• Title/Summary/Keyword: clinical sign

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Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

Rhabdomyolysis induced by venomous snake bite (독사 교상 후 발생하는 횡문근 융해증)

  • Jungho Lee;Jeongmi Moon;Byeongjo Chun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.2
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    • pp.51-57
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    • 2022
  • Purpose: Despite previous studies reporting the development of rhabdomyolysis (RM), this affliction tends to be neglected as an envenomation sign in South Korea. The current retrospective study investigates the prevalence and prognosis of RM after a snakebite. We further searched for predictors of snakebite-induced RM, which can be observed at presentation. Methods: This study included 231 patients who presented to the ED within 24 hours after a snakebite. The patients were classified according to the severity of RM, and the data, comprising baseline characteristics and clinical course including the level of creatine kinase (CK), were collected and compared according to the severity of RM. Results: The prevalence of RM and severe RM were determined to be 39% and 18.5%, respectively. Compared to the group without RM or with mild RM, the group with severe RM had a higher grade of local swelling, a higher frequency of acute kidney injury and neurotoxicity, and a greater need for renal replacement therapy and vasopressor administration. However, the incidence of acute renal injury in the RM group was 7.7%, with two patients needing renal replacement therapy. No mortalities were reported at discharge. Results of the multinomial logistic regression model revealed that the WBC levels are significantly associated with the risk of severe RM. Conclusion: RM should be considered the primary clinical sign of snake envenomation in South Korea, although it does not seem to worsen the clinical course. In particular, physicians should pay attention to patients who present with leukocytosis after a snakebite, which indicates the risk of developing RM, regardless of the CK level at presentation.

A forehead hematoma as the initial clinical sign of lung cancer

  • Park, Jonghyun;Kang, Shin Hyuk;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.198-201
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    • 2020
  • Primary lung cancer commonly metastasizes to the brain, bones, liver, and adrenal glands. In some cases, bone metastasis serves as the first presenting sign of lung cancer with bone pain and headache, but it is not common. The incidence of skull metastasis in lung squamous cell carcinoma (SCC) is low, and there have been only a few cases of skull metastases serving as the first sign of malignancy with skull mass and epidural bleeding; however, no similar cases have been reported regarding that of hematoma. We report a case of an 84-year-old man who first presented with a simple forehead hematoma and was eventually diagnosed with SCC of the lung.

Clinical Characteristics of the Orthopaedic Manual Physical Therapy (정형물리치료의 임상적 특성에 대한 비교)

  • Kim, Moo-Ki
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.236-245
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    • 2003
  • As one of the effective therapies for musculoskeletal diseases, orthopedic manual physical therapy has been watched with keen interest. In Korea, orthopedic manual physical therapy has been widely spread and applied in the field of clinical medicine since the mid-nineties. Since then, the clinical efficacy of orthopedic manual physical therapy has been approved, and orthopedic manual physical therapy has been gradually spread in the filed of clinical medicine. However, it should be noted that clinically available therapies are not well recognized. Therefore, this study was conducted to allude diagnostic and therapeutic characteristics of these therapies including deep tissue massage, manual therapy, Cyriaxs method combining manual reduction and chemotherapy, Kaltenborn-Evjenth method based on concave-convex rule for joint and soft tissue, Maitlands method based on patients sign and symptom, stress due to the posture, intraarticualr disturbance and Mckenzies method for pain due to the dysfunction.

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Application of oral cyclosporine in a dog with atopic dermatitis (개의 아토피성 피부염에 대한 cyclosporine의 경구 요법)

