• Title/Summary/Keyword: bone disorder

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Diagnosis and Management of Chronic Kidney Disease-Mineral Bone Disease in Children

  • Suh, Jin-Soon
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.14-18
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    • 2020
  • Chronic kidney disease-mineral bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism caused by CKD. Patients with early-stage CKD who present with disordered regulation of bone and mineral metabolism may be asymptomatic. However, if untreated, the condition can be a significant barrier in achieving optimal bone strength, linear growth, and cardiovascular health in pediatric patients with CKD. Thus, the current study evaluated the definition, pathogenesis, diagnosis, and management of pediatric CKD-MBD.

Temporomandibular Joint Disorder from Skull Base Osteomyelitis: A Case Report (측두하악관절 장애를 보인 두개저 골수염: 증례보고)

  • Ryu, Byoung-Gil;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.484-487
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    • 2012
  • Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.

Flapless implant surgery on atrophied alveolar ridge in a patient with growth disorder (성장 장애를 가진 부분 무치악 환자에서 위축된 골에 무피판 임플란트 수술 증례)

  • Lee, Du-Hyeong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.170-175
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    • 2014
  • The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.

Chronic non-bacterial osteomyelitis in the jaw

  • Kim, Soung Min;Lee, Suk Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.68-75
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    • 2019
  • Chronic recurrent multifocal osteomyelitis (CRMO) is one of the most severe form of chronic non-bacterial osteomyelitis (CNO), which could result in bone and related tissue damage. This autoinflammatory bone disorder (ABD) is very difficult for its clinical diagnosis because of no diagnostic criteria or biomarkers. CRMO in the jaw must be suspected in the differential diagnosis of chronic and recurrent bone pain in the jaw, and a bone biopsy should be considered in chronic and relapsing bone pain with swelling that is unresponsive to treatment. The early diagnosis of CRMO in the jaw will prevent unnecessary and prolonged antibiotic usage or unnecessary surgical intervention. The updated researches for the identification of genetic and molecular alterations in CNO/CRMO should be studied more for its correct pathophysiological causes and proper treatment guidelines. Although our trial consisted of reporting items from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), there are very few articles of randomized controlled trials. This article was summarized based on the author's diverse clinical experiences. This paper reviews the clinical presentation of CNO/CRMO with its own pathogenesis, epidemiology, recent research studies, and general medications. Treatment and monitoring of the jaw are essential for the clear diagnosis and management of CNO/CRMO patients in the field of dentistry and maxillofacial surgery.

Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

  • Ku, Jeong-Kui;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Korean Dental Science
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    • v.8 no.1
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    • pp.1-9
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    • 2015
  • Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

Osteopetrosis Tards (만발형골화석증)

  • Kim Young-Hee;Yi Jae-Seo;Yoon Suk-Ja;Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.507-521
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    • 1999
  • Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31.41.36.46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.

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A Case of Facial Palsy and Hearing Disturbance Caused by Traumatic Disorder (외상성으로 인한 안면마비 및 청력장애를 호소하는 환자 1례)

  • Shin, Dong-Gil;Kim, Deog-Gon;Kim, Ki-Hoon
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.2
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    • pp.137-148
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    • 2003
  • Objective : Oriental medical treatment may be possible or effective in patients with facial palsy and hearing disturbance caused by traumatic disorder Methods : The authors observed objectively improvement state of patient that treated by acupuncture, herbal medicine Results : 1. A Facial nerve travel long and narrow bone canal in temporal bone. so slow progressive palsy is caused by nerve swelling and impedimental blood circulation in bone canal, if bruise happens. 2. A patient with traumatic facial palsy, acupuncture, herbal medicine(Igigeopung-tang, Boicyangwitang etc.), electro acupuncture are effective to improving symptoms. 3. Despite acupuncture treatment is taken, hearing disturbance is not improved. 4. In general, everyone consider surgical operation first of all, in the case of having traumatic facial palsy. Though this case, the author are thought that can attempt access of Oriental medical treatment without doing surgical operation.

