FAQ - thromboangiitis obliterans
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Can someone explain the action of Imuran on the disease called Bronchiolitis obliterans organizing pneumonia?


My mother is taking Imuran for BOOP and I know it has to do with suppression of cell mediated immunity. what exactly is this?
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Although the exact mechanism of how Imuran works is not known, it is felt that by inhibiting the immune system, this drug suppresses the "overactive" immune reaction that is responsible for such disorders as your mother's.

Medicinenet has a really informative article on the drug here:
http://www.medicinenet.com/azathioprine/article.htm

Here is also a great article on BOOP and the role of Imuran:
http://www.merck.com/mmpe/sec05/ch055/ch055b.html  (+ info)

What is "Bronchiolitis Obliterans with Organizing Pneumonia?"?


Serious respondents only. My Dad is 81 and has been diagnosed with this. I would like to know what it is, how it can be treated, and where to go on the Internet for additional information.

My family members are Christians and we believe in healing prayers. If led by the Lord, please pray for him (his name is George).

Thanks and God Bless!
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Bronchiolitis obliterans organizing pneumonia (BOOP)is an idiopathic condition in which granulation tissue obstructs bronchioles and alveolar ducts with chronic inflammation and organizing pneumonia in adjacent alveoli. It mimics infectious pneumonia. However, diagnosis is suspected after there is no response to multiple antibiotics and blood and sputum cultures are negative for organisms. Patients with BOOP almost always have a pre existing chronic inflammatory disease like rheumatoid arthritis.
Please see the web pages for more details on BOOP.  (+ info)

What is the specific microorgaism that causes Bronchiolitis (BOOP) obliterans with Organizing Pneumonia?


BOOP is a confusing and outdated term. The American Thoracic Society & European Respiratory Society updated the current terminology in 2002 as cryptogenic organizing pneumonia (COP). This is for several reasons. First, not all COP involves bronchiolitis. Second, there are several different forms of bronchiolitis. Third, there are many causes of organizing pneumonia.

By definition, COP is due to an unknown etiology ("cryptogenic"). However, organizing pneumonia can be due to many causes. In these cases, the proper terminology would be "organizing pneumonia associated with...". These may include:

bacterial pneumonia
aspiration pneumonia
drug reactions
diffuse alveolar damage
collagen vascular disease
and many more  (+ info)

Anyone knows about alternative treatment for gangrene (Thromboanglitis Obliterans)rather than amputation?


My gandma is 81. She is diagnosed having gangrene on her left thumb toe. She has rhematoid arhtritis also. She is having ozone therapy and doesn't really work. Doctor said she needs to take amputation. Reading plenty of sources, elderly taking amputation having very low percentage of living. Please let me know if there's successful experience of overcoming this kind of disease. Of any kind of treatment and testimonial miracles. Anything to make her healed. I love her so much. Thanks.
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If gangrene has developed, amputation is the only remedy, The disease thromboangitis obliterans can be treated by symphathectomy along with medicines, If treated early & efficiently one can avoid development of gangrene very well.  (+ info)

Balanitis xerotica obliterans?


Ok im really getting upset now because i had balanitis for about 3 weeks and then i got it again 3 weeks later.

now the shaft of my penis is like white'ish and i dunno what this is

i thought it might be something called Balanitis xerotica obliterans but my penis has remained normal nothing weird exept for this white'ish stuff

its not all over the shaft my penis is normal colour at the opening and a little bit round there

