1.Polyostotic Fibrous Dysplasia of Cranio-Maxillofacial Area.
Jin Woo HAN ; Hyuk Rok KWON ; Jin Ho LEE ; In Woo PARK
Korean Journal of Oral and Maxillofacial Radiology 2000;30(2):149-154
Fibrous dysplasia is believed to be a hamartomatous developmental lesion of unknown origin. This disease is divided into monostotic and polyostotic fibrous dysplasia. Polyostotic type can be divided into craniofacial type, Lichtenstein-Jaffe type, and McCune-Albright syndrome. In this case, a 31-year-old female presented spontaneous loss of right mandibular teeth before 5 years and has shown continuous expansion of right mandibular alveolus. Through the radiographic view, the coarse pattern of the mixed radiopaque-lucent lesion was seen on the right mandibular body, and there was diffuse pattern of the mixed radiopaque-lucent lesion with ill-defined margin in the left mandibular body. In the right calvarium, the lesion had cotton-wool appearance. Partial excision for contouring, multiple extraction, and alveoloplasty were accomplished under general anesthesia for supportive treatment. Finally we could conclude this case was polyostotic fibrous dysplasia of cranio-maxillofacial area based on the clinical, radiologic finding, and histopathologic examination.
Adult
;
Alveoloplasty
;
Anesthesia, General
;
Female
;
Fibrous Dysplasia, Polyostotic*
;
Humans
;
Skull
;
Tooth
2.Eagle's syndrome: report of two cases using computed tomography.
Sul Mi LEE ; Hyuk Rok KWON ; Hang Moon CHOI ; In Woo PARK
Korean Journal of Oral and Maxillofacial Radiology 2002;32(2):119-122
Two cases of Eagle's syndrome are reported. The first case involved a 31-year-old man who complained of pain in his throat and pain at preauricular area on turning his head. Panoramic and computed tomography (CT) views showed bilateral stylohyoid ligament ossification. The symptoms were relieved after surgical removal. The second case involved a 56-year-old female whose chief complaints were a continuous dull pain and occasional "shooting" pain on lower left molar area. During the physical examination, an ossified stylohyoid ligament was palpated at the left submandibular area. Panoramic and CT images showed prominent bilateral stylohyoid ligament ossification. CT scans also showed hypertrophy of left medial and lateral pterygoid muscles. The symptoms were relieved after medication. CT is a useful tool for the examination of ossified stylohyoid ligaments and studying the relationship between Eagle's syndrome and adjacent soft tissue.
Adult
;
Female
;
Head
;
Humans
;
Hypertrophy
;
Ligaments
;
Middle Aged
;
Molar
;
Pharynx
;
Physical Examination
;
Pterygoid Muscles
;
Tomography, X-Ray Computed
3.Ameloblastic fibro-odontoma with a change of calcifying odontogenic cyst.
Hyuk Rok KWON ; Jin Woo HAN ; Jin Ho LEE ; Hang Moon CHOI ; In Woo PARK ; Suk Keun LEE
Korean Journal of Oral and Maxillofacial Radiology 2001;31(3):181-184
Thirteen-year-old girl complaining of the swelling and pain on the left midface visited our dental hospital. On the radiographic examination, well-defined radiolucent lesion with hyperostotic border was found in the left maxilla accompanying with the external root resorption of the involved teeth and the displaced second molar. CT showed calcified bodies, thinning of hard palate, inferior orbital wall and lateral wall of nasal fossa, and thinning and perforation of the buccal plate of the maxilla. Enucleation and curettage of the lesion and nasoantrostomy was carried out and histopathologic examination mainly showed a solid tumor tissue composed of odontogenic epithelium and pulp tissues admixed with dentin and enamel formation. And some part of reduced follicular epithelium of tooth germ showed a change mimicking calcifying odontogenic cyst. Taken together, we concluded the lesion is an ameloblastic fibro-odontoma with a change of calcifying odontogenic cyst.
Ameloblasts*
;
Curettage
;
Dental Enamel
;
Dentin
;
Epithelium
;
Female
;
Humans
;
Maxilla
;
Molar
;
Odontogenic Cyst, Calcifying*
;
Odontogenic Cysts
;
Odontogenic Tumors
;
Odontoma*
;
Orbit
;
Palate, Hard
;
Root Resorption
;
Tooth
;
Tooth Germ
4.A Case of Bickerstaff's Brainstem Encephalitis with Guillain-Barre Syndrome Presenting Optic Neuropathy and Seizure.
