• Title/Summary/Keyword: Symptomatic review

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Idiopathic Spinal Epidural Lipomatosis - Case Report - (특발성 척추 경막상 지방종증 - 증례보고 -)

  • Han, Young-Min;Ahn, Myung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.795-799
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    • 2001
  • Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a relatively uncommon disease. Although it has been reported frequently in association with the administration of exogenous steroids, a few cases of epidural lipomatosis with no association to exogenous steroids, have been reported. Idiopathic spinal epidural lipomatosis may be a separate disease from that induced by steroid. Here, the authors present two cases of symptomatic epidural lipomatosis with no history of steroid-dependent diseases and review the relevant literature.

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The Natural History of Anterior Cruciate Ligament Deficient Knee (전방십자인대 손상 슬관절의 자연적 병의 경과)

  • Kim, Hyoung-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.41-46
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    • 1997
  • The natural history of the anterior cruciate ligament(ACL)-deficient knee remains controversial. although numerous investigation have tried to ascertain the course that the knee would follow once the ACL has lost functional integrity. An extensive review of the literature performed according to symptoms. physical examinations, associated surrounding tissue injuries. returns to activity level and radiological changes in the knee joint. An active individual with a non-functioning ACL was susceptible to injury to the menisci and deteriorate the articular cartilage, followed radiographic changes. An activity levels in general also changed after injury. The most common symptom was pain. But instability varied in these individuals. Conclusively we believe that all these factors will eventually, if not initially, result in a symptomatic knee. which will result in significant limitations to the individual's desired level. So we recommend an aggressive approach in person who desired to return to a relatively active life style in young person as well as in middle aged individuals who have significant symptomatic ACL deficient knee.

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Venous Varix of the Digit - Two Cases Report - (수지에 발생한 정맥류 - 2예 보고 -)

  • Lee, Jin-Seok;Jung, Young-Jin;Sohn, Hyung-Bin;Hong, In-Pyo
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.55-59
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    • 2008
  • Varix of the digit is generally defined as an enlarged, tortuous palmar digital vein with or without thrombus within it. It usually presents as a firm, blue mass on the volar aspect of the finger. Mechanical compression or chronic trauma to veins on the volar surface of a digit appears central to the pathogenesis of this lesion. Aging phlebectasia has also been considered as a cause of this lesion in the elderly. A tourniquet test may be useful in demonstrating the presence of a digital varix, but it is confirmed by postoperative microscopic examination. Excision of a symptomatic lesion has proven to be curative. We report two cases of symptomatic digital varix which developed in the fourth finger with a review of literatures.

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Clinical Review of Primary Tumors and Cysts of the Mediastinum (원발성 종격동 종양 및 낭종의 임상적 고찰)

  • 장기경
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.689-694
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    • 1994
  • A retrospective analysis was performed on 36 patients with primary cysts and tumors of the mediastinum seen at the Department of Thoracic and Cardiovascular Surgery of Maryknoll Hospital from January 1983 to December 1993. There were 21 female and 15 male patients in the study. Ages ranges from 2 years to 72 years, with a mean of 34.7. There were 9 malignant tumors and 27 benign tumors.Thymic neoplasms were the most common. For the whole series, 29 of the patients had tumors in the anterior mediastinum. There appears to be an in6rease in tumors in the anterior compartment. There were 30 symptomatic patients in our series. Of the patients with malignant disease, 89 % were symptomatic. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation. There were 9[27.3 %] postoperative complications. There was no postoperative mortality. Follow-up was available on 27 patients. There was no recurrence, malignant degeneration, or growth of any tumor. It is hoped that careful evaluation and aggressive treatment of mediastinal tumors will continue to provide improvement in the prognosis for these patients.

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Protected versus Unprotected Carotid Artery Stenting : Meta-Analysis of the Current Literature

