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1.
Article in English | MEDLINE | ID: mdl-36804060

ABSTRACT

We report a case of osteonecrosis of the jaw (ONJ) with pembrolizumab, a rare yet possibly emerging complication. In this case, a temporal relationship between the development of ONJ and the patient's treatment regimen suggested an association between pembrolizumab/GVD therapy and the development of ONJ. Thrombocytosis and anatomic factors may also have played a role. The number of patients using pembrolizumab will likely continue to increase. We document this instance in order to better inform dental treatment around cancer patients undergoing pembrolizumab therapy.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Jaw Diseases , Osteonecrosis , Humans , Diphosphonates/adverse effects , Bone Density Conservation Agents/adverse effects , Jaw Diseases/complications , Osteonecrosis/complications , Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology , Jaw
2.
Head Neck Pathol ; 15(1): 262-266, 2021 Mar.
Article in English | MEDLINE | ID: mdl-32096100

ABSTRACT

The presence of non-odontogenic cysts associated with benign fibro-osseous lesions of the jaws has been well documented. However, literature is scant when describing benign fibro-osseous lesions with associated odontogenic cysts. This case report highlights the presence of a concurrent developmental odontogenic cyst, glandular odontogenic cyst with extensive squamous metaplasia, in a patient with florid cemento-osseous dysplasia (COD). The postulated pathogenesis of these synchronous lesions is discussed along with a review of current literature. Surgical treatment is discouraged for florid COD, however, radiological follow-up is recommended, especially in lesions with associated cysts.


Subject(s)
Fibrous Dysplasia of Bone/complications , Fibrous Dysplasia of Bone/pathology , Jaw Diseases/complications , Jaw Diseases/pathology , Odontogenic Cysts/complications , Odontogenic Cysts/pathology , Osteomyelitis/complications , Osteomyelitis/pathology , Adult , Female , Humans
3.
J Neuromuscul Dis ; 6(3): 361-368, 2019.
Article in English | MEDLINE | ID: mdl-31476167

ABSTRACT

BACKGROUND: Spinal muscular atrophy (SMA) is hereditary motor neuron disorder, characterised by the degeneration of motor neurons and progressive muscle weakness. It is caused by the homozygous loss of function of the survival motor neuron (SMN) 1 gene. SMA shows a wide variability of disease severity. OBJECTIVE: To investigate self-reported bulbar problems in patients with SMA, and their relationship to age, functional motor scores and active maximum mouth opening. METHODS: We used the Diagnostic List of Dysphagia and Dysarthria in (pediatric) patients and relevant recent clinical data from the national SMA database. RESULTS: The 118 included patients with SMA frequently reported jaw problems (34%), fatigue associated with mastication (44%), choking (56%) and intelligibility problems (27%). Jaw, mastication and swallowing problems frequently occurred in combination with each other. There was an increase of reported bulbar problems in patients with SMA type 3a, older than 30 years of age, compared to younger patients of this SMA type.The Hammersmith Functional Motor Scale Expanded scores showed a negligible correlation with jaw and mastication problems, a low negative correlation with swallowing problems and a moderate negative correlation with intelligibility problems. Reduced mouth opening showed a significant, but low correlation with bulbar complaints in patients with SMA type 2. CONCLUSIONS: Fatigue associated with mastication and swallowing problems were frequently reported complaints. Patients 30 years and older with milder forms of SMA showed an increase of self-reported bulbar problems.


Subject(s)
Muscular Atrophy, Spinal/complications , Adult , Aged , Airway Obstruction/complications , Airway Obstruction/epidemiology , Deglutition Disorders/complications , Deglutition Disorders/epidemiology , Fatigue/complications , Fatigue/epidemiology , Female , Humans , Jaw Diseases/complications , Jaw Diseases/epidemiology , Male , Middle Aged , Muscular Atrophy, Spinal/epidemiology , Self Report , Speech Intelligibility/physiology , Surveys and Questionnaires , Young Adult
4.
In Vivo ; 33(2): 559-562, 2019.
Article in English | MEDLINE | ID: mdl-30804141

