• Title/Summary/Keyword: Symptomatic review

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Florid cemento-osseous dysplasia: a report of two cases (개화성 백악질-골 이형성증: 증례보고)

  • Kim, Nam-Kyun;Kim, Hyun-Sil;Kim, Jin;Nam, Woong;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.515-519
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    • 2011
  • Cemento-osseous dysplasia occurs in the tooth bearing areas of the jaws and is probably the most common fibro-osseous manifestation. They are usually classified into three main groups according to their extent and radiographic appearance: periapical (surrounds the periapical region of teeth and are bilateral), focal (single lesion) and florid (scleroticsymmetrical masses) cemental-osseous dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to the jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For asymptomatic patients, the best management consists of regular recall examinations with prophylaxis and the reinforcement of good home hygiene care to control periodontal disease and prevent tooth loss. The treatment of symptomatic patients is more difficult. At this stage, there is an inflammatory component caused by the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics might be suggested, but are not always effective. Two cases of florid cemento-osseous dysplasia diagnosed in two Korean females are reported with a review of the relevant literature.

Ovarian Hyperstimulation Syndrome with Minimal Ascites and Severe Hydrothorax Induced by Quintuplet Pregnancy (오태아 임신에 의해 유발된 경미한 복수와 중증 흉수의 난소과자극증후군)

  • Jung, Hee-Jung;Kim, Hoon;Kim, Young-Jin;Ku, Seung-Yup;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Young
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.137-142
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    • 2009
  • Ovarian hyperstimulation syndrome (OHSS) is one of the most common iatrogenic complications induced by assisted reproductive technology. Hydrothorax develops in about 10 percent of patients with severe OHSS and it is usually associated with marked ascites. On the other hand, severe hydrothorax without marked ascites is uncommon, and its pathogenesis remains unclear. We recently experienced a case of severe unilateral hydrothorax with minimal ascites induced by quintuplet pregnancy following intrauterine insemination with controlled ovarian hyperstimulation. Severe hydrothorax was resolved after only conservative and symptomatic management without invasive procedure such as thoracentesis or paracentesis. We report this case with brief review of literature.

MANAGEMENT OF HASĀH WA RAML AL-KULYA (NEPHROLITHIASIS) IN UNANI SYSTEM OF MEDICINE: A REVIEW

  • Khan, Khalid Ali;Khan, Rashid Ali;Zakir, Mohammad
    • CELLMED
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    • v.10 no.3
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    • pp.19.1-19.6
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    • 2020
  • The kidneys are exposed to toxicants and waste product and can be affected easily by these toxicants and by products of the metabolism. The consumption of adequate water is necessary to remove waste and to keep kidney healthy. Deficiency of liquid in the blood leads to various adverse effects on the kidney. The most common adverse deficiency of liquid in blood is deposition of solid matter in the kidney and subsequently formation of kidney stone. Nephrolithiasis (kidney stone) can be treated by drugs if it is small in size but if it blocks the route due to its big size then surgery is the only way to remove it. The recurrence rate of the problem is very high and it may reappear within 10 years. In Unani literature Hasāh wa Raml al-Kulya (nephrolithiasis) is described in detail. As per Unani literature stagnation of Ghalīz mādda (filthy and viscous matter) in the kidney is the main cause of the formation of kidney stone. Various single and compound formulations drugs are described for the management of kidney stone which are very effective as well as safe. Management is divided into two parts i.e. symptomatic treatment to relieve pain and to methods adopted to remove stone from the kidney. Musakkin-i-Waja'(analgesic) drugs are used for pain while Mufattit-i-Hasāh (lithotriptic) and Mudirr-i-Bawl (Diuretic) drugs are used to remove stone. Majoon Aqrab, Qurs Kaknaj and Dawa-e-Gurda etc. are compound drugs mentioned in literature for removal of kidney stone. Single drugs like Alu Balu, Tukhm Khayar, and Kharkhask etc. are also used for same purpose.

