• 제목/요약/키워드: Pathological pain

검색결과 221건 처리시간 0.026초

하악골과두부에 전이된 유두상 갑상선암의 치험례 (A CASE REPORT OF PAPILLARY THYROID CARCINOMA METASTASIZED TO MANDIBULAR CONDYLE)

  • 김진권;이병인;김형준;서창호;차인호;이의웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권4호
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    • pp.442-446
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    • 1995
  • Thyroid carcinomas are usually classified as papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma. Among the thyroid carcinomas, the incidence of medullary and anaplastic thyroid carcinoma is low, but the rate of lymph node & distant metastasis from them are more common compared to other types. Follicular thyroid carcinoma has a low rate of lymph node metastasis as 10% and has a high occurrence of hematogenous metastasis to lung, bone, brain and liver. Papillary thyroid carcinoma accounts for $60{\sim}70%$ of whole thyroid carcinomas and the cervical lymph node metastasis is $21{\sim}81%$ including micrometastasis, but the distant metastasis is rare. In the case of bone metastasis, follicular type reveals most frequent, and the rate is about 5%, and more likely to be found on vertebra, pelvis, ribs, femur, and skull. The clinical symptoms of bone metastasis are pain, swelling, pathological fracture and radiologically osteolytic lesions can be observed. But distant metastasis of papillary thyroid carcinoma is very rare and especially, bone metastasis has hardly been reported. The treatment modalities of metastatic thyroid carcinoma to mandible are known as follows : thyroidectomy to treat primary site, resection of the affected site of mandible, external beam radiotherapy and radioiodine therapy etc.

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Participation of NMDA and non-NMDA glutamate receptors in the formalin-induced inflammatory temporomandibular joint nociception

  • Yang, Gwi-Y.;Lee, Ju-H.;Ahn, Dong-K.
    • International Journal of Oral Biology
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    • 제32권2호
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    • pp.59-65
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    • 2007
  • It has been well known that excitatory amino acids, primarily glutamate, are involved in the transmission of nociception in pathological and physiological conditions in the spinal and brainstem level. Recently, peripheral glutamate also play a critical role in the peripheral nociceptive transmissions. The present study investigated the role of N-methyl-D-aspartic acid (NMDA) or non-NMDA ionotropic glutamate receptors in formalin-induced TMJ pain. Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Intra-articular injection was performed under halothane anesthesia. Under anesthesia, AP-7 (10, $100\;{\mu}M$, $1\;mM/20\;{\mu}L$), a NMDA receptor antagonist, or CNQX disodium salt (0.5, 5, 50, $500\;{\mu}M/20\;{\mu}L$), a non-NMDA receptor antagonist, were administered intra-articularly 10 min prior to the application of 5% formalin. For each animal, the number of behavioral responses, such as rubbing and/or scratching the TMJ region, was recorded for nine successive 5-min intervals. Intra-articular pretreatment with 1 mM of AP-7 or $50\;{\mu}M$ CNQX significantly decreased the formalin-induced scratching behavioral responses during the second phase. Intra-articular pretreatment with $500\;{\mu}M$ of CNQX significantly decreased the formalin-induced scratching behavior during both the first and the second phase. These results indicate that the intra-articular administration of NMDA or non-NMDA receptor antagonists inhibit formalin-induced TMJ nociception, and peripheral ionotropic glutamate receptors may play an important role in the TMJ nociception.

Rare Form of Schwannoma as a Purely Hemorrhagic Cystic Tumor Located in an Intermuscular Plane

  • Lim, Joo Hee;Shim, Jae-Chan;Yoon, Byung-Ho;Kang, Yun Kyung;Lee, Kyoung Eun;Kim, Ho Kyun;Lee, Ghi Jai;Suh, Jung Ho
    • Investigative Magnetic Resonance Imaging
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    • 제21권1호
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    • pp.38-42
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    • 2017
  • Schwannomas are mostly solid tumors, some of which may contain cystic degenerations or hemorrhages. However, a schwannoma seen as a purely hemorrhagic cystic tumor is very rare. A 63-year-old woman was referred to the hospital due to a slow-growing mass (present for about 5 years) on her right thigh. She complained about vague pain but without neurologic symptoms such as numbness or tingling sensations. MR images showed an oval lesion with defined margins surrounded by the rectus femoris, vastus lateral, and the vastus intermedius. It was characterized as a multilocular cystic lesion composed of hemorrhagic fluid. In addition, the benign hemorrhagic cystic lesion was differentially diagnosed by radiological techniques as a hemorrhagic ganglion cyst. The lesion was surgically excised and, based on pathological features, was diagnosed as being a schwannoma. We report a purely hemorrhagic cystic schwannoma located in an intermuscular plane.

