Diagnosis and treatment of benign condylar hyperplasia / 口腔疾病防治

@#Benign condylar hyperplasia is one of the causes of mandibular lateral deformity, it is easily to be misdiagnosed clinically and leads to the treatment failure. This article will elaborate the etiology and clinical features of benign condylar hyperplasia, as well as the diagnostic points and treatment progress, based on the literature and the clinical experience of our research group, to provide evidence-based medical evidence for the standardized clinical treatment of benign condylar hyperplasia. The etiology of benign condylar hypertrophy includes neurotrophic disorders, local circulatory disorders, traumatic injuries (especially condylar injuries that occur in childhood), unilateral mastication, temporomandibular arthritis, endocrine disorders, condylar osteoma, and heredity. Benign condylar hypertrophy is insidious, and occurs most frequently in individuals 10-30 years old, and the course of disease can last for many years. Its clinical characteristics are slow progressive facial asymmetry. Radionuclide bone scans have become the basis for the diagnosis and differential diagnosis of and treatment planning for benign condylar hypertrophy. Different treatment plans for active and inactive periods need to be developed, including close observation, proportional condylar resection and orthognathic surgery.

Nevus verrugoso gigante con componente angiomatoso cavernoso. Presentación de un caso / Giant Warty Nevus with Cavernous Angioma Component. Case Presentation

RESUMEN El nevus verrugoso es una hiperplasia benigna y congénita de la epidermis superficial y los anexos. Se considera un hamartoma derivado del ectodermo, posiblemente ocasionado por una aberración cromosómica localizada en el brazo largo del cromosoma 1. Se presenta el caso de un paciente de sexo masculino, de 3 años de edad, portador de nevus verrugoso gigante con componente angiomatoso cavernoso, en región occipital, sin otras anomalías. Se utilizaron los datos provenientes de fuentes documentales (carné obstétrico, carné pediátrico, historias clínicas hospitalaria y ambulatoria), exámenes de laboratorio e imagenológicos, así como información obtenida a partir de la entrevista a la madre, para describir la evolución desde el nacimiento. Se realizó búsqueda bibliográfica y se comentan aspectos relacionados con la incidencia, localizaciones, edad de presentación, las características clínicas e histopatológicas, el tratamiento y la evolución. Se realiza este reporte por la baja frecuencia de esta patología en el Hospital Pediátrico General Luis Ángel Milanés de Bayamo, Granma.

ABSTRACT The warty nevus is a benign and congenital hyperplasia of the superficial epidermis and the annexes. It is considered a hamartoma derived from the ectoderm, possibly caused by a chromosomal aberration located on the long arm of chromosome 1.The case of a 3 year-old male patient is presented, with a giant warty nevus with an angioma cavernous component in the occipital region, without other anomalies. Data from documentary sources (such as obstetric card, pediatric card and hospital and outpatient medical records), laboratory and imaging tests, as well as information obtained from the mother's interview, were used to describe the evolution from birth. Issues related to the incidence, locations, age of presentation, clinical and histopathological characteristics, treatment and evolution are discussed, on the bases of a bibliographic search. This report is made due to the low frequency of this pathology at the Paquito González Cueto de Cienfuegos University Pediatric Hospital.

Comportamiento sindrómico de pacientes con hiperplasia benigna de la próstata según la Medicina Tradicional China / Syndrome behavior of patients with prostate benign hyperplasia according to the Traditional Chinese Medicine

Introducción: la hiperplasia benigna de la próstata se define como una entidad histopatológica caracterizada por un crecimiento fibromioadenoso de la glándula prostática. Según la Medicina Tradicional China se clasifica bajo categorías diferentes, dependiendo de cada paciente y de sus síntomas clínicos principales. Objetivo: establecer el comportamiento de esta enfermedad según la Medicina Tradicional China. Materiales y Métodos: se realizó un estudio observacional, descriptivo, en pacientes con diagnóstico de hiperplasia benigna de próstata atendidos en el Servicio de Referencia Provincial de Medicina Natural y Tradicional "Dr. Mario E. Dihigo" de Matanzas, en el período correspondiente a febrero 2013 agosto de 2014. El universo lo conformaron los pacientes diagnosticados con la patología y que asistieron a consulta de Medicina Natural y Tradicional. La muestra fueron los 100 pacientes dispuestos a participar en la investigación que firmaron voluntariamente el consentimiento informado y se les realizó historia clínica. Resultados: la deficiencia de Yin en riñón e hígado y la humedad-calor en Jiao inferior fueron los diagnósticos que prevalecieron en la investigación. Conclusiones: la realización del diagnóstico tradicional chino posibilita indicar un tratamiento individualizado a los pacientes al tratar la causa que lo origina (AU).

