• Title/Summary/Keyword: pathologic signs

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Subcutaneous Sparganosis on Abdomen Mimicking Multiple Lipomas

  • Ahn, Seung Ki;Choi, Hwan Jun;Kim, Jun Hyuk
    • Parasites, Hosts and Diseases
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    • v.57 no.5
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    • pp.513-516
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    • 2019
  • Human sparganosis is a food-borne zoonosis mainly caused by the plerocercoid belonging to the genus Spirometra. The most common clinical sign of sparganosis is a subcutaneous mass in the trunk including abdominal or chest wall. The mass may be mistaken for a malignant tumor, thereby causing difficulty in terms of diagnosis and treatment. A 66-year-old woman visited our clinic for the removal of a lipoma-like mass. It was movable, hard, and painless. we identified 2 white mass, measuring $0.2{\times}4cm$ and $0.2{\times}1cm$. Pathologic finding indicated the white mass was a sparganum. She recalled having eaten a raw frog approximately 60 years before. A 35-year-old who lived North Korea was also presented to our clinic with an asymptomatic nodule on her abdomen. Intraoperatively, we found sparganum approximately 24 cm size. Subcutaneous masses are associated with clinical signs of inflammation or they may mimic a soft tissue neoplasm. While the incidence rate of sparganosis has decreased with economic development and advancements in sanitation, surgeons still encounter patients with sparganosis in the clinical setting. Therefore, a careful history is required in order to diagnose sparganosis.

Intestinal Lymphoma in a Halla Horse

  • Jeong, Hyohoon;Lee, Seyoung;Park, Kyung-won;Lee, Eun-bee;Kim, Jae-Hoon;Jung, Ji-Youl;Seo, Jong-pil
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.138-143
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    • 2022
  • A 21-year-old female Halla Horse weighing 248 kg was referred to the Jeju National University Equine Hospital with the chief complaint of anorexia accompanied by general weakness and depression for the previous three days suspected to be related to colic. Extensive diagnostic tests were performed for the following six days, including complete blood count (CBC), serum chemistry, gastroscopy, x-rays, and ultrasound imaging. The signalment, history, symptoms, and test results strongly suggested a chronic intestinal inflammatory disease with or without an alimentary tumor; hence, an exploratory laparotomy was performed. Almost the entire small intestine wall was severely thickened with diffuse ecchymosis on the serosa and protruded nodules on the mucosa. A presumptive diagnosis of an intestinal tumor was made, and the patient was euthanized, considering the patient's welfare with poor prognosis and low expectancy. A massive part of the small intestine was collected and submitted for macroscopic and microscopic pathology evaluations. The pathologic examination, including immunohistochemistry (IHC), indicated equine intestinal lymphoma showing strong positivity for T cell marker. This report describes the clinical signs, diagnosis and pathological features of intestinal lymphoma in a Halla Horse in detail.

The Study on the History of Pugation therapy From -'Treatise on Febrile Diseases' to 'Longevity and Life Presservation In Oriental Medicine'- (하법(下法)의 발전 과정에 대한 연구(硏究) -상한론(傷寒論)에서 사상의학(四象醫學) 까지-)

  • Choi, Yei-Kwen;Kim, Kyung-Yo
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.524-552
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    • 1998
  • Purgation therapy has played an important role as a influential remedy from the begining of the Chinese medicine. Especially purgation therapy is raised as the effective remedy on the acute infectious disease in the book of 'Treatise on Febrile Disease'. But It was inclined to cold-nature and available only in the excess syndrome. Nevertheless it is evident that the book has showed an example of this therapy. During the middle age, purgation therapy is classified into several subtype; hydrogogue therapy, laxation with lubricants, purgation with cold-natured drugs and purgation with warm-natured drugs. Comparing with the ancient times, it must be a progression. It was investigated earnestly by a school leaded by Zhang Congzheng. They were not restricted to several diseases, but applied it to the wide range of diseases. They thought as following. 'One is ill from pathogenic factor so that you should eliminate it from the human body'. Hence, they frequently used three major remedies such as diaphoresis, emesis and purgation. In this process, purgation therapy had showed eye-opening progress. But opposition to it was not little. Li Gao was a representative man on the opposite side. He expressed a critical opinion and placed great importance on the genuine energy, the natural healing force. Under his influence, a large number of doctors evaded purgation and put it under taboo. On account of these trend, purgation therapy had took a backward step and retrograded. Therefore cathartics such as Rhei Radix et Rhizoma, Rharbitidis Semen, cold drugs such as Gypsum Fibrosum, etc. had been excluded for preservation of the genuine energy, and came about an obnoxious custom to value only 'tonity deficiency', or 'warm and tonify'. As it had came into fashion to approach most disease from the point of view, purgation therapy was merely fall into a remedy of constipation. After the eighteenth century purgation therapy encountered the new period of rivival. It was introduced by them who strived for the study of Epidemics to the new current of thought, so called '增水行舟'. It was because 온병 was apt to dissipate one's Yin fluid. Therefore purgation therapy of this period was characterized by establishing nourishment Yin and body fluid with or without use of timely purgation of accumulation of heat. From the time of Zhang Congzheng, it was accomplished by Lee Je-ma to the most epoch-making change. He caused an improvement in the use of purgation therapy by regarding innate constitutional contradiction as importance than representing clinical symptoms. He warned that existing remedies that depend only upon symptoms and signs, not upon individual characteristics including constitutional features didn't bring round to but kill them. And he understood all the pathologic processes in his constitutional theory, investigated specific drugs on four constitution, made indications of each prescriptions clear. For giving to differentiation of constition before differentiation of syndrom, his new slant on the pathologic phenomena overcome the limitations of 변증시치, and revaluate purgation therapy from remedy impaire the genuine energy to that restore it by recover the balance between the internal organ. It is the product of him to fundamentally upset the cause to be in disregard of purgation therapy.