ABSTRACT

The association of the high blood pressure D variant of the angiotensin-converting enzyme (ACE) gene with medication-related jaw osteonecrosis (MRONJ) is described in two Greek patients. The first patient, a 73-year-old man, took zolendronate, 4 mg/100 ml IV once per month for two years for prostate cancer and bone metastases. Three months after drug discontinuation, extraction of the first premolar was performed. After the intervention, he suffered from osteonecrosis of the mandible. He presented with hypertension and genetic testing revealed that he was homozygous for the high blood pressure D variant of the ACE gene. The second patient, a 65 years old woman, took denosumab, 120 mg subcutaneously once per month for 6 months for possible bone metastases from breast cancer. Three months after extraction of the first molar, she suffered from MRONJ. He also presented with hypertension and genetic testing revealed that she had the high blood pressure D variant of the ACE gene in a heterozygous state, which moderately predisposes to hypertension. To our knowledge, this is the first report indicating that genetic predisposition to hypertension may increase risk for MRONJ.


Subject(s)
Hypertension/genetics , Jaw Diseases/genetics , Osteonecrosis/genetics , Peptidyl-Dipeptidase A/genetics , Aged , Denosumab/adverse effects , Genetic Testing , Heterozygote , Humans , Hypertension/etiology , Hypertension/pathology , Jaw Diseases/chemically induced , Jaw Diseases/complications , Jaw Diseases/pathology , Male , Neoplasm Metastasis , Osteonecrosis/chemically induced , Osteonecrosis/complications , Osteonecrosis/pathology , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Zoledronic Acid/adverse effects
5.
Article in English | MEDLINE | ID: mdl-30449690

ABSTRACT

OBJECTIVE: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJuat), confounding risk assessment. This study aimed to determine if ONJuat is associated with one or more particular comorbidities. STUDY DESIGN: This was a retrospective case-control study of patients with ONJuat and delayed healing (DH). Each case was matched for patient age and gender, as well as location of ONJuat or DH lesion to a control patient who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking. RESULTS: Of the 92 patients identified, 67 (73%) met the criteria for ONJuat and 25 (27%) for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least 1) was more prevalent in ONJuat than among controls (P = .04), and there were more comorbidities in patients with ONJuat and DH than in controls [M(SD) = 1.94 (1.2) and 2.0 (1.3) vs 1.26 (0.89); both P < .001]. CONCLUSIONS: ONJ and DH are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJuat and DH.


Subject(s)
Jaw Diseases , Osteonecrosis , Case-Control Studies , Comorbidity , Humans , Jaw Diseases/chemically induced , Jaw Diseases/complications , Osteonecrosis/chemically induced , Osteonecrosis/complications , Retrospective Studies , Risk Factors
6.
BMJ Case Rep ; 20182018 May 30.
Article in English | MEDLINE | ID: mdl-29848529

ABSTRACT

This is a case of a 20-year-old woman who presented with a left jaw mass which was resected and found to be a giant cell granuloma of the mandible. Her history and physical examination were suggestive for Noonan syndrome which was confirmed with genetic testing and the finding of a PTPN11 gene mutation which has rarely been associated with giant cell lesions of the jaw. Given her particular genetic mutation and the presence of a giant cell lesion, we present a case of Noonan-like/multiple giant cell lesion syndrome.


Subject(s)
Granuloma, Giant Cell/complications , Jaw Diseases/complications , Noonan Syndrome/complications , Female , Granuloma, Giant Cell/surgery , Humans , Jaw Diseases/surgery , Mutation/genetics , Noonan Syndrome/genetics , Noonan Syndrome/surgery , Protein Tyrosine Phosphatase, Non-Receptor Type 11/genetics , Treatment Outcome , Young Adult
7.
Arthritis Rheumatol ; 70(4): 508-515, 2018 04.
Article in English | MEDLINE | ID: mdl-29195021

