• Title/Summary/Keyword: Ulceration

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A Case of Cement Hardening Agent Intoxication with Acute Kidney Injury (시멘트 경화제 중독으로 인한 급성 신손상 1례)

  • Seo, Young Woo;Jang, Tae Chang;Kim, Gyun Moo;Ko, Seung Hyun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.157-160
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    • 2018
  • Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

The Relationship Between Symptoms of Oral Mucosal Diseases and Psychological Status

  • Park, Hye Sook
    • Journal of Oral Medicine and Pain
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    • v.46 no.1
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    • pp.1-8
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    • 2021
  • Purpose: The purpose of this study was to assess the relationship between psychological factors and symptoms of oral mucosal diseases by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Methods: Three hundred and eighteen college students in Gyeonggi-do completed the MMPI-2 and a questionnaire related to symptoms of oral mucosal diseases and collected data were analyzed by Student's t-test and one way ANOVA. Results: Subjects who have experienced herpetic stomatitis revealed significantly higher mean values of T-scores than subjects who have not on hypochondriasis (Hs) and hysteria (Hy) clinical scales of the MMPI-2 (p<0.05). In comparison with subjects who have had recurrent aphthous ulceration, subjects who have not had it manifested significantly higher elevations on the schizophrenia (Sc) clinical scale (p<0.05). Subjects who have suffered oral lichen planus (OLP) showed significantly higher mean values of T-scores than subjects who have not on paranoia (Pa) (p<0.05) and hypomania (Ma) (p<0.01) clinical scales. Mean values of T-scores on Ma clinical scale were significantly higher in subjects having experienced glossodynia than in subjects having not experienced (p<0.05). Subjects having felt taste disturbance exhibited significantly higher elevations on Hs (p<0.0001) and Hy (p<0.01) clinical scales compared to subjects having not. Conclusions: Symptoms of oral mucosal diseases such as herpetic stomatitis, taste disturbance, OLP, and glossodynia were found to be related to Hs, Hy, Pa, Ma clinical scales of the MMPI-2. Therefore, comprehensive psychological evaluations of those oral mucosal diseases may be beneficial in a therapeutic approach.

Analysis of Treatment Response in Patients with Oral Lichen Planus

  • Ju, Hye-Min;Kim, Kyung-Hee;Jeon, Hye-Mi;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.41-48
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    • 2021
  • Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

Evaluation of 20(S)-ginsenoside Rg3 loaded hydrogel for the treatment of perianal ulcer in a rat model

  • Jin, Longhai;Liu, Jinping;Wang, Shu;Zhao, Linxian;Li, Jiannan
    • Journal of Ginseng Research
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    • v.46 no.6
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    • pp.771-779
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    • 2022
  • Background: As a kind of common complication of the surgery of perianal diseases, perianal ulcer is known as a nuisance. This study aims to develop a kind of 20(S)-ginsenoside Rg3 (Rg3)-loaded hydrogel to treat perianal ulcers in a rat model. Methods: The copolymers PLGA1600-PEG1000-PLGA1600 were synthesized by ring-opening polymerization process and Rg3-loaded hydrogel was then developed. The perianal ulcer rat model was established to analyze the treatment efficacy of Rg3-loaded hydrogel for ulceration healing for 15 days. The animals were divided into control group, hydrogel group, free Rg3 group, Rg3-loaded hydrogel group, and Lidocaine Gel® group. The residual wound area rate was calculated and the blood concentrations of interleukin-1 (IL-1), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) were recorded. Hematoxylin and eosin (H&E) staining, Masson's Trichrome (MT) staining, and tumor necrosis factor α (TNF-α), Ki-67, CD31, ERK1/2, and NF-κB immunohistochemical staining were performed. Results: The biodegradable and biocompatible hydrogel carries a homogenous interactive porous structure with 10 ㎛ pore size and five weeks in vivo degradation time. The loaded Rg3 can be released sustainably. The in vitro cytotoxicity study showed that the hydrogel had no effect on survival rate of murine skin fibroblasts L929. The Rg3-loaded hydrogel can facilitate perianal ulcer healing by inhibiting local and systematic inflammatory responses, swelling the proliferation of nuclear cells, collagen deposition, and vascularization, and activating ERK signal pathway. Conclusion: The Rg3-loaded hydrogel shows the best treatment efficacy of perianal ulcer and may be a candidate for perianal ulcer treatment.