by the way i am 13 almost 14
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ryu,
I understand that you are nearly 14, I shall write details which may not apply to you, but which may be necessary. Chronic balanitis is when your symptoms last for several weeks, months or longer - the term chronic refers to time, not how serious the condition is. It can affect men of any age. Balanitis can also be acute (lasting only a few weeks) or recurrent (it keeps coming back). Balanitis may be caused by a skin irritant (such as latex condoms, lubricants, soaps or antiseptics) and can become chronic if you keep using the product that is irritating you. It is doubtful that you have/had Balanitis xerotica obliterans (BXO), as it usually affects men aged 45 to 60. If left untreated there is a five percent chance that it will turn malignant. Zoon's balanitis is a rare skin condition of the glans and foreskin, also known as balanitis circumscripta plasmacellularis. It's a non-cancerous (benign) condition that affects men who haven't been circumcised. Its exact cause is unknown. Usually there are few symptoms and very little or no pain. You may see orange-red lesions and smaller redder spots on your glans and adjacent foreskin. Other causes may be chronic skin conditions which include - psoriasis, seborrhoeic dermatitis, lichen planus, pemphigus. However, as you do not mention any of these they should likely not be considered. You should keep the head of your penis and foreskin as clean as possible, and not to use anything that might irritate the area, such as soap or latex condoms. Cleaning your penis twice a day with a weak saline solution (salt water) can be soothing and can relieve discomfort. To make a weak saline solution, mix a teaspoonful of salt into half a litre (500ml) of warm water. Alternatively, you could also try using an aqueous cream (eg E45 cream) to soothe and clean the area. If a skin irritant (eg soap or washing powder) is causing your balanitis, symptoms often go a couple of days after you stop using the product. But be careful - if you start using the product again symptoms can come back. Your GP will usually prescribe a mild steroid cream. This helps to reduce the inflammation around your glans. You will also receive treatment for any other underlying medical conditions causing your balanitis. Your GP may ask you to come back after a week or so to see how you are getting on with your treatment. If your symptoms aren't responding to treatment or they keep coming back despite treatment, you should tell your GP. He or she may give you a different medication or refer you to a genitourinary medicine (GUM) clinic or a urologist so your symptoms can be investigated further. GUM clinics specialise in identifying and treating sexual health conditions and conditions related to the urinary system (the system that produces urine). A urologist is a doctor who specialises in identifying and treating conditions of the urinary tract in men. Circumcision is sometimes used to treat balanitis, especially Zoon's balanitis and BXO. Circumcision is an operation to remove the foreskin from the penis. It's usually done as a day case under general anaesthesia - this means you will be asleep during the procedure. Good genital hygiene is essential in preventing balanitis. Try to keep the head of your penis and foreskin clean and dry. And, if you are prone to balanitis after sex, use a non-latex condom or make sure you wash and dry your penis shortly after having sex.


ALL ANSWERS SHOULD BE THOROUGHLY RESEARCHED, IN ANY FORUM AND ESPECIALLY IN THIS ONE. - MANY ANSWERS ARE FLAWED.

It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms.


The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Hope this helps
Matador 89  (+ info)

i have Balanitis Xerotica Obliterans how to tell my parents?


Well i think i have "Balanitis Xerotica Obliterans" where the hardening of the skin occurs on the penis in my case i have a mild version of it on my foreskin i was reading up about it and it says that i will have to have my fore skin cut off, i actually started to cry..

Either way i need a way to tell my parents, now me and my parents DONT have the best relationship in the world infact it's terrible.. i just.. i'm at a loss for words.. and i'm crying.. T_T please help me..
Well i think i have "Balanitis Xerotica Obliterans" where the hardening of the skin occurs on the penis in my case i have a mild version of it on my foreskin i was reading up about it and it says that i will have to have my fore skin cut off, i actually started to cry..

Either way i need a way to tell my parents, now me and my parents DONT have the best relationship in the world infact it's terrible.. i just.. i'm at a loss for words.. and i'm crying.. T_T please help me..

P.S: i have looked it up and aparently Balanitis Xerotica Obliterans is a lump.. mine is flat completely with white hard skin..
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I would see your GP first as your self diagnosis may well be incorrect!  (+ info)

what is bronchilitis obliterans?


Bronchiolitis obliterans with organizing pneumonia (BOOP) is an inflammation of the bronchioles and surrounding tissue in the lungs. BOOP may affect small areas of the lungs or the entire lung.

Try this..

http://lungdiseases.about.com/od/termsdefinitions/f/what_is_boop.htm  (+ info)

Any personal experience with BOOP (Bronchiolitis Obliterans Organizing Pneumonia)?


