• Imaging Science in Dentistry
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• v.43 no.2
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• pp.91-98
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• 2013

Purpose: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. Materials and Methods: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. Results: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. Conclusion: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.247-254
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• 1999

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

• Journal of The Korean Ophthalmological Society
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• v.55 no.1
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• pp.1-6
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• 2014

Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.

• Korean Journal of Bronchoesophagology
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• v.13 no.2
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• pp.34-39
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• 2007

Background: The mediastinum is the anatomic space which is restricted and the clinical aspect varies according to location, size and type of neoplasm. Diagnostic and therapeutic approaches to mediastinal neoplasms have changed over and over. We presented our recent therapeutic experiences with these neoplasms. The object and method: The 36 patients were treated in operation from 2000 until 2006. The male patients were 20 and the female patients were 16. Age of the patients ranged from 5 to 70, and the median age was $46.4{\pm}21.9$. The child patients were two. Result: The most prevalent anatomic distribution of the neoplasm was anterosuperior mediastinum. The most common neoplasm was thymoma, followed by thymic cyst, teratoma, ganglioneuroma. The complete excison of neoplasm was accomplished in 96% of patient group except thymoma patient group. One patient underwent total thymectomy, and the other 12 patients underwent extended thymectomy from 13 thymoma patient group. In the malignant neoplasm, 7 patients were received additional treatment after operation. There was short-term death of 1 person and late death of 1 person. Conclusion: Our results except clinical manifestation are compared favorably with other reports. Surgery is the management of choice for patients with mediastinal neoplasm and early curative resection is considered to optimize clinical outcome for patients.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.94-100
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• 1996

Ossifying fibroma is one of a group of fibro-osseous lesions which arises typically within the jaw bones and only rarely affects the long bones. Ossifying fibroma of the long bones almost involve exclusively the tibia but may also involve the fibula. Ossifying fibroma of the long bones is distinct from fibrous dysplasia, adamantinoma and nonossifying fibroma with regard to age of the patient, site, radiographic appearance, histological features, and clinical course. We are reporting the cases of seven patients with a tumor-like lesion that named osteofibrous dysplasia. It is most commonly found in the tibia and fibula of a child ten years of age or younger. Of the seven cases reported in this study, only one patient was younger than ten years. In all cases, the lesions were usually located in the tibial diaphysis. The average duration of clinical manifestation was 5.2 years. The clinical symptoms were anterior bowing of the tibia in 2 cases, buldging of the tibia in 2 cases, and mass overlying the tibia in 3 cases. On the roentgenography, it shows multiple radiolucent lesion with intervening sclerotic rim of the tibial diaphysis. In seven patients, 6 cases were confirmed with biopsy. We had done curettage and bone graft in three cases, VFG was done in one case. The other three cases underwent conservative management.

• Journal of Oriental Neuropsychiatry
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• v.18 no.1
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• pp.133-142
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• 2007

Objective : Chronic headache is the most common headache. The objective of this study is to find the clinical manifestation of chronic headache and has been carried out to investigate the effects of Noechongyolhaedok-tang on the chronic headache. Method : This observation was carried out on 73 patients with chronic headache. They were applied to Noechongyolhaedok-tang and the degree of improvement of chronic headache was evaluated by VAS. Results : 1. Distribution of study population by sex, age : male : female = 1 : 3, 30s-50s group = 81% Duration of onset : over 10years = 48% Reported site of chronic headache : the whole = 28% Clinical pain characteristics : be torn = 25% Frequency of headache : everyday = 72% Time of attack : irregular = 52% 2. In VAS scores, there were significant differences between before and after Noechongyolhaedok-tang treatment. There were no differences between before and after treatment in each sex and the duration of onset Conclusion : The effectiveness of Noechongyolhaedok-tang on the chronic headache was shown through VAS. Further study is needed about Noechongyolhaedok-tang.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.610-616
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• 1994

Myasthenia gravis is a rare condition, affecting only 1/75000. It is characterized by weakness and fatigue of the voluntary muscles due to impaired neuromuscular transmission at the acetylcholine receptor site. It is probably caused by an autoimmune mechanism leading to reduction of the available nicotinic acetylcholine receptors at the neuromuscular junction. A relationship between the thymus and myasthenia gravis was suggested by Weigert in 1901, and Blalock was the first to report the efficiency of thymectomy in the treatment of myasthnia gravis in 1939. Since that time, thymectomy has become increasingly important in managing patients with myasthenia gravis. Fourteen patients with myasthenia gravis underwent thymectomy between September 1987 and March 1994 and got the following results; 1. The sex distribution was 10 females and 4 males with ages ranging from 15 to 51 years[mean, 34.8 years]. 2. Clinical manifestation of ocular symptoms were seen in all cases, dysphagia in 12[85.7%], extremity weakness in 11 [78.6 %], and dyspnea in 3 [21.4 %]. 3. According to the modified Osserman`s classification, 8 patients were in group IIb, 3 in IIa, 2 in I and 1 in IIc, respectively. 4. Histopathologic examination of the resected thymuses revealed hyperplasia in 8 patients, benign thymoma in 3, and malignant thymoma in 3. 5. There were no perioperative or immediate postoperative deaths but one patient died about two months after the thymectomy due to respiratory failure. 6. During the follow-up period, 11 patients [78.6 %] showed clinical improvement. Among them, 4 cases [28.6 %] showed complete remission, 3 [21.4 %] showed marked improvement, and 4 [28.6 %] showed subjective improvement. 7. Among the 8 patients with thymic hyperplasia, clinical improvement was noticed in 7 patients 5 %]. Among the 6 patients with thymoma, 4 patients [66.7 %] showed improvement.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.493-509
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• 1998

