• Title/Summary/Keyword: Clinical Manifestation

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Wilson's Disease in Bangladeshi Children: Analysis of 100 Cases

  • Rukunuzzaman, Md.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.121-127
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    • 2015
  • Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.

SWEET SYNDROME INITIALLY MANIFESTING ODONTOGENIC BUCCAL CELLULITIS; REPORT OF A CASE (치성 협부 봉와직염의 증상으로 발현된 Sweet 증후군; 증례 보고)

  • Kim, Yong-Jin;Byun, Soo-Hwan;Kim, Jun-Young;Ahn, Kang-Min;Jeon, Ju-Hong;Lee, Bu-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.538-542
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    • 2007
  • Sweet syndrome is characterized by acute onset of fever. neutrophilic leukocytosis, painful erythematous plaque on the face and extremities, infiltration of mature neutrophils in the dermis. Cutaneous lesion and clinical symptoms rapidly improve after treatment with systemic corticosteroids. The cause of sweet syndrome is unknown but the associations with hypersensitivity to bacteria, virus, or tumor antigen have been reported. Sweet syndrome itself can be a premonitory manifestation of malignancy, so diagnostic work up for other internal malignancy is recommended. Because of fever and leukocytosis, cutaneous infections are important differentials. Sweet syndrome can be divided into 4 categories according to associated disease and symptom. (Idiopathic Sweet syndrome, Parainflammatory Sweet syndrome, Paraneoplastic Sweet syndrome, Pregnacy associated Sweet syndrome.) Sweet syndrome is relatively rare disease and the association with myelodisplastic syndrome has been reported. We report a case of Sweet syndrome associated with myelodisplastic syndrome which has initial manifestation of odontogenic buccal cellulites.

The Inhibitory Effects of So-yangin Biman-bang on the Obese-Mice Induced by High-Fat Diet (소양인(少陽人) 비만방(肥滿方)이 생쥐의 비만 억제에 미치는 영향)

  • Park, In-Sun;Yoon, Il-Ji
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.35-50
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    • 2010
  • Objectives : In order to investigate the effects of So-yangin Biman-bang(here in after referred to BM) on the obese gene and obese inhibitory, C57BL/6 mice were distinctively induced by high fat diet. Methods : C57BL/6 mice were divided into four groups(normal, high fat diet with control, high fat diet with Reductil(here in after referred to RDT), high fat diet with BM extract) and have been fed for 8 weeks. Through observing the process, the weight change of the adipocytes in body and liver, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, glucose, leptin change in the serum, the expression of ${\beta}3AR$ and leptin gene in 3T3-L1 cell and primary adipocyte cell. Results : The following results have been found in this study. 1. Losing weight have significantly been shown. 2. The weight change of the body adipocyte and liver have been decreased but no significance has been found. 3. With close observation on the change of blood, HDL-cholesterol has positively been increased in numbers but the level of glucose, LDL-cholesterol, triglyceride have distinctively been decreased. 4. The manifestation of ${\beta}3AR$ in 3T3-L1 cell and primary adipocyte cell have shown a definite increase in numbers but the manifestation of leptin has shown certain decrease in its amount. Conclusions : As results of this, So-yangin Biman-bang is thought to be effective in metabolic syndrom and lipid metabolism disorder that can possibly be occurred by obesity control and treatment. The clinical research will be needed in order to apply to So-yangin constitution in the future.

The Study on the Korean and Western Medical Literatures for Skin Aging wrinkle, hyperpigmentation, dry skin, facial flush (피부 노화 현상에 대한 동서의학적 고찰 주름, 과색소침착, 피부건조, 안면홍조를 중심으로)

  • Han, Jung-Min;Kang, Na-Ru;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.2
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    • pp.1-13
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    • 2014
  • Objective : The purpose of this study is to understand conspicuous features of geroderma with visceral manifestation theory(臟象論). Methods : We categorized skin aging into wrinkles, hyperpigmentation, dry skin and face flush. After investigating the reason, histological changes and mechanism of each classification in western medicine, we interpreted them according to the malfunction of five viscera(五臟) in Korean medicine. Result : The results are as follows. 1. Pathologic change of dermis and subcutaneous fat makes wrinkles. We consider wrinkles as the malfunction of the spleen(脾). 2. Irregular synthesis and disproportion of melanin makes hyperpigmentation. We consider hyperpigmentation as the malfunction of the liver(肝). 3. Dry skin is attributed to a subtle disorder of epidermal maturation. We consider dry skin as the malfunction of the lung(肺). 4. Facial flush is detected in rosacea and menopausal hot flush, which are both related with blood vessel abnormality. We consider facial flush as the malfunction of the heart(心) Conclusion : We interpreted the pathologic changes and mechanism of skin aging in western medicine as the decrease of five viscera(五臟) in visceral manifestation theory(臟象論) of Korean medicine. Further studies are needed to apply these hypothesis to clinical diagnosis and treatment.

