• Title/Summary/Keyword: recurrent acute

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Ocular Sparganosis: The First Report of Spirometra ranarum in Thailand

  • Saksirisampant, Wilai;Eamudomkarn, Chatanun;Jeon, Hyeong-Kyu;Eom, Keeseon S.;Assavapongpaiboon, Buravej;Sintuwong, Sunisa;Tulvatana, Wasee
    • Parasites, Hosts and Diseases
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    • v.58 no.5
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    • pp.577-581
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    • 2020
  • A 22-year-old Thai man from the Northeast region presented with acute eye swelling, itching, and discharge on his left eye. He was suspected of having gnathostomiasis and treated with albendazole and prednisolone for 3 weeks. Nine months later, he was treated with high-dose oral prednisolone for the preliminary and differential diagnoses with thyroid-associated orbitopathy and lymphoma. He had been administered prednisolone intermittently over a few years. Then he developed a painless movable mass at the left upper eyelid and recurrent pseudotumor oculi was suspected. The surgical removal of the mass was performed. A white pseudosegmented worm revealed a definite diagnosis of ocular sparganosis by a plerocercoid larva. Molecular diagnosis of the causative species was made based on the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Proper technique of extraction and amplification of short fragments DNA from formalin-fixed paraffin-embedded tissue successfully identified parasite species. The result from the sequencing of the PCR-amplified cox1 fragments in this study showed 99.0% sequence homology to Spirometra ranarum. This is the first report of S. ranarum in Thailand.

Relationship between XRCC1 Polymorphism and Acute Complication of Chemoradiation Therapy in the Patients with Colorectal Cancer (대장, 직장암 환자에서 화학방사선치료의 급성 부작용과 XRCC1 유전자 다형성과의 상관관계)

  • Kim Woo-Chul;Hong Yun-Chul;Choi Sun-Keun;Woo Ze-Hong;Nam Jeong-Hyun;Choi Gwang-Seong;Lee Moon-Hee;Kim Soon-Ki;Song Sun-U.;Loh John-Jk
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.30-36
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    • 2006
  • Purpose: It is well known from clinical experience that acute complications of chemoradiation therapy vary from patients to patients. However, there are no known factors to predict these acute complications before treatment starts. The human XRCC1 gene is known as a DNA base excision repair gene. We investigated the possibilities of XRCC1 gene polymorphisms as a predictor for the acute complications of chemoradiation therapy in colorectal cancer patients. Materials and Methods: From July 1997 to June 2003, 86 colorectal cancer patients (71 rectal cancer, 13 sigmoid colon cancer and 2 colon cancer patients) were treated with chemoradiation therapy at the Department of Radiation Oncology, Inha University Hospital. Twenty-two patients were in stage B, 50 were in stage C, 8 were in stage D and 6 patients were unresectable cases. External radiation therapy was delivered with 10MV X-ray at a 1.8 Gy fraction per day for a total dose of radiation of $30.6{\sim}59.4 Gy$ (median: 54 Gy). All the patients received 5-FU based chemotherapy regimen. We analyzed the acute complications of upper and lower gastrointestinal tract based on the RTOG complication scale. The initial and lowest WBC and platelet count were recorded during both the RT period and the whole treatment period. Allelic variants of the XRCC1 gene at codons 194, 280 and 399 were analyzed in the lymphocyte DNA by performing PCR-RFLP. Statistical analyses were carried out with the SAS (version 6.12) statistical package. Results: When all the variables were assessed on the multivariate analysis, recurrent disease revealed the factors that significantly correlated with upper gastrointestinal acute complications. Arg399Gln polymorph isms of the XRCC1 gene, the radiation dose and the frequencies of chemotherapy during radiation therapy were significantly correlated with lower gastrointestinal complications. Arg399Gln polymorph isms also affected the decrease of the WBC and platelet count during radiation therapy. Conclusion: Although the present sample size was too small for fully evaluating this hypothesis, this study suggests that Arg399Gln polymorph isms of the XRCC1 genes may be used as one of the predictors for acute complications of chemoradiation therapy in colorectal cancer patients.

