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상기도 폐쇄를 일으킨 다발성 대칭성 지방종증 1예 (A Case of Multiple Symmetrical Lipomatosis Causing Upper Airway Obstruction)

  • 김정규;김경찬
    • Tuberculosis and Respiratory Diseases
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    • 제70권1호
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    • pp.63-68
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    • 2011
  • Multiple symmetrical lipomatosis (MSL), also called Madelung's disease, is a rare disorder of unknown etiology and characterized by abnormal accumulation of large subcutaneous fatty masses in neck, shoulder, and upper trunk. MSL has known to predominantly affect middle-aged men with a history of alcoholism. Although the clinical course of MSL is considered to be slowly progressive, in advanced stage, fatty masses in the neck may compress the upper aerodigestive tract, resulting in dyspnea and dysphagia. The treatment of MSL is surgical resection, but radical excision is very difficult and recurrence after surgery is frequent. We report the case of 55-year-old man with long lasting MSL, which caused severe airway obstruction. This patient was admitted with progressive dyspnea and massive accumulation of fat around the vocal cord that was detected on a neck CT scan. This abnormal fatty infiltration in supraglottic region caused upper airway obstruction.

Surgical Treatment of Extensive Tumoral Calcinosis Associated with Systemic Sclerosis

  • Jung, Hanna;Lee, Deok Heon;Cho, Joon Yong;Lee, Sang Cjeol
    • Journal of Chest Surgery
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    • 제48권2호
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    • pp.151-154
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    • 2015
  • Extensive tumoral calcinosis affecting a large joint is uncommon in patients with systemic sclerosis. We report the case of a 52-year-old female patient referred for a growing calcified mass in the shoulder. She was diagnosed with interstitial lung disease and progressive systemic sclerosis. Although the pain and disability associated with the affected joint was not severe, the patient underwent surgical excision because the mass continued to grow and was likely to produce shoulder dysfunction and skin ulceration. The patient appeared well 10 months after surgery with no signs of recurrence. This report highlights the timing and indication of surgical excision in similar cases.

급속진행성 사구체 신염이 동반된 막성신증 1례 (A case of Crescentic Glomerulonephritis Superimposed on Membranous Glomerulonephropathy)

  • 김백남;육진원;김지홍;김병길;정현주
    • Childhood Kidney Diseases
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    • 제3권1호
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    • pp.95-99
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    • 1999
  • Idiopathic membranous nephropathy is one of the most common causes of nephrotic syndromes in adults but rare in childhood. The occurrence of crescentic glomerulonephritis and membranous nephropathy in a patient is rare. This report describes a patient who initially was diagnosed as a membranous glomerulonephropathy at age 12 years and subsequently developed a crescentic, rapidly progressive glomerulonephritis at age 19 years. The patient responded to methylprednisolone pulse therapy and he maintained with partial remission and normal renal function with residual proteinuria.

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섬유근통(fibromyalgia)의 병태와 진단을 위한 임상 1례 보고 (A Case Report of Symptomatic Character and Diagnosis of Fibromyalgia)

  • 정태영;조정효;박봉기;손창규
    • 대한한의학회지
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    • 제30권4호
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    • pp.162-168
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    • 2009
  • Objective: This report aimed to study fibromyalgia's diagnostic criteria, differential diagnoses and its pathology from the viewpoint of oriental medicine. Method: We observed and diagnosed a female patient who complained of prolonged whole body pain, even several times hospitalized for treatment. Result: The patient's symptoms correspond with fibromyalgia and we ruled out other suspected diseases. Conclusion: Fibromyalgia is prone to be misdiagnosed because the patient has complicated symptoms such as various pains and chronic fatigue as well as depression unexplained by medical tests. Furthermore, the symptoms often never disappear completely, although it isn't progressive or life-threatening, and can be improved. So accumulation of data and analysis from the viewpoint of oriental medicine is necessary for development of oriental medical standard treatment.

