RESUMO
Pancreatic endocrine tumors are low-to-intermediate-grade neoplasms arising from the pancreatic islets that produce various hormones. These tumors account for a minority of pancreatic tumors and are generally considered functional if they are associated with a hormonal syndrome. Adrenocorticotropic hormone-secreting tumors (ACTHomas) are very rare and require special clinical consideration. Patients with ACTH-secreting tumors usually present with Cushing's syndrome, due to ectopic ACTH production. ACTHomas have a poor prognosis because of early metastasis and difficulty controlling corticosteroid production. We report a 62-year-old male with an ACTH-secreting metastatic pancreatic neuroendocrine tumor, who did not respond to somatostatin analogs and died.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Adrenocorticotrópico , Síndrome de Cushing , Ilhotas Pancreáticas , Metástase Neoplásica , Tumores Neuroendócrinos , Pâncreas , Prognóstico , SomatostatinaRESUMO
Acute respiratory failure from mycoplasma pneumonia is uncommon, because community-acquired pneumonia from mycoplasma pneumonia is typically not severe in patients without underlying disease. In addition, alveolar hemorrhage is a rare manifestation in these cases. We describe a case of acute respiratory failure that required mechanical ventilation due to diffuse alveolar hemorrhage in an immunocompetent patient with mycoplasma pneumonia.
Assuntos
Humanos , Hemorragia , Mycoplasma , Pneumonia , Pneumonia por Mycoplasma , Respiração Artificial , Insuficiência RespiratóriaRESUMO
Most cases of cytomegalovirus (CMV) colitis are associated with an immunocompromised status, especially with human immunodeficiency virus (HIV) infections and transplantation. It rarely occurs in immunocompetent adults. We report a rare case of CMV colitis in a patient with HBV related liver cirrhosis. A 49 year-old patient presented with lower abdominal pain and bloody diarrhea. Sigmoidoscopic examination showed multiple shallow ulcerations and severe mucosal edema. Conservative treatment for the patient including antibiotics was not effective. Repeated sigmoidoscopic examination with re-biopsy showed intranuclear inclusion bodies suggestive of CMV infection. After administration of Ganciclovir, abdominal pain and bloody diarrhea improved.
Assuntos
Adulto , Humanos , Dor Abdominal , Antibacterianos , Colite , Citomegalovirus , Diarreia , Edema , Ganciclovir , HIV , Corpos de Inclusão Intranuclear , Fígado , Cirrose Hepática , Transplantes , ÚlceraRESUMO
In-stent atheromatous plaque rupture is a very rare event. A 51-year-old man presented with an acute inferior myocardial infarction 9 years after bare-metal stent implantation in the mid-portion of right coronary artery. After thrombolytic therapy, coronary angiography and intravascular ultrasound (IVUS) revealed a ruptured plaque at the mid portion of the stented segment.
Assuntos
Humanos , Pessoa de Meia-Idade , Angiografia Coronária , Vasos Coronários , Infarto Miocárdico de Parede Inferior , Infarto do Miocárdio , Placa Aterosclerótica , Ruptura , Stents , Terapia Trombolítica , Ultrassonografia de IntervençãoRESUMO
A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.
Assuntos
Humanos , Arritmias Cardíacas , Suspensão da Respiração , Carcinoma Pulmonar de Células não Pequenas , Sistema Nervoso Central , Clorpromazina , Contratos , Deglutição , Desidratação , Diafragma , Glote , Soluço , Músculos Intercostais , Neoplasias Pulmonares , Desnutrição , Nervo Frênico , Reflexo , Distúrbios do Início e da Manutenção do Sono , ÁguaRESUMO
OBJECTIVES: The purpose of this study is to isolate a population of multipotent cells from human amnion and decidua, respectively. METHODS: Human placentas (gestational age, 30~42 weeks) were obtained after vaginal or cesarean deliveries. Amnions and deciduas were divided mechanically. The collected cells from the amnion and decidua were cultured. Cultured cells were immunophenotypically characterized. The adipogenic, osteogenic and neurogenic differentiation capacities were tested, and their growth kinetics were analyzed. RESULTS: We successfully isolated MSCs from both the amnion and decidua. The phenotype of MSCs cultured from different fetal and maternal parts of the placenta was comparable. The growth kinetics of MSCs derived from amnions and deciduas were similar. Isolated MSCs were differentiated into various cell lines such as adipogenic, osteogenic, myogenic and neurogenic cells. CONCLUSIONS: The human amnion and decidua could be an excellent source of MSC because they are easily obtainable after delivery and showed a higher expansion capacity than that of MSCs from adult bone marrow.