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Sudden Pulseless Ventricular Tacchycardia during the Emergence of a Child after the General Anesthesia, and Suspected Viral Myocarditis.

In Suk JEON ; Jong Hyun LEE ; Sang Baek KIM ; Dong Gi LEE ; Sang Chul BAE

Soonchunhyang Medical Science.2011;17(2):168-171.

A 10-year-old female child was underwent the tonsillectomy and adenoidectomy. She was relieved from the upper respiratory tract infection about 1 week before the operation. Her heart rate was recorded 100 to 110 per minute at the preanesthetic period, and then increased to about 140 per minute during the operation. We speculated that tacchycardia resulted from the inhalation anesthesia of sevoflurane as other common cases, so we didn't consider it as a serious problem. But the taccycardia was not relieved after the termination of anesthesia, and after the extubation, it was severely and rapidly aggravated to the ventricular tacchycardia with the circulatory collapse during the emergence period. After the rapid defibrillation and the chest compression, her resuscitation was successfully finished. We suspected her event was derived from the childhood cardiomyopathy, especially the viral myocarditis. So we reviewed viral myocarditis and focused a new aspect of childhood cardiac disease and screening.
Adenoidectomy ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Cardiomyopathies ; Cardiopulmonary Resuscitation ; Child ; Female ; Heart Diseases ; Heart Rate ; Humans ; Mass Screening ; Methyl Ethers ; Myocarditis ; Pediatrics ; Respiratory Tract Infections ; Resuscitation ; Shock ; Tachycardia, Ventricular ; Thorax ; Tonsillectomy

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A Case of Desmoplastic Malignant Mesothelioma.

Sang Woo PARK ; In Jae OH ; Young Chul KIM ; Sang Yun SONG ; Mi Sun YOON ; Song CHOI ; Yoo Duk CHOI

Soonchunhyang Medical Science.2011;17(2):164-167.

Malignant mesothelioma (MM) is a rare tumor that associated with asbestos exposure. For the reliable diagnosis, the adequate representative tissue samples are essential for the histology and immunohistochemical staining. We report a case of desmoplastic malignant mesothelioma (DMM), accounting for only 5 to 10% of all MM and having poor prognosis. A 76-year-old male visited emergency room presenting with chest pain. Chest computed tomography showed focal lobulated pleural enhancing mass in posterior aspect of left upper lobe. After video-assisted thoracoscopic surgery and several immunohistochemical stains, we could diagnose as DMM. The patient refused chemotherapy, but received analgesics and palliative radiation for the painful back area. Subsequently, he was transferred to hospice clinic after 17 months from appearance of the initial symptom.
Accounting ; Aged ; Analgesics ; Asbestos ; Chest Pain ; Coloring Agents ; Emergencies ; Hospices ; Humans ; Immunohistochemistry ; Male ; Mesothelioma ; Prognosis ; Thoracic Surgery, Video-Assisted ; Thorax

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A Case of Hypothyroxinemia with Thyroxine-Binding-Globulin Deficiency.

Soon Mi HUR ; Shin Hee KIM ; Min Jin KIM ; Dong Won BYUN ; Kyo Il SUH ; Myung Hi YOO ; Hyeong Kyu PARK

Soonchunhyang Medical Science.2011;17(2):161-163.

The transport proteins such as thyroxine-binding-globulin (TBG), albumin and transthyretin carry over 99% of circulating thyroid hormones. TBG is a major thyroid hormone transport protein in serum. Although TBG deficiency does not have metabolic consequences, it has diagnostic implications as it can lead to an incorrect interpretation of thyroid function tests. We experienced a case that a man who had an abnormal thyroid function showed unexpectedly low concentrations of serum total thyroxine. We detected the low TBG in his serum and he was diagnosed the TBG deficiency. We report this case along with a review of the related literature.
Carrier Proteins ; Prealbumin ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroxine

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Outcome Evaluation of an Immediately Placed Maxillary Anterior Single-Tooth Implant Using Objective Esthetic Criteria: Case Report.