분만과 관련된 치골결합 분리증 3례 (Three Cases of Symphysis Pubis Separation Associated with Delivery)

  • 안재홍;장영진;이동혁;이영기;박윤기
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.93-98
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    • 2000
  • 영남대학교 의과대학 부속병원에서 발생한 치골결합 분리증의 빈도는 1:693이며 분리된 정도가 심할수록 증상도 심했고 다른 합병증도 동반되었으며 완전히 회복되기까지의 기간도 길었다. 산모가 임신전 상태로 완전히 회복되기까지의 기간은 지난 후 1개월에서 4개월까지 다양하였는데 분리된 정도와 회복기간의 연장이 반드시 일치하는 것은 아니었다. 이전 임신 시의 치골결합 분리가 다음 임신 시 분만 방법에 영향을 미치기는 하지만 반드시 수술적 요법을 생각해야 하는 것은 아니다. 앞으로 치골결합 분리의 재발 유무와 적절한 상담을 위해 증례 보고를 한 환자들을 계속 추적 관찰할 예정이다.

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Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Hamza;Basharat, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1833-1835
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    • 2016
  • Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

One Stage Posterior Minimal Laminectomy and Video-Assisted Thoracoscopic Surgery (VATS) for Removal of Thoracic Dumbbell Tumor

  • Nam, Kyoung Hyup;Ahn, Hyo Yeoung;Cho, Jeong Su;Kim, Yeoung Dae;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.257-261
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    • 2017
  • Objective : This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations. Methods : Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed. Results : The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each. Conclusion : One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.

Survival of Mesothelioma in a Palliative Medical Care Unit in Egypt

  • Ibrahim, Noha;Abou-Elela, Enas;Darwish, Dalia
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.739-742
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    • 2013
  • Background: This study was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and to investigate the efficacy of chemotherapy (CT) as well as radiotherapy (RTH) and surgery compared to best supportive care (BSC). Materials and Methods: Forty patients with malignant mesothelioma (38 with pleural and 2 with intraperitoneal) were enrolled. Twenty seven patients underwent (CT) chemotherapy of which 2 also received (RTH) and surgery was only for biopsy in 15/40. Combination chemotherapy included cisplatin-gemcitabine, cisplatin-navelbine and cisplatin (or carboplatin) with premetrexed. Thirteen patients received only best supportive care. Results: A total of 12 (30%) patients were male, and 28 (70%) female. Median age was 54.0 years and the male/female ratio was 1/2.33 (P=0.210). Residential exposure played a major role in two regions, Helwan and Shoubra, in 20% and 15%, respectively. Overall mean survival time was $13.9{\pm}2.29$ months. That for patients who had received best supportive care was $7.57{\pm}1.85$ months, for chemotherapy was $16.5{\pm}3.20$ months, and multimodality treatment regimen $27{\pm}21.0$ months (P=0.028). Kaplan-Meier survival did not significantly vary for sex, residence and the pathological types epithelial, mixed and sarcomatous. The median survival for performance status and treatment modalities was significant (P=0.001 and 0.028). Best supportive care using opioids with a mean dose of 147.1 mg (range 0-1680) of morphine sulphate produced good subjective response and reasonable quality of life but did not affect survival. Conclusions: We conclude that CT prolongs survival compared to BSC in patients with malignant mesothelioma. Moreover, using escalating doses of opioids provides good pain relief and subjective responses.

