ABSTRACT
Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions. Recently, fecal microbiota transplantation, aimed at modifying the composition of gut microbiota to overcome dysbiosis, has become a potential alternative therapeutic option for IBD. Herein, we present a patient with Crohn's colitis in whom biologic therapy failed previously, but clinical remission and endoscopic improvement was achieved after a single fecal microbiota transplantation infusion.
Subject(s)
Humans , Biological Therapy , Colitis , Crohn Disease , Dysbiosis , Fecal Microbiota Transplantation , Gastrointestinal Microbiome , Immune System , Inflammation , Inflammatory Bowel Diseases , LymphomaABSTRACT
Infective endocarditis carries high risk of morbidity and mortality. Rapid diagnosis and effective treatment are essential to good patient outcome. However, nonspecific symptoms and various clinical manifestations make early diagnosis difficult. Here we report on an unusual case of infective endocarditis initially presenting as acute pyelonephritis (APN). A 44-year-old female with a history of heart surgery was admitted for fever and both flank pain. The patient had undergone dental extraction 3 weeks prior to admission. Her lab work and physical examination revealed pyuria, positive bacterial culture of both blood and urine, costovertebral knocking tenderness, and CT findings consistent with APN, leading to her initial diagnosis as APN. Despite treatment with antibiotics, her symptoms did not improve while further physical examination revealed newly developed Osler's nodes and Janeway lesions. Echocardiography showed vegetation of the aortic valve with severe aortic regurgitation. She was diagnosed as a case of infective endocarditis and was treated successfully.
Subject(s)
Adult , Female , Humans , Anti-Bacterial Agents , Aortic Valve , Aortic Valve Insufficiency , Diagnosis , Early Diagnosis , Echocardiography , Endocarditis , Endocarditis, Bacterial , Fever , Flank Pain , Mortality , Physical Examination , Pyelonephritis , Pyuria , Staphylococcus aureus , Thoracic SurgeryABSTRACT
Giardia lamblia infection, giardiasis, is the leading waterborne diarrhea-causing disease. It is common in most countries of the world, including South Korea and Japan. Giardia lamblia can cause asymptomatic infection but also acute abdominal discomfort with diarrhea. In addition, it may lead to chronic diarrhea associated with villous atrophy and impaired epithelial barrier in the small intestine. In the present case, a 45-year-old woman presented with lower abdominal discomfort in the absence of diarrhea. Colonoscopy showed diffuse mucosal edema, erythema, and erosions with exudate in the cecum and ascending colon. Colonoscopic biopsy and stool examination revealed trophozoites of Giardia lamblia. Colitis resolved after metronidazole therapy. Our case suggests that giardiasis should be included in the differential diagnosis of colitis, even if the patient does not present with diarrhea.
Subject(s)
Female , Humans , Middle Aged , Asymptomatic Infections , Atrophy , Biopsy , Cecum , Colitis , Colon, Ascending , Colonoscopy , Diagnosis, Differential , Diarrhea , Edema , Erythema , Exudates and Transudates , Giardia lamblia , Giardia , Giardiasis , Intestine, Small , Japan , Korea , Metronidazole , TrophozoitesABSTRACT
Diarrhea is a common adverse event of docetaxel with 20%-40% of incidence and severe diarrhea occurs in 5%-6%. Several treatment guidelines for chemotherapy induced diarrhea (CID) exist, however the prophylaxis for that is not well known. We describe a new prophylactic approach for the CID with loperamide. A 72-yr-old male patient with stage IV non-small-cell lung cancer developed diarrhea repeatedly after docetaxel-cisplatin chemotherapy. His diarrhea persisted despite treatment including loperamide and fasting. However, the diarrhea was successfully prevented when loperamide was given before and after the chemotherapy. To our knowledge, this is the first report of prophylactic approach for the CID with loperamide.
Subject(s)
Aged , Humans , Male , Carcinoma, Non-Small-Cell Lung/drug therapy , Cisplatin/therapeutic use , Diarrhea/chemically induced , Drug Therapy, Combination , Loperamide/adverse effects , Lung Neoplasms/drug therapy , Neoplasm Staging , Taxoids/adverse effects , Tomography, X-Ray ComputedABSTRACT
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Cardiac Tamponade/etiology , Drainage , Empyema, Pleural/diagnosis , Heart Diseases/diagnosis , Kidney Failure, Chronic/therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Pericardial Effusion/etiology , Pericardial Window Techniques , Pericardiocentesis , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritonitis/diagnosis , Pleural Effusion/etiology , Staphylococcal Infections/diagnosis , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
BACKGROUND: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. METHODS: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy. RESULTS: The biopsies were performed at a median of 24.5 months (range, 3-73 months) after liver transplantation. The serum creatinine level was 1.81+/-0.5mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN(n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%).Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%,and 80% of cases, respectively, and mesangial proliferation was detected in 40%of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease. CONCLUSION: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.
