• Title/Summary/Keyword: pain resolution

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The Use and Findings of Ultrasound in the Wrist Joint (완관절의 초음파 소견 및 이용)

  • Kim, Jung-Han;Kim, Joo-Yong;Kwon, Yong-Uk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.132-137
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    • 2014
  • We can test for small structures located at the surface layer as high resolution ultrasonic techniques and small probes were developed. Accordingly ultrasound became a useful tool in the diagnosis and treatment of wrist diseases. It is important to understand the anatomical structures and apply clinical features as well as these technical aspects when using ultrasound. The purpose of this article is to evaluate the usefulness and approach of ultrasound about typical diseases according to the area of the wrist pain.

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Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

A Case of Hepatosplenic Tuberculous Abscess (간과 비장에서 발생한 결핵성 농양 1례)

  • Han, Yu Seok;Chung, Ju Young;Kim, Sang Woo;Kim, Sung Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.108-111
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    • 2004
  • Tuberculosis is not a common cause of liver abscess and it is rarely considered in the differential diagnosis of a patient with hepatic mass. We report a case of tuberculous abscess of liver and spleen in a 15-year-old boy who presented with abdominal pain, fever and weight loss. The ultrasonographic and computed tomographic scan of the abdomen revealed multiple cystic lesions in the liver and spleen. Mycobacterium tuberculosis was cultured from the ascitic fluid and biopsy specimen of lymph node. Follow up CT scan of the abdomen after anti-tuberculosis medication for eighteen months showed complete resolution of the cystic lesions with calcified nodules.

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The Usefulness of Ultrasound Diagnosis of Acute Tendon Injury in Hand (급성 건 손상 환자에서 초음파의 유용성)

  • Choi, Chang Yong;Lee, Han Jeong;Choi, Hwan Jun;Kim, Mi Sun
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.729-734
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    • 2008
  • Purpose: The evaluation and management of a completely transected tendon of the hand is relatively clear. In most cases, the integrity is assessed by physical examination(eg, broken normal cascade, motion loss) but occasionally, It happens in troubles. because of pain, limited patient cooperation(eg, child, unconscious patient), and other associated injuries(eg, fractures, foreign bodies). Methods: From september 2006 to August 2007, 28 patients were evaluated with real time ultrasonography preoperatively and postoperatively. Twenty eight patients with injured tendon were evaluated using an HDI 5000 Sono CT(Philips Medical Systems, Bothell, WA) machine with a high resolution, 7.5MHz hockey stick linear probe. Dynamic evaluation was performed in real time. Results: Surgery was performed after the ultrasonographic evaluation. Sonographic diagnosis and intraoperative findings were correlated. Ultrasonographic findings show tendon discontinuity, gaps, and fluid collection. Conclusion: We conclude that ultrasonography is helpful in evaluating and managing acute tendon injury. Especially, in cases of completely lacerated tendon, ultrasonography can identify the location of the proximal tendon stump and partial lacerated tendon, ultrasonographic diagnostic tool can decrease misdiagnosis.

Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia

  • Kang, Min Kyu;Kwon, Hee Jung;Kim, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.246-249
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    • 2020
  • Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

A Case of Hemolytic Uremic Syndrome in a Child with Ischemic Colitis (허혈성 대장염에 동반된 용혈성 요독 증후군 1례)

  • Kim Yang-Hyun;Ahn Sun-Young;Park Ji-Min;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.86-90
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    • 2004
  • Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157 : H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.

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A DIAGNOSIS OF SUBMANDIBULAR SIALOLITHIASIS WITH COMPUTED TOMOGRAPHY (전산화 단층촬영술을 이용한 악하선 타석증의 진단)

  • Koo, Chi-Kyun;Choi, Hyung-Jun;Lee, Jong-Gap;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.545-548
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    • 1998
  • Sialolithiasis is the formation of calcareous concretions within ductal system of a major or minor salivary gland. They are formed by deposition of calcium salts around a central nidus which may consist of desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition. An 11-year-old boy complained of pain during meals and intermittent mild swelling in the right submandibular region. Although it was not detected in true occlusal radiograph, panoramic radiograph showed a round radiopaque mass 3mm in diameter. Computed tomography(CT) was taken for locating the stone and 3-dimensional reconstruction was performed. Under general anesthesia, sialoadenectomy was done through extraoral approach. Diagnosis of submandibular sialolithiasis using high-resolution CT with reconstructions was helpful for surgical decisions, namely radical removal of the submandibular gland and its duct.

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A Case Report of 4th Ipsilateral Recurrent Bell's Palsy (4번째 동측으로 발생한 벨마비의 치험 1례)

  • Kim Nam-Ok;Chae Sang-Jin;Son Sung-Se
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.198-206
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    • 2001
  • Recurrent Bell's palsy is a very rare case and have been reported that shows the incidence to be approximately 10 per cent in the Bell's palsy patents. It is generally accepted that facial paralysis caused by compression of the facial nerve by tumor develops slowly and has an unremitting course, however, reported cases have described the rare association of recurrent facial paralysis and intracranial tumor, and the same recovery rate. Usual symptoms of Bell's palsy include subacute facial palsy, hyperacusis on the affected side, postauricular pain on the affected side, altered sensation of taste, and partial trigeminal distribution hypesthesias. Complete resolution of symptoms is usually seen in 2-3months in $75-85\%$ of cases, with $25-35\%$ showing varying degrees of residual effects. We report a case of 4th ipsilateral recurrent Bell's palsy in a 14-year-old women, which was occurred in every winters. We treated her with acupuncture, moxibustion, herbal medication, carbon and silver spike point, and used House-Brackmnn grading system(HBGS) and the Fisch Detailed Evaluation of Facial Symmetry(DEFS) to assess the degree of paralysis in each part of face.

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A Case of Parathyroid Carcinoma with Spontaneous Infarction (자연경색을 동반한 부갑상선암 1예)

  • Geum, Sang Yen;Park, Hee Jun;Yoo, Jae Ho;Kim, Jeong Kyu;Lee, Dong Won
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.25-29
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    • 2022
  • Parathyroid carcinoma is very rare malignant neoplasm, accounting for less than 0.005% of all cancers. Most parathyroid carcinoma is a functioning tumor that causes hyperparathyroidism, leading to hypercalcemia. We report a parathyroid carcinoma case that was suspicious for spontaneous infarction of cancer, leading to resolution of hypercalcemia. A 29-year-old male visited our hospital presenting with right neck swelling and pain. He has been experiencing frequent urolithiasis for four years but laboratory tests showed normal serum calcium level. Right vocal cord paresis was identified with laryngoscopy. Ultrasonography revealed a 3.7 × 3.5 cm mass in the right thyroid containing a focal cystic portion. Computed tomography confirmed the presence of a low-density right thyroid mass. Right thyroid lobectomy was performed and pathological evaluation revealed parathyroid carcinoma with central necrosis. We report this very rare case with a literature review.

Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema

  • Will, Patrick A.;Hirche, Christoph;Berner, Juan Enrique;Kneser, Ulrich;Gazyakan, Emre
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.427-432
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    • 2021
  • The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2-0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.