 (fecalith impaction) 의 존재 여부가 진단 지연과 관련이 있었다. 또한 처음 접한 의료진에 의해 집에 귀가하여 관찰한 소아에게서 진단 지연이 많았다. 진단 지연군의 절반이상에서, 초기 진단은 급성 충수돌기염이 아닌 위장관염이었다. 진단 지연군에서의 천공률은 87%로 그렇지 않은 군의 22%보다 높았다. 또한 진단지연군에서 더 많은 수술 합병증 발생과 입원 기간을 보였다. 결 론: 비특이적인 증상을 동반하며 복통을 호소하는 소아과 환자를 위장관염, 감기 등 흔한 질환으로 간단히 진단해선 안되며, 급성 충수돌기염의 가능성을 염두에 두고 자세한 병력 청취와 철저한 진찰을 시행하여 급성 충수돌기염의 조기 진단에 노력을 해야 하며, 진단이 부정확한 경우 입원을 권고하고, 조기에 외과적인 의뢰를 시행함과 더불어 복부 초음파 검사, 귀가 후 추적 진찰을 조기에 함으로써 진단의 지연을 줄일 수 있다고 하겠다.