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A Case of Pleural Effusion and Pulmonary Edema Caused by Calcium Channel Blockers in a Patient of Systemic Hypertension.

Dong Keun KIM ; Jung Seok KIM ; Ha Ram YI ; In Zoo CHOI ; Hyo Seung AHN ; Wook Hyun CHO

Soonchunhyang Medical Science.2015;21(2):237-241.

Calcium channel blockers (CCBs) are very popular drugs to lower blood pressure (BP) without significant side effects. A 72-year-old man admitted for uncontrolled hypertension. He had history of hypertension, atrial fibrillation with slow ventricular response, angina, abdominal aortic aneurysm, and stage 3 chronic kidney disease. He had taken several anti-hypertensives, such as amlodipine 5 mg, perindopril 8 mg, and indepamide 1.5 mg. To control BP, nifedipine 120 mg was added. Then pulmonary edema and pleural effusion was developed. Echocardiography showed preserved left ventricular ejection fraction and mild mitral regurgitation. Fluid restriction and high dose furosemide did not cease pleural fluid accumulation. Thus a total of 4 times of thoracentesis were done and all fluid analyses revealed transudate. We thought that pleural effusion and pulmonary edema was induced by CCBs and discontinued the drugs. He recovered quickly and finally discharged in a stable condition.
Aged ; Amlodipine ; Antihypertensive Agents ; Aortic Aneurysm, Abdominal ; Atrial Fibrillation ; Blood Pressure ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Echocardiography ; Exudates and Transudates ; Furosemide ; Humans ; Hypertension* ; Mitral Valve Insufficiency ; Nifedipine ; Perindopril ; Pleural Effusion* ; Pulmonary Edema* ; Renal Insufficiency, Chronic ; Stroke Volume

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Erratum: The Structure and Orientation of Governance for Healthy Cities Programs.

Won Gi JHANG

Soonchunhyang Medical Science.2017;23(2):159-159.

There was an error in the article, “The structure and orientation of governance for Healthy Cities programs.” The footnote at the bottom of page 8 should be corrected.

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Long-Term Functional Outcome of Peripheral Neuropathy in Microscopic Polyangiitis with Poor Prognostic Factors: 3-Year Clinical Follow-up.

Hyung Geun OH ; Hyo Wook GIL ; Ji Hye LEE

Soonchunhyang Medical Science.2017;23(2):155-158.

Microscopic polyangiitis (MPA) is a systemic small vessel vasculitis with few or no immune deposits and no granulomatous inflammation. Peripheral neuropathy occurs in approximately 20%–30% of patients with MPA. We report a case of a 66-year-old woman who presented with paresthesia and motor weakness of the extremities and rapidly progressive glomerulonephritis. She was later diagnosed with MPA based on the findings of positive perinuclear antineutrophil cytoplasmic antibody along with findings on kidney biopsy. Nerve conduction study showed symmetric sensorimotor polyneuropathy. We followed the patient for 3 years, and she showed good functional outcome after immune-modulating therapy although Five-Factor Score more than 2 at diagnosis.
Aged ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Diagnosis ; Extremities ; Female ; Follow-Up Studies* ; Glomerulonephritis ; Humans ; Inflammation ; Kidney ; Microscopic Polyangiitis* ; Neural Conduction ; Paresthesia ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Vasculitis

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Loop Formation and Malposition of Subclavian Vein Catheter.

Mi Roung JUN ; Sang Ho KIM ; Jae Hwa YOO ; Doyeon KIM

Soonchunhyang Medical Science.2017;23(2):152-154.

Central venous catheterization is a useful procedure for administrating fluids and drugs as well as monitoring central venous pressure in the operating room. The internal jugular vein and the subclavian vein are preferred as catheter insertion sites because of the low risk of infection and mechanical complications. However, the risk of venous malposition is higher in subclavian vein. The loop formation of the central venous catheter accompanied by its malposition increases the risk of thrombosis. If the procedure is to be performed with any difficulty, early radiologic examination should be required to detect and avoid complications. We report a case of malposition and loop formation of central venous catheter located in subclavian vein confirmed by chest X-ray after transferred to the intensive care unit.
Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Central Venous Pressure ; Intensive Care Units ; Jugular Veins ; Operating Rooms ; Subclavian Vein* ; Thorax ; Thrombosis

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A Case of Incus Extrusion into the External Auditory Canal after Head Trauma.

Kye Hoon PARK

Soonchunhyang Medical Science.2017;23(2):149-151.

Various types of ossicular chain interruption may occur in temporal bone fractures. The most common type is incudostapedial joint disruption. Incus is the most vulnerable to traumatic injury as compared with malleus or stapes, because it is suspended only by ligamentous structures and connected to the incudomalleolar and incudostapedial joints. Incus may rarely be pushed through tympanic membrane or pass through a fracture of posterosuperior external auditory canal. However, a case of complete extrusion of incus into the external auditory canal has not been reported. The author presents a rare case of incus extrusion into the external auditory canal with temporal bone fracture after head trauma.
Craniocerebral Trauma* ; Ear Canal* ; Head* ; Incus* ; Joints ; Ligaments ; Malleus ; Skull Fractures ; Stapes ; Temporal Bone ; Tympanic Membrane

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Postoperative Psychogenic Non-epileptic Seizure in the Post-Anesthesia Recovery Unit.

Jae Hwa YOO ; Sang Ho KIM ; Hyoung June KIM

Soonchunhyang Medical Science.2017;23(2):146-148.

