• Title/Summary/Keyword: Insidious onset

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Melorheostosis with Synovial Chondromatosis of the Foot: A Report of Two Cases (족부에 발생한 활막 연골종증을 동반한 유선상 과오종: 2예 보고)

  • Lee, Chae Chil;Kim, Sang Woo;Choi, Hye Jeong;Hwang, Il Yeong;Kim, Min Seok
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.193-196
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    • 2015
  • Melorheostosis is a rare disease, belonging to the sclerotic bone dysplasia group. Initially described by Leri and Joanny in 1922, its etiology remains unknown. Onset is usually insidious, with deformity of the extremity, pain, limb stiffness, and limitation of motion in the joints. The typical radiographic appearance consists of irregular hyperostotic changes of the cortex, resembling melted wax dripping down one side of a candle. Treatment is usually symptomatic and conservative; however, conservative treatment is unsatisfactory due to functional issues when involving the distal extremity. We report on two cases of melorheostosis with synovial chondromatosis of the foot treated by mass excision.

Co-Infection with Cytomegalovirus and Helicobacter pylori in a Child with $M\acute{e}n\acute{e}$trier's Disease

  • Yoo, Yangho;Lee, Yoon;Lee, Yoo Min;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.2
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    • pp.123-126
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    • 2013
  • $M\acute{e}n\acute{e}$trier's disease is a rare protein-losing gastropathy characterized by hypertrophic gastric fold, foveolar hyperplasia, and hypoproteinemia with resulting peripheral edema. It is clinically evident as nonspecific gastrointestinal symptoms, including abdominal discomfort, nausea and vomiting, abdominal pain, weight loss, diarrhea, and edema. Pediatric $M\acute{e}n\acute{e}$trier's disease usually has an insidious onset and progressive, chronic clinical course and it spontaneously resolves in weeks or months. The pathogenesis of $M\acute{e}n\acute{e}$trier's disease is not clearly understood. $M\acute{e}n\acute{e}$trier's disease is thought to be associated with some gastric infections. But the cause of $M\acute{e}n\acute{e}$trier's disease is unknown, an association with cytomegalovirus (CMV) and Helicobacter pylori has been suggested. In Korea, We present the first a case of pediatric $M\acute{e}n\acute{e}$trier's disease with positive evidence of CMV and H. pylori.

Lesions of the Bilateral Ischial Tuberosity in a Tae-Kwon-Do Athlete - A Case Report - (태권도 선수에서의 양측성 좌골 조면 병변 - 증례 보고 -)

  • Min, Kyoung-Dae;Choi, Sang-Wook;Ryoo, Kee-Hun;Lee, Byung-Ill;Kim, Jun-Beom
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.122-125
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    • 2007
  • Avulsion of the ischial tuberosity is an acute injury caused by sudden contraction of the hamstrings, typically occurs in early adolescence, whereas ischial apophysitis has a more insidious onset during times of increased activity and its diagnosis is often missed. Authors present a rare case of having neglected avulsion fracture of the the ischial tuberosity in one side and ischial apophysitis in the other side with characteristic radiological features in a 16-year-old male who was an active Tae-Kwon-Do player.

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A Case of Perinephric Abscess Treated by Percutaneous Drainage (경피적 배농술로 치료한 신 주위 농양 1례)

  • Park Kyong-Yun;Kang Ji-Ung;Lee O-Kyong
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.72-76
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    • 2006
  • Perinephric abscess is an accumulation of pus in the perinephric space, the area anatomically defined between the kidney and Gerota's fascia. Gram negative organisms are the most prevalent bacterial species found in perinephric abscess. Fever, flank pain, vomiting and abdominal mass are the usual presenting complaints. But with its insidious onset, variable symptoms and rue frequency in children, perinephric abscess has been a major diagnostic problem, leading to delayed diagnosis and inappropriate treatment, which increase the rate of complication and mortality. Clinical diagnosis of perinephric abscess is difficult but must always be considered in children with a febrile septicemic illness. For appropriate treatment, early detection is very important, and either ultrasonography or computed tomography(CT) facilitates the diagnosis and establishment of treatment method. We experienced a case of left perinephric abscess treated by percutaneous drainage in a 1-year 7-month old boy. Review of literature was made briefly.

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The Surgical Treatment of Three Young Chronic Subdural Hematoma Patients with Different Causes

  • Hou, Kun;Li, Chen G.;Zhang, Yang;Zhu, Bo X.
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.218-221
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    • 2014
  • Chronic subdural hematoma (CSDH), which rarely happens in the young, is thought to be a disease of the elderly. Whereas unspecific symptoms and insidious onset in juveniles and young adults, as a result of its relative low morbidity, CSDH is usually neglected even undertreated in the young. Through the three cases and review of the current literature on this subject, we tried to illustrate the clinical and etiopathological characteristics of this entity and find out the most appropriate treatment strategy. We report three young CSDH patients with different but similar symptoms. The present histories, tests and examinations revealed different predisposing factors accounting for the genesis of CSDH. Their preoperative symptoms were all resolved with burr hole and drainage operation. Juveniles and young adults suffering from CSDH differ from that of their elderly counterparts in their clinical and etiopathological characteristics. Although trauma is the most important risk factor in young and old CSDH patients, some other predisposing factors may exist. Burr hole and drainage surgery could resolve the problem most of the time. But further tests and examinations even specific management should be made in some cases.