  • Cho, Young Dae;Kim, Sung-Eun;Lim, Jeong Wook;Choi, Hyuk Jai;Cho, Yong Jun;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.458-466
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    • 2018
  • Objective : To compare peri-operative any symptomatic stroke after carotid angioplasty and stenting (CAS), based on the application or absence of a cerebral protection device. Methods : A systematic literature review using PubMed, Embase, and the Cochrane Central was done across an online data base from January 1995 to October 2016. Procedures which were performed due to carotid dissection or aneurysm, procedures using covered stents or conducted in an emergency, were excluded. The primary endpoint was perioperative any symptomatic stroke within 30 days after the procedure. A fixed effect model was used in cases of heterogeneity less than 50%. Results : In the 25 articles included in this study, the number of stroke events was 326 (2.0%) in protected CAS and 142 (3.4%) in unprotected CAS. The use of cerebral protection device significantly decreased stroke after CAS (odds ratio [OR] 0.633, 95% confidence interval [CI] 0.479-0.837, p=0.001). In the publication bias analysis, Egger's regression test disclosed that the intercept was -0.317 (95% CI -1.015-0.382, p=0.358). Regarding symptomatic patients (four studies, 539 CAS procedures), the number of stroke was six (1.7%) in protected CAS and 11 (5.7%) in unprotected CAS. The protective effect against stroke events by cerebral protection device did not have a statistical significance (OR 0.455, 95% CI 0.151-1.366, p=0.160). Conclusion : The use of protection device significantly decreased stroke after CAS. However, its efficacy was not demonstrated in symptomatic patients. Routine use of protection device during CAS should be critically assessed before mandatory use.

The Effect of Dachaihu Decoction for Hyperlipidemic Acute Pancreatitis: A Systematic Review and Meta-Analysis (고지혈성 급성 췌장염에 대한 대시호탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Kim, Yoon-jung;Jung, Yu-jin;Park, Dong-il
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.306-325
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    • 2020
  • Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

Lumbar Disc Herniation Presented with Contralateral Symptoms

  • Kim, Pius;Ju, Chang Il;Kim, Hyeun Sung;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.220-224
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    • 2017
  • Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

A Review of Detection Methods for the Plant Viruses

  • Jeong, Joo-Jin;Ju, Ho-Jong;Noh, Jaejong
    • Research in Plant Disease
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    • v.20 no.3
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    • pp.173-181
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    • 2014
  • The early and accurate detection of plant viruses is an essential component to control those. Because the globalization of trade by free trade agreement (FTA) and the rapid climate change promote the country-to-country transfer of viruses and their hosts and vectors, diagnosis of viral diseases is getting more important. Because symptoms of viral diseases are not distinct with great variety and are confused with those of abiotic stresses, symptomatic diagnosis may not be appropriate. From the last three decades, enzyme-linked immunosorbent assays (ELISAs), developed based on serological principle, have been widely used. However, ELISAs to detect plant viruses decrease due to some limitations such as availability of antibody for target virus, cost to produce antibody, requirement of large volume of sample, and time to complete ELISAs. Many advanced techniques allow overcoming demerits of ELISAs. Since the polymerase chain reaction (PCR) developed as a technique to amplify target DNA, PCR evolved to many variants with greater sensitivity than ELISAs. Many systems of plant virus detection are reviewed here, which includes immunological-based detection system, PCR techniques, and hybridization-based methods such as microarray. Some of techniques have been used in practical, while some are still under developing to get the level of confidence for actual use.

Marfan syndrome and symptomatic dural ectasia: A case report and literature review

  • Eom, Si Nae;Kim, Dong Chan;Kim, Kwang Nam;Kim, Sung Hye
    • Journal of Genetic Medicine
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    • v.11 no.2
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    • pp.83-85
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    • 2014
  • Dural ectasia refers to the widening or ballooning of the dural sac surrounding the spinal cord. It can affect any plane of the spinal canal, but occurs primarily in the lumbosacral region. Dural ectasia is present in 63-92% patients who have Marfan syndrome, and is related to Ehlers-Danlos syndrome, neurofibromatosis type I, and ankylosing spondylitis. The most common symptoms are low back pain, headache, weakness, numbness above and below the affected limb, and occasional rectal and genital pain. However, in most patients, dural ectasia is usually asymptomatic. We report the case of a 5-year-old boy who presented with a severe headache who had been diagnosed with Marfan syndrome. During the evaluation, magnetic resonance imaging of the lumbar and sacral spine revealed dural ectasia. To our knowledge, this is the first report on Marfan syndrome with symptomatic dural ectasia in Korea. We concluded that dural ectasia should be suspected in patients diagnosed with Marfan syndrome who have a severe headache.

Current diagnosis and treatment of vestibular neuritis: a narrative review

  • Ba, Chang Hoon;Na, Hyung Gyun;Choi, Yoon Seok
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.81-88
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    • 2022
  • Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.