My wife was just diagnosed with it today. She was diagnosed with Ulcerative Colitis almost a year ago and after trying pretty much everything the only treatments that got her into remission were Prednisone and Remicade. After doing some research I see there are a ton of different kinds of pneumonia's, even a few different kinds of the specific one she has. Research shows that 1 type resolves itself easily while another has a high mortality rate! Scary...
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No personal expeirence

Bronchiolitis Obliterans Organizing Pneumonia

Gary R. Epler, M.D.

Harvard Medical School
Pulmonary and Critical Care Medicine
Brigham and Women's Hospital
Boston, Massachusetts



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Published in Archives of Internal Medicine.
Volume 161 (2). Pages 158-164. January 22, 2001
Copyright 2001 by the American Medical Association.
All Rights Reserved.
Used with permission for this program at www.epler.com.



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Bronchiolitis obliterans organizing pneumonia (BOOP) was described in 19851 as a distinct entity, with different clinical, radiographic, and prognostic features than the airway disorder obliterative bronchiolitis2 and the interstitial fibrotic lung disorder usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF).3 BOOP is characterized by polyploid endobronchial connective tissue masses composed of myxoid fibroblastic tissue resembling granulation tissue filling the lumens of terminal and respiratory bronchioles and extending in a continuous fashion into alveolar ducts and alveoli, representing an organizing pneumonia (Figure 1).1-3 Other histological features include central clusters of mononuclear inflammatory cells possibly found in the intraluminal polyps (the polyps appear to float freely within a bronchiole or are focally attached to the wall), chronic inflammation in the walls of the surrounding alveoli with reactive type II cells, increased foamy macrophages in the alveoli, and preserved lung architecture.2

BOOP continues to be reported throughout the world.4-7 Most patients have idiopathic BOOP, but there are several known causes of BOOP, and several systemic disorders have BOOP as an associated primary pulmonary lesion (Table 1). The BOOP pattern might also occur as a secondary process in several clinical settings, such as the inflammatory-appearing lesion of UIP/IPF, with Wegener granulomatosis, in the walls of lung abscesses, around lymphoma or other neoplasms, and with bronchiectasis. In these patients, the underlying process is the primary cause of symptoms and the subsequent clinical course.

The terms organizing pneumonia and cryptogenic organizing pneumonia are sometimes used for the broad category of patients with organizing pneumonia. There are several reasons that the term BOOP should continue to be used for the clinical disorder and corresponding pathological lesion described in this review. First, investigators and clinicians throughout the world recognize the clinical and pathological features of this disorder, and they commonly use the term BOOP. Second, BOOP is a histological process that involves distal airways and alveoli simultaneously. Although various lung diseases represent a chronic inflammatory process, it is now apparent that the processes differ markedly among various diseases, such as chronic obstructive pulmonary disease, asthma, and BOOP, with different inflammatory cells, mediators, inflammatory effects, and response to treatment.8 Therefore, an inflammatory lesion that involves only airways or only alveoli may have different inflammatory components than the BOOP lesion that involves airway and alveoli simultaneously. Third, investigations of specific treatments for BOOP will be more strongly positive if the specific definition of BOOP is used for inclusion of patients rather than using the broad definition of organizing pneumonia. This is similar to IPF, in which many distinct histological disorders were included in this category in the past, resulting in dilution of the actual mechanism and poor treatment results. Now that IPF is limited to UIP,3 the opportunity to fully characterize the fibrotic pathway is much greater, and antifibrotic treatment tailored to this fibrotic pathway will be tested more efficiently and accurately.

