• Title/Summary/Keyword: tissue fluid

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Surgical Treatment of a Plunging Ranula using the Intraoral and Submandibular Approach (구강 내 접근과 하악하 절개를 통한 몰입성 하마종의 수술적 치료)

  • Kim, Jung Hong;Eun, Seok Chan;Baek, Rong Min
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.111-115
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    • 2010
  • Purpose: A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach. Methods: A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach. Results: The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period. Conclusion: The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

Antibiotics-Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca: Two Case Reports

  • Youn, Youngmin;Lee, Sang Won;Cho, Hyun-Hae;Park, Sanghui;Chung, Hae-Sun;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.141-146
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    • 2018
  • Nowadays, Klebsiella oxytoca is described as a causative organism for antibiotic-associated hemorrhagic colitis (AAHC). Here we report two cases of pediatric AAHC, from which K. oxytoca was cultured after starting amoxicillin-clavulanate or amoxicillin treatment. The patients developed severe abdominal pain and a large amount of bloody diarrhea. K. oxytoca was obtained in intestinal fluid culture of a boy through the colonoscopy. On the other hand, colonic tissue culture and intestinal fluid culture were negative of the other patient. K. oxytoca was detected in stool culture when he was admitted. These cases showed characteristic endoscopic findings of segmental hemorrhagic colitis, and both boys recovered spontaneously within 2-3 days after they stopped taking the antibiotics. Therefore, in children who develop relatively large amount of bloody diarrhea after antibiotic treatment, we should consider AAHC caused by K. oxytoca.

Analysis of Design Parameters For Shunt Valve and Anti-Siphon Device Used to Treat Patients with Hydrocephalus

  • Lee, Chong-Sun;Jang, Jong-Yun;Suh, Chang-Min
    • Journal of Mechanical Science and Technology
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    • v.15 no.7
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    • pp.1061-1071
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    • 2001
  • The present study investigated design parameters of shunt valves and anti-siphon device used to treat patients with hydrocephalus. The shunt valve controls drainage of cerebrospinal fluid (CSF) through passive deflection of a thin and small diaphragm. The anti-siphon device(ASD) is optionally connected to the valve to prevent overdrainage when the patients are in the standing position. The major design parameters influencing pressure-flow characteristics of the shunt valve were analyzed using ANSYS structural program. Experiments were performed on the commercially available valves and showed good agreements with the computer simulation. The results of the study indicated that predeflection of the shunt valve diaphragm is an important design parameter to determine the opening pressure of the valve. The predeflection was found to depend on the diaphragm tip height and could be adjusted by the diaphragm thickness and its elastic modulus. The major design parameters of the ASD were found to be the clearance (gap height) between the thin diaphragm and the flow orifice. Besides the gap height, the opening pressure of the ASD could be adjusted by the diaphragm thickness, its elastic modulus, area ratio of the diaphragm to the flow orifice. Based on the numerical simulation which considered the increased subcutaneous pressure introduced by the tissue capsule pressure on the implanted shunt valve system, optimum design parameters were proposed for the ASD.

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Two cases of oval outflow and cyst formation in medulla of ovaries in gonadotropin-treated Sprague-Dawley rats (성선자극 Hormone을 주사한 Sprague-Dawley Rat 난소의 수질내의 난자유출 1증예 와 대 낭종형성 1증예)

  • Kwak, Soo-Dong;Kim, Chong-Sup
    • Korean Journal of Veterinary Pathology
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    • v.1 no.1
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    • pp.72-76
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    • 1997
  • Histological investigation of the number of follicles following gonadotropin treatments for superovulation was carried out in mature Sprague-Dwaley(SD) rats. Routinely serial sections of paraffin-embedded ovaries were stained with hematoxylin-eosin and evaluated with light microscope. During the study unusual cases of microscopic alterations were observed in the medulla of ovaries in two rats. Case one: An ovum and its follicular fluid outflowed in medulla of ovary. The follicular fluid was densly proteinuous. Corona raiata consisted of 2-6 layers thick cells in the periphery of the ovum. While the cortical side of the follicular wall was intact with normal granulosa cell layer the meullary side of it was ruptured. Case two: A large cyst was present in medulla of ovary hilus. The cyst occupied the entire medulla displacing the ovarian archetecture and enclosed by connective tissue and smooth muscle wall.

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A Case of Acute Acalculous Cholecystitis Superimposed on the Nephrotic Syndrome (미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례)

  • Shin Youn-Ho;Park Jee-Min;Shin Jae-Il;Kim Myung-Jun;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.91-95
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    • 2003
  • The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.

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Synovial Sarcoma of the Anterior Chest Wall: A Case Report (앞가슴벽에 생긴 윤활막육종: 증례 보고)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1227-1233
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    • 2020
  • Synovial sarcoma is a malignant soft tissue tumor that usually involves the extremities, particularly near the knees; a synovial sarcoma originating in the chest wall is extremely rare. We describe a 26-year-old woman diagnosed with a synovial sarcoma originating in the chest wall, based on CT and MRI findings. Contrast-enhanced CT images revealed a small, well-defined enhancing mass with calcification, in the subpleural area. This lesion was initially diagnosed as a benign tumor; however, the patient developed sudden severe pain with spontaneous bleeding and hemothorax, suggesting the possibility of malignancy. MRI revealed a multilobulated mass with a fluid-fluid level, which characterizes a synovial sarcoma.