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Likely pathogenic FIG4 related amyotrophic lateral sclerosis patient who correlated with clinical, imaging and neuropsychological studies

  • Ko, Pan-Woo;Min, Yu-Sun;Park, Jin-Sung
    • Annals of Clinical Neurophysiology
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    • 제22권1호
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    • pp.33-36
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    • 2020
  • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with numerous causes that include genetic factors. Efforts to reveal the genetics of ALS have identified several candidate genes that are associated with familial and sporadic ALS. Here we report a Korean ALS patient who showed prominent upper motor-neuron-related symptoms with marked brain atrophy and neuropsychological deficits. The findings were highly suggestive of ALS in a patient with a likely pathogenic FIG4 variant.

흉곽출구증후군 환자에서 Current Perception Threshold (CPT) 사용 경험 (The Experience of Using Current Perception Threshold in Bilateral Thoracic Outlet Syndrome (TOS) Patient -A case report-)

  • 최정환;최진환;성춘호;박종욱
    • The Korean Journal of Pain
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    • 제13권1호
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    • pp.97-100
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    • 2000
  • Thoracic outlet syndrome (TOS) is a combination of signs and symptoms caused by the compression of the vital neurovascular structure at the thoracic outlet region. It may stem from a number of abnormalities, including degenerative or bony disorders, trauma to cervical spine, fibromuscular bands, vascular abnormalities and spasm of the anterior scalene muscle. CPT (current perception threshold) is defined as the minimum amount of current applied transcutaneously that an individual consciously perceives. It enables quantification of the hyperesthesia that precedes progressive nerve impairment, as well as hypoesthetic conditions. We experienced a case of thoracic outlet syndrome caused by fibrosis of anterior scalene muscle. The patient was a 30 years old woman with a 3 years history of numbness on the ulnar side, progressive weakness and coldness of both hand, tiredness in the left arm, nocturnal pain in the left forearm, and pain in the left elbow, shoulder and neck. Conservative treatment, stellate ganglion block, cervical epidural block, anterior scalene block and previous operation, including both carpal tunnel release, provided no remarkable relief to the patient. A left scalenectomy and first rib resection were performed by transaxillary approach and left cervical root neurolysis was done. After surgery, we measured CPT using neurometer and found conditions worsening in the opposite arm. We performed the same procedure on right side, and followed by CPT measurement. This case suggests that CPT is a useful measurement of recovery and progression of TOS.

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한방치료 후 호전된 MELAS 증후군 증례 1례 (A Case Report of MELAS syndrome Improved by Oriental Medicine Treatment)

  • 성기문;유덕선;최병선;허래경;장명준;이인영;송봉근
    • 대한한의학방제학회지
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    • 제18권2호
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    • pp.267-277
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    • 2010
  • Objective : Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes (MELAS) syndrome is a progressive neurodegenerative disorder. The typical presentation of patients with MELAS syndrome includes features such as mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes. Other features, such as seizures, diabetes mellitus, hearing loss, cardiac disease, short stature, endocrinopathies, exercise intolerance, and neuropsychiatric dysfunction are clearly part of the disorder. Approximately 80% of patients with the clinical characteristics of MELAS syndrome have a genetic mutation. This progressive disorder is reported to have a high morbidity and mortality. This case report is intended to estimate clinical effects of oriental meedicinal treatment of MELAS syndrome. Methods : A 44 year old female patient diagnosed as MELSA syndrome was treated with general oriental medicinal therapy including acupuncture, moxibustion, cupping, pharmacupunture and herbal medication in 20XX in Wonkwang Medical Center Gwangju. And the changes in symptoms and signs were evaluated as time dependently. Results : Although there is currently no curable treatment and MEALS syndrome is tend to progress, our treatment showed improvement in general weakness, gait disturbance and pain in the patient. Conclusion : Our case report suggests that various oriental medicinal treatment could be effective for improvement of MELAS syndrome and may represent a new potential therapeutic approach to control the disease. It could be applied to improve general condition, prevent relapse, enhance the quality of life and reduce complaints in the patient.