Dystrophic Extra-Articular Soft Tissue Calcification after Burn Injury: A Case Study and Literature Review (화상 후 발생한 관절외 연조직의 이영양성 석회침착: 문헌조사 및 증례보고)

  • Yun, In-Sik;Lee, Sang-Soo;Jeon, Yeo-Reum;Chung, Seum;Song, Joon-Ho
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.38-42
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    • 2021
  • Soft tissue calcifications after burn injuries are commonly found in the periarticular region. They can easily be found because they cause severe pain and distress to the patient. However, a long period is required to identify extra-articular soft tissue calcification after burn injuries because they have no specific symptoms. Herein, we present the case of a patient with dystrophic extra-articular soft tissue calcification after a burn injury. A 70-year-old woman developed a non-healing ulcer in the right lower leg area two months before presentation to the hospital. She had third-degree flame burns on the anteromedial tibial area of the right leg approximately 40 years prior, and there had been no particular problem. Examination revealed chronic ulcers, and a review of radiograph findings revealed irregular calcification. The wound was treated with wide excision with a skin graft, and it healed without complications. During follow-up one month later, no recurrence of the calcification or ulceration of the lesion was found.

Vagus Nerve Stimulation Through Electro-acupuncture for Inflammatory Bowel Disease (염증성 장 질환에서 전침을 중심으로 한 미주신경자극에 대한 고찰)

  • Minjeong Kim;Dongwon Kim;Chaehyun Park;Jae-Woo Park;Seok-Jae Ko
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.455-465
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    • 2023
  • Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

Impact of peripheral blood mononuclear cells preconditioned by activated platelet supernatant in managing gastric mucosal damage induced by zinc oxide nanoparticles in rats

  • Darwish Badran;Ayman El-Baz El-Agroudy;Amira Adly Kassab;Khaled Saad El-Bayoumi;Zienab Helmy Eldken;Noha Ramadan Mohammed Elswaidy
    • Anatomy and Cell Biology
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    • v.57 no.1
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    • pp.105-118
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    • 2024
  • The world has witnessed tremendous advancements in nano-base applications. Zinc oxide nanoparticles (ZON) are widely used in food industry and medicine. Although their application is of important value, they may cause toxicity to body tissues. Peripheral blood mononuclear cells (PBMCs) proved its efficacy in tissue regeneration especially when it is preconditioned by activated platelet supernatant (APS). The aim of this study is to evaluate the effect of ZON on the gastric mucosa and the therapeutic role of the PBMCs preconditioned by APS in rats. Ten rats were donors and fifty rats were recipients. The recipients were divided into; control group, ZON group (10 mg/kg/day orally for five days) and preconditioned PBMCs group (1×107 once intravenously 24 hours after ZON). Gastric specimens were processed for histological, immunohistochemical, biochemical and quantitative real-time polymerase chain reaction studies. ZON group showed marked structural changes in the gastric mucosa. There was desquamation or deep ulceration of the epithelium. Cytoplasmic vacuoles and pyknotic nuclei were in glandular cells. Reduced proliferating cell nuclear antigen and increased tumor necrosis factor-α were in epithelial cells. There were significant elevation in malondialdahyde and reduction in glutathione, superoxide dismutase, and catalase. Enhancement in mRNA expression of nuclear factor kappa-B and cyclooxygenase-2 was detected. The preconditioned PBMCs group showed significant improvement of all parameters. So, ZON had cytotoxic effects on the gastric mucosa and the preconditioned PBMCs had a therapeutic effect on gastric mucosal damage after ZON.