Influence of Smoking on Matrix Metalloproteinase-9 in the Gingival Crevicular Fluid (흡연이 치은열구액 내 Matrix Metalloproteinase-9에 미치는 영향)

  • Hwang, Soo-Jeong;Kim, Young-Kwon;Yang, Seong-Ju;Cho, Hyun-Jeong
    • Journal of dental hygiene science
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    • v.11 no.4
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    • pp.339-344
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    • 2011
  • Matrix metalloproteinase(MMP)-9 is considered important in tissue destruction in periodontitis. The aim of this study was to investigate the influence of smoking on MMP-9 in the gingival crevicular fluid(GCF). GCF samples in upper incisors area from 332 male subjects were collected after the informed consent. The dental examination included the assessment of oral hygiene, gingival inflammation and probing pocket depth. A quantitative assessment of MMP-9 levels in GCF was performed utilizing and immunological procedure. The mean MMP-9 concentrations found in GCF of smokers(30.86 ng/ml) and quit-smokers(29.82 ng/ml) differed from non-smokers(11.33 ng/ml), adjusted by age, gingival index and Community periodontal index(p<0.001). Smoking seems to influence MMP-9 in GCF regardless of gingival inflammation and age. It means smoking can destruct the periodontal tissue for itself.

The Changes of Stifle Joint Fluid with Cranial Cruciate Ligament Rupture in Dogs (개에 있어서 전방십자인대 단열시 슬관절액의 변화)

  • Nam-soo, Kim
    • Journal of Veterinary Clinics
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    • v.20 no.4
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    • pp.443-448
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    • 2003
  • To determine whether localization of tartrate-resistant acid phosphatase (TRAP) and cathepsin K was associated with rupture of the cranial cruciate ligament (CCL) in dogs. Tissue specimens were obtained from 30 dogs with CCL rupture during surgical treatment, 8 aged normal dogs, and 9 young normal dogs that were necropsied for reasons unrelated to this study and unrelated to musculoskeletal disease. The cranial cruciate ligament was examined histologically. $TRAP^+$ cells and cathepsin $K^+$ cells were identified by histochemical staining and immunohistochemical staining respectively. TRAP and cathepsin $K^+$ were co-localized within the same cells principally located within the epiligamentous region and to a lesser extent in the core region of ruptured CCL. Localization of $TRAP^+$ cells (P < 0.05) and cathepsin $K^+$ cells (P =0.05) within CCL tissue was significantly increased in dogs with CCL rupture, compared with aged-normal dogs, and young normal dogs (P < 0.05 - TRAP, P < 0.001 - cathepsin K). Localization of $TRAP^+$ cells and cathepsin $K^+$ cells within the CCL tissue of aged-normal dogs was also increased compared with young normal dogs (P < 0.05). Small numbers of $TRAP^+$ cells and cathepsin $K^+$ cells were seen in the intact ligaments of aged-normal dogs, which were associated with ligament fasicles in which there was chondroid transformation of ligament fibroblasts and disruption of the organized hierarchical structure of the extracellular matrix. $TRAP^+$ cells and cathepsin $K^+$ cells were not seen in CCL tissue from young-normal dogs. Localization of the proteinases $TRAP^+$ and cathepsin $K^+$ in CCL tissue was significantly associated with CCL rupture. Small numbers of proteinase positive cells were also localized in the CCL of agednormal dogs without CCL rupture, but were not detected in CCL from young-normal dogs. Taken together, these findings suggest that the cell signaling pathways that regulate expression of these proteinases in CCL tissue may form part of the mechanism that leads to upregulation of collagenolytic ligament remodeling and progressive structural failure of the CCL over time.

Diagnosis of Residual Tumors after Unplanned Excision of Soft-Tissue Sarcomas: Conventional MRI Features and Added Value of Diffusion-Weighted Imaging

  • Jin, Kiok;Lee, Min Hee;Yoon, Min A;Kim, Hwa Jung;Kim, Wanlim;Chee, Choong Geun;Chung, Hye Won;Lee, Sang Hoon;Shin, Myung Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.20-31
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    • 2022
  • Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Inhibitory Effects of Ssanghwa-tang on Lung Injury and Muscle Loss in a Cigarette Smoke Extract and Lipopolysaccharide-induced Chronic Obstructive Pulmonary Disease Mouse Model (표준담배추출물과 Lipopolysaccharide로 유발한 만성폐쇄성폐질환 동물모델에서 쌍화탕의 폐손상 및 근감소 억제 효과)

  • Jin-kwan Choi;Won-kyung Yang;Su-won Lee;Seong-cheon Woo;Seung-hyung Kim;Yang-chun Park
    • The Journal of Internal Korean Medicine
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    • v.45 no.1
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    • pp.11-30
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    • 2024
  • Objectives: This study evaluated the effects of Ssanghwa-tang (SHT) on lung injury and muscle loss in a COPD mouse model. Methods: C57BL/6 mice were challenged with cigarette smoke extract and lipopolysaccharide, and then treated with two concentrations of SHT (250 and 500 mg/kg). After sacrifice, the bronchoalveolar lavage fluid (BALF) or lung tissue was analyzed by cytospin, ELISA, real-time PCR, flow cytometry analysis, and H&E and Masson's trichrome staining. The grip strength of COPD mice was measured using a grip strength meter. The running time of COPD mice was measured by a treadmill test. Muscle tissue of the quadriceps was stained with H&E and Masson's trichrome staining. Results: SHT significantly inhibited the increase in neutrophil numbers in BALF and significantly decreased immune cell activity in BALF and lung tissue. It also significantly inhibited the increase in TNF-α, IL-17, and MIP2 in BALF. Real-time PCR analysis revealed that the mRNA expression of TNF-α, IL-17, MIP2, and TRPV1 in lung tissue showed a significant decrease compared with the control group. Lung tissue damage was significantly reduced in the histological analysis. The grip strength and running time of the COPD mice showed a significant decrease compared with the control group. In histological staining, SHT was found to reduce the damage to muscle tissue. Conclusions: This study indicates that SHT can be used as a therapeutic agent for COPD patients by inhibiting lung injury and muscle loss.