ABSTRACT

OBJECTIVE: To investigate whether periodontitis, characterized by marginal jawbone loss, precedes the onset of symptoms of rheumatoid arthritis (RA), and to analyze plasma levels of RANKL (a cytokine that is crucial for bone resorption) and anti-citrullinated peptide antibodies (ACPAs) in presymptomatic individuals compared with matched referent controls. METHODS: Marginal jawbone loss was measured on dental radiographs of the premolar/molar regions in the jaws in 176 subjects, 93 of whom subsequently developed RA. Among these participating subjects, 46 had documented radiographs predating symptom onset, and 45 cases could be matched to controls, according to sex, age, and smoking status. Plasma RANKL concentrations were analyzed using enzyme-linked immunosorbent assay. A receiver operating characteristic curve was used to define the cutoff value for RANKL positivity. RESULTS: Bone loss was significantly greater in presymptomatic subjects classified as never smokers compared with that in controls, and increasing levels of bone loss were associated with a higher risk of the subsequent development of RA (hazard ratio 1.03, 95% confidence interval 1.01-1.05). No association between jawbone loss and RA was observed in smokers. A significantly greater extent of marginal jawbone loss was detected in RANKL-positive presymptomatic subjects, and even more pronounced jawbone loss was observed in those who were positive for both RANKL and ACPA. CONCLUSION: Marginal jawbone loss preceded the clinical onset of RA symptoms, but this was observed only in nonsmokers. Moreover, marginal jawbone loss was significantly greater in RANKL-positive presymptomatic subjects compared with RANKL-negative presymptomatic subjects and was highest in presymptomatic subjects positive for both ACPA and RANKL.


Subject(s)
Alveolar Bone Loss/blood , Arthritis, Rheumatoid/etiology , Jaw Diseases/blood , Periodontitis/blood , RANK Ligand/blood , Alveolar Bone Loss/complications , Alveolar Bone Loss/diagnostic imaging , Anti-Citrullinated Protein Antibodies/blood , Case-Control Studies , Female , Humans , Jaw/diagnostic imaging , Jaw Diseases/complications , Jaw Diseases/diagnostic imaging , Male , Middle Aged , Periodontitis/complications , Periodontitis/diagnostic imaging , Risk Factors
9.
Dtsch Med Wochenschr ; 142(3): 212-215, 2017 Feb.
Article in German | MEDLINE | ID: mdl-28187489

ABSTRACT

History and clinical findings We elaborate the case of a 72-year-old patient who presented with a painful swelling of the lower jaw in the emergency unit. Investigations and diagnosis In the clinical examination and the CT scan, a widespread cervical emphysema was found which raised suspicion for the presence of a necrotizing fasciitis of the head and neck due to aerogenic infection. Close spatial vicinity to the teeth of the left upper and lower jaw was present, so that the necrotizing fasciitis was assumed to be odontogenic. Treatment and course Based on the clinical presentation and the imaging findings the diagnosis of necrotizing fasciitis in the sense of a possible infection with gas building bacteria accompanying with an infection of the mediastinum was made. Immediately performed therapy included sternotomy and extended surgical debridement of necrosis. Conclusion The presented case emphasizes that necrotizing fasciitis due to gas-producing infections should be considered as a differential diagnosis for cervical soft tissue emphysema for which an odontogenic focus is the most common cause. Rapid diagnosis is essential for successful treatment consisting of immediate surgical debridement and intravenous antibiotics.


Subject(s)
Bacterial Infections/complications , Bacterial Infections/diagnosis , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/etiology , Jaw Diseases/complications , Jaw Diseases/diagnosis , Aged , Bacterial Infections/surgery , Diagnosis, Differential , Fasciitis, Necrotizing/surgery , Female , Humans , Treatment Outcome
10.
J Bone Miner Metab ; 35(3): 344-350, 2017 May.
Article in English | MEDLINE | ID: mdl-27372662

