ABSTRACT
A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Subject(s)
Humans , Male , Middle Aged , Abdominal Wall , Actinomycosis , Biopsy , Diabetes Mellitus , Gastrectomy , Hydrazines , Pancreatectomy , Pancreatic Neoplasms , Penicillin G , RecurrenceABSTRACT
A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Subject(s)
Humans , Male , Middle Aged , Abdominal Wall , Actinomycosis , Biopsy , Diabetes Mellitus , Gastrectomy , Hydrazines , Pancreatectomy , Pancreatic Neoplasms , Penicillin G , RecurrenceABSTRACT
The Dieulafoy lesion is a rare cause of severe gastrointestinal hemorrhage. Although it may occur anywhere in the gastrointestinal tract, the lesion is most commonly located in the stomach, and the small bowel is an extremely uncommon site. Since Dieulafoy lesion in the small bowel is difficult to access by endoscopy, it seems impossible to diagnose and treat by initial endoscopy unlike the lesions in stomach. We experienced a case of Dieulafoy lesion of jejunum with massive hemorrhage in 54-year-old male. Active jejunal bleeding was shown by computed tomography scan and mesenteric angiography. Partial resection of the jejunum was performed. Final pathologic finding revealed Dieulafoy lesion of the jejunum.
Subject(s)
Humans , Male , Middle Aged , Angiography , Gastrointestinal Hemorrhage/complications , Jejunal Diseases/complications , Mesenteric Arteries/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Arthrobacter spp., which are coryneform gram-positive bacilli, are widely distributed in the environment, including soil. In humans, infection with Arthrobacter is recognized as an opportunistic infection. In particular, since the first reported case in 1996, human infection by A. woluwensis has been reported only four times. We report on a case of A. woluwensis bacteremia in a 76-year-old female patient with multiple myeloma. Performance of 16S rRNA gene sequence analyses resulted in identification of A. woluwensis. The patient was treated with teicoplanin, and the central venous port was removed. Since then, no growth has been observed on repeated blood cultures. The patient was discharged well after the fever subsided.
Subject(s)
Aged , Female , Humans , Arthrobacter , Bacteremia , Fever , Genes, rRNA , Multiple Myeloma , Opportunistic Infections , Sequence Analysis , Soil , TeicoplaninABSTRACT
BACKGROUND/AIMS: Acute hemorrhagic rectal ulcer (AHRU) is an important etiology of lower gastrointestinal bleeding in intensive care unit patients and hospital inpatients. Moreover, with increasing elderly populations, and improved survival in critically ill patients, the incidence of AHRU has increased. The aim of this study is to determine rebleeding risk and prognostic factors of AHRU patients. METHODS: We retrospectively reviewed 32 patients with AHRU in Severance Hospital from February 2006 to October 2010, collected clinical data, and analyzed their association with the recurrence of bleeding and mortality of patients. RESULTS: The mean age of patients was 65.5 years, and 27 patients (84.4%) showed Eastern Cooperative Oncology Group performance status 3-4. Nineteen patients (59.4%) had recurrent bleeding. Hypoalbuminemia (2 mg/dL) and thrombocytopenia (40 seconds) increased mortality (P=0.028, P=0.008 and P=0.027, respectively) and the patients with rebleeding showed a tendency toward higher mortality, compared to those without (57.9% vs. 23.1%, P=0.051). CONCLUSIONS: In AHRU patients, hypoalbuminemia was a risk factor of rebleeding, and chronic liver disease, hypoalbuminemia, renal dysfunction, thrombocytopenia and no endoscopic treatment at the first bleeding event was correlated with relatively earlier rebleeding.
Subject(s)
Aged , Humans , Critical Illness , Gastrointestinal Hemorrhage , Hemorrhage , Hemostasis, Endoscopic , Hypoalbuminemia , Incidence , Inpatients , Intensive Care Units , Liver Diseases , Multivariate Analysis , Partial Thromboplastin Time , Prognosis , Rectum , Recurrence , Retrospective Studies , Risk Factors , Thrombocytopenia , UlcerABSTRACT
BACKGROUND AND OBJECTIVES: The correlation between subjective nasal obstruction symptom and minimal cross-sectional area (MCA) of nasal cavity is uncertain. Some chemicals change subjective nasal obstruction symptoms without changing MCA. The aim of this study is to evaluate the correlation between the tactile pressure sense of nasal mucosa and the nasal obstruction symptom. SUBJECTS AND METHOD: From 30 healthy adult volunteers, sensitivity to pressure change (P-sensitivity) and sensitivity to MCA change (A-sensitivity) were measured for each side of the nose, respectively. P-sensitivity was obtained as the slope of the regression line which was defined as the change of visual analog scale (VAS) score of the subjective nasal pressure sense divided by the change of inflated intranasal balloon pressure. A-sensitivity was obtained as the slope of the regression line which was defined as the change of VAS score of nasal obstruction divided by the change of MCA measured with acoustic rhinometry in experimentally narrowed or blocked nose using pieces of sponge. RESULTS: There was a strong correlation between P-sensitivity and A-sensitivity. In each volunteer, P-sensitivity or A-sensitivity of one side nose was well correlated with those of the opposite side, respectively. CONCLUSION: Both P-sensitivity and A-sensitivity of human nose vary from person to person, but they have a strong correlation with each other. Nasal obstruction symptom can be influenced by change of general somatic sense of nasal mucosa.
Subject(s)
Adult , Humans , Nasal Cavity , Nasal Mucosa , Nasal Obstruction , Nose , Porifera , Rhinometry, Acoustic , SensationABSTRACT
The empty sella syndrome is defined as the herniation of a subarachnoid space within the sella, with a flat-pressed pituitary gland accompanying hormonal problems or cerebrospinal fluid (CSF) rhinorrhea. CSF rhinorrhea is rare in the primary empty sella syndrome. We report a case of primary empty sella syndrome with CSF rhinorrhea in a 57 year-old woman. The CSF rhinorrhea was treated successfully by endoscopic transnasal transsphenoidal approach.
Subject(s)
Female , Humans , Cerebrospinal Fluid Rhinorrhea , Empty Sella Syndrome , Pituitary Gland , Subarachnoid SpaceABSTRACT
Background: Recently the elderly people have increased in Korea. So, the interest of upper gastrointestinal diseases have increased. Our aim was to determine clinical characteristics of upper gastrointestinal diseases in the elderly patients underwent esophagogastroduodenoscopy. Methods: We investigated clinical characteristics of 1190 elderly patients aged 65 years or older and 952 controls aged 64 years or younger who underwent esophagogastrodu odenoscopy in Seonam University Hospital from Jan. 2000 to Dec. 2004. retrospecti vely. Only two main symptoms were included among symptoms of two or over. The endoscopic findings were in the same manner. Results: The average age were 73.9 (+/-7.25)-year-old in the elderly, and 47.2 (+/-11.32)-year-old in controls. The most common symptom was dyspepsia in the elderly and in controls. The most common endoscopic findings showed chronic atrophic gastritis in the elderly, and chronic erythematous & erosive gastritis in controls. 64% was positive in 424 cases performed rapid urease test in the elderly and 63% was positive in controls. The most common associated diseases was hypertension in both group. The history of Non-steroidal anti-inflammatory drugs and aspirins were 21% in the elderly, and 15% in controls. Conclusion: We found that dyspepsia was the most common symptom in the elderly and controls underwent esophagogastroduodenoscopy. The most common upper intestinal disease was chronic atrophic gastritis in the elderly. We recommend esophagogastroduodenoscopy for the elderly patients in regular interval because they may have vague and atypical symptoms or asymptom.