• Journal of Chest Surgery
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• 제26권8호
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• pp.643-645
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• 1993

It is generally acknowledged that congenital coronary artery fistula is an abnormal communication of the coronary artery with the right ventricle, right atrium,left atrium and left ventricle. In young people the symptoms are unusual , but significant symptoms and complications appear among the older age group such as congestive heart failure, subacute bacterial endocarditis, coronary steal syndrome, aneurysm formation, rupture, and pulmonary hypertension. Therefore, early surgical treatment is recommended. We experienced a case of coronary arteriovenous fistula that was involving the circumflex branch of the left coronary artery with the right ventricle. It was 10mm in diameter with multiple vegetation. We repaired the fistula under extracoporeal circulation. The patient was discharged in a healthy condition twelve days after operation .

• Annals of Clinical Neurophysiology
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• 제3권1호
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• pp.40-42
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• 2001

Anorexia nervosa(AN) is a disorder characterized by disturbance of body image, fear of gaining weight, severe weight loss and, in female, amenorrhea. Compared with normal persons, patients with AN have neuropathic symptoms more frequently. But electrophysiologic abnormalities have rarely been reported. We experienced a case with recurrent neuropathic symptoms after severe weight loss. Further evaluation revealed AN. Electrophysiologic study showed sensorimotor polyneuropathy and focal neuropathy with conduction block. As far as we know, this feature of neuropathy in AN has not been described. We describe unusual feature of neuropathy in our patient with literature review.

• 대한임상독성학회지
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• 제4권2호
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• pp.166-169
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• 2006

Poisonings caused by 'mad honey' are known to occur in response to grayanotoxins, which bind to sodium channels in the cell membrane, increasing membrane sodium permeability and preventing inactivation. Mild symptoms of mad honey intoxication are dizziness, weakness, hypersalivation, nausea, vomiting, and paresthesia. Severe intoxication, however, leads to serious cardiac manifestations such as atrioventricular block, dose-dependent hypotension, bradycardia, and respiratory depression. Atropine and vasoactive drugs improve symptoms of both bradycardia and respiratory rate depression. We report an unusual case of saliva-type hyperamylasemia in a mad honey poisoning patient who developed clinically significant bradycardia. She recovered fully within 3 days following atropine administration and medical treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.209-213
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• 2018

Most solitary gastrointestinal (GI) polyps in children are either inflammatory or hamartomatous. Solitary hyperplastic polyp, sentinel polyp and solitary adenomatous polyp have been occasionally diagnosed in adults, but very rarely reported in Korean children. We recently came across a case with adenomatous polyp in the colon, a case with hyperplastic polyp beneath the gastroesophageal junction, a case with hyperplastic polyp in the prepyloric area, and a case with sentinel polyp in the distal esophagus, which are unusual pathologic types in children. These mucosal lesions were diagnosed incidentally during elective endoscopic examinations for GI symptoms. Most polyps do not cause significant symptoms, so the diagnosis might be delayed, especially in children, in whom GI endoscopy is not commonly performed for screening purpose as in the adults.

• Childhood Kidney Diseases
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• 제20권1호
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• pp.6-10
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• 2016

Poststreptococcal glomerulonephritis (PSGN) is one of the most recognized diseases in pediatric nephrology. Typical clinical features include rapid onset of gross hematuria, edema, and hypertension, and cases are typically preceded by an episode of group A ${\beta}$-hemolytic streptococcus pharyngitis or pyoderma. The most common presenting symptoms of PSGN are the classic triad of glomerulonephritis: gross hematuria, edema, and hypertension. However, patients with PSGN sometimes present with unusual or atypical clinical symptoms that often lead to delayed diagnosis or misdiagnosis of the disease and increased morbidity. Additionally, the epidemiology of postinfectious glomerulonephritis (PIGN), including PSGN, has changed over the past few decades. This paper reviews atypical clinical manifestations of PSGN and discusses the changing demographics of PIGN with a focus on PSGN.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.152-156
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• 2014

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.

• 대한기관식도과학회지
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• 제15권2호
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• pp.87-91
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• 2009

Esophageal diverticulum is a rare entity, the true incidence of which is unknown, mainly because there are usually no clinical symptoms. Most esophageal diverticulum are found incidentally during an endoscopic or radiologic examination. Their classification is based on anatomical location; namely, upper third(Zenker or pharyngoesophageal), middle third(thoracic), or lower third(epiphrenic). Here we report a 52-years-old female presenting with dysphagia and regurgitation. Esophagogram showed esophageal diveticulum at lower cervical esophagus. Its positional aspect, it is different from Zenker's diveticulum. Treatment is surgical via an endoscopic or external approach. In view of the patient's age and anatomical location, various surgical approaches were considered as a therapeutic option for the management. This paper presents our experience in the management of esophageal diverticulum which was unusual location and stapled open resection without sternotomy.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.112-115
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• 2016

Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.

• Pediatric Infection and Vaccine
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• 제21권3호
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• pp.214-218
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• 2014

가와사키병은 일반적으로 특징적인 증상 또는 검사 기준에 근거하여 진단한다. 그러나 가와사키병의 전형적인 증상 없이, 드문 동반 증상으로 먼저 발현하는 경우에 가와사키병의 진단은 어렵다. 저자들은 일측 이하선염으로 발현한 가와사키병 1례를 경험하였다. 23개월 여아가 갑자기 발열과 일측 이하선의 부종과 압통이 있어 화농 이하선염으로 추정 진단받고 항생제로 치료받았으나 발열과 증상이 호전되지 않았다. 발열 8일째에 발진과 비화농성 결막충혈, 관상동맥 이상 등 가와사키병의 증상이 나타나기 시작하여 정맥주사용 면역글로불린과 salicylate를 투약받은 뒤 모든 증상이 호전되었다. 본 증례를 통해, 일측 이하선염은 가와사키병에서 매우 드물게 발생하는 증상이지만, 항생제 치료에도 호전이 없는 경우에, 반드시 가와사키병의 가능성을 고려하여야겠다.

• 대한한방내과학회지
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• 제41권5호
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• pp.902-910
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• 2020

Medial medullary infarction, with representing symptoms of hemiparesis, lingual palsy, and sensory defect, usually has a bad prognosis. The present case is unusual as the patient had a bilateral infarction, and little information is available for bilateral cases. We treated a patient diagnosed with bilateral medial medullary infarction with the symptoms of quadriplegia, lingual palsy, dyspnea, dysphagia, spastic pain, and loss of proprioception. After 126 days of traditional Korean medicine treatment, the patient showed increased muscle power, sensory recovery, reduced spastic pain, and alleviation of dysphagia and dyspnea. This report indicates that traditional Korean medicine could be an effective treatment of the sequelae of medullary infarctions.