Ceftriaxone-Induced Acute Pancreatitis in Patient with Liver Abscess / 대한췌담도학회지

Acute pancreatitis is a rare complication in patients treated with ceftriaxone. Precipitation of ceftriaxone in the bile causes the formation of biliary sludge leading to the development of cholangitis, cholecystitis, or pancreatitis. We treated a patient with acute pancreatitis who developed this condition after the administration of ceftriaxone. A 70-year-old man presented in a drowsy state with fever. He was diagnosed with a liver abscess and treated with intravenously administrated ceftriaxone and metronidazole. He complained of dyspepsia and epigastric pain on the 25th day of ceftriaxone administration. Laboratory examination and abdominal computed tomography revealed biliary pancreatitis. Ceftriaxone-induced acute pancreatitis was suspected, and ceftriaxone administration was immediately discontinued. Two days later, serum amylase and lipase levels recovered to within reference range, and he showed rapid resolution of symptoms. We concluded that ceftriaxone results in the formation of biliary sludge and causes serious adverse events such as cholecystitis, cholangitis and biliary pancreatitis.

A Case of Gastro-Gastric Intussusception Secondary to Primary Gastric Lymphoma / 대한소화기학회지

In adults, most intussusceptions develop from a lesion, usually a benign or malignant neoplasm, and can occur at any site in the gastrointestinal tract. Intussusception in the proximal gastrointestinal tract is uncommon, and gastro-gastric intussusception is extremely rare. We present a case of gastro-gastric intussusception secondary to a primary gastric lymphoma. An 82-year-old female patient presented with acute onset chest pain and vomiting. Abdominal CT revealed a gastro-gastric intussusception. We performed upper gastrointestinal endoscopy, revealing a large gastric mass invaginated into the gastric lumen and distorting the distal stomach. Uncomplicated gastric reposition was achieved with endoscopy of the distal stomach. Histological evaluation of the gastric mass revealed a diffuse large B cell lymphoma that was treated with chemotherapy.

Trend in the Eradication Rates of Helicobacter pylori Infection in the Last 8 Years in Daegu: A Single Center Experience

BACKGROUND/AIMS: Helicobacter pylori eradication rates achieved by first-line triple treatment with proton pump inhibitor (PPI), clarithromycin, and amoxicillin have decreased to 70~85%, in part due to increasing antimicrobial resistance. This study evaluated the trend in H. pylori eradication rates during the most recent 8 years in Daegu, Korea and analyzed different clinical factors between success group and failure group of H. pylori eradication. MATERIALS AND METHODS: This was a retrospective study at a single institution. A total of 768 H. pylori-positive patients who received one or two weeks of first-line triple regimens were included between January 2007 and October 2014. RESULTS: The overall H. pylori eradication rate was 86%. The eradication rate from years 2007 to 2014 was 80.5%, 89.4%, 95.6%, 85.5%, 87.9%, 75.8%, 83.3%, and 85.8%, respectively (P=0.027). There was no significant difference in the eradication rate among various PPIs (P=0.358). In addition, there were no significant difference of clinical factors between success and failure group of H. pylori eradication. CONCLUSIONS: The eradication rates of first-line triple therapy for H. pylori over 8 years were 75.8~95.6%. No significant difference in clinical factors were noted between success and failure group of H. pylori eradication. Triple therapy may be a useful regimen for H. pylori eradication in Daegu.

Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma / 영남의대학술지

Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

A Case of a Calcitonin-Secreting Pancreatic Endocrine Tumor in a Pateint with Multiple Endocrine Neoplasia Type 1 / 대한내과학회지

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant hereditary disorder characterized by the combined occurrence of tumors of the parathyroid gland, exocrine pancreas, and anterior pituitary gland. Calcitonin-secreting pancreatic endocrine tumors are rare, and calcitonin-secreting pancreatic endocrine tumors with MEN1 have not been reported in Korea. A 46-year-old woman was admitted for a right breast cancer operation. Abnormal blood chemistry findings were hypercalcemia and elevated calcitonin. The patient was diagnosed with a calcitonin-secreting pancreatic endocrine tumor, left thyroid papillary carcinoma, right breast invasive ductal carcinoma, a thymic carcinoid tumor, left adrenal adenoma, uterine myoma, and adenomyosis by computed tomography scan, and with pituitary macroadenoma by brain magnetic resonance imaging. We present this case with a review of the literature, because it is the first reported calcitonin-secreting pancreatic endocrine tumor with MEN 1 in Korea.

