1/376. Recurrent mycetoma of the foot.mycetoma, also known as madura foot, is a local, chronic, slowly progressive disease with the classic presentation involving tumefaction, multiple draining sinuses, and grain-filled pus. It is primarily produced by either a bacteria (actinomycetoma) or a fungal (eumycetoma) organism. Determining the causative organism is fundamental to the treatment process. All types of mycetoma infections should be treated with early surgical debridement and tissue culture. Tissue should be sent for gross, microscopic, and histopathologic evaluation. In addition to surgical management, these patients should be managed adjunctively with a prolonged course of chemotherapy. patients with actinomycetoma are treated with an antibiotic and can expect to have a clinical cure with little chance for recurrence, whereas, patients with eumycetoma are treated with an antifungal agent and usually do poorly with a high rate of recurrence. The case presented involved an infection due to Actinomadura madurae (Nocardiaform madurae) and demonstrates successful treatment with surgical resection and prolonged doxycycline chemotherapy.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
2/376. Primary subcutaneous mucormycosis (zygomycosis): a case report.A case of mycormycosis presenting primarily as a subcutaneous mass of the left leg in an immunocompetent individual is described. The mass that was diagnosed initially as a non-specific foreign body granulomatous process recurred a year later. Histopathological examination of the primary and recurrent lesions revealed partly degenerated hyphae associated with acute necrotizing and chronic granulomatous inflammation. Histomorphological features of primary subcutaneous mucormycosis without predisposing factors have not been previously reported.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
3/376. Sudden recurrent laryngeal nerve paralysis due to apoplexy of parathyroid adenoma.Neoplastic lesions of the parathyroid are rare, and most of these are adenomas. Even rarer is a secondary involvement of the recurrent laryngeal nerve. A case is presented of sudden onset hoarseness in a 64-year-old man caused by acute vocal cord paralysis due to bleeding within an adenoma of the lower right parathyroid gland. Acute onset of vocal cord paralysis is rarely associated with benign processes; the current case is only the second report associated with parathyroid adenoma.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
4/376. The psychiatric symptomatology in kleine-levin syndrome.The kleine-levin syndrome is a rare disorder with its main symptoms being periodic hypersomnolence and excessive eating accompanied by behavioral changes. The dominance of the behavioral and psychological symptoms may obscure the diagnosis. In this article the diagnostic process and the psychiatric symptomatology of two adolescent male patients with kleine-levin syndrome is discussed.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
5/376. Identification of connexins in human oral mucosa and therapeutic effect of irsogladine maleate on aphthous stomatitis.We identified connexins 26 and 32 in human oral mucosa. The presence of the connexins indicates the presence of gap junctions in this tissue. However, immunofluorescence study found no significant differences in the expression of the connexins between patients with aphthons stomatitis and controls. Irsogladine maleate, which reinforces gap junctional intercellular communication in vitro, was effective for the treatment of transient and relapsing aphthous stomatitis, as well as symptomatic and drug-induced aphthous stomatitis. It was also useful for prevention of episodes of relapsing aphthous stomatitis, with daily administration preverting recurrence of stomatitis for more than 4 years one patient. These findings suggest that irsogladine maleate accelerates the wound healing process in oral mucosa by reinforcing gap junctional intercellular communication among oral mucosal cells; and that it is useful for the treatment and prevention of aphthous stomatitis.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
6/376. Recurrent pneumocystis carinii colonization in a heart-lung transplant recipient on long-term trimethoprim-sulfamethoxazole prophylaxis.INTRODUCTION: In the setting of organ transplantation, prior to prophylaxis, pneumocystis carinii pneumonia (PCP) had been a common clinical problem, particularly in heart-lung and lung recipients who receive long-term immunosuppressive therapy to prevent allograft rejection. Continuous oral trimethoprim-sulfamethoxazole (TMP-SMX) has been highly effective in preventing PCP in these patients. REPORT: In this paper we report a case of recurrent pneumocystis carinii infection in a chronic (> 15 years) heart-lung allograft recipient on long-term TMP-SMX prophylaxis. Twice, in 1995 and again in 1998, pneumocystis carinii infection was diagnosed by bronchoalveolar lavage (BAL), in the same patient, despite continued oral TMP-SMX (960 mg TMP/4800 mg SMX per week) prophylaxis. The subject was not lymphopenic (his CD4 count was 569/mm3) and there was no associated deterioration in pulmonary function, nor evidence of hypoxemia. CONCLUSION: This case demonstrates that asymptomatic pneumocystis carinii lung infections may recur in chronic heart-lung transplant recipients who take standard oral PCP prophylaxis.- - - - - - - - - - ranking = 8.7529479801367keywords = alveolar (Clic here for more details about this article) |