Young Rok DO ; Ji Eun KIM ; Jae Hyuk KWAK ; O Dae KWON ; Jin Kuk DO ; Dong Kuck LEE
Journal of the Korean Neurological Association 2005;23(3):389-391
Bickerstaff's brainstem encephalitis (BBE), characterized by acute ophthalmoplegia and ataxia, often causes impaired consciousness and hyperreflexia. A 17-year-old man was admitted with an acute meningitic condition including high and neck stiffness. His condition rapidly deteriorated over 2 weeks, and he showed ophthalmoplegia, ataxia, seizure, tetraplegia, comatose mentality, and optic neuropathy. Electroencephalography showed diffuse slow waves. Visual evoked potentials showed no responses in the right eye. This is the first case of BBE with Guillain-Barre syndrome presenting with optic neuropathy and seizure.
Adolescent
;
Ataxia
;
Brain Stem*
;
Coma
;
Consciousness
;
Electroencephalography
;
Encephalitis*
;
Evoked Potentials, Visual
;
Guillain-Barre Syndrome*
;
Humans
;
Neck
;
Ophthalmoplegia
;
Optic Nerve Diseases*
;
Quadriplegia
;
Reflex, Abnormal
;
Seizures*
5.Vancomycin-Resistant Enterococcal Bacteremia in a Hematology Unit: Risk Factors for Mortality and Impact of Adequate Antimicrobial Therapy on Mortality.
Jae Bum JUN ; Seong Ho CHOI ; Sang Rok LEE ; Min Hyuk JEON ; Hyun Hee KWON ; Sang Oh LEE ; Sang Ho CHOI ; Jun Hee WOO ; Yang Soo KIM
Infection and Chemotherapy 2007;39(3):133-141
BACKGROUND: Vancomycin resistant enterococcal (VRE) bacteremia is increasing among patients with hematologic malignancies. Our study was to determine the clinical characteristics, risk factors for mortality, and effect of adequate antimicrobial therapy on outcome in patients with hematologic malignancies who developed VRE bacteremia. MATERIALS AND METHODS: we retrospectively reviewed episodes of VRE bacteremia in 90 patients with hematologic malignancices from January 1997 to December 2006. Adequate antimicrobial therapy was defined as the use of linezolid or quinupristin/dalfopristin, initiated within 72 hours of initial positive blood culture and continuing for at least 48 hours. Outcome was evaluated at 14 and 28 days after onset of bacteremia. RESULTS: The overall 14-day and 28-day mortality rates were 44.4% (40/90) and 54.4% (49/90) respectively. Failure of neutrophil recovery (odds ratio [OR], 40.29; 95% confidence interval [CI], 6.22 to 260.72; P< or =0.001) and increased APACHE II score (OR, 1.30; 95% CI, 1.07 to 1.58; P=0.008) were independent risk factors for 14-day as well as for 28-day mortality. To specifically examine the effects of adequate antimicrobial therapy, we performed a separate analysis of the 14-day mortality, after excluding 6 patients who died within 48 hours of bacteremia onset. Multivariate analysis showed that failure of neutrophil recovery (OR, 42.10; 95% CI, 5.77 to 307.00; P< or =0.001) and increased APACHE II score (OR, 1.25; 95% CI, 1.02 to 1.53; P=0.026) were still independently associated with mortality. Adequate antimicrobial therapy, however, did not have a protective effect (OR, 1.91; 95% CI, 0.50 to 7,22; P= 0.338). Of the 65 patients with monomicrobial bacteremia, 30 (46.2%) received adequate antimicrobial therapy and 35 (53.8%) did not: their 14-day mortality rates were 40.0% (12/30) and 42.9% (15/35), respectively (P=0.816). CONCLUSION: In conclusion, severity of underlying illness was associated with mortality. Adequacy of antimicrobial therapy did not improve survival, this may be due to low virulence of enterococci and severity of underlying disease.
APACHE
;
Bacteremia*
;
Enterococcus
;
Hematologic Neoplasms
;
Hematology*
;
Humans
;
Linezolid
;
Mortality*
;
Multivariate Analysis
;
Neutrophils
;
Retrospective Studies
;
Risk Factors*
;
Vancomycin
;
Virulence
6.Vancomycin-Resistant Enterococcal Bacteremia in a Hematology Unit: Risk Factors for Mortality and Impact of Adequate Antimicrobial Therapy on Mortality.