  • Park, Seong-jun
    • Korean Journal of Veterinary Research
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    • v.45 no.3
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    • pp.439-444
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    • 2005
  • A 7.1 kg, seven-year old, castrated male, Shih-Tzu with severe pruritus, chronic otitis externa and Malassezia infection was referred to Veterinary Medical Teaching Hospital of Chungnam National University. In local animal hospital, steroid therapy was used to treat uncontrollable pruritus, but the clinical signs were recurrent when steroid therapy was discontinued. On physical examination, generalized alopecia, erythema, papules, severe crust and diffuse lichenification were presented. Tape strip test of skin lesions revealed cocci and Malassezia infections. Based on the result of history, clinical signs and examination described above, canine atopic dermatitis with secondary superficial pyoderma and Malassezia dermatitis was diagnosed. Oral challenge with cyclosporine and antibiotics had good results in clinical signs. Clinical sign scores were evaluated by investigator with CADESI at 2weeks, 4weeks, 6weeks, 8weeks and 10weeks after cyclosporine administration. And in the result of comparing of allergen-specific IgE value, the level of allergen-specific IgE to general causative allergen after 10 weeks of cyclosporine therapy was higher than that before cyclosporine therapy.

Clinical and Radiological Features of Diffuse Lacrimal Gland Enlargement: Comparisons among Various Etiologies in 91 Biopsy-Confirmed Patients

  • Sae Rom Chung;Gye Jung Kim;Young Jun Choi;Kyung-Ja Cho;Chong Hyun Suh;Soo Chin Kim;Jung Hwan Baek;Jeong Hyun Lee;Min Kyu Yang;Ho-Seok Sa
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.976-985
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    • 2022
  • Objective: To compare the clinical and radiological features of various etiologies of chronic diffuse lacrimal gland enlargement. Materials and Methods: We retrospectively reviewed 91 consecutive patients who underwent surgical biopsy for chronic diffuse lacrimal gland enlargement and were diagnosed with non-specific dacryoadenitis (DA) (n = 42), immunoglobulin G4-related dacryoadenitis (IgG4-RD) (n = 33), and lymphoma (n = 16). Data on patient demographics, clinical presentation, and CT imaging findings (n = 73) and MRI (n = 43) were collected. The following radiologic features of lacrimal gland enlargement were evaluated: size, unilaterality, wedge sign, angle with the orbital wall, heterogeneity, signal intensity, degree of enhancement, patterns of dynamic contrast-enhanced, and apparent diffusion coefficient value. Radiological features outside the lacrimal glands, such as extra-lacrimal orbital involvement and extra-orbital head and neck involvement, were also evaluated. The clinical and radiological findings were compared among the three diseases. Results: Compared to the DA and IgG4-RD groups, the lymphoma group was significantly older (mean 59.9 vs. 46.0 and 49.4 years, respectively; p = 0.001) and had a higher frequency of unilateral involvement (62.5% vs. 31.0% and 15.2%, respectively; p = 0.004). Compared to the IgG4-RD and lymphoma groups, the DA group had significantly smaller lacrimal glands (2.3 vs. 2.8 and 3.3 cm, respectively; p < 0.001) and a lower proportion of cases with a wedge sign (54.8% vs. 84.8% and 87.5%, respectively; p = 0.005). The IgG4-RD group showed more frequent involvement of the extra-orbital head and neck structures, including the infraorbital nerve (36.4%), paranasal sinus (72.7%), and salivary gland (58.6%) compared to the DA and lymphoma groups (4.8%-28.6%) (all p < 0.005). Conclusion: Patient age, unilaterality, lacrimal gland size, wedge sign, and extra-orbital head and neck involvement differed significantly different between lymphoma, DA, and IgG4-RD. Our results will be useful for the differential diagnosis and proper management of chronic lacrimal gland enlargement.

Associated Factors of Clinical sign in Herniated Lumbar Intervertebral Disc (요추간판탈출증의 임상증상에 관련요인)