Early Diagnosis and Management of Oral Pemphigus Vulgaris Lesions of Various Presentations

  • Seo-Young Choi;Soo-Min Ok;Sung-Hee Jeong;Yong-Woo Ahn;Hye-Min Ju
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.174-180
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    • 2023
  • Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease caused by autoantibodies to proteins in the oral mucosa and skin. It is a rare disease with an annual incidence of 2.059 per million in South Korea. In many patients with PV, oral mucosal lesions precede other lesions elsewhere, and oral lesions can be the only manifestation. Early diagnosis is important because the disease has a high mortality rate if untreated appropriately in the early stages, and rapid treatment initiation is associated with rapid disease control. Oral PV lesions are clinically variable. In this study, we describe oral PV lesions in a 60-year-old woman, a 75-year-old man, and a 60-year-old man presenting with various clinical presentations. Oral PV lesions can affect any part of the oral mucosa, including the buccal mucosa, gingiva, tongue, palate, and free mucosa, and can vary in appearance from desquamative gingivitis, painful ulcers, and erosions to aphthous-like stomatitis. Clinicians should be aware of the difficulty of early diagnosis in PV, particularly when oral lesions are the only manifestation, and should consider many factors, including the patient's age, to make an accurate diagnosis and manage oral lesions to improve the patient's quality of life and avoid delayed diagnosis.

Treatment of occlusal changes associated with temporomandibular joint disorder (임상가를 위한 특집 2 - 턱관절장애와 관련된 교합변화의 치료)

  • Jung, Jae-Kwang
    • The Journal of the Korean dental association
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    • v.51 no.2
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    • pp.84-91
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    • 2013
  • Temporomandibular joint disorder(TMJD) was mainly characterized with joint pain, motion limitation, joint sound, resulted from pathologic conditions in temporomandibular joint and around tissue. As temporomandibular joint is one of decisive factors determining the occlusion, disorders in temporomandibular joint may cause the occlusal changes. The causes of occlusal changes related with TMJD can be classified into 2 categories; (1) those related to progression of disorder, 2) those related to treatment of the disorder. The clinical manifestation of occlusal changes depend on their causes and affected site. Therefore, whenever possible, treatment should be directed to the relief of the underlying causes, However, it is not always possible to relieve the underlying conditions. Moreover, some occlusal changes may remain irreversible even after the considerable improvement in clinical symptoms. Regarding the treatment of the permanent occlusal changes, it has been reported that the extensive occlusal treatment including occlusal adjustment, prosthodontic treatment, orthodontic treatment should be applied. Here, we present with a case report of occlusal change caused by the progressive temporomandibular joint disorder, together with introducing the intermaxillary traction appliance as the possible treatment option.

Proposal on the Method of Regulating Ascending Kidney Water and Descending Heart Fire -through pharmacopuncture technique- (수승화강(水升火降) 조절법(調節法)(수화조절법(水火調節法))에 대한 제언 -약침을 이용하여-)

  • Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.10 no.3
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    • pp.149-155
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    • 2007
  • Objectives The purpose of this study is aimed at diagnosing and suggesting treatment plans for commonly seen clinical manifestation of heat symptom in the upper body and coldness in the lower body, also known as hot above, cold below syndrome. Methods Various reasons attribute to the presence of hot above, cold below syndrome, but mainly contributed by blockage of normal Qi flow by abnormality of heart-kidney root, spleen-stomach axis, and liver-lung axis. Diagnosing these abnormalities and timely alleviation to the healthy state is presented in the study. Results 1For heat in the upper body, Huang Lian Jie Du Tang(黃連解毒湯), CF, or JsD pharmacopuctures are injected on GB21, GB20. Qi stagnation in the thoracic area is treated with BUM injection on CV17. For impairment of transportation and transformation in the middle energizer, BUM pharmacopuncture is injected on CV12. Coldness in the lower energizer was relieved by bee venom or Sweet BV(Bee Venom free from enzymes) on CV6. Conclusion Above proposed methods of regulating water-fire were effective in treating hot above, cold below syndrome in clinical manifestations. But once the symptom subsides, treatment focused on eliminating innate cause should be rendered to achieve more successful results.

