ABSTRACT
Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function. Combination therapy with corticosteroids and NUC was started, which did result in improvement of liver function. This case shows that the combined therapy of corticosteroids and NUC can be effective in treating ACLF due to CHB exacerbation.
Subject(s)
Female , Humans , Middle Aged , Acute-On-Chronic Liver Failure , Adrenal Cortex Hormones , Fibrosis , Hepatitis B, Chronic , Hepatitis, Chronic , Liver , Liver DiseasesABSTRACT
Celiac disease is a chronic absorptive disorder of the small intestine caused by gluten. The prevalence rate of celiac disease is 1% in Western countries. But, it is rare in Asian countries, and there is no celiac disease reported in Korea. Here, we report a case of celiac disease. An 36-years-old woman complained non-specific abdominal pain and diarrhea. She had anemia and was taking medication for osteoporosis. Colonoscopy showed no abnormality except shallow ulcer at the terminal ileum. Gastroduodenoscopy showed micronodularity at the duodenum 2nd and 3rd portion. Capsule endoscopy and enteroscopy showed villous atrophy and blunting of villi from the duodenum. Small intestinal pathology showed villous atrophy with lymphocyte infiltration. After gluten free diet, diarrhea, abdominal pain, anemia and osteoporosis were improved. And, she felt well-being sensation. This is a first case of celiac disease in Korea.
Subject(s)
Adult , Female , Humans , Abdominal Pain/etiology , Anemia/etiology , Capsule Endoscopy , Celiac Disease/complications , Diarrhea/etiology , Diet, Gluten-Free , Duodenum/pathology , Endoscopy, Gastrointestinal , Ileum/pathology , Intestinal Mucosa/pathology , Osteoporosis/etiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Anthracosis mostly occurs at the lung and esophageal anthracosis has rarely been reported. As a result, the pathogenesis and prognosis of esophageal anthracosis is currently unclear. In previous reports, esophageal anthracosis has been mostly observed as relatively flat lesions that require differentiation from malignant melanoma. We report here on a case of esophageal anthracosis with polypoid features in a seventy year old male patient with hepatocellular carcinoma. The patient had undergone endoscopic examination and a 1 cm sized black polypoid lesion was observed. Pathology revealed macrophages phagocyting black carbon pigments beneath the mucosal epithelium and the diagnosis of esophageal anthracosis was made.
Subject(s)
Humans , Male , Anthracosis , Carbon , Carcinoma, Hepatocellular , Epithelium , Esophagus , Lung , Macrophages , Melanoma , Polyps , PrognosisABSTRACT
A fifty-seven year old female patient visited the emergency department with tachypnea and a decreased mental status. The patient had been receiving fluid therapy at home and a bolus of air was injected into the fluid bottle in order to increase the infusion speed. Chest computed tomography revealed air in the left brachiocephalic vein that was accompanied with pulmonary edema the diagnosis of venous air embolism was made. Venous air embolism can result from various procedures that are performed in almost all clinical specialties and they can be fatal in cases of massive air embolism. Therefore, it is important for all clinicians to be aware of this problem.
Subject(s)
Female , Humans , Brachiocephalic Veins , Embolism, Air , Emergencies , Fluid Therapy , Home Infusion Therapy , Pulmonary Edema , Pulmonary Embolism , Tachypnea , ThoraxABSTRACT
BACKGROUND: The acronym POEMS refers to polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Increased levels of cytokines, including vascular endothelial growth factor (VEGF), appear to play a pathogenic role. POEMS syndrome is progressive and eventually leads to death from neurological problem without therapy. METHODS: We treated 3 patients affected by POEMS syndrome with front-line bortezomib treatment and the high-dose melphalan with autologous stem cell transplantation (ASCT). RESULTS: Bortezomib reduced circulating levels of VEGF in sera. After a median follow-up of 18 months (range, 16~20), all patients are alive with progressive improvement in neurological disease, skin changes, performance status and have no evidence of clonal plasmacytosis or organomegaly. CONCLUSION: ASCT following bortezomib treatment may be a potential treatment option for patients with POEMS syndrome.
Subject(s)
Humans , Boronic Acids , Cytokines , Follow-Up Studies , Melphalan , Peripheral Nervous System Diseases , POEMS Syndrome , Polyneuropathies , Pyrazines , Skin , Skin Diseases , Stem Cell Transplantation , Stem Cells , Vascular Endothelial Growth Factor A , BortezomibABSTRACT
We report here on a case of a 22-year-old girl with a suprasellar mass that was originally diagnosed as lymphocytic hypophysitis, but it eventually turned out to be a germinoma. She initially underwent partial tumor removal and the tissue diagnosis was suggestive of lymphocytic hypophysitis. 46 months later, she presented with a lateral visual field defect and decreased visual acuity of her right eye. The serum and cerebrospinal beta-hCG and alpha-fetoprotein levels were measured. The beta-hCG level was elevated in both, whereas the alpha-fetoprotein level was detectable in neither. The serum anti-pituitary antibody-1 level was negative. She was reoperated and the permanent section biopsies were compatible with pure germinoma. There was no evidence of meningeal metastasis on her whole spine MRI. She was treated with chemotherapy.
