• Title/Summary/Keyword: MPD Syndrome

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A CASE REPORT OF EAGLE'S SYNDROME WITH TMJ INTERNAL DERANGEMENT (악관절내장증을 동반한 Eagle's Syndrome)

  • Park, Kwang-Ho;Kim, Hyung-Gon;Yoon, Jung-Ho;Jeong, Sang-Hoon;Park, Jung-Hyun;Kim, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.458-463
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    • 1994
  • A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

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Primary nephrotic syndrome in children : A nationwide survey in Korea (전국 병원을 대상으로 조사한 소아 특발성 신증후군의 임상적 고찰 - 다기관 공동연구 결과보고 -)

  • Cho Bytung-Soo;Kang Hyeon-Ho
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.1-10
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    • 1999
  • Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results: Results were as follows; 1) Among 2193 cases, male was 1655($75.5\%$), female was 538 cases($24.5\%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43\%$), pathologic findings were as follows; MCNS 646 cases($68.6\%$), FSCS 149 cases($15.8\%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2\%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5\%$ among patients with MCNS, $35.8\%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4\%$, n=1305). 7) 994 cases($73.1\%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1).

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DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법)

  • Chung, Hoon;Jung, Hak;Kino, Koji
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.146-153
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    • 1992
  • In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

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