Long-term Effectiveness of Enzyme Replacement Therapy in Fabry Disease (파브리병에서 효소대치요법의 장기적 효과)

  • Kim, Ja Hye;Cho, Ja Hyang;Choi, Jin-Ho;Lee, Beom Hee;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.37-41
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    • 2014
  • Fabry disease is an X-linked disease caused by deficiency of the lysosomal enzyme alpha-galactosidase A. Affected males present anhydrosis, acroparesthesia and angiokeratoma, and subsequently cardiac, cerebral and renal complications are followed. Females and atypical variants show heterogeneous clinical symptoms. In 2001, two recombinant enzymes were approved for Fabry disease: agalsidase alpha and agalsidase beta. Since the introduction of enzyme replacement therapy (ERT), the number of long-term follow-up studies has been reported. Long-term ERT showed effectiveness on renal function in patients with chronic kidney disease, decrease or stabilization of left ventricular mass, and improvement of pain and quality of life. However, there were limited effects on cerebrovascular events and their mortality. Current literatures on the clinical effect of ERT have reported limited datain adult patients who have already advanced disease. Therefore, further study for pre-symptomatic patients and atypical variants is needed to verify the impact of ERT. This review summarized recent progresses in ERT and limitations of long-term effect of ERT in patients with Fabry disease.

Six Cases of Brown Tumor with Hyperparathyroidism (고부갑상선호르몬에 의한 갈색종 6예)

  • Park, Sung Ho;Kim, Young Bum;Choi, Joo Yul;Kim, Nam Young;Lee, Guk-Haeng;Lee, Byung Chul;Lee, Myung Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.95-99
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    • 2014
  • Brown tumor is characterized as the classic skeletal manifestation of advanced hyperparathyroidism. It is considered as a benign tumor because of its reparative cellular process. We have experienced 6 patients of brown tumor with hyperparathyroidism, enrolled at Korea Cancer Center Hospital from November 2007 to September 2013. Five of the patients were diagnosed as parathyroid adenoma and treated with parathyroidectomy, and one female patient was diagnosed as parathyroid carcinoma and treated with parathyroidectomy and thyroid lobectomy. These six cases demonstrated that early parathyroidectomy after diagnosis helps to relieve symptomatic pain, normalize calcium level, treat hyperparathyroidism, prevent tumor progression and also prevent osteoporosis in bones. We present these 6 patients with a review of literature.

Evaluation of Non-Watertight Dural Reconstruction with Collagen Matrix Onlay Graft in Posterior Fossa Surgery

  • Kshettry, Varun R.;Lobo, Bjorn;Lim, Joshua;Sade, Burak;Oya, Soichi;Lee, Joung H.
    • Journal of Korean Neurosurgical Society
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    • v.59 no.1
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    • pp.52-57
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    • 2016
  • Objective : Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. Methods : We conducted a retrospective review of operations performed by the senior author from 2004-2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher's exact test was performed to assess risk factor association with specific complications. Results : Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05). Conclusion : When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery.

Management of Andersson Lesion in Ankylosing Spondylitis Using the Posterior-Only Approach: A Case Series of 18 Patients

  • Shaik, Ismail;Bhojraj, Shekhar Yeshwant;Prasad, Gautam;Nagad, Premik Bhupendra;Patel, Priyank Mangaldas;Kashikar, Aaditya Dattatreya;Kumar, Nishant
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1017-1027
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    • 2018
  • Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