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The Prognostic Factors of Solitary Pulmonary Nodule (고립성 폐결절의 예후에 관여하는 인자)

  • Jeong, Yun-Seop;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.425-435
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    • 1989
  • The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

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Clinical and pathological studies on co-infection of lowpathogenic avian influenza virus and Newcastle disease virus in the chicken (닭에서 저병원성 조류인플루엔자와 뉴캐슬 바이러스의 복합감염에 따른 임상적, 병리학적 연구)

  • Lee, Sung-Min;Cho, Eun-Sang;Choi, Bo-Hyun;Son, Hwa-Young
    • Korean Journal of Veterinary Service
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    • v.36 no.3
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    • pp.163-169
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    • 2013
  • Both of avian influenza (AI) and Newcastle disease (ND) can cause mild to severe diease in poultry. In this study, clinical signs, macro, and micro lesions were studied. Eighteen six-week-old SPF chicks were divided into 4 groups (E1, E2, E3 and C1) and housed in different rooms of the isolation facility at CAVAC (Daejeon, Korea). The control group (C1) of 3 chicks was housed separately as uninoculated. Experimental groups (E1, E2 and E3) challenged with H9N2 and/or NDV. E1 group was challenged with 0.1 mL A/Kr/Ck/01310/01 (H9N2) $10^{5.6}$ $EID_{50}$ by intranasal, E2 group was challenged with 0.5 mL Kyojeongwon (KJW) $10^{5.0}{\sim}10^{6.0}$ $ELD_{50}$ by intramuscular, and E3 group was challenged with 0.1 mL A/Kr/Ck/01310/01 $10^{5.6}$ $EID_{50}$ by intranasal and 0.5 mL KJW $10^{5.0}{\sim}10^{6.0}$ $ELD_{50}$ by intramuscular 7 days after H9N2 challenge. In clinical signs and gross findings, E1 group showed 0% mortality, anorexia, and hemorrhage of proventriculus and thymus, E2 group showed 100% mortality within 3~5 days after challenge, anorexia, green diarrhea, hemorrhage of proventriculus, proximal esophagus and thymus, enlargement of kidney, and bronze liver, and E3 group showed 100% mortality within 24~36 hours after NDV challenge, depression, anorexia, green diarrhea, hemorrhage of proventriculus, spleen, and lung, enlargement of kidney, and reduction of thymus size and number. In histopathological examination, E1 group showed depletion and necrosis in bursa of Fabricius, thymus, and spleen, and E2 and E3 group showed severe lymphocyte depletion and necrosis with destruction of lymphoid organ structures. In conclusion, co-infection of H9N2 with ND virus causes acute disease with high mortality than single infection and the pathologic lesions were more severe.

Treatments of the Compartment Syndrome of the Foot after the Calcaneal Fractures (종골 골절후 발생한 족부 구획 증후군의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Jun, Deuk-Soo;Hwang, Pil-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.93-99
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    • 2000
  • Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow-up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemia, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.

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A Literature Review about Application of an Auricular Acupuncture Therapy for Independent Oriental Medical Nursing Intervention Development (한방간호중재개발을 위한 이침요법(耳鍼療法)적용에 대한 문헌연구)

  • Moon, Hee-Ja;Kim, Kwuy-Bun;Sok, So-Hyune;Hong, Kyung-Hwa
    • Journal of East-West Nursing Research
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    • v.4 no.1
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    • pp.66-76
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    • 1999
  • The auricular acupuncture therapy is stimulus treat method that acupuncts or moxibusts at the reaction blood vessel point of various diseases in the upper portion of ear. And this effects from the reaction blood vessel point of an ear to the meridian of whole body system through blood stream. The auricular acupuncture has cured and cared signs and symptoms of many diseases and pathologic problems. And this treatment heels abnormal reactions, nursing focuses so it was examined through literature review that nurses use many portions of the auricular acupuncture in their clinical cares of oriental medicine. This study was proved that the Mae-Chim acupuncture method among various methods of the auricular acupuncture is easy and simple so this method can be used by nurses. And the ear acupuncture site which controls diarrhea, insomnia, migraine, stress vomiting, dyspepsia, high fever, insufficient lactation, bowel dysfunction, menoxenia, anxiety, pruritus and can be found easily and is few the number of acupuncture so the oriental medicine nurses can apply easily to their clients. Therefore the independent oriental medicine nursing intervention can be developed by application of the auricular acupuncture therapy on the oriental medicine clinical nursing and home care in our community.