Subject(s)
Female , Humans , Young Adult , alpha-Fetoproteins , Biopsy , Diagnosis , Drug Therapy , Germinoma , Magnetic Resonance Imaging , Neoplasm Metastasis , Spine , Visual Acuity , Visual FieldsABSTRACT
PURPOSE: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. METHODS: We have collected and analyzed the data of endoscopic thyroid operations using survey. RESULTS: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2~3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3~4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. CONCLUSION: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.
Subject(s)
Humans , Diagnosis , Follow-Up Studies , Hyperplasia , Korea , Length of Stay , Neck , Paralysis , Parathyroid Glands , Paresthesia , Recurrent Laryngeal Nerve , Surgeons , Thoracic Wall , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
PURPOSE: This is for analyzing the recent citations from papers enrolled in the Journal of Korean Academy of Nursing and understanding correct marking of references. METHOD: Targeted 2,334 references in 93 articles introduced from Feb. 2002 to Dec. 2002 which are applied current contribution rules of the Journal of Korean Academy of Nursing. RESULT: 1. 25 references are quoted per article and particularly foreign journals are most frequently quoted. Among foreign journals, Nursing Research is most frequently used. The Journal of Korean Academy of Nursing is also mostly referred material among national journals. 2. The retrieval rate is prove to be 1,539(83.8%) and 267(11.7%) are without errors and the other 2,022 have at least more than one error regardless of frequency. 3. Major error rate of periodical publication is 484(36.8%) and most occurred in the inconsistency of titles between articles and references. 4. Foreign journals have much more errors than national ones concerning periodical publications. CONCLUSION: Correct citation and marking of references can be achieved through strict reviewing process by authors, editors, publishers and paper investigators. In consequence, it is expected that these processes can cause improvement of quality in impact factor and papers.
Subject(s)
Humans , Nursing Research , Nursing , Publications , Research PersonnelABSTRACT
PURPOSE: This is for analyzing the recent citations from papers enrolled in the Journal of Korean Academy of Nursing and understanding correct marking of references. METHOD: Targeted 2,334 references in 93 articles introduced from Feb. 2002 to Dec. 2002 which are applied current contribution rules of the Journal of Korean Academy of Nursing. RESULT: 1. 25 references are quoted per article and particularly foreign journals are most frequently quoted. Among foreign journals, Nursing Research is most frequently used. The Journal of Korean Academy of Nursing is also mostly referred material among national journals. 2. The retrieval rate is prove to be 1,539(83.8%) and 267(11.7%) are without errors and the other 2,022 have at least more than one error regardless of frequency. 3. Major error rate of periodical publication is 484(36.8%) and most occurred in the inconsistency of titles between articles and references. 4. Foreign journals have much more errors than national ones concerning periodical publications. CONCLUSION: Correct citation and marking of references can be achieved through strict reviewing process by authors, editors, publishers and paper investigators. In consequence, it is expected that these processes can cause improvement of quality in impact factor and papers.
Subject(s)
Humans , Nursing Research , Nursing , Publications , Research PersonnelABSTRACT
PURPOSE: To avoid neurovascular injuries and to establish the ideal trajectory of screw insertion, a computed tomographical evaluation was conducted. MATERIALS AND METHODS: Twenty volunteers without cervical disease were employed for this study. Axial and oblique CT scans were selected for evaluation. Oblique CT scans were obtained in the direction of provisional screw insertion, starting from the junction of the lamina and the inferior articular facet of the axis and extending to the center of anterior tubercle of the atlas. In the axial and oblique reconstructed views, the screw length, the diameters of the medial and lateral cortexes of the isthmus, the vertical distance, and the angle of C1 were measured. RESULTS: The screw lengths averaged 37.6 mm (35.1-40.5 mm) in males and 37.2 mm (33.6-43.4 mm) in females. The diameters of the medial cortex of the isthmus were 4.3 mm (3.3-5.2 mm) in males and 4.0 mm (2.8-5.6 mm) in females. No measurement was statistically different between males and females. CONCLUSION: Due to individual variations of atlantoaxial anatomy, especially in terms of the size of cortical diameter of the isthmus, 3-D reconstruction CT is a useful tool for planning transarticular C1-2 screw insertion.