Association between nasogastric tube insertion and aspiration pneumonia in drug intoxication / 대한내과학회지

BACKGROUND/AIMS: The clinical usefulness of nasogastric tube insertion in poisoning patients is controversial. This study compared the incidence of aspiration pneumonia between patients with or without nasogastric tubes. METHODS: We retrospectively reviewed the clinical reports of poisoning patients seen from January 2006 to December 2007. We classified the patients into groups with and without nasogastric tube insertion and evaluated the incidence and risk factors of aspiration pneumonia. RESULTS: Ultimately, 63 patients were included. The incidence of aspiration pneumonia was higher in patients with nasogastric tube insertion than in patients without nasogastric tube insertion (conscious patients: 58.8% vs. 11.8%, p=0.010; unconscious patients: 72.2% vs. 27.3%, p=0.027). Nasogastric tube insertion was a significant risk factor for developing aspiration pneumonia (odds ratio 3.54; 95% confidence interval 1.74~12.34). CONCLUSIONS: Nasogastric tube insertion did not prevent aspiration pneumonia, but was a risk factor. The results have implications in the development of a hypothesis about why a nasogastric tube increases the risk of aspiration pneumonia. This study has important limitations stemming mostly from other compounding factors and its retrospective design.

Dengue Fever Mimicking Acute Appendicitis: A Case Report / 감염과화학요법

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.

Dengue Fever Mimicking Acute Appendicitis: A Case Report / 감염과화학요법

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.

A Case of Gastric Adenocarcinoma Mimicking a Gastrointestinal Stromal Tumor / 대한소화기내시경학회지

Gastric adenocarcinoma is the second most common cause of cancer death worldwide, but there are some geographical differences in its incidence. Gastointestinal stromal tumor (GIST) is an uncommon disease with a wide spectrum of aggressive behavior. These two tumors have a distinct pathogenesis. GIST is frequently identified as an incidental lesion found by routine endoscopy or in resection specimens that are removed for other reasons. We report a case of a gastric adenocarcinoma mimicking GIST in a 79-year-old woman. GIST was suggested by endoscopic ultrasonography and computed tomography scanning, but gastric adenocarcinoma was confirmed by gastroduodenoscopic biopsy. We performed a subtotal gastrectomy with Billroth I, lymph node dissection and transverse colon segmentectomy, and a 15.0x7.5x5.5 cm-sized gastric tumor was confirmed pathologically. Immunohistochemistry was positive for carcinoembryonic antigen and focal weakly positive for cytokeratin7 and cytokeratin20.

The Need for an Additional Pelvic CT in Cases of Acute Osseous Pelvic Injury that Has Already Been Diagnosed by Abdominal CT

PURPOSE: Abdominal CT (computed tomography) is a principal diagnostic imaging modality for torso trauma at the Emergency Department (ED). When acute osseous pelvic injuries are detected by abdominal CT, additional three-dimensional (3D) reconstruction pelvic CT is often performed. We compared abdominal CT with pelvic CT to provide information about acute osseous pelvic injuries. METHODS: A retrospective investigation of patients' electronic medical records during the five year period between January 1, 2004 and December 31, 2008 among Korean soldiers who underwent pelvic CT after abdominal CT at the ED was conducted. Axial images of abdominal CT were compared with axial images and 3D reconstruction images of pelvic CT. RESULTS: Sixteen patients underwent subsequent pelvic CT after abdominal CT. Axial images of abdominal CT showed the same results in terms of fracture detection and classification when compared to axial images and 3D reconstruction images of pelvic CT. Pelvic CT (including 3D reconstruction images) followed by abdominal CT neither detected additional fracture nor changed the fracture type. CONCLUSION: This study has failed to show any superiority of pelvic CT (including 3D reconstruction images) over abdominal CT in detecting acute osseous pelvic injury. When 3D information is deemed be mandatory, 3D reconstructions of abdominal CT can be requested rather than obtaining an additional pelvic CT for 3D reconstruction.

The Distinction of Cleanup Works of Hebei Spirit Oil Spill in Peak Expiratory Flow between Pre-works and Post-works / 가정의학회지

BACKGROUND: There were debates on the relationship between peak expiratory flow (PEF) and oil spill cleanup activity. The aim of this study was to compare the distinction of PEF among pre-works and post-works in Hebei Spirit oil. METHODS: The study subjects were participators of cleanup works. The questionaire on symptoms was done. And PEF was measured. The subjects were sampled on random basis. We then used a logistic regression analysis to evaluate the effects of cleanup works on PEF. RESULTS: Only 66 (35.3%) participants versus 121 showed with low values in PEF before cleanup works. But, 78 (80.1%) participants versus 20 significantly showed with low values in PEF after cleanup works (P = 0.002). On our analysis, measuring their own PEF after cleanup works (Odds ratio [OR], 2.328; 95% confidence interval [CI], 1.218 to 6.624), female gender (OR, 5.841; 95% CI, 3.571 to 9.557), the number of working days on cleanup activities (OR, 2.760; 95% CI, 1.364 to 7.900), and residents (OR, 4.610; 95% CI, 2.488 to 8.544) were shown to be significant risk factors for low value of peak expiratory flow. CONCLUSION: Our results suggest that exposure to petroleum in cleanup works are associated with a significant low value in PEF. But, the heterogeneity of pre-works and post-works groups is a limitation of the study.