• 제목/요약/키워드: recurrent disease

검색결과 669건 처리시간 0.032초

구강내 병변이 주소인 심상성 천포창 1예 (A Case of Oral Lesions as the Initial Sign in Pemphigus Vulgaris)

  • 박정제;김재원;안성기;전시영
    • 대한기관식도과학회지
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    • 제10권2호
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    • pp.72-75
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    • 2004
  • Pemphigus vulgaris is a rin, chronic intraepidermal bullous disease with potentially fatal outcome. Oral lesions precede skin lesions in at least $70\%$ of cases, and in cutaneous disease, concomitant oral lesions are encountered in $90\%$ of patients. This disorder involve the skin and mucous membranes, especially the oral and pharyngeal mucosa, but may also involve the nasal, oropharyngeal, laryngeal and esophageal mucosa. Oral lesions are initially vesicobullous but rapidly rupture, leaving a painful erosion that shows little tendency to heal. Pemphigus vulgaris affecting the oral mucosa is still diagnosed only after considerable delay, because oral ulceration in common, and clinicians believed the lesions to be caused by more common conditions such as recurrent aphthous stomatitis rather than a rare disorder such as pemphigus vulgaris. The definitive diagnosis of pemphigus vulgaris should be undertaken as early as possible, so that treatment can be started at an earl·y stage. Because of the presence of nonspecific oral ulcer, high degree of suspicion is often required to ultimately make the diagnosis of pemphigus vulgaris and then we report a case of pemphigus vulgaris with a literature review.

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양독발반(陽毒發斑)으로 변증(辨證)한 소양인 건선 치험 4례 (Four Treatment Cases of Psoriasis of Soyangins Demonstrated by Yang Poison Exanthema)

  • 원영호
    • 대한한의학회지
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    • 제34권3호
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    • pp.160-168
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    • 2013
  • 편도선염을 앓고 난 후 발병한 소양인 건선환자 2례와 스테로이드 중단에 의한 리바운드 현상으로 심해진 소양인 건선환자 2례는 피부증상과 병증(病證)의 양상이 소양인 위수열리열병(胃受熱裏熱病)의 양독발반(陽毒發斑)의 증상과 유사하였다. 특히 변비(便秘) 구갈(口渴) 다한출(多汗出)과 같은 위열(胃熱)의 증상과 수족부의 심한 건선 병변이 공통된 증상으로 나타났다. 이에 소양인 위수열리열병(胃受熱裏熱病) 양독발반(陽毒發斑) 변폐(便閉)에 사용하는 양독백호탕(陽毒白虎湯)과 두면사지(頭面四肢) 청양불승(淸陽不升)에 사용하는 양격산화탕(陽隔散火湯)을 투여하여 유효한 치료효과를 얻었기에 치험례로 보고하였다. 향후 건선의 다양한 종류와 발병과정에 따른 사상의학적 치료에 대한 연구가 이어지길 바라며 난치질환인 건선의 치료에 도움이 되기를 기대한다.

Prognostic Scores for Predicting Recurrence in Patients with Differentiated Thyroid Cancer

  • Somboonporn, Charoonsak
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권5호
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    • pp.2369-2374
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    • 2016
  • Background: Differentiated thyroid cancer (DTC) is a cancer group that shares molecular and cellular origin but shows different clinical courses and prognoses. Several prognostic factors have been reported for predicting recurrence for individual patients. This literature review aimed to evaluate prognostic scores for predicting recurrence of DTC. Materials and Methods: A search of the MEDLINE database for articles published until December 2015 was carried out using the terms "thyroid neoplasms AND (recurrent OR persistent) AND (score OR model OR nomogram)". Studies were eligible for review if they indicated the development of prognostic scoring models, derived from a group of independent prognostic factors, in predicting disease recurrence in DTC patients. Results: Of the 308 articles obtained, five were eligible for evaluation. Two scoring models were developed for DTC including both papillary and follicular carcinoma, one for papillary carcinoma, and the other two for papillary microcarcinoma. The number of patients included in the score development cohort ranged from 59 to 1,669. The number of evaluated potential prognostic factors ranged from 4 to 25. Tumor-related factors were the most common factors included in the final scores, with cervical lymph node metastases being the most common. Only two studies showed internal validation of the derived score. Conclusions: There is a paucity of prognostic scores for predicting disease recurrence in patients with DTC, in particular for follicular thyroid carcinoma. Several limitations of the created scores were found. Performance of the scores has not been adequately studied. Comprehensive validation in multiple cohorts is recommended before widespread use.

