• 제목/요약/키워드: Ulcerative

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궤양성 질환의 증상과 처치 (Symptoms & Treatment of Ulcerative Conditions)

  • 박준봉
    • 대한치과의사협회지
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    • 제21권6호통권169호
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    • pp.449-452
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    • 1983
  • 구강내에서 발생하는 연조직 질환중 궤양을 수반하여 환자로 하여금 통증을 호소하게 하는 질환으로는 급성 괴사성 궤양성 치간염 (Acute Necrotizing Ulcerative Gingivitis), 급성 수포성 구내염(Acute Herpetic Gingivo Stomatitis), 재발성 구순포진(Recurrent Herpes Labialis), 재발성 아프타성 구내염(Recurrent Aphthous Stomatitis), 대상성 포진(Herpes Zoster) 등이 있으며, 다른 질환보다도 그 발생빈도가 높아 임상에서 접하게 되며 그 치유속도가 늦어 가끔 당혹감을 느끼는 수가 있다. 이들 질환의 임상적 소견과 그 질환에 대한 치료법의 예를 간략하게 생각해 보고져 한다.

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궤양성 대장염에 동반된 자가면역성 간염-원발성 경화성 담관염의 중복 증후군 1예 (Autoimmune hepatitis-primary sclerosing cholangitis overlap syndrome in a 10-year-old girl with ulcerative colitis)

  • 홍지나;송미경;고재성;강경훈;김우선;서정기
    • Clinical and Experimental Pediatrics
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    • 제52권4호
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    • pp.504-507
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    • 2009
  • 자가면역성 간염, 원발성 담관성 간경화증, 원발성 경화성 담관염은 대표적인 자가 면역성 간질환이다. 이 각 질환의 임상적, 조직학적, 혈청학적 특징이 혼재되어 어느 한 질환으로 진단하기 어려운 경우를 중복증후군(overlap syndrome)이라 하고, 최근 소아에게서도 드물게 보고되고 있다. 한편 경화성 담관염은, 염증성 장질환에서 가장 흔히 동반되는 간담도계질환으로 알려져 있다. 저자들은 궤양성 대장염으로 진단된 환아에게서 간조직 검사, 혈청 검사, 방사선 검사 등을 통해 자가면역성 간염-원발성 경화성 담관염의 중복증후군을 진단하였기에 보고하는 바이다. 염증성 장질환 환아에게서 자가 면역성 간질환 또는 중복증후군 동반여부를 염두에 두어 임상적, 조직학적, 혈청학적 검사를 통해 적절한 진단과 치료가 필요하겠다.

급성괴사성궤양성 치은염을 닮은 재발성 허피스 구내염 (Recurrent Herpes-Stomatitis Mimicking Acute Necrotizing Ulcerative Gingivitis)

  • 김한석;이석근;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권1호
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    • pp.89-92
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    • 2011
  • Herpes simplex is caused by viruses of the herpesvirus hominus family. HSV have four categories: type 1, 2, 6, and 8. Generally HSV-1 affects the mouth. Once infected by HSV, the person's infection is permanent. Retrograde transport through adjacent neural tissue to sensory ganglia leads to a lifelong latent infection. Recently, we treated a patient with recurrent herpes-stomatitis mimicking acute necrotizing ulcerative gingivitis (ANUG). The results were satisfactorty so we report this case. 31 years old male patient showed sore throat, gingival ulceration, palpable both submandibular lymph node, and sulcular pus formation around posterior decayed teeth. This is the third time he has suffered from this symptom. Tentative diagnosis was acute necrotizing ulcerative gingivitis. Antibiotic therapy was started. But, intraoral symptom got worse in process of time. Especially ulcer of marginal gingiva got worse. Viral disease was suspected. We carried out viral cultivation. At the same time topical application of antiviral ointment (herpecid$^{(R)}$) was performed on oral ulcer unilaterally for the purpose of diagnosis and reducing pain experimentally. The next day pain was decreased dramatically on application area. Basing on the viral cultivation and clinical effect of antiviral ointment (herpecid$^{(R)}$), we have diagnosed it as a recurrent herpes-stomatitis and concluded that viral infection was major cause of disease and bacterial infection was secondary.

