ABSTRACT
BACKGROUND: Invasive pulmonary aspergillosis (IPA) is one of the major complications encountered by patients receiving chemotherapy for hematologic malignancies. The prolonged period of intense immunosuppression following allogeneic hematopoietic stem cell transplantation (HSCT) may increase the risk of IPA recurrence in patients with a history of IPA. We evaluated the impact of a history of IPA on allogeneic HSCT outcome, and examined the incidence of IPA after HSCT. METHODS: This retrospective study included 22 patients with a history of IPA prior to receiving allogeneic HSCT at the Samsung Medical Center from 1995 to 2007. Diagnosis of IPA was defined as proven (N=5), probable (N=0), or possible (N=17). RESULTS: All 22 patients received amphotericin-based regimens to treat pre-transplant IPA. Secondary antifungal prophylaxis was administered to 10 patients during HSCT. The development of post-transplant IPA was observed in 2 patients. One of the patients died from septic shock within 2 days of the diagnosis of possible IPA. The other patient recovered from IPA, but eventually had a relapse of the primary disease. Of the 22 patients, the overall 2-year survival rate was 63% (95% confidence interval [CI]: 41-85), and the transplant-related mortality rate was 19% (95% CI: 0-38). CONCLUSION: Our results suggest that a history of IPA prior to HSCT does not have an adverse impact on transplant outcomes, although the small number of cases was a limitation in this study. Future studies involving a larger number of cases are needed to further examine this issue.
Subject(s)
Humans , Hematologic Neoplasms , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Immunosuppression Therapy , Incidence , Invasive Pulmonary Aspergillosis , Recurrence , Retrospective Studies , Shock, Septic , Survival Rate , TransplantsABSTRACT
Rectal prolapse is a protrusion of the rectum beyond the anal canal. Since rectal prolapse is a surgical disease, it is mostly diagnosed and treated at the surgical department. However, when surgical complications occur or they are suspected after an operation for colorectal disease, colonoscopy may now have a role in diagnosing the actual status of the problem. We present here the case of penetration of mesh at the distal rectum that was incidentally diagnosed by colonoscopy and the patient had previously undergone presacral rectopexy for rectal prolapse. Only one such case has been reported abroad and there has been no such case report in Korea. We report here on a case for which colonoscopy had a crucial role in diagnosing an occult complication after a colorectal operation that used a prosthesis.
Subject(s)
Humans , Anal Canal , Colonoscopy , Korea , Prostheses and Implants , Rectal Prolapse , RectumABSTRACT
PURPOSE: To evaluate anatomic variations and pitfalls of the labral-capsular-ligamentous complex in the shoulder joint for the proper interpretation of magnetic reasonance arthrographic images. MATERIALS AND METHODS:To determine the presence of sublabral sulci, undercutting of the base of the glenoid labrum by the articular cartilage, and the proximity of the middle glenohumeral ligament to the anterior glenoid labrum, 56 MR arthrograms of 41 asymptomatic volunteers were prospectively evalvated for labral shape and capsular insertion. We also evaluated the axillary fold, which was often confused with a loose body. RESULTS: The anterior and posterior parts of the labra, varied but their shape showed several dominant features; triangular(72%, 36%, respectively), rounded(13%, 35%), cleaved(8%, 1%), notched(2%, 0%), flat(5%, 24%), and absent(0%, 4%). Anterior capsular insertion was type 1 in 82% of cases, type 2 in 13% and type 3 in 5%, whereas posterior insertion was type 1 in 62%, type 2 in 36% and type 3 in 2%. We could also detect many pitfalls, such as undercutting of the base of theglenoid labrum by the articular cartilage(29%), sublabral sulci(25%), a prominent axillary fold(38%), and the middle glenohumeral ligament in proximity to the anterior labrum(5%). CONCLUSION: Our study revealed wide variability in the MR arthrographic appearance of the labral-capsular-ligamentous complex in asymptomatic shoulders. A good understanding of normal variation and pitfalls of the normal shoulder may be helpful pathologic condition in case of glenouhumeral instability.
Subject(s)
Arthrography , Cartilage, Articular , Ligaments , Prospective Studies , Shoulder , Shoulder Joint , VolunteersABSTRACT
PURPOSE: The purpose of this study is to evaluate findings in MRI which maybe useful in differential diagnosis of cervical lymph node enlargement. MATERIALS AND METHODS: We retrospectively analyzed the MRI findings of cervical lymph node enlargement in surgically proven 13 patients. We analyzed the location, size and shape, signal intensity, margin between node and surrounding structures degree and patterns of contrast enhancement RESULTS: No disease specificity in location and size of lymphadenopathy. was demonstrated in MRI. Most lymph nodes shows isointensity or slightly increased signal intensity to adjacent muscle on T1WI and high signal intensity on T2WI. Most of the cases showed contrast enhancement with metastatic lymph nodes showing ring-like and/or patchy enhancement. Tuberculous lymphadenopathy showed homogeneous or rather thick walled ring-like enhancement and one or multiple central nonenhancing portions of eccentrical location in the node. Relatively homogeneous enhancements were noted on reactive lymphold hyperplasia, Lymphoma and Castleman's disease. CONCLUSION: MR imaging was helpful in differentiation of cervical lymph node enlargements. Tuberculous lymphadenopathy showed characteristic findings of rather spherical shaped, thick walled ring enhancement and multiple eccentrically located central nonenhancing portions.