• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.44-47
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• 2011

Background: Miller-Fisher syndrome (MFS) is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered a variant form of Guillain-Barre syndrome. Although some cases of delayed-onset facial palsy in MFS have been reported, the characteristics of this facial palsy are poorly described in the literature. Methods: Between 2007 and 2010, six patients with MFS were seen at our hospital. Delayed facial palsy, defined as a facial palsy that developed while the other symptoms of MFS began to improve following intravenous immunoglobulin treatment, was confirmed in four patients. The clinical and electrophysiological characteristics of delayed facial palsy in MFS, as observed in these patients, are described here. Results: Four patients with delayed-onset facial palsy were included. Delayed facial palsy developed 8-16 days after initial symptom onset (5-9 days after treatment). Unilateral facial palsy occurred in three patients and asymmetric facial diplegia in one patient. The House-Brackmann score of facial palsy was grade III in one patient, IV in two patients, and V in one patient. None of the patients complained of posterior auricular pain. Facial nerve conduction studies revealed normal amplitude in all four patients. The blink reflex showed abnormal prolongation in two patients and the absence of action potential formation in two patients. Facial palsy resolved completely in all four patients within 3 months. Conclusions: Delayed facial palsy is a frequent symptom in MFS and resolves completely without additional treatment. Thus, standard treatment and patient reassurance are sufficient in most cases.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.288-292
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• 2012

Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve (VI, VII, and VIII) palsy following MVD and its clinical courses. Methods : Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss. Results : DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve. Conclusion : Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

• The Journal of Korean Medicine
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• v.22 no.3
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• pp.169-178
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• 2001

After initial recovery from acute carbon monoxide (CO) intoxication, some patients occasionally undergo severe neuropsychiatric deterioration, which is called postanoxic delayed encephalopathy (sequelae). This is the clinical report about one patient, a 73-year-old man, diagnosed with delayed encephalopathy after acute CO intoxication. The symptoms of the patient were mental dysfunction including memory impairment and disorientation, abnormal behavior, incontinence and mutism. He had completely recovered after an aonxic episode, but the neurological symptoms that developed were preceded by an interval of apparent normality (the 'lucid interval'). We characterized him as suffering deficiency syndrome of the heart and prescribed for him Bokreongbosim-tang and Guipi-tang, and thereafter his symptoms were remarkably improved. For the evaluation of clinical improvement, we use the Modified Barthel Index (MBI), Canadian Neurologic Scale (CNS), and the Korean version of the Mini-Mental State Examination (K-MMSE)

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.1065-1071
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• 2001

Delayed onset muscle soreness is a sensation of discomfort that occurs 24 h after exercise, and it is associated with the performance of unfamiliar and high force muscle work, such as eccentric contractions. The injury to the muscle has been well described but the mechanism underlying the injury is not fully understood. Although the pathophysiological processes underlying delayed onset muscle soreness are not completely understood, many researchers have investigated various treatments in a attempt to reduce the soreness. Physical therapy is the most importance techniques to reduce delayed onset muscle soreness. The purpose of this study is to investigate the effect of a cryotherapt on DOMS. Thirty subjects were randomly assigned to experimental group : control, cryotherapy, and placebo group. Elbow flexion range, mechanical pain threshold. and subjective pain were measured 30 min before DOMS was induced and 24, 48, 72 hours after DOMS was induced. The results of this study were as follows: 1. Elbow flexion range showed significant difference each time, especially at 48 and 72 hours 2. Mechanical pain thershold and subjectively pain showed no significant difference between group.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.22-25
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• 2010