ABSTRACT

This study aimed to evaluate dental treatments, tooth extractions, and osteonecrosis of the jaw (ONJ) in Japanese patients with rheumatoid arthritis (RA). Patients with RA enrolled in our cohort completed self-administered questionnaires, which included questions regarding their dental treatments, tooth extractions by dentists during the past 6 months, and past history of ONJ. The history of ONJ was validated with the patients' medical records. Logistic regression was used to determine the association of variables with dental treatments and tooth extractions during the past 6 months. Among 5695 Japanese patients with RA who responded to the questionnaires (mean age, 61.0 years; 85.6 % female), 2323 patients (40.8 %) and 378 patients (6.6 %) reported having had dental treatments and tooth extractions performed by a dentist within the past 6 months, respectively. In multivariate models, advanced age was significantly (P < 0.0001) associated with both dental treatments and tooth extractions during the prior 6-month period, and ever smoking was significantly (P = 0.023) correlated with tooth extractions during that time. Among patients who reported a history of ONJ, we confirmed five cases of ONJ with patient medical records. The prevalence of ONJ was 0.094 % among all RA patients and 0.26 % among female RA patients ≥65 years of age (n = 1888). Our data suggest that more than a few Japanese patients with RA have dental complications that require care by dentists, and that Japanese rheumatologists and dentists should cooperate to improve dental health in patients with RA.


Subject(s)
Arthritis, Rheumatoid/complications , Asian People , Jaw Diseases/complications , Osteonecrosis/complications , Tooth Extraction , Cohort Studies , Female , Humans , Jaw Diseases/diagnosis , Logistic Models , Male , Middle Aged , Multivariate Analysis , Osteonecrosis/diagnosis , Surveys and Questionnaires
11.
J Med Case Rep ; 10: 166, 2016 Jun 09.
Article in English | MEDLINE | ID: mdl-27277007

ABSTRACT

BACKGROUND: Hyperparathyroidism is a disease characterized by excessive secretion of parathyroid hormone, the hormone responsible for calcium and phosphate homeostasis in the body. It can be of three types: primary, secondary, or tertiary. It is essential to bear in mind that in any one patient more than one type of hyperparathyroidism may be found, which may create perplexity regarding the etiology of the case. Hyperparathyroidism can become apparent early in its course when a patient presents with symptoms of abdominal pain, recurrent renal calculi, repeated fractures, or behavior changes. It is generally accepted that bone involvement is a late manifestation of primary hyperparathyroidism. It is imperative to consider that some patients, such as our patient described in this report, may be previously asymptomatic clinically and on the basis of laboratory findings and present with only late skeletal manifestations. Brown tumors are one of the mimickers of lytic lesions of the jaw and need to be ruled out early in the course of management. Researchers in several studies published in high-impact journals have recommended the use of high-dose vitamin D as safe in patients with primary hyperparathyroidism without the risk of raising calcium levels significantly. In our patient, we observed considerable hypercalcemia after high-dose vitamin D therapy, and we propose exercising discretion with the use of high-dose therapies. CASE PRESENTATION: We report a case of a 21-year-old Arab woman with a brown tumor who presented with hypocalcaemia. She presented with a mixed picture of primary hyperparathyroidism and severe vitamin D deficiency. CONCLUSIONS: Brown tumors, although thought to be a forgotten entity with the advent of early screening for hypercalcemia, is still prevalent, as a handful of patients may present late in the disease course with no early markers, such as in our patient. We emphasize using a holistic approach for early diagnosis and adopting a restricted attitude to treating these benign entities, especially in the context of cosmesis for sensitive locations such as the face. In addition, we express caution in using daily supplementation with a high vitamin D dose to improve vitamin D status and decrease parathyroid hormone.


Subject(s)
Hyperparathyroidism, Primary/complications , Jaw Diseases/complications , Osteitis Fibrosa Cystica/complications , Vitamin D Deficiency/complications , Adult , Diagnosis, Differential , Female , Humans , Hypercalcemia/complications , Vitamin D/therapeutic use , Vitamin D Deficiency/drug therapy , Young Adult
12.
Kyobu Geka ; 69(6): 457-9, 2016 Jun.
Article in Japanese | MEDLINE | ID: mdl-27246131

ABSTRACT

A 47-year-old man was admitted to the emergency room, half a day after having fallen down on his right cheek drunkenly onto a concrete block. Physical examination revealed that the contusion was limited to the right side of his face, only around the cheek, without trauma to the neck, chest or abdomen. But wide ranging tactile crepitus with severe swelling was present on his face and neck due to widely spread emphysema. Computed tomography (CT) scan revealed some fractures of maxillary antrum, facial and cervical emphysema spreading to the lower part of mediastinum. After a conservative treatment, he recovered without any severe systematic complication. It was found that the facial and cervical emphysema and pneumomediastimum completely disappeared on the follow-up CT scan, 18 days after the event.


