• 제목/요약/키워드: Without systemic involvement

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

  • 신동구;고명구;윤경우;김종설
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.307-311
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    • 1986
  • Behcet씨 병의 경우 중추 신경계 침범여부는 조기에 진단 치료되어야 할 정도로 불량한 예후를 나타내는 지표로써 아프타성 구내염, 생식기 궤양, 표피성 혈관염, 포도막염, 활막염 등 전신적 증상에 주의를 기울임으로써 조기 진단 및 치료를 하여야 예후의 호전에 기여할 것으로 생각된다. 저자들은 51세 여자 환장서 중추 신경계 증상을 동반한 Behcet씨 병 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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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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    • 제23권2호
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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.

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

  • 김재성;윤형근;안용찬;박찬일
    • Radiation Oncology Journal
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    • 제9권1호
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    • pp.111-116
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    • 1991
  • 1979년부터 1987년까지 서울대학교 병원에서 상기도에 국한된 다형성 세망증으로 근치적 방사선치료를 받은 33명의 환자의 치료성적을 분석하였다. 발열, 체중감소, 도한등의 전신적 증상은 대상 환자중 $48\%$에서 나타났으며 침윤병소로는 비강이 $85\%$로 가장 많았고 븐비동 및 구개부가 각각 $33\%$$30\%$이었다. 전체 환자의 5년 및 10년 생존율은 각각 $47\%$$40\%$이었다. 방사선 조사야 내에서 재발한 경우와 그렇지 않은 경우간의 방사선 선량 차이는 통계학적으로 유의하였으며 조사야 경계부위에서 재발한 경우는 그렇지 않은 경우에 비해서 조사야 면적이 작았다. 추적 관찰 기간중 악성 임파종 4예, 골수 세망증 1예 등의 전신적 전이가 확인되었다. 따라서 방사선 치료를 시행하여 다형성 세망증의 국소 치료율은 향상시키기 위해서는 최소 4,500 cGy의 선량과 병소주위의 조직을 충분히 포함하는 조사야를 사용해야 하며 전신적 전이를 효과적으로 치료할 화학요법 면에서의 개선이 필요하다고 판단된다.

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

  • 김성교
    • Restorative Dentistry and Endodontics
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    • 제21권1호
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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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    • 제41권3호
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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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    • 제23권2호
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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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    • 제39권3호
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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.

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

  • 강정호;이정호;유회성
    • Journal of Chest Surgery
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    • 제10권1호
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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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사람면역결핍바이러스 감염에 동반된 미만성 침윤성 림프구 증가 증후군 1예 (A Case of Diffuse Infiltrative Lymphocytosis Syndrome Associated with Human Immunodeficiency Virus Infection)

  • 권선옥;박원우;이현경;이성순;강윤경;이영민;이혁표;김주인;최수전;염호기
    • Tuberculosis and Respiratory Diseases
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    • 제61권3호
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    • pp.289-293
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    • 2006
  • 사람면역결핍바이러스(HIV) 감염에 동반되는 미만성 침윤성 림프구 증가 증후군(diffuse infiltrative lymphocytosis syndrome, DILS)은 순환 CD8+ T-세포의 증가와 침샘, 폐, 신장, 위장관 등에 조직 침윤이 특징인 질환이다. HIV 항체(효소 면역 측정법)가 양성이며, 양측 침샘 크기가 증가되거나 6개월 이상 구강건조증이 있으며, 침샘이나 눈물샘 또는 침범된 조직 검사에서 육아종이나 악성 종양의 증거 없이 림프구 침윤이 있으면 미만성 침윤성 림프구 증가 증후군으로 진단한다. HIV 감염에 동반된 미만성 침윤성 림프구 증가 증후군이 폐에 침범된 경우는 아직 우리나라에서 보고된 예는 없다. 저자들은 사람면역결핍바이러스(HIV)에 감염된 58세 남자에게 미만성 침윤성 림프구 증가 증후군이 폐에 침범된 1예를 개흉생검으로 진단하여 문헌 고찰과 함께 보고한다.

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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    • 제17권3호
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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.