The Strategy for Diagnosis and Treatment of Isovaleric Acidemia (아이소발레릭산혈증의 신생아선별검사 후 진단 및 치료 전략)

  • Ko, Jung Min;Lee, Kyung-A
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.57-61
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    • 2016
  • Isovaleric acidemia (IVA) is an autosomal recessively inherited organic acid disorder due to a defect of the enzyme isovaleryl-CoA dehydrogenase in the leucine metabolic pathway. Deficiency of this enzyme results in the accumulation of derivatives of isovaleryl-CoA. In acute illness in IVA, isovaleric acid and its derivatives accumulate and profound metabolic acidosis with ketosis, characteristic pungent body odor, hypoglycemia, and hyperammonemia can be developed. Additionally, recurrent vomiting, failure to thrive, developmental delay, epilepsy and mental retardation are chronic presenting symptoms and signs for IVA. On the result of newborn screening for inherited metabolic disorders, increased levels of isovalerylcarnitine (C5) are shown. However, C5 elevation can be accompanied with short/branched-chain acyl-CoA dehydrogenase (SBCAD) and therapy with certain antibiotics containing pivalic acid. Quantitative measurement of organic acids in urine and acylcarnitine profiles in plasma are necessary to differential diagnosis. Molecular genetic analysis of the IVD gene for IVA and ACADSB is also helpful to confirm IVA and SBCAD deficiency, respectively. Considering that IVA can be associated with significant morbidity and mortality at acute presentation of metabolic crisis, early diagnosis prior to the onset of symptoms by newborn screening enable to introduction of early treatment and prevention of acute and chronic complications.

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Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 인대 손상 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Lee, Myoungjin;Lee, Jun Young;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.22-29
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    • 2022
  • Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

Evaluation of Taste in the Patients with Recurrent Aphthous Ulceration by Electrogustometer (전기미각측정기를 이용한 재발성 아프타성 궤양 환자의 미각평가)

  • Jun, Jin-Yong;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.1-8
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    • 2007
  • The purpose of this study was to investigate whether there were any changes in taste sensitivity with recurrent aphthous ulceration. Nintyseven subjects(25 males and 72 females) were included for the study and they were categorized into 2 groups(recurrent aphthous ulceration 27 persons, control 70 persons), recurrent aphthous ulceration group was investigated in the department of Oral Medicine, College of Dentistry, Pusan National University from April, 2005 to August, 2006 and control group was investigated in the clinic at Incheon city from June, 2006 to August, 2006. The electrical taste thresholds were measured using an electrogustometer of the 4 different sites(tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows ; 1. The electrical taste threshold showed significant lower in the RAU group. 2. The electrical taste threshold showed significant lower in female group, and showed significant lower except soft palate in male group of the RAU group. 3. The electrical taste threshold showed a tendency to increase in all site of the multiple RAU group, but there were no significant differences. 4. The electrical taste threshold showed a tendency to increase in tongue lateral of the acute RAU group, and showed a tendency to increase in tongue tip, circumvallate papilla, soft palate of the chronic RAU group. 5. After treatment, electrical taste threshold was significant increase than initial visit in the RAU group. 6. After treatment, NAS showed a tendency to decrease in the RAU group.

A Clinical Study on the Patients with Pyuria (농뇨증이 동반된 환자군의 임상적 고찰)

  • Kim, Jong-Ho;Cho, Ihn-Ho;Yun, Sung-Chul;Choi, Soo-Bong;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.151-160
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    • 1988
  • To evaluate the features of pyuria related to the bacteriuria, 140 subjects were studied from Jan. 1987 to Dec. 1987. The pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization(25%) and urinary tract obstruction(11.4 %). Through the observation, symptomatic pyuric patients were 66 subjects(47.1%), and the subjects with significant urine culture were 121 subjects(86.4%). In the urine culture, the most common bacteria was E. coli(41.4%), and the next was Pseudomonas(19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis(71%) and urethrocystitis(67%). In the persistent urinary tract infection, there were relapsing(22 cases) and recurrent urinary tract infection(16 cases).