Subject(s)
Humans , Atrophy , Biopsy , Calcineurin , Creatinine , Diagnosis , Fibrosis , Glomerular Filtration Rate , Glomerulonephritis , Glomerulonephritis, IGA , Kidney Failure, Chronic , Kidney , Liver Transplantation , Liver , Methods , Renal Insufficiency, Chronic , Retrospective Studies , Steroids , TransplantationABSTRACT
BACKGROUND: The purpose of this study was to explore the factors related to internet addiction in college students in Korea. METHODS: This study was a cross-sectional survey of college students in Seoul, and data was collected through self-report questionnaires. Data was analyzed by one-way analysis of variance, Fisher's exact test, Kruskal-Wallis rank test, and ordinary logistic regression analysis. RESULTS: In the ordinary logistic regression analysis, the factors related to a higher risk of internet addiction were lower frequency of exercise (P=0.017), lower level of self-control (P<0.001), higher level of stress (P<0.001), living with parents (P=0.011), using the internet for extended periods of time (P<0.001), and using the internet in their own rooms (P<0.001). CONCLUSIONS: Our results suggest that exercise, self-control, stress, living with parents, and duration and place of internet use are associated with internet addiction in college students. This information can be used to design methods for preventing internet addiction. More specific studies on internet addiction in college students are needed.
Subject(s)
Humans , Behavior, Addictive , Cross-Sectional Studies , Hypogonadism , Internet , Logistic Models , Mitochondrial Diseases , Ophthalmoplegia , Parents , Surveys and QuestionnairesABSTRACT
PURPOSE: We aimed to investigate the clinical and phylogenetic characteristics of Escherichia coli Urinary Tract Infections (E. coli UTI). METHODS: We enrolled patients with culture-proven E. coli UTI, who were admitted at the study hospital from September 2008 to August 2009. We investigated clinical data of patients with E. coli UTI and characteristics of isolated E. coli strains. The phylogenetic groups were classified using triplex polymerase chain reaction (PCR), and the distribution of nine virulent genes was determined by multiplex PCR. RESULTS: A total of 47 patients have participated in this study. Thirty (63.8%) were under 6 months; eight (17.0%) were between 6-12 months; and nine (19.1%) were over 12 months. We compared two age groups between under 6-month and over 6-month. In the age group under 6-month, higher proportion of male (P=0.002) and group B2 strains (P=0.020) were observed. In contrast, higher proportion of female and group non-B2 strains were observed in age group over 6-month. Frequencies of papC, papGII, papGIII, sfa/foc, hlyC, cnf1, fyuA, iroN and iucC were estimated as 68.1%, 57.4%, 42.6%, 46.8%, 46.8%, 31.9%, 87.2%, 48.9% and 63.8%, respectively. In the comparison of phylogenetic groups, group B2 showed higher distribution of virulent genes, while group D included more strains resistant to trimethoprim/sulfamethoxazole (TMP/SMZ) than other groups. CONCLUSION: We showed the age group-specific difference in the distribution of sex ratios and phylogenetic groups; more male and group B2 strains in age group under 6-month, while more female and group non-B2 in age group over 6-month. However, further evaluation including larger number of patients will be necessary to confirm above thesis in future molecular epidemiological studies.
