• Title/Summary/Keyword: Chief-complaint

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DERMOID CYST IN AN INFANTILE UPPER LIP (영아의 상순에 발생한 유피낭종)

  • Kim, Seong-Oh;Moon, Sung-Hwan;Lee, Jae-Ho;Choi, Hyung-Jun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.501-505
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    • 2004
  • Dermoid cyst is a developmental cyst that is lined by epidermis-like epithelium and contains dermal adnexal structures in the cyst wall. Dermoid cyst most occur in the eye brow although occasionally develop in other locations such as midline of the floor of the mouth, tongue, lip and buccal mucosa. The lesion is slow growing and painless without lympadenopathy. The contents of the dermoid cyst can be caseous or sebaceous. The size can vary from a few millimeters to 12cm in diameter. Histologically, dermoid cyst is lined by epidermis and adnexaes such as sweat gland, sebaceous glands and hair follicles are present in the cyst wall. The 2-year-old female of this case visited Department of Pediatric Dentistry, College of Dentistry, Yonsei University with a chief complaint of the emergence of mass on her upper lip. An excisional biopsy was carried out for a histological examination and sebaceous gland was observed in the cyst wall. The lesion was diagnosed as dermoid cyst. Dermoid cyst does not recur if complete excision is accomplished.

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LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan syndrome: 증례보고)

  • Kim, Myoung-Gook;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.284-289
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    • 2011
  • Lesch-Nyhan syndrome is a disease caused by metabolic disorder of purine. General muscle stiffness and hyposomia are shown from infancy and symptoms can include involuntary or irregular movements of arms and legs, mental retardation, and compulsive self-mutilating behaviors. Self-mutilating behaviors begin at approximately the first year or sometimes at late teens. The patients bite their lips, especially lower lip, tongue, buccal mucosa, hands and fingers. Tongue and lips can be injured or mutilated in severe cases. As the patient gets older, self-mutilating behaviors become more serious and extensive and secondary infection of injured areas is possible. Periodic soft tissue damage due to self-mutilating may evolve to cancer. Medical treatment, appliance treatment, extraction of tooth and surgical operation was attempted to control self-mutilaing behaviors. We hereby report the case of child Lesch-Nyhan syndrome patient who has self-inflicted labial damage as chief complaint. When patient was treated with conservate therapy, such as removable or fixed appliance, the frequency of labial damage could be subdued and yielded favorable results.

Hepatoid Adenocarcinoma of the Stomach with Liver Metastasis (간 전이를 동반한 위의 간양 선암 1예)

  • Kwon Wooil;Park Do Joong;Lee Hyuk-Joon;Kim Woo Ho;Yang Han-Kwang;Choe Kuk Jin;Lee KuhnUk
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.127-132
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    • 2005
  • A hepatoid adenocarcinoma of stomach, a subtype of gastric cancr, is characterized by a histologic resemblance to a hepatocellular carcinoma and $\alpha$-feto protein production. Another feature is early metastasis to the liver and lymph nodes, thus revealing a poor prognosis. We report a case of a hepatoid adenocarcinoma of the stomach with liver metastasis. A 52-year-old male visited our hospital with a chief complaint of indigestion. Gastroscopic examination showed a Borrmann type-II lesion on the lesser curvature of the antrum. The CT scan showed a suspected advanced gastric cancer with liver metastasis. The serum AFP level was 123 ng/ml. A radical subtotal gastrectomy and a right hemihepatectomy were performed simultaneously. Pathologic examination confirmed the lesion to be confined to the submucosa. The gastric lesion was a hepatoid adenocarcinoma, and the hepatic lesion was a metastatic adenocarcinoma from the stomach. Therefore, he was classified as having stage IV (T1N1M1) gastric cancer. In cases of a hepatoid adenocarcinoma of the stomach, even patients with early gastric cancer can be staged into the poor prognostic group.

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Clinical Features of Symptomatic Meckel's Diverticulum in Children: Comparison of Scintigraphic and Non-scintigraphic Diagnosis

