• Title/Summary/Keyword: Multiple fistula

Search Result 76, Processing Time 0.024 seconds

CENTRAL MUCOEPIDERMOID CARCINOMA ARISING IN MANDIBLE WITH MULTIPLE METASTASES (다수의 전이병소를 수반한 하악골의 중심성 점액표피양암종)

  • Soh Byung-Chun;Lee Young-Ho;Choi Soon-Chul;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
    • /
    • v.27 no.1
    • /
    • pp.263-271
    • /
    • 1997
  • The authors diagnosed a 54-year-old male as central mucoepidennoid carcinoma after undergoing clinical, radiological and histopathological examinations. The characteristics were as followed : 1. Clinically, the patient complained of the painless unilateral swelling of the left mandibular molar region and had a pus discharge through the fistula. Painful nodule was palpated on the scalp of the left frontal area and it was regarded as a metastatic lesion. 2. Plain radiographs showed the ill-defined permeative radiolucent lesion. The osteolytic lesions were also detected in the cranial bone, number 9 and 11 ribs, scapula, and vertebral bodies. 3. The mandibular CT and PNS MRI showed the swelling of the left mandible and the enlargement of the several lymph nodes of 1.5 cm in size. 4. Histopathologically, many solid epidermoid type cells were mixed with mucus-secreting cells and they were arranged in duct-like structure. Most of them were epidermoid type, which indicates a high grade tumor. Mucins could be found in mucicamrine staining.

  • PDF

The Effect of Thalidomide on Entero-Behcet's Disease (장관 베체트병 환자에서 Thalidomide의 치료 효과)

  • Kim, Jung Hak;Nam, Voki;Moon, Ho Sik;Kim, Jin Ook;Sung, Choon Ho
    • The Korean Journal of Pain
    • /
    • v.22 no.1
    • /
    • pp.104-106
    • /
    • 2009
  • Behcet's disease is a chronic relapsing vasculitis characterized by recurrent aphthous oral and genital ulcers with uveitis. Multiple organs can be involved. Entero-Behcet's disease is often uncontrollable, relapsing, and can cause acute intestinal bleeding, fistula formation, or perforation. Corticosteroids, immunosuppressors, and colchicines are used to treat Entero-Behcet's disease with varying degree of success. Thalidomide may also be feasible. We present a 29-year-old male Entero-Behcet's patient suffering from abdominal pain, diarrhea, and back pain. He did not respond to prior treatments, but responded to thalidomide.

Clinical Experience of Foreign Body Granuloma in the Apex of Orbit (안와첨부 이물 육아종의 치험례)

  • Paik, Hye Won;Choi, Jong Woo;Chong, Hyun Kwon;Lee, Paik Kwon;Ahn, Sang Tae
    • Archives of Plastic Surgery
    • /
    • v.32 no.1
    • /
    • pp.131-134
    • /
    • 2005
  • It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

Actinomycosis and Sialolithiasis in Submandibular Gland

  • Kang, Jin Seok;Choi, Hwan Jun;Tak, Min Sung
    • Archives of Craniofacial Surgery
    • /
    • v.16 no.1
    • /
    • pp.39-42
    • /
    • 2015
  • Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.

Waardenburg Syndrome Type IV De Novo SOX10 Variant Causing Chronic Intestinal Pseudo-Obstruction

  • Hogan, Anthony R.;Rao, Krishnamurti A.;Thorson, Willa L.;Neville, Holly L.;Sola, Juan E.;Perez, Eduardo A.
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.22 no.5
    • /
    • pp.487-492
    • /
    • 2019
  • Waardenburg syndrome (WS) type IV is characterized by pigmentary abnormalities, deafness and Hirschsprung's disease. This syndrome can be triggered by dysregulation of the SOX10 gene, which belongs to the SOX (SRY-related high-mobility group-box) family of genes. We discuss the first known case of a SOX10 frameshift mutation variant defined as c.895delC causing WS type IV without Hirschsprung's disease. This female patient of unrelated Kuwaiti parents, who tested negative for cystic fibrosis and Hirschsprung's disease, was born with meconium ileus and malrotation and had multiple surgical complications likely due to chronic intestinal pseudo-obstruction. These complications included small intestinal necrosis requiring resection, development of a spontaneous fistula between the duodenum and jejunum after being left in discontinuity, and short gut syndrome. This case and previously reported cases demonstrate that SOX10 gene sequencing is a consideration in WS patients without aganglionosis but with intestinal dysfunction.

Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects

  • Kavea Panneerselvam;Jake S. Jacob;Ronald E. Samuel;Andy Tau;Gyanprakash A. Ketwaroo;Wasif M. Abidi;Robert J. Sealock
    • Clinical Endoscopy
    • /
    • v.56 no.6
    • /
    • pp.754-760
    • /
    • 2023
  • Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas. Methods: This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.