Purpose: As patients who take immediate breast reconstructions with TRAM flap have increased, concomitant or delayed other elective intra-abdominal operations in these patients also have increased. There are few reports of concomitant or delayed intra-abdominal operation in TRAM flap patients. We report our experiences and outcomes of these operations which is safe and feasible. Methods: We reviewed the charts and postoperative follow-up results of 11 patients among 471 consecutive patients who took immediate breast reconstruction with TRAM flap from December of 2002 to September of 2006. Four patients took concomitant intra-abdominal operation and 7 patients took delayed intra-abdominal operation between 1 to 52 months after TRAM flap Results: There were no significant postoperative abdominal and systemic complications. One patient who took concomitant intra-abdominal operation presented partial skin necrosis of abdomen, but recovered completely with conservative treatments. Two patients took transfusion in peri-operative periods. Conclusion: Concomitant or delayed intra-abdominal operation in immediate breast reconstruction with TRAM flap could be performed safely and feasibly when it is necessary. Furthermore, it could be helpful to patients and surgeons.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.37-44
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• 1999

Delayed onset muscle soreness is a sensation of discomfort that occurs 24h after exercise, and it is associated with the performance of unfamiliar and high force muscle wor, such as eccentric contractions. The injury to the muscle has been well described but the mechanism underlying the injury is not fully understood. Although the pathophysiological processes underlying delayed onset muscle soreness are not completely understood, many researchers have investigated various treatments in a attempt to reduce the soreness. These treatments have focused on reducing the inflammation, or edema, consequent to tissue damage, and breaking up the cycle which is thought provoke tonic muscle spasm or pain. Physical therapy is the most importance thechniques to reduce delayed onset muscle soreness. Physical therapy on delayed onset muscle soreness includes massage, exercise, therapeutic ultrasound, TENS, stretching and cryotherapy, this investigation should encourage physical therapists to experiment further with various techniques to reduce delayed onset muscle soreness.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.165-169
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• 2011

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

• Journal of Ginseng Research
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• v.13 no.2
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• pp.239-241
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• 1989

Naloxone partially antagonized the analgesic effect of a large dose of morphine and inhibited the development of an acute type tolerance. Ginseng total saponins did not antagonize the analgesia of a large dose of morphine but inhibited the delrelopment of acute and delayed types tolerance. The morphine analgesia and the development of acute type tolerance were affected by the opioid receptor antagonist, naloxone, but the development of acute type tolerance was not. Ginseng total saponins partially inhibited the development of the delayed type tolerance that was not inhibited by naloxone, but also partially suppressed the development of the acute type tolerance that was completely inhibited by naloxone. These results imply that the partial inhibition of the development of the acute and delayed types tolerance by ginseng total saponins is not mediated by the opioid receptors.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.1
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• pp.279-283
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• 2005

After initial recovery from acute carbon monoxide(CO) intoxication, some patients occasionally undergo severe neuropsychiatric deterioration, which is called postanomic delayed encephalopathy(sequelae). This is the clinical study about one patient, a 53-year-old woman, diagnosed with delayed encephalopathy after acute CO intoxication. The patient's symptoms were mental dysfunction including memory impairment and disorientation, aphasia, atrophy and weakness throughtout the body. She had completely recovered after an anomic episode, but the neurological symptoms that developed were preceded by an interval of apparent nomality.(the 'lucid interval'). She was characterized as suffering deficiency syndrome of the heart(心虛) and was prescribed for her an Ansinschungnoi-tang(安神淸腦湯), and thereafter her symptoms improved remarkably. For the evaluation of clinical improvement, we use the Modified Barthel Index(MBI).

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.162-168
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• 2018

An intra-articular osteoid osteoma is a very rare cause of elbow pain, and its diagnosis and treatment remain challenging. Delayed diagnosis may lead to arthritic change of the joint. In this study, the authors present the occurrence of intra-articular osteoid osteoma in the right elbow of a 15-year-old male patient who presented with prolonged pain and limited motion owing to delayed diagnosis. After confirming the nidus of osteoid osteoma from radiographic evaluation, the lesion was completely removed arthroscopically. The patient presented a complete relief of symptoms and full range of motion. This is the first domestic report of successful arthroscopic treatment of an intra-articular osteoid osteoma of the elbow.