ABSTRACT
Non-Hodgkin's lymphoma (NHL) is the secondary most common tumor in HIV-infected individuals. The AIDS-related lymphomas are a late manifestation of HIV infection and may increase in frequency as patients live longer with highly active antiretroviral therapy and effective prophylaxis of opportunistic infections. Histologically AIDS-related NHL are either high (2/3) or intermediate (1/3) grade lymphoma. We report a case of gastric Non-Hodgkin's lymphoma in AIDS patient. Two years ago, she was diagnosed as HIV-infected individual in public hospital. She presented with epigastric pain and mass-like sensation. Under the impression of gastric cancer, subtotal gastrectomy was done. But, she diagnosed as diffuse large B cell lymphoma by histologic finding, immunohistochemical study. This is the first report of gastric Non-Hodgkin's lymphoma from AIDS patients in Korea.
Subject(s)
Humans , Antiretroviral Therapy, Highly Active , Gastrectomy , HIV , HIV Infections , Hospitals, Public , Korea , Lymphoma , Lymphoma, AIDS-Related , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Opportunistic Infections , Sensation , Stomach NeoplasmsABSTRACT
Gallbladder perforation is a grave complication of acute cholecystitis, which has a high incidence of morbidity and mortality in the elderly patients. The unfavorable nature of this disease is due in part to a delay in diagnosis because of the similarity in clinical presentation of patients with uncomplicated cholecystitis and those with perforation. Although prompt surgical intervention with cholecystectomy is the treatment of choice, morbidity and mortality rates rise markedly in the elderly patient with severe systemic illness. In acute cholecystitis, percutaneous cholecystostomy is a good alternative to surgical cholecystectomy or is a temporary measure until a patient is sufficiently stable for surgery. In this report, we describe our experience of successful use of percutaneous cholecystostomy and intra- abdominal percutaneous catheter drainage for the therapy of gallbladder perforation in two patients with high surgical risk.
Subject(s)
Aged , Humans , Abscess , Catheters , Cholecystectomy , Cholecystitis , Cholecystitis, Acute , Cholecystostomy , Diagnosis , Drainage , Gallbladder , Incidence , MortalityABSTRACT
Henoch-Sch nlein purpura is a systemic small-vessel IgA dominant vasculitis involoving the capillaries, arterioles, or venules. It is characterized by the classic tetrad of abdominal pain, arthralgia, typical rash, and renal involvement, all of which can occur in any order and at any time over several days to weeks. The central nervous system and lungs may be involved. The gastrointestinal tract is involved in more than 50 percent of patients, manifested most commonly by abdominal pain and gastrointestinal bleeding. And rarely may occur intussusception, bowel nerosis, perforation and intramural hematoma of the duodenum. We report a case of intramural hematoma of the duodenum with Henoch-Sch nlein purpura in 48 year old female patient which was demostrated by upper gastrointestinal endoscopy, abdominal CT scan, hypotonic duodenography and histologic finding of duodenal biopsy. She was treated with supportive care and improved rapidly without any serious gastrointestinal complications.
Subject(s)
Female , Humans , Middle Aged , Abdominal Pain , Arterioles , Arthralgia , Biopsy , Capillaries , Central Nervous System , Duodenum , Endoscopy, Gastrointestinal , Exanthema , Gastrointestinal Tract , Hematoma , Hemorrhage , Immunoglobulin A , Intussusception , Lung , Purpura , Tomography, X-Ray Computed , Vasculitis , VenulesABSTRACT
We report an unusual case of metastatic thyroid papillary carcinoma directly invades the esophagus presenting as an intraluminal polypoid mass which causes hematemesis. The patient had a past medical history of thyroid nodule. Physical examination was unremarkable except the palpable thyroid mass. Esophagoscopy and esophagography revealed an intraluminal polypoid mass to the left of the cervical esophagus. Chest computed tomography showed round, homogenous, well-enhancing mass and calcifying thyroid nodule is found in front of the mass. Thyroid lobectomy and partial esophageal resection was performed. Microscopic finding showed typical features of thyroid papillary carcinoma. Metastatic thyroid papillary carcinoma should be included in the differential diagnosis of an intraluminal polypoid esophageal mass, particularly if the patient has a known thyroid tumor.
Subject(s)
Humans , Carcinoma, Papillary , Diagnosis, Differential , Esophagoscopy , Esophagus , Hematemesis , Physical Examination , Thorax , Thyroid Gland , Thyroid NoduleABSTRACT
According to recent studies, the immunogenetic factors are thought to be account for a part of the etiopathogenesis of autoimmune thyroid disease. In Korea, there was one report on the relationship between HLA DR5, DR8, B13 and autoimmune thyroid disease. There were also several reports on a familial hereditary transmission of autoimmune thyroid disease in other countries but not in Korea. We describe the occurrence of autoimmune thyroid disease that affected three members of a family through three generations. This is the first report on familial hereditary transmission of autoimmune thyroid disease in Korea. We report on an 80-year-old woman who presented with Hashimoto's thyroiditis, her 53-year-old daughter who had Graves' disease, and her 29-year-old grand-daughter who had Graves' disease. In order to identify the immunogenetic influence in these cases, HLA haplotypes & thyroid autoantibody were studied. HLA DRB3*02 was obseved in each of the patents. HLA DQB1*0301, DR11, DQB1*05031 and DR14 were observed in the two cases. However, HLA B13, DR5 and DR8 were not observed. The patients are currently undergoing follow-up using PTU, methimazole and synthyroid medication.
Subject(s)
Adult , Aged, 80 and over , Female , Humans , Middle Aged , Family Characteristics , Follow-Up Studies , Graves Disease , Haplotypes , HLA-B13 Antigen , Immunogenetics , Korea , Methimazole , Nuclear Family , Thyroid Diseases , Thyroid Gland , ThyroiditisABSTRACT
In order to compare post-health care between medium sized enterprises(50-300 employees) and a large enterprise(an automobile manufacture plant) and to evaluate factors related to post?health care performance of workers with noise induced hearing loss, this study was carried out. One hundred and eighty nine workers were surveyed to the questionnaire on general and occupational characteristics, receipt of the examination result, perception and attitudes toward special health examination, contentedness with post-health care performance on the examination result and reason not to have post-health care performance. The results were as follows: 1. The employee in large enterprise perform post-health care higher than medium sized enterprises and main control method was taking ear protective device. The 27.5% of workers with NJHL did not perform any post-health care. 2. Comparing with large enterprise, medium-sized enterprises had more interview with workers of NJHL and some enterprises performed more health education and more improvement of working environment. But there were a few medium-sized enterprises which did not provide ear protective device and had indifference manager. 3. The variables that significantly related to the post-health care of manager side was receipt of health examination result(p < 0.05), the post-health care of worker side were size of enterprise, age(p <0.05) and receipt of health examination result(p <0. 1).