• Title/Summary/Keyword: early treatment

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Surfer's Myelopathy : Case Series and Literature Review

  • Choi, June Ho;Ha, Jung-Ki;Kim, Chung Hwan;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.767-773
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    • 2018
  • Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

Multidisciplinary Treatment Approach in a Secondary Cleft Lip and Palate Patient for Functional Occlusal Rehabilitation (성인 구순구개열 환자에서 Multidisciplinary 치료로 기능성 교합을 형성한 증례)

  • Lee, Jina Linton
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.29-38
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    • 2012
  • A 20 year-old cleft lip and palate patient came for occlusal rehabilitation, but the constricted maxilla and early loss of posterior teeth called for an unusual treatment modalities. Distraction osteogenesis in the edentulous areas followed by artificial bone graft, dental implant along with orthodontic tooth movement were planed. Multidisciplinary treatment enabled both esthetic and functional oral rehabilitation of this patient.

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Clinical Analysis on Cancer of the Hypopharynx (하인두암의 임상적 고찰)

  • Kim Young-Ho;Choi Eun-Chang;Hong Won-Pyo;Kim Moon-Suk;Lee Sei-Young;Hong Jung-Pyoe;Chung Hyung-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.46-53
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    • 1998
  • Background: Hypopharyngeal cancer represents about one-third the incidence of laryngeal cancer which is the most common cancer in head and neck area. Although there have been numerous reports regarding its clinical and statistical characteristics, more precise and ample data should be collected and analyzed in this country. Objectives: This study was designed to evaluate the pattern and patient's profile of the hypopharyngeal cancer, and we reviewed the treatment outcomes to search for an index of treatment modalities. Materials and Methods: The authors retrospectively analyzed 73 cases of hypopharyngeal cancer treated at Yonsei Medical Center during the 10-year period from 1985 to 1994. Five-year survival rate was calculated according to the primary site, clinical stage and treatment modality. Results: The incidence was predominated in male by 9 to 1 and peak incidence was 6th and 7th decades. Pyriform sinus was the main primary site(80.8%) followed by posterior hypopharyngeal wall(13.7%) and postcricoid area(5.5%). Advanced stage cancers(87.7%) were more common than early stage cancers. Radiotherapy(60.3%) was the most commonly used as primary treatment modality. Neck node metastasis was early occurred even in early stage cancers(61.5%), and overall rate of neck node metastasis was 69.9%. All surgical cases received procedures more than total laryngectomy and partial pharyngectomy. The most common cause of death was primary failure(81.5%) and it was highest in radiotherapy group. Five-year survival rate was significantly high in surgery group(90.9%). The overall 5-year survival rate of hypopharyngeal cancer was 30.3%. Conclusion: High index of suspicion should be required for early diagnosis. Also, surgery may be recommended for the primary treatment modality in advanced stage cancers.

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Conservative and Early Arthroscopic Treatment of Calcific Tendinitis (석회화 건염의 보존적 치료와 조기 관절경적 치료 결과)

  • Kim, Myung-Ku;Bae, Joo-Han;Jeon, Yoon-Sang
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.149-154
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    • 2009
  • Purpose: We evaluated the level of pain and clinical presentation of calcific tendinitis after treatment with conservative and early arthroscopic operation. Materials and Methods: We reviewed 30 patients with calcific tendinitis with the minimum of 6 months of follow up period, treated from February 2002 to May 2008. We implemented Constant-Murley score to evaluate the pain of calcification and improvement of range of motion at the 2nd week, 12th week and 24th week with the patients who had treatment with steroid injection in 15 cases and operation in the other 15 cases. Results: Evaluating the level of pain using Constant-Murley score, we found that conservative treatment group had the scale of 3.2 before treatment and 13.6, 14.5 and 14.7 at 2nd, 12th, and 24th week, respectively since started treatment. The operation group, on the other hand, had the scale of 3.3 preoperatively and 10.2, 13.0, and 14.3 at 2nd, 12th and 24th week postoperatively. The range of motion in the conservative treatment group showed 14.3 on average before the treatment and 21.7, 31.3 and 35.7 at 2nd, 12th and 24th week after treatment. The operation group had 14.4 on average preoperatively, and 33.1, 35.8 and 36.4 at 2nd, 12th and 24th week postoperatively. The operation group had statistically significant improvement compared to the conservative group at the 2nd and 24th week, but showed no difference between the two groups at the final follow up. Conclusion: Early arthroscopic treatment of calcific tendinitis seems to be an excellent option that can increase the level of satisfaction of the patients and an efficient way of putting the patients back to their normal life promptly.

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