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KNEE: Basic Science and Injury of Bone (슬관절 주위 글격의 기초과학 및 스포츠 손상)

  • Kim Hee-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.77-81
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    • 2003
  • Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.

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ADAMTS13 Activity in Childhood Hemolytic Uremic Syndrome(HUS) (소아 용혈성요독증후군에서 ADAMTS13 활성도의 변화)

  • Lee, Cho-Ae;Kim, Nam-Keun;Jang, Moon-Ju;Lee, Jun-Ho;Cheong, Hae-Il;Lee, Sun-Ju;Park, Hye-Won;Oh, Do-Yeon
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.109-118
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    • 2006
  • Purpose : HUS usually occurs in children after infection with shiga toxin-producing microorganism(D+HUS). In contrast, non-postdiarrheal(D-) HUS occurs at any age and has a high rate of relapse and a poor prognosis. The clinical presentation of D-HUS is similar to that of thrombotic thrombocytopenic purpura(TTP). Recently severe deficiencies of ADAMTS13 were reported not only in TTP and D- HUS but also in D+ HUS during their acute phase. The purpose of the study is to evaluate the plasma ADAMTS13 activity in D+ and D-HUS. Methods : Nineteen children with HUS(D+ HUS 12 and D- HUS 7) were enrolled. The assays of plasma ADAMTS13 activity were performed during the acute stage in the D+ HUS and at various stages of relapsing courses in the D- HUS patients by multimer assay, based on electrophoresis. Results : The median plasma activity of ADAMTS13 in D+ HUS and D- HUS were 80.9%(37.8-132.4%) and 53.9%(1.0-94.1%), respectively, which were not statistically significantly different from control(86.4%, 34.2-112.3%)(P>0.05). One boy with D- HUS had severe deficiency of ADAMTS13(1.0%). His platelet count was normalized temporarily by fresh frozen plasma infusion. Conclusion : We have demonstrated that there is no significant difference of the plasma ADAMTS13 activity between D+ HUS, D- HUS and control. We detected severe deficiency of ADAMTS13 in one boy who presented with relapsing episodes of D- HUS. ADAMTS13 deficiency should be considered in the subgroup of D- HUS especially with early onset and recurrent courses. Plasma therapy can be beneficial in this subgroup.

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Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4147-4152
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    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

Clinical Effects of Sabaek-san-Kamibang in Nocturnal Cough of Children (소아(小兒)의 신수(晨嗽)에 사백산가미방 투여의 임상적 효과)

  • Lee, Sun-Woo;Park, Sang-Moo;Kang, Baek-Gyu;Lee, Min-Goo;Park, Sae-Wook;Lee, Seung-Eon;Shin, Jo-Young;Lee, Si-Hyeong;Son, Ji-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.281-284
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    • 2007
  • Cough is a very common and largely recurrent childhood respiratory disease. In Korean medicine, Zhudanxi(矢丹溪), was the first to classify cough according to the different stages of time. In this research, I examined the stage of Nocturnal Cough(晨嗽) which refers to cough that occurs at dawn. Indigestion is classified as the cause with SaBaek-san proscribed as the treatment for such cough. In this research, twenty five children who had coughing at dawn with abdominal symptoms were treated with Sabaek-san-kamibang and then examined for cough, abdominal symptoms and other related symptoms. As a result, there was a statistically notable decrease in cough, abdominal symptoms and other symptoms such as nasal discharge, sputum, constipation, vomiting and cough. In addition, of the twenty five patients found with acute cough and those with moderate cough with abdominal symptoms showed good clinical results upon completion of treatment.