• Title/Summary/Keyword: Without systemic involvement

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A case of Behcet's Disease with CNS Manifestations (중추 신경계 증상이 동반된 Behcet,씨 병 1예)

  • Shin, Dong-Gu;Ko, Myung-Ku;Yoon, Kyung-Woo;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.307-311
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    • 1986
  • Beh,cet's disease was originally described as a triple symptom complex of oral aphthous ulceration, genital ulceration, and hypopyon iritis. It is now known to have a wide systemic manifestations. Among them, the central nervous system involvement should be diagnosed earlier because of it's lethal potential. Recently the authors experienced a case of Behcet's disease with CNS involvement. A 51-year-old female patient was admitted due to deterioration of mentality and generalized ache since 2 years prior to admission. The findings on physical examination were compatible with Behcet's disease, but without cerebrospinal pleocytosis. The manifestations were improved with medications of prednisolone, chlorambucil, colchicine, but relapsed 2 months later during subsequent tapering of prednisolone and chlorambucil. The patient is now on medication again. A case of Beh,cet's disease with CNS manifestations is reported with review of literature.

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Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients

  • Park, Chan-Hong;Lee, Sang-Ho
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.147-150
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    • 2010
  • Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

Primary Radiation Therapy of Polymorhic Reticulosis (다형성 세망증의 방사선 치료성적)

  • Kim Jae Sung;Yun Hyoung Geun;Ahn Yong Chan;Park Charn Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.111-116
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    • 1991
  • From 1979 to 1987, 33 patients with polymorphic reticulosis (PMR) limited in the upper airway were treated with primary radiation therapy and the analysis of treatment results was undertaken. Systemic symptoms such as fever, night sweats, and weight ioss were noted in $48\%$. The nasal cavity was most frequently involved $(85\%)$, although involvement of PNS $(33\%)$ and palate $(30\%)$ was not uncommon. The 5 and 10 year actuarial survival rates were $47\%\;and\;40\%$, respectively. The difference in NSD between patients with in-field failure and those without it was significant statistically. Also, field size was significantly smaller in patients with marginal failure than those without it. During the follow-up period, systemic failure was found in S patients (diffuse histiocytic Iymphoma in 4, histiocytic medullary reticulosis in 1). In this study, we can suggest that total radiation dose of at least 4500 cGy with generous treatment volume should be delivered to achieve better local control and that the developement of an effective systemic chemotherapeutic regimen is required to improve the survival after systemic relapse.

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ROLE OF SYMPATHETIC NERVE ON THE CONTROL OF MICROCIRCULATION IN THE FELINE DENTAL PULP (고양이 치수에서 교감신경에 의한 미세순환조절에 관한 기능적 연구)

  • Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.21 no.1
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    • pp.375-384
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    • 1996
  • The purpose of this study was to investigate the functional involvement of sympathetic nerve in the control of the microcirculation in the dental pulp with the aim of elucidation of the involvement of neuropeptides and sympathetic nerve in neurogenic inflammation. Experiments were done on the 7 cats anesthetised with sodium pentobarbital, and sympathetic nerve to the' dental pulp was stimulated electrically (10 Hz, 4 V, 1.5 ms, 3.5 mins). Ana-adrenoceptor antagonist phentolamine and a neuropeptide Y antagonist D-myo-inositol-1,2,6-trisphosphate (PP56) were injected close intra-arterially into the dental pulp without changing the systemic blood pressure. The probe of laser Doppler flowmeter was placed on the buccal surface of ipsilateral canine teeth to the stimulation, and pulpal blood flow was measured. Stimulation of the sympathetic nerve decreased pulpal blood flow by $55.24{\pm}7.74\;%$ (mean${\pm}$SEM, n = 13). Stimulation of the sympathetic nerve following the injection of the ${\alpha}$-adrenoceptor antagonist phentolamine ($0.1{\mu}g$/kg) caused decrease of pulpal blood flow by $14.35{\pm}3.43%$ (mean${\pm}$SEM, n=5). Phentolamine attenuated the sympathetic nerve-induced pulpal blood flow decrease by $74.02{\pm}9.32%$ (mean${\pm}$SEM) Stimulation of the sympathetic nerve following the injection of the neuropeptide Y antagonist PP56 (2.3 mg/kg) caused decrease of pulpal blood flow by $30.64{\pm}7.92%$ (mean${\pm}$SEM, n=6). PP56 attenuated the sympathetic nerve-induced pulpal blood flow decrease by $44.37{\pm}11.01%$ (mean${\pm}$SEM). These data provide evidences of the co-contribution of nerepinephrine and neuropeptide Y on the sympathetic nerve-induced vasoconstriction in the feline dental pulp. In addition, they show functional evidences that sympathetic nerve plays an active role in controlling the microcirculation of the dental pulp.