Jae Bum JUN ; Seong Ho CHOI ; Sang Rok LEE ; Min Hyuk JEON ; Hyun Hee KWON ; Sang Oh LEE ; Sang Ho CHOI ; Jun Hee WOO ; Yang Soo KIM
Infection and Chemotherapy 2007;39(3):133-141
BACKGROUND: Vancomycin resistant enterococcal (VRE) bacteremia is increasing among patients with hematologic malignancies. Our study was to determine the clinical characteristics, risk factors for mortality, and effect of adequate antimicrobial therapy on outcome in patients with hematologic malignancies who developed VRE bacteremia. MATERIALS AND METHODS: we retrospectively reviewed episodes of VRE bacteremia in 90 patients with hematologic malignancices from January 1997 to December 2006. Adequate antimicrobial therapy was defined as the use of linezolid or quinupristin/dalfopristin, initiated within 72 hours of initial positive blood culture and continuing for at least 48 hours. Outcome was evaluated at 14 and 28 days after onset of bacteremia. RESULTS: The overall 14-day and 28-day mortality rates were 44.4% (40/90) and 54.4% (49/90) respectively. Failure of neutrophil recovery (odds ratio [OR], 40.29; 95% confidence interval [CI], 6.22 to 260.72; P< or =0.001) and increased APACHE II score (OR, 1.30; 95% CI, 1.07 to 1.58; P=0.008) were independent risk factors for 14-day as well as for 28-day mortality. To specifically examine the effects of adequate antimicrobial therapy, we performed a separate analysis of the 14-day mortality, after excluding 6 patients who died within 48 hours of bacteremia onset. Multivariate analysis showed that failure of neutrophil recovery (OR, 42.10; 95% CI, 5.77 to 307.00; P< or =0.001) and increased APACHE II score (OR, 1.25; 95% CI, 1.02 to 1.53; P=0.026) were still independently associated with mortality. Adequate antimicrobial therapy, however, did not have a protective effect (OR, 1.91; 95% CI, 0.50 to 7,22; P= 0.338). Of the 65 patients with monomicrobial bacteremia, 30 (46.2%) received adequate antimicrobial therapy and 35 (53.8%) did not: their 14-day mortality rates were 40.0% (12/30) and 42.9% (15/35), respectively (P=0.816). CONCLUSION: In conclusion, severity of underlying illness was associated with mortality. Adequacy of antimicrobial therapy did not improve survival, this may be due to low virulence of enterococci and severity of underlying disease.
APACHE
;
Bacteremia*
;
Enterococcus
;
Hematologic Neoplasms
;
Hematology*
;
Humans
;
Linezolid
;
Mortality*
;
Multivariate Analysis
;
Neutrophils
;
Retrospective Studies
;
Risk Factors*
;
Vancomycin
;
Virulence
7.A Comparison of Tiotropium 18microgram, Once Daily and Ipratropium 40microgram, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease.
Seung Joon KIM ; Myung Sook KIM ; Sang Haak LEE ; Young Kyoon KIM ; Hwa Sik MOON ; Sung Hak PARK ; Sang Yeub LEE ; Kwang Ho IN ; Chang Youl LEE ; Young Sam KIM ; Hyung Jung KIM ; Chul Min AHN ; Sung Kyu KIM ; Kyung Rok KIM ; Seung Ick CHA ; Tae Hoon JUNG ; Mi Ok KIM ; Sung Soo PARK ; Cheon Woong CHOI ; Jee Hong YOO ; Hong Mo KANG ; Won Jung KOH ; Hyoung Suk HAM ; Eun Hae KANG ; O Jung KWON ; Yang Deok LEE ; Heung Bum LEE ; Yong Chul LEE ; Yang Keun RHEE ; Won Hyuk SHIN ; Sung Yeon KWON ; Woo Jin KIM ; Chul Gyu YOO ; Young Whan KIM ; Young Soo SHIM ; Sung Koo HAN ; Hye Kyung PARK ; Yun Seong KIM ; Min Ki LEE ; Soon Kew PARK ; Mi Hye KIM ; Won Yeon LEE ; Suk Joong YONG ; Kye Chul SHIN ; Byoung Whui CHOI ; Yeon Mok OH ; Chae Man LIM ; Sang Do LEE ; Woo Sung KIM ; Dong Soon KIM ; Sung Soo JUNG ; Ju Ock KIM ; Young Chun KO ; Young Chul KIM ; Nam Soo YOO
Tuberculosis and Respiratory Diseases 2005;58(5):498-506
BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult*
;
Albuterol
;
Bronchodilator Agents
;
Capsules
;
Forced Expiratory Volume
;
Humans
;
Inhalation
;
Ipratropium*
;
Lung
;
Mass Screening
;
Metered Dose Inhalers
;
Outcome Assessment (Health Care)
;
Peak Expiratory Flow Rate
;
Pulmonary Disease, Chronic Obstructive*
;
Surveys and Questionnaires
;
Vital Capacity
;
Tiotropium Bromide