RESUMO
Andersen-Tawil syndrome (ATS), a rare autosomal dominant disorder, is characterized by periodic paralysis, dysmorphic features and cardiac arrhythmias. This syndrome is caused by mutations of KCNJ2 gene, which encodes inward rectifying potassium channel. Here, we report an 18-year-old girl who was presented with life-threatening cardiac arrhythmia and acute respiratory distress. She was diagnosed with ATS, based on dysmorphic features, ventricular arrhythmia, and periodic paralysis. This is the first case to be reported in Korea who experienced a fatal cardiac arrest and respiratory failure caused by ATS.
Assuntos
Humanos , Síndrome de Andersen , Arritmias Cardíacas , Parada Cardíaca , Coreia (Geográfico) , Paralisia , Canais de Potássio , Insuficiência Respiratória , Taquicardia , Taquicardia VentricularRESUMO
A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Parede Abdominal , Actinomicose , Biópsia , Diabetes Mellitus , Gastrectomia , Hidrazinas , Pancreatectomia , Neoplasias Pancreáticas , Penicilina G , RecidivaRESUMO
A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Parede Abdominal , Actinomicose , Biópsia , Diabetes Mellitus , Gastrectomia , Hidrazinas , Pancreatectomia , Neoplasias Pancreáticas , Penicilina G , RecidivaRESUMO
BACKGROUND/AIMS: Acute hemorrhagic rectal ulcer (AHRU) is an important etiology of lower gastrointestinal bleeding in intensive care unit patients and hospital inpatients. Moreover, with increasing elderly populations, and improved survival in critically ill patients, the incidence of AHRU has increased. The aim of this study is to determine rebleeding risk and prognostic factors of AHRU patients. METHODS: We retrospectively reviewed 32 patients with AHRU in Severance Hospital from February 2006 to October 2010, collected clinical data, and analyzed their association with the recurrence of bleeding and mortality of patients. RESULTS: The mean age of patients was 65.5 years, and 27 patients (84.4%) showed Eastern Cooperative Oncology Group performance status 3-4. Nineteen patients (59.4%) had recurrent bleeding. Hypoalbuminemia (2 mg/dL) and thrombocytopenia (40 seconds) increased mortality (P=0.028, P=0.008 and P=0.027, respectively) and the patients with rebleeding showed a tendency toward higher mortality, compared to those without (57.9% vs. 23.1%, P=0.051). CONCLUSIONS: In AHRU patients, hypoalbuminemia was a risk factor of rebleeding, and chronic liver disease, hypoalbuminemia, renal dysfunction, thrombocytopenia and no endoscopic treatment at the first bleeding event was correlated with relatively earlier rebleeding.
Assuntos
Idoso , Humanos , Estado Terminal , Hemorragia Gastrointestinal , Hemorragia , Hemostase Endoscópica , Hipoalbuminemia , Incidência , Pacientes Internados , Unidades de Terapia Intensiva , Hepatopatias , Análise Multivariada , Tempo de Tromboplastina Parcial , Prognóstico , Reto , Recidiva , Estudos Retrospectivos , Fatores de Risco , Trombocitopenia , ÚlceraRESUMO
Hepatocellular carcinoma (HCC) in the caudate lobe remains one of the most intricate locations where various treatments tend to pose problems with regard to the optimal approach. Surgical resection has been regarded as the most effective treatment; however, isolated resection of the caudate lobe is strenuous and associated with a high rate of early recurrence. Percutaneous ablation might be technically difficult or impossible to perform due to the deep location of tumors and adjacent large vessels. Treatment with drug-eluting beads (DEB) can potentially enhance the therapeutic efficacy for patients with unresectable HCC by drawing on the slower, more consistent drug delivery process. We described a case of a 62-year-old man with HCC in the caudate lobe who was successfully treated by DEB.