Osteoarthritis(degenerative joint disease), the most common arthropathy affecting the aged people, is characterized by degeneration of articular cartilage with proliferation and remodeling of subchondral bone. Osteoarthritis of the knee, which probably has greater social cost and more associated disability than osteoarthritis of any other joint, prevalence is known to increase with age, and females have higher rates than males; radiographic abnormalities are present in more than 30% of persons more than 65 years old, with approximately 40% of these persons symptomatic. Though the etiology of osteoarthritis is not entirely understood, much information is available regarding risk factors for the development of knee osteoarthritis that permit some reasonable guideline for preventive strategies. Traumatic damage or occupational or recreational overuse of knee joint may result in osteoarthritis, and obesity also is related to osteoarthritis of the knee. A variety of other possible risk factors for the development of knee osteoarthritis have been proposed, including increased bone mass, smoking, diseases such as diabetes or elevated serum uric acid, and some metabolic factors, but the contribustions of these and other factors such as smoking or race and diseases such as diabetes are as yet undetermined. The usual clinical manifestations include pain, stiffnesss, crepitus and loss of function. In oriental medicine, osteoarthritis of the knee is very similar to diseases such as Bijung(痺症), Haksulpung(鶴膝風), Youkjeolpung(歷節風) in symptoms. The diseases such as Bijung(痺症), Haksuipung(鶴膝風), Youkjeolpung(歷節風) is related to the of function liver(肝) and kidney(腎) and risk factors are regarded as Pung(風), Han(寒), sub(濕). The diagnosis of osteoarthritis of the knee has often been based on radiographic appearance and clinical manifestations. The acupuncture therapy of osteoarthritis of the knee has often been based on Stomach meridian(ST), Spleen meridian(SP), Kidney meridian(KI), Liver meridian(LR).

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8613-8618
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• 2016

Background: The symptoms of small bowel malignancies are mild and frequently nonspecific, thus patients are often not diagnosed until the disease is at an advanced stage. Moreover, the lack of sufficient studies and available data on small bowel cancer makes diagnosis difficult, further delaying proper treatment for these patients. In fact, only a small number of published studies exist, and there are no studies specific to Thailand. Radiologic and endoscopic studies and findings may allow physicians to better understand the disease, leading to earlier diagnosis and improved patient outcomes. Objective: To retrospectively analyze the clinical, radiologic, and endoscopic characteristics of small bowel cancer patients in Thailand's Siriraj Hospital. Materials and Methods: This retrospective analysis included 185 adult patients (97 men, 88 women; mean age = $57.6{\pm}14.9$) with pathologically confirmed small bowel cancer diagnosed between January 2006 and December 2013. Clinical, radiologic, and endoscopic findings were collected and compared between each subtype of small bowel cancer. Results: Of the 185 patients analyzed, gastrointestinal stromal tumor (GIST) was the most common diagnosis (39.5%, n=73). Adenocarcinoma was the second most common (25.9%, n = 48), while lymphoma and all other types were identified in 24.3% (n = 45) and 10.3% (n = 19) of cases, respectively. The most common symptoms were weight loss (43.2%), abdominal pain (38.4%), and upper gastrointestinal bleeding (23.8%). Conclusions: Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.306-314
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• 2018

Purpose: The objective of this study was to describe the clinical phenotypes of children and adolescents with cystic fibrosis (CF); and to assess the role of pancreatic insufficiency and neonatal screening in diagnosis. Methods: A cross-sectional study was conducted, which included 77 patients attending a reference center of CF between 2014 and 2016. Epidemiological data, anthropometric measurements, and the presence of pulmonary, pancreatic, gastrointestinal and hepatobiliary manifestations were evaluated based on clinical data and complementary examinations. Results: Of the 77 patients, 51.9% were male, with a median age of 147 months (7.0-297.0 months), and the majority showed adequate nutritional status. The most common phenotype was pulmonary (92.2%), followed by pancreatic (87.0%), with pancreatic insufficiency in most cases. Gastrointestinal manifestation occurred in 46.8%, with constipation being the more common factor. Hepatobiliary disease occurred in 62.3% of patients. The group with pancreatic insufficiency was diagnosed earlier (5.0 months) when compared to the group with sufficiency (84.0 months) (p=0.01). The age of diagnosis was reduced following implementation of neonatal screening protocols for CF (6.0 months before vs. 3.0 months after, p=0.02). Conclusion: The pulmonary phenotype was the most common, although extrapulmonary manifestations were frequent and clinically relevant, and should mandate early detection and treatment. Neonatal screening for CF led to earlier diagnosis in patients with pancreatic failure, and therefore, should be adopted universally.