Balamuthia mandrillaris amebic encephalitis (BAE) can cause a fatal condition if diagnosis is delayed or effective treatment is lacking. Patients with BAE have been previously reported in 12 provinces of China, with skin lesions being the primary symptom and encephalitis developing after several years. However, a significantly lower number of cases has been reported in Southwest China. Here we report an aggressive BAE case of a 64-year-old woman farmer with a history of skin lesions on her left hand. She was admitted to our hospital due to symptoms of dizziness, headache, cough, vomiting, and gait instability. She was initially diagnosed with syphilitic meningoencephalitis and received a variety of empirical treatment that failed to improve her symptoms. Finally, she was diagnosed with BAE combined with amebic pneumonia using next-generation sequencing (NGS), qRT-PCR, sequence analysis, and imaging studies. She died approximately 3 weeks after the onset. This case highlights that the rapid development of encephalitis can be a prominent clinical manifestation of Balamuthia mandrillaris infection.
Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.45
no.1
/
pp.34-42
/
2019
Objectives: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.
Lee, Doh Young;Jin, Young Ju;Choi, Hyo Geun;Kim, Heejin;Kim, Kwang Hyun;Jung, Young Ho
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.25
no.1
/
pp.31-35
/
2014
Objectives : The aim of this study was to evaluate the effectiveness and feasibility of coblation resection for the treatment of laryngotracheal disease. Methods : We conducted a retrospective review, evaluating 7 patients with laryngotracheal disease treated using coblator. Information collected included demographic data of the patients, diagnosis, size and location of the disease, procedure time, the number of previous operation, and the postoperative complication. Results : Among the etiology, granulation is most frequent (n=4), followed by recurrent repiratory papillomatosis (n=2) and tracheal stenosis (n=1). The location of lesions was peristomal area (n=2), glottis (n=2), subglottis (n=2) and mid-trachea. Coblation resection could remove the lesions completely and there was no significant complication including local burn, bleeding, and hypertrophic scar. The procedure time was shorter than the previous operation using $CO_2$ laser. Conclusion : Coblation resection is an effective and safe method for layngotracheal disease and can substitute the classic method such as $CO_2$ laser.
Khan, S.A.;Mustafa, G.;Chaudhry, R.A.;Iqbal, M.;Khan, M.I.
Asian-Australasian Journal of Animal Sciences
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v.8
no.1
/
pp.1-6
/
1995
This study represented an endeavor to observe clinical signs and pathological lesions in broiler chicks suffering from experimental Infectious stunting syndrome(ISS). One hundred and twenty day old broiler chicks were divide randomly into two equal groups i.e. control (A) and inoculated (B). At day one of age each chick of the groups (A and B) was dosed with one ml of either tryptose phosphate broth or prepared inoculum respectively. Chicks of both the groups were housed separately under similar standard management. Inoculation induced characteristic clinical changes in birds of treatment group like of brownish diarrhea, lameness, feather developing problems and paleness of combs, wattles and shanks. By day-29 of the experiment all the stunted birds from group-B and an equal number of birds from group-A were slaughtered. These birds were examined thoroughly to record the gross changes in various structures and then the severely affected organs were processed for histopathological examination. The skeletons of affected birds were brittle, keel bones showed quite prominence while the muscles and subcutaneous tissues were almost devoid of fat. Grossly it was observed that pancreas, spleen and bursa of Fabricius were severely atrophied while the intestines were ballooned with undigested feed and gases. Histopathological examination of pancreas and spleen revealed a classical picture necessary for understanding the pathogenesis of the syndrome. The acivar cells of pancreas were atrophied and underwent vacuolation, degeneration and vecrosis. The zymogen granules were almost absent from the acinar cells. A characteristic change was an inflammatory reaction in one or more pancreatic ducts where the epithelium and fibrous tissues occluded the lumen of the ducts and led to the obstruction in pancreatic drainage.
Purpose: The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. Materials and Methods: The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. Results: A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. Conclusion: The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health.