Subject(s)
Female , Humans , Infant , Male , Epidemiologic Studies , Escherichia , Escherichia coli , Iron , Multiplex Polymerase Chain Reaction , Sex Ratio , Urinary Tract , Urinary Tract InfectionsABSTRACT
PURPOSE: The objective of this study was to describe the frequency of hepatobiliary dysfunction (HD) at our hospital and determine the possible risk factors and complications associated with the development of HD in very low birth weight infants (VLBWI) treated with parenteral nutrition (PN). METHODS: A retrospective study of VLBWI (n=92) that required PN between 2004 and 2008 in the NICU at the Bucheon St. Marys Hospital of Catholic University was performed. HD was defined by a direct bilirubin (DB) >2 mg and a transaminase of 60 IU/L defined cholestasis and liver injury. Groups I, II, and III were limited to cases of cholestasis, liver injury without cholestasis, and no abnormalities, respectively. The VLBWI were compared to each other. RESULTS: Thirty-six subjects (39.1%) had cholestasis and 51 (55.4%) had liver injury. In addition, 36 (39.1%), 19 (20.7%), and 37 (40.2%) subjects were classified as groups I, II, and III, respectively. The three groups showed significant differences in gestational age, 1- and 5-minute Apgar scores, use of surfactant, duration of parenteral nutrition, frequency of RBC transfusions, bronchopulmonary dysplasia (BPD), and patent ductus arteriosus (PDA) (P<0.05). The multiple regression analysis with cholestasis as the dependent variable, showed a significant correlation with gestational age, use of surfactant, frequency of RBC transfusions, and PDA. CONCLUSION: Various factors, such as birth weight, gestational age, 1- and 5-minute Apgar scores, use of surfactant for respiratory distress syndrome (RDS), frequency of RBC transfusions, BPD, and PDA may be related to hepatobiliary dysfunction in VLBWI treated with PN.
Subject(s)
Humans , Infant , Infant, Newborn , Bilirubin , Birth Weight , Bronchopulmonary Dysplasia , Cholestasis , Ductus Arteriosus, Patent , Gestational Age , Infant, Very Low Birth Weight , Liver , Parenteral Nutrition , Retrospective Studies , Risk FactorsABSTRACT
PURPOSE: This study was to examine the effects of auricular acupressure therapy on insomnia of hemodialysis patients. METHOD: The subjects were recruited at a hemodialysis room in B General hospital in Kyonggi-Do. Thirty one patients who have suffered from insomnia were conveniently assigned to an experimental group(n=16) and a control group(n=15). The experimental group received a 2-week intervention composed of a series of six auricular acupressure therapy every 2~3 days. The effect of intervention was measured by completion of a 15-item sleep scale and a sleep satisfaction scale. RESULTS: The sleep score was higher in the experimental group than in the control group(p=.000). The sleep satisfaction score was higher in the experimental group than in the control group(p=.000). CONCLUSION: The auricular acupressure therapy can improve the sleep and sleep satisfaction scores in hemodialysis patients with insomnia. Auricular acupressure therapy can be used at the clinical settings as a safe and effective independent nursing intervention to decrease insomnia in hemodialysis patients.
Subject(s)
Humans , Acupressure , Hospitals, General , Nursing , Renal Dialysis , Sleep Initiation and Maintenance DisordersABSTRACT
BACKGROUND: The current health care system demands provision of quality patient care in a cost-effective manner. A clinical path defines an optimal sequencing and timing of intervention by a health care team. This path facilitates the streamlining of this process. Implementation of clinical paths may decrease hospital cost without increasing complications in acute appendicitis patients. METHODS: A prospective evaluation of a clinical pathway for acute appendicitis (during March 1999) was conducted and the results were compared with those for control patients (during Feb 1999). Pregnant patients or patients with chronic disease were excluded. The patients with acute appendicitis were classified into three groups: A-type for acute focal and suppurative appendicitis, B-type for gangrenous appendicitis, and C-type for perforative appendicitis. RESULTS: The data for 40 patients with a clinical pathway were compared to those for 30 control patients. The mean age was 25.3 11.7 years in the pathway group versus 39.3 15.8 years in the control group. The mean hospital duration were 4.5 days for the pathway with A-type appendicitis versus 5 days for the control patients (p<0.05) and the mean hospital cost was 85.73% of that for the control group (p<0.05). In B- and C-type, the hospital duration and the cost were not different. The satisfaction rates were increased in all the types of pathway patients. The complication rates for in all the pathways were no different from those for the control patients. CONCLUSION: The clinical pathway with A-type appendicitis decreased the duration of hospitalization and the cost without adversely affecting the diagnosis or the therapy. The clinical paths were useful as means to minimize cost while increasing patient satisfaction.
Subject(s)
Humans , Appendicitis , Chronic Disease , Critical Pathways , Delivery of Health Care , Diagnosis , Diagnosis-Related Groups , Hospital Costs , Hospitalization , Patient Care , Patient Care Team , Patient Satisfaction , Prospective StudiesABSTRACT
No abstract available.