Introduction: the prostate benign hyperplasia is defined as a histopathologic entity characterized by the prostate gland fibromioadenomatous growth. According to the Traditional Chinese Medicine it is classified in different categories, depending on each patient and his/her main clinical symptoms. Objective: to establish this disease behavior according to the Traditional Chinese Medicine. Materials and methods: an observational, descriptive study was carried out in patients diagnosed with prostate benign hyperplasia attended at the Provincial Reference Service of Natural and Traditional Medicine "Dr. Mario E. Dihigo" of Matanzas, in the period from February 2013 to August 2014. The universe was formed by the patients diagnosed with that pathology who assisted to the consultation of Natural and Traditional Medicine. The 100 patients who were ready to participate and voluntarily gave their informed consent were the sample; medical records were written. Results: Yin deficiency in kidney and liver, and humidity-warm in lower Jiao were the diagnoses that prevailed in the research. Conclusions: to make the traditional Chinese diagnosis allos to indicate an individualized treatment to the patients while treating the originating cause (AU).

The value of DWI and ADC of 1.5T magnetic resonance in differential diagnosis for localized prostate cancer, chronic inflammatory response and benign hyperplasia / 中国医学装备

Objective:To compare and analyze the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) of 1.5T magnetic resonance (MR) in differential diagnosis for localized prostate cancer, chronic inflammatory response and benign hyperplasia.Methods: 80 patients with localized prostate cancer were enrolled in the research. The signal to noise ratio (SNR) of DWI, ADC value and semi-quantitative classification of DWI on lesions were measured, and the diagnostic efficiencies of them were compared by using ROC curve.Results: In the 80 patients with localized prostate cancer patients, there were 52 malignant lesions and 43 benign lesions in peripheral band, and there were 31 malignant lesions and 46 benign lesions in central gland. The ADC values of prostate cancer in peripheral band and central gland were 0.91±0.12 and 0.86±0.15, respectively, and they were significantly lower than that of normal tissue (1.68±0.23 and 1.28±0.31) and benign lesions (1.24±0.21 and 1.12±0.16). The semi-quantitative classifications of DWI for benign lesions were significantly higher than that for malignant lesions in peripheral band and central gland, respectively (x2=20.88,x2=12.14;P<0.05). For the diagnostic efficiency of ADC, the sensitivities of benign and malignant lesions in peripheral band and malignant gland were 91.3% and 79.1%, respectively, and the specificities of them were 89.6% and 70.2%. And they was significant higher than the corresponding sensitivities (71.2% and 51.3%)and specificities (78.4% and 65.8%) of DWI imaging.Conclusion: Both of DWI and ADC of 1.5T magnetic resonance are the important indexes in differential diagnosis for prostate cancer, chronic inflammatory response and benign hyperplasia, while ADC value is better than DWI image in the clinical efficiency.

Low free to total PSA ratio is not a good discriminator of chronic prostatitis and prostate cancer: An Indian experience.

Aims: To find out the utility of free to total PSA ratio in discriminating chronic prostatitis and prostate cancer. Setting and design: The patients visited urology clinics at Batra Hospital and Medical Research Center, New Delhi. Background: The use of serum free to total PSA as a diagnostic tool for prostate cancer has led to early detection of prostate cancer; however, the effect of inflammation on f/t PSA ratio restricts its use in early detection of cancer. Materials and Methods: The study was conducted in age related 101 patients which include 27 carcinoma patients (group I), 34 BPH patients (group II) and 40 chronic prostatitis patients (group III). Serum total PSA (tPSA) and free PSA (fPSA) were analyzed on Elecsys 2010. These were compared with histological reports of biopsy specimen. Other biochemistry tests were done on Randox Imola. P Value was calculated using one way ANOVA with posthoc Bonferroni analysis. Results: Serum total PSA levels were comparable in group I and III and were higher than group II (P < 0.049). Serum fPSA in group I was not significantly different from group II and III, However, group II has higher levels than group III (P < 0.035). Difference was significant for f/t PSA ratio in group I and II (P < 0.00) and group II and III (P < 0.000).Group I and III were with comparable levels (P < 0.807). Conclusions: f/t PSA ratio is not a good discriminator for malignancy and chronic prostatitis. This limitation of f/t PSA ratio must be taken into consideration while interpreting the results clinically.

