ABSTRACT
Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1-3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4-5 and C5-6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.
Subject(s)
Female , Humans , Middle Aged , Arm , Atrophy , Brachial Plexus Neuritis , Electromyography , Fingers , Forearm , Hand Strength , Muscle Weakness , Neural Conduction , Radiculopathy , Shoulder , ThumbABSTRACT
Sciatic nerve block is frequently used for anesthesia or analgesia during lower leg surgery or chronic lower leg pain syndrome. Recently, a lot of ultrasound-guided peripheral nerve block has been reported because there are several benefits compared to blind technique. We performed ultrasound-guided right sciatic nerve block successfully to the patient who has been suffering from right buttock pain after previous radiation therapy.
Subject(s)
Humans , Analgesia , Anesthesia , Buttocks , Leg , Peripheral Nerves , Sciatic Nerve , Stress, PsychologicalABSTRACT
Ruptured aneurysm of sinus of Valsalva is an uncommon congenital lesion, which was first reported in 1840 by Thurman. Its incidence is representing up to 3.5% of patients undergoing congenital heart disease surgery. Predominant symptoms are dyspnea, palpitation, and chest pain, present above the half. An early diagnosis is helpful because of the favorable surgical prognosis. Echocardiography remains useful in detecting abnormalities, and provides important information prior to cardiac catheterization and surgery. Cardiac catheterization and angiography are necessary for diagnosis of receiving chamber and associated lesions such as ventricular septal defect, aortic regurgitation, and other congenital abnormalities. The effective treatment is surgery. Without operation, cause of death are heart failure or bacterial endocarditis. We report two cases of asymptomatic ruptured aneurysm of sinus of Valsalva, confirmed by transesophageal echocardiography, and cardiac catheterization. The corrective surgery was performed without complication.
Subject(s)
Humans , Aneurysm, Ruptured , Angiography , Aortic Valve Insufficiency , Cardiac Catheterization , Cardiac Catheters , Cause of Death , Chest Pain , Congenital Abnormalities , Diagnosis , Dyspnea , Early Diagnosis , Echocardiography , Echocardiography, Transesophageal , Endocarditis, Bacterial , Heart Defects, Congenital , Heart Failure , Heart Septal Defects, Ventricular , Incidence , Prognosis , Sinus of ValsalvaABSTRACT
The occurrence of double primary cancer of the esopbagus and duodenum is considered very rare. Moreover, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency to early metastasis. We report a case of double primary cancer, which we have synchronously confirmed esophageal squamous cell carcinoma and duodenal adenocarcinoma with gastrofiberscopic biopsy, and then treated them by gastrojejunostomy and systemic chemotherapy.
Subject(s)
Adenocarcinoma , Biopsy , Carcinoma, Squamous Cell , Drug Therapy , Duodenum , Esophageal Neoplasms , Gastric Bypass , Neoplasm MetastasisABSTRACT
Since coronary arteriovenous fistula(CAVF) was first reported by Krause in 1865, more than 400 cases have been reported. It is relatively rare disease and originates more commonly in the right than in the left coronary artery. We report a case of CAVF between right coronary artery and right ventricular inflow tract with significant left to right shunt in a 34-year old female who was admitted for the cardiomegaly on routine chest X-Ray. It was detected by transthoracic and transesophageal echocardiography, and confirmed by cardiac catheterization and coronary angiography. The opening of the fistula draining into the right ventricle was obliterated with sutures. There was no significant shunt in postoperative cardiac catheterization and coronary angiography.