ABSTRACT
Chronic acalculous cholecystitis is a diagnosis of exclusion in patients complaining acalculous biliary pain. The possible causes of acalculous biliary pain are chronic gallbladder (GB) inflammation, GB dysfunction, cholesterolosis, cystic duct stenosis or microlithiasis. Recently, laparoscopic cholecystectomy is the choice of treatment for acalculous biliary pain. We experienced a 32-year-old woman whose initial symptoms were right upper quadrant pain and nausea only. The abdominal computed tomography, DISIDA scan, and upper and lower endoscopic examinations were nonspecific. Up to 48 hours after endoscopic retrograde cholangiopancreatography, contrast emptying of GB was delayed, implying dysfunctional GB. As the patient's right upper quadrant pain and tenderness became aggravated, the laparoscopic cholecystectomy was done and the final diagnosis of chronic acalculous cholecystitis was confirmed.
Subject(s)
Adult , Female , Humans , Acalculous Cholecystitis/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Chronic Disease , Contrast Media , English Abstract , Gallbladder EmptyingABSTRACT
No abstract available.
Subject(s)
Humans , Bacteremia , Pneumonia , Pulmonary Disease, Chronic Obstructive , Streptococcus pyogenes , StreptococcusABSTRACT
To evaluate the role of nitric oxide (NO) in IFN-gamma production and apoptosis of splenocytes in genetically different strains of mice with toxoplasmosis, BALB/c (a toxoplasmosis resistant strain) and C57BL/6 (a toxoplasmosis susceptible strain) mice were infected with Toxoplasma gondii cysts orally and subsequently injected intraperitoneally with aminoguanidine, an iNOS inhibitor (AG; 35 mg/kg per mouse daily for 14 days). When BALB/c or C57BL/6 mice were infected with T. gondii without AG treatment, number of brain cysts, NO and IFN-gamma production by splenocytes, and percentages of apoptotic splenocytes were increased compared to uninfected control mice without AG treatment. AG treatment increased the number of brain cysts, and reduced NO and IFN-gamma production in T. gondii-infected C57BL/6 mice. In contrast, in T. gondii-infected BABL/c mice, the number of brain cysts, and NO and IFN-gamma production of splenocytes was not altered by treatment with AG. However, the percentages of apoptotic splenocytes in T. gondii-infected BALB/c or C57BL/6 mice were not affected by AG treatment. These results suggest that NO modulates IFN-gamma production in T. gondii-infected C57BL/6 mice, and that NO is involved in mediating a protective response in toxoplasmosis susceptible, but not resistant, mice strain during acute infection.
Subject(s)
Animals , Female , Mice , Apoptosis/drug effects , Comparative Study , Guanidines/pharmacology , Interferon-gamma/biosynthesis , Mice, Inbred BALB C , Mice, Inbred C57BL , Nitric Oxide/biosynthesis , Nitric Oxide Synthase/antagonists & inhibitors , Species Specificity , Spleen/immunology , Toxoplasmosis, Animal/immunologyABSTRACT
A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of 39degrees C, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still 39degrees C despite the aggressive therapy of community- acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.
Subject(s)
Humans , Hypoxia , Blood Gas Analysis , Blood Pressure , Bronchoscopy , C-Reactive Protein , Chest Pain , Cough , Diagnosis , Dyspnea , Emergency Service, Hospital , Exudates and Transudates , Fever , Kerosene , Leukocytosis , Lung , Macrophages , Percussion , Pleural Effusion , Pneumonia , Respiratory Rate , Thorax , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.
Subject(s)
Adolescent , Adult , Child , Humans , Male , Alanine Transaminase , Aspartate Aminotransferases , Communicable Diseases , Cough , Diarrhea , Disease Outbreaks , Exanthema , Fever , Headache , Hospitals, General , Immunoglobulin G , Immunoglobulin M , Korea , Measles , Pharyngitis , Retrospective Studies , Solar System , Vaccination , VomitingABSTRACT
BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.
Subject(s)
Adolescent , Adult , Child , Humans , Male , Alanine Transaminase , Aspartate Aminotransferases , Communicable Diseases , Cough , Diarrhea , Disease Outbreaks , Exanthema , Fever , Headache , Hospitals, General , Immunoglobulin G , Immunoglobulin M , Korea , Measles , Pharyngitis , Retrospective Studies , Solar System , Vaccination , VomitingABSTRACT
Carcinosarcoma is defined as a malignant tumor with an admixture of carcinoma and sarcoma. Pulmonary carcinosarcoma accounts for about 0.27 percent of all lung neoplasms. It occurs frequently in males, particularly in smokers between 50 and 80 years of age. Preoperative diagnostic tests, such as sputum cytology, percutaneous fine needle biopsy and bronchoscopy, have a low yield in detection of pulmonary carcinosarcoma. The diagnosis is verified by postoperative pathologic findings and by immunohistochemical investigations in many cases. Surgical resection is the treatment of choice. As the metastasis to regional lymph nodes and distant organ is common at diagnosed time, the prognosis is quite poor. We report a case of pulmonary carcinosarcoma presented with persistent mild fever and blood-tinged sputum in a 66-year-old male.