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Ramsay Hunt Syndrome -Case report on two cases- (Ramsay Hunt 증후군 -2예 보고-)

  • Lee, Sang-Gon;Yeo, Sang-Im;Goh, Joon-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.263-268
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    • 1992
  • Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.

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Clinical Acoustic Study of Acupuncture Therapy Effects on Post-Stroke Dysarthria (침치료가 뇌졸중으로 인한 구음장애에 미치는 음향적 특성에 대한 증례보고)

  • Lee, Min-Goo;Park, Sae-Wook;Lee, Sun-Woo;Ryu, Hyun-Hee;Lee, Seung-Eon;Kim, Yong-Jeong;Son, Ji-Woo;Rhim, Eun-Kyung;Kim, Sung-Nam;Lee, In;Moon, Byung-Soon;Yun, Jong-Min
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.660-669
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    • 2005
  • Objectives : The aim of this study is to find the acoustic characteristics of acupuncture therapy effects on post-stroke dysarthria. Methods : Acupuncture therapy was applied for four to six weeks by inserting needles into eight acupuncture points, CV23, CV24, bilateral 'Sheyu' and ipsilateral ST4, ST6 and contralateral LI4, ST36 on facial palsy side. All the speech samples were collected, pre-treatment and post-treatment, using Computerized Speech Lab. VOT and TD of each speech sample and vowel formant(F1&F2) were analyzed on spectrogram. Result : VOT and TD were decreased after treatment. F1 was decreased, and F2 was increased after treatment. Conclusions : This suggests that acupuncture therapy improves symptoms of post-stroke dysarthria by stimulating articulation organs such as tongue, lips, cheeks, larynx and pharynx.

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A Study on Relationship between Halitosis and Stress & Compulsion in Some of the Dental Hygiene Students (일부 치위생학과 학생들의 구취실태와 스트레스 및 강박증과의 관계 연구)

  • Ji, Min-Gyeong;Lee, Mi-Ra
    • The Journal of the Korea institute of electronic communication sciences
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    • v.7 no.5
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    • pp.1221-1228
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    • 2012
  • This study was carried out in order to offer basic data for preventing halitosis by understanding about the factors related to self-awareness of halitosis and about the relationship with stress and compulsion targeting students for the Department of Dental Hygiene. As a result of research, the whole subjects were indicated to be 1.76 points for the mean in stress, 1.62 points for the mean in compulsion, and 1.84 points for the mean in self-awareness of halitosis. The group of feeling the tongue to be white and the inside of the mouth to be sticky in own symptom inside the mouth was indicated to be 2.02 points(p=0.000) for stress and 2.00 points(p=0.000) for self-awareness of halitosis. The group of often feeling a sense of oral dryness was indicated to be 2.23 points(p=0.000) for stress, 1.95 points(p=0.000) for compulsion, and 1.89 points(p=0.046) for self-awareness of halitosis. The self-awareness of halitosis stood at r=0.133 with compulsion, thereby having indicated slight positive correlation. Stress and compulsion showed high positive correlation with r=0.425. Accordingly, there is a need of infusing recognition through steady education as a dental hygienist who will have interest in emotional factor along with grasping diverse causes for halitosis, and who will be in charge of a future patients' halitosis.

Result of the Early Exercise and Rehabilitation after Limited Posterior Operative Treatment of the Calcaneal Fractures (종골 골절의 제한적 후방 접근법 수술적 치료 후 조기 운동 및 재활 치료의 결과)

  • Song, Kyung-Won;Kim, Gab-Lae;Lee, Jin-Young;Lee, Kwang-Nam;Seo, Eun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.93-99
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    • 2008
  • Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

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A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive (협착음과 수유시 청색증 및 성장 장애를 보인선천성 후두개 낭종(vallecular cyst) 1예)

  • Yang, Mi Ae;Kang, Min Jae;Hong, Jeana;Shin, Seung Han;Kim, Sang Duk;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan;Kwon, Tack Kyun;Kim, In-One
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.775-779
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    • 2008
  • Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

A Study on Phrygia Headgear (프리기아[Phrygia] 모자에 대한 연구)