Arsenic Poisoning (비소 중독)

  • Kim Yang Ho;Lee Ji Ho;Sim Chang Sun;Jeong Kyoung Sook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.67-71
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    • 2004
  • Arsenic poisoning has three types of poisoning. First, acute arsenic poisoning is usually caused by oral intake of large amount of arsenic compound with purpose of homicide or suicide. Second, chronic arsenic poisoning is caused by inhalation of arsenic in the occupational setting or by long-term oral intake of arsenic-contaminated well water. Third, arsine poisoning occurs acutely when impurities of arsenic in non-ferrous metal react with acid. Clinical manifestation of acute arsenic poisoning is mainly gastrointestinal symptoms and cardiovascular collapse. Those of chronic poisoning are skin disorder and cancer. Arsine poisoning shows massive intravascular hemolysis and hemoglobinuria with acute renal failure. Exposure evaluation is done by analysis of arsenic in urine, blood, hair and nail. Species analysis of arsenic is very important to evaluate inorganic arsenic acid and mono methyl arsenic acid (MMA) separated from dimethyl arsenic acid (DMA) and trimethyl arsenic acid (TMA) which originate from sea weed and sea food. Treatment with dimercaprol (BAL) is effective in acute arsenic poisoning only.

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A study of dietetic therapy on the edema (부종(浮腫)의 식요방법(食療方法)에 관한 연구)

  • Baek, Tae-Hyeun
    • The Korea Journal of Herbology
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    • v.25 no.4
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    • pp.151-160
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    • 2010
  • Objectives : The purpose of this research was to examine dietary therapy on the edema based on the literary findings, for clinical treatment and prevention of the edema. Methods : This Research was examined on histories, compositions, applications, and effects of dietetic treatment about 100 cases of dietary therapy of the edema from Chinese literatures. Results : 1. Various vegetables and animals including herbs, grains, vegetables, fruits, food and drink were used for the dietary therapy. 2. Methods of the preparation for use as therapeutics were decoction, pulvis, gruel, cake, tea, paste, gelatin and etc. 3. Frequently used materials were Cyprinus carpio Linnaeus, Cucumis sativus L. Coix lachrymajobi var. mayuen, Zea mays, Maydis Stigma, Citrullus vulgaris, Zingiber officinale, Cinnamomum cassia Blume, Allium scorodorpasum var. viviparum Regel, Camellia sinensis, Armeniacae amarum Semen, Phyllostachys bambusoides, Luffa cylindrica, Dioscorea batatas Decne, Panax ginseng, Brassica oleracea and Raphanus sativus. Conclusion : Though dietary therapy for the edema is not based on clinical or experimental data, but through experience. It is mostly based on Yin-Yang and five elements, visceral manifestation, channels and their collateral channels and Oriental herbal medicine theories. If we use them properly according to oriental medicine method, it will be effective on treating and preventing the edema.

Electrocardiography as an early cardiac screening test in children with mitochondrial disease

  • Baik, Ran;Chae, Jung-Hyun;Lee, Young-Mock;Kang, Hoon-Chul;Lee, Joon-Soo;Kim, Heung-Dong
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.644-647
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    • 2010
  • Purpose: To evaluate myocardial conductivity to understand cardiac involvement in patients with mitochondrial disease. Methods: We performed retrospective study on fifty-seven nonspecific mitochondrial encephalopathy patients with no clinical cardiac manifestations. The patients were diagnosed with mitochondrial respiratory chain complex defects through biochemical enzyme assays of muscle tissue. We performed standard 12-lead electrocardiography (ECG) on all patients. Results: ECG abnormalities were observed in 30 patients (52.6%). Prolongation of the QTc interval (>440 ms) was seen in 19 patients (33.3%), widening of the corrected QRS interval in 15 (26.3%), and bundle branch block in four (7.0%). Atrioventricular block, premature atrial contraction and premature ventricular contraction were seen in two patients each (3.5%) and Wolff-Parkinson-White syndrome in one patient (1.8%). Conclusion: Given this finding, we recommend active screening with ECG in patients with mitochondrial disease even in patients without obvious cardiac manifestation.