Pathogenesis of BOOP

BOOP is an inflammatory lung disease and thus is related to the inflammatory pathway rather than the fibrosing pathway that occurs with UIP/IPF. The inflammatory response associated with disorders such as asthma, chronic obstructive pulmonary disease, granulomatous diseases, and BOOP have common features of the sequential inflammatory response, yet these disorders seem to have differences that have not yet been fully characterized. These differences are important because treatment directed toward one type of inflammatory response might not be effective against another type.8

There is newly formed fibromyxoid connective tissue in BOOP and UIP/IPF; in BOOP it can be completely reversed by corticosteroid therapy, but in UIP/IPF this tissue participates in the remodeling and destruction of the interstitium.9, 10 Reasons for the response to corticosteroid in BOOP and the destruction in UIP/IPF remain unknown.11 There seems to be abundant capillarization in the intra-airway fibromyxoid lesions in BOOP compared with minimal vascularization in UIP/IPF.9 This might be because of vascular growth factors in BOOP that will result in normal apoptosis (natural-occurring cell death) in BOOP but not in UIP/IPF. Results of an additional study10 showed that the apoptotic activity is higher in the fibromyxoid lesion of BOOP compared with UIP/IPF, suggesting that apoptosis has an important role in the resolution process of the newly formed connective tissue in BOOP.

Diagnosing BOOP

Lung biopsy continues to be the preferred method for establishing a diagnosis. The video-assisted thoracoscopic procedure has become the established technique. In a study12 of 49 patients who underwent the video-assisted thoracoscopic procedure for interstitial lung disease, the mean length of the operation was 45 minutes, the chest tube was inserted for 1.3 days, there were no deaths, there were no reexplorations, and none were converted to an open thoracotomy.

Radiographic findings of BOOP

The typical chest radiograph shows bilateral patchy (alveolar) infiltrates (Figure 2A). Cavities are rare, although 4 of 5 patients with a single pulmonary nodule had cavitation.13 Effusions are rare. Linear opacities occurring at the bases are usually associated with a poorer prognosis; however, a study6 of BOOP in 23 patients in Korea indicated recovery in all patients regardless of their radiographic findings. Generally, the infiltrates gradually enlarge from their original site or new infiltrates appear as the clinical course progresses; however, migratory or "mobile" pulmonary infiltrates have been reported6, 14, 15 in 10% to 25% of patients. Unilateral BOOP also has been reported.16, 17

The chest computed tomographic scan shows findings similar to the chest radiograph, with bilateral areas of consolidation and ground glass opacities, usually with a peripheral location (Figure 2 B). Costabel et al15 reported that sometimes the peripheral opacities are in the form of triangles, with the base of the triangle along the pleural surface and the tip of the triangle toward the mediastinum (Figure 2 C). In a study18 from England, high-resolution chest computed tomographic scans showed 2 types of linear opacities: the first extends in a radial manner along the line of the bronchi toward the pleura and the second occurs in a subpleural location with no relation to the bronchi. Both types usually occur in the lower lobes, frequently associated with multifocal areas of consolidation, and usually completely resolve with treatment.

Treatment of BOOP

Prednisone, with its potent anti-inflammatory property, continues to be recommend as first-line treatment for patients with symptomatic and progressive disease. Patients with asymptomatic mass lesions or nonprogressive disease can be observed and treated at a later time if needed. The dosage is generally 1 mg/kg (60 mg/d) for 1 to 3 months, then 40 mg/d for 3 months, then 10 to 20 mg/d or every other day for a total of 1 year. Every-other-day scheduling can be successfully used for this disorder. A shorter 6-month course may be sufficient in certain situations. Total and permanent recovery is seen in most patients and is somewhat dependent on the cause or associated systemic disorders. Anecdotally, erythromycin, inhaled triamcinolone, and cyclophosphamide have been used to treat BOOP.19-21 Epidemiological studies of these agents have not yet been performed for confirmation of efficacy.

Recurrence of BOOP

In patients treated for less than 1 year, BOOP might recur in one third. It is a lung disorder that can be successfully treated a second and third time with the previously responsive dosage level of prednisone.1 Relapse of BOOP may be related to the severity of the illness. In a group of 7 patients who had a relapse it was found that the level of hypoxemia at the time of diagnosis was the most important determinant of relapse22; however, Cordier11 did not find this relation.
For patients who do not respond to treatment, it is important to determine if the BOOP pattern is primary or secondary. On close evaluation by a lung pathologist, the biopsy specimen that shows the BOOP pattern might also show the typical leading edge of "fibroblastic foci" that indicates UIP/IPF. The BOOP pattern might respond to corticosteroid therapy, yet the fibrotic process of UIP/IPF is the driving force of the progressively deteriorating clinical course.