VITAMIN D-RESISTANT RICKETS : A CASE REPORT (비타민 D 저항성 구루병 환아의 치험례)

  • Kim, So-Jung;Park, Jae-Hong;Kim, Kwang-Chul;Choi, Sung-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.6 no.1
    • /
    • pp.10-14
    • /
    • 2010
  • Vitamin D-resistant rickets(VDRR) is hereditary disease manifesting marked hypophosphatemia caused by renal tubular loss of phosphate into urine and an associated decrease in the calcium and phosphorous ion product. VDRR is identified by clinical symptoms, such as in the limbs, gait disturbance, dwarfism, familial occurrence, bowlegs, and knock-knees, as well as by laboratory findings. Dental findings are enlarged chambers and extension of the pulp horns into the cusp tips in both the primary and the permanent dentition in contrast to the vitamin D-deficient rickets. The major oral manifestations are multiple spontaneous abscesses in a caries-free dentition. We reported the clinical features and treatment of a 6-year-old boy with vitamin D-resistant rickets referred to the department of pediatric dentistry in Kyung Hee University for multiple spontaneous periapical abscesses and gingival fistula without severe dental caries.

  • PDF

TREATMENT OF BASAL CELL NEVUS SYNDROME WITH ENUCLEATION FOLLOWING MARSUPIALIZATION : A CASE REPORT (다발성 악골의 치성 각화낭을 동반한조대술 후 적출술을 이용한 기저세포모반증후군의 치험례)

  • Park, Chul-Min;Kim, Hak-Kyun;Kim, Su-Gwan;Lee, Kye-Joon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.34 no.4
    • /
    • pp.485-489
    • /
    • 2008
  • Basal cell nevus syndrome is a hereditary disease of an autosomal dominant trait with variable conditions such as basal cell carcinomas of the skin, deformity of rib, fusion of vertebrae, mental retardation, hypertelorism, and multiple odontogenic keratocysts. A 32 years old man with pus discharge from fistula on the vestibule of left upper 1st molar visited to Chosun University Dental Hospital. Radiographic evaluation revealed multiple maxillary and mandibular cysts that had multilocular radiolucency on left mandibular body area, thining of inferior border of left border of ramus and well defined unilocular radiolucency above right upper 1st and 2nd molar and from left upper 1st premolar to 2nd molar. In chest PA view, he had a forked rib in the left 4th rib and in skull PA view the calcification of falx cerebri was observed. There was not any skin lesion. After the preliminary evaluation, the patient was diagnosed with basal cell nevus syndrome and he underwent marsupialization for decreasing the size of cystic lesion and came to hospital for dressing 3days a week. As time goes by, the size of lesion decreased. So, one and half year after marsupialization, he underwent cyst enucleation and iliac bone graft for the mandibular lesion and buccal fat pad grafts for the maxillary lesions. After the surgery, the patient experienced normal healing without any complications and he is on long-term follow-up.

Immunohistochemical Array Analysis of Cemento-Ossifying Fibroma Exhibiting aneurysmal Cystic Changes (백악-골화섬유종에서 보이는 동맥류성 낭종변화의 면역조직화학염색 배열분석)

  • Lee, Sang Shin;Kim, Yeon Sook;Lee, Suk Keun
    • The Korean Journal of Oral and Maxillofacial Pathology
    • /
    • v.42 no.6
    • /
    • pp.189-198
    • /
    • 2018
  • A 31 years old female had been suffered from a bony swelling in right premolar region of the mandible for 12 years, recently grown rapidly. A fistula tract developed on the right anterior mandibular border, but the lesion was relatively asymptomatic. In the radiological examination, the tumor mass was irregularly mixed with radiolucent and radiopaque areas, forming multiple cystic spaces. Under the diagnosis of calcifying odontogenic cyst, the mandibular mass was resected and examined pathologically. After decalcification, the dissected tumor mass showed multiple small cystic spaces and calcifying fibrous tissue, mimicking calcifying odontogenic cyst or ameloblastoma. Histological observation showed many calcifying cementoid materials and ossifying trabeculae. The cystic spaces were turned out to be dilated vascular channels lined by endothelial cells, containing plasma fluid. However, the main lesion was diagnosed as cemento-ossifying fibroma (COF), and the atypical vascular channels were greatly dilated and gradually expanded the whole tumor mass. The present COF was examined through immunohistochemical (IHC) array, and investigated for tumor cell characteristics, exhibiting abnormal ossification and aneurysmal cystic changes. IHC array disclosed that the tumor cells grew progressively in the lack of apoptosis, and that they showed lower expression of RUNX2 than BMP-2, RANKL, and OPG, and increases of protein expression in $HIF-1{\alpha}$, VEGF-A, and CMG2. These data suggested that the reduced expression of RUNX2, osteoblast differentiation factor, be relevant to abnormal ossification of COF, and that the consistent expressions of angiogenesis factors be relevant to de novo angiogenesis in COF, subsequently resulted in aneurysmal cystic changes.

Early and Long-term Outcomes of Pneumonectomy for Treating Sequelae of Pulmonary Tuberculosis

  • Byun, Chun-Sung;Chung, Kyung-Young;Narm, Kyoung-Sik;Lee, Jin-Gu;Hong, Dae-Jin;Lee, Chang-Young
    • Journal of Chest Surgery
    • /
    • v.45 no.2
    • /
    • pp.110-115
    • /
    • 2012
  • Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.