Liver transplantation in pediatric patients with progressive familial intrahepatic cholestasis: Single center experience of seven cases

  • Jung-Man Namgoong;Shin Hwang;Hyunhee Kwon;Suhyeon Ha;Kyung Mo Kim;Seak Hee Oh;Seung-Mo Hong
    • 한국간담췌외과학회지
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    • 제26권1호
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    • pp.69-75
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    • 2022
  • Backgrounds/Aims: Progressive familial intrahepatic cholestasis (PFIC) is an autosomal recessive inherited disease requiring liver transplantation (LT). The objective of this study was to investigate the clinicopathological features and posttransplant courses of seven LT recipients with PFIC. Methods: This was a retrospective single-center study of patients with PFIC who underwent LT from January 2013 to June 2020. Results: Two and five patients were diagnosed with PFIC type 1 and type 2, respectively. For all seven patients, age of PFIC onset was at birth. Jaundice was present in all cases. Mean pretransplant total and direct bilirubin levels were 16.1 ± 8.1 mg/dL and 12.4 ± 6.2 mg/dL, respectively. Median patient age and body weight at LT were 10 months and 7 kg, respectively. Types of donors were mothers of patients in four and deceased donors in three. All five patients with PFIC type 2 recovered uneventfully. One patient each with PFIC type 1 underwent retransplantation due to graft failure or died due to multi-organ failure. Overall graft and patient survival rates at five years were 66.7% and 83.3%, respectively. Bile salt export pump immunohistochemical staining showed normal canalicular expression in two patients with PFIC type 1, focal loss in two patients with PFIC type 2, and total loss in three patients with PFIC type 2. Conclusions: LT is currently the only effective treatment for PFIC-associated end-stage liver diseases. It is mandatory to perform regular follow-up due to the risk of complications including steatohepatitis, especially for patients with PFIC type 1.

이염성 백질 이영양증 환아의 치아우식 치료 증례 보고 (DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT)

  • 류지연;신터전;현홍근;김영재;김정욱;장기택;김종철;이상훈
    • 대한장애인치과학회지
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    • 제12권2호
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    • pp.96-100
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    • 2016
  • 저자는 후기 영아형 이염성 백질 이영양증으로 인해 신경학적인 퇴행이 관찰되고 섭식 장애로 인한 다발성 우식을 보이는 환아를 전신마취 하 치료하였기에 문헌 고찰과 함께 보고하는 바이다. 저작기능 장애로 인한 영양 결핍으로 환아는 신체 발육이 매우 저하되었으며 긴 식사 시간으로 다발성 치아 우식에 이환된 상태였다. 협조도 부족 및 치료 범위 등을 고려하여 전신마취 하에 치과 치료를 시행하였고 정기적인 검진을 시행 중이다. 진행성, 신경성 퇴행질환의 특징을 이해하고 환아의 상태를 고려한 구강 건강 관리 및 보호자 교육을 제공하는 것이 필요할 것으로 사료된다.

후기발병 정신분열병 환자에서의 뇌자기공명촬영 소견에 관한 연구 : 조기발병 정신분열병, 진행성 정신분열병, 노인성 치매 및 대조군과의 비교 (Brain MRI Findings for the Patient with the Late Onset Schizophrenia : Comparison among Patients with the Early Onset Schizophrenia, Progressive Schizophrenia, Senile Dementia and Controls)

  • 박두성;이영호;최영희;박영수;정영조
    • 생물정신의학
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    • 제4권1호
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    • pp.74-83
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    • 1997
  • With increasing tendency of incidence and interest for the late onset schzophrenia, concerns about whether this disorder is etiologically or phenomenogically distinctive entity or not have increased also. To clarify the disease entity of the late onset schzophrenia and the role of structural brain changes in its etiology, authors tried to prove following hypothesis : Are there any evidences of structural brain changes in the lateonset schizophrenia? ; If present, are they not different from those of the early-onset schizophrenia or progressive schizophrenia? ; And are they not different from those of senile dementia? Subjects were 6 patients with the late-onset schizophrenia, 6 patients with the early-onset schizophrenia, 6 patients with progressive schizophrenia, 6 patients with Alzheimer's dementia, and 6 controls. We measured regions of interest of the magnetic resonance images by computer assisted planimetry using the AutoCad and digitizer. Our study results may suggest that the third ventricular enlargement and a reversal of normal difference between left and right temporal lobe and left-right difference in posterior lateral ventricle are common brain pathology for all types of schizophrenia including the late onset schzophrenia. And also suggest that brain structural changes of the late onset schizophrenia are related with neurodevelopmental abnormality rather than degenerative change.

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