  • Yi-Chang Youngsoo
    • Journal of the Korean Society of Costume
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    • v.55 no.4 s.94
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    • pp.138-150
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    • 2005
  • Phrygia headgear has an important meaning from the perspectives of costume history and cultural exchanges in ancient times. This study is to investigate the prototype of Phrygia headgear through analysis of its manufacturing methods and styles on the basis of prior studies on ancient sculptures and literatures conducted by European researchers and to examine its history and meanings. In these ways, this study will be helpful in understanding the importance of Phrygia headgear in cultural exchanges between the East and the West. Results of this study can be summarized as follows: Phrygia headgear was orn by eastern tribes, so it was a symbol of those from the east in ancient times. Phrygia headgear is frequently found in Greek artistic works of 5th to 4th century BC that depicted eastern tribes. Also, this headgear can be observed in artistic works for Mithras, Attis, or other gods. Since Phrygia headgear's shape is similar to that of Homer's helm, many researchers believe that it might be originated from Homer's helm. This headgear made of oxen scrotum(stierbeutel) or its surrounding skin has a long end at the top. This long end is round and drooping toward the front side. From such unique shape, we top. This long end is round and drooping toward the front side. From such unique shape, we top. This long end is round and drooping toward the front side. From such unique shape, we can draw a conclusion that Phrygia headgear was made of oxen scrotum and its surrounding skin. Dependingy on drooping patterns, there are various shapes, such as the round, tightly swollen one worn by Mithras, the tongue-shaped one found in Basilika S. Apolinare Nuovo's mosaic depicting three wise men, the balloon-shaped one frequently found in Greek vases depicting Scythian, and the one drooping to the side depicted in Alexandersarkophag. Further, some Phrygia headgear has covers for neck and ears. For example, Phrygia headgear worn by Persian Satrap tribe has such covers attached to the head part. Meanwhile, Phrygia headgear worn by Amazone tribe does not show such separate covers, Rather, one piece of oxen skin was tanned and finished to make such covers. Wearing Phrygia headgear can be interpreted in several ways. Use of animal's skin for wearing things is a unique aspect in ancient societies because they believed that wearing animal skin would give them power of the animal. Further, Phrygia headgear made of oxen scrotum was a symbol of reproductive power to women.

Methodologic Aspect of LINAC-based Stereotactic Radiosurgery (선형가속기 기반 뇌정위 방사선 수술기법)

  • Choi, Tae Jin
    • Progress in Medical Physics
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    • v.23 no.3
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    • pp.127-137
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    • 2012
  • A conversing beam is firstly designed for radiosurgery by a neurosugern Lars Leksell in 1949 with orthogonal x-rays tube moving through horizontal moving arc to focusing the beam at target center. After 2 decades he composits 201 source of the Co-60 for gamma knife which beams focused at locus. Sveral linac-based stereotactic radiosurgery using the circular collimated beam which size range for 0.4~4.0 cm in a diameter by non-coplanar multiarc have been developed over the decades. The irregular lesions can be treated by superimposing with several spherical shots of radiation over the tumour volume. Linac based techniques include the use of between 4 and 11 non-co-planar arcs and a dynamic rotation technique and use photon beam energies in the range of 6~10 MV. Reviews of the characteristics of several treatment techniques can be found in the literature (Podgorsak 1989, Schell 1991). More in recent, static conformal beams defined by custom shaped collimators or a mini- or micro-multileaf collimator (mMLC) have been used in SRS. Finally, in the last few years, intensity-modulated mMLC SRS has also been introduced. Today, many commercial and in-house SRS programs have also introduced non-invasive immobilization systems include the cyberknife and tomotherapy and proton beam. This document will be compared the characteristics of dose distribution of radiosurgery as introduced gamma knife, BrainLab include photon knife in-house SRS program and cyberknife in currently wide used for a cranial SRS.

