• Title/Summary/Keyword: recurrent acute

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Recurrent syncope presenting as an initial symptom of pulmonary embolism

  • Changho, Kim;Jin Sung Park;Minsung Kang
    • Annals of Clinical Neurophysiology
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    • v.25 no.1
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    • pp.38-40
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    • 2023
  • Acute pulmonary embolism (PE) is a life-threatening disease that manifests with cardiorespiratory symptoms. Syncope can be a rare, but warning sign of PE. We report a case of a 49-year-old male diagnosed with PE who presented with recurrent syncope prior to typical cardiorespiratory symptoms. His computed tomography pulmonary angiogram revealed bilateral PE. Syncope can be a rare clinical symptom of PE, but considering lethality of the disease, a differential diagnosis of PE should be considered in patients with recurrent syncope.

Radiosurgery for Recurrent Brain Metastases after Whole-Brain Radiotherapy : Factors Affecting Radiation-Induced Neurological Dysfunction

  • Gwak, Ho-Shin;Yoo, Hyung-Jun;Youn, Sang-Min;Lee, Dong-Han;Kim, Mi-Sook;Rhee, Chang-Hun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.275-283
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    • 2009
  • Objective : We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction. Methods : In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was $12.4cm^3$. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria. Results : Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age(<60 years) and tumor volume affected survival rate(p=0.03, each). Acute (${\leq}$1 month) toxicity was observed in 22% of patients, subacute and chronic (>6 months) toxicity occurred in 21 %, respectively. Less acute toxicity was observed with small tumors (<$10cm^3$. p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gy${\times}cm^3$) was a significant predictor of both acute and chronic CNS toxicities. Conclusion: Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.

The Clinical Analysis of Recurrent Bell's Palsy (재발 벨마비의 임상 분석)

  • Kim, Kyung Jib;Seok, Jung Im;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.38-42
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    • 2008
  • Background: Idiopathic facial nerve palsy, or Bell's palsy (BP), is a common and important disease. Recurrent Bell's palsy has been known as a rare entity with only a few cases in the literature. Methods: A total of 111 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to March 2007. We classified the patients into two groups - single BP and recurrent BP - and compared them by demographic data, clinical features, MRI findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 10 (9%) patients. The number of recurrence was varied from 2 to 5. The mean age of first attack in recurrent BP was $35.70{\pm}23.65$ years old and was earlier than that of the single BP ($50.94{\pm}16.21$ year). The larger proportion of the single BP had an abnormal enhancement of affected facial nerve (91.3%) than the recurrent BP (50%). The recurrent BP showed worse prognosis than the single BP. The associated conditions, etiology, and clinical features were similar between two groups. Conclusions: In comparison with single BP, recurrent BP showed earlier onset of first BP attack, less frequent abnormal enhancement of facial nerve on MRI, and worse prognosis.

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Clinical Analysis of Recurrent Bell's Palsy in One University Hospital (한 대학병원에서 분석한 재발 벨마비 환자의 임상양상)

  • Kim, Chang Hyeong;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.15 no.1
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    • pp.1-6
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    • 2013
  • Background: Bell's palsy (BP) is the most common cause of unilateral lower motor facial palsy. Recurrent paralysis of the facial nerve is unusual and reported in only 7-8%. Methods: A total of 394 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to September 2012. We classified the patients into two groups-single BP and recurrent BP-and compared them by patient characteristics, clinical features, MRI findings, electrophysiologic findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 31 (7.9%) patients. The number of recurrence was varied from 2 to 5. The recurrent BP (9.7%) had more incidence of family history and MRI enhancement than those of single BP (2.2%, p=0.047). The single BP (63.4%) had better recovery than recurrent BP (45.2%, p=0.045). Conclusions: The recurrent BP had more incidence of family history, MRI enhancement and poor prognosis than the single BP.