Treatment of Eyelid Ptosis due to Kearns-Sayre Syndrome Using Frontalis Suspension

  • Weitgasser, Laurenz;Wechselberger, Gottfried;Ensat, Florian;Kaplan, Rene;Hladik, Michaela
    • Archives of Plastic Surgery
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    • 제42권2호
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    • pp.214-217
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    • 2015
  • Blepharoptosis is a common indication for surgery in plastic surgery units, yet its possible underlying pathology frequently remains unidentified. A 52-year-old man with a 20-year history of progressive bilateral ptosis (right>left) presented with recurrent ptosis of both eyes; he had undergone an operation on the levator aponeurosis 12 years prior. Due to the suspicion of an underlying disease, he was evaluated further. Chronic progressive external ophthalmoplegia in transition to the more severe syndromic variant Kearns-Sayre syndrome, a mitochondrial disorder causing myopathy, was diagnosed. The patient was treated with coenzyme Q10, and he underwent ptosis surgery on both eyes. This case illustrates a potentially multi-systemic disease that was diagnosed by a further evaluation of a common symptom, in this case worsening blepharoptosis. Awareness of myopathic symptoms is necessary to prevent overlooking serious yet improvable conditions.

New Insights for Febrile Urinary Tract Infection (Acute Pyelonephritis) in Children

  • Lee, Kyung-Yil
    • Childhood Kidney Diseases
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    • 제20권2호
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    • pp.37-44
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    • 2016
  • Although asymptomatic bacteriuria, cystitis, and acute pyelonephritis (APN) have been categorized as urinary tract infections (UTIs), the immunopathogenesis of each disease is different. APN shows an age predilection; the majority of children (over 70-80%) with APN are under 1-2 years of age, with a male predominance. After 1-2 years of age, female predominance has been reported. This finding suggests that the immature immune state of infancy may be associated with the pathogenesis of APN. Escherichia coli is the most common etiologic agent; other uropathogens associated with UTIs originate from the host and comprise normal flora that are continuously altered by environmental factors. Therefore, uropathogens may have characteristics different from those of extraneous bacterial pathogens. Although antibiotic-resistant uropathogens, including extended-spectrum beta-lactamase-producing strains, are increasing in Korea and worldwide, treatment failure is rare in immune-competent children. The immunopathogenesis of APN remains unknown. Intact bacteria may not be the causative substances in renal cell injury; rather, smaller substances produced during bacterial replication may be responsible for renal cell injury and scarring. Moreover, substances from host cells such as proinflammatory cytokines may be involved in renal cell injury. A dimercaptosuccinic acid scan is used to detect the site of bacterial replication in the renal parenchyma, and may be influenced by the size of the focus and the stage of APN. Traditional aggressive studies used to identify vesicoureteral reflux after the first episode of APN have been modified because of rare cases of chronic kidney disease in patients with recurrent UTI.

색소피부건조증 환자에서 발생한 안면부 기저세포암의 치료 증례 보고 (A Treatment of Basal cell Carcinoma on the Face of a Xeroderma Pigmentosum Patient: A Case Report)

  • 배재현;전동근;김지남;이명철;신동혁;임소덕;최현곤
    • 대한두경부종양학회지
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    • 제36권1호
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    • pp.39-44
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    • 2020
  • Xeroderma pigmentosum is a rare autosomal recessive disease, related to defects in DNA repair mechanism. It presents skin lesions on sun-exposed areas, leading to various skin cancer. Skin lesions can be treated with cryotherapy, skin resurfacing, 5-FU, Imiquimod, topical T4 endonuclease V, radiotherapy and genetic therapy, but invasive skin cancer should be treated by a surgery. We report a 12-year-old female xeroderma pigmentosum patient with recurrent basal cell carcinoma successfully treated by skin grafting. In that there is no cure for this disease, prevention and patient education is most important.