슬개-대퇴관절의 수술적 치료 - 관절경적 치료를 중심으로 - (Surgical Treatment of Patello-Femoral Joint Lesions - Arthroscopic treatment -)

  • 최종혁
    • 대한정형외과스포츠의학회지
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    • 제4권2호
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    • pp.79-85
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    • 2005
  • 슬개-대퇴 관절의 증상은 다양한 원인에 의해 발생될 수 있다. 대부분의 환자는 만성적인 불편감을 호소하며, 특징적인 급성통증의 양상을 보이는 경우도 매우 드물다. 따라서 우선적으로 보존적 치료가 시행되어야 하며, 이에 대한 반응이 없을 경우 수술적 치료를 시행해야 한다. 수술 방법의 결정은 환자의 연령, 활동도, 술 후 재활 능력 등을 고려하여 선택되어야 한다. 수술적 치료시 정확한 진단이 선행되어야 하며, 수술 시 그 원인적 요소를 제거 혹은 교정해야 한다. 관절경적 치료는 수술에 따른 이환율을 줄이고, 조기 재활의 장점이 있어 유용한 방법이다. 슬개골 관절면의 평가 및 치료를 위해서는 상내방 혹은 상외방 도달법도 효과적이다. 수술 시 정상적인 조직의 제거는 술 후 슬관절의 문제를 야기할 수 있으므로 병적인 변화가 없을 경우 보존해 주어야 한다. 관절경적 치료가 힘들거나 혹은 치료 효과가 없다고 판단될 경우 개방성 방법에 의한 수술도 반드시 고려해야 한다.

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Clinical Experience with Treatment of Angioleiomyoma

  • Woo, Kyoung Sik;Kim, Sang Hun;Kim, Han Seong;Cho, Pil Dong
    • Archives of Plastic Surgery
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    • 제41권4호
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    • pp.374-378
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    • 2014
  • Background Angioleiomyoma, a vascular leiomyoma, is a rare, benign smooth-muscle tumor that originates in the tunica media of vessels. It occurs anywhere in the body, most frequently in the lower extremities. Methods We reviewed the medical records of 16 patients who were treated for angioleiomyoma between 2000 and 2012. The clinical features of angioleiomyoma and the correlation between symptoms and pathological subtypes were investigated. Results There were 9 males and 6 females. Ages of the patients ranged from 21 to 61. Pain was the primary symptom in 44% of the patients. Tumors were smaller than 2.0 cm in all dimensions and were located in the face in 4 patients, whereas 5 lesions occurred in the upper extremities and the remaining 7 in the lower extremities. Three histologic subtypes were identified: solid, venous, and cavernous. The subtypes did not correlate with the clinical symptoms. Conclusions Angioleiomyoma appears to be a rare tumor that occurs in the face and the extremities. The tumor usually occurs in middle age. A differential diagnosis of this tumor is difficult, but the tumor should be considered in the diagnosis of painful subcutaneous masses. Ultrasonography and magnetic resonance imaging can be helpful in the diagnosis of angioleiomyoma. These tumors can be successfully treated with simple excision, with a low recurrence rate.

봉독이 Papain으로 유도된 골관절염 동물 모델에 미치는 영향 (Effects of Bee Venom on Papain-induced Osteoarthritis in an Animal Model)

  • 안현진;이종기;박지현;김경현;이우람;박인영;한상미;이광길;박관규
    • 생약학회지
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    • 제43권2호
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    • pp.167-172
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    • 2012
  • Osteoarthritis (OA) is an age-related joint disease characterized by degradation of articular cartilage and its association with chronic pain. Purified Bee venom (PBV) has been traditionally used to the treatment for inflammatory diseases. The purpose of the current study is to examine whether PBV regulates the pro-inflammation against a mouse model of knee OA induced by papain. We studied the effect of PBV on papain-induced OA in the knee joints of mice. Mice were split into following groups: normal control, papain induced OA, OA treated with PBV, OA treated with meloxicam as positive control. Proteoglycan deposition was analyzed by safranin O-fast green staining and H&E staining. Papain injection significantly degraded the proteoglycan in OA mice at 42 days. Cartilage proteoglycan density was significantly higher in PBV treated OA group than those of the positive control groups. These results demonstrate that PBV efficiently suppresses pathological processes in an OA model. Thus, PBV could be a potential therapeutic strategy for the treatment of OA.