Types of BOOP

Idiopathic BOOP is the most common type.1 A flulike illness, fever, and an increased erythrocyte sedimentation rate continue to be typical findings of this form of BOOP. Cough and dyspnea are common but generally mild. Hemoptysis is uncommon, although it has been reported in 2 patients as a presenting symptom23 and in some patients with nodules.13, 24 Crackles occur in two thirds of patients. Pneumothorax has occurred as a complication of BOOP in one patient with an effusion,25 one with a solitary nodule,26 and another with respiratory distress.27 Results of pulmonary function studies show mildly to moderately decreased vital capacity. The flow rates are normal except in smokers. The diffusing capacity is decreased in almost all patients, although generally mildly to moderately. The prognosis of idiopathic BOOP remains good, some patients resolve without treatment, and 65% to 80% of patients treated with corticosteroid therapy are cured.

Rapidly Progressive BOOP can occur in a small percentage of patients, but it is a deadly form of the disease.28, 29 In some of these patient reports, there was an underlying fibrotic process as the cause of the ultimate fatal course, with BOOP as a secondary component, yet some patients seemed to have a primary, rapidly developing BOOP, which had a better prognosis. This form of BOOP occurs equally in men and women and at all ages. It can occur in healthy, vigorous individuals or can be associated with other systemic disorders. The course can be rapid, with 1 to 3 days of symptoms and acute respiratory failure. Patients might present with adult respiratory distress syndrome, with pathological findings indicating an organizing adult respiratory distress syndrome pattern with the appearance of BOOP.30 Clinically, rapidly progressive BOOP can be indistinguishable from acute interstitial pneumonia.31, 32 Early histological diagnosis of the primary BOOP lesion and initiation of corticosteroid therapy might improve survival in these patients.29

Focal Nodular BOOP was reported33 in 1989 in 5 of 16 patients with idiopathic BOOP. Since then it has become a clinically important process, especially because it might be indistinguishable from carcinoma of the lung.13, 26, 34-36 Although some focal nodular lesions might progress to the typical bilateral process of idiopathic BOOP, most do not, and resection results in a cure.

Multiple Nodular Lesions can also occur,34, 35 and most regress spontaneously. Of 12 patients with multiple large nodules or masses, all had complete resolution of their symptoms, 10 with no therapy and 2 after corticosteroid therapy.34 In these patients, pleuritic chest pain was the most common presenting symptom, occurring in 50%. The number of masses varied from 2 to 8 (mean, 5). The authors concluded that BOOP should be considered when multiple large nodular lesions have chest computed tomographic findings showing air bronchograms, irregular margins, broad pleural tags, parenchymal bands, or subpleural lines.

Clinician investigators36 in New Orleans suggest that BOOP may have a connection to reports of spontaneous regression of lung metastases. They concluded that a major reason that reports of spontaneous regression of lung metastasis have decreased in recent years is the increasing emphasis on obtaining diagnostic tissue of multiple nodular lesions for lung metastasis, many of which have proven to be BOOP.

Postinfection BOOP can develop after a variety of different types of infectious pneumonias,11 including those caused by bacterial agents such as Chlamydia,37 Legionella, and Mycoplasma pneumoniae38 and viral agents such as parainfluenza virus16 and adenovirus.39 Parasitic infections such as malaria40 and fungal infections, including Cryptococcus neoformans41 and Pneumocystis carinii,42 have also been reported as a cause of the BOOP lesion.

Generally for these patients, there is initial improvement of the infectious pneumonia with use of appropriate antimicrobial agents, but after a few days, it becomes apparent that the symptoms and radiographic findings persist. The pneumonia process has now become organized into the BOOP lesion. Corticosteroid treatment at this point is almost always successful.

