A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma

Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.

The Effects of Transcanalicular Diode Laser-Assisted Revision Surgery for Failed Dacryocystorhinostomy

PURPOSE: To determine the intranasal causes of failed dacryocystorhinostomy (DCR) and the effects of transcanalicular diode laser-assisted revision surgery. METHODS: Twenty-four patients (29 eyes) who underwent revision surgery for a failed DCR at the Department of Ophthalmology, Ansan Hospital, Korea University between March 2009 and February 2011 were included in the present retrospective study. The intranasal causes of failed DCR, the time of symptoms such as epiphora and discharge after DCR, success rates of revision surgeries and follow-up periods were evaluated. RESULTS: Membranous obstruction was found in 25 eyes (86.2%) and was accompanied with granuloma in 10 eyes; these were the most common causes of failed DCR. The mean time for symptom development after DCR was 14.6 months, the success rate of the first revision surgery was 82.1% and good results were obtained in 5 eyes after the second revision surgery. Recurrence developed in 2 eyes, but symptoms improved after the lateral tarsal strip procedure. CONCLUSIONS: Membranous obstruction was the most common intranasal cause of failed DCR and transcanalicular diode laser-assisted revision surgery produced good results. Additionally, in patients with persistent epiphora following anatomically-patent revisional surgery, lacrimal pump failure due to lower eyelid laxity should be considered and corrected.

Effects of Supplementary Diet on Iron Status and Development in Infants

This study was carried out to evaluate the effects of supplementary diet in infants. Influence of appropriate dietary habits on infants was also examined by being applicable to diets fortified chewiness as a means of intervention. The iron supplementary diet was supported to the healthy infants twice a day for three months. Measures of hemoglobin, hematocrit, RBC count, serum iron, TIBC, ferritin, development examination, and dietary intake patterns of experimental group (n = 25) and control group (n = 20) were performed before and after the intervention. The amount of iron intake from the supplementary diet in the experimental group was 1.77 +/- 0.80 mg/day. After the intervention period, the experimental group not only had increased intakes of grains also decreased intakes of milk. Outcomes observed in infants receiving iron intervention showed that the improved trend of excessive milk intakes and the possibility as a regular diet by serving the iron supplementary diet which can apply to main dish. All measures in blood did not provide significant differences except TIBC between the experimental and the control group before the intervention. But, after the intervention, the experimental group improved most levels of measures, especially significance in hemoglobin, but serum iron. Development of two groups did not differ significantly and both groups were in the range of normal infants' development. However, the levels of MDI and PDI evaluated by BSID-II in the experimental group were slightly higher than the control. Furthermore, the development of cognitive and languistic function was associated with infant growth in the experimental group. In conclusion, this research demonstrated that the iron supplementary diet could affect the iron status and the development of infants despite low-dose supplementation of iron.