• Title/Summary/Keyword: Benign disease

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Topical Steroid Therapy using Stent on Chronic Ulcerative Gingival Lesions (스텐트를 이용한 만성 궤양성 치은 병소의 국소 스테로이드 치료)

  • Park, Hyung-Uk;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.259-264
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    • 2010
  • The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

Reconstruction of Mainstem Bronchus Obstructed by Endobronchial Tuberculosis (결핵성 주기관지협착에 대한 주기관지재건술)

  • Kim Su Wan;Kim Jhingook;Shim Young Mog;Kim Kwhanmien;Choi Yong Soo;I Hoseok;Kim Hojoong;Chang Jee Won
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.622-626
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    • 2005
  • Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

Outbreak of Acinetobacter septicemia in a neonatal intensive care unit (신생아 집중치료실에서 집단 발생한 Acinetobacter septicemia)

  • Kim, Myo Jing;Lee, Hye Jin;Son, Sang Hee;Huh, Jae Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.494-499
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    • 2006
  • Purpose : Acinetobacter baumannii is increasingly recognized as an important cause of nosocomial infection, especially in neonatal intensive care units. But little is known about the clinical significance and hospital epidemiology of Acinetobacter species other than A. baumannii. The objective of this study is to describe the clinical characteristics and epidemiology of septicemia due to Acinetobacter species other than A. baumannii. Methods : We retrospectively reviewed 11 cases of blood culture proven nosocomial infection which occured in our neonatal intensive care unit from $4^{th}$ to $24^{th}$, February, 2004. To establish epidemiological analysis, we performed environmental cultures and an antibiogram was obtained from susceptability tests of isolated Acinetobacter species. Results : Clinical manifestations including fever, poor feeding, abdominal distension, diarrhea, bloody stool passage, vomiting, tachypnea and apnea were similar to other infectious diseases. Benign clinical courses were compared with poor prognose, including a high mortality rate in septicemia due to A. baumannii. The major predisposing factor among our patients was the presence of a peripheral intravascular catheter. Antibiogram was similar, but surveillance cultures of environmental specimens failed to identify the source of infection. Conclusion : Acinetobacter species other than A. baumannii were often considered relatively avirulent bacteria, but could be pathologic organisms if cultured in patients with clinical symptoms.

Parathyroid Carcinoma (부갑상선암)

  • Cho Eun-Chol;Sub Jin-Hak;Chung Woong-Yun;Kim Ho-Geun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.205-209
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    • 2001
  • Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

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Evaluation of the Risk Factors Predicting Morbidity and Mortality after Major Pulmonary Resection (주요 폐절제술시 이환율과 사망률을 예견하는 위험인자의 평가)

  • Choi, Ho;Lee, Cheol-Joo;Soh, Dong-Moon;Kim, Jung-Tae;Hong, Jun-Wha;Ryu, Han-Young;Park, Jae-Beom
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.549-555
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    • 1999
  • Background: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. Material and Method: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and $\chi$2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. Result: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). Conclusion: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

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Clinical Significance of the Routine "Dipstick" Urinalyses in Pediatric Inpatients (입원 환아에서의 "dipstick" 소변검사의 임상적 의의)

  • Park, Yong-Hoon;Jun, Jin-Gon
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.115-120
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    • 1984
  • To find clinical significance of routine "dipstick" urinalysis on admission, we analyzed the results of the "dipstick" urinalyses performed in 844 patients admitted to the pediatric department of Yeungnam University hospital from May 1, 1983 to October 31, 1984. Ketonuria, proteinuria, hematuria and glucosuria were found in 9.5%, 4.9%, 2.4% and 1.1% of the patients respectively. There were no significant differences by sex, age and presence of fever. However, proteinuria and ketonuria were found more frequently in the patients with dehydration (p<0.05). The degree of ketonuria showed a positive association w:th the severity of dehydration (p<0.005). All of the patients with proteinuria and ketonuria showed negative results on follow up. However, among 13 patients with hematura, 9 patients showed negative results and 4 patients had persistent hematuria on follow up. These 4 patients were found to have chronic pyelonephritis (2), asymptomatic urinary tract infection (1) and benign recurrent hematuria (1). This routine "dipstick" urinalysis on admission seems to be simple test which is useful in detecting unrecognized kidney and other urinary tract disease.