Drug-related BOOP has been reported11, 15 from use of several different types of medications, including anti-inflammatory and immunosuppressive agents such as bleomycin sulfate, gold, and methotrexate; antibiotics such as sulfasalazine, sulfamethoxypyridazine, cephalosporins, and amphotericin B; illicit use of cocaine; and a massive dose of L-tryptophan. Minocycline-associated BOOP has been reported43 in a woman who was taking this medication for acne. Descriptions of amiodarone-related BOOP continue to be reported.44 Phenytoin-related BOOP with rapid improvement after corticosteroid therapy has been reported.45 There has been a report46 of a woman who developed carbamazepine-induced lupus erythematosus and associated BOOP, both of which responded to corticosteroid therapy. There has been a report47 of ticlopidine hydrochloride, an inhibitor of platelet aggregation, associated with BOOP that resolved after withdrawal of the agent. BOOP has now been added to the spectrum of pulmonary lesions associated with nitrofurantoin.48

Rheumatologic or connective tissue BOOP is clinically similar to the idiopathic form and has been reported49-57 with all of the connective tissue diseases. BOOP represents the patchy infiltrative lesions seen in patients with lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, and dermatomyositis. The process often responds to corticosteroid therapy, unlike the fibrotic process that may occur in these disorders.

There has been a report of a patient with BOOP associated with dermatomyositis that was resistant to corticosteroid therapy; with initiation of cyclophosphamide therapy, there was improvement of pulmonary and cutaneous findings.52 BOOP can also occur in patients with ankylosing spondylitis,53 polymyalgia rheumatica,54, 55 and Behçet disease56 and might be the first manifestation of a connective disorder.57

Immunologic disease BOOP has been reported with common variable immunodeficiency syndrome58 and essential mixed cryoglobulinemia.59

Bone marrow transplantation BOOP has been described in patients who underwent allogeneic marrow transplantation. There has also been a report of BOOP in a patient who received a syngeneic bone marrow transplant from his twin brother.60 There is an additional report of a patient who developed ulcerative colitis and BOOP 7 months after receiving a bone marrow transplant from his brother.61 It was not clear whether the BOOP was associated with the ulcerative colitis or from another cause, such as a cytomegalovirus infection. Too few reports have been published to determine whether BOOP in these patients is an incidental finding or represents a complication of bone marrow transplantation.

Lung transplantation BOOP has been reported62, 63 in 10% to 28% of lung transplant recipients. The lesion generally occurs 1 to 10 months after transplantation and is usually associated with the acute rejection reaction. The process is reversible for most of these patients, especially if the underlying acute rejection is successfully treated. The BOOP lesion may occur before the onset of obliterative bronchiolitis,62 and whether this is a risk factor for lung transplantation obliterative bronchiolitis has not been established, but it is prudent to treat the BOOP reactions aggressively in these patients. Cytomegalovirus pneumonia-associated BOOP has also been described63 in lung transplant recipients and is generally responsive to corticosteroid therapy.

Renal transplantation BOOP has been described64 in 1 patient 12 weeks after transplantation. A rapid recovery occurred after an increase of the daily dose of methylprednisolone.

Radiotherapy BOOP has become an important clinical disorder in patients receiving radiotherapy to the breast.65-68 Symptoms might occur 1 to 12 months after completion of radiotherapy. Symptoms might be minimal, but most patients have fever, nonproductive cough, and mild shortness of breath. The chest radiograph shows peripheral patchy or alveolar infiltrates, often outside the radiation field.66 One study68 indicated that all 11 patients studied had spontaneous migration of infiltrates from the irradiated lung to the contralateral nonirradiated lung with no nodular or reticular lesions. There can be a dramatic improvement with corticosteroid therapy, but relapses may occur.66, 67 Some investigators66, 68 have suggested that radiotherapy may "prime" the development of BOOP. Bronchoalveolar lavage studies of these patients indicate an increase in lymphocytes, mast cells, CD3 cells, and CD8 cells and a decrease in CD4 cells and the CD4-CD8 ratio68; however, the underlying mechanism remains unknown.