Clinical Course of Infliximab Treatment in Korean Pediatric Ulcerative Colitis Patients: A Single Center Experience

  • Kim, Jong Min;Lee, Yoo Min;Kang, Ben;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권1호
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    • pp.31-36
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    • 2014
  • Purpose: Infliximab (IFX) is considered safe and effective for the treatment of ulcerative colitis (UC) in both adults and children. The aim of this study was to evaluate the short- and long-term clinical course of IFX in Korean children with UC. Methods: Pediatric patients with UC who had received IFX infusions between November 2007 and May 2013 at Samsung Medical Center were retrospectively investigated. The clinical efficacy of IFX treatment was evaluated at 8 weeks (short term) and 54 weeks (long term) after the initiation of IFX treatment using the Pediatric Ulcerative Colitis Activity Index (PUCAI). The degree of response to IFX treatment was defined as complete response (PUCAI score=0), partial response (decrement of PUCAI score${\geq}20$ points), and non-response (decrement of PUCAI score <20 points). Adverse events associated with IFX treatment were also investigated. Results: Eleven pediatric patients with moderate to severe UC had received IFX. The remission rate after IFX treatment was 46% (5/11) and 82% (9/11) at 8 weeks and 54 weeks after IFX treatment, respectively. All patients who were steroid-dependent before treatment with IFX achieved remission at 54 weeks and were able to stop treatment with corticosteroids, while all steroid-refractory patients failed to achieve remission at 54 weeks after treatment with IFX. Conclusion: Response to IFX treatment after 8 weeks may predict a favorable long-term response to IFX treatment in Korean pediatric UC patients.

궤양성 대장염에서 다발성으로 발생된 괴저농피증 1예 (Pyoderma Gangrenosum in a Patient with Ulcerative Colitis: A Case Report)

  • 강경인;유선영;오상하;김재영
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권2호
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    • pp.240-245
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    • 2009
  • 만성 염증성 장 질환에서 유발되는 드문 피부 병변인 괴저 농피증은 초기에는 홍반으로 둘러싸인 농포로 시작하지만 빠르게 주변부로 확장되고 염증이 진피 내로 파급 되면서 깊은 궤양이 생겨 피부 함몰을 일으킨다. 초기에 감염성 연부조직염 등으로 오인하여 절개 배농이나 강한 압박 배농을 하게 되면 이 질환의 이상초과민현상 때문에 병변이 악화되는 경향이 있다. 따라서 조기 진단과 습윤-비밀폐 드레싱으로 상처에 가하는 충격을 최소화하면서 상처 부위를 보존하고 2차 세균 감염을 예방하는 것이 초기 치료에 매우 중요하다. 저자들은 궤양성 대장염을 가진 15세 여자에서 발생한 괴저 농피증을 초기 에 압박 배농하여 병변이 빠르게 악화된 증례의 치료 경험을 보고하면서 조기 진단과 초기 치료 대응의 중요성을 강조하고자 한다.

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괴사성 치은구내염환아의 증례보고 (NECROTIZING GINGIVOSTOMATITIS : CASE REPORT)

  • 정희경;양규호;김선미;최남기
    • 대한소아치과학회지
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    • 제33권1호
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    • pp.85-90
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    • 2006
  • 괴사성 치은염 (Necrotizing ulcerative gingivitis, NUG), 괴사성 치주염 (necrotizing ulcerative periodontitis, NUP), 괴사성 구내염(necrotizing stomatits, NS), 그리고 수암(noma, cancrum oris)은 급속도로 파괴적이며 쇠약하게 하는 잠재성이 큰 구강감염으로 질환의 같은 진행과정에 대해 다른 임상단계로 간주되기도 하나 집합적으로 Vincent's infection, infectious oral necrosis 또는 괴사성 치은구내염(Necrotizing gingivostomati-tis, NG)라고 한다. 이러한 necrotizing gingivostomatitis(NG)의 발생율은 $0.19{\sim}0.5%$이며 $2{\sim}6$세에 가장 높은 발병율을 보인다. Necrotizing gingivostomati-tis는 치명적인 바이러스 감염과 면역체계가 약화된 경우 발생할 수 있으며 주 진단학적 증상으로 동통, 치간유두 부위의 궤양이나 괴사, 치은출혈이 있으며 이차적인 증상은 위막 등이 있다. 이에 본원 소아과에서 의뢰되어 necrotizing gingivostomatitis로 진단받은 환아의 구강내 소견 및 치료경과에 대해 보고하고자 한다.

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편평세포암종으로 오인된 협부에 발생한 간질 호산구 증다증을 동반한 외상성 궤양성 육아종: 증례보고 (Traumatic ulcerative granuloma misjudged as oral squamous cell carcinoma (SCC) on the buccal cheek: case report)

  • 권진일;김현우;남웅;차인호;김형준
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권3호
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    • pp.217-220
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    • 2010
  • Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

Long-Term Efficacy and Safety of Golimumab for Ulcerative Colitis in a Pediatric Inflammatory Bowel Disease Center in Japan

