RESUMEN
Esophageal and gastric varix, portal hypertensive gastropathy, Mallory-Weiss tear and gastric ulcer are common causes of bleeding in patients with liver cirrhosis. However, spontaneous arterial bleeding without a history of trauma is a rare cause of bleeding which can be fatal. We report a case of a 55-year-old woman with alcoholic liver cirrhosis who developed spontaneous bleeding of multiple right lumbar arteries and died in spite of repetitive transfusion and embolization.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Arterias , Hemorragia Gastrointestinal/etiología , Hematoma/diagnóstico , Cirrosis Hepática/complicaciones , Lesión Pulmonar/patología , Tomografía Computarizada por Rayos XRESUMEN
The Japanese Classification of Gastric Carcinoma histologically classifies endoscopically resected gastric cancer into differentiated and undifferentiated types according to the presence or absence of tubular structures on histology. The former includes papillary adenocarcinoma and tubular types, and the latter includes poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucinous adenocarcinoma. However, gastric cancer sometimes contains a mixture of differentiated and undifferentiated components, and the clinical outcomes of the histological mixture are unknown, especially following endoscopic resection of early gastric cancer (EGC). This case was within the guideline indications for endoscopic submucosal resection (ESD), although it contained a partly signet ring cell carcinoma component; it recurred after 19 months with multiple lymph node and liver metastases. This case shows that additional surgical resection after ESD should be performed for patients with any mixed signet ring cell component, even in mild or moderately differentiated EGC.
Asunto(s)
Humanos , Adenocarcinoma , Adenocarcinoma Mucinoso , Adenocarcinoma Papilar , Pueblo Asiatico , Carcinoma de Células en Anillo de Sello , Estructuras Celulares , Clasificación , Hígado , Ganglios Linfáticos , Metástasis de la Neoplasia , Neoplasias GástricasRESUMEN
Botryomycosis is an uncommon chronic suppurative bacterial infection of the skin and visceral organs seen primarily in immunocompromised patients. Here, we report a case of splenic botryomycosis caused by Streptococcus mitis in a 53-year-old immunocompetent woman with a history of distal gastrectomy for advanced gastric cancer.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Infecciones Bacterianas , Gastrectomía , Huésped Inmunocomprometido , Piel , Bazo , Neoplasias Gástricas , Streptococcus mitisRESUMEN
Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.
Asunto(s)
Anciano de 80 o más Años , Femenino , Humanos , Obstrucción de las Vías Aéreas , Anestesia General , Coagulación con Plasma de Argón , Broncoscopios , Broncoscopía , Dilatación , Disulfiram , Disnea , Inflación Económica , Intubación Intratraqueal , Invasividad Neoplásica , Insuficiencia Respiratoria , Stents , Neoplasias de la Tiroides , Tráquea , Pliegues VocalesRESUMEN
BACKGROUND: We aimed to study the importance of diabetes education by investigating diabetes education rate and the associations between the presence/absence of diabetes education and the clinical outcomes of diabetic patients in Korea. METHODS: In the Fifth Korea National Health and Nutrition Examination survey (KNHANES V), a cross-sectional national survey during 2010 and 2012, 1498 subjects aged over 30 years and older were diagnosed with diabetes by doctors. The subjects were analyzed by a complex samples model. RESULTS: Only 20.3% of diabetes patients received diabetes education, and this was not significantly different between age groups. Education was delivered in hospitals/clinics, public health centers, and public lectures (15.7%, 3.0% and 1.4%, respectively). After adjusting for age, sex, and duration of diabetes, the factors independently associated with the presence of diabetes education were higher education level, frequent walking habit, and parameters regarding the presence of dyslipidemia, insulin treatment, and non-pharmacologic treatment. Among continuous variables, only the duration of diabetes was associated with diabetes education status; metabolic parameters were not associated with diabetes education status. CONCLUSION: Diabetes is a chronic disease and education on diabetes is very important. The education rate was low and quality of the education is doubtful. An effort to raise the rate of diabetes education and further study to raise the quality of diabetes training are necessary.