Kyoung Kyu KIM ; Hun Mo SUNG

Soonchunhyang Medical Science.2011;17(2):155-160.

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.
Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Titanium

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A Case of Severe Hypercalcemia and Hyperphosphatemia Concomitant to Hyperthyroidism.

Gye Yeon LEE ; Won Seon JEON ; Jung Hun OHN ; Eun Gyoung HONG

Soonchunhyang Medical Science.2015;21(1):52-57.

Changes of serum electrolytes in patients with hyperthyroidism are often disregarded. Hypercalcemia has been reported in 17% to 50% of patients with hyperthyroidism. However, severe and symptomatic hypercalcemia is rare among patients with hyperthyroidism. We report a rare case of symptomatic hypercalcemia and hyperphosphatemia in a 31-year-old male patient who was diagnosed with hyperthyroidism. He visited our hospital with nausea, vomiting, and tremor. Thyroid function test showed severe thyrotoxicosis and serum calcium and phosphorus were elevated but parathyroid hormone was low, excluding primary hyperparathyroidism as the cause of hypercalcemia. Saline hydration with diuretics to lower serum calcium and antithyroid medication with lugol solution were administered for six days. But symptoms persisted and he was treated with intravenous pamidronate. Symptoms were relieved after resolution of hypercalcemia and hyperphosphatemia. The case suggests that severe and symptomatic hypercalcemia and hyperphosphatemia can complicate hyperthyroidism and early correction of hypercalcemia can relieve symptoms.
Adult ; Calcium ; Diuretics ; Electrolytes ; Humans ; Hypercalcemia* ; Hyperparathyroidism, Primary ; Hyperphosphatemia* ; Hyperthyroidism* ; Male ; Nausea ; Parathyroid Hormone ; Phosphorus ; Thyroid Function Tests ; Thyrotoxicosis ; Tremor ; Vomiting

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Sepsis from Neonatal Mastitis and Breast Abscess.

Seung Eun LEE ; Jeongho LEE ; Eun Sook SUH

Soonchunhyang Medical Science.2015;21(1):49-51.

Although some full-term neonates suffer from mastitis or a breast abscess, mastitis is not common in neonates and concurrent bacteremia is a rarely seen. We report the case of a 30-day old boy of African ethnicity, who was a full-term infant and appropriate for gestational age. At birth, he had bilateral palpable breast masses. He had high fever as well as swelling and nipple discharge in both breasts 30 days after birth. An ultrasonography of the breast showed masses with septa in both breasts. The breast masses were red in color, swollen, and felt hot to the touch. We incised the mass and performed a culture of the discharge. Staphylococcus epidermidis was detected in both blood and the breast discharge. In conclusion, the infant experienced neonatal bacteremia that originated from a breast abscess.
Abscess* ; Bacteremia ; Breast* ; Female ; Fever ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Mastitis* ; Nipples ; Parturition ; Sepsis* ; Staphylococcus epidermidis ; Ultrasonography

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A Case of Moyamoya Disease without Transient Ischemic Attacks.

Minju PARK ; Seung Eun LEE ; Jeongho LEE ; Eun Sook SUH

Soonchunhyang Medical Science.2015;21(1):44-48.

Moyamoya disease is a cerebrovascular disorder characterized by internal carotid arteries' occlusion or stenosis. Its etiology remains unknown, and it occurs more frequently in Asian countries than western countries. It can occur at any age, and approximately 50% of patients are children. Initial manifestations of moyamoya disease are very different according to age. In general, cerebral ischemic symptoms like transient ischemic attacks (TIA) are the most common manifestation of children. It is a chronic progressive disease and cause recurrent stroke, so early diagnosis and management is very important. We report a case of moyamoya disease without TIA, in a 7 years old female child presenting as unusual symptoms, such as walking difficulty and dysarthria.
Asian Continental Ancestry Group ; Cerebrovascular Disorders ; Child ; Constriction, Pathologic ; Dysarthria ; Early Diagnosis ; Female ; Humans ; Ischemic Attack, Transient* ; Moyamoya Disease* ; Stroke ; Walking

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Neurogenic Bladder Dysfunction Caused by Seronegative Autoimmune Autonomic Ganglionopathy.