The Feasibility of Lateral Minimal Invasive Open Thyroid Lobectomy / 대한내분비외과학회지

PURPOSE: Minimal invasive open thyroidectomy is one option for minimal invasive surgery. The population of planned unilateral lobectomy is on the rise in parallel to the increased incidence of confined papillary thyroid microcarcinomas in Korea. In contrast to other minimal invasive modalities, few studies have examined the surgical outcome of minimal invasive open thyroidectomy. This study compared the lateral minimal invasive open thyroid lobectomy with conventional surgery and endoscopic surgery in terms of the feasibility and safety. METHODS: A retrospective study was performed on 197 patients undergoing a thyroid lobectomy between January 2001 and December 2010. One hundred and three patients underwent a lateral minimal invasive open thyroid lobectomy, 42 patients underwent conventional surgery, and 44 patients underwent endoscopic surgery. RESULTS: The hospitalization period with endoscopic surgery was 6.2 days, which was longer than the 5.3 days with a lateral minimal invasive open thyroid lobectomy (P=0.000). The surgical time was lower in those who underwent a lateral minimal invasive open thyroid lobectomy (88.2 minutes) than in those who underwent conventional surgery (107 minutes, P=0.000) or endoscopic surgery (124.1 minutes, P=0.000). In the patients with a diagnosis of malignancy, the mean number of retrieved LNs was similar in the three groups. CONCLUSION: A lateral minimal invasive open thyroid lobectomy offers advantages, such as a shorter surgical time and hospitalization period than others. This procedure can be a feasible alternative to the conventional or endoscopic approach in selected patients undergoing thyroid lobectomy.

A Case of Essential Thrombocythemia Presenting as Esophageal Varix Bleeding and Multiple Thrombosis / 영남의대학술지

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.

An Effect of the Secondary Stroke Prevention Education Program on Self-care of Acute Ischemic Stroke Patients / 성인간호학회지

PURPOSE: This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. METHOD: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using chi2-test, Fisher's Exact Test, t-test, Kolmogorov- Smirnov Z, and Repeated Measures ANOVA. RESULT: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. CONCLUSION: It is considered that the program can be used as an effective nursing intervention in clinical practice.

A Study on Correlation Among Cord Blood Arachidonic Acid Level, Birth Weight, and Placental Weight

PURPOSE: Arachidonic acid is known to have effects on cell growth as a controller of cell proliferation and a stimulator of platelet derived growth factor. We investigated the correlations among birth weight, placental weight and free arachidonic acid level in cord blood. METHODS: Twenty full-term well babies were included in this study. Those who had sepsis, IUGR, twin that may affect the level of arachidonic acid, birth weight, and/or placental weight were excluded. Free arachidonic acid level were measured by gas chromatographic-mass spectrometry. (GC-MS) Correlation Pearson Coefficients were used for statistical analyses. RESULTS: The correlation coefficients between birth weight and placental weight, birth weight and arachidonic acid level, and placental weight and arachidonic acid level were 0.727 (P0.05), 0.407 (P>0.05) respectively. CONCLUSION: There was statistically significant positive correlation between birth weight and placental weight. But since cord blood free arachidonic acid levels were not correlated with placental weight and birth weight, we conclude that cord blood free arachidonic acid level has no effects on fetal growth and placental growth.

A Study on Correlation Among Cord Blood Arachidonic Acid Level, Birth Weight, and Placental Weight

PURPOSE: Arachidonic acid is known to have effects on cell growth as a controller of cell proliferation and a stimulator of platelet derived growth factor. We investigated the correlations among birth weight, placental weight and free arachidonic acid level in cord blood. METHODS: Twenty full-term well babies were included in this study. Those who had sepsis, IUGR, twin that may affect the level of arachidonic acid, birth weight, and/or placental weight were excluded. Free arachidonic acid level were measured by gas chromatographic-mass spectrometry. (GC-MS) Correlation Pearson Coefficients were used for statistical analyses. RESULTS: The correlation coefficients between birth weight and placental weight, birth weight and arachidonic acid level, and placental weight and arachidonic acid level were 0.727 (P0.05), 0.407 (P>0.05) respectively. CONCLUSION: There was statistically significant positive correlation between birth weight and placental weight. But since cord blood free arachidonic acid levels were not correlated with placental weight and birth weight, we conclude that cord blood free arachidonic acid level has no effects on fetal growth and placental growth.