Subject(s)
Jaw Diseases/surgery , Maxillary Sinus/surgery , Mediastinal Emphysema/surgery , Skull Fractures/surgery , Humans , Jaw Diseases/complications , Jaw Diseases/diagnostic imaging , Male , Maxillary Sinus/diagnostic imaging , Mediastinal Emphysema/diagnostic imaging , Middle Aged , Skull Fractures/complications , Skull Fractures/diagnostic imaging , Tomography, X-Ray Computed , Treatment Outcome
13.
PLoS One ; 10(7): e0131601, 2015.
Article in English | MEDLINE | ID: mdl-26161858

ABSTRACT

Validation of claims-based algorithms to identify serious hypersensitivity reactions and osteonecrosis of the jaw has not been performed in large osteoporosis populations. The objective of this project is to estimate the positive predictive value of the claims-based algorithms in older women with osteoporosis enrolled in Medicare. Using the 2006-2008 Medicare 5% sample data, we identified potential hypersensitivity and osteonecrosis of the jaw cases based on ICD-9 diagnosis codes. Potential hypersensitivity cases had a 995.0, 995.2, or 995.3 diagnosis code on emergency department or inpatient claims. Potential osteonecrosis of the jaw cases had ≥1 inpatient or outpatient physician claim with a 522.7, 526.4, 526.5, or 733.45 diagnosis code or ≥2 claims of any type with a 526.9 diagnosis code. All retrieved records were redacted and reviewed by experts to determine case status: confirmed, not confirmed, or insufficient information. We calculated the positive predictive value as the number of confirmed cases divided by the total number of retrieved records with sufficient information. We requested 412 potential hypersensitivity and 304 potential osteonecrosis of the jaw records and received 174 (42%) and 84 (28%) records respectively. Of 84 potential osteonecrosis of the jaw cases, 6 were confirmed, resulting in a positive predictive value (95% CI) of 7.1% (2.7, 14.9). Of 174 retrieved potential hypersensitivity records, 95 were confirmed. After exclusion of 25 records with insufficient information for case determination, the overall positive predictive value (95% CI) for hypersensitivity reactions was 76.0% (67.5, 83.2). In a random sample of Medicare data, a claim-based algorithm to identify serious hypersensitivity reactions performed well. An algorithm for osteonecrosis of the jaw did not, partly due to the inclusion of diagnosis codes that are not specific for osteoporosis of the jaw.


Subject(s)
Algorithms , Hypersensitivity/diagnosis , Insurance Claim Review/statistics & numerical data , Jaw Diseases/diagnosis , Osteonecrosis/diagnosis , Aged , Aged, 80 and over , Female , Humans , Hypersensitivity/complications , International Classification of Diseases , Jaw Diseases/complications , Medicare/statistics & numerical data , Osteonecrosis/complications , Osteoporosis, Postmenopausal/complications , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , United States
14.
J Oral Pathol Med ; 43(9): 647-51, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25389542