  • Rho, Jung Hee;Kim, Jae Sook;Kim, Sang Yong;Kim, Soon Ki;Choi, Yoon Mi;Kim, Sung Min;Tchah, Hann;Jeon, In Sang;Son, Dong Woo;Ryoo, Eell;Cho, Kang Ho;Choi, Deok Young;Kim, Yoon Mi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.1
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    • pp.41-48
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    • 2013
  • Purpose: Meckel's diverticulum (MD) has various clinical manifestations, and diagnosis or selectection of proper diagnostic tools is not easy. This study was conducted in order to assess the clinical differences of MD diagnosed by scintigraphic and non-scintigraphic methods and to find the proper diagnostic tools. Methods: We conducted a retrospective review ofthe clinical, surgical, radiologic, and pathologic findings of 34 children with symptomatic MD, who were admitted to Gachon University Gil Medical Center, Inha University Hospital, and The Catholic University of Korea, Incheon St. Mary's Hospital between January 2000 and December 2012. The patients were evaluated according to scintigraphic (12 cases; group 1) and non-scintigraphic (22 cases; group 2) diagnosis. Results: The male to female ratio was 7.5: 1. The most frequent chief complaint was lower gastrointestinal (GI) bleeding in group 1 and nonspecific abdominal pain in group 2, respectively. The most frequent pre-operative diagnosis was MD in both groups. Red blood cell (RBC) index was significantly lower in group 1. MD was located at 7 cm to 85 cm from the ileocecal valve. Four patients in group 1 had ectopic gastric tissues causing lower GI bleeding. The most frequent treatment modality was diverticulectomy in group 1 and ileal resection in group 2, respectively. Conclusion: To diagnose MD might be delayed unless proper diagnostic tools are considered. It is important to understand indications of scintigraphic and non-scintigraphic methods according to clinical and hematologic features of MD. Scintigraphy would be weighed in patients with anemia as well as GI symptoms.

Two Cases of Cerebral Cysticercosis Treated with Albendazole (Albendazole을 이용한 뇌낭미충증(腦囊尾蟲症) 치험(治驗) 2예)

  • Joo, Kyoung-Hwan;Rim, Han-Jong
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.165-171
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    • 1991
  • Two patients with confirmed cerebral cysticercosis were treated with Albendazole(Zentel$^{(R)}$) at a daily dose of 1.200mg t.i.d. for 14 consecutive days and evaluated for tolerance and therapeutic effects. First case was 29 year old male, who had experience of 4 times of grand mal seizures during 1 year period before administration in Korea University Hospital. His chief complaints were seizure and moderate degree headache. He also had 4 subcutaneous nodules on the thorax, right and left upper arms. Among them one nodule was biopsied and confirmed microscopically as Cysticercus cellulosae hominis. Computed tomography of the brain showed four round low density lesions in right postero-frontal area, sylvian area, intra-occipital area and left parietal area. Second case was 48 year old male, who also had experience of seizures at 3 years, 5 months and 3 months before administration. In this case, no subcutaneous nodules and no headaches were noted. Brain CT showed four round low density lesions in right postero-parietal area and temporo-parietal area, and left temporo-parietal and parietal area. Serum antibody against cystic fluid antigen was detected by ELISA in both cases. The efficacy of the treatment of cerebral cysticercosis was assessed by the frequency of convulsions after treatment for 22 months follow-up. by the disappearance of the densities in cystic lesions at brain CT for 6 months follow-up, and disappearance of subcutaneous nodules, headache and so on. As the results, all low density lesions in both cases were disappeared in films of brain CT, and 4 nodules in first case were also disappeared. No more seizure and complain of headache occurred during the last 22 months after treatment in both cases. Post-treatment complete blood count and liver function test revealed no remarkable change compared to pre-treatment test. In the nations of Latin America, the physicians do not initially recommended the simultaneous administrations of steroids, reserving them only for patients whom the adverse reactions such as severe headache and/or seizures are occurred. According to them, in most patients these symptoms are controlled with aspirin and symptomatic drugs. But our experience using praziquantel is different, and most cerebral cysticercosis patients who takes PZQ had complaint of severe headache and sometimes seizure. So we simultaneously used dexamethasone as 6mg q.i.d. for 14 consecutive days and 6 days tapering thereafter in both cases for prevention of reactions produced by the host in response to the deaths of the parasites. As the conclusion, albendazole is effective in patients who presented cerebral cysticercosis and albendazole may help in the control of cysticercosis.

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A LONG-TERM NEGLECTED BED PATIENT WITH CEREBRAL PALSY : A CASE REPORT (병상에서 장기간 방치 된 뇌성마비 환자 : 증례보고)

  • Kim, Do-young;Yang, Yeon-mi;Kim, Jae-gon;Lee, Dae-woo
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.33-36
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    • 2017
  • Cerebral palsy(CP) is a motor disorder of the central nervous system resulting from irreversible brain injury due to congenital or acquired causes. Health-related quality of their life is associated with severity of impairment and socioeconomic factors. These patients are particularly easy to be neglected because they lack capacity to care themselves unless they have the help of caregiver from high socioeconomic status. A 11-year-old girl with severe motor impairment came with the chief complaint of severe calculus deposition on whole dentition. She was taken with bed-ridden state with pediatrician not her parents. Since brain was damaged at the age of two, she has been left alone in the city care hospitals without parental care. Main caregiver is her father with not high educational level. Oral hygiene was not performed at all. Severe calculus deposition, gingival swelling, and gingival redness around the whole dentition were observed. During the 1st and 2nd visit, scaling and extraction was performed. CP patients with low socioeconomic status and severe motor impairment tend to be neglected from dental treatment. Dental care, along with medical care, is crucial to the quality of CP patients' lives. Therefore it is important that they visit for regular dental check ups and receive preventative care.