Sang Hyun KIM

Soonchunhyang Medical Science.2015;21(1):40-43.

Autoimmune autonomic ganglionopathy is a form of acquired autonomic failure affecting parasympathetic, sympathetic functions, usually affecting healthy young people. The disorder affects both sympathetic and parasympathetic nervous systems, with acute onset, monophasic course, and partial recovery with relative preservation of motor and sensory function. We experienced a case of young man with acute autoimmune autonomic ganglionopathy who developed voiding difficulty, sudden blurred vision and gastrointestinal discomfort without motor or sensory dysfunction. Fever developed 5 days earlier and persisted until onset of autonomic failure. Patient complained voiding difficulty and urodynamic study revealed detrusor are flexia with failure to initiate and sustain adequate detrusor contraction. Sympathetic skin response and several autonomic function tests showed abnormalities. Intravenous immunoglobulin was applied for 5 days but symptoms persisted. Thus, 5 days of plasmapheresis treatment was followed showing improvements in most of the symptoms. However bladder dysfunction persisted at 6 months follow-up, showing partial recovery at bethanechol administration.
Bethanechol ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulins ; Parasympathetic Nervous System ; Plasmapheresis ; Primary Dysautonomias ; Sensation ; Skin ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics

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A Case of Colonic Hypoganglionosis Complicated with Colonic Ulcers.

Kyu Man CHO ; Sung Uk LIM ; Seon Young PARK ; Kyung Hwa LEE ; Jae Kyun JU ; Jong Sun REW

Soonchunhyang Medical Science.2015;21(1):36-39.

Hypoganglionosis is a rare form of intestinal neuronal malformation, which is characterized by reduced number and size of ganglion cells of parasympathetic nerves in the intestinal wall. Pathophysiology is not well known, however intestinal ischemia, inflammation, autoimmune process or neurotoxin may play a role. Here, we report the case of a 56-year-old man with colonic pseudoobstruction and ulcerations in marked dilatedcolon above transitional zone who was later diagnosed with colonic hypoganglionosis.
Colon* ; Colonic Pseudo-Obstruction ; Ganglion Cysts ; Humans ; Inflammation ; Ischemia ; Middle Aged ; Neurons ; Ulcer*

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Food Protein-Induced Enterocolitis Syndrome in a Neonate with Peripheral Epimerase Deficiency Galactosemia.

Jung Min HWANG ; Se Hyun OH ; Yong Hee HONG ; Sung Shin KIM ; Jang Yong JIN

Soonchunhyang Medical Science.2015;21(1):31-35.

Food protein-induced enterocolitis syndrome (FPIES) is a severe infantile form of non-immunoglobulin E-mediated gastrointestinal food hypersensitivity that manifests as profuse, repetitive vomiting, often with diarrhea, which leads to acute dehydration and lethargy and failure to thrive if chronic. Symptoms such as dehydration and lethargy are also observed in sepsis, viral infection, and food poisoning. It is difficult to differentiate FPIES from sepsis-like illness. The diagnosis is based on clinical criteria and/or an oral food challenge. FPIES developed in the patient with peripheral epimerase deficiency galactosemia after the use of soy formula. The change in feeding to soy formula is not required of a patient with peripheral epimerase deficiency galactosemia. Early intake of soy formula in our patient was harmful. Therefore, we think the changing the formula should be taken carefully. Another important point is the diagnosis. Late diagnosis and misdiagnosis are common, and inappropriate treatment or invasive treatment can occur.
Dehydration ; Delayed Diagnosis ; Diagnosis ; Diagnostic Errors ; Diarrhea ; Dietary Proteins ; Enterocolitis* ; Failure to Thrive ; Food Hypersensitivity ; Foodborne Diseases ; Galactosemias* ; Humans ; Infant ; Infant, Newborn* ; Lethargy ; Sepsis ; Vomiting

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