The Effects of Dimethyl Sulfoxide and Sodium Thiosulfate for the Prevention of Tissue Necrosis due to Extravasaion of Mitomycin-C (혈관외로 유출된 Mitomycin-C에 의한 조직괴사 예방을 위한 Dimethyl Sulfoxide와 Sodium Thiosulfate의 효과)

  • Woo, Sang-Hyun;Choi, Byung-Cheol;Kim, Ki-Hyung;Seul, Jung-Hyun;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.243-250
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    • 1996
  • Extravasation of toxic chemotherapeutic agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and II were 20 mice treated dimethyl sulfoxide and sodium thiosulfate, respectively. Depending on the starting time of treatment, group I and II were subdivided into 1, 2, 3 and 4 as immediate, 6 hours, 12 hours and 24 hours after mitomycin-c injection. Histologic studies of the necrotic area and survival area after treatment were performed using hematoxylin-eosin staining. The mean necrotic area of group I was significantly decreased depending on the starting time of treatment compared with control group(p<0.01). The results means there was no necrosis area which was treated with topical sodium thiosulfate within 6 hours, and it showed also significant decrease of necrosis area within 24 hours. There was also no necrosis area in group II-1 and significant decrease of necrosis area II-2 and III-3. But, effctiveness of intradermal injection of sodium thiosulfate was not found in group II-4 which was started after 24 hours. Hisotolgic findings showed a bland coagulative necrosis without inflammatory changes and no granulation tissue. The significant difference that cytoplasmic loss of subcutaneous fat and decrease number of hair follicles between two groups resulted from the methods of treatment by topical application and intradermal injection. In conclusion, immediate treatments with topical dimethyl sulfoxide or intradermal injection of sodium thiosulfate signifcantly prevents necrosis by extravasation of mitomycin-c.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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Laser Acupuncture Treatment on the Five Transport Points of the Spleen Meridian in Dextran-Sulfate-Sodium-Induced-Colitis in Rats (비경의 오수혈에 대한 830 nm 레이저침이 DSS로 유발된 흰쥐의 대장염에 미치는 영향)

  • Choi, Dong-Hee;Kim, Wang-In;Kim, Mi-Rea;Youn, Dae-Hwan;Na, Chang-Su
    • Korean Journal of Acupuncture
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    • v.31 no.2
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    • pp.56-65
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    • 2014
  • Objectives : The purpose of this study is to compare the effects of laser acupuncture to the 830 nm on the five transport points with the spleen meridian for treatment to intestinal disease in rat with dextran sulfate sodium(DSS)-induced colitis. Methods : Colitis was induced by DSS for 20 days. The laser therapy on the five transport points of spleen meridian (Laser Well Point-SP1(L-WE), Laser Brook Point-SP2(L-BR), Laser Stream Point-SP3(L-ST), Laser River Point-SP5(L-RI) and Laser Sea Point-SP9(L-SE) was practiced twice a week for 5 times. Colon length was measured using a measuring point. Histological evaluation of colitis was conducted by hematoxylin and eosin(H&E) staining. Reverse transcription polymerase chain reaction(RT-PCR) was determined using western blotting and quantitative reverse-transcriptase polymerase chain reaction, respectively. Results: Colon length increased significantly L-BR and L-ST points after 5 times of therapy. Damage to the colonic mucosa is an integral feature of the DSS model, so control colonic mucosa tissue was damaged in the areas of ulceration resulting in complete epithelial loss. However histological damage decreased on the epithelial lining at all points. Cyclooxygenase(COX)-2 concentrations decreased in all points groups and Interferon(IFN)-${\gamma}$ increased in L-WE, L-BR, L-RI and L-SE points but L-ST was decreased when compared with control. White blood cell(WBC) and neutrophils(NE) decreased after the fifth acupuncture on the all points. But hemoglobin(HGB) increased after the fifth acupuncture on the L-WE, L-BR, L-ST and L-RI points. Also Mean corpuscular hemoglobin(MCH) and Mean corpuscular hemoglobin concentration(MCHC) decreased after the fifth acupuncture on the all points. Conclusions: The present study indicated that five transport points of the spleen meridian can prevent the development of DSS-induced colitis in rat. Thereby suggesting that should be available for decreasing DSS-induced inflammation in a colonic mucosa of tissue.