Background: Biological control of plant pathogens using benign or beneficial microorganisms as antagonistic agents is currently considered to be an important component of integrated pest management in agricultural crops. In this study, we evaluated the potential of Bacillus subtilis strain HK-CSM-1 as a biological control agent against Colletotrichum panacicola. Methods: The potential of B. subtilis HK-CSM-1 as a biological control agent for ginseng anthracnose was assessed. C. panacicola was inoculated to ginseng plants and the incidence and severity of disease was assessed to examine the efficacy of the bacterium as a biological control against C. panacicola. Results: Inoculation of Panax ginseng plants with B. subtilis significantly suppressed the number of disease lesions of C. panacicola and was as effective as the chemical fungicide iminoctadine tris(albesilate). The antifungal activity of B. subtilis against C. panacicola was observed on a co-culture medium. Interestingly, treatment with B. subtilis did not significantly affect the diameter of the lesions, suggesting that the mechanism of protection was through the reduction in the incidence of infection related to the initial events of the infection cycle, including penetration and infection via spore germination and appressorium formation rather than by the inhibition of invasive growth after infection. Conclusion: Our results suggest that B. subtilis HK-CSM-1 can be used as an effective and ecologically friendly biological control agent for anthracnose in P. ginseng.
Objective : Primary central nervous system lymphoma[PCNSL] is a non-Hodgkin's lymphoma arising in the central nervous system. Combined chemotherapy and radiation therapy is the standard treatment for PCNSL. However, treatment induced neurotoxicity is a major problem especially in elderly patients. Methods : From May 2001 to April 2004, elderly five patients with PCNSL confirmed via pathological examination were underwent Novalis radiosurgery in authors' institution, who were investigated retrospectively. Of these patients, 2 were male and 3 were female, with a mean age 68 years old [range $65{\sim}73$]. The number of lesions was 1 in 2 patients, 2 in 2, and 3 in 1. The mean follow up period was 12.6 months [range $8{\sim}16$]. Results : Clinical symptoms and signs in all patients markedly improved within 1 weeks after Novalis radiosurgery. The Karnofsky performance status score was also improved from a pre-radiosurgery average of 68 to a post-radiosurgery one of 82. All of treated lesions showed a partial or complete regression of the original mass. There have been no complication following Novalis radiosurgery. Conclusion : The preliminary results of our experience indicate that radiosurgery with Novalis provides a safe and effective therapeutic alternative treatment of PCNSL in elderly patients.
Mutee, Murshed;Saleh, Al-Quraishy;Mohammed M, Mares;Osama B., Mohammed;Hossam M.A., Aljawdah
Journal of Animal Science and Technology
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v.64
no.6
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pp.1215-1225
/
2022
The epidemiology of parasite infection in local and imported breeds is quite an essential topic in the meat industry and human health. This study aims to determine the prevalence of Dicrocoelium dendriticum in local sheep breeds (Naemi, Najdi, and Harri) and imported breeds from Romania (Romani breed) and the epidemiology of the infection in Saudi Arabia. Morphological description, the relationship between dicrocoeliasis and sex, age, and histological changes were also presented. A total of 6845 slaughtered sheep at Riyadh Automated slaughterhouse were investigated and followed up for 4 months between 2020-2021. It included 4,680 local breeds and 2,165 imported Romanian breeds. Fecal samples and livers and gallbladders from slaughtered animals were examined for apparent pathological lesions. The results indicated that the infection rate in slaughtered animals was 10.6% in imported Romani sheep and 0.9% in the local Naeimi breed. After identifying the parasite morphologically, negative results were obtained from examining feces, gallbladders, and livers of Najdi and Harry sheep breeds. The mean number of eggs per 20 µL/gallbladder was low (72.78 ± 17.8: 76.11 ± 5.07), medium (334.59 ± 90.6: 292.91 ± 26.63), and high (1113.2 ± 22.3: 1004 ± 143.4) in imported and Naeime sheep, respectively. Significant differences were found between gender and age (males and females were 3.67% and 6.31%; > 2 years 4.39%, 1-2 years 4.22%, and 1 year 3.53%) respectively. Histopathological lesions in the liver were more pronounced. Our survey confirmed the presence of D. dendriticum in imported Romani and local Naeimi sheep, and the potential role of imported sheep in the epidemiology of dicrocoeliasis in Saudi Arabia.
Objective : To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas. Methods : We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment[FSRT] using Novalis system. The mean age of patients was 28 years [range $16{\sim}52$]. The median irradiation dose per fraction was 17Gy [range $1.7{\sim}2.0$]. The median fraction number was 23 [range $15{\sim}25$], and the median total dose was 39.1 Gy [range $25.5{\sim}42.5$]. Follow-up included MR imaging, and ophthalmologic and endocrine examinations. Results : The median follow-up period was 23 months [range $12{\sim}43$]. The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed. Conclusion : FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.
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