자가면역간염과 원발성 경화담관염을 가진 중복증후군 소아 환자에서 발생한 형질세포성 골수염 1예 (A Case of Chronic Lymphoplasmacellular Osteomyelitis with Autoimmune Hepatitis/Primary Sclerosing Cholangitis Overlap Syndrome in a Child)

  • 이지혁;이현영;김진규;이지현;최연호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.91-97
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    • 2007
  • 저자들은 4세에 진단된 자가면역간염과 궤양성 대장염 그리고 6세에 진단된 원발성 경화담관염을 가진 중 복증후군 환아에서 9세에 만성 림프형질세포성 골수염이 발병한 뒤 면역억제 치료에 잘 반응하지 않는 증례를 경험하였기에 보고하는 바이다.

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소아 위식도 역류 질환의 외과적 치료 (Surgical Management of Gastroesophageal Reflux Disease)

  • 김성철;김대연;김경모;김인구
    • Advances in pediatric surgery
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    • 제6권2호
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    • pp.100-105
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    • 2000
  • Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two had hiatal hernias and one had a history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting(81.8 %), followed by recurrent respiratory infections(72.7 %) and failure to thrive(72.7 %). The most common diagnostic tool was 24 hour esophageal pH study, which showed pH less than 4 for more than 10 % of the total recorded time in 6 of 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There was one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy considered in a patient with neurological impairment.

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두드러기 치료 조사 (The Clinical Study of Urticaria)

  • 윤정원;윤소원;윤화정;고우신
    • 한방안이비인후피부과학회지
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    • 제16권2호
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    • pp.152-176
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    • 2003
  • This study was clinically performed with the 73 outpatients of urticaria who had visited the Dept. of Dermartology, Oriental Medical Hospital, Dong-eui University from January 1st 2000 to June 30th 2003. They have all taken the oriental herb medicine as Sungmagalguntanggamibang(SGT, 升麻葛根湯加味方) more than 1 time. Urticaria is a common disease and a well known reaction pattern of the skin charaterized by erythema, wheals and edema, that is the results of various causes. Urticaria is classified into acute or chronic type. The etilogy of acute uricaria has been determined in many cases, but the cause of chronic urticaria has been determined in 10$\%$ to 20$\%$ of cases. Character of chronic type urticaria is recurrent pruritus and erythematous skin disease by stimulating factor. Through checking up the present patient state, we verified the effect of SGT in various ways. The results were summarized as follows; 1. An increase of taking a medicine(SGT) and attending a hospital in number let down repeated urticaria occurence. 2. SGT is more effective when the symptoms with the severe pruritic wheals are spread on the whole body in daily occurrence. 3. In urticaria treatment method, gradually reducing a western medicine and going side by side SGT, that is good at symptoms improvement. 4. Etiology of urticaria is classified into intestine-stomach accumulated heat by indigestion(食滯腸胃積熱), wind-moisture(風濕), wind-heat(風熱) etc. The SGT is available in the order of frequency of use.

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소아에서의 치루 및 항문 주위 농양의 임상적 고찰 (A Clinical Study of Fistula-in-Ano and Perianal Abscess in Childhood)

  • 오수연;최금자
    • Advances in pediatric surgery
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    • 제8권2호
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    • pp.133-137
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    • 2002
  • To evaluate the clinical characteristics and results of treatment of fistula-in-ano and perianal abscess in childhood, we analyzed 95 cases of fistula-in-ano and/or perianal abscess seen in childhood, between January 1995 and June 2001 at the Department of General Surgery of Ewha Womans University Mokdong Hospital. Perianal abscess was in 25 patients, anal fistula in 62 and combined disease (perianal fistula and abscess) in 8. Male predominance was noted (95%). Median age was 8 months and 78% of cases were presented under the age of 1 year. Median duration of symptoms was 60 days. Twenty four abscesses (77%) and 18 lesions (72%) of combined disease (n=25) were located on both lateral sides of the anus, and fistulas located on both lateral sides were 33 (53%). Multiplicity of the lesion was noted in 25% of cases. Sixteen percent of abscess, 81% of fistula and 88% of combination group have had previous perianal abscesses. The perianal abscesses were treated with incision and currettage and fistulas were treated with fistulotomy or fistulectomy. There were no recurrent diseases and no complications after surgical treatment. Although the progresses of the perianal abscess and fistula in ano in childhood may be self-limitied, surgical management was safe and curable.

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