Evaluation of serum immunoglobulin G4 concentrations in canine pancreatitis

The goal of this study was to measure immunoglobulin G4 (IgG4) concentrations and to evaluate the significance of these values in the management of canine pancreatitis. The medical records of 24 dogs that visited the Veterinary Medical Teaching Hospital between December 2016 and June 2018 were retrospectively reviewed to identify dogs that had been diagnosed with pancreatitis. The serum C-reactive protein and serum IgG4 concentration in the affected dogs were highly increased compared to the healthy group. Particularly, serum IgG4 measured significantly higher in dogs with pancreatitis and concurrent immune-mediated disease (p < 0.05). In conclusion, increased serum IgG4 concentrations are a characteristic finding in dogs with pancreatitis. The results of this research indicate that an elevation in IgG4 has the potential of being used as a tool for the diagnosis of pancreatitis and concurrent immune-mediated disease.

Evaluation of serum immunoglobulin G4 concentrations in canine pancreatitis

The goal of this study was to measure immunoglobulin G4 (IgG4) concentrations and to evaluate the significance of these values in the management of canine pancreatitis. The medical records of 24 dogs that visited the Veterinary Medical Teaching Hospital between December 2016 and June 2018 were retrospectively reviewed to identify dogs that had been diagnosed with pancreatitis. The serum C-reactive protein and serum IgG4 concentration in the affected dogs were highly increased compared to the healthy group. Particularly, serum IgG4 measured significantly higher in dogs with pancreatitis and concurrent immune-mediated disease (p < 0.05). In conclusion, increased serum IgG4 concentrations are a characteristic finding in dogs with pancreatitis. The results of this research indicate that an elevation in IgG4 has the potential of being used as a tool for the diagnosis of pancreatitis and concurrent immune-mediated disease.

A Case of Pericolonic Metastasis in Recurrent Signet-Ring-Cell Adenocarcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Forward-Viewing Echoendoscope / 대한내과학회지

Endoscopic ultrasound-guided fine-needle aspiration is used for the diagnosis and evaluation of rectal and pelvic lesions in lower gastrointestinal tract disease. However, it is not used widely in proximal and transverse colon disease because of the limited visual field and technical problems related to an oblique-viewing echoendoscope. Here, we report a case of recurrent signet-ring-cell gastric adenocarcinoma involving the transverse colon not diagnosed by repeated colonoscopic biopsies that was eventually diagnosed using a forward-viewing echoendoscope with fine-needle aspiration biopsy.

A Case of Pericolonic Metastasis in Recurrent Signet-Ring-Cell Adenocarcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Forward-Viewing Echoendoscope / 대한내과학회지

Endoscopic ultrasound-guided fine-needle aspiration is used for the diagnosis and evaluation of rectal and pelvic lesions in lower gastrointestinal tract disease. However, it is not used widely in proximal and transverse colon disease because of the limited visual field and technical problems related to an oblique-viewing echoendoscope. Here, we report a case of recurrent signet-ring-cell gastric adenocarcinoma involving the transverse colon not diagnosed by repeated colonoscopic biopsies that was eventually diagnosed using a forward-viewing echoendoscope with fine-needle aspiration biopsy.

The Association between the Low Muscle Mass and Osteoporosis in Elderly Korean People

The purpose of this study was to predict osteoporosis risk as decreasing muscle mass and to declare the cut-off value of low muscle mass in an elderly Korean population. This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys (KNHANES). The subjects included 1,308 men and 1,171 women over 65 yr. Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual energy X-ray absorptiometry (DXA), and appendicular skeletal muscle was adjusted by height as a marker of sarcopenia. After confirming the correlation between low muscle mass and BMD, the best cut-off value of muscle mass to estimate osteoporosis was suggested through the receiver operating characteristic (ROC) curve. For both men and women, BMD correlated positively with low muscle mass when ASM/Ht2 was used as a marker for sarcopenia. The ROC curve showed that ASM/Ht2 was the best marker for osteoporosis at a cut-off value of 6.85 kg/m2 for men and 5.96 kg/m2 for women. When these cut-off values were used to determine sarcopenia, the risk of osteoporosis increased 4.14 times in men and 1.88 times in women. In particular, men (OR 2.12) with sarcopenia were more greatly affected than women (OR 1.15), even after adjusting for osteoporosis risk factors. In elderly Korean people, sarcopenia is positively correlated with BMD and there is a strong correlation between sarcopenia and osteoporosis with risk of bone fracture.

Differentiation of Mass-Forming Autoimmune Pancreatitis from Pancreatic Cancer Using A 2-Week Steroid Trial / 대한내과학회지

The differentiation of mass-forming autoimmune pancreatitis (AIP) from pancreatic cancer is critical because AIP can be successfully treated with steroid therapy and unnecessary surgery avoided. We herein report a case of 69-year-old male with a prior history of recurrent AIP who developed a pancreatic body mass with upstream duct dilatation. Laboratory findings were nonspecific for AIP or pancreatic cancer, although an endoscopic ultrasonography-guided biopsy revealed chronic inflammation. To differentiate mass-forming AIP from pancreatic cancer, we administered oral steroids for 2 weeks. After steroid therapy, a computed tomography scan revealed a decrease in the pancreatic mass size and improvement in dilatation of the upstream duct. So we could differentiate mass-forming AIP from pancreatic cancer; thereafter resolution of pancreatic lesion could be achieved with further steroid therapy. In conclusion, a 2-week steroid trial followed by radiologic imaging was helpful to differentiate mass-forming AIP from pancreatic cancer.

A Case of Dyspnea Caused by Local Botulinum Toxin Type A Injection / 대한내과학회지

Botulinum toxin type A is widely used for functional improvement of muscles and aesthetic plastic surgery. It paralyzes the injected muscle by inhibiting acetylcholine release from synapses of neuromuscular junctions. We herein report a case of progressive respiratory distress after botulinum toxin injection at both the gastrocnemius and soleus muscles. The patient also showed ptosis, dysphonia, dysphagia, and general weakness. Vocal cord dysfunction was observed by laryngoscopy. Other neurologic examination findings, including those of the physical examination, brain MRI, and Jolly's test, were normal. To our knowledge, this is the first report of botulinum toxin injection associated with dyspnea (MRC dyspnea scale, grade 3) in Korea.

Retroperitoneal Hemorrhage after Thrombolysis in ST Elevation Myocardial Infarction / 영남의대학술지

Bleeding is the most common and serious complication of thrombolysis in ST elevation myocardial infarction. Most bleeding cases are associated with an intervention or operation, but spontaneous bleeding such as gastro-intestinal bleeding or intracranial hemorrhage can happen. This is a report on the case of a 76-year-old female patient with retroperitoneal hemorrhage due to spontaneous right colic artery branch bleeding after thrombolysis in ST elevation myocardial infarction.