A Case of Diffuse Large B-cell Lymphoma with Liver Involvement in a 67-Year-Old Woman Given Methotrexate for Rheumatoid Arthritis / 대한내과학회지

Prolonged inflammation or immunosuppression may cause lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) itself causes LPD. The immunosuppressive drug methotrexate (MTX) is used widely to treat RA, and is also related to the development of lymphoma. Although the detailed pathogenesis and association are still controversial, care is needed when managing patients with RA treated with MTX. Many reports indicate that discontinuing MTX can induce the regression of LPD. Here, we describe a case of diffuse large B-cell lymphoma that presented with liver involvement in a 67-year-old woman who had used MTX for RA for 15 years.

A Case of Acute Pyelonephritis Caused by Enterococcus Hirae in a Patient with a Horseshoe Kidney / 대한내과학회지

Enterococcus hirae mainly causes infections in animals. It has been rarely encountered in humans and, in most such cases, it is considered to be a contaminant or resident flora. Since the first case of septicemia by E. hirae was reported in 1998, only two cases of acute pyelonephritis (APN) have been reported in Korea. We describe herein a case of APN caused by E. hirae in an 83-year-old man with a horseshoe kidney. Although E. hirae was isolated only from urine and not from the blood, we were able to diagnose it as the causative organism based on the patient's clinical findings, imaging study results, and risk factors including old age, benign prostatic hypertrophy, and a horseshoe kidney.

A Case of Skin and Soft Tissue Infection by Mycobacterium massiliense / 대한내과학회지

Mycobacterium massiliense (M. massiliense) was identified recently as a species that separated from M. abscessus. Unlike M. abscessus, M. massiliense responds well to clarithromycin-based antibiotic treatment. Many cases of M. massiliense infections related to iatrogenic procedures have been reported. We report a case of skin and soft tissue infection by M. massiliense, which was not caused by medical appliances, that was treated successfully using clarithromycin monotherapy for -6 months after initial treatment with empirical antibiotics for 4 weeks.

An Experimental Study of Silastic Cuff Wrapping Around the Severed Peripheral Nerve / 대한정형외과학회잡지

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.