ABSTRACT

CONTEXT: Aneurysmal bone cysts are rare pseudocysts, commonly seen in long bones and vertebral column. Although a well described and reported lesion, many misconceptions still prevail regarding their etiopathogenesis. Many of the reported cases of jaw aneurysmal bone cysts (JABC) present with another bone pathology. AIMS: The purpose of this review was to evaluate the incidence of neoplastic lesions occurring simultaneously with a JABC (in contrast to primary JABCs). Any pathogenetic and oncogenetic association between primary and secondary jaw ABCs has been reviewed and discussed. SETTINGS AND DESIGN: A methodical narrative review of literature was performed, given the incidence of mostly case reports on this topic. METHODS AND MATERIAL: A methodical electronic search of Pubmed, Pubmed Central, Medline and Cochrane databases was performed for reported cases of JABC. These articles were analysed and segregated into primary and secondary ABC and, if secondary, the lesion it concurrently occurred with. Another search was conducted to yield articles discussing the cytopathogenetic and oncogenetic origins of ABCs. RESULTS AND CONCLUSIONS: About 15% of the ABCs reported were of secondary nature. Amongst the associated lesions, cement-ossifying fibroma and ossifying fibroma were the most common, followed by fibrous dysplasia and central giant cell granuloma. No ABCs were associated with metastatic changes. The search for histopathogenesis pointed to a specific cytogenetic abnormality as the origin of primary ABCs, with USP6 as its main oncogene and spindle cell as the neoplastic cell, unlike with secondary ABCs, suggesting that they are distinct pathological processes.


Subject(s)
Bone Cysts, Aneurysmal/etiology , Jaw Cysts/etiology , Cementoma/complications , Fibroma, Ossifying/complications , Fibrous Dysplasia of Bone/complications , Granuloma, Giant Cell/complications , Humans , Jaw Diseases/complications , Jaw Neoplasms/complications , Recurrence , Terminology as Topic
15.
J Clin Sleep Med ; 10(12): 1339-40, 2014 Dec 15.
Article in English | MEDLINE | ID: mdl-25325595

ABSTRACT

ABSTRACT: We report a healthy teenager with involuntary nocturnal tongue biting resulting in recurrent tongue injury. Causes for tongue biting during sleep in children include seizures, bruxism, faciomandibular myoclonia, hypnic myoclonia, and rarely geniospasm, which has been described as a rare inherited movement disorder accompanied with chin quivering. In the absence of family history, we diagnosed our patient with sporadic geniospasm based on polysomnographic findings with good response to clonazepam. Geniospasm should be considered in the differential diagnosis of cases with unexplained tongue injury in sleep.


Subject(s)
Jaw Diseases/complications , Sleep , Tongue/injuries , Tremor/complications , Adolescent , Anticonvulsants/therapeutic use , Clonazepam/therapeutic use , Diagnosis, Differential , Humans , Jaw Diseases/diagnosis , Jaw Diseases/drug therapy , Male , Polysomnography , Tremor/diagnosis , Tremor/drug therapy
16.
Dent Update ; 41(6): 506-8, 510-2, 2014.
Article in English | MEDLINE | ID: mdl-25195482

ABSTRACT

UNLABELLED: Complete loss of teeth from one or both arches is a disabling condition which is usually managed by a conventional removable denture. Rehabilitation may be poorly tolerated by patients, particularly in the lower jaw, and is more difficult in situations when the anatomy of the denture-bearing area is less favourable. These situations may require specific prosthodontic or surgical techniques, or a combination of both. Prosthodontic solutions involve special impression techniques and the use of soft linings and it is vitally important to manage patient expectations in such cases. This article describes prosthodontic management options for dealing with the fibrous (flabby) anterior ridge and bony exostoses. CLINICAL RELEVANCE: Although tooth loss in the UK is diminishing, it is nevertheless important that dental practitioners are able to demonstrate good prosthodontic skills for managing an ageing population. Surgical correction of anatomical defects may occasionally be employed.


Subject(s)
Denture Design , Jaw, Edentulous/rehabilitation , Patient Care Planning , Centric Relation , Dental Impression Technique , Denture Liners , Denture Retention , Exostoses/complications , Exostoses/surgery , Fibrosis , Gingiva/pathology , Gingivectomy/methods , Humans , Jaw Diseases/complications , Jaw Diseases/surgery , Jaw Relation Record , Jaw, Edentulous/complications , Jaw, Edentulous/surgery
18.
Iran J Kidney Dis ; 8(1): 76-80, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24413727

ABSTRACT

Sagliker syndrome was introduced in 2004 in patients with end-stage renal disease and severe secondary hyperparathyroidism. This syndrome describes maxillary and mandibular deformities, dental abnormalities, benign soft tissue tumors in mouth, and various kinds of skeletal changes including short stature and fingertip abnormalities. There are a few reports from different regions of the world. The aim of this study is to report 5 cases of the Sagliker syndrome from Iran.


