Asthama is a chronic inflammatory disorder of the airway with recurrent airflow obstruction. Chronic airway inflammation is invariably associated with injury and repair of the bronchial epithelium, which results in structural and functional changes known as remodeling Inflammation, remodeling, and altered neural control of the airway are responsible for both recurrent exacerbations of asthma and more permanent airflow obstruction. Asthma exacerbations may be caused by a variety of risk factors including allergens, pollutants, foods and drugs. Prevention of exacerbation aims to reduce the exposure to these risk factors to improve the control of asthma and reduce medication needs. Although no cure for asthma has yet been found, it is resonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained. Patient education involves a understanding of why and how to manage asthma and how to prevent asthma exacerbation. Medications for asthma can be administered in different ways, including inhaled, oral and parenteral. The major advantage of delivering drugs directly into the airways via inhalation is that high concentrations can be delivered more effectively to the airways, and systemic side effects are avoided or minimized. Therapy should be selected on the basis of the severity of a patient's asthma. According to the GINA guideline 2002, for intermittent asthma, no daily medication is reconmmended for the vast majority of patients. A rapid-acting inhaled β2-agonist may be taken as needed to relieve asthma symptoms. The occasional patient with intermittent asthma, but severe exacerbations, should be treated as having moderate persistent asthma. Patients with mild persistent asthma require controller medication every day to achieve and maintain control of their asthma. Treatment with an inhaled glucocorticosteroid is preferred. Sustained-relase theophyline cromolynes or a leukotriene modifier are other options. The preferred therapy for moderate persistent asthma is regular treatment with a combination of inhaled glucocorticosteroid and a long-acting inhaled glucocorticosteroid and a long-acting inhaled β2-agonist twice daily. Sustained-release theophyline or a leukotriene modifier are alternatives to the β2-agonist in this combination therapy. An alternative to combination therapy is a higher dose of inhaled glucocorticosteriod. The primary therapy for severe persistent asthma includes inhaled steroids at higher doses plus a long acting inhaled β2-agonist twice daily. Any available medications including oral steroid may be added to control asthma symptoms. Once control of asthma is achieved and maintained for at least 3 months, a gradual reduction of the maintenance therapy should be tried.
Allergens ; Asthma* ; Cromolyn Sodium ; Epithelium ; Humans ; Inflammation ; Inhalation ; Patient Education as Topic ; Risk Factors ; Steroids

No abstract available.
Clinical Laboratory Techniques* ; Tuberculosis*

Neurilemmoma is usually a solitary nerve sheath tumor, most often seen in adults. Tl: neurilemmomas of the oral cavity have been reported to develop on the tongue, buccal m7; Cosa, palate, gingiva, floor of the mouth, and lower lip, in order of frequency. We describe 7-year-old boy witlf an asymptomatic, solitary neurilemmoma on his upper lip with a brit: review of the literature. Neurilemmoma should be considered as one of the tumors that ca develop on children's lips.
Adult ; Child ; Gingiva ; Humans ; Lip* ; Male ; Mouth ; Neurilemmoma* ; Palate ; Tongue

A 2-month-old female infant presented with a bluish-black, flat, hairy patch, 1.2cm in diameter, on the posterior aspect of her neck since birth. Histologic sections from the lesion showed numerous diffusely scattered dermal melanocytes throughout the dermis. The histopathologic and clinical findings were not fully oonsistent with any other known dermal melanocytosis. The diagnosis of “hairy blue nevus” was proposed for this unique lesion.
Dermis ; Diagnosis ; Female ; Humans ; Infant ; Melanocytes ; Neck ; Nevus, Blue* ; Parturition

Rectus sheath hematoma is an uncommon entity of the anterior abdominal wall and an unusual cause of painful abdominal mass. Rectus sheath hematoma have been in association with trauma, infections, debilitating disease, collagen vascular disease, pregnancy. and the puerperium. Sudden disruption of a deep epigastric vessel may result in an abdominal wall hematoma, which depending upon its location and size, can produce symptoms and clinical findings compatible with a variety of acute intra-abdominal conditions. Such hematoma are infrequently encountered and early accurate diagnosis could prevent surgical intervention. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed under the belief that intra-abdominal pathology is present. The diagnosis was confirmed at surgery in both patient. We present two cases of rectus sheath hematoma which were diagnosed by clinical & ultrasound examination preoperatively.
Abdominal Wall ; Collagen Diseases ; Diagnosis ; Hematoma* ; Humans ; Laparotomy ; Pathology ; Postpartum Period ; Pregnancy ; Ultrasonography ; Vascular Diseases

No abstract available.
Colorectal Neoplasms*

Solitary morphea profunda is a rare form of scleroderma, characterized clinically by a solitary sclerotic plaque, and histologically by marked dermal and subcutaneous fibrosis with an inflammatory infiltrate. We describe another case of this entity presented with an ulcerative, indurated plaque on the left iliac crest, which histologically revealed a focal incidental acantholysis in the overlying epidermis and a marked eosinophilic infiltration through the dermis to the sub-cutaneous tissue.
Acantholysis* ; Dermis ; Eosinophils ; Epidermis ; Fibrosis ; Scleroderma, Localized* ; Ulcer

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Appendicitis* ; Child* ; Humans

PURPOSE: The aim of this study was to evaluate the effect of dimensional stability of splinting material on the accuracy of master casts. MATERIALS AND METHODS: A stainless steel metal model with 6 implants embedded was used as a master model. Implant level impressions were made after square impression copings were splinted using 5 different techniques as follows. (1) Splinted with autopolymerizing resin and sectioned, reconnected to compensate polymerization shrinkage before the impression procedure. (2) Splinted with autopolymerizing resin just before impression procedure. (3) Primary impression made with impression plaster and secondary impression were made over with polyether impression material. (4) Splinted with impression plaster. (5) Splinted with VPS bite registration material. From master model, 5 impressions and 5 experimental casts, total 25 casts were made for each of 5 splinting methods. The distortion values of each splinting methods were measured using coordinate measuring machine, capable of recordings in the x-, y-, z-axes. A one-way analysis of variance (ANOVA) at a confidence level of 95% was used to evaluate the data and Tukey's studentized range test was used to determine significant differences between the groups. RESULTS: Group 1 showed best accuracy followed by Group 3 & 4. Group 2 and 5 showed relatively larger distortion value than other groups. No significant difference was found between group 3, 4, 5 in x-axis, group 2, 3, 4 in y-axis and group 1, 3, 4, 5 in z-axis (P<.0001). CONCLUSION: Both Splinting impression copings with autopolymerizing resin following compensation of polymerization shrinkage and splinting method with impression plaster can enhance the accuracy of master cast and impression plaster can be used simple and effective splinting material for implant impression procedure.
Compensation and Redress ; Humans ; Jaw Relation Record ; Polymerization ; Polymers ; Splints ; Stainless Steel