A 43-year-old woman with left facial pain caused by occipital neuralgia was scheduled for C2 ganglionotomy and adhesiolysis of left C2 root. General anesthesia, surgical procedure, and emergence have done uneventfully. However, she developed seizure after 5 minutes postoperatively in post-anesthesia recovery unit. She showed loss of consciousness and generalized muscular rigidity after shouting “I want to die”. Neurologic examination and neuroimaging revealed no neuronal damage. Her generalized muscular rigidity improved by her daughter's visit and worsened by mention about her husband, and disappeared after 40 minutes spontaneously.
Adult ; Anesthesia, General ; Facial Pain ; Female ; Humans ; Muscle Rigidity ; Neuralgia ; Neuroimaging ; Neurologic Examination ; Neurons ; Seizures* ; Spouses ; Unconsciousness

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A Case of Pregnant Woman with beta-Thalassemia in Korean.

Aeli RYU

Soonchunhyang Medical Science.2017;23(2):143-145.

Thalassemia is hereditary disease characterized by impaired production of the normal globin peptide. Beta-thalassemia, a common disorder in Central Africa, the Middle East, and Southeast Asia, has been rarely reported in Korea. It should be considered in the differential diagnosis of hypochromic, microcytic anemia. The genetic subtypes among the different ethnic groups vary; this may pose challenges in prenatal diagnosis or genetic counselling. During pregnancy, women with thalassemia will often show more significant anemia. Recently we have experienced Korean pregnant woman with beta-thalassemia associated with anemia. We describe this case with a brief review of the literature.
Africa, Central ; Anemia ; Asia, Southeastern ; beta-Thalassemia* ; Diagnosis, Differential ; Ethnic Groups ; Female ; Genetic Diseases, Inborn ; Globins ; Humans ; Korea ; Middle East ; Pregnancy ; Pregnant Women* ; Prenatal Diagnosis ; Thalassemia

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Leiomyoma in the Hand.

In Woo BYUN ; Hyun Uk LEE

Soonchunhyang Medical Science.2017;23(2):140-142.

Leiomyoma is a benign tumors derived from smooth muscle cell. It is most commonly found in the uterus. However, leiomyoma rarely occurs in extremities and is more common in the lower limb than in the upper extremity. Leiomyoma in the hand is even rare. We present a case of leiomyoma which developed in the right hand of a man with a review of literatures.
Extremities ; Hand* ; Leiomyoma* ; Lower Extremity ; Myocytes, Smooth Muscle ; Upper Extremity ; Uterus

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The Association between Cerebrospinal Fluid Pleocytosis and Clinical Manifestations of Enteroviral Meningitis in Children.

Heejae AHN ; Minju PARK ; Jeongho LEE ; Yong Hee HONG ; Eun Sook SUH

Soonchunhyang Medical Science.2015;21(1):1-4.

OBJECTIVE: Enteroviruses are major causes of aseptic meningitis in children. This study aimed to describe the clinical manifestations of enteroviral meningitis according to the presence of cerebrospinal fluid (CSF) pleocytosis, and to investigate the factors influencing the CSF pleocytosis in children with this condition. METHODS: Eighty children with enteroviral meningitis treated at Soonchunhyang University Hospitals in Seoul and Bucheon between July 2012 and August 2013 were enrolled. The patients were diagnosed by reverse transcription-polymerase chain reaction (RT-PCR), and the clinical variables were compared according to the presence of CSF pleocytosis. RESULTS: Of the 80 patients, 54 (67.5%) and 26 (32.5%) patients had and did not have CSF pleocytosis, respectively. Forty-eight (60%) patients were male, and the median age was 63 months (range, 2 to 192 months). Seventy-six (95%), 67 (83.7%), 51 (63.7), and 2 (2.5%) patients presented with fever, headache, vomiting, and seizure, respectively. Increased CSF protein and pressure were associated with CSF pleocytosis. However, age, peripheral white blood cell count, C-reactive protein, CSF glucose, CSF/serum glucose ratio, and onset-puncture time interval were not associated with the presence of CSF pleocytosis. CONCLUSION: This study demonstrated a high proportion of non-pleocytic enteroviral meningitis in children, and identified several clinical manifestations that were associated with CSF pleocytosis. The findings of this study may help us better understand the characteristics of the disease and facilitate early diagnosis and treatment of enteroviral meningitis. During the outbreak seasons of enteroviral meningitis, the importance of continuous surveillance of enteroviruses and rapid RT-PCR testing should be emphasized.
C-Reactive Protein ; Cerebrospinal Fluid* ; Child* ; Early Diagnosis ; Enterovirus ; Fever ; Glucose ; Gyeonggi-do ; Headache ; Hospitals, University ; Humans ; Leukocyte Count ; Leukocytosis* ; Male ; Meningitis* ; Meningitis, Aseptic ; Pediatrics ; Seasons ; Seizures ; Seoul ; Vomiting

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Rosai-Dorfman Disease of 4-Year-Old Girl.

Jun Seak GANG ; Young Chang KIM ; Young Man LEE ; Junhun CHO ; Won Suk SUH ; Kyeong Bae PARK

Soonchunhyang Medical Science.2017;23(1):81-84.

Rosai-Dorfman disease also known as sinus histiocytosis with massive lymphadenopathy is a benign, rare systemic disease characterized by a histiocyte proliferation which presents with lymphadenopathy. We report a case of a 4-year-old girl who presented with recurrent cervical lymphadenopathy with tenderness, without any other symptoms. After 1 month of medical treatment, her lymphadenopathy still remained, so we performed complete excision and biopsy. She was diagnosed on cytology as a case of Rosai-Dorfman disease. She responded well to become asymptomatic without recurrence by 1 month.
Biopsy ; Child ; Child, Preschool* ; Female* ; Histiocytes ; Histiocytosis ; Histiocytosis, Sinus* ; Humans ; Lymphatic Diseases ; Recurrence

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