• Title/Summary/Keyword: Multiple abnormalities

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Managing Short Root Anomalies in Pediatric Cancer Survivors: Utilizing Resin Wire Splints and Miniscrews for Skeletal Anchorage

  • Taegyoung Kim;Namki Choi;Seonmi Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.51 no.1
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    • pp.88-98
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    • 2024
  • Patients with pediatric cancer often undergo multiple therapies, such as chemotherapy, radiation therapy, and stem cell transplantation. These treatments, while essential, can result in dental developmental issues, including hypodontia, microdontia, short roots, and delayed dental development. This report presents two cases of pediatric patients diagnosed with neuroblastoma who exhibited severe tooth mobility due to short roots as a complication of cancer treatment. Moreover, we investigated the conservative management of the patients' conditions using resin wire splints and orthodontic miniscrews for skeletal anchorage along with long-term follow-ups to evaluate their prognosis.

MR Imaging of Medullary Streaks in Osteosclerosis: A Case Report

  • Hak Soo Lee;Kyung-Bin Joo;Tae Soo Park;Ho Taek Song;Yong Soo Kim;Dong Woo Park;Choong Ki Park
    • Korean Journal of Radiology
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    • v.1 no.3
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    • pp.172-174
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    • 2000
  • We present a case of medullary sclerosis of the appendicular skeleton in a patient with chronic renal insufficiency for whom MR imaging findings were characteristic. T1- and T2-weighted MR images showed multiple vertical lines (medullary streaks) of low signal intensity in the metaphyses and diaphyses of the distal femur and proximal tibia.

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Clinical and Biochemical Profile of Monoclonal Gammopathies in Caribbean Patients in a Resource-limited Setting

  • Buchner-Daley, Loretta;Brady-West, Doreen;McGrowder, Donovan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6501-6504
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    • 2012
  • Background: Multiple myeloma is the most common malignant plasma cell dyscrasia and ranks second among primary haematological malignancies. This study describes the epidemiologic, clinical and pathologic profile of monoclonal gammopathies seen in the University Hospital of the West Indies (UHWI), a tertiary care referral centre. Materials and Method: A retrospective analysis of 85 cases diagnosed at UHWI over the 5-year period 2003-2007 was conducted. The cases were identified from the bone marrow records as well as the computerized database of the Medical Records Department. Clinical presentation, family and personal history and demographic data were retrieved. Haematological and biochemical results were also analyzed. Results: There were 85 patients diagnosed with monoclonal gammopathies. The M:F ratio was 1.2:1 and the mean age was $65.7{\pm}1.3$ years. Eighty percent of the patients had skeletal pain and 40% experienced weight loss. Of the patients experiencing bone pain 56.7% had multiple lytic lesions, 26.7% had pathological fractures and 26.7% had compression fractures. Seventy-four patients (87.1%) had a haemoglobin level <12.0 g/dL with 52.9% having values <8.0 g/dL. Renal impairment was evident at diagnosis in 36.5%. Hypercalcemia was seen in 26.5% and hyperuricemia in 45.9%. Of the 79 patients who had serum protein electrophoresis performed, 77.2% had at least one monoclonal band and of these 24.6% had a monoclonal protein also present on urine protein electrophoresis. Conclusions: The demographic profile in this group of patients is largely similar to other studies in predominantly Caucasian populations; however there was a notable increase in prevalence of severe disease at presentation, with the majority of patients presenting at the most advanced stage. It is probable that these differences reflect socioeconomic factors and not merely inherent ethnic variation in disease biology.

Imaging aspects of maxillomandibular bone alterations in patients with multiple myeloma treated with bisphosphonates: A systematic review

  • Amanda Katarinny Goes Gonzaga;Hannah Gil de Farias Morais;Camila Dayla Melo Oliveira;Magda Lyce Rodrigues Campos;Carolina Raiane Leite Dourado Maranhao Diaz;Marcos Custodio;Natalia Silva Andrade;Thalita Santana
    • Imaging Science in Dentistry
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    • v.54 no.3
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    • pp.221-231
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    • 2024
  • Purpose: Multiple myeloma (MM) is a rare cancer that is typically managed with bisphosphonates to slow bone resorption and prevent skeletal complications. This study aimed to identify imaging patterns in MM patients receiving bisphosphonate therapy. Materials and Methods: This systematic review included studies investigating maxillomandibular bone alterations based on imaging examinations in MM patients treated with bisphosphonates. The selected studies were qualitatively assessed using the Critical Appraisal Tools from SUMARI. Results: Six studies, involving 669 MM patients, were included, with 447 receiving bisphosphonate treatment. The majority were treated with pamidronate, zoledronate, or a combination of both. Seventy patients developed medication-related osteonecrosis of the jaw (MRONJ), predominantly in the mandible, characterized by the presence of bony sequestrum, bone sclerosis, increased periodontal ligament space, osteolytic lesions, and osteomyelitis as observed in imaging analyses. For non-MRONJ lesions, the mandible also exhibited the highest frequency of asymptomatic bone alterations. These ranged from "punched-out" osteolytic lesions or "soap bubble" lesions to solitary bone lesions, areas of bone sclerosis, abnormalities of the hard palate, osteoporosis, non-healed alveoli, and cortical bone rupture. Conclusion: MM patients treated with bisphosphonates display radiographic patterns of maxillomandibular bone lesions. These patterns aid in diagnosis and facilitate early and targeted treatment, thereby contributing to improved morbidity outcomes for these patients.