A Review of Static Blood Pattern in Stroke Pattern Diagnosis (한의 중풍 변증 표준화 연구에서 어혈증에 관한 고찰)

  • Lee, Jung-Sup;Kim, So-Yeon;Kang, Byoung-Kab;Ko, Mi-Mi;Kim, Jeong-Cheol;Oh, Dal-Seok;Kim, Yoon-Sik;Lee, In;Cho, Ki-Ho;Chen, Chan-Yong;Han, Chang-Ho;Bang, Ok-Sun
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.813-820
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    • 2009
  • Background : Static blood is a kind of etiological factor including stagnated blood and blood overflowed out of the vessels. It is one of the causes of stroke in oriental medicine. Objectives : The purpose of this study was to evaluate the static blood pattern and its indicators in stroke pattern diagnosis. Methods : For the standardization of pattern diagnosis in stroke, we set 5 patterns (Fire-heat, Dampness-phlegm, Static blood, Qi deficiency, Yin deficiency) and developed 61 indicators. Patients with a first-ever stroke, within 1 month after the onset of stroke. Two physicians checked the indicators independently. They then performed pattern diagnosis and rechecked the indicators which were referred to pattern diagnosis. If pattern identifications were diagnosed the same, it would confirm pattern identification. We examined the frequency of all indicators and referred indicators in static blood pattern patients. Results : In 859 patients, static blood pattern was shared by 24(2.8%). The indicators which affect static blood pattern were mainly rough pulse and bluish purple tongue, other indicators were not major effectors. Conclusion : This result shows that it is inconsistent to set up static blood pattern as a major pattern in stroke. Nevertheless, static blood is still a valuable concept in the clinical field. Other study methods will be required to establish the pattern diagnostic indicators for static blood pattern.

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A Case of Pressure Sore in Congenital Insensitivity to Pain with Anhidrosis (CIPA(Congenital Insensitivity to Pain with Anhidrosis)를 가진 환아에서 욕창의 치험례)

  • Hwang, Jae Ha;Park, Sun Hyung;Yoo, Sung In;Noh, Bok Kyun;Kim, Eui Sik;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.669-671
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    • 2006
  • Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

A Study of the Actual Conditions of the Dental Health of High School Girls Visiting Scaling Practice Rooms (스켈링 실습실에 내원한 여고생의 구강건강 실태 조사)

  • Jang, Gye-Weon;Cho, Pyeang-Kyu;Seo, Eun-Ju;Lee, Mi-Oak
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.1
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    • pp.13-24
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    • 2003
  • The researcher worked with a total of 158 high school girls visiting the scaling practice room at the department of dental hygiene in Jinju Health college from November 11, 2002 to December 4, 2002, having their teeth scaled, observing their teeth and interviewing them with the aid of questionnaires. The findings can be summarized as follows. 1. The survey on the understanding of dental health and the attitudes of the subjects shows the following results : "I have never learned how to brush teeth" (65.8%: 104 girls); "I brush my teeth twice a day" (57.0%: 90 girls) : "I brush my teeth for 2 minutes"(44.3%: 70 girls): "I brush my teeth vertically and horizontally" (53.2%: 84 girls): "( brush my teeth, gum and tongue" (462%: 73 girls): "I use one brush for two months" (40.5%: 64 girls); "I don't have any floss" (582%: 92 girls): "I have never had my teeth scaled" (84.2%: 133girls) : "Smoking is bad for the teeth" (77.8%: 123 girls): "Drinking is bad for the teeth" (48.7%: 77 girls): "I have ever visited dental clinics" (92.4%: 146 girls). 2. The study on part of the teeth most exposed to caries shows the following results : Mandibular right first molar(79.8%: 126 girls): Mandibular left first molar(77.5%: 124 girls), Mandibular left second molar(70.2%: 111 girls). Mandibular right second molar(65.7%: 104 girls). Maxillary left first molar(59.5%: 94 girls): Maxillary left second molar(59.5%: 94 girls): Maxillary right first molar(58.2%: 92 girls). Maxillary right second molar(50.7%: 80 girls) 3. The statistics on the subjects' caries show the following results: DMF rate: 943%: DMFT rate: 25.61%: DMFT index: 7.17 teeth : DT rate: 4651%: FT rate: 52.25%: MT rate: 124% 4. The survey on dental caries statistics, dental health, dental health behavior, and the subjects' attitudes shows the following results: The worse the subjects' dental health was(r=-327, p<.001), the more they visited dental clinics(r=.195, p<.05), the higher DMT rate, DMFT index were; The more the subjects visited dental clinics(r =.359, p<.001), the higher DT rate was; The worse the subjects teeth went(r=-.197, p<.05), the higher MT rate was. It is necessary that systematic and substantial dental health education for high school students should be carried out in regard to plaque control, fluoride application, diet control, pit & fissure sealant as a part of developing national health policies designed for the dental health of the teenagers.

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