• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.157-160
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• 2010

Tetanus is a life-threatening infection that is rare in the developed country. Because of the rarity: of the disease, the clinician may be unfamiliar with the clinical presentation and unsuspecting of the diagnosis. However, tetanus can rapidly progress into lethal muscle spasms accompanied by respiratory insufficiency, and it has a mortality of 15 to 30%. The most common presenting symptom was trismus, followed by neck pain, dysphagia, generalized pain and facial muscle contractions. Dysphagia is a common symptom of tetanus, but not common as an initial symptom, the correct diagnosis and adequate therapy are likely to be delayed. Treatment involves administration of penicillin, tetanus immune-globulin, debridement of wounds, aggressive supportive care, and initiation of active immunization. We report an elderly woman presenting with dysphagia as an initial symptom of tetanus with review of literature.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.38-40
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• 2023

Acute pulmonary embolism (PE) is a life-threatening disease that manifests with cardiorespiratory symptoms. Syncope can be a rare, but warning sign of PE. We report a case of a 49-year-old male diagnosed with PE who presented with recurrent syncope prior to typical cardiorespiratory symptoms. His computed tomography pulmonary angiogram revealed bilateral PE. Syncope can be a rare clinical symptom of PE, but considering lethality of the disease, a differential diagnosis of PE should be considered in patients with recurrent syncope.

• Journal of Oral Medicine and Pain
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• v.13 no.1
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• pp.71-84
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• 1988

The author examined 206 temporomandibular disorders patients, who visited department of Oral Diagnosis and Oral Medicine in Seoul National University Hospital during the period from May 1st 1987 to April 30th 1988, clinically and radiologically and with prepared questionnaire. By clinical and radiological examination, the patients were divided into 2 groups(the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome: the patient with temporomandibular joint internal derangement only). The symptom severity index and contributing factors were examined with the questionnaire, and differences in 2 groups were studied. The conclusions are followings : 1. The symptom severity index presenting the severity of symptom was higher and the scope of symptom was wider in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction compared to the patients with temporomandibular joint internal derangement only. 2. Emotions, behaviors, cognitions, and social factors were more undesirable in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome than the patients with temporomandibular joint internal derangement only.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.288-292
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• 2018

Objectives. To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. Methods. A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. Results. The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. Conclusion. Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.

• Journal of Genetic Medicine
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• v.18 no.2
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• pp.142-146
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• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

• Journal of Families and Better Life
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• v.10 no.2
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• pp.263-276
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• 1992

The middle aged woman today have met discord of unbalance in gender role identity due to change in cultual situation and view of value of our country since 1960. Under the promise that there is a relationship between depression which is a psychological characteristic and gender role traits of middle aged woman, and in consideration that the depression of middle-aged woman may be differentiated depend upon the expressive manner of gender role, this research was trying to find out the relationship between the gender role traits and the depression of middle aged women. The purpose of his research is to provide data to be helpful for marital hygirne of middle-aged women by presenting a plan to reduce depression of middle-aged woman by the desirable gender role. In order for such studying purpose, the gender role, physical symptom and socio-demographic feature were researched using the scale which was by this researcher. The questionnaire sheets of 327 use form middle-aged woman of 39 years to 59 years old in full with their last child is 10 years or order. The summerized results of study are as follows. In consolidation of the foregoing it have known that the socio-economic position and recognition of physical symptom and the masculinity feature has shown less depression as she feels less physical symptom due to there is relationship between recondition of physical symptom and he masculity feature, and also, it has known that the depression of middle-aged women may be reduced when such extroversive and expressional gender role features are developed as 'aggressiveness and ' fraternity, and the depression may be prompted due to such introvert and easy to be impacted by grudge as 'impression'

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.278-281
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• 2009

Bilateral renal enlargement is a very rare manifestation as the primary presenting feature of acute lymphoblastic leukemia. We are reporting an unusual clinical picture of a 9-month-old male patient diagnosed as precusor B-cell lymphoblastic leukemia, who showed bilateral nephromegaly without any hepatosplenomegaly at the time of initial presentation.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.390-393
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• 2009

Although prompt diagnosis and emergent surgical intervention are important in acute spinal subdural hematoma (SSDH), some cases with spontaneous remission of symptom and hematoma without surgery have been reported. We present a case of acute nontraumatic SSDH presenting with transient left hemiplegia for 4 hours. A magnetic resonance imaging study of cervical spine confirmed SSDH with C3-6 cervical cord compression at the left side. The patient had conservative management without recurrence. Although hemiplegia is an unusual clinical manifestation of SSDH, it should be differentiated from that of cerebrovascular origin promptly. Conservative management may be an alternative therapeutic option for selective cases with transient neurological deficits.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.44-46
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• 2018

Tuberculosis of the retropharynx is extremely rare. The diagnosis is frequently delayed because of its anatomical location and atypical symptom. It would be crucial to consider tuberculosis infection as a possible source of abscess and should be mindful about the tests to diagnose it. We experienced a 23-year-old man with retropharyngeal abscess caused by tuberculosis presenting hypernasality and hoarseness in the throat. In this article, we reviewed the etiology, diagnosis, and treatment of this case, with a review of literatures.