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Pathogenecity on experimentally infected dogs with Babesia gibsoni (Babesia gibsoni의 실험적 감염 개에 대한 병원성)

  • Suh, Myung-deuk;Chung, Mi-ra
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.587-599
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    • 2000
  • This study was conducted to observe the severity of the disease and pathogenecity of Babesia gibsoni parasite on the splenectomized dogs(SPD) and nonsplenectomized(intact) dogs (NSPD) experimentally infected with B gibsoni. The average prepatent period was 4 days in the SPD and 8 days in the NSPD, respectively. Peak parasitaemia(PE) ranged from 26% to 34% of erythrocytes infected in the SPD and from 4% to 5% in the NSPD. Latent parasitaemia was still detectable 40 days as low as under 1.0% of erythrocytes infected after the initial parasitaemia in the SPD. Blood packed cell volume(PCV) decreased to as little as 6.4% to 6.9% in the SPD. The clinical signs were mild fever and anemia in the NSPD, remissions and exacervations of temperature, intermittent or spike-like increases of temperature, progressive polychromatophilic macrocytic anemia with anisocytosis, icterus, marked loss of appetite, rarely haemoglobinuria, and deep brown-yellowish urine in the SPD. Gross pathologic changes mainly involved slightly enlargement of liver and spleen in the NSPD and marked enlargement of liver in the SPD. Anatomic changes associated with the disease included diffuse periportal and centrilobular hephatitis, and membranoproliferative glomerulonephritis. Hyaline droplets, resulting protein metabolic alterations, were found in the convoluted ephithelium of the kidney. The density of lymphocytes within the liver sinusoids was markedly increased. Aggregates of large monocytes and macrophages were demonstrated in the centrilobular veins of the liver. The density of these cells in the centrilobular veins were greatest in the SPD. The forms of B gibsoni parasite found in the acute stage of SPD were large signet ring form, small signet ring form, pyriform, elongated form, comma form, head-phone form, oval form, peared form, racket-like form, amoeboid form, triangle form, quartered form, dot form, band form and multiple, and rosette form, et al. The severity of the disease and pathogenecity of B gibsoni parasite were mild in the NSPD but fatal in the SPD.

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A Clinical Study on the Surgical Treatment of Double Chambered Right Ventricle Associated with Ventricular Septal Defect (VSD 를 합병한 DCRV 의 외과적 수술에 대한 임상적 고찰)

  • Son, Dong-Seop;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.241-249
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    • 1985
  • Twenty-one patients with Double Chambered Right Ventricle [DCRV] associated with Ventricular Septal Defect [VSD] were treated by open heart surgery under cardiopulmonary bypass with moderate hypothermia in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital between June 1982 and October 1984. The following results were obtained 1. The symptoms and physical signs, specific for DCRV, could not be identified. 2. The radiologic findings on simple chest X-ray, specific for DCRV, could not be identified. 3. Electrocardiographic findings, specific for DCRV, could not be identified. 4. Cardiac catheterization was found to be the most important diagnostic method, revealing pressure gradient between proximal chamber and distal chamber in the right ventricle. The average pressure gradient between two chambers showed 48.1523.29 mmHg[varying from 15mmHg to 94mmHg]. 5. Cardiac angiography was found to visualize the anomalous muscle bundles in right ventricle [in 17 cases, 81%] but the evidence of pressure gradient between two chambers within right ventricle is considered necessary for the diagnosis of DCRV. 6. Via surgical observation, anatomical and pathologic findings of the anomalous muscle bundles, associated DCRV were identified. 7. As the direct pressure was measured on the operating table before and after surgery, the average pressure gradient across the muscle bundles showed 40.5219.75mmHg [varying from 16 to 89mmHg] preoperatively and 8.909.72mmHg [varying from 0 to 32mmHg] postoperatively, indicating significant surgical correction of the obstruction present. 8. The presence of anomalous muscle bundles, dividing the right ventricle into two separated chambers, and the presence of the pressure gradient over 15mmHg are considered necessary for the diagnosis of DCRV.

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Dissecting Aneurysm of Vertebral Artery Manifestating as Contralateral Abducens Nerve Palsy

  • Jeon, Jin Sue;Lee, Sang Hyung;Son, Young-Je;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.194-196
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    • 2013
  • Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.