• Title/Summary/Keyword: Etiologies

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Surgical Treatment of Thoracic Outlet Syndrome; A Case Report (흉곽 출구 탈출증 수술치험 1례)

  • 김승규
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.586-590
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    • 1993
  • Thoracic Outlet syndrome is defined to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. It was previously designed due to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib or first rib syndromes. We experienced a case of thoracic outlet syndrome[scalene anticus syndrome] .Patient has been suffered from swelling and numbness of the right forearm and hand for 2 years. Diagnosis was made by preoperative selective angiography. Scalenus anticus and medius muscle resction and first rib resection was done with transaxillary approach. Postoperative course was not eventful.

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Revisiting Hepatoprotective Natural Products from a Biological Point of View

  • Kim, Hong-Pyo;Kim, Young-Choong
    • Natural Product Sciences
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    • v.17 no.3
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    • pp.165-174
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    • 2011
  • Naturally occurring small molecules from plants, microorganisms, and animals allow the design of drugs that can be beneficial in virtually all kinds of human diseases. Liver diseases with diverse etiologies such as viral infection, chemical intoxication, and metabolic fat accumulation are one of the leading causes of human mortality. Unfortunately, however, there are few effective drugs available capable of stopping or reversing the progress of liver disease. Here, we discuss the current advances in developing hepatoprotective natural products for several arrays of liver disease pathogenesis.

Cerebral Dissecting Aneurysms in Patients with Essential Thrombocythemia

  • Baek, Jin Wook;Kim, Young Don
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.257-260
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    • 2014
  • The etiologies of intracranial artery dissection are various, the exogenous as well as inherited connective tissue disorders. We report on a patient who presented with diffuse subarachnoid hemorrhage who had been suffered from essential thrombocythemia. He was diagnosed to multiple dissecting aneurysms of left superior cerebellar artery, left posterior inferior cerebellar artery and right pericallosal artery and treated with endovascular coil embolization.

Free flap thrombosis in patients with hypercoagulability: A systematic review

  • Biben, Johannes Albert;Atmodiwirjo, Parintosa
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.572-579
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    • 2019
  • Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes

  • Lee, Yun-Jin;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.56 no.7
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    • pp.275-281
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    • 2013
  • Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in seizure semiology have also been reported. Motor manifestations are prominent in infants and young children, but they become less obvious with increasing age. Further, automatisms tend to become increasingly complex with age. However, in childhood and especially in adolescence, the clinical manifestations are similar to those of the adult population. Selective amygdalohippocampectomy can lead to excellent postoperative seizure outcome in adults, but favorable results have been seen in children as well. Anterior temporal lobectomy may prove to be a more successful surgery than amygdalohippocampectomy in children with intractable TLE. The presence of a focal brain lesion on magnetic resonance imaging is one of the most reliable independent predictors of a good postoperative seizure outcome. Seizure-free status is the most important predictor of improved psychosocial outcome with advanced quality of life and a lower proportion of disability among adults and children. Since the brain is more plastic during infancy and early childhood, recovery is promoted. In contrast, long epilepsy duration is an important risk factor for surgically refractory seizures. Therefore, patients with medically intractable TLE should undergo surgery as early as possible.

Oral Pigmentation Resulting from Pharmacological Treatment in Patient with Chronic Hepatitis C (만성 C형 간염의 약물 치료와 연관된 구강 내 색소 침착의 치험례)

  • Kim, Young Gun;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.189-193
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    • 2012
  • Oral pigmentation has numerous etiologies. It can be associated with congenital diseases and syndromes, certain acquired diseases, and systemic medications. Pigmented lesions caused by serious disease such as melanoma should be diagnosed correctly, because it would be fatal. For appropriate differential diagnosis, clinicians should know about the etiologies causing oral pigmentation and take patients history carefully. Biopsies would be necessary for histopathological findings. Close follow up for clinical symptoms are also necessary. In this case report, we presented a case of oral hyperpigmentation in Asian patient who was receiving pegylated interferon and ribavirin combination therapy for hepatitis C virus infection.

Epidemiology of Hyperbilirubinemia in a Quaternary Pediatric Emergency Department over a Three-Year Period

  • Timmons, Zebulon;Timmons, Jaci;Conrad, Christina;Miloh, Tamir
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.297-305
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    • 2018
  • Purpose: There is a lack of scholarly reports on pediatric emergency department (PED) exposure to hyperbilirubinemia. We aimed to describe the epidemiology of hyperbilirubinemia in patients presenting to a PED over a three-year period. Methods: This was a retrospective cohort study, completed at an urban quaternary academic PED. Patients were included if they presented to the PED from 2010 to 2012, were 0 to 18 years in age, and had an elevated serum bilirubin for age. A chart review was completed to determine the incidence of hyperbilirubinemia, etiology, diagnostic work up and prognosis. The data set was stratified into four age ranges. Results: We identified 1,534 visits where a patient was found to have hyperbilirubinemia (0.8% of all visits). In 47.7% of patients hyperbilirubinemia was determined to have arisen from an identifiable pathologic etiology (0.38% of all visits). First-time diagnosis of pathologic hyperbilirubinemia occurred in 14% of hyperbilirubinemia visits (0.11% of all visits). There were varying etiologies of hyperbilirubinemia across age groups but a male predominance in all (55.0%). 15 patients went on to have a liver transplant and 20 patients died. First-time pathologic hyperbilirubinemia patients had a mortality rate of 0.95% for their initial hospitalization. Conclusion: Hyperbilirubinemia was not a common presentation to the PED and a minority of cases were pathologic in etiology. The etiologies of hyperbilirubinemia varied across each of our study age groups. A new discovery of pathologic hyperbilirubinemia and progression to liver transplant or death during the initial presentation was extremely rare.

Clinicopathological Analysis of Patients with Acute Generalized Exanthematous Pustulosis (급성전신발진농포증 환자의 임상 및 조직학적 분석)

  • Jung, In Soon;Yun, Sook Jung;Lee, Jee-Bum;Kim, Seong-Jin;Lee, Seung-Chul;Won, Young Ho
    • Korean journal of dermatology
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    • v.56 no.10
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    • pp.594-602
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    • 2018
  • Background: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea. Objective: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context. Methods: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients' medical records and photographs. Results: The mean age of onset was 43.6 years, and the male : female ratio was 2.1 : 1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients. Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group. Conclusion: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP.

Celiac Axis Stenosis: Incidence and Etiologies in Asymptomatic Individuals

  • Chang Min Park;Jin Wook Chung;Hyun Beom Kim;Sang June Shin;Jae Hyung Park
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.8-13
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    • 2001
  • Objective: To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals. Materials and Methods: This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circulation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac arteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was determined on the basis of angiographic appearances and CT findings. Results: Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis. Conclusion: The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition.

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The myocarditis and cardiomyopathy in children (소아 심근염과 심근증)

  • Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1049-1054
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    • 2007
  • Myocarditis represent an important condition encountered by general pediatricians & general practitioners. Its presentation is varied, and therefore a high index of suspicion must be maintained when the possibility of myocarditis is raised. A progression from viral myocarditis to dilated cardiomyopathy has long been hypothesized. Treatment is initially aimed at achieving hemodynamic stability and is largely supportive. There is currently little evidence to support the immunomodulatory or specific antiviral therapies. Pediatric cardiomyopathies are a heterogeneous group of disorders with diverse genetic, infectious, mitochodrial and metabolic etiologies. The timing and severity of presentation vary according to cardiomyopathy type as well as genetic and ethnic factors. The behavior of specific cardiomyopathies can be predicted by morphological and functional attributes, as well as underlying patient characteristics.