Resección transuretral de próstata, comparación de técnica bipolar versus monopolar / Transurethral resection of prostate: comparing bipolar versus monopolar technique

La resección transuretral de próstata (RTUP) es el tratamiento estándar de los síntomas del tracto urinario inferior (STUI), secundarios a obstrucción por crecimiento prostático benigno. El avance tecnológico hace necesario realizar estudios para determinar si todas las técnicas disponibles son igualmente efectivas y seguras que la estándar. Objetivo comparar la RTUP bipolar con la RTUP monopolar, analizando resultados sintomáticos, uroflujométricos y las complicaciones asociadas. Se analizaron pacientes sometidos a RTUP mono y bipolar entre los años 2009 y 2011. El análisis se realizo con Stata 11.2. Resultados: Se analizaron 63 pacientes, un 55 por ciento de ellos fueron sometidos a RTU monopolar y el 45 por ciento a bipolar. El promedio de edad de ambos grupos fue de 66 años. El volumen prostático promedio del grupo monopolar fue de 58.65cc, y del grupo bipolar 67.44 .La mediana del Score IPSS pre-operatorio del grupo monopolar y bipolar fue de 20 y 22 respectivamente, y el post operatorio fue de 4 y 3, siendo la diferencia pre y post operatoria estadisticamente significativa (p=0.006) pero no es significativa al comparar ambos grupos. El Q max promedio pre y post-operatorio en el grupo monopolar fue de 9.08 y 16.8 ml/seg y en el grupo bipolar fue de 6.8 y 16.2 ml/seg. respectivamente. Las diferencias entre los Q máx pre y post quirúrgicos en ambos grupos fue significativa (p<0.001) , pero no al comparar las dos técnicas. El tiempo quirúrgico promedio fue de 58 min para el grupo monopolar y de 64.5 min para el bipolar, siendo esta diferencia significativa (p=0.01). El promedio de tejido resecado para el grupo monopolar fue de 24.9g. y de 29.6g para el grupo bipolar siendo significativa esta diferencia (p=0.04). No hubo diferencias entre ambos grupos al analizar hematocrito y sodio pre y post quirúrgico, días de hospitalización, días de sonda y proporción de complicaciones: síndrome post RTU, hematuria, infecciones, retención aguda de...

Transurethral resection of Prostate (TURP) is the Standard treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction growth. Technological advancement is necessary to conduct studies to determine whether all available techniques are equally effective and safe as standart.To compare bipolar TURP with monopolar TURP, analyzing results symptomatics uroflujometics and associated complications. Patients undergoing monopolar and bipolar TURP between 2009 and 2011. The analysis was perfomed using Stata 11.2. Results: We analyzed 63 patients, 55 percent of them underwent monopolar TURP and 45 percent for bipolard. The average age of both group was 66 years. The group mean prostate volume was 58.65 cc monopolard and bipolar group 67.44 . The median preoperative IPSS Score of monopolardand bipolar group was 20 and 22 respectively, an postoperatively was 4 and , the difference before and after surgery stadisticament significant (p=0.006) but not significant when comparing both groups. The average Q max pre and postoperative in the monopolar group was 9.08 and 8.16 ml/sec and in the bipolar group was 6.8 and 16.2 ml/sec respectively. The differences between pre and post surgical Q max in both groups was significant (p< 0.001), but not to compare the two techniques. Mean operative time was 58 min for the monopolar group and 64.5 min for bipolar, this difference was significant (p=0.01). The average for the group resected tissue was 24.9 gr for the monopolar, and 29.6 gr for the bipolar group this difference was significant (p=0.04). There were no difference between the two groups to analyze hematocrit and sodium pre and post surgical, hospital days, days of probe and rate of complications: post TURP syndrome, hematuria, infection, acute urinary retention...

Outcome of 500 cases of transurethral resection of Prostate (TURP) in District level teaching Hospital.