  • Kang, Jeom-Deok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.88-92
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    • 2010
  • Purpose: This study was undertaken to evaluate the effect analysis of clinical sing in 40 patients with lumbar intervertebral disc. Methods: All patients were assessed by the low back pain protocol which was composed of symptom, clinical sing before and after the treatment. The effect of clinical sing was analyzed by age, occupation, duration of symptom. Results: Occupation by clinical sing of after the treatment was desking job s from 3.6 to 5.2 scores(p<0.05). Duration of symptoms by clinical sing of after the treatment was over 4 months from 3.8 to 5.5 scores(p<0.05). Clinical sing of after the treatment was straight leg raising test from 1.275 to 1.850 scores, sensory disturbances from 1.425 to 2.575 scores, manual muscle testing from 1.525 to 4.625 scores. Conclusion: Herniated disks are most common in middle age, especially between 35 and 45, due to aging-related degeneration of the disks. Significant or increasing pain, numbness or weakness spreading to one or both legs. Progressive loss of sensation in areas that would touch a saddle (inner thighs, back of legs and area around the rectum).

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A study on manganese health hazards among experienced welders (용접경력자의 망간에 의한 건강 장해에 관한 연구)

  • Kim, Gyu-Hoi;Lim, Hyun-Sul;Yu, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.644-665
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    • 1998
  • This study was conducted to evaluate the health hazards and to develop early diagnostic methods of the manganism in experienced welders and to know the meaning of signal intensities on the brain Magnetic Resonance images. It was carried out from December 1996 to february 1997 with 277 male welders, the duration of welding was at least 5 years or more. The study was consisted of a questionnaire, physical examination and measurements of blood & urine manganese concentrations. Brain Magnetic Resonance imaging was done on 19 study subjects by random sampling. As the duration of welding increases, the positive rates of clinical symptoms, neurological examinations and blood manganese concentrations were also increased. However, physical examinations and urine manganese concentrations were not statistically significant with the duration of welding. Authors couldn't observe any Parkinsonism-like diseases. There were statistically significant correlations between duration of welding and blood manganese concentration(r=0.16, p<0.01). There were not statistically significant correlations between duration of welding and urine manganese concentrations (r=0.06). There were statistically significant correlations between blood & urine manganese concentration(r=0.34, p<0.01). By viewing brain Magnetic Resonance images, 13 welders(68.4 %) among 19 welders were found to have signal intensities. The positive rates of clinical symptoms, physical examinations, neurological examinations and blood & urine manganese concentrations were not statistically different between those with signal intensities and those without signal intensities. We would like to suggest that some non-specific clinical symptoms and neurological signs are correlated with the duration of welding but any Parkinsonism-like diseases had not been observed with these welders. Next we suggest that the high signal intensities on TlWI of brain Magnetic Resonance images are not the sign of manganese intoxication but the sign of manganese deposition.

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Clinical Case Study on Piriformis Syndrome after Traffic Accident (교통사고 후 발생한 이상근 증후군 치험 1례)

  • Yun, Jong-Min;Lee, Jung-Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.5
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    • pp.898-902
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    • 2010
  • This study is performed to report that oriental medical treatment was effective to the patient with piriformis syndrome after traffic accident. The patient was diagnosed as piriformis syndrome by considering clinical symptom, clinical history, physical examination, radiologic study and NCV EMG study. We applied acupuncture, herbal medicine, cupping, Chuna manipulation and exercise to the patient. After treatment, VAS decreased, and physical examination sign was disappeared. This result suggest that oriental medical treatment can be effective to piriformis syndrome.

Clinical management of suspected intracranial meningioma in three dogs with pulsed high-dose hydroxyurea

  • Cho, Jae-Geum;Song, Kun-Ho;Seo, Kyoung-Won
    • Korean Journal of Veterinary Research
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    • v.58 no.2
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    • pp.103-106
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    • 2018
  • Three aged dogs, all over 15 years old, with multiple seizure events and various neurologic signs such as head turn and ataxia were brought to the referring hospital. Two cases were tentatively diagnosed with intracranial meningioma based on magnetic resonance imaging, and one case was histopathologically confirmed as meningioma at necropsy. All dogs improved after initiation of pulsed high-dose hydroxyurea (HU) treatment. Clinical sign relapses were managed by repeating high-dose HU without obvious side effects. Pulsed high-dose HU can be applied when clinical signs are refractory to the traditionally recommended dosage for intracranial meningioma in dogs.