Environment-related BOOP continues to be reported rarely. In 1992, textile printing dye-related BOOP was described in 22 textile airbrush workers.69 Six died initially. Follow-up of some of the workers indicated gradual improvement over time.70 It has been suggested69 that the cause was related to the spraying of a respirable aerosol into the distal airways and alveoli; however, the reactive chemical agent and mechanism remain unclear. It is also not known whether the organizing pneumonia was a de novo process or resulted from the late organization of pulmonary edema.69 Penicillium mold dust-related BOOP has been described71 in a patient who developed BOOP after inhalation of powdery dust of a growth of Penicillium janthinellum mold on the top of a discarded orange juice container. Smoke inhalation BOOP has been reported72 in a patient who was in a house fire and had erythema nodosum.

Miscellaneous BOOP continues to be reported, eg, in association with myelodysplastic syndrome,73 Hunner interstitial cystitis,74 chronic thyroiditis,75 alcoholic cirrhosis,75 and, in England, seasonal syndrome with cholestasis.76 It has been reported in patients with human immunodeficiency virus infection,77 with one report during pregnancy.78 Inflammatory bowel disease-related BOOP has been described79 as an important treatable disorder in these patients. The BOOP lesion might be associated with lymphoma, and an atypical course of what is thought to be idiopathic BOOP may indicate a neoplastic process such as a lymphoma.80 Recurrent BOOP responsive to prednisone treatment has been reported in T-cell leukemia.81, 82 BOOP has also been reported in primary biliary cirrhosis83 and after coronary artery bypass graft surgery.84

Conclusion

The busy clinician will see patients with a febrile illness and patchy infiltrates who have not responded to antibiotic drug therapy. The patient might have BOOP. Sometimes this disorder is treated in the hospital, but it is generally managed on an ambulatory basis. Typical idiopathic BOOP is characterized by a flulike illness, bilateral crackles, and patchy infiltrates and can be cured in 65% to 80% of patients with prednisone therapy. BOOP has become an important consideration in the diagnosis of focal nodular lesions. Postinfectious pneumonia BOOP remains a treatable process. BOOP occurs in virtually all of the connective tissue disorders and generally responds to corticosteroid therapy. It is an important treatable inflammatory lung disease.  (+ info)

Do I have balanitis xerotica obliterans Or Phimosis ?


Ok , Need A Bit Of Help , In Detail . I have Been Reading the conditions of these two Problems Or Diseases Whatver You Want To Call Them , And I Hear About Foreskin Streching , But This Is My Problem

My Penis Is Quite Small For My Age ( 16 ) , And I Am Unable To See My Glands , I Have Only Ever Seen My Pee Hole , And A Lil More , I Am Unable to Remove My Foreskin And It Is Very THICK AND BUMPY , The Texture Is Horrid When Retracted , Like I Say Thick And REALLLY Tight , Making It Impossible For Me To Retract It Past My Glands , Plus There Seems To Be A String Piece Of Skin On The Inner Left Side Of My Penis Attached To My Glands Making It Impossible For Me To retract My Foreskin , Im 16 So This Is Obvious Techinaclly , Ruining My Life When It Comes to Girls , Sex And Confidence , I Obviousley Cant Have Sex Until I get This Sorted , Im Gonna Make The Brave Decision of Going to the Doctor On Monday .

If I Need Circumcised , Is There Anyway Of Them Doing The Procedure Without Consulting My Parents .

Thanks

:D All Help Apreciated
Really Dont Want To Tell My Parents If I end Up Gettin Circumsized , I Have A Really Bad Social RelationShip , And Just Cant Talk About That Sort Of Thing . Also Is This Condition Whats Made My Penis Like . 2in Placid 3.5 erct
Rich i cant ive tryed so hard , but theres hardly no room to put m fingers in , and its really THICK and its so hard to hold because its that tight , i Have booked an appointment with a doctor on monday , i dont really care about tellin him , just my parents are weird they fit over stupid things .. well specially my mom
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For most people with phimosis (unretractable foreskin), the cause isn't BXO.