Differential Diagnosis and Treatment of Septic Arthritis in the Temporomandibular Joint: A Case Report and Literature Review

  • Kim, Bola;Choi, Hyo-Won;Kim, Jae-Young;Park, Kwang-Ho;Huh, Jong-Ki
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.127-132
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    • 2019
  • Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sjögren syndrome: Report of 3 cases

  • Thomas, Nithin;Kaur, Aninditya;Reddy, Sujatha S.;Nagaraju, Rakesh;Nagi, Ravleen;Shankar, Vidya Gurram
    • Imaging Science in Dentistry
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    • v.51 no.2
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    • pp.209-216
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    • 2021
  • Sjögren syndrome is a chronic autoimmune inflammatory disease characterized by lymphocytic infiltration of exocrine glands, predominantly the parotid and lacrimal glands, thereby resulting in oral and ocular dryness. It has been reported to occur most frequently in women between 40 and 50 years of age. Sjögren syndrome has an insidious onset, is slowly progressive, and presents a wide range of clinical manifestations, leading to delays or challenges in the diagnosis. Early diagnosis of this condition is essential to prevent the associated complications that affect patients' quality of life. This report presents 3 cases of Sjögren syndrome in female patients aged between 40 and 75 years who presented with complaints of persistent dry mouth and burning sensation. The cases highlight the diagnostic value of 3-dimensional cone-beam computed tomographic sialography in the detection of salivary gland pathologies at an early stage.

A Clinical Review of Surgically Treated 115 Cases of Lung Abscess (외과적 치료를 가한 폐농양 115례에 대한 임상적 관찰)

  • 문한배;이호일
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.3-12
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    • 1969
  • Prior to availability of antibiotics, lung abscess has been recognized as one of the most serious pulmonary disease, and despite of diminished morbidity and mortality rate with the advent of antibiotics and development of better technique in the fields of surgery on pulmonary disease it continues to be a virulent form of pulmonary supuration. It is the purpose of this paper to present a clinical review of 115 lung abscess treated by surgically at "The National Medical Center" during past 9 years. 1. The most common age of occurrence is between the age of 30 and 50, and 105 cases were male and 31 cases occurred in female. 2. Numerous etiological factors may play a role in the formation of a pulmonary abscess; aspiration in 36 patients of which 2 patients had diabetes, 54 patients had preceding URI or pneumonia, and 5 patients followed liver abscess, one of which in hematogenous route. In 20 patients, no predisposing factor could be determined- 3. Clubbing digits were presented in 26 of 1315 patients suggesting chronicity of the disease, and gastric ulcer were combined in 3 of 136 patints. 4. Apparently the onset was insidious, and the progress was masked by indiscriminate administration of antibiotics for URI and TB remedies under impression of pul. tbc. Previous TB treatments were done in 56.%[76 cases] for one week to two years and administration of antibiotics in 51 cases. 5. 89 cases were on tbe right and 2t5 cascs were on the left side. 51 cases of pneumonectomy and 8 of open drainage, of which 4 of Monaldi procedure, were made and operative mortality rate was 5.2%. Numerous complications such as 8 of empyema, 4 of each bleeding and atelectasis, 2 of BPF, 1 of esophageal fistula and one of pneumothorax which were responded well to prolonged treatment with good results, were obtained. 6. The incidence of Klebsiella and Pseudomonas were increased recently. In these results, we submit the surgery should be performed if the conservative therapy had failed. The resection was most favorable operation for pulmonary abscess though drainage procedure may be of value in certain patients with grave systemic menifestations. In chronic long standing abscess, more complications and high mortality rate were assumable although the prognosis has been improved with the advent of antibiotics, the development of improved surgical technique and complete preoperative care.

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Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years

  • Jung, Jae Yeob;O, A Rum;Kim, Je Keong;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.335-340
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    • 2016
  • Purpose: This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP Methods: The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed. Results: The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years) and $9{\times}10^9/L$ (range, $0-84{\times}10^9/L$), respectively. No patient experienced severe bleeding. Nineteen children (29.7%) spontaneously recovered their platelet count to ${\geq}100{\times}10^9/L$ at a median of 10 days. In total 45 patients (70.3%) received intravenous immunoglobulin (IVIG) as first-line therapy, and showed platelet recovery at 1 week. The final diagnosis of 55 (85.9%) and 9 patients (14.1%) was acute and chronic ITP, respectively. Older age, absence of prior infection and insidious onset of symptoms were significantly associated with the development of chronic ITP. Among the patients who received IVIG, those with platelet count <$45{\times}10^9/L$ at 1 month after IVIG showed a significantly higher incidence of chronic ITP compared to those with platelet count ${\geq}45{\times}10^9/L$ (88.8% vs. 44.4%, P<0.01). Conclusion: In most patients, ITP runs a benign course and approximately 86% of them recover within 1 year of their initial diagnosis. The potential impact of the risk factors of chronic ITP on clinical practice needs to be explored and further studies are warranted to determine whether IVIG influences the course of ITP.

Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis (급성 출혈성 대장염으로 오인된 궤양성 대장염 1예)

  • Moon, Hee-Jung;Jang, Byung-Ik;Kim, Sung-Bum;Lee, Ho-Chan;Park, Jae-Hyun;Eun, Jong-Ryul;Kim, Tae-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.182-186
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    • 2008
  • Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

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