Type of Study: This is a prospective study in a district level teaching from 1sr march 2003 to December 2008. The sample size was n – 500. All Patients were evaluated with history, clinical examination and allied investigations. As per selection criteria we did TURP and each patient was followed up to six months. Purpose & Importance of TURP: It has been established that open prostatectomy has got higher morbidity than that of transurethral resection of prostate (TURP). The shorter hospital stay, early institution to working place, minimum blood loss, and acceptable financial involvement makes it excellent patient’s compliance. Method: The prospective studies include n – 500 cases of LUTS predominately obstructive voiding symptoms. After evaluation & fulfilling the selection criteria standard TURP were done in all cases. Result: The mean Q max improved in n – 476 cases (from 6.68 ml/ sec. to 17.47ml/second) in early post-operative period. Among others most of the cases improved within 06 months. Some of the cases (0.25%) needs secondary procedure for late complications like stricture urethra. Erectile dysfunction was not a major problem in our series. Death noticed in two cases in post operative ward due to cardiogenic shock. Conclusion: The outcome of the present study has been compared with other studies and it appears that TURP is an excellent minimally invasive procedure for the management of symptomatic BPH.

Benign hyperplasia of duct-associated lymphoid tissue: Report of a case and review of literature.

Focal lymphoid tissue is ubiquitously present in the oral mucosa and serves as a barrier for entrapment of antigens. The mucosa-associated lymphoid tissue is generally dispersed and sometimes associated with the ducts of the minor salivary glands. Proliferation of the duct-associated lymphoid tissue (DALT) is rarely reported, though probably of common occurrence. We report a case of benign hyperplasia of DALT in the buccal mucosa of a 58-year-old male. The histogenesis and pathological implications of this tissue are discussed and the need for recognition of this entity is stressed.

Study on the characteristics and some risk factors of transurethral prostatectomy syndrome

Background: Benign hyperplasia prostate is a common disease in older men (over 60 years old). Transurethral resection of benign hyperplasia prostate is a method of improving symptoms with the best results, though with a high rate of complications, in which the most serious complication is transurethral prostatectomy syndrome (TURPS). Objective: The study aimed to describe clinical and para-clinical characteristics of TURPS and to define some risk factors of TURPS. Subject and methods: A descriptive, prospective study was conducted in 200 patients, who underwent TURPS, ASA I-II at the Anesthetic Emergency Department, Viet Duc Hospital from April 2007 to October 2007. To describe TURPS by observing clinical signs and serum sodium. The risks of TURPS were considered as prostate weight, operation time and amounts of used irritants. Results: The incidence of the TURPS was 7% of all resections. Clinical signs of the TURPS were nausea, vomiting, headaches, confusion and disorientation. TURPS was associated with hypotension (42.9%), bradycardia (35.7%), increased CVP (21.4%). The sodium concentration fell below normal in certain patients (64.3%). The amount of 3% Sorbitol (> 20 liters) was an independent risk factor of TURPS, but not the prostate weight or the operation time. Conclusions: The main signs of TURPS included central nervous symptoms (100%), circulatory and respiratory disorders (42.9%, 21.4%, respectively) and hyponatremia (64.3%). Sorbitol 3% > 20 liters was an independent risk factor of TURPS.

Evaluación del extracto lipofílico de Cucurbita pepo L. sobre la hiperplasia prostática inducida por andrógenos / Evaluation of Cucurbita pepo L. lipophilic extract on androgen-induced prostatic hyperplasia

El aceite de semillas de calabaza ha sido ampliamente utilizado en el tratamiento de la hiperplasia prostática. En el presente trabajo se estudió el efecto del extracto lipofílico de semillas de Cucurbita pepo L (ELMSC) en el modelo in vivo de hiperplasia prostática experimental inducida por propionato de testosterona durante 15 días. Se observó que el ELMSC a las dosis de 400 y 200 mg/ kg provocó una disminución significativa del crecimiento prostático. Nuestros resultados indican que el ELMSC a dosis mayores de 200 mg/ Kg inhibe el crecimiento prostático inducido por la testosterona en el modelo experimental de hiperplasia prostática en ratas.

Oil from pumpkin seeds has been widely used in the treatment of prostatic hyperplasia. In the present paper, the effect of lipophilic extract of Cucurbita pepo L seeds (ELMSC) was studied in an in vivo model of testosterone propionate -induced experimental prostatic hyperplasia during 15 days. It was found that ELMSC at doses of 400 and 200 mg/kg caused a significant decrease of prostatic growth. Our findings showed that doses of ELMSC over 200 mg/kg inhibits the testosterone-induced prostatic growth in the experimental model of prostatic hyperplasia in rats.