7/376. Occurrence of acute nonlymphoblastic leukemia in two girls after treatment of recurrent, disseminated Langerhans cell histiocytosis.The occurrence of Langerhans cell histiocytosis (LCH) and acute leukemia in one individual has rarely been observed. Despite few exceptions, two distinct patterns of association appear evident: acute lymphoblastic leukemia preceding LCH and LCH preceding acute nonlymphoblastic leukemia (ANLL). The latency of ANLL after the diagnosis of LCH is suggestive of a therapy-related process. This report describes two new cases in whom ANLL was diagnosed 7 years 8 months and 5 years 8 months after the start of initial treatment of disseminated recurrent LCH. Morphology showed blasts from FAB-type M4/M5 in the first patient, who died due to progression of leukemia. The second patient showed myelodysplastic syndrome (refractory anemia with excess of blasts in transformation; RAEB-t) and is now in remission from leukemia 3 years 11 months after allogeneic bone marrow transplantation. The review of a total of 26 patients with ANLL after LCH suggests that the disease has a poor prognosis and allogeneic BMT seems to be the treatment of choice.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
8/376. Takayasu's arteritis accompanied with massive pericardial effusion--a case report.A 40-year-old woman who had been treated for Takayasu's arteritis was admitted to the hospital with fever, fatigue, malaise, and severe chest pain. Computed tomography of the chest demonstrated massive pericardial effusion and bilateral pleural effusion. In laboratory data, the c-reactive protein was high at 22.0 mg/dL, and erythrocyte sedimentation rate was also high at 80 mm/hr. The diagnosis was pericarditis with a recurrence of the systemic inflammatory process of Takayasu's arteritis. The patient was treated with methylprednisolone pulse therapy. Her massive pericardial effusion disappeared without pericardiocentesis.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
9/376. Recurring fibro-obliterative venopathy in liver allografts.Recurrent diseases in liver allografts are not uncommon. These occur most frequently in those transplanted for viral hepatitis b and C. We report an unusual case of recurrent process in two consecutive liver allografts received by a 37-year-old woman, who previously had an unremarkable past medical history but developed a rapidly progressive cholestatic liver failure. Histopathologic examination of the native liver showed fibroocclusive lesions of both terminal hepatic venules and portal vein branches. The exuberant fibroobliterative process created dense fibrosis with whorled appearance, and broad fibrous septa connecting adjacent central areas, and sometimes bridging portal to central areas. Dense portal fibrosis resulted in compression atrophy and loss of bile ducts. The first allograft, which failed within 3 months, showed histopathologic findings similar to that of the native liver. A liver biopsy that was performed 20 months after the second liver transplant again showed similar histopathology. The histopathologic features and clinical presentation of this patient suggest an unusual form of recurring progressive fibroobliterative venopathy causing liver failure.- - - - - - - - - - ranking = 2keywords = process (Clic here for more details about this article) |
10/376. Treatment planning and biomechanics of distraction osteogenesis from an orthodontic perspective.As in traditional combined surgical and orthodontic procedures, the orthodontist has a role in the planning and orthodontic support of patients undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function in addition to planning both the predistraction and postdistraction orthodontic care. Based on careful clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and evaluation of three-dimensional computed tomographic scans, the orthodontist, in collaboration with the surgeon, plans distraction device placement and the predicted vectors of distraction. Both surgeon and orthodontist closely monitor the patient during the active distraction phase, using intermaxillary elastic traction, sometimes combined with guide planes, bite plates, and stabilization arches, to mold the newly formed bone (regenerate) while optimizing the developing occlusion. Postdistraction change caused by relapse is minimal. growth after mandibular distraction is variable and appears to be dependent on the genetic program of the native bone and the surrounding soft tissue matrix. A significant advantage of distraction osteogenesis is the gradual lengthening of the soft tissues and surrounding functional spaces. Distraction osteogenesis can be applied at an earlier age than traditional orthognathic surgery because the technique is relatively simple and bone grafts are not required for augmentation of the hypoplastic craniofacial skeleton. In this new technique, the surgeon and the orthodontist have become collaborators in a process that gradually alters the magnitude and direction of craniofacial growth.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
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