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Hypoxia Upregulates Mitotic Cyclins Which Contribute to the Multipotency of Human Mesenchymal Stem Cells by Expanding Proliferation Lifespan

  • Lee, Janet;Kim, Hyun-Soo;Kim, Su-Min;Kim, Dong-Ik;Lee, Chang-Woo
    • Molecules and Cells
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    • v.41 no.3
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    • pp.207-213
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    • 2018
  • Hypoxic culture is widely recognized as a method to efficiently expand human mesenchymal stem cells (MSCs) without loss of stem cell properties. However, the molecular basis of how hypoxia priming benefits MSC expansion remains unclear. In this report, our systemic quantitative proteomic and RT-PCR analyses revealed the involvement of hypoxic conditioning activated genes in the signaling process of the mitotic cell cycle. Introduction of screened two mitotic cyclins, CCNA2 and CCNB1, significantly extended the proliferation lifespan of MSCs in normoxic condition. Our results provide important molecular evidence that multipotency of human MSCs by hypoxic conditioning is determined by the mitotic cell cycle duration. Thus, the activation of mitotic cyclins could be a potential strategy to the application of stem cell therapy.

A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report

  • Park, Young Joo;Woo, Hyun Young;Kim, Moon Bum;Ahn, Jihyun;Heo, Jeong
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.256-261
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    • 2022
  • Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.

Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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A Case of Diffuse Infiltrative Lymphocytosis Syndrome Associated with Human Immunodeficiency Virus Infection (사람면역결핍바이러스 감염에 동반된 미만성 침윤성 림프구 증가 증후군 1예)

  • Kwon, Sun Ok;Park, Won Wo;Lee, Hyun Kyung;Lee, Sung Soon;Kang, Youn Kyung;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Choi, Soo Jeon;Yum, Ho Kee
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.289-293
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    • 2006
  • Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection.

Ki67 Frequency in Breast Cancers without Axillary Lymph Node Involvement and its Relation with Disease-free Survival

  • Shandiz, Fatemeh Homaei;Shabahang, Hossein;Afzaljavan, Fahimeh;Sharifi, Nourieh;Tavasoli, Alireza;Afzalaghaee, Monavar;Roshanzamir, Emane;Pasdar, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1347-1350
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    • 2016
  • Background: Breast cancer prognosis is influenced by several histopathology and clinical factors including expression of Ki67 which may have a predictive role in lymph node negative breast cancer patients. The aim of this study was to assess Ki67 expression in breast cancers without axillary lymph node involvement and to evaluate its prognostic value with regard to disease-free survival. Materials and Methods: Subjects were selected from non-metastatic invasive breast cancer patients who were referred to the oncology department of Ghaem hospital during 1 April 2001 to 1 April 2008. Ki67 levels were measured using immunohistochemistry (IHC) and compared with clinicopathological features. The relation of Ki67 expression with disease-free survival was also analysed. Results: A total of 106 women with a mean age of 49 were examined. Some 94.3% were classified as having invasive ductal carcinomas and the mean tumour diameter at the time of diagnosis was 2.8 cm. Some 50.9% of cases were ER positive and 47.2% were PR positive. P53 expression was positive in 48.1% of the cases. According to the IHC results, only 8.5% of the patients were Her2/neu positive. Ki67 was positive in 66 (62.3%) with a significant relation to lower age (p=0.0229) and P53 positivity (p=0.005). After an average of 40-months follow up, 13 (12.3%) demonstrated recurrence, most commonly systemic. Of 13 cases with relapse, 10 patients (77%) were Ki67 positive. Conclusions: In our population Ki67 appeared to be an independent prognostic factor for three-year survival. However, we stress that a survival study with a bigger sample size would help to support this conclusion.