Meta-Analysis of Endovascular Treatment for Acute M2 Occlusion

  • Kim, Chul Ho;Kim, Sung-Eun;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.193-200
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    • 2019
  • Objective : Endovascular treatment (EVT) outcomes for acute M2 segment of middle cerebral artery occlusion remains unclear because most results are obtained from patients with large artery occlusion in the anterior circulation. The objective of this study was to assess procedural outcomes for acute M2 occlusion and compare outcomes according to thrombus location (M1 vs. M2). Methods : A systematic review was performed for online literature published from January 2004 to December 2016. Primary outcome was successful recanalization rate and symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used if heterogeneity was less than 50%. Results : Eight articles were included. EVT showed successful recanalization rate of 69.1% (95% confidence interval [CI], 54.9-80.4%) and S-ICH rate of 6.1% (95% CI, 4.5-8.3%). The rates of good clinical outcome at 3 months and mortality were 59.4% (95% CI, 49.9-68.2%) and 14.9% (95% CI, 11.4-19.3%), respectively. According to thrombus location (M1 vs. M2), successful recanalization (odds ratio [OR], 1.539; 95% CI, 0.293-8.092; p=0.610) and S-ICH (OR, 1.313; 95% CI, 0.603-2.861; p=0.493) did not differ significantly. Good clinical outcome was more evident in M2 occlusion after EVT than that in M1 occlusion (OR, 1.639; 95% CI, 1.135-2.368; p=0.008). However, mortality did not differ significantly according to thrombus location (OR, 0.788; 95% CI, 0.486-1.276; p=0.332). Conclusion : EVT seems to be technically feasible for acute M2 occlusion. Direct comparative studies between EVT and medical treatment are needed further to find specific beneficiary group after EVT in patient with M2 occlusion.

Multifactorial Traits of SARS-CoV-2 Cell Entry Related to Diverse Host Proteases and Proteins

  • You, Jaehwan;Seok, Jong Hyeon;Joo, Myungsoo;Bae, Joon-Yong;Kim, Jin Il;Park, Man-Seong;Kim, Kisoon
    • Biomolecules & Therapeutics
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    • v.29 no.3
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    • pp.249-262
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    • 2021
  • The most effective way to control newly emerging infectious disease, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, is to strengthen preventative or therapeutic public health strategies before the infection spreads worldwide. However, global health systems remain at the early stages in anticipating effective therapeutics or vaccines to combat the SARS-CoV-2 pandemic. While maintaining social distance is the most crucial metric to avoid spreading the virus, symptomatic therapy given to patients on the clinical manifestations helps save lives. The molecular properties of SARS-CoV-2 infection have been quickly elucidated, paving the way to therapeutics, vaccine development, and other medical interventions. Despite this progress, the detailed biomolecular mechanism of SARS-CoV-2 infection remains elusive. Given virus invasion of cells is a determining factor for virulence, understanding the viral entry process can be a mainstay in controlling newly emerged viruses. Since viral entry is mediated by selective cellular proteases or proteins associated with receptors, identification and functional analysis of these proteins could provide a way to disrupt virus propagation. This review comprehensively discusses cellular machinery necessary for SARS-CoV-2 infection. Understanding multifactorial traits of the virus entry will provide a substantial guide to facilitate antiviral drug development.

Wide heterogeneity of congenital myasthenic syndromes: analysis of clinical experience in a tertiary center

  • Cho, Anna;Kim, Soo Yeon;Lee, Jin Sook;Lim, Byung Chan;Kim, Hunmin;Hwang, Hee;Chae, Jong-Hee
    • Journal of Genetic Medicine
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    • v.17 no.2
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    • pp.73-78
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    • 2020
  • Purpose: Congenital myasthenic syndrome (CMS) is a clinically and genetically heterogeneous group of disorders characterized by impaired neuromuscular transmission. This study aims to provide the clue for early diagnosis and improved therapeutic strategies in CMS. Materials and Methods: Through the targeted panel sequencing including twenty CMS causative genes, eleven patients were genetically confirmed and enrolled in this study. A retrospective medical record review was carried out for the clinical and laboratory data analysis. Results: The age of patients ranged from 5 to 23 years, with the median age of 16 years. The peak age at onset of symptoms was the neonatal period. Seven out of the eleven patients were symptomatic at birth. The most commonly reported initial finding was generalized hypotonia with poor sucking and crying. Mean time to accurate diagnosis was 9.3±5.0 years. Total fifteen different variants in seven genes associated with CMS (DOK7, AGRN, RAPSN, CHRNE, COLQ, SLC5A7, and GFPT1) were identified. Conclusion: We describe the clinical and genetic characteristics of CMS patients and treatment outcome in a single tertiary center. High clinical suspicion and timely molecular diagnosis is particularly important for the tailored therapy to maximize clinical improvement in CMS.