The role of Type 2 Diabetes as a predisposing risk factor on the pulpo-periapical pathogenesis: review article / 대한치과보존학회지

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type 1and 2 DM are most common form and the prevalence of the latter is recently increasing. The aim of this article was to assess whether Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction was larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 DM itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered. The function of polymorphonuclear leukocyte is also impaired and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process. Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.

Early Stage Syphilis: Clinical and Pathological Analysis of 1200 Cases / 中华医院感染学杂志

OBJECTIVE To study the clinic feature and cause of misdiagnosis of early stage syphilis and evaluate the significance of histopathology in the diagnosis of the disease. METHODS Totally 1 200 early syphilis cases were analyzed.The serologic test for syphilis was performed.Thirty five of them were performed with histopathological examination. RESULTS The primary syphilis was found to be commonly misdiagnosed as chancroid,genital herpes,scabies nodules and ulcus vulvae acutum.For secondary syphilis,macular syphilide and maculopapular syphilide were easily misdiagnosed as pityriasis rosea or dermatitis.The papulosquamous syphilide was commonly misdiagnosed as psoriasis.The condyloma latum was commonly misdiagnosed as condyloma acuminatum. CONCLUSIONS The serologic test is important in diagnosis of primary syphilis.The histopathologic test plays a role in diagnosis of primary syphilis,condyloma latum and papulosquamous syphilide,but of limited value in diagnosis of macular syphilide.

Two Cases of Prurigo Pigmentosa: A Histopathologic Anaylsis / 대한피부과학회지

Prurigo pigmentosa - a rare dermatosis described first by Nagashima in 1971 - presents as intensely pruritic papules arranged in a reticular pattern and distributed symmetrically on the back of young women. Individual lesions involute within weeks, leaving net-like pigmentation, but recurrences are the rule. According to the recent report of Ackerman et al., prurigo pigmentosa shows discernable characteristic histopathologic stages successively in its natural course. We report two cases of prurigo pigmentosa with clinico-histopathologic analysis - one, occurred in 24-year old man who recovered spontaneously after 7 months of morbidity and the other, occurred in 23-year old woman who responded dramatically to dapsone.

Clinical and Histopathological Analysis of 494 Cases of Percutaneous Renal Biopsies / 대한신장학회잡지

Percutaneous renal biopsy is an essential component for diagnosis and management of glomerular diseases. In order to elucidate clinical and pathological features, 494 renal patients who had undergone renal biopsies at Gil Medical Center from January 1989 to June 1999 were studied retrospectively. The male to female ratio was 1.3 : 1 and average age was 33.2 years. There were 370(83.5%) cases of primary glomerular disease and 58(13.1%) cases of secondary glomerular disease. Among primary glomerular disease, IgA nephropathy was the most common(175 cases), followed by minimal change disease(84 cases), membranous glomerulonephritis(34 cases), and focal segmental glomerulosclerosis(33 cases). In secondary glomerular disease, lupus nephritis was the most common(21 cases), followed by 11 cases of hepatitis B associated glomerulonephritis, 9 cases of Henoch-Sch nlein purpura, and 4 cases of diabetic nephropathy. Among 99 cases of asymptomatic urinary abnormalities, IgA nephropathy was most common(69 cases) followed by 12 cases of thin basement membrane disease, 4 cases of minimal change disease, and 3 cases of focal segmental glomerulosclerosis, membranous glomerulonephritis, nonspecific glomerulonephritis. Among 159 cases of nephrotic syndrome, minimal change disease was most common(60 cases) followed by 25 cases of IgA nephropathy, 23 cases of focal segmental glomerulosclerosis, 21 cases of membranous glomerulonephritis, and 13 cases of lupus nephritis. Documented complication of renal biopsies included 23 cases of gross hematuria, 6 cases of perirenal hematoma, and 4 cases of infection. Death, AV fistula, aneurysm or serious compications that required surgical intervention were not reported. In conclusion, the percutaneous renal biopsy is relatively safe, and useful for diagnosis and management of glomerular diseases. The most common type of primary glomerular disease was IgA nephropathy.