Arthroscopic Medial Retinacular Repair in Acute patellar Dislocation (급성 슬개골 탈구증의 관절경적 내측 지지대 봉합술)

  • Bin Seong-Il;Cha You-Cheol;Moon Ho-Saeng
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.98-101
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    • 1997
  • Acute patellar dislocation is a painful, terrifying experience that always occurs suddenly. The recurrence is unfortunately common and each experience is just as painful to the patient. With each acute dislocation, additional intraarticular derangement occurs. Therefore the goals of treatments are not only to relieve acute pain by prompt reduction of the dislocation but also to remove any chondral or osteochondral fragments that may be present within the knee joint and to restore normal patellofemoral anatomy, thereby preventing recurrent dislocation and avoiding future patellar subluxation. To present the details of arthroscopic medial retinacular repair in acute patellar dislocation. we report 2 patients with treatment of acute patellar dislocation with osteochondral loose body.

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Four Cases of Chronic Recurrent Bell's Palsy (만성 재발성 벨마비 4예)

  • Kim, Kyung Jib;Lee, Dong Kuck;Kim, Ji Eun
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.114-116
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    • 2005
  • Idiopathic facial nerve palsy, or Bell's palsy(BP) is an acute paralysis of the facial muscles innervated by the seventh cranial nerve. The cause and prognosis of recurrent BP are various. The frequency and heterogenicity of etiology suggest a predisposing factor or immune mechanisms. About 10% to 15% of patients with BP will suffer a recurrence, and less than 1.5% will have more than 4 episodes. We report four patients of chronic recurrent BPs.

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Clinical Effectiveness of Cefoperazone(Cefobid) in Obstetrics-Gynecological Infection (부인과감염증(婦人科感染症)에 대(對)한 Cefoperazone(Cefobid)의 임상효과(臨床效果))

  • Park, S.K.;Lim, J.K.
    • The Korean Journal of Pharmacology
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    • v.16 no.2 s.27
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    • pp.71-75
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    • 1980
  • A total of 30 cases of gynecological infection were treated with Cefoperazone at the Department of Ob-Gy, Seoul Baik Hospital, Seoul, Korea from Sept. 1979 to Aug. 1980. Cefoperazone sodium was administered in a dose of 2g/day intramusculary or intravenously for 6 to 13 days. The effective rates of Cefoperazone based on clinical and bacteriological response were 100% in 9 cases of acute non-gonorrheal PID, 5 cases of postpartum endometritis, 2 cases of recurrent non-gonorrheal PID and 80% in acute gonorrheal PID(8 out of 10 cases). A case of recurrent gonorrheal PID and 2 out of 3 cases of postoperative infection responded also satisfactorily to Cefoperazone treatment. There were no drug-related abnormal findings in urinalysis, hematology and blood chemistry. Any particular side effects, except for one case of fever and rash which disappeared spontaneously without any treatment or discontinuation of the drug, were not noted during or after the treatment.

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Risk Factors for Recurrent Abdominal Pain in Children with Nonorganic Acute Abdominal Pain

  • Piriyakitphaiboon, Varisa;Sirinam, Salin;Noipayak, Pongsak;Sirivichayakul, Chukiat;Pornrattanarungsri, Suwanna;Limkittikul, Kriengsak
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.129-137
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    • 2022
  • Purpose: The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. Methods: A retrospective, single study was conducted on 2-15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. Results: Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314-8.162), 3.052 (1.172-7.949), 3.706 (1.847-7.435), and 2.649 (1.477-4.750), respectively. Conclusion: RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.

Oral ulcerative and vesicular diseases (구강궤양 및 수포성 질환)

  • Byun, Jin-Seok
    • The Journal of the Korean dental association
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    • v.55 no.9
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    • pp.634-639
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    • 2017
  • Oral ulcerative and/or vesicular diseases have similar characteristics of clinical phenotypes. Detailed and careful history taking is the cornerstone of the diagnosis of oral mucosal disease. Moreover, complete screening of review of system for patient is important. Through this article, the simple ulcerative, recurrent ulcerative, acute multiple ulcer, chronic multiple ulcerative diseases will be discussed. Clinicians have to keep in mind its differential diagnosis and management.

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Efficacy of Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate in Acute Bleeding Patient (급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성)

  • Jae, Hwan Jun;Kim, Sang Youn;Lee, Eui Jung;Lee, Whal;Suh, Gil Joon
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.112-118
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    • 2005
  • Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.