Subject(s)
Hyperparathyroidism, Secondary/complications , Jaw Diseases/complications , Kidney Failure, Chronic/complications , Mouth Diseases/complications , Adult , Chronic Kidney Disease-Mineral and Bone Disorder/complications , Female , Humans , Iran , Male , Parathyroid Hormone/blood
19.
J Stroke Cerebrovasc Dis ; 23(1): 179-81, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23040957

ABSTRACT

A 76-year-old man with a history of pontine, cerebellar infaction suddenly became speechless during the procedure of percutaneous coronary intervention. On examination, he was unable to close his mouth voluntarily, but spontaneous closing was preserved when smiling. He had anarthria and hypophonia, although his comprehension was preserved. He also had a severe dysphagia. Radiological studies revealed an acute stroke in the left anterior operculum, indicating Foix-Chavany-Marie Syndrome (FCMS) caused by a unilateral opercular lesion. Pathophysiology of the previous cases reported as unilateral FCMS remains controversial, but in our case, it could be delineated by the combination of the new lesion in the unilateral operculum and the old one in the contralateral pons. Since FCMS is not only related to biopercular lesions, we should consider thorough radiologic examination to clarify its anatomic basis.


Subject(s)
Cerebral Infarction/complications , Deglutition Disorders/etiology , Dysarthria/etiology , Facial Paralysis/etiology , Aged , Angioplasty , Brain Stem Infarctions , Cerebellum/pathology , Cerebral Infarction/diagnosis , Cerebral Infarction/physiopathology , Deglutition Disorders/diagnosis , Deglutition Disorders/physiopathology , Diffusion Magnetic Resonance Imaging , Dysarthria/diagnosis , Dysarthria/physiopathology , Facial Paralysis/diagnosis , Facial Paralysis/physiopathology , Humans , Image Processing, Computer-Assisted , Intraoperative Complications , Jaw Diseases/complications , Magnetic Resonance Imaging , Male , Muscle Weakness/etiology , Pons/pathology , Positron-Emission Tomography , Tomography, Emission-Computed, Single-Photon
20.
Vestn Khir Im I I Grek ; 173(5): 16-22, 2014.
Article in Russian | MEDLINE | ID: mdl-25823329

ABSTRACT

Dynamics of mean value indices and mean dispersion doesn't exclude the feedback (Mayanskiy D.N., 2008) in process of study the disease according to cooperative processes using system leukocyte-monocyte-lymphocyte (L+M+LM). The authors investigated a dynamic balance between these cell substratums and collagen formation. Acute inflammatory processes in tissues of maxillofacial area accompanied by leukemoid response of peripheral blood in the form of leukocytosis (10 x 10(9)-15 x 10(9)/l and more). The authors completely agree with the opinion of M.M. Solov'yov (2012) and N.K. Artyushenko (2008) that mechanism of this reaction is associated with both the leukocyte redistribution in the inflammation zone and with changes of hematopoietic rostock which aimed to balance the affected compensatory mechanisms of nonspecific resistance.


Subject(s)
Cellulitis , Jaw Diseases , Leukocytes , Surgical Procedures, Operative/adverse effects , Surgical Wound Infection , Adult , Aged , Cellulitis/etiology , Cellulitis/immunology , Cellulitis/surgery , Female , Humans , Immunity, Cellular , Jaw Diseases/complications , Jaw Diseases/immunology , Jaw Diseases/surgery , Leukocyte Count , Male , Middle Aged , Prognosis , Reoperation/methods , Reoperation/statistics & numerical data , Risk Assessment , Risk Factors , Severity of Illness Index , Statistics as Topic , Surgical Procedures, Operative/methods , Surgical Wound Infection/immunology , Surgical Wound Infection/surgery
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