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Acute Lymphoblastic Leukemia with Bone Marrow Infiltration and Hypoplastic Anemia in a German Shepherd (German Shepherd에서 골수침윤과 재생불량성빈혈을 동반한 급성림프모구성백혈병 1증례)

  • 이창우;신남식;최윤주;정동희;권오경;임채형
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.247-251
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    • 2000
  • A male German Shepherd dog, $2{\frac{1}{2}}$years of age, was admitted with sudden anemia, weakness, hyperpyrexia, anorexia and lethargy. The patient showed hypoplastic anemia, thrombocytopenia, absolute and relative lymphocytosis, absolute and relative granulocytopenia, hypoalbuminemia, slight hepatic disorder, slight azotemia, hematuria and proteinuria by the screening examination. The bone marrow aspiration smear showed high cellularity, severs infiltration of lymphoblasts and prolymphocytes, and mitotic figures of lymphoid cells. The liver aspiration smear demonstrated infiltration of lymphoblasts. Acute lymphoblastic leukemia was diagnosed as none of the superficial lymph nodes showed enlargement and marked functional disorder of important organs other than the liver was not found. The patient was treated with vincristine, cyclophophamide, predniosolone for chemotherapy and blood transfusion and either ampicillin or cefoperazone for supportive treatment. But the patient did not show marked remission and died 9 days after the start of the chemptherapy. The necropsy was not permitted.

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Management of Chronic Kidney Disease-Mineral Bone Disorder with Sevelamer Hcl Phosphate Binder in Korean Patients with Dialysis (Sevelamer 인결합제와 투석환자의 Chronic Kidney Disease-Mineral Bone Disorder 관리)

  • Shin, Seung Woo;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.2
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    • pp.97-106
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    • 2016
  • Background: Sevelamer is associated with reduced complications of chronic kidney disease-mineral bone disorder (CKD-MBD) resulted from hyperphosphatemia, which may contribute mortality, in CKD patients with dialysis. So far clinical outcomes of sevelamer on mortality and risk of cardiovascular mortality related to CKD-MBD are debating. Purpose of this study was to evaluate the effectiveness of sevelamer HCl on mortality of secondary hyperparathyroidism (SHPT), risk of cardiovascular mortality and, frequency of osteopathy in end stage renal disease (ESRD) patients with dialysis. Methods: We retrospectively reviewed the electronic medical records of 536 patients with ESRD, who were admitted for moderate to severe SHPT, for 36 months. 75 patients who met inclusion criteria were evaluated for the efficacy of sevelamer (mean serum iPTH = 487.5 pg/mL). Results: Sevelamer intervention was not associated with increased three-year survival time compared with non-sevelamers group [average survival month: 30.4 months in sevelamer group, 26.8 months in non-sevelamer group, p = 0.463]. Sevelamer intervention was not associated with significant mortality benefit and cardiovascular mortality benefit as compared to non-sevelamer group [sevelamer group: non-sevelamer group, all-cause mortality (iPTH > 600 pg/mL): 14.3% (1/34): 20% (1/41) p = 0.962, OR = 0.935, 95% CI, 0.058-14.98, heart disease mortality: 6.67% (2/30): 0% (0/32) p = 0.138]. Sevelamer was not associated with significantly lower cumulative incidence of osteopathy compared to non-sevelamer group (sevelamer group: non-sevelamer group, 5.9% (2/34):9.8% (4/41); p = 0.538; OR = 0.578; 95% CI, 0.099-3.367). Conclusion: Sevelamer was not associated with decreased all-cause mortality and risk of cardiovascular mortality compared to non-sevelamer group in ESRD patients with SHPT.

MULTIPLE EXTRACTION ON PATIENTS WITH DISORDER OF HEMATOPOIESIS (조혈모세포 질환 환자에서의 다발치)

  • Yoon, Hyun-Joong;Kim, Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.87-91
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    • 2001
  • On patients with disorder of hematopoiesis such as leukemia, aplastic anemia, MDS(Myelodisplastic Syndromes), removal of infectious foci prior to the BMT(Bone Marrow Transplantation) is a necessity and what is more, there is no sufficient time to control the infections because the chemotherapy for BMT should be started as soon as possible. And the transfusion should be minimized to prevent the alloimmunization. In those reasons, oral & maxillofacial surgeons are often in need of multiple extractions, and should take into consideration the possibility of complications after multiples extractions such as infection, severe bleeding because those situations can be fatal on patients with disorder of hematopoiesis. We present our experience in multiple extractions on 30 patients with disorder of hematopoiesis referred from Catholic Hematopoiesis Stem Cell transplantation Center at St. Mary's Hospital, The Catholic University of Korea.

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