  • Tokita, Kazuhide;Shimizu, Hirotaka;Takeuchi, Ichiro;Shimizu, Toshiaki;Arai, Katsuhiro
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권6호
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    • pp.461-472
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    • 2022
  • Purpose: Golimumab (GLM) is an anti-tumor necrosis factor (TNF)-α antibody preparation known to be less immunogenic than infliximab (IFX) or adalimumab. Few reports on GLM in pediatric patients with ulcerative colitis (UC) are available. This study aimed to review the long-term durability and safety of GLM in a pediatric center. Methods: The medical records of 17 pediatric patients (eight boys and nine girls) who received GLM at the National Center for Child Health and Development were retrospectively reviewed. Results: The median age at GLM initiation was 13.9 (interquartile range 12.0-16.3) years. Fourteen patients had pancolitis, and 11 had severe disease (pediatric ulcerative colitis activity index ≥65). Ten patients were biologic-naive, and 50% achieved corticosteroid-free remission at week 54. Two patients discontinued prior anti-TNF-α agents because of adverse events during remission. Both showed responses to GLM without unfavorable events through week 54. However, the efficacy of GLM in patients who showed primary nonresponse or loss of response to IFX was limited. Four of the five patients showed non-response at week 54. Patients with severe disease had significantly lower corticosteroid-free remission rate at week 54 than those without severe disease. No severe adverse events were observed during the study period. Conclusion: GLM appears to be safe and useful for pediatric patients with UC. Patients with mild to moderate disease who responded to but had some adverse events with prior biologics may be good candidates for GLM. Its safety and low immunogenicity profile serve as favorable options for selected children with UC.

The Treatment Effect of Ulcerative Colitis of Supercritical Heat-Treated Radish Extracts

  • Kim, Hyun-Kyoung
    • International Journal of Internet, Broadcasting and Communication
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    • 제13권2호
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    • pp.145-155
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    • 2021
  • With the recent rapid improvement in the standards of life and westernization of dietary lifestyles, the consumption of high-calorie diets such as high-fat and high-protein red meat and instant foods has increased, while less vegetables containing dietary fiber are consumed. In addition to that, stress, erroneous dietary behaviors, and contaminated environments are linked to the risk of developing ulcerative colitis, which is on the rise. Another cause of ulcerative colitis is that involve laxative abuse, including repeated, frequent use of laxatives, and include such conditions as deteriorated bowel function, irritable bowel syndrome, diarrhea, intestinal inflammation, etc. The present study aimed to investigate the comparative evaluation of pharmacological efficacy between sulfasalazine alone and combination with herbal medicine on dextran sodium sulfate (DSS)-induced UC in mice. Balb/c mice received 5% DSS in drinking water for 7 days to induce colitis. Animals were divided into five groups (n = 9): group I-normal group, group II-DSS control group, group III-DSS + sulfasalazine (30 mg/kg), group IV-DSS + sulfasalazine (60 mg/kg), group V-DSS + sulfasalazine (30 mg/kg) + Radish Extract mixture (30 mg /kg) (SRE). DSS-treated mice developed symptoms similar to those of human UC, such as severe bloody diarrhea and weight loss. SRE supplementation, as well as sulfasalazine, suppressed colonic length and mucosal inflammatory infiltration. In addition, SRE treatment significantly reduced the expression of pro-inflammatory signaling molecules through suppression both mitogen-activated protein kinases (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways, and prevented the apoptosis of colon. Moreover, SRE administration significantly led to the up-regulation of antioxidant enzyme including SOD and Catalase. This is the first report that Radish extract mixture combined with sulfasalazine protects against experimental UC via the inhibition of both inflammation and apoptosis, very similar to the standard-of-care sulfasalazine.

Protective Role of the Toll-Like Receptor 5 Agonist KMRC011 against Murine Colitis Induced by Citrobacter rodentium and Dextran Sulfate Sodium

  • Jun-Young Kim;Sun-Min Seo;Han-Woong Kim;Woo-Jong Lee;Yang-Kyu Choi
    • Journal of Microbiology and Biotechnology
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    • 제33권1호
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    • pp.35-42
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    • 2023
  • This study aimed to identify the therapeutic ability of a novel toll-like receptor (TLR) 5 agonist, KMRC011, on ulcerative colitis induced by Citrobacter rodentium and dextran sulfate sodium in a C57BL/6N mouse model. Ulcerative colitis was induced in the mice by the oral administration of 1% dextran sulfate sodium in sterile drinking water for seven days ad libitum, followed by C. rodentium infection on the seventh day by intra-gastric administration (DSS-CT group). KMRC011 was administered intramuscularly at both 24 h and 15 min before (Treatment 1 group), and at both 15 min and 24 h after (Treatment 2 group) the C. rodentium infection. The length of the large intestine and histopathological counts were significantly greater and mucosal thickness was significantly thinner in the Treatment 1 group compared to the DSS-CT and Treatment 2 groups. Il-6 and Il-10 mRNA expression levels were upregulated, while Ifn-γ and Tnf-α mRNA expression levels were significantly downregulated in the Treatment 1 group, compared to the DSS-CT group. NF-κB p65 expression level was elevated due to ulcerative colitis in the DSS-CT group, but was significantly downregulated in the Treatment 1 group. Overall, KMRC011 showed protective effects against murine colitis by inhibiting NF-κB signaling.