If you have balanitis xerotica obliterans then you will likely have an unretractable foreskin. You should notice a hardened ring of skin around the foreskin normally with a whitish discolouration.
Example pic: http://www.terveyskirjasto.fi/terveyskirjasto/tk.koti?p_artikkeli=ima01494

Do a google image search to make sure:
http://images.google.com

Also see this page:
http://www.cirp.org/library/treatment/BXO/

and this blog for a guy who cured it:
http://bxo-phimosis.blogspot.com/

If it is not BXO but just normal phimosis then it can be cured. It may be down to your masturbation technique.

The average age for the foreskin to retract is 10 years of age. For some boys though it doesn't become retractable until the early teenage years. See here for what normal retraction looks like:
http://geocities.com/painfulquestioning/naturalresources

Certain masturbation techniques that differ from the normal up and down motion mimicking sex can damage both the foreskin and the 3 delicate spongy arteries within the penis.
Diagram: http://dic.academic.ru/dic.nsf/enwiki/265769

Examples of damaging masturbation habits include:
*Rubbing the penis head through clothes - this often comprises pushing down on the penis. Many boys/men do this watching porn.
*Thrusting against the bed.

Using these techniques (especially the first one) does 2 things. Firstly, rubbing the top of the foreskin and manipulating it in an unnatural manner creates scar tissue. This scar tissue is inelastic. Normal foreskin tissue is pliable making it easier to retract.

Secondly, if you are applying large pressure to the penis through your masturbation technique the 3 spongy arteries that make up the penis will become damaged (see diagram above). Consequently, the penis doesn't fill up with blood properly and doesn't stretch the skin from the inside-out in the normal manner.

Check for signs of damage:
* The glans (the head underneath) can be sensitive
* Each side of the pee-hole is red.

So, do you do any of these techniques? I'd be interested to know.

Presuming you do, a few things you need to do to cure the unretractable foreskin.
Initially, give your penis time to repair the spongy arteries that may have been damaged. Repair happens when the penis isn't in use. Masturbate as little as possible initially. You can start doing it again after a while - but don't do it too frequently.

When you start masturbating again, you will need to change to a masturbation technique which isn't damaging. This is the one most people use: Lightly grip the shaft and move the foreskin up and down, applying as little pressure as possible. Stop any 'rubbing' masturbation techniques.

I'm pretty sure if you stick with this advice, it will retract. It may take some time though.

If you go to the doctors , he might offer you circumcision. However, if you follow the above advice you will likely not need it. Circumcision is bad for several reasons.

The foreskin contains many specialized nerves on it's underside. When the foreskin is moved up and down it is very pleasurable. Circumcised men have lost this ability to masturbate easily as there is no gliding effect. Circumcised men often have to resort to artificial lubrication in masturbation and sex. See here for the function of the foreskin:
http://geocities.com/painfulquestioning/naturalresources

Without the foreskin protecting the glans, circumcised men lose further sensitivity. The glans (head of the penis) dries out. It also brushes on underwear causing the skin to toughen. See here for the full damage done:
http://www.noharmm.org/IDcirc.htm

There are good reasons to believe that sex is better for the woman as well, if the man has his foreskin intact:
http://xrl.us/foreskinfunctions

Circumcision is also a risky procedure with a lot of complications:
http://www.circumstitions.com/Complic.html  (+ info)

Doctor says I need a Meatonomy?


My doctor has diagnosed me with bxo (Balanitis xerotica obliterans) and says i need a Meatonomy. Can anyone share their experiences or knowledge with type of procedure?
I know that this is a body modification procedure as well - please share any knowledge please
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I am writing because I did a search on this procedure that might be of help. I am including the link to the search:

http://search.yahoo.com/search?p=Meatonomy  (+ info)

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