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Risk of Breast Cancer among Young Women and Importance of Early Screening

  • Memon, Zahid Ali;Kanwal, Noureen;Sami, Munam;Larik, Parsa Azam;Farooq, Mohammad Zain
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7485-7489
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    • 2015
  • Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

Clinical and molecular biological aspect of the hyaluronidases: basis and clinical overview for oriental medical application

  • Kim, Cheorl-Ho;Lee, Dong-Gyu;Jang, Jun-Hyouk;Kim, Jong-De;Nam, Kyung-Soo;Kim, Jeong-Joong;Park, Jong-Kun;Choo, Young-Kug;Kim, Hyung-Min;Lee, Young-Choon
    • Advances in Traditional Medicine
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    • v.1 no.1
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    • pp.8-27
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    • 2000
  • Components of extracellular matrix and the matrix-degrading enzymes are some of the key regulators of tumor metastasis and angiogenesis. Hyaluronic acid (HA), a matrix glycosaminoglycan, is known to promote tumor adhesion and migration, and its small fragments are angiogenic. Until now, we have compared levels of hyaluronidase, an enzyme that degrade HA, in normal adult prostate, benign prostate hyperplasia and prostate cancer tissues and in conditioned media from epithelial explant cultures, using a substrate (HA)-gel assay and ELISA-like assay (Kim et al., unpublished results). The present review described an overall characterization of hyaluronidases and its application to human diseases. The hyaluronidases are a family of enzymes that have, until recently, deed thorough explication. The substrate for these enzymes, hyaluronan, is becoming increasingly important, recognized now as a major participant in basic processes such as cell motility, wound healing, embryogenesis, and implicated in cancer progression. And in those lower life forms that torment human beings, hyaluronidase is associated with mechanisms of entry and spread, e.g. as a virulence factor for bacteria, for tissue dissection in gas gangrene, as a means of treponema spread in syphilis, and for penetration of skin and gut by nematode parasites. Hyaluronidase also comprises a component of the venom of a wide variety of organisms, including bees, wasps, hornets, spiders, scorpions, sh, snakes and lizards. Of particular interest is the homology between some of these venom hyaluronidases and the enzyme found in the plasma membrane of mammalian spermatozoa, attesting to the ancient nature of the conserved sequence, a 36% identity in a 300 amino acid stretch of the enzyme protein. Clearly, hyaluronidase is of biological interest, being involved in the pathophysiology of so many important' human disorders. Greater effort should be made in studying this family of enzymes that have, until recently, been overlooked. Also, oriental medical application of the hyaluronidase will be discussed with respect to inhibition and suppression of inflammation and malignacy.

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Clinical Analysis of Neck Masses Proved by Diagnostic Excisional and Incisional Biopsies (진단적 절제 및 절개 생검술을 시행한 경부 종양에 대한 임상적 고찰)

  • Kwon Soo-In;Noh Dong-Young;Oh Seung-Keun
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.2
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    • pp.112-118
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    • 1992
  • Neck mass as a primary presenting sign is a common problem that physicians and surgeons alike have to face but conclusive diagnosis cna be made only by histopathological examination. During the period of four years from January 1988 to December 1991, three hundred sixteen diagnostic incisional or excisional biopsies of the neck masses were performed at the outpatient department of Surgery, Seoul National University Hospital and tissue diagnoses were confirmed by histopatholotical examination. On which a clinical analysis was performed and its results were compared with the results of one hundred fifteen Fine Needle Aspiration Cytologic examinations on neck masses during the same period. The results were as follows: In the histologic types of neck masses. inflammatory disease was the most common (58.2%), metastatic malignant tumor(22.5%), benign tumor(15.2%). primary malignant tumor(0.4%) in decreasing order. Among the individual lesions. tuberculous lymphadenitis was the most common(29.4%) and nonspecific lymphadenitis was the next. Of overall sexual distribution, female preponderated by a ratio of 1.15:1, but in the primary and metastatic malignancies, male did by a ratio of 1.60:1 and 1.53:1, respectively. The most common age group was third decade(26.8%), and fourth decade was the next(20.9%) but in malignant tumors. sixth decade was the most commom. The duration of symptom between one and three months(33.8%), was the most common and between three and six month was the next but the difference between the individual diseases was not significant. Of the metastatic tumor of seventy one cases, primary site was found in fifty cases(84.2%) and stomach cancer was the most comon primary site. In the result of the Fine Needle Aspiration Cytologic(FNAC) examinations, positive for mlignant cells was the most common(33.1%), following the frequencies with tuberculosis(22.6%), and nonspecific lymphadenitis(16.5%) in decreasing order. Eleven cases of FNAC underwent diagnostic biopsies and the diagnostic accuracy of FNAC was 83.3%. Conclusively, in our study, tuberculous lymphadenitis was the most common histologic type, female was predominant third decade was the most common age group. the duration of symptom between one and three month was the most common and in the metastatic tumors, stomach cancer was the most common primary site.

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A Case of Hypersensitivity Pneumonitis Caused by Methotrexate (Methotrexate에 의한 약제 유발 과민성 폐렴 1례)

  • Suh, Hyun Joo;Chung, Man Pyo;Park, Eun Ha;Shin, Sung Chul;Jeon, Kyeong Man;Yu, Chang Min;Pyun, Yu Jang;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.203-209
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    • 2004
  • Background : Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.