Full mouth rehabilitation of the patient with severely worn dentition using monolithic zirconia prosthesis: A clinical report (치아 마모 환자에서 단일 구조 지르코니아를 이용한 완전 구강 회복 증례)

  • Kim, Tae-Yeon;Han, Jung-Suk;Kim, Sung-Hun;Yeo, In-Sung;Lee, Jai-Bong
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.140-145
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    • 2016
  • Excessive occlusal wear causes loss of tooth structure, occlusal plane disharmony, impaired function and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by the growth of alveolar bone and tooth eruption, minimal increase of occlusal vertical dimension may be required for esthetics and retention of prosthesis. In this case, a 44-year-old male patient visited Seoul National University Dental Hospital with chief complaint of severe tooth wear and shade disharmony. Based on assessment of diagnostic wax-up, 3 mm increase of occlusal vertical dimension was determined. Removable occlusal splint and interim prosthesis was used to ascertain patient's comfort and adaptation. After the adaptation period, definitive prosthesis fabricated with full-contour monolithic zirconia were delivered and the patient was recommended to wear a nightguard device for prosthesis protection. This report presents a case of full mouth rehabilitation with the elevation of patient's occlusal vertical height, resulting in satisfactory esthetics and functions.

DENTAL TREATMENT OF THE PATIENT WITH AUTISM AND HEMOPHILIA A UNDER GENERAL ANESTHESIA A CASE REPORT (자폐증상이 있는 혈우병 A 환아의 전신 마취를 통한 치과적 치험례)

  • Park, Kyeong-Sun;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.593-600
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    • 1996
  • This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.

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FOCAL EPITHELIAL HYPERPLASIA : A CASE REPORT (Focal epithelial hyperplasia : 증례보고)

  • Han, Yu-Ri;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.581-585
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    • 2002
  • Focal epithelial hyperplasia(FEH) is Human papilloma virus - induced, localized proliferation of oral squamous epithelium. FEH usually occurs in the childhood, but occasionally affects the young and middle-aged adults. Sites of the greatest involvement include the labial, buccal and lingual mucosa, but lesions of gingiva or tongue have also been reported. This disease is typically characterized by multiple soft, non-tender flattened papules and plaques. Occasional lesions show a slight papillary surface change. Individual lesions are small, discrete and well demarcated. The histopathologic hallmark of FEH is acanthosis of the oral epithelium. Cells demonstrating viral cytopathic changes including koilocytes or mitosoid cells may be present. The 5-year-old female of this case visited Department of Pediatric Dentistry, College of Dentistry, Yonsei University with a chief complaint of exophytic lesions on gingiva. Sessile papillary papules were detected by clinical examination on buccal gingiva at the maxillary left and right second deciduous molars. The patient did not complain of pain by palpation. An excisional biopsy was carried out for a histological examination and acanthosis was observed. The lesions were diagnosed as FEH. FEH would regress spontaneously after several months or years. Conservative excision may be performed for diagnostic or esthetic purpose. The risk of recurrence after this therapy is minimal, and there is no malignant transformation.

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PYKNODYSOSTOSIS : A CASE REPORT (Pyknodysostosis 환아의 구강증상: 증례보고)

  • Kim, Nam-Hyuk;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Hyung-Jun;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.619-624
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    • 2009
  • Pyknodysostosis(PKND) is a rare sclerosing bone disorder that has an autosomal recessive trait, also known as Toulouse-Lautrec syndrome. Deficiency of the cathepsin enzyme K in the osteoclasts of PKND patients results in continuous endosteal bone deposits without osteoclastic resorption or remodeling. This causes a generalized increase in sclerosis and fragility of bones. Osteomyelitis in the mandible and recurrent fracture of the long bones are characteristic complicatons of PKND. The patients present typical features of PKND, such as short stature under 150 cm, open cranial suture and fontanelle, club-shaped phalanges, and underdevelopment of midface. This is a case of a 7-year-old girl with PKND, who visited our clinic with the chief complaint of anterior Open-bite and generalized crowding. The patient had been diagnosed as PKND by an orthopedist and manifested characteristic clinical and radiographic features, such as open cranial suture and fontanelle, obtuse madibular gonial angle, frontal and occipital bossing, grooved palate, club-shaped phalanges, and short stature. Orthodontic treatment was not considered because patients with PKND show abnormal bone resorption and remodeling. Instead, removal of deciduous teeth near exfoliation and TFA were performed, and periodic check-up is planned to maintain good oral hygiene.

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