Relations of Cataract to Metabolic Syndrome and its Components - Based on the KNHANES 2005, 2007 (백내장과 대사증후군의 관련성 - 2005, 2007년 국민건강영양조사 이용)

  • Park, Sang-Shin;Lee, Eun-Hee
    • Journal of Korean Ophthalmic Optics Society
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    • v.14 no.3
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    • pp.103-108
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    • 2009
  • Purpose: This study was performed to assess the effects of metabolic syndrome and its components to cataract. Methods: We investigated the relation of metabolic syndrome and its components to cataract using data for 2,120 adults, aged 60 years or older, from the Korean National Health and Nutrition Examination Survey 2005, 2007. Using multiple logistic regression analysis, we presented significant odds ratio (OR) increase of cataract according to the number of metabolic abnormalities ${\leq}$1, 2, 3, ${\geq}$4). We also analyzed OR by the prevalence of metabolic components, and analyzed the effects of metabolic medication intakes to cataract prevalence using multiple logistic regression analysis. Results: The risk of cataract development was significantly increased according to the number of metabolic abnormalities, after adjusting for age, sex, life style, and social economic status variables (p for trend < 0.0001). In metabolic components, the disturbances of blood pressure (OR(95% Confidence Interval): 1.32(1.05,1.65)) and fasting glucose (1.35(1.09,1.67)) significantly increased the prevalence of cataract after adjusting for age and sex. Among these metabolic components, the significance of fasting glucose (1.26(1.01, 1.58)) was remained after adjusting for the other variables. Medication intake of hypertensive also increased the risk of cataract (1.49(1.14,1.96)). Conclusions: Metabolic syndrome and its components increased the risk of cataract, and some medication for treating hypertension was also associated with the cataract incidence.

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Factors for Predicting the Need for an Emergency Blood Transfusion to a Multiple Trauma Patient Using Emergency Room Transfusion Score (ETS) (다발성 외상 환자에서 Emergency Room Transfusion Score (ETS)를 이용한 응급수혈의 예측인자)

  • Jo, Hyeon Kyu;Park, Yong Jin;Kim, Sun Pyo;Kim, Seong Jung;Cho, Soo Hyung;Cho, Nam Soo
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.1-8
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    • 2015
  • Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas received an emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture.

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Liver Involvement in Multiple Myeloma: A Hospital Based Retrospective Study

  • Poudel, Bibek;Mittal, Ankush;Shrestha, Rojeet;Farooqui, Mohammad Shamim;Yadav, Naval Kishor;Shukla, Pramod Shanker
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2153-2155
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    • 2012
  • Objective: This study was to assess liver involvement in multiple myeloma with the aid of liver function tests. Materials and Methods: A hospital based retrospective study was undertaken using data retrieved of multiple myeloma from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2007 and $28^{th}$ February, 2012. We collected biomarkers of liver profiles including bilirubin (Total, Direct and Indirect), total protein, albumin, AG ratio, SGOT, SGPT, ALP, ${\gamma}GT$, LDH, ferritin, renal profile and hematological profile. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: Out of 37 cases of multiple myeloma, serum level of AST, ALT, ALP, ${\gamma}GT$ and LDH were increased above the cut-off point in 22 (59.5%), 24 (64.86%), 13 (35.13%), 9 (24.3%) and 11 (29.7%) respectively. The mean values of AST ($65.5{\pm}28.18$ U/L), ALT ($68.37{\pm}29.74$ U/L), ALP ($328.0{\pm}148.4$ U/L), ${\gamma}GT$ ($44.5{\pm}29.6$ U/L) and LDH ($361.7{\pm}116.5$ U/L), total protein ($9.79{\pm}1.03$ gm/dl) were significantly increased when compared with controls. In contrast, albumin ($3.68{\pm}0.43$ gm/dl) and the AG ratio ($0.62{\pm}0.15$) were significantly decreased. Similarly, anemia, hyperuricemia, azotemia, hypercalcaemia and Bence Jones proteinuria were found in 30 (78.9%), 27 (71.1%), 19 (51.5%), 15 (39.5%) and 16 (42.1%) respectively, in cases of multiple myeloma. Conclusions: While clinical manifestation of liver disease among the multiple myeloma was not common, abnormalities in liver function were characteristic.

Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome (Osler-Rendu-Weber 증후군 환자에서 색전요법을 이용한 다발성 폐동정맥루 치험 1예)

  • Kim, Jae-Hag;Choi, Taek-Hee;Nam, Seung-Mo;Chang, Jae-Jin;Park, Yeon-Hee;Hur, Nam-Hyun;Choe, Du-Hwan;Lee, Byung-Hee;Kim, You-Cheoul;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.914-921
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    • 1997
  • Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blood in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II). clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization. significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she had the improvement of symptoms and iron deficiency anemia.

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Multiple-dose Intramuscular Toxicity Study of Shinbaro Pharmacopuncture in Sprague-Dawley Rats over a 4-week period (SD(Sprague-Dawley) 랫드를 이용한 신바로 약침의 4주 반복 근육투여 독성시험)

  • Lee, Jin Ho;Ha, In Hyuk;Kim, Me Riong;Kim, Min Jeong;Lee, Jae Woong;Lee, In Hee;Chung, Hwa Jin;Kim, Eun Jee
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.77-89
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    • 2015
  • Objectives : To evaluate the safety of multiple-dose intramuscular Shinbaro Pharmacopuncture in male and female Sprague-Dawley(SD) rats over a period of 4 weeks(12 sessions). Methods : In order to test the safety of multiple-dose intramuscular Shinbaro Pharmacopuncture we used 40 healthy male and female 6-week old SD rats(male weight 171.79~196.37 g, female weight 127.93~146.43 g). Shinbaro Pharmacopuncture was administered intramuscularly to male and female SD rats at doses of 4.6 (low dose group, n=10), 9.2 (moderate dose group, n=10), and 18.5 mg/kg(high dose group, n=10), respectively. General symptoms, body weight changes, blood tests, biochemical testing, necropsy, organ weight and histopathogical findings were examined over a 4-week period. Results : 1. No mortalities or adverse effects were caused by the investigational substance were observed during the study period. 2. There was no significant difference in body weight caused by the the investigational substance across all groups. 3. No significant between-group difference was found to be caused by the investigational substance in blood tests and biochemical testing. 4. No abnormalities were detected by a necropsy examination with the unaided eye at the macro level after treatment with the investigational substance. 5. Difference in organ weight between groups caused by the investigational substance was not found. 6. All groups did not exhibit pathological findings caused by the investigational substance in histopathogical examination. Conclusions : According to these results, Shinbaro Pharmacopuncture has no systemic or organ toxicity with multiple-dose intramuscular administrations in male and female SD rats over a 4-week period (12 sessions). These results imply that no adverse effects are observed at a level (NOAEL) of Shinbaro Pharmacopuncture of 18.5 mg/kg.

Predictors of High-grade Vesicoureteral Reflux in Children with Febrile Urinary Tract Infections

  • Choi, Eom Ji;Lee, Min Ju;Park, Sin-Ae;Lee, Oh-Kyung
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.136-141
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    • 2017
  • Purpose: This study aimed to investigate clinical and radiological factors that may predict high-grade vesicoureteral reflux (VUR) in patients with febrile urinary tract infection (UTI). Methods: We retrospectively analyzed medical records of 446 patients diagnosed with febrile UTI from March 2008 to February 2017. All patients underwent renal-bladder ultrasonography (RBUS), 99mTc dimercaptosuccinic acid (DMSA) renal scan, and voiding cystourethrography (VCUG), and were divided in to 3 groups: a high-grade VUR group (n=53), a low-grade VUR group (n=28), and a group without VUR (n=365). Results: The recurrence and non-Escherichia coli infection rates in febrile UTI were significantly higher in the high-grade VUR group than in the other two groups (P<0.05). RBUS showed that hydronephrosis and ureter dilatation were more frequent in the high-grade VUR group than in the other groups (P<0.05). In the high-grade VUR group, a renal cortical defect was more likely to appear as multiple defects, and the difference in bilateral renal scan uptake between both kidneys was larger than in the other two groups (P<0.001). Conclusion: Recurrent UTI, non-E. coli UTI, abnormal findings on RBUS such as hydronephrosis and ureter dilatation, and abnormal findings in the DMSA renal scan such as multiple renal cortical defects and greater uptake difference were associated with high-grade VUR. VCUG should be selectively performed when RBUS and/or DMSA renal scan reveal significant abnormalities.