Metastatic endophthalmitis and thyroid abscess complicating Klebsiella pneumoniae liver abscess

The thyroid is resistant to infection due to its anatomical and physiological characteristics. We present a rare case of invasive liver abscess with metastatic thyroid abscess and endogenous endophthalmitis in a previously healthy 55-year-old female patient without diabetes or other medical illness. This report raises an important question of the virulence of Klebsiella pneumoniae as an increasingly common causative agent of liver abscess.

Development and Validation of Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B)

PURPOSE: This purpose of this study was to develop and validate a Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B). METHODS: The SESSM-B was developed and validated as follows: Item generation, pilot study, and tests of validity and reliability. Twenty-one items were developed through evaluation by 10 experts and 13 items were finally confirmed through item analysis and factor analysis. Psychometric testing was performed with a convenience sample of 303 women with breast cancer. Data were analyzed using factor analysis, Pearson correlation coefficients, and Cronbach's alpha. RESULTS: Five factors evolved from the factor analysis, which explained 69.8% of the total variance. The first factor 'coping with psycho-informational demand' explained 17.2%, 2nd factor 'maintenance of healthy lifestyle' 14.5%. 3rd factor 'management of side-effects' 13.3%, 4th factor 'therapeutic compliance' 12.8%, and 5th factor 'sexual life' 11.9%. SESSM-B also demonstrated a concurrent validity with health-related quality of life scale, EORTC QLQ-C30 & BR23. The internal consistency, Cronbach's alpha, was .78, and reliability of the subscales ranged from .61 to .79. CONCLUSION: The results of this study suggest that the SESSM-B is an easy, reliable, and valid instrument to measure self-efficacy for self-management of breast cancer.

A case of unilateral abdominal protrusion following cutaneous zoster / 대한내과학회지

Approximately 5% of patients infected with Herpes zoster experience motor complications, such as muscle atrophy or paresis, caused by motor neuron involvement. The majority of paretic cases are associated with involvement of cranial nerves or of spinal nerves that innervate the muscles of extremities. We report the case of an 82-year-old female patient with cutaneous Herpes zoster involving the T10-11 sensory dermatomes, complicated by ipsilateral abdominal protrusion. Electromyography on the left external oblique muscle revealed marked denervation potentials, implying motor neuron involvement. One month after the onset of abdominal protrusion, the patient's motor symptoms markedly improved. Clinicians should consider the possibility of motor neuron involvement with Herpes zoster, even in cases of zoster involving thoracic branches of spinal nerves.

A case of unilateral abdominal protrusion following cutaneous zoster / 대한내과학회지

Approximately 5% of patients infected with Herpes zoster experience motor complications, such as muscle atrophy or paresis, caused by motor neuron involvement. The majority of paretic cases are associated with involvement of cranial nerves or of spinal nerves that innervate the muscles of extremities. We report the case of an 82-year-old female patient with cutaneous Herpes zoster involving the T10-11 sensory dermatomes, complicated by ipsilateral abdominal protrusion. Electromyography on the left external oblique muscle revealed marked denervation potentials, implying motor neuron involvement. One month after the onset of abdominal protrusion, the patient's motor symptoms markedly improved. Clinicians should consider the possibility of motor neuron involvement with Herpes zoster, even in cases of zoster involving thoracic branches of spinal nerves.

A Case of Cytomegalovirus Colitis with Nontuberculous Mycobacterium Infection in Immunocompetent Host

Cytomegalovirus(CMV) infections are common in immune compromised situations such as human immunodeficiency virus infection and organ transplantation. However CMV colitis had been rarely found in immunocompetent individuals. We experienced a case of an 83-year-old female patient, initially immune competent, who developed a massive lower gastrointestinal bleeding caused by CMV colitis. Previously, multiple antibiotics were used for nontuberculous Myco- bacterium and other bacterial infections after total knee arthroplasty. Colonoscopy revealed multiple ulcerations and mucosal congestion with hemorrhage. In spite of ganciclovir therapy, our patient did not recover.

A Case of Splenic Infarction Complicating Lymphoma

Splenic infarcts are comparatively less common lesions. Caused by the occlusion of the major splenic artery or any of its branches, they are almost always due to emboli that arise in the heart. The spleen, along with the kidneys and brain, ranks as one of the most frequent sites of localization of systemic emboli. Infarcts may be small or large, multiple or single, and sometimes involve the entire organ. Usually these infarcts are of the bland anemic type. Septic infarcts are found in vegetative endocarditis of the valves of the left side of the heart. Much less often, infarcts in the spleen are caused by local thromboses, especially in leukemia, myeloproliferative syndrome, sickle cell anemia, polyarteritis nodosa, Hodgkin's disease, and bacteremic diseases. We experienced a rather unusual splenic infarction due to lymphoma in a 80-year-old man.

The Prevalence of Gastroesophageal Reflux Disease Associated with Age and Body Mass Index in Healthy Koreans

BACKGROUND: The prevalence of obesity is increasing year after year in Korean; and gastroesophageal reflux disease(GERD) is increasing in this population as well. The aim of this study is to assess the association between age, body mass index(BMI) and GERD in healthy Korean adults. METHODS: Analysis was done on 1,016 subjects who had not had malignancy, uncontrolled metabolic disease, enteric surgery and organic esophageal disease. They completed a questionnaire that included past history and reflux symptoms. Endoscopy was performed by two gastroenterologists who were not given any patient information. Existence of GERD was determined by the esophageal syndrome criteria of the Montreal guidelines. Subjects were categorized by BMI, initially as: underweight, normal(18.5 or =25) group(12.1%) showed a meaningful increment in the prevalence of erosive GERD compared to the non-obese(BMI<25) group(6.2%)(p value 0.002). CONCLUSION: The prevalence of GERD in healthy Korean adult subjects was not closely associated with obesity and age[according to BMI]; however, erosive GERD was found to have a strong association with obesity.

Splenic Infarction, and Common Hepatic Artery and Pulmonary Emboli after Histoacryl(R)(N-butyl-2-cyanoacrylate) Injection for Control of Variceal Bleeding

Bleeding from esophageal and gastric varices is a life-threatening complication for patients with liver cirrhosis. Endoscopic injection of Histoacryl(R)(N-butyl-2-cyanoacrylate) has been reported to be an effective therapy for variceal bleeding; however, distal embolization of unwanted areas has been described in some cases with a fatal outcome. A change in the rationale of treatment of variceal bleeding in patients with liver cirrhosis was not advocated because of the infrequency of such cases. We report two cases of splenic infarction with celiac trunk and pulmonary emboli as serious complications of Histoacryl(R) injection.